MENTAL HEALTH SYSTEMS ACT
MENTAL HEALTH SYSTEMS ACT
99-654
Statute Compilation
United States House of Representatives
Office of the Legislative Counsel
text/xml
EN
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Mental Health Systems Act
1777
96
1980-10-07
MENTAL HEALTH SYSTEMS ACT1
[References in black brackets
[ ]
are to title 42, United States Code]
[As Amended Through P.L. 99-654, Enacted November 14, 1986]
[Currency: This publication is a compilation of the text of chapter 417 of the 84th Congress. It was last amended by the public law listed in the As Amended Through note above and below at the bottom of each page of the pdf version and reflects current law through the date of the enactment of the public law listed at https://www.govinfo.gov/app/collection/comps/]
[Note: While this publication does not represent an official version of any Federal statute, substantial efforts have been made to ensure the accuracy of its contents. The official version of Federal law is found in the United States Statutes at Large and in the United States Code. The legal effect to be given to the Statutes at Large and the United States Code is established by statute (1 U.S.C. 112, 204).]

Short Title and Table of Contents
Section 1.
This Act may be cited as the “Mental Health Systems Act”.

TABLE OF CONTENTS
Sec. 1.
Short title and table of contents.
Sec. 2.
Findings.
TITLE I—
GENERAL PROVISIONS
Sec. 102.
Definitions.
* * * * * * *
TITLE V—
MENTAL HEALTH RIGHTS AND ADVOCACY
Sec. 501.
Bill of rights.
TITLE VI—
RAPE PREVENTION AND CONTROL2
^2
Section 87(d) of Public Law 99–646, and section 3(b) of Public Law 99–654, amended various provisions of this Act by striking “rape” and inserting “sex offense”, but failed to conform the table of contents in the item relating to section 601.
Sec. 601.
Rape prevention and control.
* * * * * * *
TITLE VIII—
MISCELLANEOUS
* * * * * * *
Sec. 802.
Report on shelter and basic living needs of chronically mentally ill individuals.
* * * * * * *
^1
Public Law 96–398. This compilation does not include provisions of such Public Law that amended other provisions of law.

findings
Sec. 2.
[9401]
The Congress finds—
(1)
despite the significant progress that has been made in making community mental health services available and in improving residential mental health facilities since the original community mental health centers legislation was enacted in 1963, unserved and underserved populations remain and there are certain groups in the population, such as chronically mentally ill individuals, children and youth, elderly individuals, racial and ethnic minorities, women, poor persons, and persons in rural areas, which often lack access to adequate private and public mental health services and support services;
(2)
the process of transferring or diverting chronically mentally ill individuals from unwarranted or inappropriate institutionalized settings to their home communities has frequently not been accompanied by a process of providing those individuals with the mental health and support services they need in community-based settings;
(3)
the shift in emphasis from institutional care to community-based care has not always been accompanied by a process of affording training, retraining, and job placement for employees affected by institutional closure and conversion;
(4)
the delivery of mental health and support services is typically uncoordinated within and among local, State, and Federal entities;
(5)
mentally ill persons are often inadequately served by (A) programs of the Department of Health and Human Services such as medicare, medicaid, supplemental security income, and social services, and (B) programs of the Department of Housing and Urban Development, the Department of Labor, and other Federal agencies;
(6)
health care systems often lack general health care personnel with adequate mental health care training and often lack mental health care personnel and consequently many individuals with some level of mental disorder do not receive appropriate mental health care;
(7)
present knowledge of methods to prevent mental illness through discovery and elimination of its causes and through early detection and treatment is too limited;
(8)
a comprehensive and coordinated array of appropriate private and public mental health and support services for all people in need within specific geographic areas, based upon a cooperative local-State-Federal partnership, remains the most effective and humane way to provide a majority of mentally ill individuals with mental health care and needed support; and
(9)
because of the rising demand for mental health services and the wide disparity in the distribution of psychiatrists, clinical psychologists, social workers, and psychiatric nurses, there is a shortage in the medical specialty of psychiatry and there are also shortages among the other health personnel who provide mental health services.
TITLE I—

GENERAL PROVISIONS

definitions
Sec. 102.
[9412]
For purposes of this Act:
(1)
The term “Secretary” means the Secretary of Health and Human Services.
(2)
The term “State” includes (in addition to the fifty States) the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, the Trust Territory of the Pacific Islands, and the Northern Mariana Islands.
(3)
The term “nonprofit”, as applied to any entity, means an entity which is owned and operated by one or more corporations or associations no part of the net earnings of which inures or may lawfully inure to the benefit of any private shareholder or person.
* * * * * * *
TITLE V—

