Implementation Update on Mental Healthcare Act, 2017

Abstract

The Mental Healthcare Act, 2017 (MHCA) has a broad mandate which places obligations on various stakeholders to ensure mental healthcare through rights-based approaches. However, this mandate is likely to be unfulfilled without effective implementation. Since its enforcement, the MHCA’s implementation has progressed at a very slow place (as of time of writing, December 2019). Many State Governments are yet to establish the State Mental Health Authority and Mental Health Review Boards which play a crucial role in the implementation of the MHCA. The legislation has also been subject to judicial scrutiny by the Supreme Court of India and High Courts in matters of public interest for adjudicating important questions of constitutional law and monitoring implementation of the MHCA at the central and state levels. The MHCA is confronted with several challenges for its speedy and effective implementation. Mental health professionals have expressed resistance to various provisions of the MHCA including advance directives, nominated representatives and modified electroconvulsive therapy. At the bureaucratic level, there is a lack of political commitment to address mental health as a legitimate health concern on a par with physical health. Further, poor inter-sectoral coordination between different government departments and an inadequate trained mental health workforce are other significant barriers to the MHCA’s implementation. It is thus incumbent upon civil society to assume a proactive role in advocating for mental health as a priority on the national agenda to address systemic gaps, infrastructural deficits and human resource challenges, and to compel Governments to fulfil the MHCA’s mandate.