mental health act

CHAPTER XI
MENTAL HEALTH REVIEW COMMISSION (sec. 73 to 93)

 
86. All proceedings before the Commission and the Board, shall be deemed to be
judicial proceedings within the meaning of sections 193, 219 and 228 of the Indian Penal code.
91. (4) If the mental health establishment does not comply with the orders or directions of
the Commission or the Board or wilfully neglects such order or direction, the Commission or
the Board, as the case may be, may impose monetary penalty which may extend up to five
lakh rupees on such mental health establishment or order the Central Authority or the State
Authority to cancel the registration of such mental health establishment.
92. Any person or establishment aggrieved by the decision of the Commission or a
Board may, within a period of thirty days from such decision, prefer an appeal to the High
Court of the State in which the Board is situated:
Provided that the High Court may entertain an appeal after the expiry of the said period
of thirty days, if it is satisfied that the appellant had sufficient cause for not preferring the
appeal within the period of thirty days.
CHAPTER XII
ADMISSION, TREATMENT AND DISCHARGE
Admission of
minor.
96. (1) A minor may be admitted to a mental health establishment only after following
the procedure laid down in this section.
(2) The nominated representative of the minor shall apply to the medical officer in
charge of a mental health establishment for admission of the minor to the establishment.
(3) Upon receipt of such an application, the medical officer or psychiatrist in charge
of the mental health establishment may admit such a minor to the establishment, if two
psychiatrists, or one psychiatrist and one mental health professional or one psychiatrist and
one medical practitioner, have independently examined the minor on the day of admission or
in the preceding seven days and both independently conclude based on the examination
and, if appropriate, on information provided by others, that,—
(a) the minor has a mental illness of a severity requiring admission to a mental
health establishment;
(b) admission shall be in the best interests of the minor, with regard to his or her
health, well-being or safety, taking into account the wishes of the minor if ascertainable
and the reasons for reaching this decision;
(c) the mental health care needs of the minor cannot be fulfilled unless he is admitted;
and
(d) all community based alternatives to admission have been shown to have
failed or are demonstrably unsuitable for the needs of the minor.
(4) A minor so admitted shall be accommodated separately from adults, in an
environment that takes into account his age and developmental needs and is at least of the
same quality as is provided to other minors admitted to hospitals for other medical treatments.
(5) The nominated representative or an attendant appointed by the nominated
representative shall under all circumstances stay with the minor in the mental health
establishment for the entire duration of the admission of the minor to the mental health
establishment.
(6) In the case of minor girls, where the nominated representative is male, a female
attendant shall be appointed by the nominated representative and under all circumstances
shall stay with the minor girl in the mental health establishment for the entire duration of her
admission.
(7) A minor shall be given treatment with the informed consent of his nominated
representative.
(8) If the nominated representative no longer supports admission of the minor under
this section or requests discharge of the minor from the mental health establishment, the
minor shall be discharged by the mental health establishment.
(9Any admission of a minor to a mental health establishment shall be informed by the
medical officer or psychiatrist in charge of the mental health establishment to the concerned
Board within a period of seventy-two hours.
(10The concerned Board shall have the right to visit and interview the minor or
review the medical records if the Board desires to do so.
(11Any admission of a minor which continues for a period of thirty days shall be
immediately informed to the concerned Board.
(12The concerned Board shall carry out a mandatory review within a period of seven
days of being informed, of all admissions of minors continuing beyond thirty days and every
subsequent thirty days.
(13) The concerned Board shall at minimum, review the clinical records of the minor
and may interview the minor if necessary.
 
