4 - The country / regional level

Summary

Defining the country / regional level

By country we mean the level with a shared government at which mental health laws are established, any relevant minimum clinical standards are set, overall policy is formulated and which is often the level at which the training of professionals is organised. In some countries different regions or states, while sharing some regulations, may formulate their own policy directives and clinical practice guidelines, particularly in countries with a more federal or decentralised political structure.The issues relevant at this country / regional level can be considered in the following three domains: social and political,economic,and professional.

Social and political domains

In the social and political domain, there is the balance that exists in each country, on one hand between concerns for the duty of care to individual patients and the degree of importance attached to their civil liberties, and on the other hand the legitimate expectations of the wider public that mentally ill individuals should receive prompt and proper treatment and care and also that the wider community should be protected from disturbance and harm from patients.

To simplify the complex interactions which take place within the social and political domain, we think that it is useful to consider three aspects within this domain: perceptions by the public, perceptions by politicians, and their policy and legal consequences.Although we portray this as a linear association in Table 4.1, these are recursive pathways, and the chaining effects can be considered to start from any point.