PANIC AND ANXIETY ATTACK AMONG STUDENTS:A CRTICAL

ANALYSIS IN ACCORDANCE WITH MENTAL HEALTH CARE ACT

SUBMITTED BY-

NAME- SHIVANGI
ROLL NO- 1077
SECTION-B
SEM- IX

SUBMITTED TO- Dr.koushik Bagchi

Assistant professor

National University of Study and Research in Law ,Ranchi

STATEMENT OF PROBLEM:
The interface of policy and legislation is crucial in making quality mental health care accessible in an
effective manner. Shortage of psychiatrists and other mental health personnel in India poses a huge
challenge in delivering mental health care. The social context is instrumental in subjecting the mentally
ill to human rights violations and discriminations with low awareness, illiteracy, superstitions, denial,
and the prevailing social perception of mental illness in India. International developments in mental
health care have brought a paradigm shift from “charity-” to “rights-” based approach which is very
much reflected in India's first-ever Mental Health Policy, 2014, and the newly enacted Mental
Healthcare Act, 2017. The paper analyses the panic and anxiety disorders among the students and what
triggers it and what are legal and health measures should work in tandem and eventual convergence be
directed toward the best interest of mentally ill persons.

OBJECTIVES:
 To analyze the panic and anxiety disorder among students
 The Role of Policy and Legislation in Mental Health Care
 To know about different rights available to mentally ill persons

RESEARCH METHODOLOGY:
The primary research methodology is used and data is collected through surveys.
TABLE OF CONTENTS:

1.INTRODUCTION

2.INDIAN LAWS REGULATING TREATMENT OF PERSONS WITH MENTAL

DISORDERS

3.INTERNATIONAL POLICIES
 UN CONVENTION ON RIGHTS OF PERSONS WITH DISABILITIES
 UN PRINCIPLES FOR PROTECTION OF MENTAL ILLNESS AND HEALTH
CARE(THE MI PRINCIPLES 1994

4.CASE LAWS

5.DATA ANALYSIS

6.CONCLUSION
 1.INTRODUCTION:

Mental health laws involve a wide range of regulatory matters and pertain to people who manage,
diagnose, or treat psychiatric patients as well as those who may develop a mental illness. It is
essential to know mental health legislation in order to fully appreciate mental health and the
rationale behind mental healthcare-related legal measures. Our emotions, mental stability, &
sociological welfare are the components that make up mental health. It also governs our capacity for
sound decision-making, how we respond to stress, and how others interpret us.All people need to
maintain good mental health throughout their lives. Individuals with mental disabilities and the
treatment they require are also included in the category of mental health. Every human being needs
to maintain good mental health throughout their life. Mentally ill individuals and the care they
require are also included in the category of mental health. Mental health laws apply to anyone who
need treatment for a mental illness or handicap. In India, the word "PMI" refers to individuals who
suffer from mental illness or disorders. When the British acquired control of the Indian government
in 1800, the system of asylums for the care of PMI was established.1
The legal framework that governs India is referred to as Indian Legal Systems. Historically, there
existed a unique legal tradition with a separate school of legal theory and practice. India has a
distinguished tradition of using law as a vehicle for philosophical discussion and religious precepts.
Important treatises that were regarded as authoritative legal counsel in India were the 400 BC
Arthashastra & the 100 AD Manusmriti. Manu was widely recognized throughout Southeast Asia
for his core beliefs in diversity and tolerance. Sharia law arrived in India during the Islamic era, but
it was mostly used by Muslims. Hindu and Islamic rules were introduced when India joined the
British Empire, breaking with custom.Because of this, the country's current legal system is mostly
based on the British system and bears little resemblance to the pre-British institutions.English
Common Law, a body of law founded on documented judicial precedents that exhibits significant
influence from Europe and America, serves as the foundation for a huge portion of modern Indian
laws. Numerous laws enacted by the British are still in effect today. Thus, the majority of laws
pertaining to people with mental illnesses (PMI) had their origins in British times.2

2.INDIAN LAWS REGULATING TREATMENT OF PERSONS WITH

MENTAL DISORDERS:

The link between law and psychiatry most often comes into play during PMI therapy. Reducing a
mental patient's level of personal independence is another aspect of PMI therapy. The majority of
nations have laws governing the treatment of mental health patients

1
Legalupanishad (2023) Mental health laws in India: All you need to know in 2022, Legal Upanishad. Available at:
https://legalupanishad.com/mental-health-laws-in-india/ (Accessed: 20 November 2023).

