Mental health law profiles

Australia and the USA, two high-income countries within the increasingly divergent Anglo-Saxon tradition, provide the focus of this issue’s thoughtful and stylistically diverse mental health law profiles. An emerging question in this series is whether law primarily aimed at protecting the civil liberties of people with a mental disorder may have reached its high point. With the economic crisis, the continuing influence of neo-liberal economics, the global retreat of the welfare state and the rise in the numbers of older people, neglect rather than coercion may be the more pressing issue. Kirkby and Henderson suggest that, in Australia, more emphasis should be put on ensuring access to good-quality, evidence-based treatment, and this position seems to be echoed to some extent in the USA, according to Vitacco and Degroot. The latter authors write in favour of community treatment orders, while the former refer to evidence seriously questioning their effectiveness or superiority in terms of service use, social functioning and quality of life. An interesting issue raised in the Kirkby and Henderson review is the increasing contribution of private/independent practitioners in the provision of compulsory mental healthcare and this, in Australia at least, appears to be related to the greater use of community treatment orders.