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

1. MENTAL HEALTH
Mental health is a state of well-being in which an individual
realizes his or her own abilities, can cope with the normal
stresses of life, can work productively and is able to make a
contribution to his or her community.(WHO)

3. VARIOUS LAWS PERTAINING TO
MENTAL HEALTH
Indian Lunacy act,1912
Narcotic Drugs and Psychotropic Substances (NDPS) Act 1985
The Mental Health Act, 1987
The Protection of Human Rights Act, 1993
Persons with Disability Act, 1995
The National Trust Act, 1999
Protection of Women from Domestic Violence Act, 2005
Protection of Children from Sexual Offences Act, 2012
The National Mental Health Policy 2014
National Mental Health Programme
The mental health care act,2017 (Latest)

4. INDIAN LUNACY ACT -1912
8 chapters 100 sections.
Term asylum ,medical practitioner and lunatic.
State government authority.
Reception , detention, and care of lunatics and their property.
Parole-maximum 90 days
It considered mental illness and mental retardation as the same
condition.

5. MENTAL HEALTH ACT-1987
10 chapters 98 sections.
New term psychiatric hospital , mentally ill person ,mentally ill
prisoner used.
Central and state government authority.
Psychiatric hospitals and psychiatric nursing homes.
Admission and detention in psychiatric hospital.
Leave of absence –maximum 60 days.
No cruelty towards patient , no participation in research without
consent, no letters or other communications detained or destroyed.

6. IDENTIFY THE IMAGE

7. ERWADI FIRE ACCIDENT
The fire accident occurred on 6, august 2001
at a mental asylum in Erwadi village in
Tamilnadu and claimed the lives of 28
people who were bound by chains.

8. THE MENTAL
HEALTH CARE
ACT-2017

9. India ratified the united nations convention on the rights of
persons with disabilities(UNCRPD) in october,2007.
Mental health act 1987,was not adequate to protect the rights of
persons with mental illness.
To fulfill this obligation of UNCRPD, the new mental health
care bill was set in process.

10. In India , the
mental health
care act,2017
was Passed on
7 April 2017
and came into
force from 29th
May, 2018.
The law described in its
opening paragraph as
“an act to provide for
mental healthcare and
services for persons
with mental illness and
to protect, promote and
fulfill the rights of such
persons during delivery
of mental healthcare
and services for matters
connected therewith or
incidental thereto”.

11. The act effectively decriminalized attempted suicide which was
punishable under section 309 of the Indian penal code.
This act superseded the previously existing mental health act,
1987 that was passed on 22 may,1987.
Enacted by parliament in the 68th year of the republic of India.
MHCA,2017 consists of 16 chapters and contains 126 clauses.

12. PARADIGM SHIFT
INDIAN LUNACY
ACT: CUSTODIAL
CARE OF
PERSONS WITH
MENTAL
ILLNESS.
MENTAL HEALTH
ACT,1987:
TREATMENT OF
PERSON WITH
MENTAL ILLNESS.
MENTAL HEALTH
CARE ACT,2017:
PROTECTION OF
HUMAN RIGHTS
DURING MENTAL
ILLNESS

13. CHAPTER OF MENTAL HEALTH CARE
ACT 2017
Chapter I Definition, short titles
Chapter II Mental healthcare and treatment decision
Chapter III Advance directive
Chapter IV Nominated representative
Chapter V Rights of mentally ill patient
Chapter VI Duties of appropriate government
Chapter VII Central mental health authority
Chapter VIII State mental health authority

14. Chapter IX Finance, accounts and audit
Chapter X Mental health establishments
Chapter XI Mental health review commission
Chapter XII Admission, treatment & discharge
Chapter XIII Responsibilities of other agencies
Chapter XIV Restriction to discharge function by
professionals not covered by profession
Chapter XV Offense & penalties
Chapter XVI miscellaneous

15. CHAPTER III
ADVANCE DIRECTIVE

16. FEATURES OF ADVANCE DIRECTIVE
Every person except minor has right to take
advance directive by writing.
It empowers the patient to choose his/her
treatment and appoint a representative to take
decision on behalf of patient.
If patient is minor ,his/her parent or care giver will
act as representative.
It will not be applicable at the time of emergency.

