Can psychiatry lead the way in legislating for health and wellbeing?

Earlier this year, the World Health Organisation robustly highlighted “the vital role of law” in “advancing the right to health”1. Psychiatry is the medical field best acquainted with use of legislation in day-to-day clinical care, although for many decades mental health law did little to improve the situation of the majority of the mentally ill; i.e. voluntary patients. From certifying lunacy to building asylums, the evolution of mental health law has been slow, and many countries still retain severely outdated laws focused on involuntary care rather than ensuring access to treatment for all2.

Recent revisions of legislation have, however, sought to harmonise mental health law with international conventions on human rights including the United Nations’ Convention on the Right of Persons with Disabilities (CRPD)3. India, for example, is on the verge of enacting its long anticipated Mental Healthcare Bill that explicitly seeks to accord with the CRPD, which commits ratifying countries not only to protect from violations of rights but also “to ensure and promote the full realisation of all human rights and fundamental freedoms for all persons with disabilities”4. The Indian legislation is admirably ambitious.

Having done too little to promote the wellbeing of the majority of people with mental illness for the last two centuries, then, might the latest iterations of mental health law finally advocate more effectively for everyone with mental illness? And might such legislation also lead the way for health legislation in general, as proposed by the WHO, as other medical specialties follow the Indian example and use legislation more assertively to improve the lives of their patients?

R.M. Duffy, B.D. Kelly
Department of Psychiatry, Trinity College Dublin
Trinity Centre for Health Sciences, Tallaght Hospital, Dublin, D24 N0A, Ireland

Correspondence:
B. D. Kelly, Department of Psychiatry,

Trinity College Dublin, Trinity Centre for Health Sciences, Tallaght Hospital, Dublin, D24 N0A, Ireland.
Email: brendan.kelly@tcd.ie
Telephone + 353 1 896 3799

References

  1. World Health Organisation. Advancing the Right to Health: The Vital Role of Law. Geneva: World Health Organisation, 2017.
  2. Shorter E. A History of Psychiatry: From the Era of the Asylum to the Age of Prozac. New York: John Wiley and Sons, 1997.
  3. United Nations. Convention on the Rights of Persons with Disabilities. Geneva: United Nations, 2006.
  4. Duffy RM, Kelly BD. Privacy, confidentiality and carers: India’s harmonisation of national guidelines and international mental health law. Ethics, Med Public Health 2017 (ePub ahead of print: http://dx.doi.org/10.1016/j.jemep.2017.02.018)

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