Policies and Acts

National Mental Health Program 1982

It is estimated that 6-7 % of population suffers from mental disorders. Poor awareness about
symptoms of mental illness, myths & stigma related to it, lack of knowledge on the treatment
availability & potential benefits of seeking treatment are important causes for the high treatment
gap. The Government of India has launched the National Mental Health Programme (NMHP) in 1982,
with the following objectives:

1. To ensure the availability and accessibility of minimum mental healthcare for all in the
foreseeable future, particularly to the most vulnerable and underprivileged sections of the
population;
2. To encourage the application of mental health knowledge in general healthcare and in social
development;
3. To promote community participation in the mental health service development and to
stimulate efforts towards self-help in the community.

To realize these objectives the following approaches were envisaged:

 Integration of the mental health care services with the existing general health services.
 Utilization of the existing health services infrastructure to deliver minimum mental health
care services.
 Provision of appropriate task-oriented training to the existing health staff.
 Linking of mental health services with the existing community development programs.

The original NMHP guidelines carried many ambiguities. Most importantly, no budgetary estimates
or provisions were made for the implementation of the programme. There was lack of clarity
regarding who should fund the programme – the central government of India or the state
governments who perpetually had inadequate funds for health care. Great doubts were expressed
about the feasibility of implementing the programme in larger populations and in real world settings
as almost all the pilots and feasibility projects were carried out by only research and training
institutes and in smaller populations of up to 40, 000. The need for planning the implementation of
the programme at a district level was stressed upon by majority of such critiques.

Mental Health Act of 1987

Prior to 1993, Indian Lunacy Act, 1912 was governing the mental health in India. In 1947 when we
got independence and Indian Psychiatric society came into existence, ILA, 1912 was considered an
inappropriate act for mentally ill. So IPS drafted a mental health bill and submitted it to govt. of India
1950 but it took another 28 years for govt. to present it in the Lok Sabha which was subsequently
referred to JPC. Various committees established didn't consult IPS at any juncture though 10
psychiatrists were invited to give oral evidences. After a gap of another 8 years the bill was adopted
as Mental Health Bill by Rajya Sabha in 1986 and the Lok Sabha in 1987.This bill received President's
assent on May, 1987 but another 6 years were wasted before finally implementing the act in April
1993.
Objectives of the MHA 1987:

1. To establish central and state authorities for licensing and supervising the psychiatric
hospitals.
2. To establish such psychiatric hospitals and nursing homes.
3. To provide a check on working of these hospitals.
4. To provide for the custody of mentally ill persons who are unable to look after themselves
and are dangerous for themselves and or, others.
5. To protect the society from dangerous manifestations of mentally ill.
6. To regulate procedure of admission and discharge of mentally ill persons to the psychiatric
hospitals or nursing homes either on voluntary basis or on request.
7. To safeguard the rights of these detained individuals.
8. To protect citizens from being detained unnecessarily.
9. To provide for the maintenance charges of mentally ill persons undergoing treatment in such
hospitals.
10. To provide legal aid to poor mentally ill criminals at state expenses
11. To change offensive terminologies of Indian Lunacy act to new soother ones

The advantage of the Mental Health 1987 is that the act is conceptually definitely many steps ahead
of ILA (Indian Lunacy Act), 1912, trying to keep pace with advances in psychopathology and
psychopharmacology. This was definitely a breakthrough and distinctly miles ahead of the then
obsolete and anarchic Indian Lunacy Act,1912. Various positive changes in the MHA, 1987 are:

