Mental Disorder and Public Policy in Selected Countries
Mental health services in the United Kingdom have undergone significant changes since the 1960s (Busfield 2011; Pilgrim and Rogers 2014). The strategy used to implement change was the Mental Health Act of 1959, which formally recommended an “open-door” policy for mental patients. The idea was that patients would be as free to seek help for mental disorders as they were for physical illnesses. Mental patients were also to be treated in the least restrictive environment compatible with their safety and that of the general public. This meant that the majority of patients would be given treatment in community settings and in most cases continue to live at home. Hospitalization, if necessary, would take place largely on a voluntary basis, and most patients would be kept on unlocked wards. Severely mentally ill people could nevertheless be compulsorily admitted to mental hospitals for observation and assessment, but not long-term treatment (Busfield 2011). For those patients who were a threat to themselves or other people, the National Health Service Act of 1977 set aside four special mental hospitals to house the criminally insane and others considered violent or dangerous. Not surprisingly, since 1960, the number of patients in mental hospitals in the United Kingdom has declined dramatically.