The legislative tenets of client's right to treatment in the least restrictive environment and freedom from harm: implications for community providers.
For over four decades, national legislation has supported efforts to move persons with severe and persistent mental illness out of restrictive hospital settings and into community based services. Within institutional walls, numerous duties of state have been established to help ensure humane and effective treatment. However, the legal protections afforded hospitalized residents have not appeared to follow these individuals into the community. This article analyzes relevant case law and attempts to establish similarities between the state hospital's duty to protect its residents and the responsibility of community mental health centers to do the same for the persons they serve. The authors argue that the client's right to freedom-from-harm must receive increased attention and community based service providers will have to enhance their capacity to deliver more effective risk management services if mental health reform is to become a successful social policy.
Marty
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DA
OSPA, School of Social Welfare, University of Kansas, Lawrence 66045-2510, USA. dougm@sw1.socwel.ukans.edu
Chapin
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R
D003156:Community Mental Health Services / Q000331:legislation & jurisprudence*; D003688:Deinstitutionalization / Q000331:legislation & jurisprudence*; D006291:Health Policy / Q000331:legislation & jurisprudence*; D049673:History, 20th Century; D006801:Humans; D001523:Mental Disorders / Q000266:history / Q000628:therapy; D010344:Patient Advocacy / Q000331:legislation & jurisprudence; D019989:Persons with Intellectual Disabilities / Q000266:history / Q000331:legislation & jurisprudence*; D012017:Referral and Consultation; D012308:Risk Management / Q000331:legislation & jurisprudence*; D014481:United States; D014754:Violence / Q000517:prevention & control