2
Narayan, C.L. and Shikha, D. (2013) Indian legal system and Mental Health, Indian journal of psychiatry. Available at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705679/ (Accessed: 20 November 2023).
The care of mentally sick individuals in Indian asylums is a British invention, but several Ayurvedic
treatises provide comprehensive explanations of various forms of mental diseases. Many rules
governing the care and treatment of mentally ill individuals in British India were passed quickly after
the British Crown assumed control of the country's government in 1858. Those were the laws:
The Lunacy (Supreme Courts) Act, 1858 The Act of 1858 on Lunacy (District Courts)

The 1858 Indian Lunatic Asylum Act (modified in 1886 and 1889)

The Military Lunatic Acts, 1877.

These Acts established guidelines for the founding of 'mental health facilities & for the admission of
mentally ill individuals. 'The British scenario that emerged in the middle of the 19th century served ,as
the precedent for lunacy legislation during that time in India. Naturally, the several Acts of 1858
reflected the legalistic framework for the treatment of mentally sick individuals.

Persons with disabilities (equal opportunity, protection of rights, full participation) Act, 1995
(PDA-95)

'PDA95' was adopted in 1995 with the goals of opposing violence against & exploitation of people
with disabilities (PWD) as well as eliminating prejudice in the sharing of developmental resources
with non-disabled individuals. PDA-95 classifies 'mental disorders & mental retardation 'as
disabilities. As a result, the PMI is qualified to receive the benefits granted to PWDs as stipulated
by the Act. There is a three percent reservation for govt. jobs, but the PMI doesn't include it.

NATIONAL TRUST ACT:

This Act was passed in 1999 in order to support equal opportunity realization and the protection of
rights for individuals with autism, cerebral palsy, mental retardation, and other impairments, as
well as to enable and encourage them to live as independently and near to society as possible. 3
The aforementioned legislation provided guidelines for the creation of mental asylums and the
process for admitting people with mental illnesses. India's lunatic laws around the same time period
were based on the British image that existed in the middle of the 19th century. The several 1858
legislation served as a reflection of the legal framework governing the care of mentally sick people.
Thus, in 1912, the ‘Indian Lunacy Act’ was passed. In 1922, mental hospitals were renamed as
'lunatic asylums, 'and they are currently managed & overseen by a central body. There was an
introduction to the act of voluntary admission.

3
Legal Aid & Support Centre (2021) Mental health laws in India, Legal Aid & Support Centre. Available at:
https://legalaid.nmims.edu/mental-health-laws-in-india/ (Accessed: 20 November 2023).
Nevertheless, the primary goals were to safeguard society from the threat posed by’ mental
illnesses’ ,&to ensure that no sane person was admitted to these ‘mental asylums’. In these asylums,
psychiatrists were employed full-time. The statute also included provisions for judicial probation for
those with mental illnesses. The UN General Assembly adopted the Universal Declaration of Human
Rights (UDHR) in 1948, following World War II. In an attempt to replace the antiquated ‘ILA-1912,
the Indian Psychiatric Society’, filed a draft of the ‘Mental Health Bill in 1950.’ The lengthy process
culminated in the creation of the’ Mental Health Act (MHA-87) in 1987.’

As a result, appropriate mechanisms are required to guarantee that those who are impacted receive
the needed medical care, & laws and regulations are put in place to safeguard the rights of this group.
India has regulations governing the treatment of psychiatric patients, or mentally ill individuals, just
like many other nations do. Though they also have many shortcomings, relatively few acts are for the
immediate interests or rights of persons with PMI.The National Mental Health Program was
redesigned in 1996, although since its inception in 1982, it has been more proactive than reactive.
The National Human Rights Commission's 2008 assessments on the nation highlight the best parts of
the mental health care reform.