MENTAL HEALTH RIGHTS AND ADVOCACY

bill of rights
Sec. 501.
[9501]
It is the sense of the Congress that each State should review and revise, if necessary, its laws to ensure that mental health patients receive the protection and services they require; and in making such review and revision should take into account the recommendations of the President's Commission on Mental Health and the following:
(1)
A person admitted to a program or facility for the purpose of receiving mental health services should be accorded the following:
(A)
The right to appropriate treatment and related services in a setting and under conditions that—
(i)
are the most supportive of such person's personal liberty; and
(ii)
restrict such liberty only to the extent necessary consistent with such person's treatment needs, applicable requirements of law, and applicable judicial orders.
(B)
The right to an individualized, written, treatment or service plan (such plan to be developed promptly after admission of such person), the right to treatment based on such plan, the right to periodic review and reassessment of treatment and related service needs, and the right to appropriate revision of such plan, including any revision necessary to provide a description of mental health services that may be needed after such person is discharged from such program or facility.
(C)
The right to ongoing participation, in a manner appropriate to such person's capabilities, in the planning of mental health services to be provided such person (including the right to participate in the development and periodic revision of the plan described in subparagraph (B)), and, in connection with such participation, the right to be provided with a reasonable explanation, in terms and language appropriate to such person's condition and ability to understand, of—
(i)
such person's general mental condition and, if such program or facility has provided a physical examination, such person's general physical condition;
(ii)
the objectives of treatment;
(iii)
the nature and significant possible adverse effects of recommended treatments;
(iv)
the reasons why a particular treatment is considered appropriate;
(v)
the reasons why access to certain visitors may not be appropriate; and
(vi)
any appropriate and available alternative treatments, services, and types of providers of mental health services.
(D)
The right not to receive a mode or course of treatment, established pursuant to the treatment plan, in the absence of such person's informed, voluntary, written consent to such mode or course of treatment, except treatment—
(i)
during an emergency situation if such treatment is pursuant to or documented contemporaneously by the written order of a responsible mental health professional; or
(ii)
as permitted under applicable law in the case of a person committed by a court to a treatment program or facility.
(E)
The right not to participate in experimentation in the absence of such person's informed, voluntary, written consent, the right to appropriate protections in connection with such participation, including the right to a reasonable explanation of the procedure to be followed, the benefits to be expected, the relative advantages of alternative treatments, and the potential discomforts and risks, and the right and opportunity to revoke such consent.
(F)
The right to freedom from restraint or seclusion, other than as a mode or course of treatment or restraint or seclusion during an emergency situation if such restraint or seclusion is pursuant to or documented contemporaneously by the written order of a responsible mental health professional.
(G)
The right to a humane treatment environment that affords reasonable protection from harm and appropriate privacy to such person with regard to personal needs.
(H)
The right to confidentiality of such person's records.
(I)
The right to access, upon request, to such person's mental health care records, except such person may be refused access to—
(i)
information in such records provided by a third party under assurance that such information shall remain confidential; and
(ii)
specific material in such records if the health professional responsible for the mental health services concerned has made a determination in writing that such access would be detrimental to such person's health, except that such material may be made available to a similarly licensed health professional selected by such person and such health professional may, in the exercise of professional judgment, provide such person with access to any or all parts of such material or otherwise disclose the information contained in such material to such person.
(J)
The right, in the case of a person admitted on a residential or inpatient care basis, to converse with others privately, to have convenient and reasonable access to the telephone and mails, and to see visitors during regularly scheduled hours, except that, if a mental health professional treating such person determines that denial of access to a particular visitor is necessary for treatment purposes, such mental health professional may, for a specific, limited, and reasonable period of time, deny such access if such mental health professional has ordered such denial in writing and such order has been incorporated in the treatment plan for such person. An order denying such access should include the reasons for such denial.
