The Mental Health Care Bill sets out provisions for the treatment of people with mental disorders, including how and when they can be involuntarily admitted for treatment. It aims to protect the rights of those with mental illness and ensure safeguards for their rights. The bill proposes to replace the existing Mental Health Act of 1987 and introduces changes such as decriminalizing attempted suicide, defining the rights of those with mental illness, and requiring medical insurance to cover mental health treatment. However, some experts have raised criticisms that certain provisions may introduce barriers to treatment or undermine the role of family members in care.
The Mental Healthcare Act of 2017 aims to improve India's mental healthcare system by recognizing the rights of those suffering from mental illness and increasing access to treatment. Some key points of the act include decriminalizing attempted suicide, ensuring dignity and confidentiality for patients, requiring insurance coverage for mental illness, and empowering individuals to choose their treatment or appoint a representative to make decisions. However, critics argue the act has limitations like insufficient oversight and an inadequate number of mental healthcare professionals to implement its goals effectively.
Psychosocial rehabilitation aims to help individuals with mental illness achieve their optimal level of independent functioning in the community. It involves reducing impairments through treatment, remediating disabilities using skill training and supportive interventions, and helping overcome handicaps through social programs. A multidisciplinary team provides services like assessment, education, group therapy, social skill training, and family support. The nurse's role includes comprehensive assessment of the individual, family, and community, as well as implementing skill training, supportive interventions, and facilitating community integration through halfway homes and other programs.
This document provides an overview of psychosocial rehabilitation. It defines rehabilitation as enabling individuals to return to their highest possible level of functioning. Psychosocial or psychiatric rehabilitation specifically aims to restore community functioning for those with mental health disorders. It discusses the history of deinstitutionalization and increased focus on community support. Key aspects of psychosocial rehabilitation covered include definitions, approaches, rehabilitation teams, steps, principles, facilities like day care centers, halfway homes, sheltered workshops, and the roles of nurses.
Psychiatric rehabilitation aims to enable individuals with mental illnesses to return to their highest level of functioning. It focuses on reducing impairments, training skills, and supporting people to overcome disabilities and handicaps through interventions like medication, skills training, social support, and advocacy. Nurses play an important role in psychiatric rehabilitation by comprehensively assessing individuals, families, and communities; planning and implementing rehabilitation programs; and evaluating outcomes. Barriers to rehabilitation include lack of suitable housing and jobs as well as stigma.
Psychosocial rehabilitation is the process that facilitates opportunities for persons with chronic mental illness to reach their optimal level of independent functioning in society and for improving their quality of life.
In India, the Mental Health Care Act 2017 was passed on 7 April 2017 and came into force from 29 May, 2018. An act to consolidate and amend the law relating to the treatment and care of mentally ill persons, to make better provision with respect to their property and affairs and for maters connected therewith or incidental thereto
The National Mental Healthcare Act-2017 and its implication to current psychiatric care practice in India.
A webinar on the topic at Parul University, Vadodara, Gujrat India
The Mental Healthcare Act of 2017 aims to improve India's mental healthcare system by recognizing the rights of those suffering from mental illness and increasing access to treatment. Some key points of the act include decriminalizing attempted suicide, ensuring dignity and confidentiality for patients, requiring insurance coverage for mental illness, and empowering individuals to choose their treatment or appoint a representative to make decisions. However, critics argue the act has limitations like insufficient oversight and an inadequate number of mental healthcare professionals to implement its goals effectively.
Psychosocial rehabilitation aims to help individuals with mental illness achieve their optimal level of independent functioning in the community. It involves reducing impairments through treatment, remediating disabilities using skill training and supportive interventions, and helping overcome handicaps through social programs. A multidisciplinary team provides services like assessment, education, group therapy, social skill training, and family support. The nurse's role includes comprehensive assessment of the individual, family, and community, as well as implementing skill training, supportive interventions, and facilitating community integration through halfway homes and other programs.
This document provides an overview of psychosocial rehabilitation. It defines rehabilitation as enabling individuals to return to their highest possible level of functioning. Psychosocial or psychiatric rehabilitation specifically aims to restore community functioning for those with mental health disorders. It discusses the history of deinstitutionalization and increased focus on community support. Key aspects of psychosocial rehabilitation covered include definitions, approaches, rehabilitation teams, steps, principles, facilities like day care centers, halfway homes, sheltered workshops, and the roles of nurses.
Psychiatric rehabilitation aims to enable individuals with mental illnesses to return to their highest level of functioning. It focuses on reducing impairments, training skills, and supporting people to overcome disabilities and handicaps through interventions like medication, skills training, social support, and advocacy. Nurses play an important role in psychiatric rehabilitation by comprehensively assessing individuals, families, and communities; planning and implementing rehabilitation programs; and evaluating outcomes. Barriers to rehabilitation include lack of suitable housing and jobs as well as stigma.
Psychosocial rehabilitation is the process that facilitates opportunities for persons with chronic mental illness to reach their optimal level of independent functioning in society and for improving their quality of life.
In India, the Mental Health Care Act 2017 was passed on 7 April 2017 and came into force from 29 May, 2018. An act to consolidate and amend the law relating to the treatment and care of mentally ill persons, to make better provision with respect to their property and affairs and for maters connected therewith or incidental thereto
The National Mental Healthcare Act-2017 and its implication to current psychiatric care practice in India.
A webinar on the topic at Parul University, Vadodara, Gujrat India
Psychiatric Rehabilitation, definition, indication, principles, approaches, steps, advantages, types, rehabilitation team and role of nurse in rehabilitation.
The Mental Healthcare Act 2017 aims to decriminalize suicide, empower persons with mental illness, and fulfill India's obligations under the UN Convention on Rights of Persons with Disabilities. It recognizes the autonomy of people with mental illness and aims to protect their rights. Key aspects include advancing community-based mental healthcare, restricting the use of ECT, outlining the roles of various authorities and oversight boards, and regulating admission, treatment and discharge processes to safeguard patient rights and dignity. The Act replaces the Mental Health Act of 1987 and contains expanded provisions to promote inclusion, non-discrimination, and delivery of equitable mental health services across India.
Epidemiological studies in psychiatry in IndiaSujit Kumar Kar
Epidemiological studies in psychiatry have been conducted in India for over 60 years, starting with Dr. K.C. Dube's 1961 study in Agra. Initial studies found wide variation in prevalence rates of psychiatric disorders from 9.5 to 370 per 1000 population. Landmark international studies provided more standardized approaches. However, Indian studies were inadequate to assess non-psychotic disorders. Substance use epidemiological studies included the National Household Survey and Drug Abuse Monitoring System. The National Mental Health Survey was the largest nationwide survey and found treatment gaps of 73-85% for mental disorders. Ongoing national surveys continue to inform mental healthcare in India.
