The Mental Healthcare Act, 2017: An Overview

In India, the Mental Healthcare Act, 2017, was passed on 7 April 2017 and came into force on 29 May 2018. First of all, this landmark legislation decriminalized attempted suicide, which was previously punishable under Section 309 of the Indian Penal Code. The Act aims to provide mental healthcare services, promote the rights of persons with mental illness, and align Indian mental health laws with global standards. It replaced the Mental Health Act, 1987, to address evolving perspectives on mental health.


The Act mandates that mental illness must be determined in accordance with nationally and internationally accepted medical standards, including the World Health Organization's International Classification of Diseases. It also prohibits classifying individuals as mentally ill unless directly related to their treatment or legal provisions.

Purpose of the Act

To provide mental healthcare and services for individuals with mental illnesses and protect their rights during treatment.

Advantages of the Act

Ø  Ensures accessible and affordable mental healthcare.

Ø  Protects individuals from discrimination and stigma.

Ø  Promotes community living and rehabilitation.

Ø  Provides mechanisms for advance directives and nominated representatives.

Chapters of the Act

Chapter I: Preliminary (Sections 1 & 2)

This chapter lays the foundation of the Act by defining key terms and specifying its objectives, scope, and applicability. It emphasizes a rights-based approach to mental healthcare and sets the tone for other provisions.

Important Sections:

Ø  Section 1: Specifies the short title, extent, and commencement of the Act.

Ø  Section 2: Provides definitions, such as "mental illness," "mental health establishment," and "nominated representative."

Chapter II: Mental Illness and Capacity to Make Mental, Healthcare and Treatment Decisions (Sections 3 & 4)

This chapter elaborates on how mental illness should be determined and asserts the capacity of individuals to make decisions about their mental healthcare and treatment.

Further, mental illness is to be assessed following internationally accepted medical standards. The Act ensures that the determination of illness respects individual dignity and avoids stigmatization. It also highlights that a person's ability to make decisions should not be judged solely on their diagnosis.

Important Sections:

Ø  Section 3: Standards for determining mental illness, disallowing classification based on social, political, or cultural values.

Ø  Section 4: Establishes the capacity to make mental healthcare decisions, emphasizing informed consent.

 Chapter III: Advance Directive (Sections 5 to 13)

This chapter empowers individuals to create advance directives, allowing them to specify their preferences for treatment or appoint a representative for decisions during future periods of incapacity.

Further, advance directives reflect the individual's autonomy in deciding the nature of their mental health treatment. This provision ensures that personal choices are respected even when the person is unable to communicate.

Important Sections:

Ø  Section 5: Provides the right to create an advance directive in writing.

Ø  Section 8: Describes the process for revocation, amendment, or cancellation of an advance directive.

Chapter IV: Nominated Representative (Sections 14 to 17)

This chapter enables individuals to appoint a nominated representative to make mental healthcare decisions on their behalf if they become incapable of doing so.

Further, the concept of a nominated representative ensures that a trusted person can act in the best interests of individuals with mental illness, safeguarding their rights and preferences.

Important Sections:

Ø  Section 14: Appointment and revocation of a nominated representative.

Ø  Section 17: Duties of the nominated representative, including ensuring informed decision-making.

Chapter V: Rights of Persons with Mental Illness (Sections 18 to 28)

This chapter enshrines the rights of persons with mental illness, such as the right to affordable care, confidentiality, and protection from inhumane treatment.

Further, the rights-based focus of this chapter guarantees equality, dignity, and non-discrimination in mental healthcare. It emphasizes community integration and the elimination of stigma.

Important Sections:

Ø  Section 18: Right to access affordable and good-quality mental healthcare.

Ø  Section 23: Right to confidentiality in mental health treatment.

Ø  Section 27: Right to free legal aid.

Ø  Section 28: Right to make complaints about deficiencies in provision of services.

Chapter VI: Duties of Appropriate Government (Sections 29 to 32)

The Act places specific responsibilities on the government to implement mental health programs, reduce stigma, and ensure adequate infrastructure and resources.

Further, the government’s role is pivotal in creating awareness, developing human resources, and integrating mental health into the broader healthcare framework.

Important Sections:

Ø  Section 29: Promotion of mental health and preventive programs.

Ø  Section 31: Training healthcare professionals and addressing resource gaps.

Chapter VII: Central Mental Health Authority (Sections 33 to 44)

This chapter establishes a central authority to regulate and monitor mental health services, ensuring uniform implementation of the Act across the country.

Further, the Central Mental Health Authority acts as the primary body for policymaking, regulation, and coordination in mental health services at the national level.

Important Sections:

Ø  Section 33: Establishment of the Central Mental Health Authority.

Ø  Section 43: Functions of the Central Authority, including maintaining a national register of mental health professionals.

Chapter VIII: State Mental Health Authority (Sections 45 to 56)

Similar to the central authority, state-level authorities ensure the effective implementation of the Act within their jurisdiction.

Further, State Mental Health Authorities focus on localized governance, addressing region-specific mental health needs.

Important Sections:

Ø  Section 45: Establishment of State Authorities.

Ø  Section 55: Functions of the State Authorities, including registering mental health establishments.

