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 Table of Contents    
EDITORIAL  
Year : 2019  |  Volume : 61  |  Issue : 10  |  Page : 636
Mental Healthcare Act (MHCA 2017)- Is a Relook Necessary for Effective Implementation?


Professor of Psychiatry, WBMES and Consultant Psychiatrist, AMRI Hospitals, Kolkata, West Bengal, India

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Date of Web Publication8-Apr-2019
 

How to cite this article:
Singh OP. Mental Healthcare Act (MHCA 2017)- Is a Relook Necessary for Effective Implementation?. Indian J Psychiatry 2019;61, Suppl S4:636

How to cite this URL:
Singh OP. Mental Healthcare Act (MHCA 2017)- Is a Relook Necessary for Effective Implementation?. Indian J Psychiatry [serial online] 2019 [cited 2019 Sep 17];61, Suppl S4:636. Available from: http://www.indianjpsychiatry.org/text.asp?2019/61/10/636/255592




The MHCA 2017 received Presidential assent on 7 th April, 2017 to provide for mental healthcare and services for persons with mental illness (PMI) and to protect, promote and fulfil the rights of such persons during delivery of mental healthcare services. This act was enacted keeping in mind the need to align and harmonize with UNCRPD (United Nations Convention of Person with Disabilities)which India signed on 1st April, 2007. This was hailed as one of the most progressive legalizations in the world for rights of PMI. However, there is a lot of skepticism whether it is going to meet the same fate as many other legalisations which were enacted with the right intentions but stumbled at the point of implementation, like the Right to Education Act (RTE ACT, 2009).

There are many issues regarding the act some of which are

  1. The definition of mental Illness as laid down in the act and as subsequently defined later. Mental Illness as defined in act means, “A substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgement, behavior, capacity to recognize reality or meet the ordinary demands of life, mental conditions associated with the abuse of alcohol or drugs but does not include mental retardation. This definition is at variance with the definition provided in the International Classification of Diseases (ICD-10) which has subsequently been referred in the later parts of the act
  2. In this era of biological psychiatry where more and more psychiatric diseases are shown to have underlying brain changes and many neurological disorders have psychiatric symptoms, the act creates more confusion in the treatment settings as it makes a clear distinction of mental health establishments from other health establishments. This raises a concern whether such a retrogressive step will take us back to the days of mental asylum era
  3. Advance directives are provided for mental illness but are not available for any other illness in our country
  4. The financial burden of setting up of Mental Health Review Boards and other infrastructure is huge and the provisions have been laid down without adequate budgetary sanctions
  5. Though insurance coverage for PMI has been notified by IRDA (Insurance Regulatory and Development Authority of India), the costs are still being worked out and implementation does not seem likely in the near future


In this backdrop after 2 years of passing of the MHCA, 2017 we need to take a critical look retaining its positive aspects and removing the inconsistencies that PMI get benefitted and their treatment and care is facilitated

This supplement has been conceived by the Indian Psychiatric Society, South Zone and comprehensively discusses various facets related to the act. Guest Editors Shahul Ameen, Mahesh Gowda and Ramkumar GS have worked hard to bring out this supplement and I hope that it will provide a path for navigation and generate debate regarding various provisions of the act.



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Correspondence Address:
Dr. Om Prakash Singh
AMRI Hospital, Dhakuria, Kolkata, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5545.255592

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