To address these problems, The Mental Health Care Act was approved on April 7, 2017, &’ it went
into effect on July 7, 2017. The purpose of this legislation is to uphold and defend the rights of those
who suffer from mental illness. This Act took the place of the earlier Mental Health Act of 1987. It is
unclear if this act will give mental health patients protection and fair treatment.’4

The Mental Healthcare Act:

In 2017, the Mental Healthcare Act was put into effect, adopting a 'rights-based approach' to mental
health & mental healthcare. Throughout the course of treatment, it seeks to provide mental health
services in a way that upholds, defends, & fulfills the rights of those who are mentally ill.

The law acknowledges that everyone, including those with 'mental illnesses, 'has the capacity to
decide for themselves what kind of treatment & mental health care they would like to receive. A
person is considered to have this capacity ,if they can communicate this knowledge, understand all
pertinent information about the treatment, & understand the implications of their choice. The law
makes it clear that, in the event that a third party believes that a decision is incorrect, it doesn't
means that one can't make decision.
The Act affirms that 'people with mental illnesses have the same rights to treatment as people with
physical illnesses ' in all respects & acknowledges their right to live a life devoid of discrimination.
Additionally, it shields patients from cruel, inhumane, & dehumanizing treatment in facilities that
provide mental health services.'
The following are extra advantages as specified by the law:
 It grants people with mental illness the right to live in the community &; if medically
feasible, the right to live outside of a mental health facility. It also provides government
support in situations 'where the person lacks family support,

4
Indian legal system and Mental Health, Legal Service India - Law, Lawyers and Legal Resources,
https://www.legalserviceindia.com/legal/article-7286-indian-legal-system-and-mental-health.html (last visited Nov 20,
2023).
  It gives the person with the mental illness & her/his designated representative the right to
comprehensive information about the 'law, the nature of the illness, and treatment.'
 It is required of all mental health providers to keep client information 'private'. Without the
individual's permission; no data or images pertaining to a mental health patient may be shared
with the media.

 Unless otherwise stated, a person with mental illness is entitled to make decisions about their
own communication & personal interactions, within the policies of the mental health facility.
This covers 'emails, in-person meetings, phone conversations, & so on, and gives the
individual the option to accept or decline contacting anyone.'

 Additionally, it guarantees the provision of 'high-quality, easily-acquired, & reasonably

priced mental health facilities' by the government, as well as free services for individuals who
are homeless or Below Poverty Line (BPL), even in the absence of a BPL card.5

REFORMS IN POLICY AND LAW NEEDED FOR MENTAL HEALTHCARE ACT IN

INDIA:

The world's mental health problems ,have come to light in this unprecedented period. There was an
epidemic of mental illness in India even prior to the' COVID-19 pandemic.'

The 'World Health Organization (WHO)' estimates that mental illness accounts for 15% of all
medical conditions worldwide. According to the WHO, one of the biggest populations in the world
suffering from mental illnesses, from severe conditions like 'schizophrenia to depression and
anxiety,' is found in India.

Issues that need to be addressed:

1.India leads the world in suicide rates. There is a clear correlation between mental health & India's
high rates of drug addiction and crime.
2. The pandemic has brought attention to previously unreported mental health problems, exposing
flaws in the current legal framework & mental health enforcement. The pandemic has revealed the
need for the Central or State governments to provide greater support & reinforcement to India's
mental health care system. In India, there is a dearth of' integrated mental health services & a botched
attempt to implement the DMHP.'

3.People's mental health is suffering as a result of the 'COVID-19 pandemic, '& this is only the
beginning. There will be significant negative effects on mental health, social welfare, & the economy
if we don't make firm commitments to increase funding in this area immediately.
4. 'Anxiety and depression,' two of the most prevalent mental illnesses, cause lost productivity that
costs the world economy money every year. Over 75% of individuals with mental illnesses in low-
& middle-income nations;14 don't receive any treatment at all for their condition.

