Under the law, there are three main authorities:
- Central Mental Health Authority – It is the central authority under the law, which has functions like to register all mental health establishments under the Central Government and maintain a register of all mental health establishments in the country, develop quality/service norms for mental health establishments under the Central Government, supervise all mental health establishments under the Central Government, receive complaints about deficiencies in provision of services, etc. .
- State Mental Health Authority – It is the authority on the state level under the law, which has functions like to generally register all mental health establishments in the State, to develop quality/service norms for mental health establishments in the State, supervise all mental health establishments in the State , receive complaints about deficiencies in provision of services, etc.
- Mental Health Review Board – It is the authority on the district level under the law, which has functions like to register, review, alter, modify or cancel an advance directive, to appoint a nominated representative, to adjudicate complaints regarding deficiencies in care, etc.
As of now, the authorities, particularly the Central Mental Health Authority and the Mental Health Review Boards, are largely not functioning. However, some states, such as Delhi, Kerala, etc. have constituted the State Mental Health Authority. You should seek information about the functioning of these authorities from your respective state.
The National Mental Health Policy of India was released in 2014 by the Ministry of Health and Family Welfare. The policy has recognized certain principles such as integrated care, equality, evidence based care and participatory and rights based approach to mental health.
Some of its goal are to provide universal access to mental healthcare in the country, decrease premature deaths due to mental illness, to increase access to mental healthcare for vulnerable groups such as homeless persons, to reduce suicide, etc. It recognizes the need for adequate funding, support for families and access to institutional care, among other things. Please see here for more details.
The Government of India launched the National Mental Health Program (NMHP) in 1982, and the District Mental Health Program was added to the NMHP in 1996. In 2003, it was re-strategized to include two schemes i.e. Modernization of State Mental Hospitals and Upgradation of Psychiatric Wings of Medical Colleges/General Hospitals.
The basic objectives of the NMHP are:
- To ensure the availability and accessibility of minimum mental healthcare for all in the foreseeable future.
- To encourage the application of mental health knowledge in general healthcare and in social development.
- To promote community participation in the mental health service development.
- To enhance human resources in mental health specialties.
The NMHP has aimed to open centres for persons with mental illness, carry out awareness programs and interventions ,etc. Please see here for more details.
A caregiver refers to a person who resides with a person with mental illness and is responsible for providing care to that person. This includes a relative or any other person who takes care of the person, either for free or with remuneration.
If you want to take a leave from the mental health establishment where you are admitted, you should approach the mental health professional in charge of the establishment. He can grant a leave to you to be absent from the establishment under certain conditions (if any) for such time duration as determined by the professional.
If a prisoner who is in a mental health establishment absents himself without leave/discharge, he will be taken into protection by a police officer at the request of the professional in-charge and will be sent back to the establishment immediately.
If you believe that a person with mental illness is being mistreated or neglected by the person who has the responsibility for his care, you should report this to the police officer in-charge of the police station within whose jurisdiction the person with mental illness resides.
Once the police have received the report, they will conduct the necessary investigation.
The officer in-charge of a police station has the following duties:
Protecting Persons with Mental Illness
He must take under protection any person wandering within the limits of the police station and who is believed to have a mental illness who:
- Is not able to take care of himself
- Poses a risk to himself/others due to his mental illness
Once a person with mental illness has been taken into protection, the police must:
- Inform the person/his nominated representation the reasons for taking him into protection.
- Take the person to the nearest public health establishment within 24 hours for assessment of his healthcare needs. It will be the responsibility of the medical officer in-charge of the public health establishment to arrange the person’s assessment.
- After the assessment, if the person does not need to be admitted to an establishment, the police officer must take the person to his house or to a Government establishment for homeless persons (if the person is homeless).
Reporting Mistreatment of Persons with Mental Illness
If the officer believes that a person who resides within the limits of the police station has a mental illness and is being mistreated or neglected, he must report that to the Magistrate.
Locking Persons with Mental Illness
The police cannot, in any situation, lock the person with mental illness in a jail or detain him.
Under the law, a person with mental illness can be admitted to a mental health establishment by his nominated representative for treatment. However, there is very specific criteria for such an admission, which is known as supported admission.
The government only has the power to get a person assessed for mental healthcare needs. Except this, the government has no power regarding a person’s treatment for mental health. For example, the Magistrate may order that a person is admitted to a mental health establishment for a maximum duration of 10 days for assessment of his healthcare needs, and the police have certain powers with respect to persons with mental illness who are found wandering within the jurisdiction of the police station.
If you require help with your mental health, you can go to a mental health professional. A mental health professional refers to the following:
- A psychiatric social worker, which requires a postgraduate degree in Social Work and a Master of Philosophy in Psychiatric Social Work of two years, including supervised clinical training from any University recognised by the University Grants Commission, or other qualifications, as prescribed
- A professional registered with the concerned State Mental Health Authority
- A professional having a postgraduate degree (Ayurveda) in Mano Vigyan Avum Manas Roga or a postgraduate degree (Homoeopathy) in Psychiatry or a postgraduate degree (Unani) in Moalijat (Nafasiyatt) or a postgraduate degree (Siddha) in Sirappu Maruthuvam.
It is mandatory for every mental health establishment to be registered under the law. Depending on whether the establishment is under the central government or state governments, the establishment must be registered with the Central Mental Health Authority or State Mental Health Authority.
If someone carries on a mental health establishment without registration, he may be punished with a fine between Rs. 5,000 to Rs. 50,000 for the first offence, and for the second offence, with a fine between Rs. 50,000 to Rs. 2 lakhs, and for every subsequent offence, with a fine between Rs. 2 lakhs to Rs. 5 lakhs.
Further, if someone knowingly works at an unregistered establishment as a mental health professional, he may be punished with a fine of Rs. 25,000.