Mental health bill 2013 India

1. New Mental Health Act
Tanushree Bhargava
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2. What is a mental Health Act?
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3. Mental Health Act
 It is a short title used for all kinds
legislation relating to mental health laws.
 Developed to protect the basic fundamental right
of people “Right to live ” that comes under article
21 of constitution.
 IPC 309
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4. The Mental Health Act sets out:
• What is Mental Health?
• When and how people can be treated if they have
a mental disorder
• When people can be treated or taken into hospital
against their will?
• What people's rights are, and the safeguards
which ensure that these rights are protected
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5. Mental Health Acts In India?
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6. MENTAL HEALTH ACTS IN INDIA
PRE-INDEPENDENCE
1858:Indian
Lunatic assylum
act of 1858
1912:Indian
Lunancy act of
1912
POST-INDEPENDENCE
1947:Indian
Psychiatric
association
established.
1987:Mental
Health act of
1987(indian
psychiatric
society)
Mental Health
Care Bill
proposed in
2013
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7. 1858:Indian Lunatic Assylum
act of 1858
The main stress was on preventing the society from
dangerousness of mentally ills and taking care
that no sane person is admitted in these asylums
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8. 1912:Indian Lunacy act of 1912
 The 1912 Act guided the destiny of Psychiatry in India
 regulated and supervised by a central authority.
 Procedure of admission and certification in this respect was clearly
defined.
 The provision of voluntary admission was introduced.
 Psychiatrists were appointed as full time officers in these hospitals.
Still, the main stress was on preventing the society from dangerousness of
mentally ills and taking care that no sane person is admitted in these
asylums.
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9. Why 1912 Act needed to be changed
Offensive terminologies used in Indian Lunacy act of 1912:
 Lunatic person
 Criminal Lunatic
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10. MHA Act 1987
 Came into effect in April 1993
 To ensure availability and accessibility of minimum mental health care for
all.
 10chapters and 98 Sections
 Main Aim to establish governing bodies at central and state level for
licensing and supervision of psychiatric hospitals and nursing home.
 Protection of human rights of mentally ill.
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11. MHA 1987
 To promote community participation in mental health service development
and to stimulate self-help in the community
 Provisions of voluntary admission and admission on the reception orders
were retained.
 Role of Police and Magistrate to deal with cases of wandering mentally ill.
 Guardianship and Management of properties of mentally ill.
 Provisions of penalties in case of breach of provisions of the Act.
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12. Why MHA 1987 needed
Amendment
 Concerned with legal proceedings and guardianships.
MHA 1987 has not been able to adequately protect the
rights of person with mental illness and promote access to
the mental health care in the Country.
 Human right issues and mental health care delivery are not
properly addressed in this Act. It Could never be
implemented properly
 Human right activists have questioned the constitutional
validity of the MHA, 1987 because it involves curtailment
of personal liberty without the provision of proper review
by any judicial body.
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13. Need of the new bill:
 It is provided that research on mentally ill can be
carried out by consent of guardian. This provision
violates human rights.
 Once a person is admitted to mental hospital he is
termed insane or mad by the society. There should be
provisions in the act to educate the society against
these misconceptions in which this act lacks.
 Rights-based protection of mentally-ill person’s .This
was not focused in focus of the Mental Health Act
1987 .
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14. The Mental Health Care Bill, 2013
 Comes under Ministry Of Health and Family Welfare.
 The Mental Health Care Bill, 2013 was introduced in the
Rajya Sabha on August 19, 2013. The Bill repeals the Mental
Health Act, 1987.
 The union cabinet has approved the amendments on Jan 30,
2014.
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15. Mental health Bill 2013:
 The new Bill is much longer than the existing MHA having 16 Chapters and 137
clauses.
 The Draft Mental Healthcare bill, tries to fix both the issues of taboo and Abuse
related to mental illness.
 10th October:Mental Health Day
 MHA 1987 was medical model of disability, while the 2013 Bill understands
mental illness from a Social model, giving a broad and inclusive definition as to
what may constitute mental illness. A entire chapter covers the criteria for
determination of mental illness.
 The definition of ‘mental illness’ is a major improvement from the MHA
which did not provide any guidance as to what would constitute mental
illness except for stating that a person who was mentally ill was anyone
needing treatment and who did not come under the definition of mental
retardation.
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16. Definition of Mental Illness
‘Mental illness’ is a “a disorder
of mood, thought, perception,
orientation and memory which
causes significant distress to a
person or impairs a person’s
behavior, judgment and ability
to recognize reality or impairs
that person’s ability to meet the
demands of daily life and
includes
mental conditions associated
with the abuse of
alcohol and drugs, but does not
include mental retardation”.
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17.  awareness among the general public about the
services related to mental health. Providing
mental health services by the government at the
grass root level is definitely a daunting task given
the difficulties in finding enough qualified experts
in the field. The second issue is concerned with
public awareness regarding mental health.
 Visiting a mental health professional has an
associated stigma with it that discourages people
to take the benefit of preventive and curative
mental health services. They think that they will
be branded or labelled in the society as insane
and they might be socially excluded
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18. Headings of the 16 chapters and 137 clauses.