The document discusses the importance of securing human rights for the mentally ill in the Indian context. It outlines some key challenges like cultural stigma, lethargy from policymakers, and widespread unawareness. Mental health social workers can play important roles as educators to increase awareness, lobbyists to influence policy, and activists to reduce stigma. The media also has a responsibility to educate rather than stigmatize and promote understanding of mental illness. Overall, the document argues for a community-based approach and greater protections under human rights law to help reintegrate the mentally ill into society.
Neuropsychological rehabilitation focused on improving cognitive functions which further results in improving symptoms, functional ability which enhance overall quality of life.
It is a treatment approach to improve the lives of people with disabilities by teaching emotional,social and cognitive skills to work independently in the community.
Supportive psychotherapy, family and marital therapydivya2709
This document provides an overview of supportive therapy. Supportive therapy helps patients relieve emotional distress and symptoms without delving into past issues or personality changes. It is used to treat conditions like schizophrenia, personality disorders, anxiety, PTSD, eating disorders, substance abuse, and psychosis. The therapist establishes a relationship with the patient and uses techniques like ventilation, environmental manipulation, persuasion, and reassurance. Supportive therapy involves assessment, relationship building, working through problems, and preparing the patient to end treatment. Family and marital therapy views individual symptoms as related to family issues and aims to treat the family system. It uses assessment, skills training, and various models like individual, conjoint, couples, group, and network therapy.
This document provides an overview of Acute and Transient Psychotic Disorder (ATPD). It discusses the history and evolution of ATPD from early descriptions in the late 19th century to its inclusion as a diagnostic category in ICD-10 in 1992. The document outlines the ICD-10 diagnostic criteria for ATPD and reviews several landmark studies that helped establish ATPD as a separate diagnostic category from schizophrenia and affective disorders. It also discusses cultural variants of brief psychotic episodes and debates around classifying certain culture-bound syndromes as ATPD.
Brief therapy, sometimes also referred to as short term therapy (usually 10 to 20 sessions) , is a generic label for any form of therapy in which time is an explicit element in treatment planning.
The document provides an overview of community psychiatry, including definitions, services, and developments in various countries. It focuses on the development of community psychiatry in India. Key points include:
- Community psychiatry aims to provide mental healthcare in community settings rather than institutions.
- It originated in the US and Italy in the mid-20th century with deinstitutionalization and a shift toward community-based care.
- In India, community psychiatry developed through initiatives like the National Mental Health Programme in 1982, which integrated mental healthcare into primary care.
- Notable experiments included training general physicians in Ranchi and community programs run by NGOs. The Indian Mental Healthcare Act of 1987 also supported
Family therapy is a family oriented psychotherapy that is aomed at resolving the conflicts and poor communication pattern among the family members. It also aid them in learning coping strategies to deal with distress and deal with the stress related to psychiatric illness of the family member.
This document provides an overview and critical review of India's Mental Health Act of 1987. It discusses the history and objectives of mental health legislation in India. The positives of the 1987 Act include more humane terminology and provisions for patient rights and property management. However, it is still criticized for prioritizing legal over medical considerations and not removing the criminal element for involuntary patients. The 10 chapters of the Act are also analyzed, identifying inadequacies around definitions, oversight, and emphasis on hospitalization over community care. Improvements are suggested regarding admission criteria and independent review of involuntary treatment.
1. Marital therapy aims to help couples address issues in their relationship through counseling.
2. Marriage is a legally recognized union that forms the basis of family and procreation according to Indian society, though views and laws have evolved over time.
3. Factors like compatibility, communication, mutual understanding and respect are important for a healthy marriage, while distressed couples often engage in destructive patterns like coercion and blaming that damage the relationship.
The document provides an overview of psychiatric classification systems. It discusses the definition and advantages of classification, as well as key terms and historical approaches including etiological, descriptive, categorical, and dimensional.
It then describes the development of major classification systems including the DSM and ICD. The DSM is the diagnostic manual published by the American Psychiatric Association while the ICD is published by the World Health Organization. The document outlines the various editions of the DSM from DSM-I to the current DSM-5. It also discusses other classification systems and tools used in psychiatry such as the Chinese Classification of Mental Disorders and the Research Domain Criteria.
The document discusses India's history of mental health acts and the proposed Mental Health Care Bill of 2013. It provides context on the 1858 and 1912 acts and outlines key aspects of the 1987 Mental Health Act. The proposed 2013 bill aims to replace the 1987 act and improve on its shortcomings like outdated definitions and lack of human rights protections. The bill has 16 chapters covering areas like rights of those with mental illness, administrative bodies, and duties of the government. It introduces important definitions of mental illness and informed consent. While praised for promoting rights and access to care, critics argue implementation will be difficult and some provisions could increase stigma or hinder effective treatment.
This document outlines guidelines for assessing disability in psychiatric patients in India. It discusses definitions of impairment, disability, and handicap. It describes how the Indian Disability Evaluation and Assessment Scale (IDEAS) is used to measure disability in mental disorders. Specific sections address assessing intellectual disability, specific learning disability, and general guidelines for the certification process. Disability is assessed based on functioning in areas like self-care, interpersonal activities, communication, and work performance.
This document discusses group psychotherapy and provides information on various aspects of conducting group therapy sessions. It defines group psychotherapy as a treatment involving carefully selected emotionally ill individuals who meet under a trained therapist's guidance to help one another change behaviors. The document outlines three major types of groups - group therapy, therapeutic groups, and adjunctive groups. It provides details on group size, session frequency/length, therapeutic factors involved, steps of group therapy, techniques used, and contraindications for certain patient types.
Psychoeducation involves educating patients and families about mental health conditions to help them better understand and manage the illness. It has roots in movements from the early 20th century and has been shown to improve outcomes. Psychoeducation can be delivered individually, to families, or in groups. It covers topics like the nature of the illness, treatment, and how to prevent relapse. Various models exist including providing information, teaching skills, and being supportive. Psychoeducation has benefits for conditions like schizophrenia, depression, and eating disorders.
Psychoanalysis is a lengthy insight therapy developed by Freud that aims to uncover unconscious conflicts through techniques like free association and dream analysis. It views human behavior as resulting from interactions between the id, ego, and superego. The goal of psychoanalysis is to help patients understand their unconscious motivations by becoming aware of unresolved conflicts driving their behaviors. Techniques include free association, dream analysis, and interpretation by the therapist to provide insight and allow new ways of coping with anxiety and guilt.
This document provides an overview of transcultural psychiatry and cultural factors that are relevant to mental illness. It discusses what culture is, how culture can influence psychopathology in different ways such as pathogenic effects, pathoplastic effects, and pathofacilitative effects. It also examines cultural psychodynamics and how cultural variables like dependency versus autonomy, linguistic competence, and social support systems can impact mental health. The document provides examples of culture-bound syndromes and discusses the importance of considering culture in clinical practice and research in psychiatry.
