An Applied Research Project Proposal On INFRASTRUCTURE STIPULATED BY LAW FOR MENTAL HEALTH CARE CENTRES

CHR- Winter Internship Program 2018- Infrastructure Stipulated by Law for Mental Health Care Centres
Assignment Project
INFRASTRUCTURE STIPULATED BY LAW FOR MENTAL

HEALTH CARE CENTRES
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AN APPLIED RESEARCH PROJECT

PROPOSAL
ON
INFRASTRUCTURE STIPULATED BY LAW FOR MENTAL

HEALTH CARE CENTRES
Submitted
To:
(The Centre for Human Rights, National University

of Advanced Legal Studies at Kochi)
Submitted
By:
(........................)
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Table of Contents
ACKNOWLEDGEMENT................................................................................................................................... 4
EXECUTIVE SUMMARY.................................................................................................................................. 4
ABSTRACT..................................................................................................................................................... 4
1- INTRODUCTION AND BACKGROUND OF THE RESEARCH.............................................................................4
1.1 AIM OF THE RESEARCH.....................................................................................................................................5
1.2 THE OBJECTIVES OF THE RESEARCH.....................................................................................................................5
1.3 THE SCOPE OF THE RESEARCH............................................................................................................................6
1.4 THE SIGNIFICANCE OF THE RESEARCH..................................................................................................................6
1.5 THE LIMITATIONS OF THE RESEARCH....................................................................................................................7
2. LITERATURE REVIEW................................................................................................................................. 7
2.1 A REVIEW ON RELEVANT THEORIES OF LITERATURE.................................................................................................7
2.1.1 The constitution of India........................................................................................................................9
2.1.2 Indian laws regulating treatment of persons with mental disorders....................................................9
2.1.3 Mental Health Act – 1987 - History.....................................................................................................11
2.1.4 National Mental Health Survey of India 2015–2016...........................................................................17
2.1.5 Infrastructure facilities in mental health care centres in India...........................................................18
3. RESEARCH METHODOLOGY..................................................................................................................... 20
3.1 THE RESEARCH APPROACH, STRATEGY AND PHILOSOPHY.......................................................................................21
3.2 RESEARCH DESIGN........................................................................................................................................21
3.2.1 The Types and Sources of Data..........................................................................................................21
3.2.2 The Data Collection Tools....................................................................................................................21
3.2.3 Sampling Techniques...........................................................................................................................21
3.2.4 The Techniques of Data Analysis.......................................................................................................22
3.2.5 The Presentation of Data....................................................................................................................22
3.3 THE ETHICAL IMPLICATIONS OF THE RESEARCH..................................................................................................22
3.4 SCHEDULE FOR THE PROPOSED RESEARCH........................................................................................................23
3.5 THE REFLECTION ON PERSONAL DEVELOPMENT................................................................................................23
BIBLIOGRAPHY............................................................................................................................................ 23
BOOKS........................................................................................................................................................ 23
REPORTS..................................................................................................................................................... 24
JOURNAL ARTICLES..................................................................................................................................... 24
WEB PAGES................................................................................................................................................. 24
APPENDICES............................................................................................................................................... 26
LIST OF FIGURES.......................................................................................................................................... 26
List of Tables...........................................................................................................................................................26
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Acknowledgement
The director, Centre for Human Rights in National University for Advanced Legal
Studies and members and staff to be submitted this report on “Infrastructure
Stipulated by Law for Mental Health Care Centres” gratefully remembered for
to deviated my attention to this area and provided to be part of this research
opportunity, besides that those who interacted from various health care sector,
legal persons and authorities, organizations and its functional department
heads to gather information to formulate views on how “Infrastructure
Stipulated by Law for Mental Health Care Centres “ has been gratefully
acknowledged.
Executive Summary
This report provides an analysis and evaluation of what infrastructure

