Determining Risks and Responsibilities Under the Mental Health Law Available to Purchase

This chapter examines how the MHL has been interpreted and implemented in everyday practices and court cases regarding hospitalization and discharge. It focuses on how the interpretation of risk shapes and is shaped by institutional arrangements and people’s sense of responsibility. When the law was initially implemented, professionals and government officials often read the risk criterion stringently and restricted involuntary hospitalization for fear of legal liability. As hospitals continued to dominate the landscape of mental health care, freedom from institutionalization was seen by many caregivers as neglect. To secure hospital treatment for patients, caregivers, professionals, and officials often worked together to expand and manipulate the legal notion of risk. As such, involuntary commitment has again become the norm, and the law has entrenched the mentality of risk management. This mentality, along with economic calculations, has made hospitals unwilling to grant discharge to long-term inpatients, generating institutional impasse and ethical unease.