Author: Krishna Gawade

Background and Objective of the Act 

The MHCA was enacted in India to establish rights-based mental healthcare. As India also ratified the UN Convention on the Rights of Persons with Disabilities, we decided to protect the rights of people with mental illness by protecting their dignity and autonomy of people with mental illness, decriminalizing suicide attempts, ensuring affordable quality care, and replacing the outdated 1987 Act to provide better access to services and combat stigma, ensuring the right to confidentiality, community living, and non-discriminatory treatment. 

The objective of the Act is stated in the preamble of the MHCA, which states that “It is an act to provide healthcare and services to persons with mental illness and to protect, promote and fulfill the rights of the patients while delivering mental healthcare services to them.”

Who does it apply to?

This act is specifically for those suffering from any kind of mental illness. Before 2017, mental illness in India was treated as something very dangerous and abnormal; even mentally ill people were treated differently, as someone who did not belong to that community. The people in the surrounding community humiliate patients with mental illness and their families as well. Hence, mental illness is ignored most of the time and is not considered as important as it is. Due to the fear of being judged, people suffering from mental health issues keep hiding their illness or even fail to diagnose that they are suffering from a mental health problem, which leads to dangerous impacts, such as being silent, being lonely, losing interest in life, and eventually leading to suicide. This was also considered a crime before the enactment of this act; hence, to protect the rights of these people and ensure that they are treated rightly, this law is made for all people suffering from mental illness. 

Key Sections : 

The following are some key sections of MHCA, which every individual should be aware of, 

Section 4 – explains when a person is legally capable of making their own decisions regarding mental healthcare or treatment. A person’s capacity is decided on the following three bases: can a person understand the information about treatment, can they appreciate the consequences of accepting or rejecting a treatment, and can they communicate their decision by any means. If the decision taken by an individual who satisfies the above-mentioned three conditions seems wrong to others, that does not mean the person is incapable of making the decision. 

Section 5 – This section gives every adult the right to prepare a written advance directive about their future treatments, mentioning how they want to be treated and which methods of treatment should be avoided. This gives a person their liberty, and their will is respected. It can be made regardless of past mental illness, and it becomes effective when a person lacks the capacity to make decisions until they regain the capability. If a person makes a decision in the current situation, it overrides an advance directive. The most important thing is that an advance directive that violates any law is considered void ab initio ( void from the beginning). 

Section 14 – discusses a nominated representative, who is a person who can be appointed by a patient to make decisions on their behalf when they lack capacity. The NR cannot be a minor. The NR should be any relative, caretaker, suitable person appointed, or a person mentioned in an advance directive. In case such a person is not available, the board shall appoint an NR for the concerned person.  

Section 94 – This section provides for emergency treatment. Emergency mental healthcare can be provided without a person’s consent to prevent the death of the patient or others or to prevent serious harm to the person or others. 

Section 95 – This section explains the procedures that are strictly prohibited. They are electroconvulsive therapy (ECT) without anesthesia, ECT for minors (except for special permission), sterilization as treatment, and chaining or physical punishment. It protects individuals from abuse and inhumane treatment. 

Section 107 – Subsection 1 of this act outlines penalties for illegally running mental health facilities or working in unregistered ones. For the first offence, the fine is not less than ₹5,000 and not more than ₹50,000. For the second offence, the fine can exceed Rs.50,000 to Rs. 2 lakhs, and for more such offences, it can further exceed Rs. 5 lakhs. Subsection 2 discusses the penalty for a mental health professional who knowingly serves in an unregistered establishment, penalizing ₹25,000. 

Section 108 – A person who violates any provision or rule under this Act for the first contravention shall be punishable with imprisonment for up to six months, or with a fine up to ten thousand rupees or with both, and for subsequent contravention,s the imprisonment can be extended to two years, and the fine will be not less than Rs. 50,000 and may extend to five lakhs or with both.

Rights, Duties, and Penalties 

Rights are explained in Chapter 5 of the Act. It has Sections 18 to 28. 

Section 18 – Right to Access Mental Healthcare 

Every person has the right to access appropriate mental healthcare without discrimination. People who cannot afford treatment should be provided free treatment. 

Section 19 – Right to Community Living 

A person with a mental illness has the complete right to be part of the community. No one can force them to live in mental health facilities.

Section 20 – Right to protection from Cruel, Inhuman and Degrading Treatment

Individuals suffering from mental illness must be treated with humanity and dignity. 

Section 21 – Right to Equality and Non-Discrimination

Every person with a mental illness shall be treated as a person with a physical illness. There should be no discrimination based on gender, sex, sexual orientation, religion, culture, caste, social or political beliefs, class, or disability. 

Section 22 – Right to Information 

Patients have the right to know about their diagnosis, treatment, and side effects. All information should be provided in simple language so that the person can easily understand it. 

Section 23 – Right to Confidentiality 

Information about a person suffering from a mental illness, whether medical or personal, must be kept confidential. 

Section 24 – Right to Access Medical Records

Patients have the right to access their medical records. 

Section 25 – Right to Personal Contacts and Communication

Patients can meet, call, or write to their family, friends, and legal advisers. Some restrictions may be imposed for safety purposes or as part of the treatment.

Section 26 – Right to Legal Aid 

Individuals with mental illnesses are entitled to free legal services. 

Section 27 – Right to Make Complaints 

Patients can complain about deficiencies in care or violations of their rights. Complaints can be made to the Mental Health Review Board or the Authority. 

Section 28 – Duties of Appropriate Government 

The government must take measures to protect and promote mental health. It must ensure the implementation of all the rights guaranteed under the Act.