The document summarizes and critiques key aspects of the Mental Health Care Bill 2013 in India. It discusses several provisions that are seen as problematic, impractical, or likely to hinder mental healthcare services. Concerns include definitions being overly broad and stigmatizing, procedures being too cumbersome, rights priorities hindering treatment, marginalization of psychiatrists and families, lack of consideration for cultural and resource realities, and lack of evidence for some prohibitions like on ECT for minors. In conclusion, it is argued that the bill imported Western ideas without regard to the local context, diluted the role of psychiatrists, created too many legal barriers to care, and made commitments that seem beyond the government's
Psychiatric Rehabilitation, definition, indication, principles, approaches, steps, advantages, types, rehabilitation team and role of nurse in rehabilitation.
The Mental Healthcare Act 2017 aims to decriminalize suicide, empower persons with mental illness, and fulfill India's obligations under the UN Convention on Rights of Persons with Disabilities. It recognizes the autonomy of people with mental illness and aims to protect their rights. Key aspects include advancing community-based mental healthcare, restricting the use of ECT, outlining the roles of various authorities and oversight boards, and regulating admission, treatment and discharge processes to safeguard patient rights and dignity. The Act replaces the Mental Health Act of 1987 and contains expanded provisions to promote inclusion, non-discrimination, and delivery of equitable mental health services across India.
Epidemiological studies in psychiatry in IndiaSujit Kumar Kar
Epidemiological studies in psychiatry have been conducted in India for over 60 years, starting with Dr. K.C. Dube's 1961 study in Agra. Initial studies found wide variation in prevalence rates of psychiatric disorders from 9.5 to 370 per 1000 population. Landmark international studies provided more standardized approaches. However, Indian studies were inadequate to assess non-psychotic disorders. Substance use epidemiological studies included the National Household Survey and Drug Abuse Monitoring System. The National Mental Health Survey was the largest nationwide survey and found treatment gaps of 73-85% for mental disorders. Ongoing national surveys continue to inform mental healthcare in India.
The document discusses the importance of securing human rights for the mentally ill in the Indian context. It outlines some key challenges like cultural stigma, lethargy from policymakers, and widespread unawareness. Mental health social workers can play important roles as educators to increase awareness, lobbyists to influence policy, and activists to reduce stigma. The media also has a responsibility to educate rather than stigmatize and promote understanding of mental illness. Overall, the document argues for a community-based approach and greater protections under human rights law to help reintegrate the mentally ill into society.
Neuropsychological rehabilitation focused on improving cognitive functions which further results in improving symptoms, functional ability which enhance overall quality of life.
It is a treatment approach to improve the lives of people with disabilities by teaching emotional,social and cognitive skills to work independently in the community.
Supportive psychotherapy, family and marital therapydivya2709
This document provides an overview of supportive therapy. Supportive therapy helps patients relieve emotional distress and symptoms without delving into past issues or personality changes. It is used to treat conditions like schizophrenia, personality disorders, anxiety, PTSD, eating disorders, substance abuse, and psychosis. The therapist establishes a relationship with the patient and uses techniques like ventilation, environmental manipulation, persuasion, and reassurance. Supportive therapy involves assessment, relationship building, working through problems, and preparing the patient to end treatment. Family and marital therapy views individual symptoms as related to family issues and aims to treat the family system. It uses assessment, skills training, and various models like individual, conjoint, couples, group, and network therapy.
This document provides an overview of Acute and Transient Psychotic Disorder (ATPD). It discusses the history and evolution of ATPD from early descriptions in the late 19th century to its inclusion as a diagnostic category in ICD-10 in 1992. The document outlines the ICD-10 diagnostic criteria for ATPD and reviews several landmark studies that helped establish ATPD as a separate diagnostic category from schizophrenia and affective disorders. It also discusses cultural variants of brief psychotic episodes and debates around classifying certain culture-bound syndromes as ATPD.
Brief therapy, sometimes also referred to as short term therapy (usually 10 to 20 sessions) , is a generic label for any form of therapy in which time is an explicit element in treatment planning.
The document provides an overview of community psychiatry, including definitions, services, and developments in various countries. It focuses on the development of community psychiatry in India. Key points include:
- Community psychiatry aims to provide mental healthcare in community settings rather than institutions.
- It originated in the US and Italy in the mid-20th century with deinstitutionalization and a shift toward community-based care.
- In India, community psychiatry developed through initiatives like the National Mental Health Programme in 1982, which integrated mental healthcare into primary care.
- Notable experiments included training general physicians in Ranchi and community programs run by NGOs. The Indian Mental Healthcare Act of 1987 also supported
Family therapy is a family oriented psychotherapy that is aomed at resolving the conflicts and poor communication pattern among the family members. It also aid them in learning coping strategies to deal with distress and deal with the stress related to psychiatric illness of the family member.
This document provides an overview and critical review of India's Mental Health Act of 1987. It discusses the history and objectives of mental health legislation in India. The positives of the 1987 Act include more humane terminology and provisions for patient rights and property management. However, it is still criticized for prioritizing legal over medical considerations and not removing the criminal element for involuntary patients. The 10 chapters of the Act are also analyzed, identifying inadequacies around definitions, oversight, and emphasis on hospitalization over community care. Improvements are suggested regarding admission criteria and independent review of involuntary treatment.
1. Marital therapy aims to help couples address issues in their relationship through counseling.
2. Marriage is a legally recognized union that forms the basis of family and procreation according to Indian society, though views and laws have evolved over time.
3. Factors like compatibility, communication, mutual understanding and respect are important for a healthy marriage, while distressed couples often engage in destructive patterns like coercion and blaming that damage the relationship.
The document provides an overview of psychiatric classification systems. It discusses the definition and advantages of classification, as well as key terms and historical approaches including etiological, descriptive, categorical, and dimensional.
It then describes the development of major classification systems including the DSM and ICD. The DSM is the diagnostic manual published by the American Psychiatric Association while the ICD is published by the World Health Organization. The document outlines the various editions of the DSM from DSM-I to the current DSM-5. It also discusses other classification systems and tools used in psychiatry such as the Chinese Classification of Mental Disorders and the Research Domain Criteria.
The document discusses India's history of mental health acts and the proposed Mental Health Care Bill of 2013. It provides context on the 1858 and 1912 acts and outlines key aspects of the 1987 Mental Health Act. The proposed 2013 bill aims to replace the 1987 act and improve on its shortcomings like outdated definitions and lack of human rights protections. The bill has 16 chapters covering areas like rights of those with mental illness, administrative bodies, and duties of the government. It introduces important definitions of mental illness and informed consent. While praised for promoting rights and access to care, critics argue implementation will be difficult and some provisions could increase stigma or hinder effective treatment.
