Citation

Gowda G, Enara A, Raveesh B, Gowda M. Indian J. Psychiatry 2019; 61(10): S816-S820.

Copyright

(Copyright © 2019, Medknow Publications)

DOI

10.4103/psychiatry.IndianJPsychiatry_88_19

PMID

unavailable

Abstract

India enacted the Mental Healthcare Act, 2017 (MHCA 2017) on April 7, 2017 to align and harmonize with United Nations Convention on Persons with Disabilities and the principles of prioritizing human rights protection. While MHCA 2017 is oriented toward the rights of the patients, the rights of the family members and professionals delivering treatment, care, and support to persons with severe mental disorder (SMD) often suffer. MHCA 2017 mandates discharge planning in consultation with the patients for admitted patients and makes the service providers responsible for ensuring continuity of care in the community. The concerns surrounding the chances of relapse and recurrence when a person with a SMD stops medications continue to remain largely unaddressed. The rights-based MHCA 2017 makes it difficult for the prevailing practices of surreptitious treatment by the family/caregiver and proxy consultations on behalf of the patients. This will, in turn, lead to increased chances of relapse, risk of violence, homelessness, stigma, and suicide in persons with SMDs in the community, largely due to noncompliance to treatment. This will also result in increased caregiver burden and burnouts and may also cause disruptions in the family and the community. To strike a balance over the current MHCA 2017, there is a need to amend or bring-forth a new law rooted in the principles of community treatment order. © 2019 Indian Journal of Psychiatry | Published by Wolters Kluwer - Medknow.

Language: en

Keywords

human; violence; mental health; suicide; Review; India; family; schizophrenia; hospitalization; stigma; homelessness; mental disease; clinical practice; community care; recurrent disease; patient right; freedom; mental patient; treatment refusal; caregiver; patient compliance; hospital discharge; relapse; maintenance therapy; paternalism; persuasive communication; group therapy; clinical decision making; involuntary commitment; act; human rights abuse; medical order; stakeholder engagement; Community treatment order; Mental Healthcare Act 2017; severe mental disorders