Penalties are explained in Chapter 15, from sections 107 to 109 

Section 107 – Sub-section 1 of this act outlines penalties for illegally running mental health facilities or working in unregistered ones. The first offence incurs a fine of not less than ₹5,000, and the second offence incurs a fine of not more than ₹50,000; it can exceed ₹ 2 lakhs, and for more such offences, it can further exceed ₹ 5 lakhs. Sub-section 2 talks about the penalty for a mental health professional who knowingly serves in an unregistered establishment, penalizing ₹25,000. 

Section 108 – The person who violates any provision or rule under this act for first contravention shall be punishable with imprisonment for up to 6 months, or with a fine up to ten thousand rupees or with both and for subsequent contravention the imprisonment can be extended till 2 years and fine will be not less than Rs. 50,000 and may extend till 5 lakhs or with both. 

Section 109 – This act deals with offences by companies, holding both the company and individuals in charge liable if the company commits an offense under the Act, making them punishable as if they committed the offense under the Act, making them punishable as if they committed the offense personally, unless they prove lack of knowledge or diligence. The fine ranges till Rs. 50,000 to imprisonment up to 2 years or more for later offenses.

Practical examples / Real-life scenario 

We come across such a person once in our lives who is mentally ill, not in his senses, who talks to himself, and just roams around without any reason. We ignore these kinds of people, we get afraid of their actions, and we leave them in their condition. As we can’t do anything, they don’t respond to anything, they just don’t care about anything, or don’t understand anything. For these kinds of people, MHCA is important. They need to be treated, they need to get admitted at mental healthcare establishment to regain their soundness. People often get traumatized by numerous things, the death of a loved one, failure at exams, or loosing job, even breakups can also be the reason for mental illness. We as society should help others, at least our close ones, as the awareness about mental health has became need of the time.

Common Myths or Mistakes 

Mental illness is itself considered a myth. People think that they are just overreacting to something, and there is no such thing as mental illness. We should change the perspective of looking towards mental illness; it is a very important but misinterpreted concept in our society. People start looking at mentally ill people as if they are some kind of alien. People make them feel they are abnormal, vulnerable, and different from us. People think that the person who is taking therapy is crazy and often make fun of them. This takes away their confidence and scares them that they have some incurable disease, and they will live their remaining life with this thing. 

For women, at least it’s possible to express what they feel; they can cry in front of their close people, but it is very hard for men in Indian society to express their sad feelings. Men never express their stress; they cry in silence, too very rarely, hence the suicide rate of men is greater than that of women. Teaching male children that they are not allowed to feel bad, not allowed to cry, men can’t be weak is a mistake we are making as parents, as a society. 

Until we make mental illness normal, people will suffer by themselves, and many of them will end their lives, just because of our mistake in not understanding them and treating them as someone who is not accepted in society. People suffering from mental illness just need some support from others, and we should be kind enough to understand that. 

Recent Amendments / Landmark Cases 

An amendment, including expansion of definitions of mental healthcare providers (including psychotherapists/counselors) and duties of educational institutions, aiming to strengthen mental health support in schools, streamline procedures for caregivers, and address geriatric care issues, is proposed in parliament but has yet to be passed. 

Many cases were decided under the Mental Healthcare Act. Some of them are :

Common Cause v. UOI

A public interest petition asked the Supreme court to legalize advance medical directives, although the case was about Right to die, its principles are relevant to advance directives under the MHCA. The court held advance directives legally valid and laid down a clear procedure for making and implementing them. Since MHCA allows advance directives under section 5, this judgment guides how they should be interpreted and implemented, emphasizing safeguards, simple procedures, and the need for proper registration and verification by authorities. 

Pooja Sharma v. State of U.P. & Ors. 

The case dealt with the relationship between court-appointed guardians and nominated representatives under MHCA and how mental healthcare decisions affect the personal and financial rights of a person. In this case Allahabad High Court clarified the role and limits of nominated representatives and stated that the nominated representatives, according to MHCA, cannot replace guardians in other laws. Also directed that both systems must work together to protect the person and their rights. This case explained how decision making in MHCA should be coordinated with guardianship and financial settings in real situations, helping families, individuals, hospitals, and authorities to balance care, property protection, and personal rights. 

High Court on its own motion v. State of Maharashtra

The Bombay High Court took up several suo motu and PIL cases to examine the mental health conditions of prisoners, under-trial inmates, and practices in prisons and hospitals, using the MHCA. The Court ordered authorities to identify prisoners with mental illness, shift them to proper treatment facilities, conduct regular medical screening, submit quarterly reports, and follow procedures in the MHCA. The case showed that the application of MHCA is not only for hospitals but also for prisons, custodial institutions, and juvenile homes. 

Conclusion: Why does this Act matter today?

Mental healthcare issues are increasing day by day, while stigma associated with it, discrimination, lack of proper knowledge, and lack of access to mental healthcare are still there. The MHCA helps to change the perspective of society towards mental illness and treatment. It shifts India’s mental health law from a custodial and punitive approach to a rights-based framework that respects dignity, autonomy, and equality. It ensures access to affordable mental healthcare, recognizes patients’ rights and choices through an advance directive mechanism. Decriminalizing attempts to suicide protects persons with mental illness from abuse and neglect. In a society facing rising stress, social pressures ect. The MHCA aligns mental healthcare with constitutional values and human rights, making care, protection, and inclusion a legal obligation rather than a matter of charity.

References :

https://juslextra.in/f/ten-landmark-cases-under-mhc-act-2017?blogcategory=Health+Law