ASSIGNMENT FOR MODULE 10:
DRAFTING, ADOPTING AND IMPLEMENTING MENTAL HEALTH LEGISLATION

Exercise 1

For people with mental illness, being involved in work and education has benefits beyond managing symptoms. These include improved social and cognitive abilities, self-esteem and social networks. All of these factors support people’s ability to live independently and have a decent income. 
Further, it is evident that individuals with mental illness value work, are motivated, and can succeed in a variety of jobs requiring different skills and abilities. The evidence shows what consumers themselves report — that work has financial, social, mental health and other benefits unique to each individual. 
The common areas of mental health needs of person with disability included financial help, medical reimbursement, Employment and education, free treatment, certification of mental illness, flexible work/job timings, etc…
Needs	How legislation can address these needs	
Employment need: 
Employment is important for people with mental illness. As individuals, our own experience provides the best evidence of this, whether or not we deal with mental illness. Employment is fundamental aspects of our social context and is directly linked to health and quality of life. Research shows that individuals with mental illness are often relegated to minimum-wage jobs. 
	•	Human rights are supported by comprehensive legislation and effective practice. Human rights bodies play a role in increasing awareness of human rights issues, including accommodations for employees with disabilities.
•	The needs for local employment and the development of skills within the community must enter the equation of planning mental health programs with the promotion of local trades.
•	Climate in workplaces that is unbiased and accepting, like Flexible work hours in jobs, strict punitive actions against exploitation at work place.
•	Adding interventions to different supported employment models like motivational interviewing, Motivational interviewing is a therapeutic treatment that supports people to move towards positive changes in their lives and has been found through extensive research to be an effective treatment.
•	Promoting Rights: Human rights bodies play a role in increasing awareness of human rights issues, including accommodations for employees with disabilities such as the Mental Health Works program which help employers, managers, unions and employees learn about human rights, requirements and promising practices in promoting mentally healthy workplaces. 
•	Welfare schemes, easy loan facility, rebates in taxes for person with mental illness who are interested in self-employment or running small businesses. 
•	In services and other aspects of living. Providing modifications or accommodations to structures and processes to allow people to perform their jobs is required up to the point of undue hardship on the employer.
	
Needs for education 

Barriers exist for individuals with mental illness wanting to return to school and complete secondary education programs. These barriers occur due to stigma, discrimination from instructors, onset of psychiatric illness and past educational failures. These barriers are compounded by challenges many potential students face, such as the inability to access financial aid.	•	 Climate in workplaces and schools that is unbiased and accepting. like flexible work/job timings
•	In educational settings, providing accommodations to structures and processes to allow people to complete their education is required up to the point of undue hardship on the academic institution.
•	 Special awareness & sensitization programs regarding mental illness
•	Human rights are supported by comprehensive legislation and effective practice. Human rights bodies play a role in increasing awareness of human rights issues, including accommodations for students, volunteers and employees with disabilities. 
•	Reservations-for person with mental illness as reservations are better effort in meeting the needs for education while maintaining the quality of mental health services.
•	Antidiscrimination laws for the protection of vulnerable populations, minorities and underprivileged groups. 	
  
Needs for treatment and prevention of the disorders :
A lack of mental health services in some areas or in the country as a whole. The cost of mental health care is unaffordable to many, and health insurance offers partial or no coverage for mental health treatment. The quality of care and the living conditions in mental hospitals are poor, leading to human right violations. Regulations and checks concerning involuntary admission and treatment are usually lacking, and this is often associated with loss of liberty. Stigma and discrimination, lack of resources for mental health promotion and prevention 
	•	To identify if the different provisions of this legislation establishes equity between persons with mental disorders and people with other health problems. Special clauses can also ensure the protection of vulnerable populations
•	 The combination of knowledge of specific disorders, knowledge of treatments and their effectiveness for each specific condition, information about the epidemiology of these conditions, and a grasp of the technical resources that must be brought into play in order to put the effective treatments into practice -Provision of free medications
•	provision of services to cater the physical &spiritual health too 
•	Development of community-based mental health care: primary care centers and outpatient psychiatric centers. Accreditation of formal and informal mental health services.  

Exercise 2

Regulations can be used for particular actions that are likely to need constant modifications. They are not written into the legislation, which simply outlines the process for introducing and reviewing them. The success of mental health legislation is critically dependent on the process for drafting and enacting as well as in having effective implementation strategies. 
Many of the obstacles to implementation can be anticipated at the drafting stage and appropriate action taken to increase the chances that the legislation once adopted is brought into day to day practice.
Poor attention to implementation has meant that in many countries ‘law in the books’ and ‘law in practice’ are rather different. Barriers can be tackled by legislative efforts, and identifies priority areas for legislation. Drafting, adopting and implementing mental health legislation should not be viewed as an event but as an ongoing process that evolves with time. This means that legislation should be reviewed, revised and amended after some years of implementation.
The process of drafting new legislation varies in different countries depending on the particular legislative, administrative and political structures, some of the barriers that can be tackled by legislative efforts, and identifies priority areas for legislation are:
Potential barriers/obstacles to drafting, adopting or implementing mental health legislation	Strategies to overcome them
	
1.Barrier to drafting
Low priority to mental health legislation by government, parliament and sectors outside the health sector.
Resistance from psychiatrists who perceive a new legislation as undermining medical authority. 
Insufficient expertise about drafting mental health legislation in the country.
	•	Training of mental health professionals and lawyers. Technical support from WHO and international experts. 
•	Informing human right violations of people with mental disorders through the mass media. Denouncing human right violations to international bodies
•	Lobbying the executive and legislators.
•	Empowerment of organizations of consumers, families and other advocacy groups.
•	Seminars on patients’ rights and medical ethics with the participation of experts in these areas. Formulating the law from a consumer perspective and involving many sectors and disciplines in a consultation process with oral hearings.	
2.Barrier to adopting
Resistance from the general public to human rights-oriented legislation.
Tension between those in favour of a human rights-oriented legislation and those who emphasized public safety
Tension between the rights and responsibilities of consumers and the rights and responsibilities of families.
Conflicts between those who favor legislation solely concerning patients’ rights and those	•	Workshops with consumers and families groups to examine and discuss the key issues and interest of each group. Include both groups in the drafting body and consultation process. 
•	Formulating mental health law taking a needs based approach.
•	Appoint representatives from both interest groups to the drafting body and participation from both groups in the consultation process.	
3.Barrier to implementing
Insufficient funding to develop the mechanisms needed to implement the law
Mental health, health and other professionals are unaware, or resist the provisions of mental health legislation.
Lack of coordinated action in the implementation of mental health legislation 
Most consumers and families are not aware of major changes in protection of their rights.

	Ensure that an oversight agency is appointed to monitor the implementation process, by having this included in the text of the law. 
Negotiation for additional funding should be done 
Training of mental health and health professionals and lawyers on the provisions of mental health legislation. Seminars on patients’ rights and health ethics.
Education and training of consumers and families about the rights of people with mental disorders. 
Empowerment of organizations of consumers, families and other advocacy groups.
Dissemination of guidebooks and leaflets about the mental health law.