National Mental Healthcare Act 2017 – a paradigm shift in the way we treat our mentally sick

Published by Dileep V S on September 15, 2020September 15, 2020

By passing the National Mental Healthcare Act 2017, the Indian parliament has put in place the much needed reform in mental health care diagnosis and treatment. It covers all aspects of mental healthcare and is aimed at better health care deliverance and treatment of individuals with mental illness. The bill revolutionizes health care for mentally sick and approaches their concerns and problems at grassroots levels. One of the major reasons for the passing of the bill was to ensure people with mental illness lead normal lives without getting subjected to discrimination or harassment.

Mental illness as defined by the bill

To facilitate better health care, the bill first identifies the definition of mental illness. According to the bill, it is a disorder in individuals, wherein they are unable to think, perceive moods, orientations or have poor memory which ultimately influences their judgment, response, behavior, or ability to perceive reality. The bill also encompasses mental disabilities brought in due to abuse of alcohol or drugs.

While it attempts to define what mental illness is, the bill also specifically mentions what it isn’t an attempt to set any standards for defining health. As per the bill, mental sickness does not include mental retardation, which is characterized by an incomplete or arrested development of the mind.

What does the national mental healthcare act ensure?

The bill identifies several factors associated with the treatment of people with mental sickness and addresses each of them in detail. According to the Bill –

• Every individual has the basic right to mental health care from clinics or centers funded by the government
• It ensures free mental health care treatment for the homeless and those who live below the poverty line. The reassuring part is that the bill does not require a BPL card for their treatment and mental health care
• The bill reassures that any person suffering from mental sickness has the right to confidentiality with respect to his or her mental illness or its treatment. No photograph or other personal information about the patient can be not released to media houses without acquiring a proper consent of the individual
• The bill identifies several factors of discrimination such as gender, religion, sexual orientation, culture, race, class, disability, political beliefs and more and gives individuals the right to dignity
• It also gives the right to the patient to initiate an advance directive regarding instructions to be followed by the care providers in case he/she loses the capability to make decisions. It also allows a person to nominate representative(s) to act on his/her behalf in such situations
• Patients will not be required to undergo electro-convulsive treatment without the use of anesthesia or muscle relaxants. Further, minors will not be subject to such treatment at all
• Patients will not be in any form or manner chained
• Such individuals will be in solitary confinement only if deemed necessary for the safety of self or others

Additionally, the bill facilitates the establishment of a Central Mental Health Authority followed by a state-run State Mental Health Authorities. These authorities mandate all mental health institutions and mental health practitioners including nurses, psychiatrists and others to be registered with them and also have the final say in providing care.

State Mental Health Authority(MHA)

Once formed, the responsibilities of the state level Mental Health Authority include:

• Register, maintain and supervise all health care institutions
• Develop and maintain quality standards and norms for the operations of such institutions
• Maintain a record of all mental health practitioners and professionals
• Train mental health practitioners and law enforcers on the bill and its provisions
• Be an advising body to the government on mental health cases

Increased patient focus in the national mental healthcare act

This bill decriminalizes suicide. It defines suicide as a mental sickness that needs treatment. With this individuals attempting suicide will not be charged under the Indian penal code. Instead, the act puts onus on the government to takes responsibility for providing better health care, treatment and facilitating a safe and stress-free environment for such patients.

The incredible attention to detail given to addressing the shortcomings in the metal healthcare system in the country comes as a welcome change. With this act in place, we can expect top see a paradigm shift in the way we see and treat people suffering from mental sickness.

We are fully committed to supporting the development of tools and technology solutions that will be deployed to effectively implement this act across the country. Our EHR.Network platform is the core foundation that has been used to build e-Manas, the Karnataka Mental Health Management System. e-Manas is the first attempt by any Indian state to implement this act.

We are constantly working on building capability in our EHR.Network platform to help care providers document and care for mental health patients in line with this initiative from the government.