UNIT-I , B.SC NURSING-III YEAR: MENTAL HEALTH ACT

1. THE MENTAL HEALTH ACT
Prepared By:
Mrs.AKILA. A , M.Sc (N), M.Sc (PSY),
ASSOCIATE PROFESSOR

2. INTRODUCTION
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 matters connected therewith
or incidental thereto

3. HISTORY
In 1946, Bhore committee submitted its
recommendations .
The Indian Psychiatric Society was established
in January 1947, was quick to react to the
recommendations of Bhore committee.
In January 1949, A committee was formed with
3 distinguished Psychiatrists. They Prepared a
draft bill called as the Indian Mental Health Act,
which was redrafted and finalised in January 1950.
After 37 years in 1987, The Indian Mental
health Act (MHA) was drafted by the Parliament.
but it came into effect in all the States and Union
territories of India in April1, 1993. This replaces
the Indian Lunacy Act of 1912.

4. REASON FOR ENACTMENT
 The attitude of the society, towards the
mentally ill has changed considerably and
now it is realised that no stigma should be
attached to such illness, as it is curable
practically when diagnosed at an early stage.
 The experience of working with Indian lunacy
act , has revealed that it has become
outmoded with the rapid advancement of
medical science and the understanding of the
nature of malady.

5. OBJECTIVES OF THE INDIAN
MENTAL HEALTH ACT
• 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
• To protect society from the presence of mentally ill persons
who have become or might become a danger to others
• To protect citizens from detained in psychiatric hospitals or
psychiatric nursing homes with out sufficient cause.

6. • To regulate responsibility for maintenance
charges of mentally ill persons who are admitted
to psychiatric hospitals or psychiatric nursing
homes.
• To provide facilities for establishing guardianship
or custody of mentally ill persons who are
incapable of managing their own affairs.
• To provide for the establishment of Central
Authority and State Authorities for Mental Health
Services.
• To regulate the powers of the Government for
establishing, licensing and controlling psychiatric
hospitals and psychiatric nursing homes for
mentally ill persons.
• To provide for legal aid to mentally ill persons at
State expense in certain cases

7. SALIENT FEATURES OF THE ACT
CHAPTER I: Preliminary informations
• Lunatics- Mentally ill person
• Criminal lunatics- Mentally ill prisoner
• Asylum - Mental Health Hospital
• Reception Order - Its an order made under the
provisions of this act for the admission & detention
of mentally ill person in psychiatric hospital.

8. CHAPTER II: Mental Health Authority
• Deals with the establishment of central &
state authorities for development,
regulation, direction & coordination of
mental health services
• These authorities advices the government
on mental health matters

9. CHAPTER- III: Psychiatric Hospitals &
Psychiatric Nursing Homes
• Lays down the guidelines for the
establishment & maintenance of psychiatric
hospitals & nursing homes
• License for the psychiatric hospitals & nursing
homes

10. CHAPTER- IV: Admission And Detention
It describe the procedure for admission & detention
of clients in psychiatric units
• On voluntary Basis
• Admission under special circumstances
• Temporary Treatment order
• Reception order
• Admission in emergencies
• Miscellaneous

11. VARIOUS TYPES OF ADMISSION
Admission
on
Voluntary
Basis
Admission
under special
circumstances
Admission
under
reception
order
Admission in
Emergencies
Temporary
treatment
order
Admission
of Mentally
ill prisoners
Miscellaneous
Admission

12. 1. Admission on Voluntary Basis
Major: Wish to apply to the medical officer in charge
Minor: Guardian can apply
Medical Officer in charge : Inquiry with in 24 hours
admit the patient if treatment required
2. Admission under special circumstances
Unwilling for Admission
Application made by relatives
Medical Officer in charge inquired & admits the
patient

13. 3. Admission under Authority or order:
Any mentally ill person can be admitted
and detained at a Psychiatric hospital or
psychiatric nursing home in accordance with
an order passed by the court of law or an
approved authority. This includes 4 different
categories,
1.Reception order an application
2. Reception order on production of a mentally
ill person before a magistrate.
3. Reception order after inquest
4.Admission and detention of a mentally ill
prisoner.

