Mental Healthcare Act, 2017

The Mental Healthcare Act, 2017 makes access to mental healthcare a legal entitlement and places dignity, autonomy and non-discrimination at the centre of treatment. Its rights-based framework combines individual choice, standards for humane care, safeguards against coercion and institutions for review and accountability.

Autonomy and supported decision-making

The Act treats a person with mental illness as a rights-holder rather than merely a recipient of medical control.

• Section 4 presumes decision-making capacity when a person can understand relevant information, appreciate foreseeable consequences and communicate a decision.
• Under Section 5, an adult may issue an advance directive stating preferred or refused treatment.
• Section 14 allows appointment of a nominated representative to support the person when required.

Rights during care and treatment

Sections 18-28 create enforceable entitlements governing access, dignity and treatment.

• Every person has a right to affordable, good-quality and geographically accessible mental healthcare from government-run or government-funded services.
• The Act protects the rights to community living, dignity, humane conditions, privacy, information, access to medical records and confidentiality.
• Mental illness must be treated without discrimination, and insurers must provide coverage on the same basis as for physical illness.
• Persons may obtain free legal services and complain about deficiencies in mental health services.

Safeguards against coercion

Admission and treatment must follow statutory criteria, professional assessments and review mechanisms, especially when the person requires substantial support in decision-making.

• Sections 89-90 regulate supported admission and provide for assessment, time limits and Mental Health Review Board oversight.
• Sections 95 and 97 prohibit chaining and seclusion, restrict physical restraint and regulate electroconvulsive therapy.
• Psychosurgery requires informed consent and approval of the concerned Mental Health Review Board.

Accountability and protection

The Act establishes Central and State Mental Health Authorities to register and regulate mental health establishments and professionals. Mental Health Review Boards examine advance directives, nominated representatives, certain admissions and complaints concerning rights violations.

• Section 115 presumes severe stress in a person attempting suicide, unless proved otherwise, protects the person from punishment for the attempt and requires government care, treatment and rehabilitation.