How does our legal and mental health system handle the mentally disordered? In this book, George C. Klein presents a revealing survey that explores the system of processing prisoners and patients from arrest to admissions to court. In an investigation spanning over 30-years, Klein examines and evaluates the intersection of law, mental health, and social control.

Today, American mental health law and policy promote the restoring of "law and order" in the community rather than protecting civil liberties for the individual. This compelling book recounts how and why mental health law is being reshaped to safeguard society rather than mentally ill citizens. The authors, both experts in the field, convincingly demonstrate how rapidly changing American values ignited two very different visions of justice for the mentally ill. They argue that during the "Liberal era"-- from 1960 to 1980-- Americans staunchly supported civil liberties for all, particularly for disadvantaged citizens like the mentally ill. Also, criminal law provided ample opportunities for mentally ill offenders to avoid criminal punishment for their crimes, and restrictive civil commitment laws made it difficult to hospitalize the mentally disabled against their will. During the "Neoconservative era"--from 1980 on-- however, the public demanded new laws as a result of the rise in crime and the increasing number of homeless in communities. These changes make it much more difficult for mentally ill offenders to escape criminal blame and far easier to put disturbed citizens into hospitals against their will. Back to the Asylum accurately describes how this abrupt shift in from protecting individual rights to protecting the community has had a major impact on the mentally ill. It examines these legal changes in their broader social context and offers a provocative analysis of these law reforms. Finally, this timely work forecasts the future of mental health law and policy as America enters the twenty-first century.

Doubts about the reality of mental illness and the benefits of psychiatric treatment helped foment a revolution in the law's attitude toward mental disorders over the last 25 years. Legal reformers pushed for laws to make it more difficult to hospitalize and treat people with mental illness, and easier to punish them when they committed criminal acts. Advocates of reform promised vast changes in how our society deals with the mentally ill; opponents warily predicted chaos and mass suffering. Now, with the tide of reform ebbing, Paul Appelbaum examines what these changes have wrought. The message emerging from his careful review is a surprising one: less has changed than almost anyone predicted. When the law gets in the way of commonsense beliefs about the need to treat serious mental illness, it is often put aside. Judges, lawyers, mental health professionals, family members, and the general public collaborate in fashioning an extra-legal process to accomplish what they think is fair for persons with mental illness. Appelbaum demonstrates this thesis in analyses of four of the most important reforms in mental health law over the past two decades: involuntary hospitalization, liability of professionals for violent acts committed by their patients, the right to refuse treatment, and the insanity defense. This timely and important work will inform and enlighten the debate about mental health law and its implications and consequences. The book will be essential for psychiatrists and other mental health professionals, lawyers, and all those concerned with our policies toward people with mental illness.