This document outlines guidelines for assessing disability in psychiatric patients in India. It discusses definitions of impairment, disability, and handicap. It describes how the Indian Disability Evaluation and Assessment Scale (IDEAS) is used to measure disability in mental disorders. Specific sections address assessing intellectual disability, specific learning disability, and general guidelines for the certification process. Disability is assessed based on functioning in areas like self-care, interpersonal activities, communication, and work performance.
This document discusses group psychotherapy and provides information on various aspects of conducting group therapy sessions. It defines group psychotherapy as a treatment involving carefully selected emotionally ill individuals who meet under a trained therapist's guidance to help one another change behaviors. The document outlines three major types of groups - group therapy, therapeutic groups, and adjunctive groups. It provides details on group size, session frequency/length, therapeutic factors involved, steps of group therapy, techniques used, and contraindications for certain patient types.
Psychoeducation involves educating patients and families about mental health conditions to help them better understand and manage the illness. It has roots in movements from the early 20th century and has been shown to improve outcomes. Psychoeducation can be delivered individually, to families, or in groups. It covers topics like the nature of the illness, treatment, and how to prevent relapse. Various models exist including providing information, teaching skills, and being supportive. Psychoeducation has benefits for conditions like schizophrenia, depression, and eating disorders.
Psychoanalysis is a lengthy insight therapy developed by Freud that aims to uncover unconscious conflicts through techniques like free association and dream analysis. It views human behavior as resulting from interactions between the id, ego, and superego. The goal of psychoanalysis is to help patients understand their unconscious motivations by becoming aware of unresolved conflicts driving their behaviors. Techniques include free association, dream analysis, and interpretation by the therapist to provide insight and allow new ways of coping with anxiety and guilt.
This document provides an overview of transcultural psychiatry and cultural factors that are relevant to mental illness. It discusses what culture is, how culture can influence psychopathology in different ways such as pathogenic effects, pathoplastic effects, and pathofacilitative effects. It also examines cultural psychodynamics and how cultural variables like dependency versus autonomy, linguistic competence, and social support systems can impact mental health. The document provides examples of culture-bound syndromes and discusses the importance of considering culture in clinical practice and research in psychiatry.
The document summarizes and critiques key aspects of the Mental Health Care Bill 2013 in India. It discusses several provisions that are seen as problematic, impractical, or likely to hinder mental healthcare services. Concerns include definitions being overly broad and stigmatizing, procedures being too cumbersome, rights priorities hindering treatment, marginalization of psychiatrists and families, lack of consideration for cultural and resource realities, and lack of evidence for some prohibitions like on ECT for minors. In conclusion, it is argued that the bill imported Western ideas without regard to the local context, diluted the role of psychiatrists, created too many legal barriers to care, and made commitments that seem beyond the government's
This document summarizes a presentation on mental health legislation in India. It provides background on the need for such legislation to protect the rights of those with mental illness. It then outlines the evolution of mental health laws in India from British rule through the Lunacy Act of 1912 and Mental Health Act of 1987 to the proposed Mental Health Care Bill of 2013. The presentation analyzes key aspects of the proposed bill, including its chapters covering rights of those with mental illness, duties of government authorities, oversight boards, admission and discharge procedures, and penalties for non-compliance.
The document discusses the history and provisions of mental health laws in India. It notes that the Indian Lunacy Act was passed in 1912 to regulate the admission and care of mentally ill individuals in asylums, as no comprehensive law previously existed. This act was replaced by the Mental Health Act of 1987, which introduced updated definitions and emphasized the human rights and dignity of mentally ill persons. The 1987 Act established authorities to regulate facilities, outlined licensing and admission procedures, involuntary commitment provisions, and guidelines for discharge and protection of rights.
This document discusses admission, discharge, and transfer procedures in a healthcare setting. It covers the admission process, responsibilities of admitting and nursing staff, types of admissions, discharge methods and planning, and nursing responsibilities for discharging and transferring patients. Standard procedures are outlined for admitting, orienting, and assessing new patients, as well as preparing patients for discharge or transfer.
Republic of ireland mental health tribunals 2009Anselm Eldergill
This document provides information about mental health tribunals in Ireland. It discusses several key points:
1) It outlines the statutory framework for involuntary admission and renewal orders under the Mental Health Act 2001, including criteria for admission due to mental disorder, time limits on orders, and tribunal review requirements.
2) Patient rights and protections are discussed, including principles of best interests, dignity, and least restrictive care. Relevant articles from the European Convention on Human Rights are also summarized.
3) Procedures for transfers between approved centers and discharge of patients are covered in brief, noting the roles of clinical directors and mental health tribunals.
The document summarizes key concepts in UK mental health law, including the Mental Health Act 1983 as amended in 2007. It discusses how mental health law allows for the detention and treatment of individuals with mental disorders against their will if they pose a risk to themselves or others. The key sections of the Mental Health Act are outlined, including Section 2 for assessment, Section 3 for treatment, community treatment orders under Section 17A, and rules around consent to treatment under Part 4. Definitions of important terms like "mental disorder" are also provided.
This document discusses drug-induced sexual dysfunction and its management. It covers the nosology of sexual dysfunction, etiology focusing on medication-induced and substance-induced causes. It evaluates epidemiology of sexual side effects of various classes of medications like antidepressants, antipsychotics, mood stabilizers, etc. based on controlled studies and clinical observations. Specific substances like alcohol, opioids, cannabis are discussed in relation to sexual dysfunction. Evaluation, approach and management strategies are also mentioned.
The document provides an overview and summary of the Mental Health Care Bill 2013 in India. It begins with an introduction to the need for mental health legislation and the evolution of previous acts. It then summarizes some of the key chapters and sections of the new bill, including provisions for determining mental illness, advance directives, nominated representatives, rights of those with mental illness, admission and treatment procedures, and oversight bodies like the Central and State Mental Health Authorities. The bill aims to better protect the rights of those with mental illness and replace the older Mental Health Act of 1987.
This document is an Act of Parliament in Kenya that establishes rights and protections for persons with disabilities. Some key points:
- It establishes the National Council for Persons with Disabilities to develop policies and measures to promote equal opportunities and participation for persons with disabilities.
- The Council is tasked with registering persons with disabilities, disability organizations, rehabilitation services and facilities. It also provides assistive devices and advocates for accessibility.
- The Act prohibits discrimination against persons with disabilities in employment, education and access to public services. It requires accessibility of public buildings and transportation and provides incentives for employers hiring persons with disabilities.