 
98. (1) The medical officer or psychiatrist in charge of a mental health establishment
shall admit every such person to the establishment, upon application by the nominated
representative of the person, under this section, if––
(athe person has been independently examined on the day of admission or in
the preceding seven days, by one psychiatrist and the other being a mental health
professional or a medical practitioner, and both independently conclude based on the
examination and, if appropriate, on information provided by others, that the person
has a mental illness of such severity that the person,––
(i) has recently threatened or attempted or is threatening or attempting
to cause bodily harm to himself; or
(ii) has recently behaved or is behaving violently towards another person
or has caused or is causing another person to fear bodily harm from him; or
(iii) has recently shown or is showing an inability to care for himself to a degree that places the individual at risk of harm to himself;
(b) the psychiatrist or the mental health professionals or the medical practitioner,
as the case may be, certify, after taking into account an advance directive, if any, that
admission to the mental health establishment is the least restrictive care option possible
in the circumstances; and
(c) the person is ineligible to receive care and treatment as an independent
patient because the person is unable to make mental health care and treatment decisions
independently and needs very high support from his nominated representative in
making decisions.
(2The admission of a person with mental illness to a mental health establishment
under this section shall be limited to a period of thirty days.
(3) At the end of the period mentioned under sub-section (2), or earlier, if the person no
longer meets the criteria for admission as stated in sub-section (1), the patient shall no longer
remain in the establishment under this section.
(4) On the expiry of the period of thirty days referred to in sub-section (2), the person
may continue to remain admitted in the mental health establishment in accordance with the
provisions of section 99.
(5) If the conditions under section 99 are not met, the person may continue to remain
in the mental health establishment as an independent patient under section 95 and the
medical officer or psychiatrist in charge of the mental health establishment shall inform the
person of his admission status under this Act, including his right to leave the mental health
establishment.
(6) Every person with mental illness admitted under this section shall be provided
treatment after taking into account,––
(a) an advance directive if any; or
(b) informed consent of the patient with the support of his nominated representative
subject to the provisions of sub-section (7).
(7) If a person with the mental illness admitted under this section requires nearly
hundred per cent. support from his nominated representative in making a decision in respect
of his treatment, the nominated representative may temporarily consent to the treatment plan
of such person on his behalf.
(8) In case where consent has been given under sub-section (7), the medical officer or
psychiatrist in charge of the mental health establishment shall record such consent in the
medical records and review the capacity of the patient to give consent every seven days.
(9The medical officer or psychiatrist in charge of the mental health establishment
shall report the concerned Board,––
(a) within three days the admissions of a woman or a minor;
(b) within seven days the admission of any person not being a woman or minor.
(10) A person admitted under this section or his nominated representative or a
representative of a registered non-governmental organisation with the consent of the person,
may apply to the concerned Board for review of the decision of the medical officer or
psychiatrist in charge of the mental health establishment to admit the person to the mental health establishment under this section
(11The concerned Board shall review the decision of the medical officer or psychiatrist
in charge of the mental health establishment and give its findings thereon within seven days
of receipt of request for such review which shall be binding on all the concerned parties.
(12) Notwithstanding anything contained in this Act, it shall be the duty of the medical
officer or psychiatrist in charge of the mental health establishment to keep the condition of
the person with mental illness admitted under this section on going review.
(13) If the medical officer or psychiatrist in charge of the mental health establishment
is of the opinion that the conditions specified under sub-section (1) are no longer applicable,
he shall terminate the admission under this section, and inform the person and his nominated
representative accordingly.
(14) Non applicability of conditions referred to in sub-section (13) shall not preclude
the person with mental illness remaining as an independent patient.
(15) In a case, a person with the mental illness admitted under this section has been
discharged, such person shall not be readmitted under this section within a period of seven
days from the date of his discharge.
(16) In case a person referred to in sub-section (15) requires readmission within a
period of seven days referred to in that sub-section, such person shall be considered for
readmission in accordance with the provisions of section 99.
(17) If the medical officer or psychiatrist in charge of the mental health establishment
is of the opinion that the person with mental illness admitted under this section in the mental
health establishment requires or is likely to require further treatment beyond the period of
thirty days, then such medical officer or psychiatrist shall be duty bound to refer the matter
to be examined by two psychiatrists for his admission beyond thirty days.
99. (1) If a person with mental illness admitted under section 98 requires continuous
admission and treatment beyond thirty days or a person with mental illness discharged
under sub-section (15) of that section requires readmission within seven days of such
discharge, he shall be admitted in accordance with the provisions of this section.
(2) The medical officer or psychiatrist in charge of a mental health establishment, upon
application by the nominated representative of a person with mental illness, shall continue
admission of such person with mental illness, if—
(a) two psychiatrists have independently examined the person with mental illness
in the preceding seven days and both independently conclude based on the
examination and, on information provided by others that the person has a mental
illness of a severity that the person––
(i) has consistently over time threatened or attempted to cause bodily
harm to himself; or
(ii) has consistently over time behaved violently towards another person
or has consistently over time caused another person to fear bodily harm from
him; or
(iii) has consistently over time shown an inability to care for himself to a
degree that places the individual at risk of harm to himself;
(b) both psychiatrists, after taking into account an advance directive, if any,
certify that admission to a mental health establishment is the least restrictive care
option possible under the circumstances; and
(c) the person continues to remain ineligible to receive care and treatment as a
independent patient as the person cannot make mental health care and treatment

 

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