Mental Healthcare Act, 2017

Mental Healthcare Act, 2017

“Mental health…is not a destination, but a process. It’s about how you drive, not where you’re going.”

                          NOAM SHPANCER, PHD

Author:- Aarti Khanduri, a Student of DAV (PG) College, Dehradun, Uttarakhand 

“Mental health is an important topic, and should be discussed more frequently”. Mental healthcare is vital for overall well-being, addressing conditions like depression, anxiety, and stress. It fosters resilience, enhances productivity, strengthens relationships, and reduces the stigma surrounding mental health, ultimately promoting a healthier and more balanced society.  

 In recent years, there has been increasing acknowledgement of the important role mental health plays in achieving global development goals, as illustrated by the inclusion of mental health in the Sustainable Development Goals. Depression is one of the leading causes of disability. Suicide is the fourth leading cause of death among 15-29-year-olds. People with severe mental health conditions die prematurely as much as two decades early -due to preventable physical condition. In 2019, WHO launched the WHO Special Initiative for Mental Health (2019-2013): Universal Health Coverage for Mental Health to ensure access to quality and affordable care for mental Health Conditions in 12 Priority countries to 100 million more people.

In 2022, WHO launched the World Mental Health Report: Transforming Mental Health For All.

The Mental Healthcare Act of 2017 was enacted to ensure the provision of mental healthcare and services to individuals dealing with mental illness while safeguarding, advocating for, and fulfilling their rights during the delivery of mental healthcare and related matters. This legislation replaced the Mental Health Act of 1987 and became effective on April 7, 2017.

The term Mental Illness in MHA 2017 is defined in section 2 under the act according to which mental illness indicates a substantial disorder of thinking, mood, perception, orientation, or thought that seriously impairs behavior, capacity to recognize reality, or ability to meet daily needs; mental conditions linked to the degradation of alcohol and drugs; but does not constitute a mental barrier, which is a state of person’s mind that has not developed normally or at all, often characterized by knowledge that is below average. 

Important provision of the Act:

1. Rights of persons with mental illness:

Individuals with mental illness have the right to government-supported mental health care that is affordable, or high quality, and easily accessible. They are also entitled to equal treatment, protection from inhuman or degrading treatment, free legal aid, access to their medical records, and the ability to voice concerns about deficiencies in mental health care. The provision includes the following-

• Section 18.  Right to access mental healthcare.  

• Section 19.  Right to community living.  

• Section 20.  Right to protection from cruel, inhuman and degrading treatment.  

• Section 21.  Right to equality and non-discrimination.  

• Section 22.  Right to information.  

• Section 23.  Right to confidentiality.  

• Section 24.  Restriction on release of information in respect of mental illness.  

• Section 25.  Right to access medical records.  

• Section 26.  Right to personal contacts and communication.  

• Section 27.  Right to legal aid.  

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

2. Advance directives: The Act allows individuals to create advance directives that specify their preference for treatment and care in case they lose the capacity to make decision about their treatment. These directives must be respected by healthcare providers.

3. Mental health-related administrative bodies -Central and state Mental Health Authority: Administrative bodies, the central and state Mental Health Authorities, have essential roles. They must oversee and register mental health facilities, establish quality standards, maintain professional registries, provide training for law enforcement and mental health experts, handle service complaints, and offer guidance to the government on mental health matters.

4. Mental Health Establishments:

Historically, mental health facilities were limited to hospitals and nursing homes. However, the act expanded this to include Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy under government oversight. All mental health facilities, regardless of type, must register with the central or state mental health authority. These Authorities are responsible for tracking mentally ill individuals receiving treatment and maintaining an update list of qualified healthcare professionals, in accordance with the Act’s specified criteria.

5. Mental Health Review Boards:

The Act establishes Mental Health Review Boards at the district, state, and national levels to safeguard the rights of individual with mental illness. These boards have the authority to review and decide on issues related to the admission, treatment, and discharge of individuals with mental illness.

6. Prohibition of Electroconvulsive Therapy (ECT) and Psychosurgery:

The Act prohibits the use of ECT without the informed consent of patient and bans the use of psychosurgery for minors.

7. Decriminalizing suicide: A person who attempts suicide shall be presumed to be suffering from mental illness at that time and will not be punished under the Indian Penal Code.

8. Penalties and offenses: Any infringement of a provision under this Act is punishable by Six-month prison sentence, a Rs. 10,000 fines, or both. Repeat offender may face a further two years in prison, a fine ranging from 50,000 to 5 lakh rupees, or both.

The Mental Healthcare Act, 2017

The Mental Healthcare Act, 2017 (MHCA) of India is a landmark and welcome step towards centering persons with mental illness (PwMI) and recognizing their rights concerning their treatment and care decisions and ensuring the availability of mental healthcare services. As mentioned in its preamble, the Act is a step towards aligning India’s laws or mental health (MH) policy with the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), which India ratified in 2007. Amidst several positives, the implementation of the Act has been marred by certain practical issues which are partly attributed to the inherent conceptual limitations. Countries across the globe, both High Income- and Low-and Middle-Income Countries, have enacted legislation to ensure that the rights of treatment and care of PwMI are respected, protected, and fulfilled. They have also provisioned quasi-judicial bodies (Mental Health Review Boards MHRBs/tribunals) for ensuring these rights.