Notes: Indian Mental Health Act 1987

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Medical Acts

Indian Mental Health Act 1987

Indian Mental Health Act 1987
History
  • Drafted in 1987
  • Came in to action on April 1993
Reason for enactment
  • Change in attitude of the society
  • Rapid advance in technology outdated Indian Lunacy Act 1912
Objectives
  • To regulate admissions
  • To protect society
  • To protect citizens from detained in psychiatric hospitals without cause
  • To regulate maintenance charges
  • Guardianship
  • Establish central and state authorities
  • Regulate the powers of Government
  • To provide legal aid to mentally ill
Salient features
  • 10 chapters
  • 98 sections
Chapter I
  • Included definition of
    • Psychiatric hospital- 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
    • Mentally ill person- a person who is in need of treatment by person of any mental disorder other than mental retardation
    • Psychiatrist- a medical practitioner possessing a post-graduate degree or diploma in psychiatry, recognised by the Medical Council of India, constituted under Indian Medical Council Act, 1856 (102 of 1956), and includes, in relation to any State, any medical officer who, having regard to his knowledge and experience in psychiatry.
    • Reception order- an order made under the provision of this Act for the admission and detention of a mentally ill person in a psychiatric Hospital or psychiatric nursing home
Chapter II It deals with establishment of central and state authorities for regulation and coordination of mental health services.
Chapter III
  • Guidelines for establishment and maintenance of psychiatric hospitals/ nursing homes
Chapter IV  It deals with procedure for admission and detention in psychiatric hospitals.
Admission on-
  • Voluntary basis - Any persons (not being a minor), who considers himself to be a mentally ill person and desires to be admitted to any psychiatric nursing home for treatment, may request the medical officer in charge for being admitted as a voluntary patient.
  • Special Circumstances: Any mentally ill persons who does not, or is unable to, express his willingness for admission as a voluntary patient, may be admitted and kept as an in-patient in a psychiatric nursing hospital or psychiatric nursing home on an application made in that behalf by a relative or a friend of the mentally ill persons if the medical officers-in-charge is satisfied that mentally ill person need admission.
  • Reception order-
    • On application- Only a relative not other than husband, wife, guardian or a friend can make out an application for admission. Such application should be made out to magistrate with two medical certificates among them one should be a Gazetted medical officer. Patient can be admitted only after getting consent from medical officer.
    • On production before magistrate- Mentally ill person exhibiting violence can be brought by police, produce before magistrate within 24 hours and admission can be issued by the Magistrate, when it is supported by two medical certificates. 
  • Emergencies-Medical officer in- charge can issue admission of a mentally ill patient, if he thinks that patient can be dangerous to society or him. However within 24 hours Magistrate should visit patient in hospital or patient should be taken to Magistrate to issue admission.
  • Temporary treatment order- When a risk is perceived by the medical officer he can apply to the magistrate with a single medical certificate.
  • Mentally ill Prisoners- A prisoner can be admitted to hospital on the order of court.
  • Miscellaneous: Those who are wandering on road can be admitted to hospital by a social worker by getting order from magistrate and medical officer.
  Chapter V
  • Deals with discharge
    • Discharge who was on voluntary admission-Medical officer in charge with recommendation from two medical practioners preferably psychiatrist can discharge the patient
    • Discharge of patient admitted under special circumstances-A relative or a friend may 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.
    • Discharge of a patient admitted on reception order- A person who feels that patient is fit to recover can apply for discharge. A certificate from medical officer should accompany the application and if magistrate approves fit person can be discharged.
    • Discharge of a patient admitted by police-If police had admitted the patient, relatives can apply for discharge by assuring that they will take care of the patient by written agreement. Medical officer should approve it.
    • Discharge of mentally ill prisoner- every 6 months a report has to be sent to prison authority. When the person is fit for trail it needs to be informed to the authority. After discharge person should be handed over to prison officer.
    • Leave of absence- On application by a relative or others can apply for a leave of absence for maximum 60 days. It should accompany a written agreement stating the responsibility to take care of the patient and will prevent any harm to society also.
Chapter VI
  • Judicial enquiry on mentally ill persons property and its guardianship
  • Legal practitioner in Government expense
Chapter VII
  • Ways and means to meet the cost of maintenance of mentally ill persons
  • Section 78
Chapter VIII
  • Section 81
  • Protect the human rights
    • No indignity or cruelty
    • Use for research- It should be allowed when the person gets the direct benefit from it and a consent from patient or guardian is taken.
    • No letter or communication sent by or to the person shall be intercepted
Chapter IX
  • Establishing and licensing of psychiatric hospitals
  • Penalties if it is violated
Chapter X
  • Procedures to be followed by the medical officer in charge of the psychiatric hospitals
Advantages
  • Incorporates scientific knowledge and social concepts
  • An attempt is made to make mental illness look on par with physical illness to reduce stigma
  • Definitions are in a progressive way
  • Treatability is an essential criterion
  • Formation of mental health authorities provide opportunities for better monitoring
  • Outpatient services are mandatory
  • Admission and discharge procedures made simple
  • Separate hospitals for children and addicts
  • Protected human rights
Disadvantages
  • Not applicable to mental retardation and dementia
  • Patients admitted in general hospitals and nursing homes are spared
References
  • R.A guide to mental health and psychiatric nursing.2nd ed.New delhi: Jaypee publishers; 2006.
  • Ahuja .N.A short text book of psychiatry.5th New delhi: Jaypee publishers;2006.


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Notes: Indian Mental Health Act 1987
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