The justification for these measures continued to protect patients' liberty from unwarranted intrusion. Protection and advocacy systems, patient representatives and other mechanisms were created to defend patients against the risk of illegitimate incursions on their freedoms. Even today, when new restrictions are placed on the use of seclusion or restraint or on the participation of psychiatric patients in research, the motivation is the historic concern with protecting patients' liberty. A new paradigm for mental health law may be emerging, however, growing out of the cataclysmic changes in how we pay for and deliver psychiatric care. This model may give less emphasis to patients' liberties, and focus more on ensuring that appropriate care is delivered in a manner that minimizes the costs involved.
Law changes slowly.
Indeed, it is commonplace in legal studies to note that alterations in the law may lag a decade or more behind shifts in the substantive areas regulated. At this point, therefore, we can only hint at what may be looming ahead. But these hints may be enough to help us anticipate where mental health law is headed. What follows are several areas of change in psychiatric services and the effects they are likely to have on the shape of the law. Managed Care Commentators frequently note that the near-complete demise of indemnity insurance has left us with a system that might better be called managed cost than managed care .