Overview of Mental health Act 1987:Act Section Articles and Their implication

 

THE MENTAL HEALTH ACT 1987

Overview

The Indian Lunatic Act, of 1912 which was based on earlier English Lunatic Act of 1890 h been replaced by Mental Health Act, 1987 with a focus to improve the quality of services and project the rights of mentally ill people. Mental Health Act has been a very important milestone in the development of modem psychiatric services and care for mentally sick persons in our country. The Act. is made patient friendly and safeguards the patient's rights. This Act, enacted on 22 May, 1987 but could not come into force in many States. Later on, looking to its widening scope, changed scenario and rapid advancement in medical science as well as increasing awareness about the mental illness, it was realized to replace this Act with new approach. By virtue of this, the Mental Health Act, was introduced in 1987(hereinafter will be referred as "The Act, 1987"). The draft of this Act was prepared by Parliament in 1987 but it came into force in all the states and Union Territories of India in April, 1993.

Objectives of the Act, 1987

• To protect the patient from the ill treatment, cruel behaviour from the society.
• To maintain the dignity and respect of the patients.
• To decrease the mental health burden of the society.
• To regulate the admission into psychiatric hospitals and nursing homes. 
• To protect the individuals from being unnecessary detained in the psychiatric hospitals/nursing homes without sufficient cause.
• To safeguard the basic human rights of mentally ill patients. 
• To the psychiatric hospitals/nursing homes and to regulate the powers of government for establishing, licensing and controlling them.
• To provide guardianship to look after the property to whom, those are not capable to handle their own affairs.
• To establish the Central and State Authorities for mental health services.     
• To provide free legal aid facility to mentally ill persons from State Government.
• To regulate maintenance charge (received from patients in Beu of the services) of psychiatric hospital/nursing homes

Important features of The Act, 1987 

The Act, 1987 consists following 10 chapters with 98 Sections:

Chapter 1 -Preliminary

It deals with-

• Short title, extent and commencement .
• Various definitions. Related to mentally ill person like, mentally ill patient, mentally ill Prisoner, Major, Relatives, Psychiatrist Medical Practioner, Medical Officer in charge Magistrates. Court, District court, Reception Order, License, Licensing Authority, Psychiatric Hospital. Psychiatric Nursing Home, State Government Inspection Officer, Cost of Maintenance etc. In this chapter the word mentally ill used instead of "Lunatic", and defines it is a person who needs treatment by reason of mental disorder.

• Second the term mentally ill prisoner is used instead of "Lunatic Criminal" Third the term psychiatric hospital/nursing home is used instead of "Mental Hospital" 

Chapter II: 

It provides the provision of establishment of mental health Authorities at centre and state level. The authorities will regulate and coordinate the mental health services and provide direction and control, supervise and advise on matters related to mental health

Chapter III:

 It provides the guidelines for establishment and maintenance of the psychiatric Hospitals/psychiatric Nursing Homes.

There is a provision for licensing authority that will process for these licenses

1. No private psychiatric hospital or Nursing Home will be allowed to function without a valid license, has to be renewed every 5 year .

II.There is a provision of inspecting officer for the inspection of such hospitals for any irregularities

III. There is a provision of separate hospitals for

• Those under 16 year of age.

• Addicted to alcohol or any other substance lead to behavior changes.
• Convicted for only offense. Those who belongs to other special category like senior citizens etc.
• Treatment of patients as OPD patients.

Chapter IV:

 It deals with the procedure of admission of the psychiatric patents and important to know by all nurses specially working in psychiatric hospitals there are three parts in this chapter.

Part I: 

• Voluntary Admission: Under the section-15 request by the major for admission as voluntary basis when he/she feels and wish to admit in psychiatric hospital. 
• Section-16 Request is made by the guardian or parents for admission for minor (under 16 year of age)
• Section-17: Admission of and regulation with respect to voluntary patient after receipt of 
• request under 15, 16 and making a careful inquiry, the medical officer in charge admit a patient for 24 Hour.
• Section-18:Deals with discharge of mentally ill. 
• Within 24 hours after receipt of request by voluntary patient or guardian of minor patient.
•  In case of minor patient, on attaining his majority, the medical officer in charge of the Hospital
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• shall intimate the patient about attaining his majority, and that unless request made by him/her for continuance as an inpatient within a period of 1 month. He/she shall be discharged on the expiry of said period. 
• If the patient requests for continuance of treatment as in patient, then a board of two medical officers decide the need for further treatment or discharge. In case the treatment is needed,then it will not be exceeding 90 days at a time.

Part-II: Deals with admission under special circumstances.

• Section-19: This is an involuntary admission or hospitalization of mentally ill person who does not express his willing for admission. The request is made by the relatives or friends for admission of such patient. The medical officer in charge of psychiatric hospital assess the patient and if satisfied that the admission of the patient is in interest of the patient, then he admits the patient for the duration not exceeding 90 days at a time.

