act 1987 and mental health care bill

1. Mental Health Act
Presented By:
Rahul Singh Gusain
Msc(n) Ist year

2. Introduction
Indian mental health act (MHA) was drafted by the
parliament in 1987, but it came into effect in all the
states and union territories of India in April 1993. This
act replaces the Indian lunacy Act of 1912.

3. Need
• To change the attitude of the society towards the mentally ill &
considerably realized that no stigma should be attached to such
illness.
• Every mentally ill individual has the right to be treated like others sick
people.
• To modify the act according to the rapid advancement of medical
science and the understanding.

4. Objectives of the Mental Health Act
• To regulate the power of the government for establishing, licensing
and controlling psychiatric hospital / nursing homes.
• To provide legal aid mentally ill persons at state expense in certain
cases.
• To protect citizens from being detained in psychiatric hospital /
nursing homes without sufficient cases
• Central and state authorities for mental health services.
• To regulate maintenance charges of psychiatric hospitals/nursing
homes

5. Act
The act is divided into 10 chapters consisting of 98 sections.

6. Chapter I
Preliminary information
It contains definition included :-
• Psychiatric hospital/nursing homes :-
A hospital/ nursing home established or maintained by the government
or any other person for the case of mentally ill persons.
• Mentally ill person :- A person who is in need of treatment by reason
of any mental disorder other than mental retardation.

7. Contd..
• Psychiatrist –a medical practitioner possessing postgraduate degree
or diploma in psychiatry recognized by the MCI (medical council of
India)
• Reception order:-
An order made under the provision of this Act for the admission and
detention of mentally ill person in a psychiatric hospital / nursing
home.

8. Outdated definition are changed based on
current knowledge
Old term New term
Lunatic mentally ill person
Lunatic asylum psychiatric hospital
Criminal lunatic mentally ill prisoner

9. Chapter II
It deals with establishment of central & state authorities for regulation
and co- ordination of mental health services.

10. Chapter III
It provides guidelines for establishment and maintenance of psychiatric
hospital/nursing home.

11. Chapter IV
It deals with the procedure for admission and detention in psychiatric
Hospital/nursing homes.

12. Types of admission
Typesofadmission
Admission on voluntary
basis sec. 15 and 16
Admission under
authority / order
Reception on
application sec 20
Reception on production
before magistrate sec 23
Reception after sec 26
Admission and
detention of mentally ill
Admission under special
circumstance Sec 19

13. Admission on voluntary basis
Voluntary admission is made
If the medical officer is satisfied for admission
Medical officer makes enquires within 24 hrs
Request by a major/ guardian of the minor for admission to medical officer

14. Admission under special circumstances (Involuntary)
Patient is unwilling or unable to make a request for admission , a
relative /friend makes an application to the medical officer on behalf of
the patient
Medical officer makes enquires within 24hours
If the medical officer is satisfied for admission
Involuntary admission is made

15. Admission under authority or order
Mentally ill person can be admitted to psychiatric
nursing hospital by court of law or an approved
authority .
The authority can pass an order for reception and
detention mainly under four different categories.

16. Contd..

17. Reception order on application
Only a relative not other
than husband ,wife ,guardian
or a friend can make out an
application for admission of
client
Two official
certificate
needed
Being a minor or one has
not seen the mentally ill
patient in the last 14 days
can make such application
With the application a
medical officer can extend
inpatient treatment to
more than 6 month

18. Reception order on production of a mentally ill person before a
magistrate

19. 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

20. Admission under Reception order
Petition
Examination
Determination
Medical
administrator

21. Contd..
Medical administrator
Emergency to control
on immediate threat
to self or others
Short term for
diagnose and short
term therapy
Long term for
treatment and
determined ready for
discharge
Release hospitalization

22. Chapter V
Discharge procedure to be followed for a mental hospital under
different circumstances
Discharge procedure
Voluntary discharge
under sec 18
Discharge under
special admission sec
19
Discharge in respect of
admission due to an
order of an authority
in all five types

23. Discharge of a patient admitted on voluntary
basis
Medical officer in-charge of psychiatric hospital /nursing home on
recommendation from two medical practitioner preferably a
psychiatrist, can issue directions for discharge of the patient.

