Belegaled: mental health and the law in the United States, 1986

Kenneth Gray, an attorney as well as a psychiatrist, was the leader in the development of law and psychiatry in Canada prior to his death in 1970. He lived during the post WWII years which saw a phenomenal growth of psychiatry as well as the beginnings of the modern era of a renewed concern for human rights. This later concern has caused the belegalment of many areas of psychiatric practice. Kenneth Gray would have to learn a new set of rules for commitment, the use of ECT and informed consent. He would discover that a patient has a right to treatment that must be buttressed by an individual treatment plan. He would discover that a committed patient has a right to refuse treatment and that some courts in the United States have said that anti-psychotic medications are mind-altering and thus an invasion of the patients 1st amendment rights. He would see untreated refusing patients languishing in the hospital or the homeless mentally ill on the streets because of restrictive commitment laws. As an attorney he would also be concerned about the proposed solution to the homeless, outpatient commitment. He certainly would have been impressed with some of the recent decisions in the United States on our duty to warn or protect known and unknown victims. Seeing patients' advocates on the hospital wards would be a real surprise to him. These controls on the practice of psychiatry for the protection of our patients cut both ways. Dr. Gray's medical/legal education would be tested to its full.