On this page you will read detailed information about Mental Healthcare Act of 2017.
As a citizen interested in mental healthcare laws and policies, being informed on the Mental Healthcare Act of 2017 allows you to understand your rights and responsibilities. This legislation overhauled India’s previous mental health laws to align with a human rights-based approach. The 100-word overview provided in this article will enable you to grasp the key components of the act, including the expanded rights and protections now guaranteed for persons with mental illness. You will also learn about the act’s provisions related to access to mental healthcare, equality and nondiscrimination, and safeguards against cruel, inhuman or degrading treatment. Though not comprehensive, the high-level summary offers valuable insights into this historic legislation and how it may benefit you or your loved ones.
History and Background of Mental Healthcare Act 2017
The Mental Healthcare Act of 2017 (MHCA) was passed by the Indian Parliament to replace the Mental Health Act of 1987. The new act aimed to align India’s mental healthcare legislation with the United Nations Convention on the Rights of Persons with Disabilities.
Shift to a rights-based approach
The MHCA transitioned India’s mental healthcare system to a rights-based approach. It recognized that people with mental illnesses are entitled to the same rights as all citizens. The act prohibited unjustified detention and cruel, inhuman or degrading treatment of people suffering from mental disorders. It also guaranteed free legal aid to individuals with mental illnesses to enforce these rights.
Decriminalization of suicide
The MHCA decriminalized suicide, stating that a person who attempts suicide shall be presumed to be under severe stress and shall not be punished. It mandated that the government shall provide care, treatment and rehabilitation to such individuals to prevent future attempts.
Advance Directives
The MHCA allowed individuals with mental illness to draft ‘Advance Directives’ regarding the manner in which they wish to be cared for and treated for their mental illness. These directives would come into effect if the individual subsequently lost the capacity to make mental healthcare decisions. The act also allowed individuals to nominate representatives to make decisions on their behalf.
Changes to admission and discharge processes
The MHCA established additional safeguards for the admission and discharge of individuals in mental health institutions. Admission to such institutions now requires independent evaluations by psychiatrists and a magistrate’s review. Discharge of individuals can only be done with the approval of a review board. These changes aimed to prevent unjustified detention and protect the rights of people with mental illness.
The Mental Healthcare Act of 2017 was a landmark legislation that aligned India’s mental healthcare system with a rights-based approach. It expanded the rights and protections of people with mental illness and decriminalized suicide. The act also established safeguards regarding admission to and discharge from mental healthcare institutions. Overall, the MHCA was a progressive step forward in protecting the rights and welfare of individuals with mental disorders in India.
Key Provisions of the Mental Healthcare Act 2017
Rights of Persons with Mental Illness
A major highlight of the Act is that it gives more rights to people with mental illness. It decriminalizes suicide and prohibits the use of electroconvulsive therapy without anesthesia. It also prohibits the chaining of mentally ill patients. The Act mandates that insurance companies provide medical insurance for mentally ill patients on the same basis as for physical illnesses.
Advance Directives
The Act allows competent persons to execute advance directives regarding their mental healthcare needs. This means a person can outline their preferences for care and nominate representatives to make decisions on their behalf if they become unwell. The advance directive has to be certified by a medical practitioner. If a person’s advance directive is not followed, there are provisions to file a complaint with the Mental Health Review Board.
Mental Health Establishments
The Act brings some much-needed regulations for mental health establishments. It mandates the registration of all mental health establishments. The appropriate government will maintain a register of all mental health establishments, and no establishment can operate without registration. The Act also sets minimum standards for living conditions and treatment in mental health establishments. It gives the government the power to take action against non-compliant establishments.
Mental Health Review Boards
The Act provides for the establishment of Mental Health Review Boards in each district. These quasi-judicial bodies will review the cases of persons with mental illness and ensure their rights are protected. The Boards have the power to review admissions and discharge from hospitals, approve advance directives, appoint nominated representatives, and look into complaints regarding non-adherence to advance directives or inadequate facilities in mental health establishments.
Decriminalization of Suicide
The Act decriminalizes suicide, stating that any person who attempts suicide shall be presumed to be suffering from mental illness at that time. This is a welcome change from the previous act, where attempting suicide was punishable by up to one year in prison and/or a fine. The new act takes a more humane and rehabilitative approach to those with suicidal tendencies.