 More humane approach to problems of mentally ill persons by changing the terminology e.g.
lunatics and criminal lunatics have been replaced by the term mentally ill person and
mentally ill prisoner etc. and new chapters on management of their property and protection
of human rights have been included
 Creation of Central and State Mental Health Authorities- a welcome step to safeguard the
interests of the mentally ill person under one authority
 Procedure for admission and discharge of voluntary patients have been simplified and
liberalized. In this act, no consent from two visitors is required as well as no written request
is required
 Minor can be admitted with the consent of a guardian under this act. This provision is not
there in the Indian Lunacy Act, 1912
 Separate provision for admission of involuntary patients under category “Admissions Under
Special Circumstances”
 Special centres for special population like drug addicts, under 16 years, mentally ill prisoners
etc.
 Establishment and maintenance of psychiatric hospitals and psychiatric nursing homes in
private sector which was not in the earlier law
 Discharge procedure have been made easy and more simplified
  There are new different addition in this law like protection of human rights of mentally ill
persons, penalties, cost of maintenance and management of properties of mentally ill
persons
 Prohibition on any research on subjects without proper consent.

Mental Health Act 1987 is divided into 10 chapters consisting of 98 sections:

Chapter I: deals with Preliminaries of the act, definitions and provides for change of offensive
terminologies used in Indian Lunacy act 1912.

Chapter II: Deals with the procedures for establishment of mental health authorities at central and
state levels.

Chapter III: It lays down the guidelines for establishment and maintenance of psychiatric hospitals
and nursing homes. There is a provision for licensing authorities to process applications for license
which have to be renewed every five years.

Chapter IV: It deals with the procedures of admission and detention of mentally ill in psychiatric
hospitals.

Chapter V: It deals with the inspection, discharge, leaves of absence and removal of mentally ill
persons.

Chapter VI: It deals with the judicial inquisition regarding alleged mentally ill persons possessing
property and its management.

Chapter VII: It deals with the maintenance of mentally ill persons in a psychiatric hospital or
psychiatric nursing homes.

Chapter VIII: It deals with the protection of human rights of mentally ill persons.

Chapter IX: This section pertained to “Penalties and Procedures” related to punishments and
offences.

Chapter X: “Miscellaneous” issues are written in this chapter.

Rehabilitation Council of India (RCI) Act of 1992

CHAPTER - I

In this Act, the definitions given in this act are "handicapped" means a person-

 visually handicapped;
 hearing handicapped;
 suffering from locomotor disability; or
 suffering from mental retardation
"hearing handicapped" means with hearing impairment of 70 decibels and above, in better ear or
total loss of hearing in both ears;

"locomotor disability" means a person's inability to execute distinctive activities associated with
moving, both himself and objects from place to place and such inability resulting from affliction of
either bones joints muscles or nerves;

"mental retardation" means a condition of arrested or incomplete development of mind of person

which is specially characterized by sub-normality of intelligence;

"Register" means the Central Rehabilitation Register maintained under sub-section (1) of section 23;

"regulation" means regulation made under the Act "rehabilitation professional" means- audiologists
and speech therapists; clinical psychologists; hearing aid and ear mould technicians; rehabilitation
engineers and technicians; special teachers for educating and training the handicapped; vocational
counsellors, employment officers and placement officers dealing with handicapped; multi-purpose
rehabilitation therapists, technicians; or such other category of professionals as the Central
Government may, in consultation with the Council, notify from time to time.

CHAPTER – II THE REHABILITATION COUNCIL OF INDIA

The Central Government may, by notification, appoint in this behalf, there shall be constituted for
the purposes of this Act a Council to be called the Rehabilitation Council of India. The Council is
vested with power, subject to the provisions of this Act, to acquire, hold and dispose of property
both movable and immovable.

This chapter specifies the term of office of Chairperson and Members, provides guidelines for
disqualification and vacation of office by members and constitutions of executive committee and
other committees. This chapter also dealt with the power and duties of member secretary and
employees of council. It also points out the term and conditions for dissolution of Rehabilitation
Council and transfer of right.

CHAPTER – III - FUNCTIONS OF THE COUNCIL

Recognition of qualifications granted by university etc., in India for Rehabilitation Professionals The
qualification granted by any University or other institution in India which are included in the
Schedule shall be recognized qualifications for rehabilitation professional. Any University or other
institution which grants qualification for the rehabilitation professional not included in the schedule
may apply to the Central Government to have any such qualification recognized and the Central
Government after consulting the Council may by notification, amend the Schedule so as to include
such qualification therein and any such notification may also direct that a entry shall be made in the
last column of the schedule against such qualifications only when granted after a specified date.

