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Caveats of mental healthcare act‑2017: Recommendation for amendments

Preprint · December 2022

DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_893_21

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1 LETTER TO EDITOR 1
2 2
3 3
4 Caveats of mental healthcare act‑2017: Recommendation for amendments 4
5 5
6 6
7 Dear Sir, acute side effects such as post‑injection delirium sedation 7
8 The rights‑based framework in the current Mental Healthcare syndrome, and acute dystonia and oculogyric crisis. 8
9 Act 2017 (MHA‑2017) has received a wider acceptance in 9
10 the minds of policymakers, patients, caregivers, judicial The other concerns requiring immediate attention for the 10
11 officers, and mental health professionals.[1,2] However, functioning of MHRB include notifying advance directives, 11
12 there appears to be a huge gap between acceptance in our continuing admission under special circumstances, and 12
13 minds and implementation at the ground level. Theoretical provision of separate wards for children and women under 13
14 knowledge of MHA‑2017 and the inability to translate it psychiatry in a general hospital. These amendments could 14
15 into practice in most of the general hospitals in the country also add the role of MHRBs for adolescents involved in 15
16 due to systemic issues has created a dilemma in the minds juvenile delinquency, child custody, termination of parental 16
17 of psychiatry residents. Therefore, it is necessary to have rights, and other related issues.[5] 17
18 periodic sensitization programs for psychiatry trainees as 18
19 well as psychiatrists to learn about changing scenarios in The protection of the rights of a person with mental 19
20 mental health legislation in the past five years.[3] illness should not be viewed as safeguarding oneself from 20
21 the practice of psychiatry in the absence of full‑fledged 21
22 The only discipline of Medicine that carries special implementation of MHA‑2017. This could be important 22
23 significance beyond ethical practice involving beneficence, for making a provision for the psychiatrist witnessing 23
24 autonomy, non‑maleficence, and justice is psychiatry. nonsexual or sexual boundary violation to notify the 24
25 This practice and the respect for the rights of a person MHRB in advance, a point not placed in MHA‑2017. 25
26 to bring about optimum mental health outcomes have The spirit of the MHA‑2017 also does not clarify the 26
27 been legally guided. Forensic psychiatry has started to role of the Consultation Liaison Psychiatrist and its 27
28 evolve as a subspecialty of psychiatry.[4] However, are effective practice in different departments under general 28
29 psychiatrists in the country confident in dealing with hospital units. Further, the role of the psychiatrist in 29
30 legal issues evolving in the aftermath of MHA‑2017 and cases requiring cognizance of other specified acts such 30
31 imparting this practice to postgraduate trainees? Is clinical as the Prevention of Child Sexual Offense (POCSO) Act, 31
32 practice synchronizing with the legal framework? Are Narcotics and Psychoactive Substances (NDPS) Act, The 32
33 we dealing with the paradox of MHA‑2017? Are budding Rights of Persons with Disabilities (RPwD) Act, Right 33
34 psychiatrists across the country in dilemma with regard to To Information (RTI) Act, etc. should also be viewed in 34
35 MHA‑2017? The response of different states is varied in parallel with MHA‑2017. 35
36 terms of readiness of infrastructure, the constitution of the 36
37 State Mental Health Authority (SMHA), the functioning of Authors emphasize the opportunity of teaching programs 37
38 Mental Health Review Boards (MHRB), and overall dismal to highlight the gaps in training and implementation of 38
39 application of MHA‑2017. Are there hasty translations of MHA‑2017.[6] The absence of functional implementation of 39
40 Western World rules on the infertile grounds of India? More MHA‑2017 requires the churning of thoughts of stakeholders 40
41 than four years after passing the act, the current level of to amend a few provisions such as the formation of the 41
42 functional implementation does not appear to be a healthy transitional local hospital review board till formal MHRBs 42
43 indicator for the growth of mental health services in the are functional.[7] This letter encourages clinicians and 43
44 country. This could provoke lawmakers to bring out the researchers to assess the compliance status of Indian states 44
45 amendments to MHA‑2017 to best suit the mental health with MHA‑2017 and to provide feasible solutions through 45
46 services and practices of the country. In the absence of systematic scientific research. 46
47 functional MHRBs, the practical caveats that may require 47
48 amendments may include providing electroconvulsive Financial support and sponsorship 48
49 therapy (ECT) to children and use of hospital beds for Nil. 49
50 day‑care procedures in psychiatry that include but are 50
51 not limited to the somatic therapies in psychiatry such as Conflicts of interest 51
52 administration of electroconvulsive therapy and repetitive There are no conflicts of interest. 52
53 transcranial magnetic stimulation (rTMS). It also includes 53
54 short‑term observation for a few hours in a general hospital 54
55 following administration of long‑acting injectables (LAI) Vijender Singh, Devendra S. Basera, 55
56 antipsychotics and assessment for the appearance of Roshan F. Sutar 56

© 2022 Indian Journal of Psychiatry | Published by Wolters Kluwer - Medknow 1

 Letter to Editor

1 Department of Psychiatry, All India Institute of Medical This is an open access journal, and articles are distributed under the terms of 1
2 Sciences (AIIMS), Bhopal, Madhya Pradesh, India the Creative Commons Attribution‑NonCommercial‑ShareAlike 4.0 License, 2
3 E‑mail: roshidoc@yahoo.co.in which allows others to remix, tweak, and build upon the work non‑commercially, 3
as long as appropriate credit is given and the new creations are licensed under
4 the identical terms. 4
5 Submitted: 03‑Nov‑2021, Revised: 08‑Oct‑2022, 5
6 Accepted: 09‑Nov‑2022, Published: *** 6
Access this article online
7 REFERENCES 7
Quick Response Code
8 Website: 8
1. Mishra A, Galhotra A. Mental healthcare act 2017: Need to wait and watch.
9 Int J Appl Basic Med Res 2018;8:67. www.indianjpsychiatry.org 9
10 2. Math SB, Gowda MR, Sagar R, Desai NG, Jain R. Mental health care act, 10
11 2017: How to organize the services to avoid legal complications? Indian J 11
Psychiatry 2022;64:S16‑24.
12 DOI: 12
3. Malathesh BC, Das S. Being a forensic psychiatrist in India: Responsibilities,
13 difficulties, and criticalities. Indian J Psychol Med 2017;39:732. 10.4103/indianjpsychiatry.indianjpsychiatry_893_21 13
4. Nambi S, Ilango S, Prabha L. Forensic psychiatry in India: Past, present,
14 and future. Indian J Psychiatry. 2016;58(Suppl 2):S175‑80. 14
15 5. Sharma  E, Kommu  JVS. Mental healthcare act 2017, India: Child and 15
adolescent perspectives. Indian J Psychiatry 2019;61(Suppl 4):S756‑62.
16 6. Math  SB, Basavaraju  V, Harihara  SN, Gowda  GS, Manjunatha  N,
16
How to cite this article: Singh V, Basera DS, Sutar RF.
17 Kumar CN, et al. Mental healthcare act 2017 – Aspiration to action. Indian 17
J Psychiatry 2019;61(Suppl 4):S660. Caveats of mental healthcare act‑2017: Recommendation for
18 7. Harbishettar  V, Enara  A, Gowda  M. Making the most of mental amendments. Indian J Psychiatry 2022;XX:XX-XX. 18
19 healthcare act 2017: Practitioners’ perspective. Indian J Psychiatry © 2022 Indian Journal of Psychiatry | Published by Wolters Kluwer - Medknow
19
20 2019;61(Suppl 4):S645. 20
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