The document summarizes the history and provisions of the Indian Mental Health Act of 1987. It discusses: - The act replaced previous laws from 1858 and 1912 and consolidated treatment of the mentally ill. - It established new terminology to replace outdated terms like "lunatic" and regulated admission, discharge, and rights of the mentally ill in psychiatric facilities. - The act is divided into chapters addressing establishment of authorities, procedures for voluntary and involuntary admission, temporary treatment orders, discharge processes, and leave of absence for patients. It aims to protect rights of the mentally ill and safety of society.

1. Mr. Basavaraj S Hukkeri
Msc Nursing, Msc Psychology
Belagavi, Karnataka
INDIAN MENTAL HEALTH ACT

2. • Mental health care acts in India was covered in two
phases- pre-independence and post independence.
• Pre-independence-
1858- Indian Lunatic asylum act of 1858
• 1912- Indian Lunacy act of 1912
• Post Independence
1947- Indian Psychiatric Society established
1987-Indian Mental health Act of 1987
• Mental health care bill (Proposed)

3. HISTORY
• Mental health act was drafted by parliament
in 1987 but it came into effect in all the states
and union territories of India in April 1993.
• This act replaces the Indian Lunacy act of
1912, which had earlier replaced the Indian
Lunatic Asylum act of 1858.

4. MHA- 1987
PURPOSE
 Consolidate and amend law relating to
treatment and care of mentally ill persons.
 For better provision with respect to property
and affairs of mentally ill persons.

5. TERMINOLOGIES USED IN ACT
• Change of offensive terminologies used in Indian
Lunacy act of 1912
OUTDATED TERMS NEW TERMS
Nursing Home/Asylum Psychiatric Hospital
Lunatic Mentally ill person
Criminal Lunatic Mentally ill prisoner

6. i. To regulate admission to psychiatric hospitals or
psychiatric nursing homes of mentally ill-persons
who do not have sufficient understanding to seek
treatment on a voluntary basis, and to protect the
rights of such persons while being detained;
ii. To protect society from the presence of mentally
ill persons who have become or might become a
danger or nuisance to others;
iii. To protect citizens from being detained in
psychiatric hospitals or psychiatric nursing homes
without sufficient cause;
OBJECTIVES

7. iv. To regulate the maintenance charges psychiatric
hospitals or psychiatric nursing homes;
v. To provide facilities for establishing guardianship
or custody of mentally ill persons who are
incapable of managing their own affairs.
vi. To establish central and state authorities for
mental health services.

8. vii. To regulate the power of the government for
establishing, licensing and controlling
psychiatric hospitals and nursing homes .
viii. To provide for legal aid to mentally ill
persons at State expense in certain cases.

9. SALIENT FEATURES OF THE ACT
• The act is divided into 10 chapters and
consisting of 98 sections

10. Chapter 1
• It Contains some preliminary information Some
definitions included in this are:
• Psychiatric Hospital-
Hospital / Nursing home established and maintained
by govt or any other person for the care of mentally
ill persons.
• Mentally ill person
person suffering from mental disorder, other than
Mental Retardation

11.  Psychiatrist
A Medical practitioner possessing a postgraduate
degree or diploma in psychiatry recognised by MCI.
 Reception Order
A Provision made under this act for admission
and detention of a mentally ill person in a psychiatric
hospital.

12. Chapter 2
• It deals with the establishment of central and state
authorities for regulation and co-ordination of mental
health services
• Suggested changes:
– Licensing authorities do not have a doctor who
may be in a better position to assess the facilities
and services of these centers. There should be
budgetary provisions in the law.

13. Chapter 3
• It Provides the guidelines for Establishment and
maintenance of psychiatric hospitals/ Nursing home
• Suggested changes:
• No mention is made of incorporating General
hospitals and centers in this act rather they are
prohibited. Such hospitals if taken along may provide
a better health care.
• Licensing process should be made simpler.
• Provision should be there for checking the working of
licensing authorities and powers vested in them to be
limited.