5
Rasika Rane, Know your mental health rights at work in India Kool Kanya (2023), https://blogs.koolkanya.com/mental-
health-rights-at-work-in-india/ (last visited Nov 20, 2023).
Due to a lack of funding and resources, mental health in India is receiving less attention. It is
imperative that we give mental health a higher priority by funding & incorporating mental healthcare
into both the 'public & private sectors.'

MEASURES REQUIRED:
1.Experts point out that fixing many of the major problems with mental healthcare delivery in India
will require a successful implementation of the' DMHP.'

2.In restrictive mental health establishments, the government is required by the new Act to provide
'less restrictive community-based establishments including half-way homes, group homes, &the like
for persons who no longer require treatment.' In actuality, though, India's mental health care services
lack or have insufficient rehabilitation facilities. The order from the 2017 Supreme Court to establish
or grow these halfway houses has not yet been complied with by the federal or state governments.
The states have only offered a roadmap for implementation as of 2020.
3. Since there can be 'no health without mental health,' treating mental health disorders requires
serious consideration and should be prioritized even above physical health. At the primary healthcare
level, policymakers should support mental health & provide easy access to affordable treatment for
common mental disorders.

4.The current state of mental health in India necessitates the government to allocate resources
& create dynamic policies. By implementing nationwide programs, there is an urgent need to use the
media, social media, and other community services to raise awareness & lessen the stigma associated
with mental health illness. Global reports indicate that the pandemic has also resulted in major
psychological effects, including stress, anxiety, depression, fear, and sleeplessness.
5. According to a recent report by India Today, there has been a 20% rise in mental health cases in
India since the lockdown was implemented in March 2020.

6.As it can be observed, the NMHP has offered some preliminary measures to enhance the mental
healthcare system. Improving the situation will require appropriate intervention, awareness of the
problem, and easy access to professionals. To control this, collaboration between the public, private,
and social spheres is necessary. In order to ease people's distress and guarantee convenient access to
mental health facilities, there is an immediate need to offer psychological assistance with qualified
mental health professionals acting as first aid.A plea pending before the Supreme Court has prayed
for mental disorders to also be covered by insurance.6

6
Healthcare act, 2017 and concerns - rajasthanjudicialacademy.nic.in,
https://rajasthanjudicialacademy.nic.in/docs/studyMaterial09022021.pdf (last visited Nov 19, 2023).
3.INTERNATIONAL POLICIES:

1.UN Principles for the Protection of Mental Illness and Health Care (The MI Principles
1994):

In 1991, the General Assembly of the United Nations approved the MI principles. The MI
principles offer the non-binding guidelines that national mental health systems must adhere to in
order to treat mental illnesses in their citizens. The text essentially lays forth 25 principles for the
defense of the rights of those who suffer from mental illness. The following section discusses a few
of the key ideas:

Basic rights & fundamental freedoms: This clause includes numerous enshrined provisions in
addition to a single one. They are as follows:

• The health and social care systems must include the greatest mental health care that is available to
all individuals.

• Every individual suffering from a mental disease must be handled with kindness.

• Every individual suffering from mental illness is entitled to safeguarding from financial, sexual,&
further types of exploitation.

• Discrimination on the basis of mental illness is prohibited. Any preference or exclusion that
results in the nullification or destruction of the equal enjoyment of rights is referred to as
‘discrimination.'

• The Universal Declaration of Human Rights & other accords acknowledge that every individual
with mental illness has the right to exercise all civil, political, social, economic, & cultural rights.

• A person must be appointed following a fair hearing by an impartial and independent tribunal if
their mental illness prevents them from having the competence to act in court.

• A person who lacks the capacity for reasoned decision-making is entitled to legal representation.
• For the extent that he lacks the financial resources, services will be rendered without cost to the
individual whose ability is in question if he fails to get such representation on his own.

• When a court or other competent body determines that an individual with a mental illness is
incapable of handling their own affairs, appropriate action will be taken to safeguard the
individual's interests, to the extent that it is necessary given their condition.

Medical Examination: Except in compliance with the legal processes, no one may be forced to
submit to a medical examination in order to ascertain if they are mentally well.

