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Rapprochement and Reform: Overcoming Factionalism in Policy Making for Serious Mental Illness
William R Smith1, Dominic A Sisti1
1Department of Psychiatry (Smith) and Department of Medical Ethics and Health Policy (Sisti), University of Pennsylvania, Philadelphia.
Psychiatric Services (Washington, D.C.)
|January 19, 2022
Summary
Factionalism in serious mental illness policy has hindered progress. A new Public Mental Health Policy Commission, using deliberative democracy, can improve policy-making and address unmet needs.
Area of Science:
- Public Health
- Health Policy
- Mental Health Services Research
Background:
- Factionalism has historically impacted policy-making and advocacy for individuals with serious mental illness since deinstitutionalization.
- This division has eroded trust and hampered efforts to effectively address the needs of this population.
Purpose of the Study:
- To analyze the historical impact of factionalism on serious mental illness policy and advocacy.
- To propose a novel framework for improving policy development and representation.
Main Methods:
- Drawing on deliberative democratic theory to examine advocacy and policy-making failures.
- Historical analysis of factionalism in mental health policy.
Main Results:
- Factional advocacy by special interest groups has led to policy-making failures.
- Distrust and undermined efforts to serve individuals with serious mental illness are direct consequences of factionalism.
Conclusions:
- Formation of a Public Mental Health Policy Commission is proposed to overcome factionalism.
- The commission, guided by deliberative democracy principles and including diverse stakeholders (especially those with lived experience), can enhance policy-making for serious mental illness.
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