International Journal of Law and Psychiatry 86 (2023) 101845 Available online 1 December 2022 0160-2527/© 2022 Elsevier Ltd. All rights reserved. On a long, narrow road: The mental health law in Turkey Fatih Artvinli a, * , Merve Kardelen Bilir Uslu b a The Department of History of Medicine and Ethics, Acibadem University School of Medicine, Istanbul, Turkey b Department of Modern Turkish History, Institute of Social Sciences, Yıldız Technical University, Istanbul, Turkey A R T I C L E INFO Keywords: Psychiatric system Mental health law Mental health system Mental health policy Turkey ABSTRACT This article presents the historical transformation of the mental health system and policies in the case of Turkey and discusses the challenges to their effective implementation. The mental health system in Turkey has under- gone a series of reforms in three periods, namely, the institutionalization of psychiatry and hospital-based mental health services in the mid-19th century, the introduction of first-generation community-based mental healthcare services in the 1960s, and the policy of deinstitutionalization after the 1980s. In this transformation process, certain initiatives have been implemented with the participation of interested actors across periods and small but important improvements. A draft has been prepared after a series of studies were conducted with regard to mental health policies and plans. However, no results have been obtained. The necessity of the mental health law has been clear. A notion that has been known is that the mental health law, which offers a holistic perspective, positively influences the functioning of the mental health system in terms of service users and providers. However, whether or not it actually pursues these intended improvements has been subject to doubt. Until now, no mental health law has been effectively implemented in Turkey, and measuring and evaluating in which as- pects the law will be successful and where it will fail have been impossible. Turkey continues to be in need of a mental health law is practical and in line with international standards for the rights of patients and supervision against coercive measures. 1. Introduction On a long, narrow road That’s where I’ve been I’m going day and night Never know what a state I’m in I’m going day and night ˆ As¸ık Veysel (1894–1973) The historical adventure of the poem, aside from being one of the best known ones written by As¸ık Veysel, a highly regarded poet of the Turkish folk literature, is seemingly the best analogy for mental health law in Turkey. On a long, narrow road: the issue of the mental health law is the first agenda among psychiatrists, clinical psychologists, and mental health users in Turkey. The issue dates back to the mid-19th century, although many endeavors were made until today. Unfortu- nately, all efforts failed, and Turkey continued to lack a mental health law. Mental health law is essential for protecting the human rights of people with mental disorders. It aims for the prevention of human rights violations and discrimination, the promotion of autonomy and liberty of a person, and the establishment of minimum mental health service standards (Rosenthal & Sundram, 2001). A comprehensive mental health law provides a legal framework for addressing the critical issues of people with mental disorders. It also involves community-based mental health service structures, facilities, personnel, and professional training and addresses the restraint and protection of individual pa- tients, regulation of compulsory admission, discharge procedures, ap- peals, and protection of property. Mental health law performs other functions of mental health law, such as integrating people with mental disorders into the community, establishing uniform services, and providing accessible quality-based mental healthcare services by rein- forcing the goals of mental health policies and plans (Rosenthal & Sundram, 2001; World Health Organization (WHO), 2011; Latif and Malik, 2012). Specific historical, political, social, cultural, and economic contexts influence the formulation of mental health laws. Currently, the majority of mental health laws across the world mainly focus on certain key areas, such as human rights, accessible and qualified mental health care * Corresponding author. E-mail address: fatih.artvinli@acibadem.edu.tr (F. Artvinli). Contents lists available at ScienceDirect International Journal of Law and Psychiatry journal homepage: www.elsevier.com/locate/ijlawpsy https://doi.org/10.1016/j.ijlp.2022.101845 Received 18 September 2022; Received in revised form 16 November 2022; Accepted 16 November 2022