Participatory Concepts in Mental Health Care: Will they be a driving force behind a reform movement supported by unified advocacy? PART II
BY Maria Mangicaro
THE BUCK ERA: A Non-Participatory Model of Mental Health Care.
The 1927 U.S. Supreme Court case of Buck v. Bell decided the fate of Carrie Buck, an 18-year-old patient at the Virginia State Colony for Epileptics and Feeble Minded who was sentenced to compulsory sterilization because she represented a “genetic threat to society”. The Court’s decision sanctioned the state’s use of medical procedures on select individuals without their consent “for the protection and health of the state”. Unlike other infamous decisions, the ruling
in Buck has never been directly overruled and there are some reasons to believe that Buck is still good law today. 
This decision set a dangerous precedent as the states were allowed to employ medical opinion to create a class of people who were no longer afforded equal protection. The medical opinion that certain individuals and their offspring posed a “threat to society” empowered professionals to
practice coercive medicine in what became a prejudiced and culturally accepted, non-participatory model of mental health care.
The current paradigm of mental health care seems flawed as the treatment options for some consumers are legally mandated in an unequal relationship with their provider. This model does not honor the patient’s perspective and places the physician in an authoritative role. Compulsory psychiatric treatment is contrary to the Participatory Medicine movement, but why does it exist?