mental health act, 1987 &mha, 2010

Mental health Act 1987 :

Mental health Act 1987 Presented by – Neeraj Chaudhary Batch 2005

HISTORY :

HISTORY Mental health act was drafted by parliament in 1987 but it came into effect in all the states and union territories of India in April 1993. This act replaces the Indian Lunacy act of 1912, which had earlier replaced the Indian Lunatic Asylum act of1858.

Definition of the act :

Definition of the act " An act to consolidate and amend the law relating to the treatment and care of mentally ill persons , to make better provision with respect to their property and affairs and for matters connected there with or incidental thereto."

Objectives of the act:

Objectives of the act 1. To establish central and state authorities for licensing and supervising the psychiatric hospitals. 2. To establish such psychiatric hospitals and nursing homes. 3. To provide a check on working of these hospitals. 4. To provide for the custody of mentally ill persons who are unable to look after themselves and are dangerous for themselves and or, others.

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5. To protect the society from dangerous manifestations of mentally ill. 6. To regulate procedure of admission and discharge of mentally ill persons to the psychiatric hospitals or nursing homes either on voluntary basis or on request. 7. To safeguard the rights of these detained individuals.

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8. To protect citizens from being detained unnecessarily. 9. To provide for the maintenance charges of mentally ill persons undergoing treatment in such hospitals. 10. To provide legal aid to poor mentally ill criminals at state expenses 11. To change offensive terminologies of Indian Lunacy act to new soother ones.

Terminologies used in the act :

Terminologies used in the act New term Outdated terms Psychiatric hospital / Nursing home Asylum Mentally ill person Lunatic Mentally ill prisoner Criminal lunatic

Salient features of the act :

Salient features of the act Mental health act is divided into 10 chapters consisting of 98 sections .

CHAPTER I :

CHAPTER I “Medical Officer” means a gazetted medical officer in the service of Government and includes a medical practitioner declared, by a general or special order of the State Government, to be a medical officer for the purpose of this Act. “mentally ill person” means a person who is in need of treatment by reason of any mental disorder other than mental retardation “psychiatrist” means a medical practitioner possessing a post-graduate degree or diploma in psychiatry, recognized by the Medical Council of India, constituted under the Indian Medical Council Act, 1956, and includes, in relation to any State, any medical officer who, having regard to his knowledge and experience in psychiatry, has been declared by the Government of that State to be a psychiatrist for the purposes of this Act.

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“Psychiatric hospital" or “Psychiatric nursing home" means a hospital, or as the case may be, a nursing home established or maintained by the Government or any other person for the treatment and care of mentally ill persons and includes a convalescent home established or maintained by the Government or any other person for such mentally ill persons; but does not include any general hospital or general nursing home established or maintained by the Government and which provides also for psychiatric services; “ Reception order" means an order made under the provision of this Act for the admission and detention of a mentally ill person in a psychiatric Hospital or psychiatric nursing home

CHAPTER II :

CHAPTER II Central Authority For Mental Health Services The Central Government shall establish an authority for mental health It shall be in charge of regulation, development, direction and co-ordination with respect to Mental Health Services under the Central Government. Supervise the psychiatric hospitals and psychiatric nursing homes and other Mental Health Service Agencies (including places in which mentally ill persons may be kept or detained) under the control of the Central Government. Advise the Central Government on all matters relating to mental health State Authority for Mental Health Services in States/UTs

CHAPTER III:

CHAPTER III It lays down the guidelines for establishment and maintenance of psychiatric hospitals and nursing homes. There is a provision for licensing authorities to process applications for license and their renewal.

CHAPTER IV:

CHAPTER IV It deals with the procedures of admission and detention of mentally ill in psychiatric hospitals PART I Admission on voluntary basis PART II Admission under Special Circumstances

CHAPTER V:

CHAPTER V It deals with the inspection, discharge, leaves of absence and removal of mentally ill persons.

CHAPTER VI :

CHAPTER VI It deals with the judicial inquisition regarding alleged mentally ill persons possessing property and its management.

CHAPTER VII :

CHAPTER VII It deals with the maintenance of mentally ill persons in a psychiatric hospital or psychiatric nursing homes

CHAPTER VIII :

CHAPTER VIII PROTECTION OF HUMAN RIGHTS OF MENTALLY ILL PERSONS 1) No mentally ill person shall be subjected during treatment to any indignity (whether physical or mental) or cruelty. (2)    No mentally ill person under treatment shall be used for purposes of research, unless- ( i )  such research is of direct benefit to him for purposes of diagnosis or treatment; or (ii)   such person, being a voluntary patient, has given his consent in writing or where such person (whether or not a voluntary patient) is incompetent by reason of minority or otherwise, to give valid consent, the guardian or other person competent to give consent on his behalf, has given his consent in writing for such research.

CHAPTER IX :

CHAPTER IX It deals with the penalties and procedures for infringement of guidelines of the act.

CHAPTER X :

CHAPTER X It deals with miscellaneous matters not covered in other chapters of the act.

