Comparative analysis of mental health legislation in forty-three countries: A discussion of historical trends

Abstract

The examination of trends in any field requires perspective over time. This dimension was offered to me in this past year by the opportunity to work with the World Health Organization (WHO) at the headquarters in Geneva, Switzerland, in an international comparative legislative review of the mental health legislation of over forty nations of the world. The time perspective was provided by the fact that WHO had conducted a somewhat similar review of the mental health legislation of the world in 1954. It happens that this time span is also a personal one. I conducted my own first review of mental health legislation in the United States in 1951 and I have had an interest in the field ever since.’ The perspective I will offer is therefore a relatively limited one, a quarter century in the modern history of man, but yet important and significant years, I believe, in the international development of mental health legislation. The 1954 international survey by WHO included thirty-seven countries, largely drawn from Europe and the Americas, though its scope was worldwide. The world being observed was that of the first decade after World War II; not the most immediate years with their problems of rebuilding after the devastation and disruption, but the first years of hope and development in the early 1950s. In 1955 when the survey was published, there were eighty-four members and associate members in WHO. At the time of the second survey in 1976. the world was quite different. The political revolution of the so-called developing nations had taken place in these intervening years. The membership of the WHO had grown to 151 members and associate members with forty-nine 01 these on the continent of Africa. Methods of the Current Survey Initial planning for the current survey began at WHO in 1972. The decisior was made in 1975 to go ahead with an extensive, worldwide up-dating of the work done in the 1950s. A questionnaire was drafted by the Office of Menta Health in consultation with the Regional Offices around the world. English French and Spanish versions were prepared and distributed to over fifty coun