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19. CHAPTER I: PRELIMINARY:CLAUSES
CHAPTER II: MENTAL ILLNESS AND CAPACITY TO MAKE
MENTAL HEALTH CARE AND TREATMENT DECISIONS
CHAPTER III: ADVANCE DIRECTIVE
CHAPTER IV: NOMINATED REPRESENTATIVE
CHAPTER V: RIGHTS OF PERSON WITH MENTAL ILLNESS
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20. CHAPTER VI:DUTIES OF APPROPRIATE GOVERNMENT
CHAPTER VII: CENTRAL MENTAL HEALTH
CHAPTER VIII: STATE MENTAL HEALTH
CHAPTER IX :FINANCE,ACCOUNTS AND AUDIT
CHAPTER X :MENTAL HEALTH ESTABLISHMENTS
CHAPTER XI: MENTAL HEALTH REVIEW COMMISSION
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21. CHAPTER XII: ADMISSION, TREATMENT AND DISCHARGE
CHAPTER XIII :RESPONSIBILITIES OF OTHER AGENCIES
CHAPTER XIV: RESTRICTION TO DISCHARGE FUNCTIONS BY
PROFESSIONALS NOT COVERED BY PROFESSION
CHAPTER XV: OFFENCES AND PENALTIES
CHAPTER XVI: MISCELLANEOUS
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22.  The proposed on MHCB, 2013 came after ratifying the
United Nations Convention on the Rights of Persons with
Disabilities (UNCRPD) which came into force in 2008.
MHCB, 2013 aims
 “to provide access to me services for persons with mental
illness and
 to protect, promote and fulfill the rights of person with
mental illness during the delivery of mental health care and
services and for matters concerned therewith.
 Enactment of this bill will replace the Mental Health Act
(MHA) 1987 and the new Act may be called the Mental
Health Care Act (MHCA), 2013
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23.  What is Mental health Act? Need?
 Mental Health Acts in India?
 Introduction to mental health care bill 2013 and
Chapters and Clauses?
 Important Definitions?
 Need of New mental health act?
 Features of New Mental Health Care Bill 2013
 Criticisms of New Mental Health Care Bill 2013
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24. Features of the New Bill
1. Legal Capacity
2. Informed Consent for treatment and researches
3. Rights of persons with mental illness
4. Administrative Bodies
5. Mental health Professionals
6. Mental Health Establishments 24

25. 7. Duties of the Government
8. Special Measure for Minors
9. Decriminalizes attempted suicides
10. Medical insurance to cover mental health treatment
11. Ban on ECT without anaesthesia,psychosurgery and
chaining
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26. 12. Prohibition
13. Emergency treatment
14. Granting Divorce
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27. Criticism of Mental Health Bill 2013
1. Even persons with minor mental ailments are to be deemed as having
"mental illness," as per the proposed Law.
2. Over-inclusive definition for mental illness. This will hurt a huge
number of victims of even minor mental illnesses and their families,
because of the wide prevalence of stigma.
3. This bill is very ambitious, but practically it is very difficult to
implement at the ground level
4. There is no mention about the huge resource-mobilization that is
required to realize various promises that the Bill is holding out.
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28. 5. The Chapter v in proposed Law expects people to "announce" that they
are mentally ill and avail benefits.
6. Even the NR may not have ideas concerning the treatment
procedures. So, the treatment process should be on the basic of
reciprocal understanding of NR and the treating doctors.
7. ECT is a cost and very effective treatment. Modified ECT will
increases the cost of treatment and will makes it inaccessible poor.
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29. 8. Unmodified ECT is the safest and the most affordable treatment for
conditions like schizophrenia, manic depression and psychotic
patients The shock is given at very low voltage and for short duration.
9. chapter xv of the Bill, there is not even one section is there, to punish
government functionaries who fail to deliver various "promises"
offered to mentally ill, through this Bill.
10. Those people who have no family members or any caretaker and
he/she is not eligible to take his/her own decision; who will take them
to the hospital?
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30. CONCLUSION
1. The MHCB, 2013 comes out to be a praiseworthy effort
for addressing the long standing problems encountered by
patients and practitioners in the sector of mental health
care.
2. The bill can bring a radical change in the field of mental
health care and service in our country.
3. Even though some sections of this bill are being criticized
but still this bill seems more humane and appropriate in
the current situation.
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31. References
Banerjee, G. (2001). The law and mental health: An Indian perspective. Mental health reviews.
Krishnamurthy, K., Venugopal D., Alimchandani A.K. (2000) Mental Hospitals in India. Indian Journal
of Psychiatry.;42:125–32
Math, S.B., Murthy, P., & Chandrashekar, C. R. (2011) Mental Health Act (1987): Need for a paradigm
shift from custodial to community care. Indian Journal of Medical Research.; 133(3): 246-249.
Math. S.B., Murthy, P., & Chandrashekar, C. R. (2011) History of Psychiatry in India, Indian Journal of
Psychiatry. 52(1): 7-12.
Narayan, C.L., & Shikha, D. (2013). Indian legal system and mental health. Indian Journal of Psychiatry,
55(2), 177-181.
Government of India – The Mental Health Act- 1987. published by Delhi Law House. 2002
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32. New Delhi: (1982). National Mental Health Programme for India. Directorate General of Health Services,
Ministry of Health,Government of India and Family Welfare
Nizamie, S.H., & Goyal , N. (2007) Repeated psychiatric epidemiology in India. Indian journal of Medical research
126(1): 183-92
Sarkar J. (2004). A new mental health act for India: An ethics based approach. Indian Journal of Psychiatry.;46:104–14
Sharma S, Chadda RK. Delhi: Institute of Human Behaviour and Allied Sciences; 1996. Recommendations of WHO workshop on
‘Future role on mental hospitals in mental health care’ In: Mental Hospitals in India: Current Status and Role in Mental
Health Care
Somasundaram, O. (1987) The back ground of Indian Lunacy Act, 1912. Indian Journal of Psychiatry, 29, 3-14
Mental Health ACT 1987. Available from: http://www.disabilityindia.org/mentalact.cfm, accessed on January 11, 2010.
Ministry of Health and Family Welfare, Government of India. National Mental Health Programme (NMHP). Available from:
http://mohfw.nic.in/WriteReadData/l892 s/9903463892NMHP%20detail.pdf(Acc essed on January 15, 2014).
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33. Thank you
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