Index

1. What Is The Mental Health Care Act? 
2. What Are Aspects Of The Mental Health Care Act?
3. What Are The Rights Of Persons With Mental Illness According To This Act?
4. Which Authorities Are Established Under The Mental Healthcare Act?
5. What Are The Responsibilities Of The Mental Health Administrative Bodies  Under This Act? 
6. What Are The Responsibilities Of The Police Under The Mental Healthcare Act? 
7. How Does The Mental Healthcare Act Ensure Confidentiality? 
8. What Is The Provision For An Advance Directive Under The Mental Healthcare Act? 
9. What Is The Mental Health Review Commission And Board?
10. How Does This Act Decriminalise Suicide And Regulate Electro-Convulsive Therapy?
11. What Are The Penalties And Offences Mentioned Under This Act? 

What Is The Mental Health Care Act? 

The Mental Healthcare Act, 2017 is a law that provides for mental healthcare and services for persons with mental illness. It aims to protect, promote and fulfil the rights of such persons during the delivery of mental healthcare and services.

What Are Aspects Of The Mental Health Care Act? 

The Mental Healthcare Act, 2017, represents a significant shift from the Mental Health Act, 1987, in several key aspects:

1. The 2017 Act defines mental illness as a substantial disorder of thinking, mood, perception, orientation, or memory that grossly impairs judgement, behaviour, capacity to recognize reality, or ability to meet the ordinary demands of life, mental conditions associated with the abuse of alcohol and drugs. In contrast, the 1987 Act defined mental illness as any mental disorder and sometimes as mental retardation.
2. The 2017 Act emphasises the rights of persons with mental illness, including the right to access mental healthcare, live in a community, equality, information, confidentiality, and to make complaints. It also provides for the right to make an advance directive and prohibits inhumane forms of treatment. The 1987 Act did not provide for these rights and instead prioritised institutionalisation.
3. The 2017 Act decriminalizes attempted suicide, presuming the person to be under severe stress and prohibiting investigation or prosecution. The 1987 Act did not address this issue.
4. The 2017 Act envisages the establishment of Central and State Mental Health Authorities to regulate mental health services. The 1987 Act did not have such provisions.
5. The 2017 Act promotes community-based care, including the provision of halfway homes and sheltered accommodation for persons with mental illness. The 1987 Act focused more on institutional care.
6. The 2017 Act prohibits certain treatments, such as neurosurgical treatments and the use of solitary confinement. The 1987 Act did not have such provisions
7. The 2017 Act Regulating the use of electroconvulsive therapy (ECT) and prohibiting its use on minors
8. The 2017 Act outlines responsibilities of agencies like the police with respect to persons with mental illness
9. The 2017 Act aims to tackle stigma associated with mental illness

What Are The Rights Of Persons With Mental Illness According To This Act? 

Every individual has the right to access mental health care and treatment through government-operated or funded services. This includes affordable, high-quality services that are easily accessible. Persons with mental illness also have rights to equal treatment, protection from inhumane and degrading treatment, free legal services, access to their medical records, and the ability to file complaints about deficiencies in mental health care. The specific provisions are as follows:

1. Section 18: Right to access mental healthcare.  
2. Section 19: Right to community living.  
3. Section 20: Right to protection from cruel, inhuman, and degrading treatment.  
4. Section 21: Right to equality and non-discrimination.  
5. Section 22: Right to information.  
6. Section 23: Right to confidentiality.  
7. Section 24: Restriction on the release of information regarding mental illness.  
8. Section 25: Right to access medical records.  
9. Section 26: Right to personal contacts and communication.  
10. Section 27: Right to legal aid.  
11. Section 28: Right to lodge complaints about deficiencies in service provision.

Which Authorities Are Established Under The Mental Healthcare Act?

The Mental Healthcare Act, 2017 established two new authorities:

1. Central Mental Health Authority: This authority is responsible for regulating mental health services at the national level and ensuring compliance with the Act’s provisions.
2. State Mental Health Authority: Each state has its own State Mental Health Authority, which is responsible for regulating mental health services within the state and ensuring compliance with the Act’s provisions.

What Are The Responsibilities Of The Mental Health Administrative Bodies  Under This Act? 

