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date: 22 June 2018

Abstract and Keywords

This chapter examines mental health and other behavioral health services in the United States. It examines physical and behavioral healthcare, with a focus on when equal treatment is required and when relevant differences should be recognized. It first considers the issue of personal decision-making autonomy in the behavioral health context, with particular emphasis on the right to choose/refuse medical care/treatment. It then discusses decisional autonomy in psychiatric institutions and paternalism in the service of patient safety. It also looks at challenges in healthcare delivery for people with mental illness, focusing on the shift from institutional to community care, therapeutic advances allowing community care, and the uncoordinated nature of community care. Finally, it explores federal and state laws that address the differential treatment of behavioral healthcare by health insurers, including the Americans with Disabilities Act, state and federal parity laws, and the Affordable Care Act.

Keywords: mental health services, behavioral health, healthcare, treatment, paternalism, mental illness, community care, health insurers, parity laws, Affordable Care Act

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