1. THE MENTAL HEALTH ACT, 1987 Aim: To consolidate and amend the law relating to the treatment And care of mentally ill person. To make better provisions with respect to their property and Affairs and for matters connected herewith or incidental thereto. It has 10 chapters

2. MENTAL HEALTH AUTHORITIES Central authority for mental health services: established by the Central government State authority for mental health services: established by the State government.

3. THE AUTHORITY SHALL: Be in charge of regulation department Supervise Psychiatric Hospital Advice Central government and State government.

4. Psychiatric Hospitals/Nursing Homes Establishment or maintenance of psychiatric hospital by Central and State Government Establishment or maintenance of psychiatric hospital only with license Application for license Grant or refusal of license

5. The licensing authority should be satisfied in matters relating to Establishment / maintenance Minimum facilities provided The hospital / nursing home should be under the control of medical officers

6. Types of admission to Psychiatric Hospitals On voluntary basis Requisition made by the Guardian Admission under special circumstance Reception orders on application

7. Discharge of mentally ill person The medical officer in charge may direct the discharge Only if an application is made to the medical officer Any person not being ill prisoner who feels that he has recovered The application should be of the prescribed format

8. Other points Property of the mentally ill person Cost of maintenance of a mentally ill person Protection of human rights of mentally ill person Penalties and procedures

9. Issues IN THE SUPREME COURT OF INDIA Decided On: 12.04.2002 In Re: Death of 25 Chained Inmates in Asylum Fire in Tamil Nadu WITH Appellants: Saarthak Registered Society and Anr. Vs. Respondent: Union of India (UOI) and Ors. Hon'ble Judges: union of India is directed- a) To frame a policy and initiate steps for establishment of at least one Central Government run Mental Health Hospital in each State (as provided under Section 5 of the Act); b) To examine the feasibility of formulating uniform rules regarding standard of services for both public and private sector Mental Health Institutes; c) To 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) To frame norms for n on-Government Organisations working in the field-of Mental Health and to ensure that the services rendered by them are supervised by qualified/trained persons.

10. LEGAL AID Under Section 43 of the Mental Health Act (MHA), a patient is required to apply to the Magistrate in order to be discharged. The procedure prescribed under the section, on occasions causes difficulties to the patients inasmuch as many patients may not be in a position to make the requisite applications before a Magistrate, nor would they be aware of their rights, and the procedure to seek discharge. Hence it is directed that two members of the Legal Aid Board of each State be appointed to make monthly visit to such Institutions, so as to assist the patients and their relatives in applying for discharge from the Institutions If they have fully recovered, and do not require institutional assistance any longer or to find out whether as a matter of fact they require any such treatment as indoor patients,

11. 1. INFORMING PATIENTS OF THEIR RIGHTS Patients and their guardians shall be explained their rights by a team of 2 members of the Legal Aid and a Judicial Officer, under the Mental Health Act, in a language known to them, at the time of the admission to any Institute. They should also be informed whom to approach in case their rights are being infringed. RIGHTS

12. INSPECTION BY THE BOARD OF VISITORS Section 37 provides for inspection of psychiatric hospital and psychiatric nursing home. In view of the said section a Board of Visitors must be formed by the State Mental Health Authority in every State within a time bound period, and a compliance report be filed to this Court. The Board of Visitors shall be required to visit every State or Private Institution for the time being at least once every month. The membership of the Board of Visitors is contained in Section 37 of the Mental Health Act, 1987, which includes :-- a) Not less than 5 members b) At least one psychiatrist c) Two social workers preferably with knowledge of the issues in the hospital and may be from the NGO Sector. d) Head of Medical Services or their nominees (preferably a psychiatrist) as ex- officio member of Board of Visitors in the State; The Board of Visitors should also include :-- 1. The Additional District Judge, and/or Chief Judicial Magistrate, and/or the President of the Bar Association of the area; 2. State Disability Commissioner or his/ her nominee. A monthly record of visits of the Board of Visitors and a quarterly report should be filed with the State Mental Health Authority.

13. Further it has been suggested by the learned counsel for the parties that appropriate norms be prescribed for maintenance of Mental Hospitals and Institutions for which various suggestions are made by the learned counsel for the parties but are not discussed at present as it is for the concerned authorities to first frame such norms. A Scheme may be envisaged for rehabilitation process for those who are not having any backing or lack of support in the community. The Scheme may be on the basis of quarter-way homes (Supported Shared Home Like Accommodation) for all patients ready to be discharged, but are not being discharged due to family not taking them back, or lack of support in the community, should be placed in a home like accommodation created on the hospital campus itself. This accommodation could be an existing ward converted to have a home like environment, with patients being taught housekeeping skills, cooking, shopping and also encouraged to take up responsibilities in the hospital for which they should be paid for and then gradually encouraged to go to the community for work.

14. Disease of the mind Whether a particular condition amounts to a disease of the mind within the Rules is not a medical but a legal question to be decided in accordance with the ordinary rules of interpretation. It seems that any disease which produces a malfunctioning of the mind is a disease of the mind and need not be a disease of the brain itself. The term has been held to cover numerous conditions:

15. * R v Kemp 1957 1 QB 399: arteriosclerosis or a hardening of the arteries caused loss of control during which the defendant attacked his wife with a hammer. This was an internal condition and a disease of the mind. * R v Sullivan 1984) AC 156 during an epileptic episode, the defendant caused grievous bodily harm: epilepsy was an internal condition and a disease of the mind, and the fact that the state was transitory was irrelevant. * R v Quick & Paddison 1973 3 AER 397 a diabetic committed an assault while in a state of hypoglycemia caused by the insulin he had taken, the alcohol he had consumed and not eating. Since the immediate condition was caused by external factors, it was not caused by a disease of the mind. Automatism was not available either because the loss of control was foreseeable

16. Land mark judgments Rakesh chandra narayan Vs state of Bihar in the supreme court of India – Ordered proper civic amenities. Sheela Barse Vs Union of India in the supreme court of India – ordered safe custody of abandoned, destitute and Intellectually challenged children. Chandan Kumar Vs State of west Bengal in the supreme court of India barred chaining of mentally ill patients in mental hospitals. Sheela Barse Vs Union of India in the supreme court of India – ordered jailing of non criminal, mentally ill persons is unconstitutional and ordered state government for upgradation of mental hospitals. Social jurist Vs Government of NCT of Delhi in the high court of Delhi – ordered the state to provide for the proper treatment and rehabilitation of mentally ill persons deserted by the family as per law.

17. QUESTIONS What are we as professional social worker doing? Is there any method of social work available? If so available why is that not effectively used? As social workers should we act or react or be proactive?