Treatment consent: No one should get medical care without giving their free and informed consent.
When consent is given freely and isn't coerced by another individual, it's considered free will. In the
event of an emergency, a medical professional is legally permitted to treat a patient without the
patient's previous agreement in order to eliminate a serious threat to the patient's health.

Every attempt should be taken by an individual to tell the patient about the nature of the therapy and
any available alternatives, as well as to involve the patient in the treatment plan, when treatment is
administered to someone without their 'previous consent. '

Rights and conditions in mental health facilities: Everyone residing in a mental health facility, is
entitled to full 'legal recognition, complete respect for their privacy, as well as freedom of
communication,' which includes the ability to send and receive uncensored private messages.

Procedural safeguards: In the event of a violation, complaint procedure, or appeal, the patient shall
be entitled to select and appoint counsel, & free legal assistance shall be granted to the patient to the
degree that he is financially unable of affording.
2. UN Convention on Rights of Person with Mental Disabilities:

On December 13, 2006, the United Nations Convention on the Rights of Persons with Disabilities
was ratified. The Convention reiterates that all people with disabilities, regardless of their nature,
must be able to exercise their 'fundamental freedoms & human rights'. It also includes a broader
group of people with disabilities.

It makes clear how these rights relate to people with disabilities & points out areas where laws in
different nations need to be changed in order to properly protect the interests of people with 'mental
illnesses 'and successfully enforce their rights.The following are the basic provisions listed in the
'convention':

• Respect for 'people's independence, freedom of choice, & inherent dignity' as individuals.

• It is unacceptable for society to discriminate against 'admitted patients ',because of their mental
health conditions.

• The persons who are affected by mental health issues in society should be fully and effectively
involved.

• Individuals with disabilities should be respected for their differences and accepted as valuable
members of society.

• An individual's mental health condition or impairment should not be a barrier to their capacity to
continue growing.

• Individuals must be able to exercise their rights in a conscious and efficient manner and have
appropriate access to facilities.

• People shouldn't be subjected to discrimination based on their gender, which includes factors like
age, race, or gender identity.

• Children with disabilities should be respected for their developing abilities as well as their right to
maintain their identities.
 • The Convention represents a common change in how people view and interact with those who
have 'disabilities.' The ability of a person with mental illness to assert his rights and participate
actively in society has been taken to a new level.7

4.CASE LAWS:
1.Ratanlal Chamar v. State of Rajasthan 2018 (3) RLW 1827 (Raj.)
Accused with a mental illness—prosecuted for a crime under Section 302 of the Penal Code—was
unable to prepare or organize his defense & was experiencing an ongoing mental illness at the time of
the incident. He was also diagnosed with a case of schizophrenia.
Held: The accused appellant’s trial was vitiated & the conviction for the offense under Sec. 302 of the
Penal Code could not be upheld; the trial court’s order was set aside, the matter was remanded for a
new medical examination of the accused.
Section 330 of the Cr.P.C. has an engrafted special provision that states that if a person is found to be
incapable of getting into defense under Sec. 328 or 329 ,due to’ mental retardation or unsoundness of
mind,’ the court may order their release on bail, regardless of whether bail is permitted in the case.
However, the provision does not require in-patient treatment, and the person’s friend or relative must
agree to obtain regular outpatient mental treatment from the closest medical facility & to refrain from
harming themselves or anyone else. ‘We have encountered other similar instances recently in which,
despite facts coming to light regarding the accused’s serious mental illness, neither the police have
called for neither the courts nor any relevant legal provision have given the law’s mandate adequate
consideration.In situations like these, it is expected of the police to act quite sensitively. Looking into
Officer in this instance, even though they were aware of the serious mental illness of the many
witnesses, yet this was not mentioned in the’ charge sheet’ summary which was submitted to the court.
Pushpa M. Rawtani . v. In Reference Through, High Court Registrar, Principal Seat At
Jabalpur, Madhya Pradesh . Special Leave Petition Criminal nos.3999-4000 of 2017:

