From status to contract: a future for mental health law

Given the many complex issues and interests involved it is hardly surprising that mental health is a controversial topic. The law has a critical role in protecting interests and balancing claims. But the law is a major part of the problem. Indeed analysis of its role in producing anti-therapeutic outcomes led to the development of therapeutic jurisprudence. And we keep changing the law; for example on 16 October, 1999 the British Government announced proposals for radical reform of the mental health laws of England and Wales which, in the current form, were heavily influenced by developments in the United States of America. A major problem, it is submitted, is that we do not have an agreed model of the law, upon which to develop an appropriate structure for the delivery of mental health services. Currently we emphasis 'status', which puts a premium upon drawing distinctions which it is difficult, if not unrealistic, to achieve in practice. Another approach would be to emphasize the centrality of the relationship between the patient, or client, and the inter-disciplinary team of people providing him or her with services. This approach, outlined and argued for in this article, would involve developing the law of contract.