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THE MENTAL HEALTH ACT

(22nd May 1987)

(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 Mental Health Bill became the Act 14 of 1987 on 22nd May 1987. Later, the Government of
India issued orders that the Act came in force with effect from April 1, 1993 in all the states and
Union territories of India.

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

CHAPTER I

Chapter I (Preliminary) deals with the various definitions.

The Act uses the term ‘mentally ill person’ instead of ‘lunatic’ and defines it as ‘a person who is
in need of treatment by reason of any mental disorder other than mental retardation’. The term
‘mentally ill prisoner’ is used instead of ‘criminal lunatic’. Other new terms, which are defined in
the Chapter 1, are psychiatric hospital (instead of mental hospital), psychiatric nursing home
and psychiatrist.

“COST OF MAINTENANCE”, in relation to a mentally ill person admitted in a psychiatric

hospital or psychiatric nursing home, shall mean the cost of such items as the State Government
may, by general or special order, specify in this behalf.

“MENTALLY ILL PERSON” means a person who is in need of treatment by reason of any mental
disorder other than mental retardation.

“MENTALLY ILL PRISONER” means a mentally ill person for whose detention in, or removal to,
a psychiatric hospital, psychiatric nursing home, jail or other place of safe custody, an order
referred to in section 27 has been made.

“PSYCHIATRIC HOSPITAL” or “PSYCHIATRIC NURSING HOME” means a hospital or, as the

case may be, a nursing home established or maintained by the Government or any other person
for the treatment and care of mentally ill persons and includes a convalescent home established
or maintained by the Government or any other person for such mentally ill persons; but does
not include any general hospital or general nursing home established or maintained by the
Government and which provides also for psychiatric services.

“PSYCHIATRIST” means a medical practitioner possessing a post-graduate degree or diploma

in psychiatry, recognized by the Medical Council of India, constituted under the Indian Medical
Council Act, 1956, and includes, in relation to any State, any medical officer who, having regard
to his knowledge and experience in psychiatry, has been declared by the Government of that
State to be a psychiatrist for the purposes of this Act.

“DISTRICT COURT” means, in any area for which there is a city civil court, that court, and in any
other area the principal civil court of original jurisdiction, and include any other civil court
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which the State Government may, by notification, specify as the court competent to deal with all
or any of the maters specified in this Act.

“INSPECTING OFFICER” means a person authorized by the State Government or by the

licensing authority to inspect any psychiatric hospital or psychiatric nursing home.

“LICENSE” means a license granted under section 8;

“LICENSEE” means the holder of a license.

“LICENSED PSYCHIATRIC HOSPITAL” or “LICENSED PSYCHIATRIC NURSING HOME” means

a psychiatric hospital or psychiatric nursing home as the case may be licensed, or deemed to be
licensed, under this Act.

“LICENSING AUTHORITY” means such officer or authority as may be specified by the State
Government to be the licensing authority for the purposes of this Act.

“MEDICAL OFFICER” means a gazetted medical officer in the service of Government and
includes a medical practitioner declared, by a general or special order of the State Government,
to be a medical officer for the purpose of this Act.

“MEDICAL OFFICER IN CHARGE”, in relation to any psychiatric hospital or psychiatric nursing

home, means the medical officer who for the time being, is in charge of that hospital or nursing
home.

“MINOR” means a person who has not completed the age of eighteen years;

“RECEPTION ORDER” means an order made under the provisions of this Act for the admission
and detention of a mentally ill person in a psychiatric hospital or psychiatric nursing home.

“RELATIVE” includes any person related to the mentally ill person by blood, marriage or
adoption;

CHAPTER II

Chapter II provides for establishment of Mental Health Authorities at Centre and State levels.
These authorities will regulate and coordinate mental health services under Central and State
Government, respectively.

CHAPTER III

Chapter III lays down the guidelines for establishment and maintenance of psychiatric hospitals
and nursing homes. In addition, there is a provision for a Licensing Authority who will process
applications for licenses. No private psychiatric hospital or nursing home will be allowed to
function without a valid license, which has to be renewed every 5 years. There is also a
provision for an Inspecting Officer who will inspect the psychiatric hospitals and nursing homes
to prevent any irregularities.
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There is a provision for separate hospitals for:

1. Those under the age of 16 years,

2. Those addicted to alcohol or other drugs which lead to behavioural changes,

3. Mentally ill prisoners, and

4. Any other prescribed class or category.

CHAPTER IV

Chapter IV deals with the procedures of admission and detention in psychiatric hospitals or
nursing homes. In addition to the 5 methods allowed by the Indian Lunacy Act of 1912, one
more method has been incorporated.

Admission on
voluntary basis
Reception order on
application
Admission under
TYPES OF ADMISSION
special circumstances
Reception order on
production of a
mentally ill person
before a magistrate
Admission under
authority or order
Reception order after
inquest

Admission under
reception order
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1. ADMISSION ON VOLUNTARY BASIS-

Request by a major/guardian of a minor for admission to medical officer

Medical officer makes enquires within 24 hours

If the medical officer is satisfied that the applicant requires treatment as an inpatient in the
psychiatric hospital and requires admission

Voluntary admission is made

On receipt of a request under section 15 or section 16, the medical officer-in-charge shall make
such inquiry as he may deem fit within a period not exceeding twenty-fours and if satisfied that
the applicant or, as the case may be, the minor requires treatment as an inpatient in the
psychiatric hospital or psychiatric nursing home, he may admit therein such applicant or, as the
case may be, minor as a voluntary patient.