The Mental Healthcare Act of 2017 is a progressive legislation that aligns India’s mental health laws with international standards. By upholding the rights and dignity of people with mental illness, it aims to improve mental health services and access to care across the country.
Decriminalizing Suicide and Mental Illness
Mental healthcare reform has long been needed in many countries. The Mental Healthcare Act of 2017 aimed to decriminalize suicide and mental illness, reducing the stigma around such conditions.
Removing Criminality of Suicide
Prior to the Act, attempting suicide was considered a criminal offense in some countries, punishable by law. The Act decriminalized suicide, recognizing it as a public health issue rather than a criminal one. This allows for suicide prevention and mental health intervention rather than legal punishment.
Decriminalizing Mental Illness
Certain mental illnesses were also criminalized or led to unlawful confinement before the Act. It established that people with mental illness cannot be treated as criminals solely due to their condition. They cannot be confined against their will in prisons or psychiatric hospitals for an indefinite period. This aims to protect the rights and liberty of those with mental illness.
In the previous post, we had shared information about An Overview of the Rights of Persons With Disabilities Act, 2016, so read that post also.
Improving Access to Mental Healthcare
The Act also aimed to improve access to mental healthcare, especially in rural and underserved areas. It called for government investment in mental health services and professionals across all regions. Greater access to mental healthcare, especially for marginalized groups, helps address this long-neglected area of public health. With increased awareness and decreased stigma, more people may seek mental health support when needed.
Protecting Patient Rights
Finally, the Act established certain rights for those accessing mental healthcare. Patients have the right to confidentiality, humane and respectful treatment, and consent to treatment. Restrictive practices like physical restraints or seclusion are limited to situations where the patient poses a risk of harm. Overall, the Act codifies the rights and protections of patients to uphold their dignity even when in crisis.
In summary, the Mental Healthcare Act of 2017 was groundbreaking legislation aiming to decriminalize mental illness, increase access to mental healthcare, and protect patient rights. By reducing stigma and criminal punishment, the Act brought mental health issues into the sphere of public health and established baseline standards for ethical care and treatment.
Advancing Patient Rights and Consent
Informed Consent
The Act strengthens the patient’s right to informed consent. Healthcare providers must disclose appropriate information about diagnoses, treatments, and prognoses to enable patients or their representatives to make well-considered decisions about care. Patients have the right to review their medical records and ask questions about their condition and treatment options.
Advance Directives
The Act reaffirms the patient’s right to make advance directives for medical care in the event they become incapacitated. Advance directives, such as living wills and durable powers of attorney for healthcare, allow patients to specify in writing their wishes regarding the use or refusal of certain medical procedures and treatments. Healthcare providers and healthcare organizations are required to provide patients with information about advance directives and facilitate their completion and implementation.
Privacy and Confidentiality
The Mental Healthcare Act reinforces protections of patient privacy and confidentiality. Healthcare providers may not disclose patients’ personal or medical information without their consent. Exceptions are made only when patients pose an imminent threat of harm to themselves or others or when legally obligated to report suspected abuse or neglect. Patients have the right to review their medical records and request corrections or amendments to ensure accuracy.
Complaints and Grievances
The Act establishes additional safeguards allowing patients to file complaints regarding the quality of care and services received. Healthcare organizations must implement complaint resolution processes to address patient grievances promptly and fairly. Patients have the right to file complaints without fear of discrimination or retaliation. Healthcare organizations found to have violated patients’ rights or provided substandard care may face penalties and corrective actions.
The rights and protections established in the Mental Healthcare Act of 2017 aim to empower patients and promote patient-centered care in mental health treatment. By upholding principles of informed consent, privacy, advocacy, and quality assurance, the Act helps to ensure patients receive appropriate, ethical, and compassionate care for their conditions. Overall, the legislation marks an important step forward in affirming the dignity and humanity of those seeking mental health services.
Regulating Mental Health Establishments
The Act establishes provisions for the regulation of mental health establishments by the Central and State Mental Health Authorities.
Registration and Licensing
All mental health establishments are required to register with the Central Mental Health Authority. The State Mental Health Authority will grant licenses to establishments that meet the prescribed standards. Licenses must be renewed every five years. Unlicensed establishments will face penalties including imprisonment and fines.
