The Mental Healthcare Act 2017 replaces the Lunacy Act of 1912 and aims to make mental healthcare more humane and rights-based. Some key points: - It recognizes mental illness as a medical condition like any physical illness and aims to reduce stigma. - It simplifies admission and discharge procedures from mental hospitals and protects the rights of the mentally ill. - It establishes central and state authorities to regulate mental health services and monitor psychiatric hospitals and nursing homes. - It provides legal aid for the mentally ill and safeguards their right to confidentiality and informed consent regarding treatment.

1. PRESENTED BY:-
ARCHANA TRIPATHY
MSC.TUTOR

2. HISTORY-:
 Drafted by the parliament on 22nd May
1987 but came into effect in all the
states and union territories in April
1993
 Replaces the Indian Lunacy act of
1912

3.  The attitude of the society towards the
mentally ill has changed considerably and it is
now realized that no stigma should be
attached to such illness as it is curable
practically if diagnosed as an early stage and
thus should be treated as other any sick
persons and the environment around them
made as normal as possible.
 The Lunacy act 1912 has become outmoded
with the rapid advancement of medical
science and the understanding of the nature
of Malady.

4.  To regulate admission into Psychiatric
hospitals and Psychiatric nursing homes.
 To protect society from the presence of
mentally ill persons
 To protect citizens from being detained in
Psychiatric hospitals/Nursing homes
without sufficient cause .
 To regulate maintenance charges of
Psychiatric hospitals/Nursing homes

5.  To facilitate guardianship of mentally ill persons
who are incapable of carryout their own affairs.
 To establish central and state authorities for
mental health services.
 To regulate the powers of government for
establishing, licensing and controlling Psychiatric
hospitals/Nursing homes
 To provide legal aid to mentally ill persons with
state’s expense in some cases.

6.  Divided in to 10 Chapters with 98 sections
CHAPTER I-:
 Contains some preliminary information
Psychiatric hospitals/Nursing homes : A
govt/private hospital/Nursing home for the
care of mentally ill persons.
Mental ill person: A person who needs
treatment for mental disorder other than
mental retardation.

7. Psychiatrist: A medical practitioner who holds a
postgraduate degree or diploma in Psychiatry
recognized by Medical council of India.
Reception order: An Order made under this act for
the admission and detention of a mentally ill
person in a Psychiatric hospital/Nursing home
Old terms - New Terms:
 Lunatic - Mentally ill Person
 Lunatic Asylum – Psychiatric Hospital
 Criminal Lunatic – Mentally ill Prisoner

8. Chapter II
 It deals with establishment of central and
state authorities for regulation and co-
ordination of mental health services.
Chapter III
 It provides guidelines for establishment and
maintenance of Psychiatric hospitals/Nursing
homes

9. Chapter IV
 It deals with the procedure for admission and
detention in Psychiatric hospitals/Nursing
homes.
Admission on voluntary basis:
 Any person who considers himself as mentally ill
and wishes to be admitted to a Psychiatric
hospital may apply to the medical officer in
charge . If he is a minor , his guardian can make
this application on his behalf.
Admission under Special circumstances:
 A relative or a friend can make an application on
behalf of the mentally ill patient if he/she is
unwilling for admission on voluntary basis.

10.  Admission under authority or order
1. Admission under Reception order
2. Reception order on production of a mentally ill person
before magistrate
3. Reception order after inquest
4. Admission and detention of a mentally ill prisoner

11. 1. Admission under Reception order :
 on application: Only a relative not other than
husband, wife, guardian or a friend can make
an application for the admission of a mentally
ill patient. Such an application should be
made to a magistrate in writing supported by
two medical certificates one of them made by
a gazetted medical officer.
 However no person being a minor or one who
has not seen the mentally ill patient in the
last 14 days can make such an application.
The patient may now be admitted after the
magistrate in-charge of the mental hospital .

12.  The medical officer in charge can extend
patient’s treatment to more than 6 months by
making such an application to the magistrate.
2. On production before the magistrate:
Mentally ill patients exhibiting violent
behaviour , creating obscene scenes and
dangerous to the society can be detained by
the police officer and produced in court
within 24hrs of such detention supported by
two medical certificates, subsequent to which
the magistrate issues a reception order.

