Legal mobilization for mental health: A case study in public health advocacy

The increase in the use of litigation to accomplish public health goals such as tobacco control, gun control, lead abatement, and access to health services warrants a closer analysis and better understanding of the use of litigation as an advocacy tool.; Legal advocacy has been criticized as ineffective in creating long-term policy change. Critics also argue that courts do not have the resources and expertise to develop and implement policy, nor is it their appropriate role. Furthermore, litigation has been criticized as resource intensive and detracting from other, more traditional, advocacy methods.; Mental health advocacy groups have been employing litigation since the early 1960's for the purposes of deinstitutionalization, gaining a right to treatment, receiving treatment in “the least restrictive setting,” attaining a right to education, the creation of community-based services, fighting discrimination, and gaining access to federal entitlements. Hence, mental health policy provides a rich setting for a case study on the use of legal advocacy.; This study used case study methods to test Michael McCann's Legal Mobilization Theory to assess the extent to which it explained the use of litigation by mental health advocacy groups. McCann's theory acknowledges the limitations and drawbacks of litigation but asserts that litigation provides significant benefits for interest groups aside from legal victories or policy change. Through a qualitative multiple case study of three national mental health advocacy groups and one local group, the study sought to answer: (1) Why and how is litigation used by mental health advocacy groups and; (2) How well does McCann's Legal Mobilization Theory explain why and how litigation is used by mental health advocacy groups?; The study concluded that mental health advocacy groups use litigation strategically when it is congruent with their ideological framework as well as their ability to gain access to policy makers, available resources and political opportunities. The results also demonstrated that the secondary effects of litigation were significant to advocacy groups and promoted their continued use of litigation. Finally, the study found that McCann's theory, for the most part, predicted what was observed in the use of litigation by mental health advocacy groups.