Optional Grouping: Mental Health Overview

Mental illness is a health condition((Section 2(s), the Mental Healthcare Act, 2017. )) which involves substantial disorder of thinking, mood, perception and orientation or memory. This may lead to gross impairment of judgment, behaviour, capacity to recognise reality or ability to meet the ordinary demands of life. Abuse of drugs or alcohol may also result in a mental condition.Some examples of mental illness are substance abuse disorder, bipolar disorder, etc. This does not include mental retardation i.e. incomplete intellectual development. Persons with mental illness also have rights under the law including the right to confidentiality, right to treatment, etc. 

Determination of Mental Illness

To determine whether one has a mental illness it must be determined according to nationally/internationally accepted medical standards, like the International Classification of Disease of the World Health Organisation((Section 3(1), the Mental Healthcare Act, 2017 )) 

These reasons cannot determine whether a person is mentally ill((Section 3(3),  the Mental Healthcare Act, 2017 )):

• Past treatment for a mental illness((Section 3(4),  the Mental Healthcare Act, 2017 ))
• Political, economic or social status
• Belonging to a cultural, racial or religious group, or for any other reason not directly relevant to mental health status of the person; 
• Refusal to conform to moral, social, cultural, work, political, or religious values prevalent in one’s community.

Please note that one cannot be considered as a person of unsound mind, merely because they have a mental illness. Only a Court can declare a person to be of unsound mind((Section 3(5),  the Mental Healthcare Act, 2017 )). 

Capacity to Make Treatment Decisions

The capacity to make mental healthcare-related decisions depends on the conditions given above((Section 4(1),  the Mental Healthcare Act, 2017 )) :

• The ability to understand relevant information on mental healthcare related issues, such as admission, personal assistance or treatment. Please note the information given to the person has to be comprehensible. For example, Ram cannot hear properly. The information given to him will be using means that will enable him to understand it((Section 4(2),  the Mental Healthcare Act, 2017 )). 
• The ability to understand the consequences of a decision on the treatment, admission or personal assistance
• The ability to communicate the formed decision through speech, expression, gesture, etc. 

If one takes a decision that others think is incorrect or inappropriate, that solely will not mean that one does not have the capacity to make such a decision((Section 4(3),  the Mental Healthcare Act, 2017 )). For example, against the wishes of his parents, Ram decides not to go to a mental health establishment. The sole fact that Ram’s parents think that a decision is inappropriate does not mean they do not have the capacity to make such a decision.

Under the law, emergency treatment refers to any medical and mental health care treatment. It can be provided by a registered medical practitioner to a person with mental illness((Section 94(1),  the Mental Healthcare Act, 2017 )). For this, the consent of the nominated representative is required, if they are available.

The immediate treatment prevents((Section 94(1),  the Mental Healthcare Act, 2017. )):

• The death or harm to the person
• The person from inflicting serious harm to themselves and/or to others
• The person from causing serious damage to their or others’ property

However, this does not allow the use of electroconvulsive therapy((Section 94(3),  the Mental Healthcare Act, 2017 )). Further, it does not allow to use any treatment not directly related to the criteria mentioned above((Section 94(2),  the Mental Healthcare Act, 2017 )).

In addition, this treatment is limited to 72 hours under normal circumstances or up to 7 days during an emergency((Section 94(4),  the Mental Healthcare Act, 2017 )).