13. 3. Reception order after inquest
4. Admission and detention of a mentally ill
prisoner

14. Chapter V
 It deals with inspection, Discharge, Leave of
absence and removal of mentally ill persons.
Discharge of a patient admitted on
voluntary basis:
 Medical officer in-charge of the psychiatric
hospital/nursing home on recommendation
from two medical practitioners preferably a
Psychiatrist can issue directions for discharge
of the patient.

15. Discharge of a patient admitted under
special circumstances:
 A relative or a friend may make an application
to the medical officer for care and custody of
the patient. The relatives are required to
furnish a bond with or without sureties, along
with an understanding that the mentally ill
person shall be prevented from causing injury
to self or others.

16. Discharge of a patient admitted on
reception order:
 An applicant who feels that the patient has
recovered from illness may make an
application for discharge to the magistrate. A
certificate from medical officer in charge of
the psychiatric hospital/nursing home should
accompany such an application. If the
magistrate deems fit he may issue an order
for discharge.

17. Discharge of a patient admitted by
police:
 In case where the police detain the mentally
ill individual in hospital he may be discharged
after the family members agree in writing to
take proper care and the medical officer in-
charge opines that he is fit to be discharged.

18. Discharge of a mentally ill prisoner:
 The hospital authorities have to report every 6
months about the person’s state of mind to the
authority which had order detention. As soon as
they find that the person is fit to stand the trial
they have to inform about the same to the
authority concerned. The person is then handed
over to the prison officer for further legal action.
Leave of Absence (Section 45):
 On application by a relative or others to the
medical officer in-charge and a bond duty signed
stating that the patient will be taken proper care
and prevented from injuring self or others, leave
of absence may be granted (for period of
maximum 60days)

19. Chapter VI
 This section deals with judicial inquiry
regarding alleged mentally ill person
possessing property, custody of the person
and management of his property.
Chapter VII
 This section deals with liability to meet cost
of maintenance of mentally ill persons
detained in Psychiatric hospital/nursing
home.

20. Chapter VIII
 This section deals with protection of human
rights of mentally ill persons.
Chapter IX
 This section deals with procedures to be
followed for establishment and maintenance
of Psychiatric hospital/nursing home and
penalties, which can be relatively sever and
explicit contravening them.

21. Chapter-X
 This chapter deals with clarification
pertaining to certain procedures to be
followed by medical officer in-charge of
Psychiatric hospital or nursing home.

22. :
 Incorporates the latest scientific knowledge
and social concepts.
 An attempt is made to make mental illness
look on par with physical illness to reduce
stigma.
 The definition are in a progressive way
 The treatability is the essential criterion
 Indian Mental Health Act is not applicable to
untreatable conditions like mental retardation
and dementia.

23.  Psychiatric patients admitted to general hospitals
or nursing homes are spared
 Formation of mental health authorities provide
opportunities for better monitoring of services.
 Outpatient service is mandatory in Psychiatry
hospitals and nursing homes
 Admission procedures are simplified
 Discharge procedures are made easier
 Provision for separate hospitals for children,
addicts and psychopaths.
 Efforts are made to safeguard the rights of
mentally ill person.

24.  It is derived from English lunacy act 1980.
The act was divided into 4 parts and 8
chapters consisting of 100 sections.
CHAPTER-1
 It contains some preliminary information and
definitions.
CHAPTER-II
 It contains mainly the procedure to be
followed to admit a psychiatric patient into a
mental hospital.

25. CHAPTER –III
 It describes the procedure to be followed for
administering care , treatment and discharge
.
CHAPTER-IV
 It deals with proceeding of lunacy in
presidency town.
CHAPTER-V
 It deals with proceedings in lunacy outside
presidency towns .

26. CHAPTER-VI
 It deals with establishment of asylum.
CHAPTER-VII
 It deals with expenses of lunatics.
CHAPTER-VIII
 It deals with rules to be imposed by the state
government regarding care of lunatics.

