Federal and state governments set national standards of care and enact legislation that shapes mental health services across the nation. Unfortunately, there are often gaps when addressing crisis and mental health services at this level. Organizations can help address some of these issues, but stigma and slow progress still makes advocacy extremely vital.
Legislation
The largest impact the federal government has on the field of mental health and psychology is in the legislation it passes. Laws introduced at the federal level have tremendous impacts across the entire United States. Federal Bill HR 5221 (Preventing Tragedies Between Police and Communities Act of 2016), for example, requires all law enforcement academies to include deescalation training in their curriculum. Other legislation includes those that define and enforce mandated reporting, gun laws impacting those with mental illness, and legal status of narcotics and other substances. Similarly, state laws regarding these issues can have drastic impacts on residents and can set precedence for more specific federal laws. Protests and rallies regarding these issues are seen most at the federal and state levels. This is arguably one of the most impactful forms of advocacy and contributes greatly to the development of laws involving mental health care and crisis prevention.
Criminal Justice
While legislation sets the laws, the criminal justice system is often left to define the penalties for breaking the laws. Penalties for the use or sale of illicit substances, alternatives to incarceration for those with mental illness, and mental competency are a few of the highly debated issues within the criminal justice system. Oftentimes, cases involving those with mental illness are complex and a sense of fairness for all parties can be difficult to achieve. Major cases – especially those seen at the Supreme Court – can set a precedent that impacts the entire nation and help provide clearer guidelines for cases like these.
The criminal justice system is deeply intertwined with the mental health community. Although individuals with mental illness are more likely to be victims of violent crime than perpetrators, negative stereotypes and assumptions about mental illness and criminality remain. Research has found that those with mental illness are often handed longer sentences than those who have committed comparable crimes but have no history of mental illness. The majority of individuals with mental illness who are incarcerated are arrested for non-violent crimes such as trespass or public disturbance. In many of these cases, such acts may be a result of untreated mental illness. In addition, many individuals do not get the help they need while incarcerated. The National Alliance on Mental Illness (NAMI) states that only 63% of those incarcerated at state or federal prisons receive mental health treatment. These issues remain unaddressed and contribute to the cycles of poverty, drug use, and repeated incarceration. Advocacy for mental healthcare and awareness in the criminal justice system can help break these cycles and prevent repeated crises.
Federal Standards of Care
While legislation defines legal limitations, standards are often set by individual organizations. The most crucial standards in psychology are the ethical guidelines set by the American Psychological Association (APA). Since the APA is the largest mental health organization that licenses mental health professionals and institutions, their standards are followed by the whole industry and define required conduct. As for requirements for care, these standards are often set by smaller organizations that are focused on specific issues. Some of the regulations need to be followed exactly for accreditation from the organization while others serve more as guidelines for effective care. Organizations like the National Institute of Mental Health (NIMH) and the Substance Abuse and Mental Health Service Administration (SAMHSA) provide these guidelines based on research. Some mental health advocates call for more standardized care to address the issue of inconsistent quality of services between facilities. Others maintain that loose guidelines are crucial in individualizing care. As someone who has seen a range in quality of care and who has also benefited from an individual care plan, I believe both are important and a balance is needed – a balance we have not quite achieved.
Final Thoughts
Federal and state governments, along with organizations that work at the federal level, are ultimately responsible for setting guidelines and ensuring the protection of rights for those experiencing a mental health crisis. While there has been progress in recent years with the passage of laws protecting those with mental illness and promoting better crisis prevention systems, there are many gaps that are still not addressed at this level. Issues in the criminal justice system still persist and vague laws and guidelines cause inequality in care between mental health institutions. Understanding crisis prevention at the federal level is the first step in advocating for better crisis prevention and management services.
For more information check out the links below…
American Psychological Association – Ethical Principles & Code of Conduct
Crisis Prevention Institute – Federal Bill HR 5221
Mental Health America – Federal and State Role in Mental Health
National Alliance on Mental Health – Criminalization of People with Mental Illness
National Library of Medicine – Psychiatric Illness & Criminality
Substance Abuse and Mental Health Services Administration – Laws & Regulations
Or click on our resources tab for crisis services