Mental Health Commissions of Different Sub‐species: can they effectively propagate mental health service reform? Provisional taxonomy and trajectories

Published date30 November 2012
Pages167-179
Date30 November 2012
DOIhttps://doi.org/10.1108/13619321211289344
AuthorAlan Rosen
Subject MatterHealth & social care
Editorial
Mental Health Commissions of Different
Sub-species: can they effectively
propagate mental health service reform?
Provisional taxonomy and trajectories
Alan Rosen
Abstract
Purpose – The aim is to provide a brief overview of a series of articles tracing the emergence
of several Mental Health Commissions (MHCs) in developed countries over recent years, sometimes
to enhance mental health law administration, but often in connection with mental health reform
strategies. The paper seeks to review the functions of, and elicit a framework for, Mental Health
Commissions (MHCs) as effective vehicles for effective operationand reform of a mental health service
system.
Design/methodology/approach The approach of the paper is to identify the
functions and limitations of Mental Health Commissions and then cluster them to form a typology of
commissions.
Findings – There are broadly three types of MHCs: the first is more inspectorial and focussed on issues,
concerns and complaints affecting the care of individuals, and is more restricted investigating the
mental health service and the workings of mental health laws mainly to these ends; the second type is
focussed on the entire mental health service system, including relevant all-of-government operations,
concentrating on monitoring for and promoting system-wide reform. While this appears to constitute a
spectrum, with different MHCs mandated to work mainly at either end of it, there is conceivably a third
type which has a combination of these functions. This occurs with some commissions, though an equal
balance between these functions is unusual, so they usually can be assigned to a type on the basis of
their predominant functions.
Research limitations/implications There was a limited sample size, obliging a non-statistical
descriptive analysis which may well affect the validity of these distinctions.
Practical implications There is sometimes a combination of functions encompassing some features
of both of these types. While type I MHCs can ensure that individual rights are upheld and that mental
health laws and regulations are adhered to, to improveservice quality, type II MHCs are likely to be more
effective in achieving system-wide mental health service reform.
Social implications MHCs can contribute to more holistic, evidence-based and recovery-oriented
service delivery, which are more likely to lead to more desirable health and wellbeing outcomes for all
mental health service users, their families and the community.
Originality/value – This typology provides a useful provisional framework for understanding the roles of
MHCs in mental health services and in reform of the whole mental health service system and related
systems.
Keywords Mental Health Commission, Typology, Reform, Transformation,Mental health service system,
Human rights, Recovery, Inspectorate, Transparent accountability monitoring, Developed countries,
Mental health services
Paper type General review
DOI 10.1108/13619321211289344 VOL. 17 NO. 4 2012, pp. 167-179, QEmerald Group Publishing Limited, ISSN 1361-9322
j
MENTAL HEALTHREVIEW JOURNAL
j
PAGE 167
Alan Rosen is based in the
Faculty of Health &
Behavioural Sciences,
School of Public Health,
University of Wollongong,
Wollongong, Australia;
the Brain & Mind Research
Institute, Sydney Medical
School, University of
Sydney, Sydney, Australia;
and at the Far West Local
Health Network
Mental Health Service,
New South Wales, Australia.
Thanks to Deborah Lee,
Professor David Goldbloom,
Louise Bradley, Dr Peter
McGeorge, Dr Ken Thompson,
Dr Lesley Van Schoubroeck,
Eddie Bartnick, Sebastian
Rosenberg, John Feneley, Hon.
Mark Butler,Hon. Helen Morton,
Hon. Kevin Humphries, Hon.
Michael Kirby, Barbara Disley,
Dr Donnie Lyons, Lisa O’ Farrell,
Patricia Gilheaney, Rosemary
Smyth, Robyn Kruk, Professor
Alan Fels, Dr Lynne Lane,
Dr Bill Kingswell, Vivienne
Miller, Dr Janice Wilson,
Dr Wayne Miles, Associate
Professor Roger Gurr, and
Professor Steven P. Segal for
advice regarding the MHCs
considered here. Also to
Current Opinion in Psychiatry
Journal for permission to
reproduce Table Iand a few
other excerpts.

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