The Mental Healthcare Act, 2017

Its key features and challenges.

The Mental Healthcare Act which was passed on 7th April, 2017 seeks to replace the Mental Health Act, 1987. The 1987 Act failed to acknowledge the agency of those with mental illnesses and adequately safeguard their rights. Initially introduced in the Parliament in August, 2013, the bill was finally passed last April.

The Act mainly aims to protect the rights of persons with mental illnesses and promote and provide mental healthcare services to those in need. It ensures that the law is in accordance with the UN Convention on the Rights of Persons with Disabilities (UNCRPD) after India ratified the UNCRPD in October 2007. Such a legislation is extremely important for our country which has more than 70 million people suffering from mental disorders. A fairly inclusive bill with certain gaps, here is a comprehensive review of the Mental Healthcare Act, 2017.

Key features and provisions:

1. The bill provides statutory rights to all persons to access mental healthcare and treatment from mental health services run or funded by the Government which includes affordable, good quality, and easy access to facilities such as minimum mental health services in every district without any discrimination.

2. The bill ensures the right to equality of treatment, and protection from inhuman and degrading treatment at any medical health establishment.

3. The Act broadens the definition of mental illness as a substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgment, behaviour, capacity to recognise reality or ability to meet the ordinary demands of life, mental conditions associated with the abuse of alcohol and drugs and does not include mental retardation which is characterised by sub-normality of intelligence.

4. The bill provides for procedure and process of admission, treatment and discharge of patients. The patient has the right to make an ‘advance directive’ stating how he wishes to be treated and how not to be treated.

5. They can also appoint a ‘nominated representative’ to take all health-related decisions on their behalf.

6. Entitlement to free mental health services at all mental health establishments run or funded by the Government for those persons with mental illnesses living below the poverty line or who are destitute or homeless.

7. Insurers are now bound to provide medical insurance to persons with mental illnesses for treatment on the same basis as available for treatment of physical illnesses.

8. Suicide is decriminalised. An attempted suicide will not be considered as punishable, which earlier included imprisonment up to a year and/or fine. Now, the attempt will be presumed as a result of severe stress and the person will not be subjected to investigation or prosecution.

Challenges:

1. The impact of the law may not be immediate as the implementation may take time to be properly established and set up and moreover, funds may not be adequate to meet the estimated expenditures under the Act.

2. There are no specifications provided as to how the insurance clause will be enforced.

3. Both the ‘Advance Directive and the ‘Nominated Representative’ are not absolute and can be overruled if an application is made in that behalf to the Mental Healthcare Board.

4. The Act does not do away with declarations of unsound mind or findings of mental illness for the purpose of divorce proceedings which denotes two parallel proceedings with respect to the same case.

5. Giving the patient the right to decide their treatment may also hamper their overall process of getting better.

What can be done:

1. The Act prohibits electro convulsive therapy as well as making an ‘Advance Directive’ for minors which may not be ideal as there are increasing reports of suicide amongst teenagers and youth due to stress, academics and peer pressure.

2. There must also be the provision of a full list of treatment options available to make the bill more thorough.

3. The Central government has to ensure funds for meeting the legal obligations.

4. As there are provisions for inclusion of non-allopathic fields, there should also be a broader definition of a Mental Health Professional which should include psychotherapists, counsellors and psychoanalysts.

5. There should be a clear provision of procedures for making an ‘Advance Directive’.

The Mental Healthcare Act, 2017 definitely empowers persons with mental illnesses and establishes new procedures and authorities but delayed implementation can be unfavourable and the legislation will not be as powerful if the challenges are not resolved. If properly executed, this bill can lead to a progressive nation that effectively helps its citizens with poor mental health issues— which is crucial for the overall development of a country.

Feature Image Credit: Daniel Watson on Unsplash

Shruti Venkatesh is a Research Associate (Mental Health) at One Future Collective.

References:

1. The Mental Health Care Act 2017 : A Brief. (2017, November 29).2thepoint.

2. Duffy, R. M., & Kelly, B. D. (2017). Concordance of the Indian Mental Healthcare Act 2017 with the World Health Organization’s Checklist on Mental Health Legislation. International Journal of Mental Health Systems, 11, 48. http://doi.org/10.1186/s13033-017-0155-1

3. Raval, N. (2017, June 16). An analysis of Mental Healthcare Act, 2017.Libertatem Magazine.

4. Satav, R. (2017, December 20). The gaps in the Mental Healthcare Act.LiveMINT.

5. Bakshy, A. (2017, May 18). Know Your Mental Health Care Act. Patients Engage

6. Salelkar, A. (n.d.). Reviewing the Mental Healthcare Act, 2017. White Swan Foundation.