Buying Indifference, Selling Permission: A Formal Model of Mental Health Advocacy
32 Pages Posted: 2 Sep 2013
Date Written: 2013
Abstract
Mental health policy advocacy exhibits some ideological paradoxes. Among advocates, the rhetoric of consumer rights is frequently associated with service contraction rather than expansion. At the same time, advocates of increased provision often also prefer coercive treatment and are most restrictive in their view of the rights of persons with a psychiatric diagnosis. Thus, against expectations derived from other areas of social welfare policy - where rights advocacy accompanies calls for expanded services and spending - actors in the mental health policy arena form unlikely coalitions. Liberals tolerate spending cuts because this “buys” indifference and protects (negative) liberties. Conservatives tolerate rights rhetoric because this “buys” permission to abdicate social service spending. We develop a simple formal model to explain the strategic relationship of advocates who lobby for or against both government funding and the regulation of mental health consumer rights. We demonstrate that multidimensional advocate preferences result in an unexpected policy equilibrium, in which the rights of consumers may be conditionally protected as long as government also decreases spending.
Keywords: Mental Health Politics, Advocacy, Formal Models
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