What Constitutes a Mental Health Policy?
In this chapter, I will provide the substantive context for mental health policy as outlined in Chap. 1 and will situate it within historical context. I argue here that the mental health policies now permeating the globe are the product of a long-standin
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What Constitutes a Mental Health Policy?
In this chapter, I will provide the substantive context for mental health policy as outlined in Chap. 1 and will situate it within historical context. I argue here that the mental health policies now permeating the globe are the product of a long-standing policy development process which has the nation-state as central mediator of mental illness and its treatment. Further, that this cultural vetting has taken place primarily in the nation-states of North America and Western Europe, regions that I will refer to collectively as constituting the mental health ‘policy core’. This chapter proceeds by first establishing what I mean to discuss under the rubric of ‘mental health’. Mental health, as a policy concept, needs to be understood within its global formulation in international texts and promoted by international organisations (IOs), as well as within the particular cultural assumptions bound up with mental health, including those used by medical and legal practitioners. Mental health will therefore be seen to encompass more than merely mental disorder; it will be seen as an expansive construction of a right common to human beings as individuals, involving the inherent conflict this liberal construction has with collectivist and traditional cultural constructions of mental health and illness. With the concept of mental health situated, I next present the notion of a ‘mental health system’. A mental health system will be seen to encapsulate, in the context of this book, any state activities implicating mental health such as state health care, welfare and criminal justice systems. This broad construction also envisions public-private collaboration on certain aspects of mental health service delivery including the important shift of the locus of mental health care from the institution to the community care model (see e.g. Morrissey and Goldman 1984; Susser 1965). Once this generic mental health construct has been assembled, I ask whether the political science concept of institutionalism, specifically historical institutionalism, applies to this context and argue that it does. Mental health systems contain a myriad of elements (laws, formal policies, rules, norms) that are historically situated. They are also deeply embedded within the state apparatus and can both constrain and be influenced by the actions of individuals. I consider several aspects of this rich research including Tuohy’s (1999) consideration of the theory in the broader health care context. © Springer Nature Singapore Pte Ltd. 2020 T. P. Fadgen, Mental Health Public Policy in Global Context, https://doi.org/10.1007/978-981-15-6479-6_2
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2 What Constitutes a Mental Health Policy?
With this preliminary construction of the mental health context and the theoretical conception of it within historical institutionalism, I next consider the historical development of mental health policy in the policy core regions of North America and Western Europe. I argue that the mental health best practices construct is on
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