predetermined and mandated by Indian Penal Code Act. The collection of
information method and investigation used the historical research papers and
results, information from website, published books and journals and articles.
The result found that more to be added and developed with existing
infrastructure according to what Indian mental Health Act instructed.
Abstract
There has been a lot of information collected and done the research to
understand the infrastructure stipulated by law for mental health care centres. It
shows that, in India Infrastructure facilities has to improve in mental health
centres to balance with what the law of Mental Health Act demanded.
1- Introduction and background of the Research
The law for mental health defines as “An Act to provide for mental
healthcare and services for persons with mental illness and to protect, promote
and fulfil the rights of such persons during delivery of mental healthcare and
services and for matters connected there with or incidental thereto.”
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The United States of America firstly recognized the term Mental health at the
beginning of the 20th century, Clifford Beers founded "Mental Health America
– National Committee for Mental Hygiene", after publication of his accounts
from lived experience in lunatic asylums, A Mind That Found Itself, in 1908 and
opened the first outpatient mental health clinic in the United States.
The National Mental Health Act (1946) became law on July 3, 1946. It
established and provided funds for a National Institute of Mental
Health (NIMH), through the National Mental Health Act and the NIMH; a new
form of diagnosis and treatment was created to better help those facing mental
health problems. Since 1946, after The National Mental Health Act (1946)
became law, America achieved significant events of mile stones in
infrastructure and facilities in mental health care, but about in India still to go a
far to achieve what law instructed (NIH, 2018)1
1.1 Aim of the Research
The reason and aim of doing this research is to investigate and explain the
infrastructure stipulated by law for mental health care centres in Indian state of
Kerala in accordance with The Centre for Human Rights , National University
of Advanced Legal Studies at Kochi for their Winter Internship Program
2018 conducted for under graduate and post graduate students . The
proposed intern shall be entrusted with legal research for the centre; more
over the survey work which will constitute an important part of the internship
will be conducted in various districts of Kerala and allocated to participants.
1.2 The Objectives of the Research
The personal research objectives are as part of the selection process in CHR to
investigate on “explain the infrastructure stipulated by law for mental health
care centres”, but on topic WHAT LAW STIPULATED infrastructure for the
mental health care centres in India.
The topic data or evidence collection is significant and analyzing and

interpreting the data generate to the raised problem of research questions and
it will contribute new knowledge in the picky area of topic. Moreover to find
solutions for the recognized problems derived from the research.
1
NIH, 2018. National Insstutute of Health. [Online] Available at: The National Mental Health
Act (1946) became law [Accessed 25 Novomber 2018].
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The research objectives set for the research topic are:-

1. To examine the infrastructure in mental health care centres in India.
2. To critically compare the infrastructure in mental health care and what
stipulated by LAW.
3. To carry out an investigation whether private and public sector mental
health care centres have any disparity in infrastructure quality & qty.
4. To suggest government to improve quality & qty of infrastructure.
5. To list the merits and demerits of suggestions to improve quality and
quantity in mental health care centres in India.
1.3 The Scope of the Research
The proposed applied research will be carried out within the period of four
months, besides that the collection of data from the reliable sources that
relevant and focusing to the Indian state Kerala and its mental health care
centres. The proposed research not covering the publication from the other
languages and regions, besides that the scarcity of financial and time resources
limits the scope.(As part of the research, and as a participant the data
collection carried out in 15 days in Indian state Kerala at Thiruvananthapuram
District)
1.4 The Significance of the Research.
The importance of the research is that, the outcome of the research is useful
to the end users of the mental health care sector, government, legal bodies,
local bodies, public in India for their practical decision making process such as:-
1. It will provide answers to raised questions and superior improved

knowledge to the users by new or improved evidence, methodology,
concepts or theories.
2. It will supportive to improve the health and social care system in India
3. It will help new entrepreneurs in the decision making process and may
attract new businesses.
4. It will help to develop a new model or techniques in quality strategies for
the users.
5. It will helpful in solving the problems and improve situations
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Moreover the research outcome has commercial value in knowledge based

market, besides that the proposed research will carry out under ETHIC codes
and also academically worthy. The research is important to the researcher for
improving the experience and knowledge,
1.5 The Limitations of the Research
The limitations of the proposed applied research are as follows:-