Inspections and Reviews
The State Mental Health Authority will conduct periodic inspections and reviews to ensure compliance with prescribed standards. Reviews will evaluate facilities, staff qualifications, quality of treatment and care, living conditions, and respect for the rights of persons with mental illness. Deficiencies must be rectified within six months, or the establishment risks losing its license.
Admission and Discharge
The Act establishes admission, treatment and discharge procedures that protect the rights of persons with mental illness. Voluntary admissions require the individual’s consent. Involuntary admissions may only occur in emergency situations with a magistrate’s order.
All admissions require evaluations by two psychiatrists. Treatment plans must aim for discharge at the earliest possibility. Discharges require the approval of at least one psychiatrist and advance notice to the individual and family. The Act prohibits prolonged confinement without cause.
Responsibilities of Mental Health Establishments
Establishments must provide treatment, care and rehabilitation services suited to the needs of each resident. They must maintain records, ensure living conditions meet prescribed standards, and protect the rights and dignity of all persons with mental illness.
Policies and programs should aim to reintegrate residents into community life. Establishments must facilitate contact with family and friends and may not restrict communications without cause.
The Mental Healthcare Act of 2017 provides comprehensive regulation and oversight of mental health establishments to ensure high standards of care, ethical treatment and rehabilitation of persons with mental illness. By upholding the rights and dignity of India’s most vulnerable populations, it represents a progressive step towards mental health reform.
Expanding Access to Mental Healthcare
The Mental Healthcare Act of 2017 aimed to increase access to mental health services for Americans. It expanded coverage for mental health conditions and substance use disorders, allowing more people to get the treatment they need.
Coverage for Pre-Existing Conditions
The Act prohibited health insurance companies from denying coverage or charging higher premiums due to pre-existing mental health conditions. This allowed those with a history of mental illness to purchase affordable health insurance despite their condition.
Expansion of Covered Services
The legislation compelled insurance companies to cover mental health and substance use disorder services, including inpatient and outpatient treatment. It required coverage of rehabilitation services, crisis intervention, prescription drugs, and counseling.
Parity in Coverage
The Act enforced mental health parity, requiring insurance companies to cover mental health care at the same level as physical health care. It prohibited companies from limiting number of covered therapy visits or hospital stay days for mental health compared to other medical conditions.
Access to Care
To address shortages in mental healthcare providers, the Act provided grants to recruit and train mental health professionals. It also increased Medicare reimbursement rates for mental health services to incentivize more providers to accept Medicare patients.
Integration of Care
The legislation promoted integration of mental health, substance use, and primary care services. It provided funding for collaborative care models where behavioral health specialists work together with primary care physicians. This integration aims to improve care coordination and access to behavioral health services.
The Mental Healthcare Act of 2017 took significant steps toward expanding Americans’ access to affordable, comprehensive mental health coverage and care. By enforcing parity, expanding coverage, and promoting integration, it worked to overcome barriers that previously made mental healthcare inaccessible for many. While more progress is still needed, the Act was a milestone in establishing mental health as an essential component of overall health and well-being.
Role of State Mental Health Authorities
As designated by the Mental Healthcare Act of 2017, each state’s mental health authority plays an essential role in administering mental healthcare services and ensuring compliance with the Act. These agencies are responsible for planning, developing, and coordinating mental health services within their state. They also supervise community mental health centers and other agencies providing mental health services.
The state mental health authorities evaluate need and availability of services, set priorities for allocation of resources to address unmet needs, and develop plans for establishment of new services where required. They are also tasked with promoting integration of mental health services into the general healthcare system. These responsibilities aim to guarantee access to high-quality mental healthcare for all citizens regardless of their location or economic status.
To fulfill their obligations under the Act, state mental health authorities receive block grants from the federal government which they then allocate to local mental health agencies and treatment facilities. They are required to report on how these funds were utilized and evaluate the impact and effectiveness of funded programs. The authorities also review compliance of service providers with the Act’s mandates around treatment standards, patients’ rights, and other regulations. Non-compliant agencies may face loss of funding or other penalties.
Mental health authorities work with various stakeholders within their state including government agencies, healthcare institutions, community organizations, law enforcement, and patient advocacy groups. By fostering cooperation between these entities, the authorities can gain valuable input on mental health priorities and strategies tailored to their state’s unique needs. They also promote public awareness around mental health issues and work to reduce stigma through education and outreach.
