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Laws and regulations are intertwined with most elements of psychiatric treatment; becoming knowledgeable about the historical evolution of these laws and regulations assists in understanding the legal parameters governing the practice of psychiatry. For centuries, persons with mental illness have faced marginalization, treatment inequities, and stigmatization. In the nineteenth century, patients isolated in state asylums and mental hospitals had no right to association, privacy, or speech. Institutionalized patients had no input or control over the type, location, or duration of their treatment. All treatment was involuntary because no distinction between involuntary and voluntary admission existed. Well into the twentieth century, most institutionalized patients continued to lack basic human rights or the assurance that hospitalization would be humane and bear some relation to treatment and that they might again live freely in their own communities when possible.
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