Educationals

Mental Health Act, 1987

The enactment of the Mental Health Act, 1987 is a landmark in the mental healthcare delivery in India. It is not simply a cosmetic improvement over the outdated Indian Lunacy Act,1912, but represents the conclusion of lengthy presentation by the Indian Psychiatric Society to the Government of India. This Act came into force in April 1993, as per the government of Indian order, even though it is still in hibernation in some States.

The Mental Health Act is " an act to consolidate and amend the law relating to the treatment and care of the mentally ill persons, to make better provisions with respect to their property and for matters connected with or incidental thereto."

The Mental Health Act has the following objectives:

• To regulate admission to psychiatric hospitals or psychiatric nursing homes, of mentally ill persons who do not have sufficient understanding to seek treatment on a voluntary basis, and to protect the rights of such persons while being detained.
• To protect society from the presence of mentally ill persons who have become a danger or nuisance to others.
• To protect citizens from being detained in psychiatric hospitals or psychiatric nursing home without sufficient cause.
• To regulate responsibility for maintenance charges of mentally ill persons who are admitted to psychiatric hospitals or psychiatric nursing homes.
• To provide facilities for establishing guardianship or custody of mentally ill persons who are incapable of managing their own affairs.
• To provide for the establishment of Central Authority and State Authorities for mental health services
• To regulate the powers of the Government for establishing, licensing and controlling psychiatric hospitals and psychiatric nursing homes for mentally ill persons.
• To provide for legal aid to mentally ill persons at state expense in certain cases. the Government of India has constituted Central Mental Health Authority. Before implementing the Mental Health Act in the States, the states have to take action regarding the following:
  
  • To establish a State Mental Health Authority.
  • To spell out guidelines for establishment of private psychiatric hospitals and nursing homes.
  • Formation of a Board of Visitors.

In the Mental Health Act, 1987, a modest attempt has also been made to bring mental illnesses on par with physical illness, thus reducing the stigma attached to mental illnesses. The Mental Health Act has modified certain terms and definitions. The Act uses the term mentally ill person instead of lunatic, mentally ill prisoner, instead of criminal lunatic. Other new terms are psychiatric hospital instead of lunatic asylum, psychiatric nursing home and psychiatrist. New terminology and definitions are given in Chapter 1. The Mental Health Act has 10 chapters in total, consisting of 100 sections.

Chapter 2 deals with establishment of mental health authorities at the Center and at State levels. These authorities will regulate and coordinate mental health services under Central and State Governments, respectively. Chapter 3 lays down the guidelines for establishment and maintenance of psychiatric hospitals and nursing homes. Also, there is a provision for a licensing authority who will process applications for licenses. No private psychiatric hospital or nursing homes will be allowed to function without a valid license, which has to be renewed every five years.

There is also a provision for an inspecting officer who will inspect the psychiatric hospitals and nursing homes to prevent any irregularities.

Chapter 4 deals with the procedures of admission and detention in psychiatric hospitals or nursing homes. In addition to the five methods allowed by the Indian Lunacy Act of 1912, one more method has been incorporated.

Chapter 5 deals with the inspection, discharge, leave of absence and removal of mentally ill persons.

Chapter 6 deals with the judicial inquisition regarding alleged mentally ill persons possessing property, custody of their person and management of their property.
If the court feels that the alleged mentally ill person is incapable of looking after both himself and his property, an order can be issued for the appointment of a guardian, If however, it is felt that the person is only incapable of looking after his property but can look after himself a manager can be appointed.

Chapter 7 deals with the liability to meet the cost of maintenance of mentally ill persons detained in psychiatric hospitals or nursing homes.

Chapter 8 is aimed at the protection of human rights of mentally ill persons. It provides that:

• No mentally ill person shall be subjected, during treatment, to any indignity (whether physical or mental) or cruelty.
• No mentally ill person, under treatment, shall be used for the purpose of research unless:
  • Such research is of direct benefit to him.
  • A consent has been obtained in writing from the person (if a voluntary patient) or from the guardian/ relative (if admitted involuntarily).
  • No letters or communications sent by or to a mentally ill person shall be intercepted, detained or destroyed.