- Government is tasked with achieving full realization of the rights of persons with disabilities, including in
San Francisco VA Mental Health Summit 2016 Presentation by Megan McCarthySwords to Plowshares
San Francisco Veteran Mental Health Summit 2016
Presentation by Megan McCarthy, Ph.D.
Deputy Director, Office of Suicide Prevention
U.S Department of Veterans Affairs
August 12, 2016
Consultation-liaison psychiatry involves the study and practice of the relationship between medical and psychiatric disorders. Psychiatrists in this field act as consultants to medical colleagues, consulting on patients in medical/surgical settings and providing follow-up psychiatric treatment. Common problems addressed include suicide attempts, depression, agitation, hallucinations, sleep disorders, confusion, noncompliance, and cases where no organic basis is found for a patient's symptoms. Special situations involve intensive care units, hemodialysis units, surgical units, and transplantation issues.
This document discusses reversible causes of dementia and delirium. It begins by defining major neurocognitive disorder and reversible dementias. Common reversible causes of dementia include central nervous system infections, normal pressure hydrocephalus, nutritional deficiencies, drugs, endocrine disorders, depression, and sleep apnea. Delirium is then discussed, including risk factors, pathophysiology, clinical subtypes, DSM-5 criteria, assessment scales, differential diagnosis, course, prevention, and management. Reversible dementias are estimated to account for 8-40% of dementia cases. Early diagnosis and treatment of the underlying cause can improve cognitive functioning.
Its all about forensic psychiatry aspects of India not very frequently discussed and so a little attempt from me. Its not exhaustive and many more aspects regularly updated should be tallied.
This document provides an overview of mental health laws and policies in India, including:
1. It summarizes the history of mental health acts in India from the 1858 Indian Lunatic Asylum Act to the present-day Mental Health Care Bill of 2013.
2. It describes the key aspects and chapters of the Indian Lunacy Act of 1912 and the Mental Health Act of 1987, including definitions, admission procedures, and establishment of psychiatric hospitals.
3. It outlines the proposed amendments in the Mental Health Care Bill of 2013, such as expanded definitions of mental illness, the introduction of advance directives and nominated representatives, and establishment of new governing bodies.
RFB - Plano Anual da Fiscalização para 2017 e Resultados de 2016Jose Adriano Pinto
Plano Anual da Fiscalização da Secretaria da Receita Federal do Brasil para o ano-calendário de 2017:
quantidade, principais operações
fiscais e valores esperados de
recuperação de crédito tributário, incluindo os Resultados de 2016
This document discusses discharge planning from a hospital. It begins by defining discharge planning as the process of coordinating care between hospitals, community services, and caregivers to ensure continuity of care as patients transition from inpatient to outpatient. An effective multidisciplinary approach is emphasized, involving medical, nursing, allied health, and social services both within the hospital and in the community. The benefits of thorough discharge planning include improved patient outcomes, reduced hospital readmissions, and shorter hospital stays.
Este documento lista diferentes frutos secos y sus árboles o arbustos correspondientes, incluyendo nueces, almendras, castañas, avellanas, uvas, granadas, naranjas, mandarinas, aceitunas, manzanas y membrillos junto con sus nombres en español.
This document provides an overview of the intersection between psychiatry and law. It discusses how law and psychiatry both aim to regulate human behavior but through different approaches - law punishes based on concepts of right and wrong, while psychiatry treats aberrant behavior as potential symptoms of illness. The document then examines key areas where psychiatry interfaces with civil law regarding issues like contracts, marriage, and testimony in court. It also explores the role of psychiatry in criminal law in assessing criminal responsibility, competency to stand trial, and other forensic issues. Finally, it outlines the various laws and acts in India governing mental health certification, disability assessment, and the psychiatrist's role as an expert witness in legal proceedings.
El documento clasifica los alimentos según su función principal en formadores, energéticos y protectores. Los formadores como la carne y los huevos ayudan al crecimiento del cuerpo. Los energéticos como la papa y el pan brindan energía. Y los protectores como las frutas y verduras ayudan a mantener la salud del cuerpo. El documento también pide identificar la función de algunos alimentos específicos.
Mental health care act 201 Dr gghjjjjh7.pptxRobinBaghla
This document summarizes the Mental Health Care Act of 2017 in India. It provides background on mental health legislation in India, from the 1858 Indian Lunatic Asylum Act to the 1987 Mental Health Act. It describes the need for reform and an updated law to better protect the rights of those with mental illness. The key aspects of the Mental Health Care Act of 2017 are outlined, including its 16 chapters covering definitions of mental illness, advance directives, patient rights, review boards, and provisions for admission, treatment and discharge.
The document discusses India's laws and policies related to mental health, including the evolution from the Indian Lunacy Act of 1912 to the current Mental Healthcare Act of 2017. Some key points:
- The Mental Healthcare Act of 2017 aims to protect the human rights of those with mental illness and fulfill India's obligations under the UN Convention on Rights of Persons with Disabilities.
- It decriminalized attempted suicide and introduced concepts such as advance directives, nominated representatives, and rights of persons with mental illness.
- The act established authorities like the Central Mental Health Authority and State Mental Health Authorities to oversee mental healthcare delivery.
- Compared to previous laws which took a custodial approach, the new
The document provides an overview of mental health laws and acts in India, beginning with the Lunatic Removal Act of 1851 and continuing through to the present-day Mental Healthcare Act of 2017. It discusses how early laws focused on custodial care and neglected human rights, leading to reforms with the Mental Health Act of 1987 and eventual passage of the Mental Healthcare Act of 2017. The 2017 Act aims to balance consumer rights with the need for treatment, recognize family/carer roles, and enable voluntary and involuntary treatment according to legal procedures. Key aspects covered include definitions of mental healthcare professionals, establishments, informed consent, and provisions for assessment, admission, and review related to involuntary treatment.
This document summarizes the history and key aspects of mental health care legislation in India. It discusses the Indian Lunacy Act of 1912, which was replaced by the Mental Health Act of 1987. However, both acts were criticized for their custodial and rights-violating nature. The Mental Health Care Act of 2017 was passed to address these issues and protect the human rights of those with mental illness based on recommendations from the Indian Psychiatric Society and India's ratification of the UN Convention on the Rights of Persons with Disabilities. The 2017 act includes provisions on advance directives, nominated representatives, rights of those with mental illness, registration of mental health establishments, and mental health review boards.
This document summarizes several key Indian acts related to psychiatric disability and mental health:
1) The Mental Health Act of 1987 and the Mental Healthcare Act of 2017 both aim to regulate treatment of mentally ill persons and protect their rights, with the latter act expanding definitions and rights.
2) The Persons with Disabilities Act of 1995 and its subsequent amendments aim to prevent discrimination and promote opportunities for those with disabilities including mental illness. It defines terms and outlines government responsibilities.