Chapter IX: Finance, Accounts, and Audit (Sections 57 to 64)

This chapter provides financial guidelines for implementing the Act, including creating funds and conducting audits.

Further, proper financial management is essential for ensuring sustained implementation and accountability of mental healthcare services.

Important Sections:

Ø  Section 57: Grants provided by the Central Government.

Ø  Section 58: Establishment of the Central Mental Health Authority Fund.

Chapter X: Mental Health Establishments (Sections 65 to 72)

This chapter sets out the registration and operational guidelines for mental health establishments to ensure quality care.

Further, it emphasizes the need for transparent procedures and accountability in mental health facilities.

Important Sections:

Ø  Section 65: Registration requirements.

Ø  Section 68: Inspection and inquiry of establishments.

Ø  Section 72: Duty of mental health establishment to display information.

Chapter XI: Mental Health Review Boards (Sections 73 to 84)

This chapter establishes Mental Health Review Boards to oversee the implementation of the Act and address grievances. These boards act as quasi-judicial bodies ensuring transparency and accountability in mental healthcare.

Further, the Mental Health Review Boards provide a platform for individuals to seek redressal against violations of their rights and ensure decisions are taken in the best interests of persons with mental illness.

Important Sections:

Ø  Section 73: Constitution of Mental Health Review Boards.

Ø  Section 82: Powers and functions of the Board, including reviewing decisions on admission, treatment, and grievances.

Chapter XII: Admission, Treatment, and Discharge (Sections 85 to 99)

This chapter provides guidelines for admitting, treating, and discharging individuals with mental illnesses, ensuring their rights are respected throughout the process.

Further, it emphasizes informed consent, the least restrictive treatment options, and the right to dignity during the admission and treatment phases. Provisions are also made for emergency care and research ethics.

Important Sections:

Ø  Section 85: Admission as an independent patient.

Ø  Section 94: Emergency treatment provisions without prior approvals.

Ø  Section 97: Restrictions on restraints and seclusion.

Chapter XIII: Responsibilities of Other Agencies (Sections 100 to 105)

This chapter outlines the roles of police, magistrates, and custodial institutions in protecting and assisting individuals with mental illnesses.

Further, other agencies, such as law enforcement and judicial bodies, play a vital role in safeguarding the rights of persons with mental illnesses, especially in emergencies or custodial situations.

Important Sections:

Ø  Section 100: Duties of police officers to assist individuals with mental illnesses.

Ø  Section 105: Handling mental illness issues during judicial processes.

Chapter XIV: Restriction To Discharge Functions By Professionals Not Covered Profession (Section 106)

This chapter restricts unqualified individuals or entities from providing mental health services, ensuring only licensed professionals engage in mental healthcare.

Further, by defining the scope of professional practice, this chapter protects individuals from malpractice and ensures quality standards in mental healthcare.

Important Section:

Ø  Section 106: Restricts unauthorized professionals from discharging mental health functions.

Chapter XV: Offences and Penalties (Sections 107 to 109)

This chapter prescribes penalties for violations of the Act, such as running unregistered establishments or failing to comply with its provisions.

Further, the penalties serve as a deterrent against non-compliance and ensure adherence to the Act's standards for mental healthcare services.

Important Sections:

Ø  Section 107: Penalties for establishing or maintaining unregistered mental health establishments.

Ø  Section 109: Offences by companies violating the Act's provisions.

 Chapter XVI: Miscellaneous (Sections 110 to 126)

This chapter includes special provisions for states, transitory arrangements, and the power to make rules for effective implementation.

Further, it addresses residual issues such as jurisdictional conflicts, rule-making powers, and the repeal of previous mental health laws.

Important Sections:

Ø  Section 115: Presumption of severe stress in cases of attempted suicide, ensuring care instead of punishment.

Ø  Section 120: Act's overriding effect over other laws in matters of mental health.

Ø  Section 126: Repeals the Mental Health Act, 1987.

Conclusion

The Mental Healthcare Act, 2017, is a progressive step toward ensuring accessible and equitable mental healthcare in India. By prioritizing individual rights, de-stigmatizing mental illness, and mandating accountability, the Act lays the groundwork for a more inclusive mental health system.

 

Frequently Asked Questions (FAQs)

1. What is the purpose of the Mental Healthcare Act, 2017?

To provide accessible, affordable mental healthcare while protecting the rights of persons with mental illness.

2. How does the Act decriminalize suicide?

It presumes individuals attempting suicide are under severe stress and focuses on treatment rather than punishment.

3. What is an advance directive?

A document specifying treatment preferences or appointing a representative for future decisions.

4. Who can be a nominated representative?

Any competent adult appointed by the person with mental illness.

5. What are Mental Health Review Boards?

Bodies set up to address grievances and oversee the implementation of the Act.

6. Are mental health services free under the Act?

Yes, for individuals below the poverty line and others in need as specified.

7. How does the Act address stigma?

By promoting awareness programs and integrating mental health into public healthcare.

8. What penalties are there for violations?

Establishments operating without registration face penalties under Section 107.

9. Does the Act apply to private mental health establishments?

Yes, all establishments must comply with registration and quality norms.

10. What role does the government play under this Act?

The government ensures infrastructure, training, and promotion of mental health awareness.

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