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date: 17 July 2019

Abstract and Keywords

This chapter explores ethical issues in mental health policy from a public health perspective, with a focus on the United States. Ethical discourse about mental health treatment has typically focused on paradigmatic concepts of individual autonomy, competence, paternalism, and appropriate justifications for overriding individual decision-making and restricting individual liberty. This chapter focuses on overarching ethical challenges in mental health policy at the population level—enhancing access of persons with mental illness to preventive services and community supports, and facilitating their successful community integration. Achieving these goals can reduce the need for coercion and ameliorate the social burden and stigma of mental illness. Shifting ethical discourse to the population level is an important step in the continuing transformation of mental health care and policy in the twenty-first century.

Keywords: mental illness, access to services, autonomy, paternalism, stigma, coercion, public health ethics

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