Understanding Mental Health Laws and Client Protections in India

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Written by: Vedha I.K

What Are the Legal Foundations of Mental Health Care in India?

India’s mental health legal framework has evolved significantly over the past century. The Indian Lunacy Act of 1912, one of the earliest legislations, focused primarily on the institutionalization of individuals with mental illnesses. It laid down procedures for admission, treatment, and discharge, and emphasized custodial care under state supervision. However, it failed to uphold individual autonomy and contributed to the stigmatization and dehumanization of those with mental illness.

A turning point came with the Persons with Disabilities Act (PDA), 1996, which recognized mental illness as a form of disability and emphasized rights-based support, including 3% reservation in employment, and access to education and rehabilitation. Importantly, the Act empowered persons with mental illness to participate in planning welfare programs.

The UN Convention on the Rights of Persons with Disabilities (CRPD), 2006, shifted global perspectives—viewing people with disabilities as rights-bearing individuals, not merely as recipients of care or charity. Article 12 of the CRPD introduced the concept of full legal capacity, allowing individuals with mental illness to make decisions for themselves with supported decision-making systems in place, even when symptomatic.

India responded by updating its laws. The outdated 1912 Act was replaced by the Mental Health Act of 1987, which still had gaps, including permitting involuntary admissions without patient consent and using derogatory language like “lunatic.” It was later revised into the Mental Health Care Act of 2017, which emphasizes:

• Voluntary and informed consent-based treatment

• Respect for autonomy

• Community-based care over institutionalization

• Non-discriminatory practices

• Protection of human rights and dignity

This Act also advocates for insurance coverage for mental health care and encourages deinstitutionalization.

What Rights Do Clients Have in Mental Health Settings?

Across mental health settings, clients are entitled to a set of universal rights designed to uphold their dignity, protect their well-being, and support their healing. These rights include:

• Confidentiality: Therapists are obligated to keep client information private, except in situations involving imminent harm, such as suicidal ideation or abuse.

• Autonomy and Consent: Clients have the right to make decisions about their care. Any treatment must be conducted only with informed consent. While parental involvement is common for adolescents in India, autonomy remains a foundational principle.

• Safety and Protection: Clients must be shielded from harm, exploitation, or boundary violations. Mental health professionals must not accept gifts, act on bias, or discriminate based on caste, religion, gender identity, or sexual orientation.

• Competent Care: Individuals have the right to receive care from trained, qualified professionals. Therapists must remain up to date with ethical guidelines and provide culturally competent, trauma-informed support.

• Reporting Obligations: In cases of abuse or neglect, therapists are required to inform appropriate authorities such as child welfare committees or the police, prioritizing client safety.

What Are the Drawbacks in India’s Mental Health Systems?

Despite progressive legislation, the implementation of mental health laws in India faces numerous barriers. Some of the major challenges include:

• Lack of Awareness and Training: Many professionals in the judiciary, police force, and medical fields lack awareness of mental health rights and laws. This leads to routine violations of client rights, especially in government-run institutions.

• Institutionalization Over Community Care: Many laws still favor institutionalization, often in underfunded, prison-like facilities that strip individuals of autonomy. Institutional settings sometimes fail to offer humane, respectful care, leading to re-traumatization.

• Exploitation and Loss of Rights: People who cannot speak for themselves are particularly vulnerable to forced institutionalization, property exploitation, unlawful guardianship, and physical restraints.

• Financial Inaccessibility: While public hospitals are often overcrowded and under-resourced, private mental health care remains unaffordable for many, particularly economically disadvantaged populations.

• Cultural and Social Barriers: India’s collectivist values often prioritize family or community interests over individual autonomy. Stigma, victim-blaming, and lack of trauma-informed care further silence survivors and inhibit their recovery.

• Focus on Diagnosis Over Healing: Mental health care often emphasizes symptom reduction and diagnosis rather than understanding the root causes of distress—neglecting emotional, social, and historical trauma.

How Does the National Human Rights Commission Safeguard Mental Health Rights?

The National Human Rights Commission (NHRC), in collaboration with NIMHANS, has played a pivotal role in protecting the rights of individuals with mental illness in India. Since 1999, the NHRC has:

• Conducted regular hospital inspections

• Issued directives under Supreme Court supervision

• Advocated against abusive practices such as chaining or seclusion

• Ensured that only qualified professionals manage admissions and discharge

• Educated families about rehabilitation and reintegration

The NHRC has been instrumental in shifting mental health care from custodial control to a rights-based, rehabilitative model.

What Was the Impact of the Quality Assurance Project?

The Quality Assurance in Mental Health Project, initiated by NIMHANS and supported by the NHRC, aimed to assess and improve the quality of care in government-run mental health institutions. The project involved three phases:

1. Assessment: Hospitals were visited and evaluated through questionnaires, direct observation, and stakeholder interviews, including patients, staff, and NGOs.

2. Training Workshops: Sensitivity training was conducted for middle-level staff to help foster empathy, respect, and patient-centered care.

3. Reporting and Recommendations: Each hospital received specific, actionable feedback. The overarching recommendation emphasized community-based treatment, social rehabilitation, and deinstitutionalization as essential for improving care.

What Must Be Done to Ensure Mental Health Justice?

To uphold the rights of individuals with mental illnesses, India must move beyond laws on paper to implementation in practice. This requires:

• Training and sensitizing professionals across systems—legal, medical, and administrative

• Funding and scaling community-based mental health services

• Eliminating harmful practices and promoting trauma-informed, person-centered care

• Ensuring accessible, affordable treatment regardless of economic status

• Actively challenging stigma, discrimination, and the taboo around mental health

• Involving survivors in policy-making and treatment planning

True justice in mental health care will be realized only when every individual is treated not as a diagnosis, but as a human being—with dignity, autonomy, and the right to heal.

Want the references for this article?

Math, S. B., & Nagaraja, D. (2008). Mental health legislation: an Indian perspective. Mental health care and human rights, 49.

Sinha, A., Bhola, P., Raguram, A., & Chandra, P. S. (2017). ‘Power positions are embedded in our minds’: focus group discussions on psychotherapy ethics in India. International Journal of Culture and Mental Health, 10(2), 217-227.

Srinivasaraghavan, J., Fernandez, A., & Pandurangi, A. K. (2014). Mental Health Services in USA: Ethical and Legal Aspects and Human Rights—What India can Learn from Western Models. In Mental Health in South Asia: Ethics, Resources, Programs and Legislation (pp. 133-152). Dordrecht: Springer Netherlands.