<p>The Act on the Improvement of Mental Health and the Support for Welfare Services for Mental Patients (2017) marks a significant reform in South Korea’s mental health system. This study reviews the legal amendments from 2016 to 2023, alongside the mental health policies and programs published in the Health and Welfare White Paper during the same period. The focus is on the ethical challenges and future directions in mental health care, analyzed through the lens of Beauchamp and Childress’ four principles of biomedical ethics—autonomy, beneficence, non-maleficence, and justice. In conducting this study, we performed a focused document analysis of legislative amendments and policy reports published between 2016 and 2023. We selected and reviewed the Health and Welfare White Papers and the official amendments to the Mental Health Welfare Act according to predefined inclusion criteria, focusing on relevance to mental health governance and ethical considerations. This paper evaluates how key provisions of the Act address involuntary admission, patient autonomy, the expansion of services, and the integration of mental health care into broader welfare systems. Moreover, by incorporating public health ethics concepts such as equity, solidarity, and the common good, this study highlights the importance of balancing individual rights with broader societal needs—especially during public health crises—to ensure comprehensive and inclusive mental health governance. Additionally, it proposes future policy directions to enhance patient autonomy, maximize well-being, and ensure equitable access to services, particularly for vulnerable populations such as the elderly and low-income groups. Key recommendations include developing informed consent protocols, expanding telemedicine and community-based care, and addressing digital health equity. This paper contributes to ongoing discussions on mental health reform and bioethics, emphasizing the importance of equitable mental health care as a fundamental component of social justice.</p>