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The Evolution Of Mental Healthcare Acts In India

A person with less immunity becomes more vulnerable to diseases, similarly a person with mental disorder becomes more vulnerable and prone to violation of their rights. The violation of rights or abuse can take in any form or by any institution, and thus arises the question of providing some protective mechanism for their protection.

This can be done by implementing legislations, acts, various policies with provisions of protection from such abuses. There are legislations in every field which are timely amended, but mental health is such a subject which is being mostly ignored, even though being one such area which requires proper attention.

Now let us look at the journey of legislation on mental health in India.

The first major step
The journey of mental healthcare legislations in India began with the coming of the Indian lunacy act,1912, which was basically the first law that looked after mental health in India. The Indian Lunacy Act,1912, was an act for consolidating and amending the law relating to lunacy.

The act was in furtherance of other acts relating to mental healthcare which were previously enacted by the British, such as the:
  • The Lunacy (Supreme Courts) Act, 1858(ActXXXIVof1858).
  • The Lunacy (Districts Courts)Act, 1858(ActXXXVof1858).
  • The Indian Lunatic Asylums Act,1858 (ActXXXVIof1858).
  • The Military Lunatics Act,1877(Act XIof1877),
  • The Indian Lunatic Asylums(Amendment)Act,1886(ActXVIIIof1886), etc.
Whereas, in this context we can be quite sure that these acts may have had their roots connected to the 1845 English Acts such as the, the Lunatics Act and the Lunatic Asylums and Pauper Lunatics Act. This British stage in the mid nineteenth C.E may had served as the background for the upcoming legislations. The various previous acts contemplated the legalistic framework for the management of mentally ill and disturbed.

But identical to others this act too focused more on protecting the public from the mentally ill patients as they were considered dangerous and harmful to society. It neglected the basic human rights of such disabled or ill people, not only this thus but also it was concerned only with custodial issues and thus was highly criticized by the Indian Psychiatric Society,1947.

The second very major attempt was made 31 years after independence in 1987, when the Mental Healthcare Bill, 1987 was introduced in legislation, and led to it's drafting and finally existence in 1993. This time the act was far better than the Indian Lunacy Act, 1912 in terms of settling spotlight on care and treatment unlike previous custodial sentences, protecting the human rights, stressing on guardianship and management of the property of mentally ill people.

Chapter VIII, sec 81 of this act contained provisions of this act for the protection of human rights of mentally ill people. It also contained provisions for Admission Under Special Circumstances under sec 19.

However, same as others this act also had it's own drawbacks. The criticism of the MHA,1987 were mainly associated to the legal procedures of licensing, admission(part I , part II) and guardianship. Also, It shrieked the liberty of such individuals was a weighty ignorance to human rights. Moreover, this curtailment of human rights was without any provision or review of any body and hence further disappointed human rights activists.

Further, it didn't mentioned any relief to patients on rehabilitation and treatment plans after their discharge (Part II, sec 40,41,42,43,44) from hospitals. what's more was insufficient treatment facilities as compared to the pace of upcoming new technologies posed financial, social and emotional burdens on caretakers, and family of the disabled or ill person.

Now, with criticisms comes changes, which leads to new improvements. And therefore, the criticism of the MHA,1987 consequently led to formation of Mental Health Care Bill,2013 which was introduced in the Rajya Sabha on 19th August, 2013.

Currently the Mental Health Care Act,2017 is in process. It was enforced on 25th August, 2018. It is an Act to provide for mental healthcare and services for persons with mental illness and to protect, promote and fulfil the rights of such persons during delivery of mental healthcare and services and for matters connected therewith or incidental thereto. The MHCA,2017. is a major advancement in the Indian healthcare legislation as it contains much important provisions that none other previously enacted had.

The following are some of the important features of the MHCA, 2017:

Decriminalizes attempts to suicide:

In this bill, suicide attempts are decriminalized, since a person who attempts suicide is presumed to have severe stress and should not be punished. Also, the law requires the government to rehabilitate such individuals so that suicide attempts do not recur in the future.

Human Rights of People with Mental Illness are protected (Chapter V):
This ensures that all people have access to mental health services. These services should be of good quality, readily available, affordable, and convenient. As well as protecting such people from inhuman treatment, it provides them with access to free legal services and records of their medical care.

Advance Directives ( Chapter III):
An individual with a mental illness is given the right to make an advance directive on how they would like to be treated for their specific illness and who should act on their behalf. It must be vetted by a medical practitioner.

Protects the Right to Confidentiality (Chapter V):
Section 22 and 23 of the MHCA,2017 grants confidentiality rights to the people with mental illness regarding their mental illness, healthcare and treatment. Not only this, Section 24 safeguards against the release in the media of any pictures or other information related to the patient without their consent.

Strict Punishments for Breach (Chapter XV):
Section 108 provides the punishment for contravention or breach of provisions under this Act. It states that the offender will be imprisoned up to 6 months or Rs. 10,000 or both. Offenders recurring the violations of these provisions under this Act can face up to 2 years of imprisonment with a fine of 50,000 , which may extend up to 5 lakhs.

As such, this was the journey of the Mental Health Care acts in India. It is inevitable that changes will be made over time, and so it will keep evolving.


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