These administrative bodies are responsible for:

1. Registering, supervising, and maintaining a record of all mental health establishments.
2. Developing quality and service provision standards for these establishments.
3. Keeping a register of mental health professionals.
4. Training law enforcement officials and mental health professionals on the Act’s provisions.
5. Receiving complaints about service deficiencies.
6. Advising the government on mental health matters.

Historically, mental health facilities were limited to hospitals and nursing homes for individuals with mental illnesses. The Act now includes establishments for Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy under government oversight. All mental health facilities must register with the relevant central or state mental health authority. These authorities are responsible for tracking individuals receiving mental health treatment and maintaining a list of qualified healthcare professionals. Establishments must meet the Act’s specific requirements to register.

What Are The Responsibilities Of The Police Under The Mental Healthcare Act? 

The Mental Healthcare Act, 2017 outlines the following key responsibilities for police officers with respect to persons with mental illness:

1. If a police officer has reason to believe that a person is mentally ill and is unable to take care of themselves or is a danger to themselves or others, they can take the person into protection, not custody. 
2. The police officer must inform the person or their nominated representative of the grounds for taking them into protection. 
3. The police officer must take the person to the nearest public health establishment within 24 hours for assessment of their healthcare needs. The person cannot be detained in a police lock-up or prison. 
4. If the medical assessment finds the person does not have a mental illness requiring admission, the police must take the person to their residence or a government shelter if they are homeless. 
5. If the person is found to have a mental illness, the medical officer will arrange for their admission and treatment as per the provisions of the Act. 
6. The police must file a missing person report and try to trace the family of a homeless person with mental illness who is admitted to a mental health establishment. 
7. The police must report to the Magistrate if they have reason to believe a person with mental illness is being ill-treated or neglected in a private residence. 

How Does The Mental Healthcare Act Ensure Confidentiality? 

The Mental Healthcare Act, 2017 ensures confidentiality of mental health information in several ways:

1. Persons with mental illness have the right to confidentiality in respect of their mental health, treatment and physical healthcare.
2. All health professionals providing care must keep information obtained during treatment confidential, with limited exceptions.
3. No photograph or information relating to a person with mental illness undergoing treatment can be released to the media without consent.
4. Confidential information can only be released to the nominated representative, other healthcare professionals involved in treatment, to protect others from harm, or upon order by a statutory authority.
5. Commonly, conflicts arise regarding access to basic medical records, but the Act mandates maintaining and providing records like outpatient notes, inpatient records, psychological assessments etc. on demand.
6. In police investigations, the medical officer is responsible for providing information after receiving a written request, but can educate the officer about confidentiality concerns. Consent should be obtained from the patient or guidance sought from the concerned Board if unsure about releasing information

What Is The Provision For An Advance Directive Under The Mental Healthcare Act? 

A person with a mental illness has the right to create an advance directive, specifying their preferred treatment during a mental health crisis and naming a representative to act on their behalf. This directive must be certified by a medical practitioner or registered with the Mental Health Board. If a mental health professional, relative, or caregiver disagrees with the directive, they can request the Mental Health Board to review, modify, or cancel it.

What Is The Mental Health Review Commission And Board?

The Mental Health Review Commission, a quasi-judicial body, will periodically review the use of advance directives and advise the government on protecting the rights of individuals with mental illness. With the state governments’ agreement, the Commission will establish Mental Health Review Boards in each district. These Boards have the authority to:

1. Register, review, modify, or cancel advance directives.
2. Appoint a nominated representative.
3. Adjudicate complaints about deficiencies in care and services.
4. Handle applications from individuals with mental illness, their representatives, or other interested parties against decisions made by medical officers or psychiatrists in charge of mental health establishments.

How Does This Act Decriminalise Suicide And Regulate Electro-Convulsive Therapy?

A person who attempts suicide is presumed to be suffering from mental illness at the time and will not face punishment under the Indian Penal Code. Electro-convulsive therapy is permitted only with muscle relaxants and anaesthesia and is prohibited for minors.

What Are The Penalties And Offences Mentioned Under This Act? 

Violating any provision of this Act can result in a six-month prison sentence, a fine of Rs. 10,000, or both. Repeat offenders may face up to two years in prison, a fine ranging from Rs. 50,000 to Rs. 5 lakh, or both.