Legal Aspects of Mental Health Care Act Enforcement
- ByAdmin --
- 02 May 2025 --
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The enforcement of the Mental Healthcare Act, 2017 (MHCA) in India marked a major shift toward a rights-based approach to mental health.
It aims to protect the dignity, autonomy, and rights of persons with mental illness, aligning Indian law with international human rights standards.
However, challenges persist in its implementation, raising serious legal concerns about rights protection, compliance, and service delivery.
Relevant Legal Framework
- Mental Healthcare Act, 2017:
- Enacted to provide mental healthcare and services for persons with mental illness.
- Repealed the outdated Mental Health Act, 1987.
- Constitution of India:
- Article 21: Right to life includes the right to health and dignity.
- Article 14: Equality before law and equal protection of laws.
- Article 15(1): Prohibits discrimination based on disability, among others.
- UN Convention on the Rights of Persons with Disabilities (CRPD):
- India ratified the CRPD in 2007, influencing the MHCA's rights-based framework.
Key Features of the Mental Healthcare Act, 2017
- Right to Access Mental Healthcare:
- Every person has the right to affordable, good quality mental health services without discrimination.
- Every person has the right to affordable, good quality mental health services without discrimination.
- Advance Directives:
- Individuals can specify how they wish to be treated if diagnosed with a mental illness in the future (Section 5).
- Individuals can specify how they wish to be treated if diagnosed with a mental illness in the future (Section 5).
- Nominated Representative:
- A person may appoint someone to make decisions on their behalf during illness (Section 14).
- A person may appoint someone to make decisions on their behalf during illness (Section 14).
- Decriminalization of Suicide:
- Attempt to die by suicide is no longer a criminal offense (Section 115).
- Attempt to die by suicide is no longer a criminal offense (Section 115).
- Mental Health Review Boards (MHRBs):
- Established to protect the rights of patients and ensure legal compliance.
- Established to protect the rights of patients and ensure legal compliance.
- Insurance Coverage:
- Mandates that insurance for mental illnesses be treated at par with physical illnesses (Section 21(4)).
Legal Challenges in Enforcement
1. Inadequate Infrastructure
- Shortage of mental health professionals compared to demand.
- Lack of functioning Mental Health Review Boards across many states.
2. State Non-Compliance
- Several states delayed framing rules and setting up institutions as required under the MHCA.
- Reference:
- Section 121: Powers of the State Governments to make rules.
- Section 122: Central Government’s rule-making power.
3. Violation of Patient Rights
- Reports of forced admissions, treatments without consent, and absence of patient-centric care.
- Violates the right to autonomy and right to informed consent under the Act.
4. Lack of Awareness
- Both patients and families often unaware of their rights under the MHCA.
- Legal literacy and sensitization programs are minimal.
Landmark Judicial Interpretations
- Gaurav Kumar Bansal v. Union of India (2019):
- Supreme Court directed the government to ensure implementation of MHCA provisions, especially for homeless persons with mental illness.
- Supreme Court directed the government to ensure implementation of MHCA provisions, especially for homeless persons with mental illness.
- Common Cause v. Union of India (2018):
- Recognized the right to make advance directives concerning medical treatment, influencing interpretation of advance directives under MHCA.
Government Initiatives to Strengthen Enforcement
- National Mental Health Programme (NMHP):
- Aims to provide community-based mental health services.
- Aims to provide community-based mental health services.
- Kiran Helpline:
- Launched by the Ministry of Social Justice and Empowerment to provide mental health support.
- Launched by the Ministry of Social Justice and Empowerment to provide mental health support.
- Ayushman Bharat:
- Some packages include mental healthcare services under government insurance schemes.
Recommendations for Better Enforcement
- Fast-track the establishment and functioning of Mental Health Review Boards.
- Enhance funding and infrastructure for mental health services.
- Conduct regular audits of mental health institutions to ensure compliance.
- Launch widespread public awareness and legal literacy campaigns.
- Training for police, judiciary, and healthcare workers on the rights under MHCA.
Conclusion
The Mental Healthcare Act, 2017 is a progressive law that recognizes mental health as a matter of right and dignity.
However, without robust enforcement, its promises remain unfulfilled.
Effective implementation requires political will, public awareness, professional training, and strong judicial oversight to truly safeguard the rights of persons with mental illness in India.
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