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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