17. CHAPTER IV
NOMINATED
REPRESENTATIVE

18. Every person who is not a minor has a right to appoint a
nominated representative (NR).
Nomination can be made in writing on a plain piece of paper
with the thumb impression/signature of the person referred to
register in board.
NR should not be minor , should be competent enough to
discharge his/her duties , should also give consent to mental
health professional to discharge his/her duties.

19. If no nominated representative(NR) then any person from NGO
working for person with mental illness can make an application
to medical officer/mental health personnel treating the patient ,
and he/she will be appointed as temporary NR.
If the board feels that its better to change the NR for the benefit
of the patient it can do so.
If the mental health professional feels that legal guardian is not
acting in the best interest of the minor , then they may make an
application to board regarding same and board shall then
appoint a suitable person as NR.

20. CHAPTER V
RIGHTS OF PERSONS WITH
MENTAL ILLNESS

21. 1. Right to access mental health care and
treatment
Mental health services of affordable cost and of good quality.
Available in sufficient quantity
Accessible geographically
Without discrimination.

22. 2.Right to access mental healthcare services
Outpatient and inpatient services
Half-way homes, sheltered accommodation
Home based rehabilitation
Hospital and community based rehabilitation
child mental health services and old age mental health services.

23. 3.Integrate mental health services into general healthcare
services at all levels of healthcare including primary, secondary
and tertiary healthcare and in all health programmes run by the
appropriate Government.

24. 4. Persons with mental illness living below the poverty line shall
be entitled to mental health treatment and services free of any
charge.
5. Right to equality and non discrimination.
6. Essential drug list and all medicines on the essential
drug list shall be made available free of cost to all
persons with mental illness.

25. 7. Right to live in community.
8. Right to live with dignity.
9. Every person with mental illness shall be treated as equal
to persons with physical illness.
10. Right to information.

26. 11. Right to confidentiality .
Exceptions of right to confidentiality
Information to the nominated representative.
Information to other mental health professionals and other health
professionals.
To protect any other person from harm or violence; to prevent
threat to life.
Information to board or the central authority or high court or
supreme court.
Public safety and security

27. 12. Right to access their basic medical records.
13. Right to refuse or receive visitors and to refuse or receive
and make telephone or mobile phone calls at reasonable times .
14. A person with mental illness shall be entitled to receive free
legal services to exercise any of his rights given under this Act.
15. Right to complain regarding deficiencies in provision of
care, treatment and services in a mental health establishment.

28. CHAPTER XII
ADMISSION,TREATMENT
AND DISCHARGE

29. Independent patient or an independent admission should be done
as far as possible.
Mentally ill person who requires treatment beyond 30 days
should be reviewed by two psychiatrists.
No restraints shall be used as a form of punishment. If used ,
patient should be kept on supervision.
Professional conducting research should take sign in informed
consent of mentally ill person and consent from board.

30. INDEPENDENT ADMISSIONS
Anybody who is not a minor and wishes to get admitted in mental
health establishment can make a request to psychiatrist/medical
officer admission as independent patient.
If mental health professional is satisfied that the patient is capable of
making that decision to get admitted and if the patient is likely to get
benefitted from admission, patient might be admitted.
If it is found that patient is not in a position to make treatment
related decisions independently, then he shall not be admitted under
this section.
All treatment should be given only after obtaining informed consent
from patient.

31. ADMISSION OF MINOR
Admission of minors as independent patients.
Nominal representative is supposed to make a request to medical
officer of mental health establishments.
Then the minor shall be examined by 2 psychiatrists or 1
psychiatrist and 1 mental health personnel, and if both conclude
independently that admission is needed (OP basis management
not possible, community based alternatives exhausted) , minor
shall be admitted.

