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New Mental Health Act

Tanushree Bhargava

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What is a mental Health Act?

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Mental Health Act It is a  short title used for all kinds

legislation  relating to mental health laws.

Developed to protect the basic fundamental right of people “Right to live ” that comes under article 21 of constitution.

IPC 309

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The Mental Health Act sets out:• What is Mental Health?

• When and how people can be treated if they have a mental disorder

• When people can be treated or taken into hospital against their will?

• What people's rights are, and the safeguards which ensure that these rights are protected

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Mental Health Acts In India?

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MENTAL HEALTH ACTS IN INDIA

PRE-INDEPENDENCE

1858:Indian Lunatic assylum

act of 1858

1912:Indian Lunancy act of

1912

POST-INDEPENDENCE

1947:Indian Psychiatric association established.

1987:Mental Health act of 1987(indian psychiatric

society)

Mental Health Care Bill

proposed in 2013

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1858:Indian Lunatic Assylum act of 1858

The main stress was on preventing the society from dangerousness of mentally ills and taking care

that no sane person is admitted in these asylums

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1912:Indian Lunacy act of 1912

The 1912 Act guided the destiny of Psychiatry in India

regulated and supervised by a central authority.

Procedure of admission and certification in this respect was clearly defined.

The provision of voluntary admission was introduced.

Psychiatrists were appointed as full time officers in these hospitals.

Still, the main stress was on preventing the society from dangerousness of mentally ills and taking care that no sane person is admitted in these asylums.

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Why 1912 Act needed to be changed

Offensive terminologies used in Indian Lunacy act of 1912: Lunatic person Criminal Lunatic

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MHA Act 1987

Came into effect in April 1993

To ensure availability and accessibility of minimum mental health care for all.

10chapters and 98 Sections

Main Aim to establish governing bodies at central and state level for licensing and supervision of psychiatric hospitals and nursing home.

Protection of human rights of mentally ill.

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MHA 1987

To promote community participation in mental health service development and to stimulate self-help in the community

Provisions of voluntary admission and admission on the reception orders were retained.

Role of Police and Magistrate to deal with cases of wandering mentally ill.

Guardianship and Management of properties of mentally ill.

Provisions of penalties in case of breach of provisions of the Act.

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Why MHA 1987 needed Amendment

Concerned with legal proceedings and guardianships. MHA 1987 has not been able to adequately protect the rights of person with mental illness and promote access to the mental health care in the Country.

Human right issues and mental health care delivery are not properly addressed in this Act. It Could never be implemented properly

Human right activists have questioned the constitutional validity of the MHA, 1987 because it involves curtailment of personal liberty without the provision of proper review by any judicial body.

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Need of the new bill:

It is provided that research on mentally ill can be carried out by consent of guardian. This provision violates human rights.

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 in which this act lacks.

Rights-based protection of mentally-ill person’s .This was not focused in focus of the Mental Health Act 1987 .

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The Mental Health Care Bill, 2013

Comes under Ministry Of Health and Family Welfare.

The Mental Health Care Bill, 2013 was introduced in the Rajya Sabha on August 19, 2013.  The Bill repeals the Mental Health Act, 1987.

The union cabinet has approved the amendments on Jan 30, 2014.

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Mental health Bill 2013:

The new Bill is much longer than the existing MHA having 16 Chapters and 137 clauses.

The Draft Mental Healthcare bill, tries to fix both the issues of taboo and Abuse related to mental illness.

10th October:Mental Health Day

MHA 1987 was medical model of disability, while the 2013 Bill understands mental illness from a Social model, giving a broad and inclusive definition as to what may constitute mental illness. A entire chapter covers the criteria for determination of mental illness.

The definition of ‘mental illness’ is a major improvement from the MHA which did not provide any guidance as to what would constitute mental illness except for stating that a person who was mentally ill was anyone needing treatment and who did not come under the definition of mental retardation.

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Definition of Mental Illness ‘Mental illness’ is a “a disorder of mood, thought, perception, orientation and memory which causes significant distress to a person or impairs a person’s behavior, judgment and ability to recognize reality or impairs that person’s ability to meet the demands of daily life and includes mental conditions associated with the abuse of alcohol and drugs, but does not include mental retardation”.

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awareness among the general public about the services related to mental health. Providing mental health services by the government at the grass root level is definitely a daunting task given the difficulties in finding enough qualified experts in the field. The second issue is concerned with public awareness regarding mental health.

