MHCA2017 has set new criteria for admission, treatment and discharge of mentally ill people. It stipulates that patients who do not meet the criteria of ‘substantial disorder with gross impairments’ cannot be admitted even if they are keen to do so and the doctor is willing to provide treatment. Clinicians argue that such a condition amounts to a violation of the right of the individual to seek treatment in the most appropriate setting.
To get a minor admitted for treatment, the nominated representative of the minor needs to apply for admission. Two professionals need to independently assess and certify that the minor has a mental illness of severity requiring admission, that too, in the best interest of the minor. They also have to certify that all community-based interventions have failed.
The admission of a minor should be reported to the Mental Health Review Board within seven days and if the minor remains in the hospital for more than 30 days, the board should be informed immediately.
For supported admissions, two professionals should examine the patient independently for seven days and conclude that the mental illness is severe enough to warrant hospital admission and treatment.
The professionals must also certify that admission is the best restrictive option available and the patient’s capacity to make a decision about mental health treatment is impaired. The whole process needs to be repeated if the patient requires a hospital stay for more than 30 days.
Interestingly, the review board has no power to review such admissions even though the criteria for admissions have been described in the law, points out a senior psychiatrist from National Institute of Mental Health and Neurosciences, Bangalore, preferring anonymity.