Crisis Intervention: Theory and Methodology

By Donna C. Aguilera | Go to book overview

CHAPTER 4
Legal and Ethical
Issues in
Psychotherapy

4 The law is the witness and external deposit of our moral life. Its history is the history of the moral development of the race.

—Oliver Wendell Holmes, Jr.

If mental health professionals are to be expected to know the relevant law, it is important to provide a definition of mental health law that sets boundaries for the field. Mental health law is defined as the field of inquiry that is concerned with the intersection of the law with the mental health status of individuals: the operation of the mental health system and of other public or private systems in their provision of services to individuals with mental illness (e.g., education and child welfare systems and private psychiatric hospitals) and the roles, functions, and responsibilities of mental health professionals, who need to be familiar with the law as it operates in each of these contexts (Sales and Shuman, 1994).

Law and mental health care are now so interconnected that it is difficult to remember a time when they did not interact. For better or for worse, mental health professionals are both directly and indirectly affected by the law. Their practice is directly controlled by laws that regulate such matters as licensure and certification, third-party reimbursement, and professional incorporation. The quality of their services is subject to review by courts in malpractice actions. Indirectly, the law affects mental health professionals through the increasingly frequent involvement of their patients in legal entanglements in which mental status issues are pivotal (e.g., divorce proceedings, child custody disputes, litigation over mental and emotional injury, and involuntary civil commitment) (Sales and Shuman, 1994).

Laws relating to the competence of a patient to consent to mental health services focus on the patient's mental status, as well as on the patient's legal right to consent or refuse to consent to these services. Laws focusing on the authority of the state to operate a public mental health system that includes both voluntary and involuntary services are an important component of mental health law and continue to raise significant legal controversy. Mental health professionals' roles,

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