32. Minors should be accommodated in an appropriate ward.
Along with minor, nominated representative or an appointed
person should stay in mental health establishments till the time
of discharge.
If the minor is female, accompanying person should also be
female.

33. All treatment to minors will be after taking consent from
nominated representative.
All minor admission to be informed to board within 72 hours.
Any minor admission beyond 30 days should be immediately
informed to board, who will compulsorily visit in next 7 days
and review the records.
Minor can be discharged as and when nominated representative
requests for it or when IP care is not necessary.

34. CHAPTER XIII
RESPONSIBILITIES OF
OTHER AGENCIES

35. Officer in charge of police station can take person into
protection, if there is risk of harm to self or others or if police
officer feels that the person is mentally ill.
Within 24 hours, such person should be produced to nearest
healthcare establishment, and should never be kept in lock-up or
prison.
If on examination by mental health personnel there is no need of
admission then police may take person back to home or to
government establishment for homeless persons.

36. If admission is needed then admitted as supported admission.
If police believes that any patient with mental illness is being
treated improperly in private residence in his jurisdiction, he
may produce such patient with mental illness in front of
magistrate.
Magistrate then sends the patient to mental health
establishments for 10 days for assessment. Following the report
of assessment the patient with mental illness will be dealt
accordingly.

37. CHAPTER XV
OFFENCES AND PENALITIES

38. It deals with penalty and punishment.
Running Mental Health Establishments without registration —
fine between 5,000-50,000.
For first offence, 50,000 — 2,00,000.
For second offence, 2,00,000 — 5,00,000.
Working as Mental Health Personnel in Mental Health
Establishments that is not registered — fine up to 25,000 rupees

39. LANDMARK OF THE ACT
Until this bill anyone who attempted suicide was booked, faced
charges and prosecution. The maximum penalty was a year in
prison. Now, an attempted suicide will be presumed, unless
otherwise, proven, to have been under severe stress at the time
and thereby liable to be prosecuted.
This bill recognizes the rights and dignity of the mental
healthcare patient. The act states that every citizen has right to
access mental health care and treatment from facilities run or
funded by the appropriate government.
It assures free treatment to those who are homeless or below
poverty line.

40. A person with mental illness will also have the right to
confidentiality with respect to his/her mental health, mental
health care and treatment.
The bill mentions that every insures shall make provisions for
medical insurance for treatment of mental illness on the same
basis is available for treatment of physical illness.
This act abolished the ECT for children and made provisions
forgiving modified ECT.
It also empowers the mentally ill person to chose the treatment
and appoint individual as nominated representatives who can
take decisions on behalf on them.

41. LIMITATIONS
The act mentions that a six member mental review board formed
by the states will take decisions on what treatments to offer at
government facilities.
Some psychiatrists are also concerned that giving all patients to
choose forms of treatment could hamper the process.
As this act provide advance directives it increases the work of
psychiatrist whose number is very less in our country.
The provision of ECT is not scientific based.

42. This act mentioned about establishing new improvised
institutions without concerning about reforming already
established institutions.
“Harm” term is not defined clearly. Even during day to day life
individual fight back to protest, that individual can not be
considered as mentally ill person.
It included AYUSH doctors but did not included mental health
nurse, psychologist as mental health professionals.

43. DIFFERENCE BETWEEN
MENTAL HEALTH
ACT,1987 AND MENTAL
HEALTH CARE ACT,2017

44. S.NO. MHA -1987 MHCA-2017
1 Terminology Mentally ill Person with mental
illness(PMI) ,
Mental health
establishments (MHE) ,
mental health
professional (MHP)
2 Focus Law Rights of Persons with
mental illness
3 Authorities State and central government central mental health
authority(CMHA),
state mental health
authority(SMHA),
mental health review
board (MHRB ),
Advanced directive,
Nominated
representative,
Decriminalization of
suicide ,
Emergency treatment

45. IDENTIFY IMAGES