2. ADMISSION UNDER SPECIAL CIRCUMSTANCES (INVOLUNTARY BASIS) –

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 24 hours.

If the medical officer is satisfied that the applicant requires treatment as an inpatient in the
psychiatric hospital and requires admission

Involuntary admission is made

Any mentally ill person who does not, or is unable to, express his willingness for admission as a
voluntary patient, may be admitted and kept as an inpatient in a psychiatric hospital or
psychiatric nursing home on an application made in that behalf by a relative or a friend of the
mentally ill person if the medical officer-in-charge is satisfied that in the interests of the
mentally ill person it is necessary so to do: Provided that no person so admitted as an
inpatient shall be kept in the psychiatric hospital or psychiatric nursing home as an
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inpatient for a period exceeding ninety days except in accordance with the other
provisions of this Act.

Every application under sub-section (1), shall be in the prescribed form and be accompanied by
two medical certificates, from two medical practitioners of whom one shall be a medical
practitioner in the service of Government, to the effect that the condition of such mentally ill
person is such that he should be kept under observation and treatment as an inpatient in a
psychiatric hospital or psychiatric nursing home. Provided that the medical officer, in charge of
the psychiatric hospital or psychiatric nursing home concerned may, if satisfied that it is proper
so to do, cause a mentally ill person to be examined by two medical practitioners working in the
hospital or in the nursing home instead of requiring such certificates.

3. ADMISSION UNDER AUTHORITY OR ORDER -

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

a. Reception order on application –

Only a relative not other than husband, wife, guardian or a friend can make an
application for admission of patient.

Two official certificates are needed from medical officers.

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
months.

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

Mentally ill patient exhibit violent behaviour detained by police

Case to be produced in the court within 24 hours of detention

Application is supported by two medical certificates

Magistrate issues reception order

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c. 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.

d. Admission under reception order

Petition to be submitted

Examination of the patient to be done by the medical officer

Determination

Case referred to Medical administrator Release

Advised for hospitalisation

1. Emergency to control on immediate threat to self or others.

2. Short term hospitalization for diagnose and short term therapy

3. Long term hospitalization for treatment and afterwards discharge.

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CHAPTER V

Chapter V of Mental health act,1987, deals with the inspection, discharge, leave of absence of
mentally ill persons.

DISCHARGE
PROCEDURE

Discharge under Discharge in respect of

Discharge on
special admission due to an
Voluntary basis
circumstances order of an authority

1. DISCHARGE ON VOLUNTARY BASIS- Medical officer in-charge of psychiatric

hospital/nursing home on recommendation from two practitioner preferably a
psychiatrist can issue directions for discharge of the patient.

2. DISCHARGE UNDER SPECIAL CIRCUMSTANCES-

• Relatives or a friend can make an application to the medical officer for care and
custody of the patient.
• Relatives are required to furnish a bond with or without sureties along with an
undertaking that the mentally ill person shall be prevented from causing injury
to self and others.

3. DISCHARGE IN RESPECT OF ADMISSION DUE TO AN ORDER OF AN AUTHORITY-

• Discharge of a patient admitted on reception order-

Application to make

A certificate from medical officer in charge of psychiatric hospital/ nursing home to obtain

A magistrate issues an order if patient is fit for discharge

• Discharge of a patient admitted by police- If police detain the mentally ill

individual in hospital, he may be get discharge after the family members agree in
writing to take proper care that he is fit to be discharged.

• Discharge of a mentally ill prisoner-

➢ Hospital authorities have to report every 6 months about the person’s
state of mind to the authority which had ordered detention.
➢ As soon as the client is fit to stand in trial, they have to inform about the
same to the authority concerned for the person.
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➢ The person then will handed over to the prison officer for further legal
actions.

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

Chapter VI deals with the judicial inquisition regarding the alleged mentally ill person
possessing property, custody of his person and management of his property.

• If the court feels that the alleged mentally ill person is incapable of looking after both
himself and his property, an order can be issued for the appointment of a Guardian.
• If, however, it is felt that the person is only incapable of looking after his property but
can look after himself, a Manager can be appointed.

CHAPTER VII

Chapter VII deals with the liability to meet the cost of maintenance of mentally ill persons
detained in psychiatric hospitals or nursing homes.

• 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 expense shall be borne by
the Government of the state.
•
CHAPTER VIII

Chapter VIII is aimed at the protection of human rights of mentally ill persons. This is a new
chapter in the Act. It provides that,

1. No mentally ill person shall be subjected, during treatment, to any indignity (whether
physical or mental) or cruelty.
2. No mentally ill person, under treatment, shall be used for the purposes of research,
unless,
i. Such research is of direct benefit to him.
ii. A consent has been obtained in writing from the person (if a voluntary patient)
or from the guardian/relative (if admitted involuntarily).
3. No letters or communications sent by or to a mentally ill person shall be intercepted,
detained or destroyed.
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CHAPTER IX

Chapter IX deals with the penalties and the procedures to be followed for the establishment
and maintenance of psychiatric hospital and penalties which can be relatively severe and
explicit for containing them.

CHAPTER X

This chapter deals with clarification pertaining to certain procedures to be followed by the
medical officer in-charge of the psychiatric hospital/nursing home.

NURSES IMPLICATION FOR PROTECTING PATIENT RIGHTS

• Nurse should to be aware of patient’s rights in the first place.

• Nurse should guide the patient’s relatives for their rights and to protect the patient from
any mistreatment
• Nursing care plan should include rights of the patient and it should be discussed be the
mental health team.