Mental Health Act, Rights of Patient

This presentation is on Mental Health Act, Indian Lunacy Act and Rights of Patient. Mental Health Nursing one of core subject of B.Sc. Nursing Third Year.
BIBILIOGRAPHY
R SREEVANI “A Guide to Mental Health &
Psychiatric Nursing” 3rd Edition
Jaypee Medical Publisher Pp: 345 to 350
Shelia L Vedibeck “Psychiatric Mental Health
Nursing” 5th Edition Lippincott & Williams.
Mary C Townsend “Essential of Psychiatric health
nursing” 7th Edition F A Devis 2013.
ANTONY JAMES T (2000): “A decade with the
mental health act, Indian Journal
of Psychiatry, 42(4)
Kothari, Jaya “Moving towards autonomy &
equity an analysis of mental health care
bill 2013”

1. Subject: Mental Health Nursing Topic: Mental Health Act, Indian Lunacy Act, Rights of Patient By : Ujjwal M Patel B.Sc . Nursing Govt. College of Nursing Vaccine Institute Campus Vadodara

2. OBJECTIVES Specific Objectives At the end of teaching students will be able to, Describe their behavior in legal issues regarding mental health Nursing. Explain the Mental Health Act Describe the nursing implication of MHA Describe the Indian Lunacy Act Enumerate the Mental Health Care Bill Enlist the rights of patient

3. Mental Health Act, Indian Lunacy Act, Rights of Patient

4. THE INDIAN MENTAL HEALTH ACT 1987 – SECTIONS AND THERE IMPLICATIONS

5. History The Indian Mental Health Act (MHA) was drafted by the parliament in 1987, but it came into effect in all States and UT of India in April 1993. This Act replaces the Indian Lunacy Act 1912. Reason for Enactment The mentally ill individuals should be treated like any other sick persons and the environment around them made as normal as possible. The experience of working of the Indian Lunacy Act, 1912 has revealed that it has become outmoded with rapid advancement of medical science, therefore become necessary to make fresh legislation in accordance with new approach.

6. Objectives of the Indian Mental Health Act To regulate admission into psychiatric hospitals and psychiatric nursing home. To protect citizen from being detained in psychiatric hospitals/nursing homes without cause. To protect society from the presence of mentally ill persons. To regulate maintenance charges of psychiatric hospital. T o provide facilities for establishing guardianship of mentally ill person who are incapable of managing their own affairs. To establish central and state authorities for mental health services. To regulate the power of the government for establishing, licensing and controlling psychiatric hospitals. To provide legal aid to mentally ill persons at state expense in certain cases.

7. Silent features of act The Act is divided into 10 chapters consisting of 98 section

8. CHAPTER 1 It contains the preliminary information. Some definitions included in this are: Psychiatric Hospitals: A hospital/nursing home established or maintained by the government or any other person for the care of mentally ill persons. Mentally ill person: A person who is in need of treatment by reason of any mental disorder other than mental retardation. Psychiatrist: A medical Practitioner possessing a PG or diploma in psychiatry recognized by the MCI. Reception Order: An order made under the provision of this Act for the admission and detention of mentally ill persons in a psychiatric hospitals. Old terms New terms Lunatic Mentally ill person Lunatic asylum Psychiatric hospital Criminal Lunatic Mentally ill prisoner

9. CHAPTER 2 It deals with establishment of Central and State authorities for regulation and coordination of health services. CHAPTER 3 It provides guidelines for establishment and maintenance of psychiatric hospitals/nursing homes.