1. It is focused only in KERALA region only
2. It is carried out within four months
3. It is not covering the literature in other languages
4. It is focused on mental health care centres only
5. It is using published historical data only
6. It is only focusing the legal and government level possibilities
7. It is not analysing the philosophical, political. Psychological and ethical
factors
2. Literature Review
Refers to (Hart, 1998) Literature review is, “the selection of available

documents (both published and unpublished) on the topic which contain
information, ideas, data and written evidence from a particular standpoint to
fulfil certain aims or express certain views on the nature of the topic and how it
is to be investigated and the effective evaluation of those documents in
relation to the research being proposed”2
2.1 A review on relevant Theories of Literature
Refers to Indian journal of Psychiatry (Shikha, 2013), regarding the Indian legal
system and mental health says: “Although there was a rich tradition of legal
2
Hart, C., 1998. cuzproduces.com. [Online] Available at:
https://www.cuzproduces.com/producinganew/files/resources/HART_Doing%20a%20literature
%20review_1988_ch1.pdf[Accessed 27 November 2018].
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system in Ancient India, the present judicial system of the country derives
largely from the British system and is based on English Common Law, a system
of law based on recorded judicial precedents. Earlier legislations in respect of
mental health were primarily concerned with custodial aspects of persons with
mental illness and protection of the society. Indian laws are also concerned
with determination of competency, diminished responsibility and/or welfare of
the society. United Nations Convention for Rights of Persons with Disabilities
(UNCRPD) was adopted in 2006, which marks a paradigm shift in respect of
disabilities (including disability due to mental illness) from a social welfare
concern to a human right issue. The new paradigm is based on presumption of
legal capacity, equality and dignity. Following ratification of the convention by
India in 2008, it became obligatory to revise all the disability laws to bring them
in harmony with the UNCRPD. Therefore, the Mental Health Act – 1987 and
Persons with Disability Act – 1995 are under process of revision and draft bills
have been prepared. Human right activists groups are pressing for provisions
for legal capacity for persons with mental illness in absolute terms, whereas
the psychiatrists are in favour of retaining provisions for involuntary
hospitalization in special circumstances.”
“There is a dynamic relationship between the concept of mental illness, the

treatment of the mentally ill and the law. As Rappeport has noted, for the
psychiatrists the court is “another house … with its different motives, goals and
rules of conduct.” While the psychiatrist is concerned primarily with the
diagnosis of mental disorders and the welfare of the patient, the court is often
mainly concerned with determination of competency, dangerousness,
diminished responsibility and/or the welfare of society. Therefore, in India also,
most of the earlier legislations in respect of PMI were concerned with these
aspects. However, legislations drafted after eighties tend to give some stress on
the rights of PMI also”. 3
2.1.1 The constitution of India

The constitution of India provides under Article 21 that no person shall be
deprived of his life or personal liberty except according to procedures
established by law. It has been held that right to life and personal liberty under
this article includes “facilities for reading, writing and expressing oneself in
diverse forms, freely moving about and mixing and comingling with fellow
human beings.”
3
Shikha, C. L. N. a. D., 2013. ncbi.nlm.nih.gov. [Online] Available at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705679/[Accessed 22 November 2018].
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According to the Representation of People Act, 1950 (sec 16), a person is

disqualified for registration in an electoral roll if he is of unsound mind and
stand so declared by a competent court. Therefore, the person so disqualified
cannot hold public offices under the Constitution like President, Vice-President,
Ministers or Member of Parliament and State Legislatures.
2.1.2 Indian laws regulating treatment of persons with mental disorders