14. Chapter 4
• It deals with the procedures of admission and
detention of mentally ill in psychiatric
hospitals/Nursing homes.
ADMISION ON VOLUNTARY BASIS
• Any persons (not being a minor), who considers
himself to be a mentally ill person and desires to be
admitted to any psychiatric nursing home for
treatment, may request the medical officer in charge
for being admitted as a voluntary patient.

15. • If he is a minor , the guardian can make this
application on his behalf.
• The medical officer should make enquiry within 24
hours and admit the patient if he opines that treatment
is required.
• The voluntary patient thus admitted is now bond to
abide by the rules made by the institution.

16. For Minors??
Who is my
Nominated
Representative

17. Admission of Minors
2 Psychiatrists 1 Psychiatrist & 1 mental
health professional
1 Psychiatrist & 1 medical
practitioner
Minor

18. ADMISION UNDER SPECIAL CIRCUMSTANCES
• Any mentally ill person who is unwilling for
admission on a voluntary basis may be admitted and
kept as inpatient in psychiatric hospital/nursing home.
• For such purpose an application should be made out
on his/ her be half by a relative or a friend of the
mentally ill person, provided the medical officer
deems fit.

19. ADMISION UNDER RECEPTION ORDER
On Application
• Only a relative not other than husband, wife/ guardian
or a friend can make out an application for the
admission of mentally ill patient.
• Such an application should be made out to the
magistrate in writing supported by two medical
officer , one of them issued by the gazetted medial
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

20. • The patient may now be admitted after the magistrate
obtain consent from the medical officer in- charge of
the mental hospital.
• The medical officer in-charge can extend inpatient
treatment to more than 6 months by making such an
application to the magistrate.

21. Petition
Examination
Determination
Medical
Administrator
Release Hospitalization
Emergency to control on
immediate threat to self
or others
Short term for
diagnosis and short
term therapy
Long term for treatment and
determined ready for
discharge

22. On Production before Magistrate
• Mentally ill parents exhibiting violent behaviour, or
creating obscene scenes and dangerous to the society
can be detained by the police officer and produced in
the court within 24 hours of such detention supported
by two medical certificates, subsequent to which the
magistrate issue a reception order .

23. ADMISION IN EMERGENCES
• The medical officer in-charge may order the
admission of mentally ill patient if he thinks he is
dangerous to himself or others.
• However the patient should be produced before the
magistrate within 24 hours ( Maximum time limit is
72 hours, which is exclusively of the examination
period), he magistrate himself may visit the
psychiatric hospital / nursing home and pass the
reception order on examination.

24. TEMPORARY TREATMENT ORDER
• It is an order issued by magistrate in cases where the
risk is perceived to the patient’s life or that of others.
• If the medical officer in-charge feels it necessary to
bring legal authorities into the picture he can do so
by applying to the magistrate.
• Alternatively the relatives can get the magistrate to
issue an order for treatment.
• In such case a single medical certificate is required
which is valid for 6 month.

25. ADMISSION OF MENTALLY ILL PRISONERS
• A mentally ill prisoner may be admitted into a mental
hospital on the order of presiding officer or court. .

26. MISCELLANEOUS ADMISSION
• A mentally ill patient can be admitted on humanitarian
grounds (For Ex Wanderers) or for observation
purpose.
• Social workers can obtain an order from the magistrate
pending report from medical officer

27. Chapter 4
• It deals mainly with the procedure to be fol
lowed for the discharge of mentally ill per sons
from a mental hospital under different
circumstances

28. Discharge Procedures
Voluntary Discharge
Under Sec. 18
Discharge under
special admission
under sec. 19
Discharge in respect
of admission due to
an order of authority
in all five types

29. Discharge of a Patient Admitted on Voluntary
Basis
Medical officer in-charge of psychiatric
hospital/nursing home on recommendation from
two medical practitioners preferably a
psychiatrist, can issue directions for discharge of
the patient.