3) The Rights of Persons with Disabilities Act of 2016 incorporates the UN Convention and further defines rights and entitlements regarding education, employment, social security, and more.
The document discusses the Mental Health Act of 1987 in India. It provides definitions of key terms from the act like mentally ill person, psychiatrist, and reception order. It outlines the objectives and various chapters of the act. The chapters cover establishment of mental health authorities, psychiatric hospitals and nursing homes, procedures for admission and detention of mentally ill patients, discharge and leave of absence. It also discusses the penalties and procedures under the act. The Mental Healthcare Act of 2017 introduced revisions like decriminalizing attempted suicide and recognizing the agency of people with mental illness. It has 16 chapters covering rights of persons with mental illness, duties of government authorities, and establishments and boards for mental healthcare.
mental health act 2017 for police personnel Suneetha Nairy
The Mental Health Care Act, 2017 aims to provide access to mental healthcare in India and protect the rights of persons with mental illness. Some key points:
- It repeals the Mental Health Act of 1987 and is in line with the UN Convention on the Rights of Persons with Disabilities.
- It establishes Central and State Mental Health Authorities to oversee licensing and regulation of mental health establishments.
- Police are required to take persons with apparent mental illness into protection and have them assessed within 24 hours.
- Magistrates can order assessment or admission of ill-treated persons with mental illness for up to 10 days based on medical reports.
- Provisions cover transfer of prisoners with mental
Legal & ethical issue in psychiatry by suresh aadi8888Suresh Aadi Sharma
This document discusses legal issues in psychiatric nursing. It begins with an overview of the relationship between psychiatry and the law, noting the tension between individual rights and social needs. It then discusses ethical considerations for psychiatric nurses, including sensitivity to patient rights and needs, issues of power, and avoiding paternalism. The document provides an overview of mental health law and shifting perspectives from a focus on patient rights to limiting rights of the mentally ill. It discusses sources of mental health laws and provides a history and overview of key Indian mental health acts - the Indian Lunacy Act of 1912, the Mental Health Act of 1987, and the draft National Mental Health Care Act of 2010. Key concepts around forensic psychiatry are also summarized.
Forensic psychiatry deals with issues at the interface of psychiatry and the law. It has benefited from increased knowledge of the relationship between mental illness and criminality, evolutions in forensic legal operations, developments in systems interactions, and deeper understanding of biomedical ethics issues. The Mental Health Act of 1987 governs mental health care in India and introduced more humane terminology and emphasis on human rights compared to the previous 1912 act. However, it also retains some criminal aspects and does not fully reflect current policy or WHO guidelines. Other relevant laws include the Disability Act, Juvenile Justice Act, and those covering marriage, contracts, voting, and wills as they relate to individuals with mental illness.
The document discusses legal issues in mental health nursing in India. It provides an overview of the Mental Health Act of 1987 and the Mental Health Care Bill of 2013, including their objectives, key features, and rights of mentally ill patients. It also explains the roles and legal responsibilities of nurses in admission and discharge procedures, including issues of consent, confidentiality, and record keeping. The legal responsibilities of mentally ill patients regarding civil and criminal matters are also outlined.
This document discusses the Mental Health Act of 1987 and the Mental Health Care Act of 2017 in India. It provides an overview of the objectives and chapters of each act. The Mental Health Act of 1987 established central and state mental health authorities to license and supervise psychiatric hospitals and nursing homes, and provide oversight of facilities. The Mental Health Care Act of 2017 defines mental illness and provides for the rights of those with mental illness, including advance directives and nominated representatives.
LEGAL ASPECTS IN MENTAL HEALTH IN CRIMINAL LAW.pptxanandM654977
This document outlines the topic "Legal Aspects in Mental Health in Criminal Law" presented by student Mahadevan Anand. It discusses the Indian Mental Health Act of 1987, including its objectives and key features. It also examines the Mental Health Care Bill of 2013, outlining its chapters and key aspects. The document explores the basic rights of mentally ill patients and discusses their legal responsibilities in both civil and criminal contexts. Various admission and discharge procedures under the Indian Mental Health Act are also summarized.
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.
The document summarizes the Mental Health Care Act of 2017 in India. Some key points:
- The Act was passed in 2017 to provide legal framework for mental healthcare and protect rights of those with mental illness.
- It outlines provisions for advance directives, nominated representatives, rights of those with mental illness, and establishment of central and state mental health authorities.
- The Act has 16 chapters covering definitions of key terms, determination of mental illness, consent procedures, admission/discharge processes, and offenses/penalties. It aims to improve community integration and access to high quality care for those suffering from mental illness.
[Forensics] comparison of lunacy act 1912 with mental health ordinanceMuhammad Ahmad
The Lunacy Act of 1912 used outdated, derogatory terms like "lunatic" and focused on detention of patients rather than treatment. The Mental Health Ordinance of 2001 updated terminology, definitions, procedures and protections to bring Pakistan closer to international standards. Key improvements included limiting involuntary detention to 72 hours, requiring psychiatric evaluation, establishing an oversight body, strengthening human rights protections, and increasing community and psychiatric involvement in treatment. However, more reforms are still needed to fully uphold the rights of the mentally ill according to international declarations.
The document provides an overview and critical analysis of the Mental Health Care Bill (MHCB) 2013 in India. It summarizes the key aspects of the bill, including its chapters covering preliminaries, determination of mental illness, rights of persons with mental illness, admission and treatment procedures, and oversight authorities. The analysis notes both merits of the bill in modernizing terminology and focusing on patient rights, but also drawbacks like potential over-inclusion of mental illness definitions and traditional providers as mental health professionals. Overall, the document aims to concisely outline and assess the provisions and implications of India's major mental health law reform.
This presentation is on Mental Health Act, Indian Lunacy Act and Rights of Patient. Mental Health Nursing one of core subject of B.Sc. Nursing Third Year.
BIBILIOGRAPHY
R SREEVANI “A Guide to Mental Health &
Psychiatric Nursing” 3rd Edition
Jaypee Medical Publisher Pp: 345 to 350
Shelia L Vedibeck “Psychiatric Mental Health
Nursing” 5th Edition Lippincott & Williams.
Mary C Townsend “Essential of Psychiatric health
nursing” 7th Edition F A Devis 2013.
ANTONY JAMES T (2000): “A decade with the
mental health act, Indian Journal
of Psychiatry, 42(4)
Kothari, Jaya “Moving towards autonomy &
equity an analysis of mental health care
bill 2013”
Unit-VIII M.Sc II National Mental Health Policy.pptxanjalatchi
The vision of the National Mental Health Policy is to promote mental health, prevent mental illness, enable recovery from mental illness, promote de- stigmatization and desegregation, and ensure socio-economic inclusion of persons affected by mental illness by providing accessible, affordable and quality health
The Mental Health Act of 1987 replaced the previous Indian Lunacy Act of 1912. Some key points of the Mental Health Act include:
- It established central and state mental health authorities to regulate and coordinate mental health services.
