unit 14 LEGAL ASPECTS IN PSYCHIATRIC NURSING.pptx

EASY TO UNDERSTAND

1. Indian mental health act (MHA) Indian mental health act (MHA) was drafted by the parliament in 1987, but it came into effect in all the states and union territories of India in April 1993. This act replaces the Indian lunacy Act of 1912 To change the attitude of the society towards the mentally ill & considerably realized that no stigma should be attached to such illness. Every mentally ill individual has the right to be treated like others sick people. To modify the act according to the rapid advancement of medical science and the understanding

2. Objectives of the Mental Health Act To regulate the power of the government for establishing, licensing and controlling psychiatric hospital / nursing homes. • To provide legal aid mentally ill persons at state expense in certain cases. • To protect citizens from being detained in psychiatric hospital / nursing homes without sufficient cases • Central and state authorities for mental health services. • To regulate maintenance charges of psychiatric hospitals/nursing homes The act is divided into 10 chapters consisting of 98 sections

3. CHAPTER I Chapter I Preliminary information It contains definition included :- • Psychiatric hospital/nursing homes :- A hospital/ nursing home established or maintained by the government or any other person for the case 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 postgraduate degree or diploma in psychiatry recognized by the MCI (medical council of India) • Reception order:- An order made under the provision of this Act for the admission and detention of mentally ill person in a psychiatric hospital / nursing home. Outdated definition are changed based on current knowledge OLD TERM NEW TERM Lunatic mentally ill person Lunatic asylum psychiatric hospital Criminal lunatic mentally ill prisoner

4. Chapter II, Chapter III & Chapter IV Chapter II : It deals with establishment of central & state authorities for regulation and co- ordination of mental health services Chapter III : It provides guidelines for establishment and maintenance of psychiatric hospital/nursing home Chapter IV : It deals with the procedure for admission and detention in psychiatric Hospital/nursing homes.

5. Chapter IV CONTD…

6. Admission on voluntary basis

7. INVOLUNTARY ADMISSION

8. Admission under authority or order

9. Admission under authority or order CONTD…

10. Reception order on application

11. Reception order on production of a mentally ill person before a Magistrate

12. Reception order after Inquest

13. Chapter V

14. Discharge of a patient admitted on voluntary basis Medical officer in-charge of psychiatric hospital /nursing home on recommendation from two medical practitioner preferably a psychiatrist, can issue directions for discharge of the patient. Discharge of patient admitted under special circumstances • Relative or a friend may be make an application to the medical officer for care and custody of the patient. • Relative are required to furnish a bond with or without sureties , along with an undertaking that the mentally ill person shall be prevented from causing injury to self or others

15. Discharge of a patient admitted by police If police detain the mentally ill individual in hospital , he may be discharged after the family members agree in writing to take proper care that he is fit to be discharged . Discharge of a mentally ill Prisoner • Hospital authorities have to report every 6 months about the persons state of mind to the authority , which had ordered detention • As soon the client is fit to stand in trial , they have to inform about the same to the authority concerned . • Person then hand over to the prison officer for further legal action. Leave of absence (section 45) • It means patient is given time limit permission to visit family members . • On application by a relative or others to the medical officer-in-charge And a bond duly signed stating that the patient will be taken proper care of and prevented from injuring self or others (for a period of maximum 6 days)

16. Chapter VI • Consist of legal customary actions towards the property possess by mentally ill persons. • Under sections 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. • Under section 97 of the act when a mentally ill person is not represented by a legal practitioner in any proceeding before a district court or magistrate and such a patient does not have sufficient means to engage a legal practitioner then the district court

17. Chapter VII • Deals with ways and means to meet the lost of maintenance of mentally ill persons detained in psychiatric hospital. • 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 this expenses shall be borne by the government of the state. Chapter VIII Contains the novel and explicit provision for protection of human right of mentally ill patients Section 81 provides that: No letter or communication sent by or to a mentally ill person shall be interpreted detained or destroyed. 2. No mentally ill person shall be subjected during treatment to any indignity (physically or mental ) or cruelty 3. No mentally ill person under treatment shall be used for purpose of research unless:- • Such research is of direct benefit to him • A consent has been obtained in writing from the person (in voluntary admission) or from the guardian/ relative (if admission was involuntary

18. Chapter IX • Deals with procedure to be followed for the establishment and maintenance of psychiatric hospital and penalties which can be relatively severe and explicit for containing them. • Article 6(1)of the mental health Act prohibit the running of a home without license. • Article 11(1b) says the licensing authority can revoke the license if the maintenance of the manner detrimental to the moral, mental or physical well being of the in patients. Chapter X • It deals with clarification pertaining to certain procedures to be followed the medical officer –in-charge of the psychiatric hospital / nursing home.

19. RIGHTS OF A MENTALLY ILL CLIENTS Right to access mental health care Right to community living Right to protection from cruel, inhuman and degrading treatment Right to equality and non- discrimination Right to information Right to confidentiality Restriction on release of information in respect of mental illness Right to access medical records Right to personal contacts and communication Right to legal aid Right to make complaints about deficiencies in provision of services

20. FORENSIC PSYCHIATRY Psychiatry deals with the study, diagnosis &treatment of mental illness. Forensic Psychiatry is a subspecialty deals with the application of psychiatry knowledge to legal issues, i.e. Psychiatry Scope of Forensic Psychiatry CRIMINAL CASES Crime committed in state of unsoundness of mind Inability to plead defense Deference of punishment Insane women is raped In sexual perversions y in Law CIVIL CASES •Testamentary capacity •Continuance ofbusiness contract •Nullity of the marriage and divorce •Competence of witness •Competence to stand trial •Validity of the consent •Inability to look after property

21. Role of Forensic psychiatry Treatment assurance of mentally ill people who become the perpetrator;  Giving evidence to courts in cases where the offender’s mental stability is in question Competency evaluations;  Working effectively to understand and upgrade the connection of the law and psychiatry; Working with additional clinical and non-clinical experts in the field; Preventing a delay in the treatment of offenders with a mental disorder.