Visiting a mental health professional has an associated stigma with it that discourages people to take the benefit of preventive and curative mental health services. They think that they will be branded or labelled in the society as insane and they might be socially excluded

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Headings of the 16 chapters and 137 clauses.

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CHAPTER I: PRELIMINARY:CLAUSES

CHAPTER II: MENTAL ILLNESS AND CAPACITY TO MAKE MENTAL HEALTH CARE AND TREATMENT DECISIONS

CHAPTER III: ADVANCE DIRECTIVE

CHAPTER IV: NOMINATED REPRESENTATIVE

CHAPTER V: RIGHTS OF PERSON WITH MENTAL ILLNESS

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CHAPTER VI:DUTIES OF APPROPRIATE GOVERNMENT

CHAPTER VII: CENTRAL MENTAL HEALTH

CHAPTER VIII: STATE MENTAL HEALTH

CHAPTER IX :FINANCE,ACCOUNTS AND AUDIT

CHAPTER X :MENTAL HEALTH ESTABLISHMENTS

CHAPTER XI: MENTAL HEALTH REVIEW COMMISSION

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CHAPTER XII: ADMISSION, TREATMENT AND DISCHARGE

CHAPTER XIII :RESPONSIBILITIES OF OTHER AGENCIES

CHAPTER XIV: RESTRICTION TO DISCHARGE FUNCTIONS BY PROFESSIONALS NOT COVERED BY PROFESSION

CHAPTER XV: OFFENCES AND PENALTIES

CHAPTER XVI: MISCELLANEOUS

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The proposed on MHCB, 2013 came after ratifying the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) which came into force in 2008. MHCB, 2013 aims

“to provide access to me services for persons with mental illness and

to protect, promote and fulfill the rights of person with mental illness during the delivery of mental health care and services and for matters concerned therewith. 

Enactment of this bill will replace the Mental Health Act (MHA) 1987 and the new Act may be called the Mental Health Care Act (MHCA), 2013

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What is Mental health Act? Need? Mental Health Acts in India? Introduction to mental health care bill 2013 and

Chapters and Clauses? Important Definitions? Need of New mental health act? Features of New Mental Health Care Bill 2013 Criticisms of New Mental Health Care Bill 2013

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Features of the New Bill

1. Legal Capacity

2. Informed Consent for treatment and researches

3. Rights of persons with mental illness

4. Administrative Bodies

5. Mental health Professionals

6. Mental Health Establishments

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7. Duties of the Government

8. Special Measure for Minors

9. Decriminalizes attempted suicides

10. Medical insurance to cover mental health treatment

11. Ban on ECT without anaesthesia,psychosurgery and chaining

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12. Prohibition

13. Emergency treatment

14. Granting Divorce

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Criticism of Mental Health Bill 2013

1. Even persons with minor mental ailments are to be deemed as having "mental illness," as per the proposed Law.

2. Over-inclusive definition for mental illness. This will hurt a huge number of victims of even minor mental illnesses and their families, because of the wide prevalence of stigma.

3. This bill is very ambitious, but practically it is very difficult to implement at the ground level

4. There is no mention about the huge resource-mobilization that is required to realize various promises that the Bill is holding out.

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5. The Chapter v in proposed Law expects people to "announce" that they are mentally ill and avail benefits.

6. Even the NR may not have ideas concerning the treatment procedures. So, the treatment process should be on the basic of reciprocal understanding of NR and the treating doctors.

7. ECT is a cost and very effective treatment. Modified ECT will increases the cost of treatment and will makes it inaccessible poor.

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8. Unmodified ECT is the safest and the most affordable treatment for conditions like schizophrenia, manic depression and psychotic patients The shock is given at very low voltage and for short duration.

9. chapter xv of the Bill, there is not even one section is there, to punish government functionaries who fail to deliver various "promises" offered to mentally ill, through this Bill.

10. Those people who have no family members or any caretaker and he/she is not eligible to take his/her own decision; who will take them to the hospital?

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CONCLUSION

1. The MHCB, 2013 comes out to be a praiseworthy effort for addressing the long standing problems encountered by patients and practitioners in the sector of mental health care.

2. The bill can bring a radical change in the field of mental health care and service in our country.

3. Even though some sections of this bill are being criticized but still this bill seems more humane and appropriate in the current situation.

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References

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Government of India – The Mental Health Act- 1987. published by Delhi Law House. 2002

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Mental Health ACT 1987. Available from: http://www.disabilityindia.org/mentalact.cfm, accessed on January 11, 2010.

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Thank you