30. 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 undertaking that the mentally ill person
shall be prevented from causing injury to self or
others.

31. 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
should accompany such as an application from
medical officer in-charge of the psychiatric
hospital/nursing home. If the magistrate deems
fit, he may issue an order for discharge.

32. • Discharge of a Patient Admitted by Police
In cases 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.

33. • Discharge of a Mentally III Prisoner
The hospital authorities have to report
every 6 months about the person's state of mind
to the authority, which had ordered 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.

34. • Leave of Absence (Section 45)
Leave of absence means, when mentally ill
patients are detained in a hospital, they may be
given time limited leave, to leave the hospital
with permission to visit family members. On
application by a relative or others to the medical
officer-in-charge and a bond duly signed stating
that the patient I will be taken proper care of and
prevented from injuring self or others, leave of
absence may be granted (for a period of
maximum 60 days).

35. • It is a step towards community treatment,
enables the patient to retain or obtain skills
which will be necessary once the patient is
discharged. It is in consonance with the
modern trend that the mental illness is curable
and does not need a hospitalization for a long
period.

36. CHAPTER VII
• It deals with judicial enquiry regarding
mentally ill persons possessing property, their
custody and management of property. Under
section 54(1) a guardian may be appointed by
court of law on behalf an alleged mentally ill 1
person incapable of looking after self and
property.

37. • Under section 97 of the Act when a mentally
ill person is not represented by a legal
practitioner in any proceedings before a
District Court or Magistrate and such a patient
does not have sufficient means to engage a
legal practitioner then the District Court or
Magistrate shall assign a legal practitioner to
represent him at the expenses of the state.

38. CHAPTER VIIII
It is the latest addition to the Act that contains a
very novel and explicit provision for protection
of human rights of mentally ill persons. Section
81 provides that:
1. No mentally ill person shall be subjected
during treatment to any indignity (physical or
mental) or cruelty.

39. 2. No mentally ill person under treatment shall
be used for the purpose of research unless:
Such research is of direct benefit to him
A consent has been obtained in writing from
the person (in voluntary admission) or from
the guardian/relative (if admission was
involuntary).
3. No letter or communication sent by or to a
mentally ill person shall be intercepted, detained
or destroyed.

40. CHAPTER IX
It deals with procedures to be followed for
the establishment and maintenance of psychiatric
hospitals/nursing homes, and the penalties,
which can be relatively severe and explicit, for
contravening them. The Article 6(1) of the
Mental Health Act prohibits the running of a
home without license and Article 11 (1b) says
the licensing authority can revoke the license if
the maintenance of the home is being carried out
in a manner detrimental to the moral, mental or
physical well being of the inpatients.

41. CHAPTER X
• It deals with clarification pertaining to certain
procedures to be followed by the medical
officer-in-charge of the psychiatric hospital/
nursing home.

42. Summary- MHA 87
• An Act to regulate and set standard for
restrictive psychiatric treatment facilities
• To establish procedure for Guardianship for
mentally ill who need it
• To protect Human Rights of mentally ill
• To set up authorities for development ,
regulation and coordination of mental health
services

43. Criticisms of the MHA-1987
• The change in terminologies –will it be
practically helpful in removing social stigma ?
• Establishing new hospitals in a developing
country – a costly affair.
• No mention of incorporating General Hospitals
and centers in the act.
• Stress laid on hospital admission and
treatment.

44. • Simpler discharge provisions, but no
provisions for after discharge rehab
• If a relative comes forward to discharge of pt,
how long will that person be detained in the
hospital,and expenses after discharge.
• Research on Pts, by consent of guardian.-
Human rights?

45. • Unnecessary detention of a person- No Provision
for punishing relatives and officers who request
for the same.
• Society- Provisions to educate the society
regarding the misconceptions regarding mentally
ill persons.
• Provisions to start Community Mental health
centres