Mental Health Acts in India
The foremost legislation governing mental health issues in India is the Mental Health Care Act (MHCA) [2017] that was passed on 27 March 2017 and enforced on 29 May 2018. The act supersedes the previously existing laws on mental health, including the earlier Mental Health Act [1987] and the colonial-era Indian Lunacy Act [1912].
The act also supplements—amongst related pieces of legislation—the National Mental Health Policy (NMHP) [2014], the Rights of Persons with Disabilities Act [2016], the Indian Penal Code, and the Universal Declaration of Human Rights [1948] and the Convention on Rights of Persons with Disabilities and its Optional Protocol [2006] adopted by the United Nations.
The preamble of the Mental Health Care Act (MHCA) reads:
An Act to provide for mental healthcare and services for persons with mental illness and to protect, promote and fulfill the rights of such persons during delivery of mental healthcare and services and for matters connected therewith or incidental thereto.
In comparison to the earlier laws, the provisions of the MHCA takes a more human rights-based approach to addressing mental health issues, keeping up with “improved delivery of care, societal changes, and increasing awareness of a person’s human rights and privileges”. It has been hailed as a landmark piece of legislation in its decriminalization of suicide, ban of electroconvulsive therapy as a form of treatment, and increased regulation of psycho-surgeries and forceful incarcerations in mental health establishments.
Most importantly, the MHCA seeks to actualize mental healthcare in India as a collaborative relationship between various stakeholders from diverse backgrounds, namely, mental health professionals (MHPs), police and medical officers, governmental and non-governmental agencies, law courts, citizens, society, consumers of mental health services and their families, and other significant actors operating within the territorial jurisdiction of India.
How does the Mental Health Care Act define “mental health”?
The MHCA defines “mental illness” as “a substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgment, behavior, capacity to recognise reality or ability to meet the ordinary demands of life, mental conditions associated with the abuse of alcohol and drugs, but does not include mental retardation which is a condition of arrested or incomplete development of mind of a person, specially characterized by subnormality of intelligence”.
The act further lays down that mental illness within India “shall be determined in accordance with such nationally or internationally accepted medical standards (including the latest edition of the International Classification of Disease of the World Health Organization) as may be notified by the Central Government.” As such, no person or authority can make assumptions about the mental health status of a person on grounds of coercion, religion, ethnicity, political ideology, caste, class, non-conforming lifestyle, and medical history.
How does the Mental Health Care Act define “mental healthcare”?
According to the MHCA, mental healthcare “includes analysis and diagnosis of a person’s mental condition and treatment as well as care and rehabilitation of such a person for [his/her] mental illness or suspected mental illness”.
According to the Mental Healthcare Act, who has the right to mental healthcare and treatment?
The MHCA lays down that “every person shall have a right to access mental health care and treatment from mental health services run or funded by the appropriate government.”
It extends the right of mental health and human dignity to:
- Minors
- People living below the poverty line
- The destitute
- The homeless
- The incarcerated
What are the provisions for mental healthcare services in the Mental Healthcare Act?
The MHCA makes it mandatory to “integrate mental health services into general healthcare services at all levels of healthcare including primary, secondary and tertiary healthcare” and in all health programmes run by the central government and the respective state governments. It states that mental health services should be of equal quality as other general health services or services for physical illness—with no discrimination to be made in quality of services provided to people who are deemed mentally ill.
Accordingly, the right to access mental health care and treatment means mental health services which are:
- Of affordable cost
- Of good quality
- Available in sufficient quantity
- Accessible geographically
- Rendered without discrimination on the basis of gender, sex, sexual orientation, religion, culture, caste, social or political beliefs, class, disability or any other basis; and
- Provided in a manner that is acceptable to persons with mental illness and their families and care-givers
The act reserves provisions of acute mental healthcare services such as:
- Outpatient and inpatient services
- Half-way homes, sheltered accommodation, and supported accommodation
- Family or home based rehabilitation facilities
- Hospitals and emergency facilities
- Community based rehabilitation establishments and services
- Child mental health services
- Old age mental health services
- Tele-medicine
- Mental health services in prisons
Mental Healthcare Act 2017, https://egazette.nic.in/WriteReadData/2017/175248.pdf
Mental Health Act 1987, https://www.wbhealth.gov.in/mental_health/Acts_Rules/MHA_1987.pdf
National Mental Health Policy 2014, https://nhm.gov.in/images/pdf/National_Health_Mental_Policy.pdf
Rights of Persons with Disabilities Act 2016, https://legislative.gov.in/sites/default/files/A2016-49_1.pdf
Indian Penal Code 1960, https://legislative.gov.in/sites/default/files/A1860-45.pdf
United Nations Convention on the Rights of Persons with Disabilities, December 13, 2006, https://www.ohchr.org/en/hrbodies/crpd/pages/conventionrightspersonswithdisabilities.aspx
United Nations Universal Declaration of Human Rights, December 10, 1948, https://www.un.org/en/udhrbook/pdf/udhr_booklet_en_web.pdf
Raveesh, B. N., Gowda, G. S., & Gowda, M. (2019). How right is right-based mental health law?. Indian journal of psychiatry, 61(Suppl 4), S640–S644. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_115_19
Nallur, D. (2019). The need for “code of practice” as a supplement to mental healthcare act 2017. Indian Journal of Psychiatry, 61(10), 798. https://doi.org/10.4103/psychiatry.indianjpsychiatry_113_19