THE MENTAL HEALTH ACT

Prepared By:
Mrs.AKILA. A , M.Sc (N), M.Sc (PSY),
ASSOCIATE PROFESSOR
 INTRODUCTION
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.
 HISTORY

In 1946, Bhore committee submitted its

recommendations .
The Indian Psychiatric Society was established in
January 1947, was quick to react to the recommendations
of Bhore committee.
In January 1949, A committee was formed with 3
distinguished Psychiatrists. They Prepared a draft bill
called as the Indian Mental Health Act, which was
redrafted and finalised in January 1950.
After 37 years in 1987, The Indian Mental health Act
(MHA) was drafted by the Parliament. but it came into
effect in all the States and Union territories of India in
April1, 1993. This replaces the Indian Lunacy Act of 1912.
 REASON FOR ENACTMENT
 The attitude of the society, towards the
mentally ill has changed considerably and now
it is realised that no stigma should be attached
to such illness, as it is curable practically when
diagnosed at an early stage.
 The experience of working with Indian lunacy
act , has revealed that it has become outmoded
with the rapid advancement of medical science
and the understanding of the nature of malady.
OBJECTIVES OF THE INDIAN MENTAL
HEALTH ACT
• To regulate admission to psychiatric hospitals or psychiatric
nursing homes of mentally ill persons who do not have
sufficient understanding to seek treatment on a voluntary basis,
and to protect the rights of such persons while being detained
• To protect society from the presence of mentally ill persons who
have become or might become a danger to others
• To protect citizens from detained in psychiatric hospitals or
psychiatric nursing homes with out sufficient cause.
• To regulate responsibility for maintenance charges of
mentally ill persons who are admitted to psychiatric
hospitals or psychiatric nursing homes.
• To provide facilities for establishing guardianship or
custody of mentally ill persons who are incapable of
managing their own affairs.
• To provide for the establishment of Central Authority
and State Authorities for Mental Health Services.
• To regulate the powers of the Government for
establishing, licensing and controlling psychiatric
hospitals and psychiatric nursing homes for mentally
ill persons.
• To provide for legal aid to mentally ill persons at
State expense in certain cases
 SALIENT FEATURES OF THE ACT
CHAPTER I: Preliminary informations
• Lunatics- Mentally ill person
• Criminal lunatics- Mentally ill prisoner
• Asylum - Mental Health Hospital
• Reception Order - Its an order made under the
provisions of this act for the admission & detention
of mentally ill person in psychiatric hospital.
CHAPTER II: Mental Health Authority
• Deals with the establishment of central &
state authorities for development,
regulation, direction & coordination of
mental health services
• These authorities advices the government
on mental health matters
CHAPTER- III: Psychiatric Hospitals &
Psychiatric Nursing Homes
• Lays down the guidelines for the
establishment & maintenance of psychiatric
hospitals & nursing homes
• License for the psychiatric hospitals & nursing
homes
CHAPTER- IV: Admission And Detention

It describe the procedure for admission & detention of

clients in psychiatric units
• On voluntary Basis

• Admission under special circumstances

• Temporary Treatment order

• Reception order

• Admission in emergencies

• Miscellaneous
VARIOUS TYPES OF ADMISSION
Admission
on
Voluntary
Basis
Admission
Miscellaneous
under special
Admission
circumstances

Admission
Admission
under
of Mentally
reception
ill prisoners
order

Temporary Admission in
treatment Emergencies
order
1. Admission on Voluntary Basis
Major: Wish to apply to the medical officer in charge
Minor: Guardian can apply
Medical Officer in charge : Inquiry with in 24 hours
admit the patient if treatment required

2. Admission under special circumstances

Unwilling for Admission
 
Application made by relatives
 
Medical Officer in charge inquired & admits the
patient
3. Admission under Authority or order:
Any mentally ill person can be admitted and
detained at a Psychiatric hospital or psychiatric
nursing home in accordance with an order
passed by the court of law or an approved
authority. This includes 4 different categories,
1.Reception order an application
2. Reception order on production of a mentally ill
person before a magistrate.
3. Reception order after inquest
4.Admission and detention of a mentally ill
prisoner.
 Admission under reception
order
Petition

Examination

Determination

Medical administrator

Release Hospitalization

Emergency to Short term Long term for

control on for diagnosis treatment &
immediate threat & short term determined ready
to self or others therapy for discharge
(i) Reception order an application:
Application is made by a relative /friend to
the magistrate

Application should be supported by two medical certificates

Magistrate obtains consent from the medical officer-Incharge of mental

hospital/ nursing home

Admission under reception order is made

(14 days observation, Medical Officers can extend < 6 months).