Relationship between psychiatry and law most often comes into play at the
time of treatment of PMI. Treatment of PMI often involves curtailment of
personal liberty of psychiatric patients. Most of the countries in the World have
laws regulating treatment of psychiatric patients. Though there are elaborate
descriptions of various forms of mental disorders in various treatises in
Ayurveda, the care of mentally ill in the asylums in India is a British innovation.
After the takeover of the administration of India by the British crown in 1858, a
large number of laws were enacted in quick succession for controlling the care
and treatment of mentally ill persons in British India. These laws were
 The Lunacy (Supreme Courts) Act, 1858
 The Lunacy (District Courts) Act, 1858
 The Indian Lunatic Asylum Act, 1858 (with amendments passed in 1886
and 1889)
 The Military Lunatic Acts, 1877.
These Acts gave guidelines for establishment of mental asylums and procedure
to admit mental patients. The British scene existing in the middle of the
19th century served as the background of lunacy legislations in that period in
India. The various Acts of 1858 naturally reflected the legalistic frame for the
management of the mentally ill. During the first decade of the 20 th century,
public awareness about the pitiable conditions of mental hospitals accentuated
as a part of the growing political awareness and nationalistic views
spearheaded by the Indian intelligentsia. As a result, the Indian Lunacy Act,
1912 was enacted. The 1912 Act guided the destiny of Psychiatry in India.
Lunatic asylums (named mental hospitals in 1922) were now regulated and
supervised by a central authority. Procedure of admission and certification in
this respect was clearly defined. The provision of voluntary admission was
introduced. Still, the main stress was on preventing the society from
dangerousness of mentally ills and taking care that no sane person is admitted
in these asylums. Psychiatrists were appointed as full time officers in these
hospitals. Provisions of judicial inquisitions for mentally ill persons were also
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given in the Act. After the Second World War, Universal Declaration of Human
Rights was adopted by the UN General Assembly. Indian Psychiatric Society
submitted a draft Mental Health Bill in 1950 to replace the outmoded ILA-1912.
Mental Health Act (MHA-87) was finally enacted in 1987 after a long and
protracted course. Main features of the Act are as follows.
 Definition of mental illness in a progressive way and introducing modern
concept of their treatment with stress on care and treatment rather than
on custody.
 Establishment of Central/State Mental Health Authority to regulate and
supervise the psychiatric hospitals/nursing homes and to advise
Central/State Governments on Mental Health matters.
 Admission in special circumstances in psychiatric hospital/nursing
homes. Provisions of voluntary admission and admission on the
reception orders were retained.
 Role of Police and Magistrate to deal with cases of wandering PMI and
PMI cruelly treated.
 Protection of human rights of PMI.
 Guardianship and Management of properties of PMI.
 Provisions of penalties in case of breach of provisions of the Act.
Though having many positive features, the MHA-1987 has been the target of
criticism right since its inception. It is alleged to be concerned mainly with the
legal procedure of licensing, regulating admissions and guardianship matters of
PMI. Human right issues and mental health care delivery are not properly
addressed in this Act. Because of a large number of very complicated
procedures, defects and absurdities in the Act and also in the Rules made
under the Act, it can never be implemented properly. Human right activists
have questioned the constitutional validity of the MHA, 1987 because it
involves curtailment of personal liberty without the provision of proper review
by any judicial body. MHA-87 is currently under process of amendment to
make it United Nations Convention for Rights of Persons With Disabilities
(UNCRPD) compliant.
2.1.3 Mental Health Act – 1987 - History
1. Mental health act was drafted by parliament in 1987 • Came into effect in all
the states and union territories of India in April 1993 • Replaces the Indian
lunacy act of 1912 • which had earlier replaced the Indian lunatic asylum act of
1858
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2. MENTAL HEALTH ACT 1987 HISTORY: • Mental health act was drafted by
parliament in 1987 • Came into effect in all the states and union territories of
India in April 1993 • Replaces the Indian lunacy act of 1912 • which had earlier
replaced the Indian lunatic asylum act of 1858
3. MENTAL HEALTH ACT 1987 Definition of the Act “An act to consolidate and
amend the law relating to the treatment and care of mentally ill persons, to
make better provision with respect to their property and affairs and for matters
connected therewith or incidental thereto”
4. SALIENT FEATURES OF THE ACT Mental health act is divided into 10 chapters
consisting of 98 sections • Chapter I: Deals with preliminaries of the act •
Chapter II: Deals with establishment of mental health authorities at central and
state levels • Chapter III: Deals with establishment and maintenance of
psychiatric hospitals and nursing homes
5. • Chapter IV: Deals with the procedures of admission and detention of