10. It deals with the procedures for admission and detention n psychiatric hospitals. CHAPTER 4

11. ADMISSION ON VOULNTARY BASIS

12. ADMISSION UNDER SPECIAL CIRUMSTANCES

13. ADMISSION UNDER AUTHORITY OF ORDER. PETITION EXAMINATION DETERMINATAION MEDICAL ADMIISTRATION RELEASE HOSPITALIZATION EMERGENCY SHORT TERM LONG TERM

14. Reception order on application Only a relative or friend makes application to magistrate. Application should be supported by two medical certificates, Magistrate obtains consent from the medical officer in-charge of mental hospital. Admission under reception order is made. Reception order on production before magistrate Mentally Ill patient exhibiting violent behavior detained by police officer. Production in the court within 24 hours of detention. Application is supported by two medical certificates. Magistrate issues reception order.

15. Reception order after inquest. A district court holding an inquisition regarding any person who is found to be mentally ill, in the interest of such person, may, by order direct for admission. Every such order may be varied from time to time. Admission of a mentally ill prisoner A mentally ill prisoner may be admitted into a mental hospital on order of the presiding officer or a court.

16. CHAPTER 5 It deals mainly with the procedure to be followed for the discharge of mentally ill persons from the mental hospitals. Discharge of a patient admitted on voluntary basis. MO of hospital on recommendation from two medical practitioners can issue direction for discharge of patient. Discharge of a patient admitted under special circumstances A relative or a friend makes an application to the medical officer for care and custody of the patient. The relatives are required to furnish a bond, along with an undertaking that the mentally ill person shall be prevented from causing injury to self and others. Discharge of a patient admitted on reception of order. An application is made. A certificate from medical officer-in-charge of psychiatric hospital. A magistrate issues an order if patient is fit for discharge.

17. Discharge of a mentally ill Prisoner The hospital authorities have to report every 6 months about the persons state of mind to the authority, which had ordered detention. As soon as they find that the person is fit to stand the trial, they have to inform about the same to the authority concerned. The person is then handed over to the prison officer for further legal action. Leave of Absence (section 45) Leave of absence means, when mentally ill patients are detained in a hospital, they may be given time limited leave, to leave the hospital with permission to visit family members. It is a step towards community treatment.

18. CHAPTER 6 It deals with judicial enquiry regarding mentally ill persons possessing property, their custody and management of property. Under section 54(1) a guardian may be appointed by court of law on behalf of an alleged mentally ill person incapable of looking after self and property. CHAPTER 7 It deals with way and means to meet the cost of maintenance of mentally ill persons detained in psychiatric hospitals. Under section 78 when a mentally ill patient is detained as an inpatient and does not have property to bear the cost of treatment in such cases his expenses shall be borne by the govt.

19. CHAPTER 8 It is the latest addition to the act that contains very novel and explicit provision for protection of human rights of mentally ill persons. No mentally ill person shall be subjected during treatment to any indignity or cruelty. No mentally ill person under treatment shall be used for research No communication channels are broken. CHAPTER 9 It deals with procedures to be followed for the establishment and maintenance of psychiatric hospitals/nursing homes, and the penalties, which can be relatively severe and explicit, for contravening them.

20. CHAPTER 10 It deals with clarification pertaining to certain procedures to be followed by the medical officer of the hospital.

21. NURSING IMPLICATION OF MENTAL HEALTH ACT A psychiatric nurse is in the ward 24 hours of the day and the final responsibility of the ward management is on the nurse. She should therefore, be well-versed in legal aspects of care and treatment of the mentally ill. This knowledge helps her to guide the patients and relatives in matters related to rights of the patient and other aspects of mental health. The legal and ethical contest of care is important for all psychiatric nurses because it focuses concern on the rights of patient and the quality care they receive.

22. THE INDIAN LUNACY ACT 1912

23. It is derived from English Lunacy Act. 1890 and it contains eight chapters, Act 4 of Indian Lunacy Act(IL A), 1912, replaced Act 36 of the Indian Lunatic Asylums Act, 1858. It was enacted to govern reception, detention and care of lunatics and their property and to consolidate and amend the laws related to lunacy. The act is divided into 4 parts 8 chapters and 100 section. The enactment of ILA of 1912 was followed by opening of many new asylums, and an increase in awareness regarding the prevailing situation of lunatics in such asylums.

