Gopal was concerned about his neighbour: he had witnessed extreme reactions from him which indicated a mental health issue. When a family member spoke to Gopal about how the neighbour’s behaviour was affecting them, he suggested they consult a mental health professional. The family went on to do this, and Gopal set out to understand the legal framework applicable to persons with mental illness (PMI).
OBJECTIVE
With his understanding that mental health is a state of well-being in which an individual realizes his own abilities, can cope with the normal stresses of life, work productively and contribute to the community, Gopal learnt about the Mental Healthcare Act, 2017 enacted to recognize and affirm the rights of a PMI and provide for their care and related services.
MENTAL ILLNESS
Mental illness refers to a substantial disorder of thinking, mood, perception, orientation or memory that significantly impairs judgment, behaviour, capacity to recognize reality or ability to meet the ordinary demands of life, and includes mental conditions associated with substance abuse. It does not include mental retardation resulting from arrested or incomplete development of a person, specially characterised by sub normality of intelligence.
Mental illness is to be determined according to accepted medical standards notified by the Central Government in its Guidance document for capacity assessment.
PERSON WITH MENTAL ILLNESS
A person can be classified as PMI only for treatment of mental illness or other matters covered under this law or other law. Mental illness is not to be determined based on political, economic or social status or membership of a cultural, racial or religious group or other reason not directly relevant to mental health. It cannot be determined by different moral, social, cultural, work or political values or religious beliefs from those prevailing in a person’s community.
While previous treatment or hospitalization for mental illness could be relevant, it cannot form the sole basis of a person’s mental illness.
Determination of mental illness does not mean a person is of unsound mind unless he is so declared by a competent court.
RIGHTS OF PMI
Access to mental healthcare: A person has a right to mental healthcare including in-patient and out-patient services, half-way homes, sheltered accommodation, supported accommodation, support to their family, home-based rehabilitation; hospital and community based rehabilitation and services and provision for child and old age mental health services. These services must be affordable, of quality and quantity and provided close to the PMI’s residence. Free treatment is to be provided to destitute or PMI below the poverty line. Long term treatment or care in a mental health establishment (MHE) is to be used only in exceptional circumstances, for as little time as required and only when appropriate treatment has been tried and failed.
Community living: A PMI has the right to be part of society. He cannot be required to remain in a MHE merely because he does not have a family, is not accepted by his family, is homeless or due to absence of community based facilities. The Government is required to provide support to the PMI to facilitate his living in the family home and to provide establishments like half-way homes and group homes for PMI who no longer require treatment in more restrictive MHEs.
Protection from cruel and degrading treatment: A PMI is entitled to live in a safe and hygienic environment with adequate sanitary conditions, leisure facilities, recreation, education and religious practice, right to privacy, right to wear his own clothes and not forced to wear uniforms. A PMI has the right to wholesome food and articles of personal hygiene. He cannot be compelled to have his head hair shaven unless required for hygienic purposes. He cannot be forced to work and if required to work, is entitled to appropriate remuneration and is to be protected from physical, verbal, emotional and sexual abuse.
Equality and non-discrimination: A PMI is entitled to be treated equally as a person with physical illness for treatment. The Government is required to provide facilities such as ambulance, adequate and appropriate living conditions similar to those provided for physical illness. Medical insurance is to be provided on the same basis as for physical illness.
Information: A PMI is entitled to information in his language about the reason for admission and the review of admission and treatment procedure.
Confidentiality: A PMI has the right to confidentiality in respect of his mental health, healthcare, treatment and physical healthcare.
Access to medical records: A PMI has the right to access his medical records. Such information may be withheld only if the disclosure would result in serious mental harm to the PMI or is likely to harm other persons.
Right to personal contacts & communication: A PMI admitted to a MHE has the right to receive or refuse visitors and to make/receive or refuse telephone calls at reasonable times as per the MHE’s rules. He can send and receive e-mail.
Right to legal aid: A PMI is entitled to receive free legal services to exercise his rights under this law.
Right to make complaints about deficiencies in provision of services: A PMI has the right to complain about deficiencies in care, treatment and services in a MHE.
With this understanding about the rights of a PMI, Gopal was keen to know about the other legal provisions on mental health...
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