Academic journal article Canadian Journal of Psychiatry

Mental Health Law

Academic journal article Canadian Journal of Psychiatry

Mental Health Law

Article excerpt

Mental Health Law Canadian Mental Health Law and Policy: Second Edition John E Gray, Margaret A Shone, Peter F Liddle. Markham (ON): LexisNexis Canada Ine; 2008. 490 p. Can$ 165.00

Reviewer rating: Good

This book is the second edition of a book that was highly regarded when first published in 2000. It is a comprehensive review and analysis of mental health legislation in Canada updated to reflect the many changes that have occurred in the intervening years. All the major issues in the framing of mental health legislation are discussed, and for the most part it is balanced and dispassionate, in an area that has been prone to much polarization and political wrangling.

This book deals with all aspects of the law and mental disorder. It is comprehensive and scholarly, with copious references and appendices. The 3 authors are, respectively, a psychologist with experience in hospital management, a lawyer with long experience in mental health law, and a psychiatrist with forensic experience and much practical clinical knowledge. The first 4 chapters describe the current mental health legislation in Canada with its recent history and the psychiatric classification of mental disorders and their modern treatment - all primarily from a legal perspective.

The next 5 chapters discuss issues that have been controversial in the past 5 decades, and that successive revisions to the legislation have tried to address. These include criteria and procedures for involuntary admission, psychiatric treatment authorization and refusal including consent and capacity, assisted community treatment, and rights and safeguards for patients, including those contained in the Charter of Rights and Freedoms.

Chapter 1 0 discusses mandated services and attempts to develop Comprehensive Mental Health Legislation (CMHL) on a national level. Chapter 1 1 discusses mental disorder and the Criminal Code of Canada. Chapter 12 sums up the arguments made earlier and makes recommendations for a national approach to CMHL. They assert that there is at least some level of agreement about criteria for involuntary admission, rights, and safeguards for patients, and increasing recognition of the need for assertive community treatment. Areas of disagreement include the authorization of treatment in people who meet the criteria for involuntary admission but give competent refusal to all treatment. This is an issue that has remained very controversial and which different jurisdictions in Canada have handled differently.

The civil libertarian view is that imposing treatment on an involuntary patient who does not or cannot give consent is an abuse of human rights. There have been several well-known court cases on this issue. Often the courts have decided in favour of authorizing treatment but sometimes they have not. In either case, the protracted process has meant that these people remain incarcerated for long periods without the treatment that would shorten their period of illness. …

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