(K)
The right to be informed promptly at the time of admission and periodically thereafter, in language and terms appropriate to such person's condition and ability to understand, of the rights described in this section.
(L)
The right to assert grievances with respect to infringement of the rights described in this section, including the right to have such grievances considered in a fair, timely, and impartial grievance procedure provided for or by the program or facility.
(M)
Notwithstanding subparagraph (J), the right of access to (including the opportunities and facilities for private communication with) any available—
(i)
rights protection service within the program or facility;
(ii)
rights protection service within the State mental health system designed to be available to such person; and
(iii)
qualified advocate;
for the purpose of receiving assistance to understand, exercise, and protect the rights described in this section and in other provisions of law.
(N)
The right to exercise the rights described in this section without reprisal, including reprisal in the form of denial of any appropriate, available treatment.
(O)
The right to referral as appropriate to other providers of mental health services upon discharge.
(2)
(A)
The rights described in this section should be in addition to and not in derogation of any other statutory or constitutional rights.
(B)
The rights to confidentiality of and access to records as provided in subparagraphs (H) and (I) of paragraph (1) should remain applicable to records pertaining to a person after such person's discharge from a program or facility.
(3)
(A)
No otherwise eligible person should be denied admission to a program or facility for mental health services as a reprisal for the exercise of the rights described in this section.
(B)
Nothing in this section should—
(i)
obligate an individual mental health or health professional to administer treatment contrary to such professional's clinical judgment;
(ii)
prevent any program or facility from discharging any person for whom the provision of appropriate treatment, consistent with the clinical judgment of the mental health professional primarily responsible for such person's treatment, is or has become impossible as a result of such person's refusal to consent to such treatment;
(iii)
require a program or facility to admit any person who, while admitted on prior occasions to such program or facility, has repeatedly frustrated the purposes of such admissions by withholding consent to proposed treatment; or
(iv)
obligate a program or facility to provide treatment services to any person who is admitted to such program or facility solely for diagnostic or evaluative purposes.
(C)
In order to assist a person admitted to a program or facility in the exercise or protection of such person's rights, such person's attorney or legal representatives should have reasonable access to—
(i)
such person;
(ii)
the areas of the program or facility where such person has received treatment, resided, or had access; and
(iii)
pursuant to the written authorization of such person, the records and information pertaining to such person's diagnosis, treatment, and related services described in paragraph (1)(I).
(D)
Each program and facility should post a notice listing and describing, in language and terms appropriate to the ability of the persons to whom such notice is addressed to understand, the rights described in this section of all persons admitted to such program or facility. Each such notice should conform to the format and content for such notices, and should be posted in all appropriate locations.
(4)
(A)
In the case of a person adjudicated by a court of competent jurisdiction as being incompetent to exercise the right to consent to treatment or experimentation described in subparagraph (D) or (E) of paragraph (1), or the right to confidentiality of or access to records described in subparagraph (H) or (I) of such paragraph, or to provide authorization as described in paragraph (3)(C)(iii), such right may be exercised or such authorization may be provided by the individual appointed by such court as such person's guardian or representative for the purpose of exercising such right or such authorization.
(B)
In the case of a person who lacks capacity to exercise the right to consent to treatment or experimentation under subparagraph (D) or (E) of paragraph (1), or the right to confidentiality of or access to records described in subparagraph (H) or (I) of such paragraph, or to provide authorization as described in paragraph (3)(C)(iii), because such person has not attained an age considered sufficiently advanced under State law to permit the exercise of such right or such authorization to be legally binding, such right may be exercised or such authorization may be provided on behalf of such person by a parent or legal guardian of such person.
(C)
Notwithstanding subparagraphs (A) and (B), in the case of a person admitted to a program or facility for the purpose of receiving mental health services, no individual employed by or receiving any remuneration from such program or facility should act as such person's guardian or representative.
TITLE VI—