27.  In India the opium Act of 1857was revised first in 1878. In
1950, the opium Act of 1878 was revised as the Opium and
Revenue Laws Act 1950. On 16thSeptember 1985, the above
mentioned Acts were repealed and NDPSAAct 61of 1985 was
enforced.
Contents
 The act includes Narcotic drugs (opium, poppy, straw,
cannabis, cocaine, coca and all related synthesized drugs) and
psychotropic substances (76 drugs and their derivatives e.g.
major tranquilizers, minor tranquilizers, pentazocine,
barbiturates etc.).
 In this act if a person produces, possesses, transports, imports,
sells, purchases or uses any narcotic drugs or psychotropic
substances (except 'Ganja') he shall be punishable with

28. rigorous imprisonment for not less than 10years, which
may be extended up to 20 years and a fine of not less
than 1 lakh rupees, which may extend to two lakh rupees.
 For repeat offence a rigorous imprisonment of not less
than 15 years which may be extended upto 30 years and
a fine of not less than 1.5 lakh rupees, which may be
extended up to 3 lakh rupees. For handling 'Ganja', a
rigorous imprisonment which may extend to 10years
and a fine upto 1 lakh rupees.

29.  On carrying' small quantities' e.g. Heroin 250 mg,
Opium - 5 gm, Cocaine – 125 mg, Charas - 5 gm, as
were later specified in this act, the punishment may
extend to 1 year or a fine or both. For Ganja, (below
500gms),imprisonment is up to 6months.
 Under a specified court order, there is a provision for
detoxification of the patient.

30.  Under a later enactment, the prevention of illicit traffic
in Narcotic Drugs and Psychotropic Substances Act
(NDPSA) 1988(Act 46) has been passed. Now there is
a provision for preventive detention, seizure of
property, death penalty if a person is bound to be
trafficking more than or equal to 1 kg of pure heroin
warning on the first attempt.

31. Role of the Nurse in Admission
Procedure
 A most important feature of the admission procedure
involves settling the patient in the ward.
 It begins with introducing him to the other staff members and
patients. Before assigning him a bed consider his biological
and emotional needs.
 If he seems to be nurturing suicidal ideation or is completely
psychotic, he should be located in a place where he can be
closely observed.
 He should be shown various facilities like eating, recreation,
bathroom facilities, etc.

32.  Acquaint him with some of the ward rules, e.g. meal time, ward
activities, visiting hours, how to make appointments to see staff
members, timings of any group meetings, etc. The patient and
his relatives are likely to have all sorts of anxieties about
various procedures and investigations.
 The nurse needs to be sensitive to these feelings, and give
enough time and attention and allow them to express their
feelings about the patient's condition, treatment and outcome.
 All information should be provided as appropriate.
 Write nurse note, enter in admission register.

33.  Relatives are clearly instructed about the purpose for
which the patient is being sent home and when he
should be brought back.
 Instruct the relatives as to how they should converse or
behave with the mentally ill person according to the
instructions given by the doctor.
 If the patient is receiving any medications, insist on
regularity and give necessary instructions to the family
members about dosage, side-effects, etc.

34. Nurses responsibility during Discharge :
Nurse must ensure that the patient leaves the unit
with all belongings and personal effects, has the
appropriate medications with him, and
appointment for follow up.
All necessary instructions, especially regarding
his medication regimen, side-effects, etc. must be
clearly given to the patient and his family
members.
Any paper work, signing of documents should be
completed. The hospital file along with all charts
and notes should be sent to the medical records
section.

35. The nurse should ascertain his travel plan
and offer assistance if necessary.
The nurse must bear in mind that the
patient may have mixed feelings about
leaving the hospital and going back to his
home environment.

36. LEGAL RESPONSIBILITYOF
A NURSE
NURSE MUST BE AWARE OF:
Both the law in the state in which they
practice.
Patient’s rights.
Criminal and civil responsibilities of
mentally ill patients.
Legal documentation

37. LEGAL REPONSIBILITIES
Malpractice involves the failure of
professionals to provide proper and
Nursing malpractice:
competent care that is given by the
members of their profession, resulting in
harm to the patient.

38. Confidentiality:
Confidentiality refers to the non-
disclosure of private information related
to one individual to another, such as from
patient to nurse.

39. Informed consent:
The informed consent is a process of
communication between patient and a
nurse that results in a patient’s
authorization or agreement to a specific
medical intervention.

40. Substitute Consent:
It refers to the situation where a patient is not
capable of giving their own consent to the
proposed treatment. In such cases authorization
is given by another individual, being a
guardian appointed by the court or the kith and
kin on behalf of the patient.
Before getting the consent of the patient or his
legal guardian, a full explanation is necessary
in thein regard to the risks involved
investigation, treatment and procedures
administered to the patient.

41. Record Keeping:
Nursing notes and progress records
constitute legal documents and hence
should be maintained carefully.
They should be non-judgmental and the
statements made should be objective in
nature.