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Mental health as an issue is a part of a number of laws
but more particularly the following:
1. Matrimonial laws where certain kinds of mental illnesses are treated as
grounds of divorce or for nullity of marriage;
2. Mental Health Act (earlier the Lunacy Act) which deals primarily with
institutionalization of mentally ill persons.
3. Persons with Disabilities Act, which includes the issue of mental disability.
4. Laws dealing with contracts where contractual obligations are contingent upon
the contracts having been entered into in sane state of mind.
5. Criminal laws where liability is diminished or extinguished if the person was
of unsound mind at the time of committing the crime.
6. Many laws where occupying a position under the law is contingent upon the
person being mentally sound.
Right to Treatment: The Court recommended that
psychiatric treatment be provided to the mentally ill inmates, for which the
record of the time and place of the treatment should be maintained.
Human Rights Violations in Institutions: Court
observed: It seems that there are a number of children who are mentally or
physically handicapped and there are also children who are abandoned or
destitute and who have no one of take care of them. They are lodged in various
jails in different states... .
...The State Governments must take care of these mentally or physically
handicapped children and remove them to a Home where they can be properly looked
after and so far as the mentally handicapped children are concerned, they can be
given proper medical treatment and physically handicapped children may be given
not only medical treatment but also vocational training to enable them to earn
their livelihood. Those children who are abandoned or lost and are presently
kept in jails must also be removed by the State
Governments to appropriate places where they can be looked after and
rehabilitated... .
...We would also ask the Director General, All India Radio and the Director
General, Doordarshan to give publicity requesting non-governmental social
service organisations to offer their services for the purpose of accepting these
children with a view to taking care of them and providing for their
rehabilitation in accordance with a hand-out to be sent by the Registrar of this
Court.
In light of the provisions of Mental Health Act, Supreme Court issued following
directions for its implementation:
(i) Every State and Union Territory must undertake a district-wise survey of all
registered/unregistered bodies, by whatever name called, purporting to offer
psychiatric/ mental health care. All such bodies should be granted or refused
licence depending upon whether minimum prescribed standards are fulfilled or
not. In case licence is rejected, it shall be the responsibility of SHO of the
concerned police station to ensure that the body stops functioning and patients
are shifted to government mental hospitals.
(ii) Chief Secretary or Additional Chief Secretary designated by him shall be
the nodal agency to coordinate all activities involved in implementation of the
Mental Health Act, 1987, the Persons with Disabilities (Equal Opportunities,
protection of rights and full participation) Act, 1995 and National Trust for
Welfare of Persons with Autism, Cerebral Palsy, mental Retardation and Multiple
Disability Act, 1999. He shall ensure that there are no jurisdictional problems
or impediments to the effective implementation of the three Acts between
different Ministries or Departments. At the Central level, Cabinet Secretary,
Government of India or any Secretary designated by him shall be the
nodal agency for the same purpose.
(iii) The cabinet Secretary, Union of India shall file an affidavit in SC within
one month from the date of this order indicating:
a) The contribution that has been made and that is proposed to be made under
Section 21 of the 1999 Act which would constitute corpus of the National Trust.
b) Policy of the central Government towards setting up at least one Central
Government-run mental hospital in each State and union Territory and definite
time schedule for achieving the said objective.
c) National policy, if any framed under Section 8(2)9b) of the 1995 Act.
d) In respect of the States/UT that do not have even one full-fledged State
Government-run mental hospital, the Chief Secretary of the State/UT must file an
affidavit within one month from date of this Order indicating steps being taken
to establish such full-fledged State
Government-run mental hospital in the State/UT and a definite time schedule for
establishment of the same.
e) Both Central and State Governments shall undertake a comprehensive awareness
campaign with a special focus to educate people as to provisions of law relating
to mental health, rights of mentally challenged persons, the fact that chaining
of mentally challenged persons is illegal and mental patients should be sent to
doctors and not to religious places for treatment.
(iv) Every State shall file an affidavit stating:
a) Whether the state Mental Health Authority under Section 3 of the 1987 Act
exists in the State and if so, when was it set up.
b) If it does not exist, the reason thereof and when such an Authority is
expected to be established and operationalised.
c) The dates of meetings of those Authorities, which already existed, from the
date of inception till date and a short summary of the decisions taken.
d) A statement that the State shall ensure that meetings of the Authorities take
place in future at least once in every four months or at more frequent intervals
depending on exigency and that all the statutory functions and duties of such
Authorities are duly discharged.
e) The number of prosecutions, penalties or other punitive/coercive measures is
taken, if any, by each State under the 1987 Act.
In Saarthak Registered Society and another vs. Union of India, as a continuation
to the above order, the Supreme Court passed the following directions:
1. Every State and Union Territory shall undertake an assessment survey and file
the report on the following aspects:
a. Estimated availability of mental health resources including psychiatrists,
psychologists, psychiatric social workers and nurses in both public and private
sector
b. Type of Mental Health Delivery System available in the State including
available bed strength, outpatient and rehabilitation services c. An estimate of
the Mental Health Services that would be required considering the population of
the State and the incidence of mental illness.
2. The Chief Secretary of each State and Administrator/Commissioner of every UT
to file affidavit stating clearly a. Whether any minimum
standards have been prescribed for licensing of Mental Health Institutions in
the State/UT and in case such minimum standards have been prescribed
b. Whether each of the existing registered Mental Health Institutions in the
State/ UT whether private or run by the State meet the basic minimum standards
as on date of passing this order and if not, what steps have been taken to
ensure compliance of licensing conditions
c. Number of unregistered bodies providing psychiatric/mental health care exist
in the State and whether any of them comply with minimum
standards.
d. Whether any mentally challenged person is found to be chained in the State.
3. The report on the Need Assessment Survey and affidavit was to be submitted to
the Health Secretary, Union of India within a stipulated
time. The Health Secretary was to compile them and present it to the Court.
4. Further Union of India was directed to:
a. Frame a policy and initiate steps for establishment of at least one Central
Government run Mental Health Hospital in each State
b. Examine the feasibility of formulating uniform rules regarding standard of
services for both public and private sector Mental Health Services
c. Constitute a committee to give recommendations on the issue of care of
mentally challenged persons who have no immediate relatives or who have been
abandoned by relatives. d. Frame norms for non-government
organizations working in the field of mental health and to ensure that the
services rendered by them are
supervised by qualified/trained persons.
5. All State Governments were also directed to frame policy and initiate steps
for establishment of at least one State Government run Mental Health Hospital in
each State.
6. Two members of the Legal Aid Board of each State were appointed to make
monthly visit to such institutions to help the patients and their relatives in
applying for discharge if they have been fully discharged.
7. Two members of the Legal Aid and Judicial Officer would explain their rights
to patients and their guardians at the time of admission
to the institutions.
8. Form a Board of Visitors as required under the Mental Health Act to every
State or private institution at least once a month.
9. Envisage a scheme for rehabilitation process for people who are not having
any backing or support in the community.
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