SEX OFFENSE PREVENTION AND CONTROL

sex offense prevention and control
Sec. 601.
[9511]
(a)
The Secretary, acting through the National Center for the Prevention and Control of Sex Offenses (hereafter in this section referred to as the “Center”), may, directly or by grant, carry out the following:
(1)
A continuing study of sex offenses, including a study and investigation of—
(A)
the effectiveness of existing Federal, State, and local laws dealing with sex offenses;
(B)
the relationship, if any, between traditional legal and social attitudes toward sexual roles, sex offenses, and the formulation of laws dealing with sex offenses;
(C)
the treatment of the victims of sex offenses by law enforcement agencies, hospitals or other medical institutions, prosecutors, and the courts;
(D)
the causes of sex offenses, identifying to the degree possible—
(i)
social conditions which encourage sexual attacks, and
(ii)
the motives of offenders, and
(E)
the impact of a sex offense on the victim and family of the victim;
(F)
sexual assaults in correctional institutions;
(G)
the estimated actual incidence of forcible sex offenses as compared to the reported incidence of forcible sex offenses and the reasons for any difference between the two; and
(H)
the effectiveness of existing private and local and State government educational, counseling, and other programs designed to prevent and control sex offenses.
(2)
The compilation, analysis, and publication of summaries of the continuing study conducted under paragraph (1) and the research and demonstration projects conducted under paragraph (5). The Secretary shall submit not later than March 30, 1983, to the Congress a summary of such study and projects together with a review of their effectiveness and recommendations where appropriate.
(3)
The development and maintenance of an information clearinghouse with regard to—
(A)
the prevention and control of sex offenses;
(B)
the treatment and counseling of the victims of sex offenses and their families; and
(C)
the rehabilitation of offenders.
(4)
The compilation and publication of training materials for personnel who are engaged or intend to engage in programs designed to prevent and control rape.
(5)
Assistance to qualified public and nonprofit private entities in conducting research and demonstration projects concerning the prevention and control of rape, including projects (A) for the planning, development, implementation, and evaluation of alternative methods used in the prevention and control of rape, the treatment and counseling of the victims of rape and their families, and the rehabilitation of offenders; (B) for the application of such alternative methods; and (C) for the promotion of community awareness of the specific locations in which, and the specific social and other conditions under which sexual attacks are most likely to occur.
(b)
The Secretary shall appoint an advisory committee to advise, consult with, and make recommendations to the Secretary on the implementation of subsection (a). The recommendations of the committee shall be submitted directly to the Secretary without review or revision by any person without the consent of the committee. The Secretary shall appoint to such committee persons who are particularly qualified to assist in carrying out the functions of the committee. A majority of the members of the committee shall be women. Members of the advisory committee shall receive compensation at rates, not to exceed the daily equivalent of the annual rate in effect for grade GS–18 of the General Schedule, for each day (including traveltime) they are engaged in the performance of their duties as members of the advisory committee and, while so serving away from their homes or regular places of business, each member shall be allowed travel expenses, including per diem in lieu of subsistence, in the same manner as authorized by section 5703 of title 5, United States Code, for persons in Government service employed intermittently.
(c)
No grant may be made under subsection (a) unless an application therefor is submitted to and approved by the Secretary. The application shall be submitted in such form and manner and contain such information as the Secretary may prescribe.
(d)
For the purpose of carrying out subsection (a), there are authorized to be appropriated $6,000,000 for the fiscal year ending September 30, 1981, $1,500,000 for the fiscal year ending September 30, 1982, $1,500,000 for the fiscal year ending September 30, 1983.
(e)
For purposes of subsection (a), the term “sex offense” includes statutory and attempted rape and any other criminal sexual assault (whether homosexual or heterosexual) which involves force or the threat of force.
(f)
Part D of the Community Mental Health Centers Act is repealed.
* * * * * * *
TITLE VIII—

MISCELLANEOUS
* * * * * * *

report on shelter and basic living needs of chronically mentally ill individuals
Sec. 802.
[9522]
(a)
The Secretary of Health and Human Services and the Secretary of Housing and Urban Development shall jointly submit a report to the Committees on Labor and Human Resources and Banking, Housing, and Urban Affairs of the Senate, and the Committees on Interstate and Foreign Commerce and Banking, Finance and Urban Affairs of the House of Representatives, relating to Federal efforts to respond to the shelter and basic living needs of chronically mentally ill individuals.
(b)
The report required by subsection (a) shall include—
(1)
an analysis of the extent to which chronically mentally ill individuals remain inappropriately housed in institutional facilities or have otherwise inadequate or inappropriate housing arrangements;
(2)
an analysis of available permanent noninstitutional housing arrangements for the chronically mentally ill;
(3)
an evaluation of ongoing permanent and demonstration programs, funded in whole or in part by Federal funds, which are designed to provide noninstitutional shelter and basic living services for the chronically mentally ill, including—
(A)
a description of each program;
(B)
the total number of individuals estimated to be eligible to participate in each program, the number of individuals served by each program, and an estimate of the total population each program expects to serve; and
(C)
an assessment of the effectiveness of each program in the provision of shelter and basic living services;
(4)
recommendations of measures to encourage States to coordinate and link the provisions in State health plans which relate to mental health and, in particular, the shelter and basic living needs of chronically mentally ill individuals, with local and State housing plans;
(5)
recommendations for Federal legislation relating to the provision of permanent residential noninstitutional housing arrangements and basic living services for chronically mentally ill individuals, including an estimate of the cost of such recommendations; and
(6)
any other recommendations for Federal initiatives which, in the judgment of the Secretary of Health and Human Services and the Secretary of Housing and Urban Development, will lead to improved shelter and basic living services for chronically mentally ill individuals.
(c)
The report required by subsection (a) shall be submitted to the committees referred to in subsection (a) no later than January 1, 1981.
* * * * * * *