According to Section 18(1), ‘everyone has the right to receive mental health assistance & treatment from
organizations that are managed or supported by the appropriate govt. ‘
According to Section 18(2), the right to receive mental healthcare & treatment includes the following: mental
health services that are reasonably priced, of high quality, sufficiently available, geographically accessible,
& free from discrimination on the basis of gender, sex, sexual orientation, religion, culture, caste, social or
political beliefs, class, disability, or any other basis; additionally, these services must be provided in a way; that
is acceptable to those who are suffering from mental illness; as well as to their caregivers & their families.
As per Section 18(7), individuals who are homeless or in poverty but do not have a below-the-line card are
entitled to free mental health services & treatment at all mental health facilities funded or operated by the
relevant government, as well as at other facilities designated by it, without any financial burden.
Common Cause (A Regd. Society) v. Union of India (UOI) and Ors. (2018) 5 SCC 1:
Held: An advance directive is recognized by the Act. Written advance directives are required. It
requires that the subscriber be a major. When a maker of an advance directive does so, they specify

(i)How they want to be cared for and treated, if at all mental disease; and

7
Subodh Asthana, Mental health and laws governing mentally disabled-human rights issue iPleaders (2019),
https://blog.ipleaders.in/mental-health-laws-conventions/ (last visited Nov 20, 2023).
(ii) The individual he or she designates as the nominee.

An advance directive should only be used in the event that the person who made it no longer has
the ability to decide on mental health treatment. It is still in effect until the creator gets the ability to do
so again.

Accused ‘x’ v. State of Maharashtra (2019) 7 SCC 1:

It was decided that: Future cases must adhere to guidelines stating that severe mental illness following
a conviction will serve as a ‘mitigating factor’, & the appellate court must take this into consideration
when it makes sense ;while imposing the death penalty on an accused person. An evaluation of this
kind of disability ought to be carried out by a multidisciplinary group of certified experts (seasoned
medical practitioners, criminologists, and so forth), including experts in the field of accused specific
mental disease. The onus is on the accused to establish by a ‘preponderance of the evidence proof’ that
, he is experiencing serious mental illness.. The Accused must provide evidence symptoms that were
either prodromal, persistent, or active and indicated a severe mental illness. The accused must present
evidence of ‘prodromal, residual, or active symptoms ‘of the severe mental illness. The State could
present proof to refute the’ claim in question. ‘In suitable circumstances, the court may assemble a
panel to present an expert report. The ‘test of severity’ that is envisioned here requires that ‘the
offender have a severe mental illness or disability.’ This simply means that the illness must be so
severe that the accused is unable to understand the nature of the ‘punishment or it’s purpose. ‘
5.DATA ANALYSIS:
  From the above survey it can be seen that out of 50 students,76%(motre than half of
population) of the students have gone through panic and anxiety attack and they have faced
various sypmtoms.
 And also most of the students had thought of hurting himself i.e. 48% which is almost 50% of
the population.
 Whereras as 36% of the students had thought of suicide.
 76% of the students had trouble on concentrating things and 54% of them have anxiety issues
and has sense of being detached from family as well as surroundings.
 75% of the population have trouble falling asleep or sleeping too much.

 Out of 50 students, 64% of the population had taken steps to avoid repeated attacks.

So from the above analysis it can be concluded that most of the students have suffered panic attack and
steps and measures should be taken to avoid panic attacks and proper medical treatment should be
given to mentally ill persons.
6.CONCLUSION:

Because of the inefficiencies of the current healthcare system and the dearth of professionals in the
field, the quality of life and care provided to mentally ill individuals has declined. One of the main
features of the Act is the decriminalization of suicide attempts, along with the idea of an Advance
Directive and the prohibition of all treatment methods that gave these mentally ill people
nightmares. It also aims to improve the system of institutions by hiring staff and ensuring that they
adhere to the standards set forth by the authorities in the Act.It is imperative to assign qualified
mental health specialists to tasks.

India, the second most populous country in the world and one of the fastest-growing economies, is
expected to adopt a more 'patient-centric approach 'to mental health issues with the passage of the
Mental Healthcare Act 2017. The guidelines must be strengthened in areas like primary prevention,
reintegration, and rehabilitation, otherwise, their execution would fall short & the problem of
former mental health patients would persist.