24. Discharge of patient admitted under special
circumstances
• Relative or a friend may be make an application to the medical officer
for care and custody of the patient.
• Relative are required to furnish a bond with or without sureties ,
along with an undertaking that the mentally ill person shall be
prevented from causing injury to self or others

25. Discharge of a patient admitted on reception
order
Application
A certificate from medical
officer –in charge of psychiatric
hospital /nursing home
A magistrate issues an order if
patient is fit for discharge

26. Discharge of a patient admitted by police
If police detain the mentally ill individual in hospital ,
he may be discharged after the family members agree in writing to take
proper care that he is fit to be discharged .

27. Discharge of a mentally ill Prisoner
• Hospital authorities have to report every 6 months about the persons
state of mind to the authority , which had ordered detention
• As soon the client is fit to stand in trial , they have to inform about the
same to the authority concerned .
• Person then hand over to the prison officer for further legal action.

28. Leave of absence (section 45)
• It means patient is given time limit permission to visit family
members.
• On application by a relative or others to the medical officer-in-charge
And a bond duly signed stating that the patient will be taken proper
care of and prevented from injuring self or others (for a period of
maximum 6 days)

29. Chapter VI
• Consist of legal customary actions towards the property possess by
mentally ill persons.
• Under sections 54(1) a guardian may be appointed by court of law on
behalf of an alleged mentally ill person incapable of looking after self
and property.

30. Contd..
• Under section 97 of the act when a mentally ill person is not
represented by a legal practitioner in any proceeding before a district
court or magistrate and such a patient does not have sufficient means
to engage a legal practitioner then the district court.

31. Chapter VII
• Deals with ways and means to meet the lost of maintenance of
mentally ill persons detained in psychiatric hospital.
• Under section 78 when a mentally ill patient is detained as an
inpatient and does not have property to bear the cost of treatment ,
in such cases this expenses shall be borne by the government of the
state.

32. Chapter VIII
Contains the novel and explicit provision for protection of human right
of mentally ill patients Section 81 provides that:
1. No letter or communication sent by or to a mentally ill person shall
be interpreted detained or destroyed.
2. No mentally ill person shall be subjected during treatment to any
indignity (physically or mental ) or cruelty

33. Contd..
3. No mentally ill person under treatment shall be used for purpose of
research unless:-
• Such research is of direct benefit to him
• A consent has been obtained in writing from the person (in voluntary
admission) or from the guardian/ relative (if admission was
involuntary)

34. Chapter IX
• Deals with procedure to be followed for the establishment and
maintenance of psychiatric hospital and penalties which can be
relatively severe and explicit for containing them.
• Article 6(1)of the mental health Act prohibit the running of a home
without license.
• Article 11(1b) says the licensing authority can revoke the license if the
maintenance of the manner detrimental to the moral, mental or
physical well being of the in patients.

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

36. Mental health care bill 2013
• Mental health care bill ,2013 was introduced in the Rajya sabha on
August 19,2013. the bill abolished the mental health Act, 1987
• It have 16 chapters

37. Chapters
• Chapter 1- preliminary information on definition, short titles , extent
and commencement
• Chapter 2- mental illness and capacity to make mental health care
and treatment decision
• Chapter 3-advance directive
• Chapter 4- nominative representative
• Chapter 5- right of persons with mental illness
• Chapter 6- duties of appropriate government
• Chapter 7- central mental health authority

38. Contd..
• Chapter 8- state mental health authority
• Chapter 9-finance , accounts and audit
• Chapter 10- mental health establishments
• Chapter 11- mental health review commission
• chapter 12-admission, treatment and discharge
• Chapter 13- responsible of other agencies
• Chapter 14 –restriction to discharge functional by professional not covered
by profession
• Chapter 15- offences and penalties
• Chapter 16-iscellaneous

39. Nurses implication for protecting Patients Rights
• Nurse should guide the patients relative to their rights and protect
the patient from any mistreatment.
• Nurse should be aware of these rights in the first place.
• Nursing care plan should include rights of the patient and it should be
discussed by the mental health team.

40. Summary

41. Conclusion
The Indian mental health Act (MHA) was drafted by the parliament to
change the attitude of the society towards the mentally ill. In the
advancement of medical science it has become necessary to make
fresh legislation in accordance with the new approach.

42. Bibliography
• R. Sreevani A guide to mental health & psychiatric nursing Jaypee
342-348
• www.prindia.org>media.meantal health
• www.livemint.com.meatal health act
• www.mohfw.gov.in>default>files>mentalhealth act
• www.patient engage .com

43. Thank you