14. Short term
for diagnosis
& short term
therapy
Long term for
treatment &
determined ready
for discharge
Petition
Examination
Determination
Medical administrator
HospitalizationRelease
Emergency to
control on
immediate threat
to self or others
Admission under reception
order

15. (i) Reception order an application:
Application is made by a relative /friend to
the magistrate
Application should be supported by two medical certificates
Magistrate obtains consent from the medical officer-Incharge of mental
hospital/ nursing home
Admission under reception order is made
(14 days observation, Medical Officers can extend < 6 months).

16. (ii) Reception order on Production before
magistrate:
Mentally ill patient exhibiting violent behaviour
detained by police officer
Produced in the court within 24 hours of detention
Application is supported by 2 medical certificates
Magistrate issues reception order

17. (iii) Reception order after inquest
Inquest of Mentally ill patient by district court
in the interest of such Person district court directs
for admission
Admission is made

18. (iv) Admission and detention of a
mentally ill Prisoner:
A mentally ill Prisoner may be admitted into a
mental hospital on the order of the Presiding
officer or a court.

19. Short term
for diagnosis
& short term
therapy
Long term for
treatment &
determined ready
for discharge
Petition
Examination
Determination
Medical administrator
HospitalizationRelease
Emergency to
control on
immediate threat
to self or others
3. Admission under
reception order

20. 4. Admission in Emergencies
Medical Officer in charge
Admit the mentally ill clients
24 hrs produce to Magistrate (Maximum 72 hrs)
Magistrate visit & issue R.O

21. 5. Temporary treatment order
Magistrate
Medical Officer in charge
Relatives
Medical certificate valid for 6 months
6. Miscellaneous Admission
• Humanitarian Grounds (Wanders)
• Social worker
• Magistrate

22. CHAPTER- V:- Discharge
Deals with the procedure for discharge of
mentally ill from the mental hospital

23. Discharge of patient
admitted on
Voluntary Basis
Discharge of patient
admitted on under special
circumstances
Discharge of patient
admitted on
reception order
Discharge of patient
admitted by Police
Discharge of patient
admitted on mentally ill
prisoners
Leave of
Absence
Types of
Discharg
e

24. 1. Discharge of patient admitted on Voluntary
Basis
Medical Officer in charge
2 Medical Practitioners (Psychiatrist)
Discharge
2. Discharge of patient admitted on under special
circumstances
Relatives / friends make an application
Medical Officer in charge
To take care of Custody(Surety & bond)

25. Applicant application
A certificate medical officer in charge of
psychiatric hospital
A magistrate issues an order if patient is fit
for discharge
3. Discharge of patient admitted on reception order
4. Discharge of patient admitted by Police
Family members agree to take care
Medical Officer in charge
Discharge

26. 5. Discharge of mentally ill prisoners
6 months report
Authority person
Discharge
Detention
Fitness
Handed over to prison officer
6. Leave of Absence
Medical Officer in charge
A bond duly signed
Maximum 60 days

27. CHAPTER- VI: Management of Property
Narrates about judicial enquiry regarding mentally ill
person possessing property, their custody & management of
property
CHAPTER-VII: Cost of Maintenance
It deals with the liability to meet the cost of maintenance of
mentally ill persons detained in psychiatric hospitals

28. CHAPTER- VIII: Human Rights Protection
• Describes the protection of human rights of
mentally ill person
• Consent should be obtained for discharge
(from the client / from the relative)
• Mentally ill should not be included in
research unless its benefiting him

29. CHAPTER- IX: Mental hospitals Maintenance
Deals with the penalties & procedure for
establishment & maintenance of mental
hospitals
CHAPTER- X:
Miscellaneous section

30. POSITIVE QUALITIES OF MHA
• Incorporates the latest scientific
knowledge
• Attempts to reduces stigma
• Definitions are in Progressive way
• Treatability is an essential criteria
• It is not applicable for non treatable
conditions like MR and Dementia
• Psychiatric Patients admitted in general
hospitals are spared.

31. • Formation of mental health authorities
provide opportunities for better monitoring
of services.
• Outpatient services are mandatory in
Psychiatric hospitals
• Admission Procedures are simplified.
• Discharge procedures are made easier.
• Provision for separate hospitals for
children, addicts and Psychopaths.
• Efforts made to safeguard human rights of
mentally ill person.

32. NURSING IMPLICATIONS
• Nurses should be well versed in legal
aspects of care and treatment of the
mentally ill.
• This knowledge helps her to guide the
patients and relatives.
• Knowledge about MHA enhances the
freedom for both nurse and Patient.