Part-III: Reception order

• Section - 20: Application for the reception order may be made by: 

1. Medical officer in charge.
2. Husband/wife/relative of mentally ill patient.
3. When Medical Officer in charge of hospital in which patient is undergoing treatment under a temporary treatment is satisfied that-

• There is a requirement of more than 6 months as an inpatient.
• It is necessary in the interest of the health and personal safety of the patient and protection of the other person that such patient should be detained for more than 6 months.
• When the spouse of mentally ill is not in India, then other relatives can produce an application. 
• Every application under section 20 part-III should be made in the prescribed form, shall be signed and verified by two medical certificates from two medical practitioners; one shall be medical practitioner in government service.
• Section-21: Form and content of medical certificate. 
• Section -22: It describes about procedure upon application for order. On the receipt of an application under sub section (2) of Section 20 magistrate may make reception order if satisfied. The magistrate may also order for further examination of patient by psychiatrist and  pass order on behalf of medical report.
• Section -23: Power and duties of police officer in respect to mentally ill person. A Police Officer may take into protection any person found wandering within the limits of his station. If the sufficient reason to believe that person is mentally ill and is incapable to take care of himself and may be dangerous for him others by reason of mental illness. Such patient is produced to nearby Magistrate within 24 hours of detention. The Magistrate shall examine the person to assess his capacity to understand or cause him to be examined by Medical Officer and make inquiry deemed necessary if Medical Officer certified and Magistrate is satisfied that the person is mentally ill may pass order to treat as inpatient in the psychiatric hospital 
• Section-24: Procedure on production of Section 23 
• Section-25: Order in case of mentally ill person crucity treated or not under proper care and control.
• Section-26: Admission as in patient after inquisition.
• Section-27: Admission and detention of mentally ill prisoner.
• Section-28: Detention of alleged mentally ill person, pending report by medical officer. 
• Section-29: Detention of mentally ill person, pending his removal from psychiatric hospital or psychiatric nursing home.

Chapter -V

Deals with the inspection, discharge, leave of absence and removal of mentally ill person from one hospital to another.

Part-1: Inspection

• Section - 37: Appointment of visitors.
• Section-38:Monthly inspection by visitors.
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• Section-39:Inspection of mentally ill prisoners.

Part II: Discharge

• Section - 40:Order of discharge by medical officer incharge.
• Section -41:Discharge of mentally ill person on application. 
• Section - 42:Order of discharge on the undertaking of relatives or friends etc for due care of mentally ill person.
• Section - 43:Discharge of person on his request.
• Section - 44:Discharge of person subsequently found on inquisition to be of sound mind.

Part III: Leave of absence 

• Section - 45:Leave of absense.
• Section - 46:Grant of leave of absence by magistrate.

Part IV: Removal

• Section - 47: Removal of mentally ill person from one psychiatric hospital to another psychiatric hospital or psychiatric nursing home. 

 Chapter VI -

 Deals with the judicial inquisition regarding the alleged mentally ill person. Possession of  property,   custody of person and the management of his/her property. If the court feels that alleged mentally ill person is unable to look after his property himself and an appointment of a guardian by the court, if it is fell that he can look after himself but incapable of looking after his property a manager can be appointed by the Court.

Chapter-VII: 

Deals with the liability to meet the cost of maintenance of mentally ill patient detained in  pychiatric hospital or nursing home.

Chapter-VIII: 

Deals with the protection of human rights of mentally ill person. This act geode that 

• No mentally ill person shall be subjected to any indignity (physical or mental) or cruelty during the treatment.
• A consent has been obtained in writing from the person if a voluntary patient, or from the person from the person voluntary patient, or from guardian/relative if minor or involuntary patient.
• No later or communication sent by or to a mentally ill person shall be interpreted or detained

Chapter-IX: 

Deals with the procedures to be followed for the establishment and maintenance psychiatric hospital Nursing Homes, and the penalties which can be relatively severe and explicit for contravening them. The article 6(1) of the Mental Health Act deals with the prohibition of running a Nursing Home without license and article 11(1B) says the licensing authority can cancel the license if the maintenance of the home is being carried out in a disadvantageous manner to the moral, mental or physical wellbeing of the indoor patients.

Chapter-X: 

Deals with the clarification pertaining to certain procedures followed by the  medical officer in charge of the psychiatric hospitals/Nursing Home and also provides the miscellaneous sections, like provision of bonds, pension, and report by Medical Officer etc.

FAQ:

Q.1 What is the mental health Act of 1987?

Ans. Mental Health Act, 1987 with a focus to improve the quality of services and project the rights of mentally ill people. Mental Health Act has been a very important milestone in the development of modem psychiatric services and care for mentally sick persons in our country. The Act. is made patient friendly and safeguards the patient's rights. This Act, enacted on 22 May, 1987 .

Q.2 Who first used the word mental health?

Ans. The term mental hygiene has a long history in the United States, having first been used  in 1843 by William sweetzer. After the Civil War, which increased concern about the effects of unsanitary conditions.