- It provided guidelines for establishing and licensing psychiatric hospitals and nursing homes.
- It outlined procedures for voluntary admission, involuntary admission via a reception order from a magistrate, and discharging patients.
- It addressed the inspection of facilities, leaves of absence, and transferring patients.
- It covered judicial inquiries regarding mentally ill individuals with property and appointing guardians to manage their affairs.
- It discussed who bears the cost of maintaining patients and protecting the human rights of mentally
Indian Mental Health Act 2017_Dr._Ruchi Kushwaha.pptxDr Ruchi Kushwaha
The document summarizes India's National Mental Health Program (NMHP). It details the burden of mental illness in India and globally. It then outlines the objectives, strategies and components of the NMHP, including district mental health programs, day care centers, residential care centers, and tertiary activities like upgrading central mental health institutes. The overall aim of the NMHP is to ensure access to mental healthcare and promote community-based rehabilitation in India.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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3. 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
3
4. The Mental Health Care Bill 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
4
6. 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
6
7. 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
7
8. 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.
8
9. Why 1912 Act needed to be changed
Offensive terminologies used in Indian Lunacy act of 1912:
Lunatic person
Criminal Lunatic
9
10. MHA Act 1987
Came into effect in April 1993
To ensure availability and accessibility of minimum mental
health care for all.
10 chapters 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.
10
11. 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.
11
12. 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
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.
12
13. 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 .
13
14. The Mental Health Care Bill, 2013
Comes under Ministry Of Health and Family Welfare.
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.
14
15. Mental Health Care 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.
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.
15
16. 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 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
16
Contd.
17. Comes under Ministry Of Health and Family Welfare
Passed in the Rajya Sabha on August 8th , 2016.
If passed in Lok Sabha, then it repeals the Mental Health
Act, 1987.
The premeable clearly depicts protect, promote and fulfill
rights of persons with mental illnesses.
Consists of 16 chapters and 126 clauses.
17
Mental Health Care Bill 2016
18. 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
18
Chapters and Clauses
19. 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
19
20. 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
20
21. ‘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”.
21
Definition of Mental Illness
22. Features of the New Bill
1. Mental health Professionals
2. Mental Health Establishments
3. Legal Capacity
4. Informed Consent for treatment and researches
5. Rights of persons with mental illness
22
23. 6. Administrative Bodies
7. New rules on admission, leave and discharges
8. Duties of the Government
9. Special Measure for Minors
10. Decriminalizes attempted suicides
23
Contd.
24. 11. Medical insurance to cover mental health treatment
12. Ban on ECT without anaesthesia, psychosurgery and
chaining
13. Nominated representatives
14. Emergency treatment
15. Granting Divorce
24
Contd.
25. Appreciation of the MCHB 2016
Decriminalization of attempted suicide
Rights of person with mental illness
Provision for medical insurance for
treatment for mental illness
Duties of appropriate government
25
26. Admission, Treatment and Discharge
INDEPENDENT ADMISSION
Any person who considers himself to have mental illness and
desires admission, who is not a minor.
Admitted if the Medical officer or Psychiatrist is satisfied that
A. Mental illness of severity requiring admission
B. Patient should benefit from admission and treatment
C. Request made is under free will and not under undue influence
and has capacity to make mental health care decision
D. Informed consent
E. Bound to rules and regulations of the establishment.
27. Discharge procedures
An independent patient may get
himself discharged from the mental health
establishment without the consent of the medical
officer or mental health professional in charge of the
MHE.
Minor : If the nominated representative no longer
supports admission or requests discharge of the
minor, from the mental health establishment, the minor
shall be discharged thereof
28. Contd.
Power with the mental health professional to
prevent discharge of person for a period of 24 hrs to
allow assessment if necessary ?
Recent suicide
attempt/threatening
Violence
towards others
Inability to care
for oneself
29. Admission and Treatment up to 30 days
When and how?
Upon application by Nominated Representative
2 mental health professionals, including a Psychiatrist,
after independent examination
Feels that the person has a mental illness of such severity
that the person
a) Recently threatened or attempted to cause bodily harm
b) Recently behaving violently towards another person, or
causing another person to fear bodily harm
30. Contd.
c) Recently shown inability to care oneself to a degree
that places at risk of harm to oneself
Limited to a period of 30 days.
To be informed to MHRC within 7 days (10 days for
Northeast) of admission
31. Admission and treatment exceeding 30 days
Continue admission in the establishment
Same procedures as the previous clause, where a re-
examination will be done, but 2 psychiatrists examine the
patient
Consistent inability to take care of oneself
To be informed to MHRC, to be approved within 21 days
(30 days for Northeast)
Limited to 90 days. Renewal to 120-180 days.
32. Admission of Minors
2 Psychiatrists 1 Psychiatrist & 1 mental
health professional
1 Psychiatrist & 1
medical practitioner
Minor
33. Contd.
Nominated Representative to
be with the minor for the
entire duration of admission
Treatment for the minor with
informed consent of
Nominated Representative.
34. Leave of absence
Granted by - Medical officer or Psychiatrist
After securing consent of Nominated Representative
Power with the practitioner to terminate when
appropriate to do so
If the patient does not return, contact the patient on
leave, or nominated Representative or both
35. Absence without leave
Without discharge, absents one-self
Taken into protection by Police Officer at the request
of the Psychiatrist in charge and brought back.
36. Emergency Treatment
Who can treat ?
Any Registered Medical Practitioner, subject to informed
consent from the Nominated Representative.
When ?
When its necessary to prevent :
a) Death or irreversible harm to health of the person, or,
b) Person inflicting serious harm to himself/others
c) Person causing damage to property
37. Contd.
ECT is NOT permitted as an emergency procedure
Emergency treatment limited to 72 hrs (96 hrs for
Northeast) or till the person is assessed at a mental
health establishment.
Disasters/emergencies, it may extend to 7 days.