(ii) Reception order on Production before
magistrate:

Mentally ill patient exhibiting violent behaviour

detained by police officer

Produced in the court within 24 hours of detention

Application is supported by 2 medical certificates

Magistrate issues reception order

(iii) 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
(iv) Admission and detention of a
mentally ill Prisoner:
A mentally ill Prisoner may be admitted into a
mental hospital on the order of the Presiding
officer or a court.
 3. Admission under
reception order
Petition

Examination

Determination

Medical administrator

Release Hospitalization

Emergency to Short term Long term for

control on for diagnosis treatment &
immediate threat & short term determined ready
to self or others therapy for discharge
4. Admission in Emergencies
Medical Officer in charge

Admit the mentally ill clients

 24 hrs produce to Magistrate (Maximum 72 hrs)

 Magistrate visit & issue R.O

5. Temporary treatment order
Magistrate

 Medical Officer in charge

 Relatives

 Medical certificate valid for 6 months

6. Miscellaneous Admission
• Humanitarian Grounds (Wanders)
• Social worker
• Magistrate
CHAPTER- V:- Discharge
Deals with the procedure for discharge of
mentally ill from the mental hospital
 Discharge of patient
admitted on
Voluntary Basis

Discharge of patient
Leave of
admitted on under special
Absence
circumstances

Types of
Discharg
e
Discharge of patient Discharge of patient
admitted on mentally ill admitted on
prisoners reception order

Discharge of patient
admitted by Police
1. Discharge of patient admitted on Voluntary
Basis
Medical Officer in charge
 
2 Medical Practitioners (Psychiatrist)
 
Discharge
2. Discharge of patient admitted on under special
circumstances

Relatives / friends make an application

 
Medical Officer in charge
 
To take care of Custody(Surety & bond)
3. Discharge of patient admitted on reception order
Applicant application

A certificate medical officer in charge of

psychiatric hospital
A magistrate issues an order if patient is fit
for discharge

4. Discharge of patient admitted by Police

Family members agree to take care

 
Medical Officer in charge
 
Discharge
5. Discharge of mentally ill prisoners
6 months report
 
Authority person
 
Discharge
 
Detention
 
Fitness
 Handed over to prison officer

6. Leave of Absence
Medical Officer in charge

A bond duly signed

 Maximum 60 days
CHAPTER- VI: Management of Property
Narrates about judicial enquiry regarding mentally ill
person possessing property, their custody & management of
property

CHAPTER-VII: Cost of Maintenance

It deals with the liability to meet the cost of maintenance of
mentally ill persons detained in psychiatric hospitals
CHAPTER- VIII: Human Rights Protection
• Describes the protection of human rights of
mentally ill person
• Consent should be obtained for discharge
(from the client / from the relative)
• Mentally ill should not be included in
research unless its benefiting him
CHAPTER- IX: Mental hospitals Maintenance

Deals with the penalties & procedure for

establishment & maintenance of mental
hospitals

CHAPTER- X:
procedures to be followed by medical officer
in charge.
 POSITIVE QUALITIES OF MHA
• Incorporates the latest scientific
knowledge
• Attempts to reduces stigma
• Definitions are in Progressive way
• Treatability is an essential criteria
• It is not applicable for non treatable
conditions like MR and Dementia
• Psychiatric Patients admitted in general
hospitals are spared.
• Formation of mental health authorities
provide opportunities for better monitoring of
services.
• Outpatient services are mandatory in
Psychiatric hospitals
• Admission Procedures are simplified.
• Discharge procedures are made easier.
• Provision for separate hospitals for children,
addicts and Psychopaths.
• Efforts made to safeguard human rights of
mentally ill person.
 NURSING IMPLICATIONS
• Nurses should be well versed in legal
aspects of care and treatment of the
mentally ill.
• This knowledge helps her to guide the
patients and relatives.
• Knowledge about MHA enhances the
freedom for both nurse and Patient.
 THE MENTAL HEALTH CARE BILL,2013

• AUGUST 2013
• Every person have a rights to access
mental health care and treatment services
• Advance directive
• Registration
• Review commission
• Suicide
• ECT with muscle relaxants
• Chapter 1: Preliminary information
• Chapter 2: Mental illness and capacity
• Chapter 3: Advanced directive
• Chapter4 Nominated representative
• Chapter 5: Rights
• Chapter 6: Duties
• Chapter 7: Central mental health authority
• Chapter 8: state
• Chapter 9: Finance, accounts
• Chapter 10: Mental health establishments
• Chapter 11: Mental health review commission
• Chapter 12: Admisssion, treatment
• Chapter 13: Responsibilities of agencies
• Chapter 14: Restriction to discharge
• Chapter 15: Offenses, penalities
• Chapter 16: Miscellaneous