Critical Analysis of the Improvements Made Through the Mental Healthcare Act, 2017, Its Existing Shortcomings and Possible Solutions

Abstract

The Chapter 5 of the Mental Healthcare Act, 2017, referred henceforth as “the Act,” lays down the “rights of person with mental illness” and it forms the core depth of this legislation. The Act makes provision for the care, treatment, and rehabilitation measures to reduce its recurrence. One of the main objectives of the Act is to make inclusion and rehabilitation of mentally ill persons into the society and help in eliminating the stigma attached to mental illness in India. The significance of the new Act is seen as soon as one turns to the facts, an estimated that 20% of Indians are likely to suffer from depression and 14% of Indians have mental disorders as per a WHO report. The Act covers everything from common to severe mental disorders and from mental hospitals to primary health-care centers. The Act decriminalizes the attempt of suicide having the presumption that the person who attempted suicide has undergone severe stress, and the Act mandates helping the person rather than punishing them. The Act provides the right of having access to treatment at affordable cost, and of good quality. The government must provide for a range of services including outpatient as well as inpatient services, medicines free of cost, specialized services of children and adolescents, etc. Another key feature is the implementation of medical insurance for treating those with mental illness at parity with physical illness by all insurers. However, the Act also has some shortcomings such as there is the breach of the fundamental right – “right to privacy” as the Act provides power to the nominated representative to unlimited access to the records of the persons with mental illness. Then, there is the question of the feasibility of implementation of the Act, which is the scarcity of resources, under the budget allocated to the National Mental Health Programme was just rupees 40 crores in FY18. This means that the budget allocated in India for mental health makes up only 0.06% of the total health-care budget. Further, there are only 3800+ registered psychiatrists in India when the need is for at least 13,500 psychiatrists, this explains the 80%–90% treatment gap that exists in India. Under the Act, individual persons living without family members or caregivers would struggle to get appropriate care in a Mental Health Establishment if their capacity is limited, by a mental disorder, even if it is limited for a short while if the medical practitioner tries to treat a person without valid consent, this might make them vulnerable to be charged for negligence and/or be prosecuted for assault or battery. Furthermore, the Act is silent on matters such as management of properties of persons with severe mental illness, rehabilitation, and integration of homeless mentally ill into the community. The Act further provides the police with the power to enter a person’s private residence (without a magistrate’s approval) if they have reason to believe that an individual is mentally ill. The Act does not mention the use of ambulance to transport such patients. This research paper will discuss all these points and more in detail, analyzing what the current Act offers and where it lacks or falls short of benefitting the ones it is meant to help, care, protect, and rehabilitate.