38. Criticism/suggestions of
Mental Health Bill 2016
1. Mental Health Establishment
2. Capacity to make mental health care and treatment
3. Advance directives
4. Nominated representatives
5. Mental health review boards
6. Right to confidentiality
7. Discharge planning
8. Role of family members
9. Treatment guidelines
10. Lack of resources
38
39. Mental Health Establishments
NMHP mandates integration of mental healthcare into
primary healthcare
MHCB mandates all the establishments to take license
to treat patients
In MHA-1987, “any general hospital or general
nursing home established or maintained by the
government and which provides also for psychiatric
services” were excluded from the ambit of definition
“psychiatric hospital/ psychiatric nursing home” 39
40. Contd.
Refusal of private hospitals and nursing homes
Hostels, prisons, jails, juvenile homes, temples,
churches, dargahs keeping patients with mental illness
will be at stake
Anticipated “License Raj” of harassing MHC
providers
Supposed to inflict greatest damage to the system of
mental health care delivery
40
41. Capacity to make MHC and treatment
Inadequate & can have dangerous consequences
Clause by default says everyone has capacity and right and
so the contrary has to be proved before involuntary
admission
Psychotic patients with absent insights usually refuse
admission ultimately troubling the family
Permission be sought from the mental health board
Proposed admission by informed consent of family
41
42. Advance directives
To be followed by mental health profesionals during
treatment
Becomes difficult in Indian scenerio when :
1. Treatment proposed in a costly/far to reach hospital
2. Treatment choice may be 2nd or 3rd choice some
situations
3. Cochrane review studies doesn’t support advance
directives in mental illness
Can put family to heavy burden and difficulties
42
43. Nominated representatives
Selection by patient (with colored thought and
perception) may be affected by the illness
Nominated representative may break the Indian family
system who ultimately care for the patient after all odds
Costly treatment selection by the nominated
representative can affect the whole family
Ultimately at some point the family may disown the
patient 43
44. Mental health review boards
Quasi judicial boards
May introduce hurdles in smooth treatment
procedures
Limited boards to visit individual patient is
questionable and delay in addressing the issue is
anticipated (e.g. festive seasons in India)
Tedious, prolonged and costly judicious procedures
Time limit for doctors while no time limit for
boards
44
45. Right to confidentiality
The MHCB provides unlimited access to all the
documents of the patient by nominated representative
“Breach of confidentiality” by Mental health
professionals as per Medical council ethics, 2002
Impinges on fundamental rights “right to privacy”
Proposed disclosure of family members only in verbal
form and written form only on written request
45
46. Discharge planning
Ultimate decision of continuation of treatment or not lies
on patient/ nominated representative
“Continuity of care” is at stake due to lack of role of
family members and most of all the treating
psychiatrist/physician
Bill is silent about much needed community care
Finally pressure over the family members even if they
want treatment in proper way 46
47. Role of family members
Not only protects right of the patient but also
promotes family participation in active treatment
process
MHCB undermines the role of family members in
providing care
Bill needs to modified that in case of involuntary
treatment, presence of at least one family member
should be present
Management of property of person with severe
mental illness is absent
47
48. Treatment guidelines
Treatment should be as per national professional
guidelines
ECT has been established as a modality of choice in
many major psychiatric illnesses
The bill banns ECT during emergency management as
well as in minors
Withholding the same just for the permission of
mental health board is “delay in justified treatment”
Hands of treating Psychiatrist this way is curtailed to
a large extent
48
49. Lack of resources
Bills overloaded with right based ideology not fully
acceptable in Indian family structure
Logistic problems like poor infrastructure, inadequate
mental health workforce, low budget allocation for
MHC, siphoning fund of MHC to general health care
Bill needs to focus on smooth running of the MHC
rather than over exaggeration on compensation
Urgent need to introduce basic psychiatry at UG level
(MBBS) for learning of treatment of basic psychiatric
diseases
49
50. Neglected role of statutory body
MHA-1987 was conceived, piloted and drafted by the Indian
Psychiatry Society (IPS)
Though invited to the consultation process at different
stages, IPS was not assigned any role in drafting of the
current Bill
IPS expressed apprehensions about a number of provisions
in the Bill as not considered to be in the interest of persons
with mental illness
MOHFW, for unknown reasons, entrusted the job of drafting
the current Bill and conducting the initial consultation
process to a private psychiatrist, who is not even an ordinary
member of the IPS 50
51. CONCLUSION
1. The MHCB, 2016 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.
4. With further amendments in necessary areas this bill can
prove a blessing to the Mental health care system
51
52. References
Rao GP, Math SB, Raju M, Saha G, Jagiwala M, Sagar R, et al. Mental
Health Care Bill, 2016: A boon or bane?. Indian J Psychiatry 2016;58:244-
9.
Narayan CL, Shikha D, Narayan M. The Mental Health Care Bill 2013: A
step leading to exclusion of psychiatry from the mainstream medicine?
Indian J Psychiatry 2014;56:321-4.
Antony JT. The mental health care bill 2013: A disaster in the offing?.
Indian J Psychiatry 2014;56:3-7.
Kala A. Time to face new realities; mental health care bill-2013. Indian J
Psychiatry 2013;55: 216-9.
Mental Health Care Bill. Available from
http://www.prsindia.orguploads/media/Mental%20Health/Mental%20health
%20care%20as%20 passed%20by%20RS.pdf. [Last accessed on 2016 Aug
15].
52
53. Contd.
Math SB, Srinivasaraju R. Indian psychiatric epidemiological studies:
Learning from the past. Indian J Psychiatry 2010;52 Suppl 1:S95-103.
Ranjan R, Kumar S, Pattanayak RD, Dhawan A, Sagar R. (De-)
criminalization of attempted suicide in India: A review. Ind Psychiatry J
2014;23:4-9.
Pattanayak RD, Sagar R. Health insurance for mental health in India:
A welcome step toward parity and universal coverage. J Ment Health Hum
Behav 2016;21:1-3
Math SB, Murthy P, Chandrashekar CR. Mental health act (1987):
Needvfor a paradigm shift from custodial to community care. Indian J
Med Res 2011;133:246-9
Seventy-Fourth Report on the Mental Health Care Bill-2013, Rajya Sabha
Secretariat, November; 2013. Available from: http://www. 164.100.47.5/
webcom/MainPage.aspx. [Last accessed on 2016 Jan 19]
53
1requests the medical officer to admit as independent pt.
When Mental health prof is of opinion- person unable to understand the nature and purpose of his./her decisions.and requre high support from NR,either- recent threatened or attempted or is threatening to cause bodily harm to himself, behaving violently or causing fear bodily harm , inability to care for oneself to a degree that places the individual at risk of harm to self or others.
Mental illness with high support needs
After 30 days, if he no longer meets the criteria for admission, the pt should be no longer kept in the establishment.if he may clause for admission more than 30 days.
a) Already admitted under previous clause., both psychiatrists after taking into acct the adv directive, issue a certificate for admission., if not approved, dishcarge,
only in exceptional circumstances, Ideally by nominated representative, upon receiving application, They should independently examine the minor on the day of admission or in the preceding 7 days- in the best interest of minor,mental health needs will not be met unless admitted,and accomodated separately from adults.
30 days, does not return after expiry of duration,