24. Chapter 1: It contains some preliminary information and definitions. Chapter 2: It contains mainly the procedures to be followed to admit a patient. Chapter 3: It describes the procedure to be followed for administrating care, treatment and discharge. Chapter 4: It deals with proceeding of lunacy in presidency town. Chapter 5: It deals with proceedings in lunacy outside presidency town. Chapter 6: It deals with establishment of asylums. Chapter 7: It deals with expenses of lunatics Chapter 8: It deals with rules to be imposed by the State Govt. regarding care of lunatics.

25. THE MENTAL HEALTH CARE BILL 2013

26. The mental health care bill, 2013 was introduced in the Rajya Sabha on August 19, 2013. The abolishes the Mental Health Act, 1987. REASONS TO THE BILL The new Bill was introduced as the existing Act does not adequately protect the rights of persons with mental illness nor promotes their access to mental healthcare.

27. THE KEY FEATURES Every person shall have the right to access mental health care and treatment from services run or funded by govt. A mentally ill person shall have the right to make an advance directive that states how he wants to be treated for illness. Every mental health establishment has to be registered with the relevant Central or State Mental Health Authority, These authorities are in addition responsible for supervising and maintaining a register of all mental health establishment. A person who attempts suicide shall be presumed to be suffering from mental illness at that time and will not be punished under the Indian Penal Code. Electro-convulsive therapy is allowed only with the use of muscle relaxants and anesthesia. The therapy is prohibited for minors. Mental health review commission will be a quasi-judicial body that will periodically review the use of and the procedures for making advance directives and advise the government on protection of rights of mentally ill person.

28. THE RIGHTS OF PSYCHIATRIC PATIENT

29. Chapter 8 of Mental Health Act 1987 contains a very novel and explicit provision of protection of human rights, Universal Declaration of Human Rights in Article 24(1) explicitly mentions. “Every one has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing and medical care and necessary services”. Article 5 of UDHR states no one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishments. Mental illness is also recognized as disability according to sections 2 of the Person with Disability Act. 1995

30. RIGHTS OF PATIENTS The right to wear their own clothes. The right to have individual storage space for their private use. The right to keep and use their own personal possessions. The right to spend a sum of their money for their own expenses. The right to have reasonable access to all communication media likes telephone, letter writing and mailing. The right to see visitors every day. The right to hold civil service status. The right to manage and dispose of property and execute wills.

31. Nursing Implication in Protection of Rights Psychiatric patients are often the least capable of protecting their own rights. It is, therefore, one of the responsibilities of the nurse to guide the patient and relatives. To protect patients rights, the nurse should be aware of these rights in the first place. She should ensure that ward procedures and policies should not violate patients rights. Discussing these rights with the mental health team and including these rights in the nursing care plan is all part of her responsibility in protecting the patients right.

32. Summary Mental Health Act HISTORY OBJECTIVES CHAPTER Nursing Implication of Mental Health Act The Indian Lunacy Act INTRODUCTION CHAPTERS Mental Healthcare Bill 2013 Rights of Psychiatric Patients NURSING IMPLICATION

33. QUESTION ANSWER?

34. ASSIGNMENT Write down the rights of psychiatric patients and nursing implication.

35. BIBILIOGRAPHY R SREEVANI “A Guide to Mental Health & Psychiatric Nursing” 3 rd Edition Jaypee Medical Publisher Pp: 345 to 350 Shelia L Vedibeck “Psychiatric Mental Health Nursing” 5 th Edition Lippincott & Williams. Mary C Townsend “Essential of Psychiatric health nursing” 7 th Edition F A Devis 2013. ANTONY JAMES T (2000): “A decade with the mental health act, Indian Journal of Psychiatry, 42(4) Kothari, Jaya “Moving towards autonomy & equity an analysis of mental health care bill 2013”

36. THANK YOU "Unexpressed emotions will never die. They are buried alive and will come forth later in uglier ways."