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Copyright (c) 2012 Loyola University Chicago School of Law, Beazley Institute for Health Law and Policy
Annals of Health Law

ARTICLE: Redefining the Legal Basis for Mental Health Emergencies+

+ This manuscript is based in part on a presentation given by James G. Hodge, Jr., entitled "Assessing the Legal Environment for Mental and Behavioral Health Services in Emergencies," at the ASLME Health Law Professors Conference on June 10, 2011 in Chicago, IL, as well as the following published manuscripts: James G. Hodge, Jr. et al., A Hidden Epidemic: Assessing the Legal Environment Underlying Mental and Behavioral Health Conditions in Emergencies, 4 St. Louis J. Health L. & Pol'y 33 (2011); James G. Hodge, Jr. et al, Mental and Behavioral Health Legal Preparedness in Major Emergencies, 125 Pub. Health Rep. 759 (2010). This research was supported by the Centers for Disease Control and Prevention (CDC) through a project entitled "Legal and Ethical Assessments Concerning Mental and Behavioral Health Preparedness" and funded at the Johns Hopkins Bloomberg School of Public Health and Arizona State University Sandra Day O'Connor College of Law. While the authors acknowledge funding for this project through CDC, any views or opinions expressed in this article are those of the authors and not CDC or other project partners.

ASLME Special Edition, 2012

Annals of Health Law

21 Ann. Health L. 163


James G. Hodge, Jr., J.D., LL.M.*, Lainie Rutkow, J.D., Ph.D, M.P.H.** and Lexi C. White, B.A.***


I. Introduction
Public health emergencies and natural or man-made disasters are often measured by their impacts on physical health. Recent, large-scale disasters, including the 2011 Japanese tsunami, 2010 Haiti earthquake, 2009/2010 H1N1 pandemic, and Hurricane Katrina in 2005, have collectively impacted the physical health of millions of individuals. Hundreds of thousands died and many more suffered permanent or long-term physical disabilities from these catastrophes. Addressing and preventing these catastrophic effects on communal health and well-being in the future are the focus of emergency planning, preparedness, and response efforts at all levels of government and private sector entities.

Another, hidden epidemic, however, underlies these disasters and is pervasive across all affected populations within and outside immediate "danger zones." This epidemic impacts people at all socio-economic levels and may continue for months or years beyond environmental destruction or physical health impacts. Underlying major emergencies are often significant mental and behavioral health effects that may be invisible to many, unspoken among victims and their families, and largely ignored as part of response efforts. 1 Particularly among vulnerable individuals (e.g., children, elderly, ethnic minorities, emergency workers), mental health crises stemming from major emergencies may be crippling without effective surveillance and treatment.

Increasingly emergency planners, mental health providers, and other actors recognize the need to address the debilitating mental and behavioral health impacts of major emergencies. However, they face legal impediments and barriers to effectively detect and treat societal mental and behavioral health conditions. Part of the problem relates to the ...
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