Through diligent oversight and a collaborative approach, state mental health authorities strive to create integrated systems of care where mental health is valued equally with physical health. Their important work helps turn the goals of the Mental Healthcare Act into reality, improving lives across the nation. Overall, these agencies are instrumental in safeguarding the rights and well-being of some of the most vulnerable members of society.
Challenges in Implementing the Act
The Mental Healthcare Act of 2017 aims to provide mental healthcare and services for all Indian citizens. However, there are several challenges in fully implementing the provisions of the Act.
A major challenge is the lack of mental healthcare professionals in India. According to WHO, there are only 0.3 psychiatrists and 0.07 psychologists per 100,000 people in India. This severe shortage of specialists makes it difficult to provide treatment and services to all those in need. The Act advocates for training more professionals, but this will take time.
Another issue is lack of infrastructure and facilities. Many districts do not have mental healthcare establishments like psychiatric hospitals, rehabilitation centers or community outreach programs. The Act mandates the government to set up such facilities in all districts and regions to make mental healthcare accessible, but this requires substantial investments and resources.
Stigma around mental illness poses a significant barrier. Many people are hesitant to seek help due to the stigma and discrimination associated with mental health conditions. The Act aims to raise awareness to tackle stigma, but changing public perceptions and attitudes will require continuous education and sensitization.
Lack of health insurance coverage for mental illness deters people from accessing care. Though the Act directs insurance companies to provide medical insurance for mental illness on par with physical illnesses, many companies still do not provide adequate coverage. Making treatment affordable through insurance is key to enabling access.
Finally, lack of funding and financial resources hampers effective implementation. The ambitious provisions and programs proposed in the Act require substantial funds and resources. However, mental health is not always a high priority area, and budgetary allocations may fall short. Sustained funding and investments are essential for the Act to achieve its objectives.
Overall, while the Mental Healthcare Act of 2017 is a progressive legislation, operationalizing all its provisions will take time and require surmounting many challenges. With concerted efforts across public and private sectors, these challenges can be addressed to build an equitable mental healthcare system in India.
FAQs on Mental Healthcare Act 2017
The Mental Healthcare Act of 2017 replaced the Mental Health Act of 1987 in India. It aims to provide mental healthcare and services for persons with mental illness and to protect their rights. If you have questions about this Act, here are some common FAQs and answers:
The Act safeguards the rights and liberties of persons with mental illness. Some of the key rights include:
I) Right to access mental health care and treatment from mental health establishments run or funded by the government.
II) Right to equality of treatment and non-discrimination on any basis including gender, sex, sexual orientation, religion, culture, caste or social and political beliefs.
III) Right to live in a least restrictive environment and to live in the community.
IV) Right to confidentiality and right to information about own mental health and treatment.
Admission and discharge of persons with mental illness from mental health establishments is governed under the Act. Some key provisions include:
I) Admission in a mental health establishment can only be done after a Mental Health Review Board examines the person and certifies the need for admission.
II) Discharge from the mental health establishment shall not be delayed if the Board finds that the person no longer requires admission.
III) The Board shall review cases of admitted persons periodically and may order discharge if admission is no longer needed.
IV) Any person with mental illness admitted in a mental health establishment shall have the right to apply for discharge to the Board.
Police officers have certain duties towards persons with mental illness under the Act. Some key duties are:
I) To take the person with mental illness to the nearest public health establishment for assessment of the person’s healthcare needs.
II) To inform the person’s nominated representative, if any, about the admission in a mental health establishment.
III) To maintain confidentiality of information obtained during assessment and admission of the person.
IV) To not use any force for the purpose of search, entrance into any place where the person resides or for taking the person to a mental health establishment.
Conclusion
As we have covered, the Mental Healthcare Act of 2017 was a landmark piece of legislation for mental health rights in our country. Through its comprehensive reforms, the Act has expanded access to mental healthcare, reduced stigma, and increased protections for those with mental illness. While work remains to fully implement the Act, it represents an important step on the path towards a more just, compassionate, and effective mental healthcare system. The true promise of the Act will be realized as we continue to build on this foundation in the years to come. With sustained effort, we can create a society where those struggling with mental illness are treated with the dignity, respect, and care that all people deserve.
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