The Persons with Disabilities (equal opportunities, protection of rights & full
participation) Act 1995
The enactment of the Persons with Disabilities (Equal opportunities, Protection of Rights and Full
Participation) Act 1995 (referred to as persons with Disability Act) is guided by the philosophy of
empowering persons with disabilities and their associates. The endeavour of the Act has been to
introduce an instrument for promoting equality and participation of persons with disability on the
one hand, and eliminating discriminations of all kinds, on the other. The Act aims to protect and
promote economic and social rights of people with disabilities.

The Act covers seven disabilities. The criteria for classification of each disability are embodied in a
biomedical model. Section 2(t) of the Act proclaims that a person with disability means ‘a person
suffering from not less than forty percent of any disability as certified by a medical authority.’ The
disabilities that have been listed in Section 2 include blindness, low vision, hearing impairment,
locomotor disability or cerebral palsy, mental retardation, mental illness and persons cured of
leprosy. In addition, autism and multiple disabilities have been covered under the National Trust for
Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities Act,
1999.

The Act spells out responsibilities of the Government at all levels including establishments under its
control. It lays down specific measures for the development of services and programmes for
equalising opportunities for the enjoyment of right to education, work, housing, mobility and public
assistance in case of severe disability and unemployment. To execute the mandated responsibilities,
a Central Co-ordination Committee and State Co-ordination Committees representing major
development ministries, Members of Parliament and disability NGOs and having a woman with
disability as a member have been envisaged in a multi-sector model. Furthermore, the institution of
Chief Commissioner in the Centre and Commissioner for Persons with Disabilities in States has been
proposed. Their mandate is to redress individual grievances, provide safeguards to the rights of
persons with disabilities, monitor implementation of disability related laws, rules and regulations,
and oversee utilisation of budget allocated on disability. These quasi-judicial bodies are vested with
the powers of a civil court.

The PWD Act has an exclusive chapter entitled Non-Discrimination. Sections 45, 46 and 47 of this
chapter prohibit discrimination on the basis of disability in the matter of public employment and in
access to public facilities. It is another thing that corresponding reforms in service rules, building
codes and motor vehicle standards have been extremely slow. Consequently, disability litigation is
on the rise but the redeeming feature of the current scenario is efficient disposal of disability
discrimination cases both by courts and quasi-judicial bodies.
The National Trust for the Welfare of Persons with Autism, Cerebral Palsy,
Mental Retardation and Multiple Disabilities Act, 1999
The Government has also introduced a National Trust for the Welfare of Persons with Mental
Retardation and Cerebral Palsy Bill, 1995. The trust aims to provide total care to persons with mental
retardation and cerebral palsy and also manage the properties bequeathed to the Trust.

As certain groups among the disabled are more vulnerable than others, a special enactment for the
protection of such persons, their property and well-being was felt necessary. The enactment of the
National Trust for Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple
Disabilities Act, 1999 (referred to as the National Trust Act) aims to fulfil a common demand of
families seeking reliable arrangement for their severely disabled wards. The specific objectives of the
Act are:

 To enable and empower persons with disabilities to live as independently and as fully as
possible within and as close to the community to which they belong;
 To promote measures for the care and protection of persons with disabilities in the event of
death of their parent or guardian; and
 To extend support to registered organisations to provide need-based services during the
period of crisis in the family of disabled covered under this Act.

References
Trivedi, J. K. (2009). Mental Health Act, salient features, objectives, critique and future directions.
Indian J Psychiatry, 51, 11-9.

Roy, S., & Rasheed, N. (2015). The national mental health programme of India. New Delhi:
Government of India, 9.

Rastogi P. (2005) Mental Health Act, 1987 – An Analysis, JIAFM; 27 (3)

Mental Health Act, 1987