MHA-87;Focus on treatment and care of Patients:

MHA-87;Focus on treatment and care of Patients Establishment or maintenance of psychiatric hospitals or psychiatric nursing homes only with license Psychiatric hospital and psychiatric nursing home to be maintained in accordance with prescribed conditions Inspection of psychiatric hospitals and psychiatric nursing homes and visiting of patients Admission And Detention In Psychiatric Hospital Or Psychiatric Nursing Home

Admission Procedure in Psychiatric Hospital:

Admission Procedure in Psychiatric Hospital Request by major for admission as voluntary patient (section 15) Request by guardian for admission of a ward (Section 16) Admission of, and regulation with respect to, voluntary patient (Section 17) Discharge of voluntary patients (Section 18) Admission of mentally ill persons under certain special circumstances (section 19) Application for reception order (Section 20)- could be made by spouse, relative or medical officer in charge where the patient is undergoing inpatient treatment.

Guardianship:

Guardianship Judicial Inquisition Regarding Alleged Mentally Ill Person Possessing Property, Custody Of His Person and Management of His Property On completion of the inquisition, the District Court shall record its findings on – Whether the alleged mentally ill person is in fact mentally ill or not, and Where such person is mentally ill, whether he is incapable of taking care of himself and managing his property, or incapable of managing his property only. In appointing guardian the court looks for the most suitable person for it rather than going by the relatives wishes

Summary-MHA 87:

Summary-MHA 87 An Act to regulate and set standard for restrictive psychiatric treatment facilities To establish procedure for Guardianship for mentally ill who need it To protect Human Rights of mentally ill To set up authorities for development , regulation and coordination of mental health services

Criticism of the act:

Criticism of the act 1 . Change of older terminologies to newer ones might be good from theoretical aspects. But practically will it be helpful in removing the social stigma attached to the illness. This approach is just like a window dressing. This change should be implemented in practice and not on paper. 2. Licensing authorities do not have a doctor who may be in a better position to assess the facilities and services of these centers . 3. Concept of establishing new hospitals might appear good but in a developing country like ours this may be a costly affair. It will put extra burden on health budget

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4. No mention is made of incorporating General hospitals and centres in this act rather they are prohibited. Such hospitals if taken along may provide a better health care. 5. Much stress is laid on hospital admission and treatment . This again increases the cost of health care. No provisions are made for home treatment . 6. Although the act provides for a simple discharge procedure but no provisions are made for after discharge care and rehabilitation , of patients. 7. In case no relative comes forward for discharge of patient, will that person be detained indefinitely in hospital. Who will bear the expenses in such case? If Govt. then for how long.

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8. It is provided that research on such subjects can be carried out by consent of guardian. Is it not like treating them as inanimate objects? This provision violates human rights. 9. There are no provisions for punishing the relatives and officers requesting unnecessary detention of a person to such hospitals. 10. Once a person is admitted to mental hospital he is termed insane or mad by the society. There should be provisions in the act to educate the society against these misconceptions . 11. Act adopts different views for Govt. And private hospitals.

Suggestions for improvement of the act:

Suggestions for improvement of the act 1 . Provisions for educating society about mental illness and treating it at par with physical illness should be incorporated. 2. Licensing process should be made simpler. 3. Provision should be there for checking the working of licensing authorities and powers vested in them to be limited. 4. Licensing authorities should appoint a doctor preferably a psychiatrist as inspecting officer.

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5. Private Doctors and general nursing homes should be allowed to treat such patients at par with recognized centres . This will help in reducing the workload on the system and will provide much better health care to the patients . This provision can be withdrawn later , once there are adequate recognized hospitals with adequate staff. 6 . To regulate procedure of admission and discharge of mentally ill persons to the psychiatric hospitals or nursing homes either on voluntary basis or on request

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7. Adequate provisions to be provided for long term treatment and expenses on treatment. If this is not possible, then community mental health centres should be opened to provide such care. 8. Provisions for rehabilitation centres are to be incorporated . Efforts should be there for post discharge care and rehabilitation. 9. Strict provisions should be there for punishing the individuals requesting unnecessary detention and exploitation of mentally ill.

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10 . Stress should be on treatment of illness rather than the ill 11. Treatment should be based on concept of socialization and not on hospitalization.

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During the Regional Consultations on the amendments to the MHA, 1987, it became clear that the number of amendments to the MHA 1987 led to multiple repealed sections and this resulted in difficulty in reading the amended Act. This is now written as a new Act because it allows for certain sections to be moved to the front of the Act and renumbering of sections sequentially. Most importantly it makes for ease of reading and use of the Act.

NATIONAL MENTAL HEALTH CARE ACT, 2010 (DRAFT):

NATIONAL MENTAL HEALTH CARE ACT, 2010 (DRAFT) Chapter I: Preliminary (sec 1-6) Chapter II : Rights of Persons with Mental Illness (sec 7-16) Chapter III Duties of Government (sec 17-20) Chapter IV Mental Health Review Commission (sec 21-31) Chapter V State Mental Health Authority (sec 32-38)

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Chapter VI Mental Health Facilities (sec 39-41) Chapter VII : Admission, Treatment and Discharge (sec42-55) Chapter VIII : Responsibilities of Other Agencies(sec 56-60) Chapter IX : Penalties and Miscellaneous provisions (sec 61-67)

bibliography:

bibliography Mental health act - an analysis; by Dr. Prateek Rastogi Forensic Psychiatry (published by IPS) The Mental Health Act, 1987 (commercial law publishers) DRAFT MENTAL HEALTH CARE ACT, 2010 Ministry of Health & Family Welfare Government of India New Delhi

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Thank You