mentally ill in psychiatric hospitals • Chapter V: It deals with the inspection,
discharge, leaves of absence and removal of mentally ill persons • Chapter VI: It
deals with the judicial inquisition regarding alleged mentally ill persons
possessing property and its management.
6. • Chapter VII: It deals with the maintenance of mentally ill persons in a

psychiatric hospital or psychiatric nursing homes • Chapter VIII: It deals with
the protection of human rights of mentally ill persons • Chapter IX: It deals
with the penalties and procedures for infringement of guidelines of the act •
Chapter X: It deals with miscellaneous matters not covered in other chapters of
the act
7. OBJECTIVES OF THE ACT 1. To establish central and state authorities for

licensing and supervising the psychiatric hospitals 2. To establish such
psychiatric hospitals and nursing homes 3. To provide a check on working of
these hospitals 4. To provide for the custody of mentally ill persons who are
unable to look after themselves and are dangerous for themselves and or,
others 5. To protect the society from dangerous manifestations of mentally ill
8. 6. To regulate procedure of admission and discharge of mentally ill persons

7. To safeguard the rights of these detained individuals 8. To protect citizens
from being detained unnecessarily 9. To provide the maintenance charges of
mentally ill 10. To provide legal aid to poor mentally ill criminals at state
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expenses 11. To change offensive terminologies of Indian Lunacy act to new

soother ones
9. CHAPTER I - PRELIMINARY  TERMS USED • DISTRICT COURT: a city Civil

Court, the principal Civil Court of original jurisdiction, or any other Civil Court
competent to deal with all or any of the matters specified in this Act •
INSPECTING OFFICER: means a person authorized by the State Government or
by the licensing authority to inspect any psychiatric hospital or psychiatric
nursing home • LICENSE: means a license granted under Sec.8 • LICENSEE:
means the holder of a licence
10. • MAGISTRATE: - Metropolitan Magistrate; the Chief Judicial Magistrate,

Sub-Divisional Judicial Magistrate or such other Judicial Magistrate of the first
class • MEDICAL OFFICER: means a gazetted medical officer in the service of
Government • MENTALLY ILL PERSON: means a person who is in need of
treatment by person of any mental disorder other than mental retardation •
MINOR: person who has not completed the age of 18 years
11. • MENTALLY ILL PRISONER: Is a mentally ill person, ordered for detention in
a psychiatric hospital, jail or other places of safe custody • PSYCHIATRIC
HOSPITAL / NURSING HOME: hospital or nursing home established or
maintained by the Government or any other person for the treatment and care
of mentally ill NEW TERM PREVIOUSLY USED TERMS Psychiatric
hospital/Nursing home Asylum Mentally ill person Lunatic Mentally ill prisoner
Criminal Lunatic
12. Chapter II - Mental Health Authorities Deals with the procedures for
establishment of mental health authorities at central and state levels
13. CENTRALAUTHORITY • Shall be subject to the superintendence, direction

and control of the central government • Shall be in charge of regulation,
development, direction and co-ordination with respect to mental health
services under the central government • Supervise the psychiatric hospitals
and psychiatric nursing homes and other mental health service agencies under
the control of the central government • Advise the central government on all
matters relating to mental health
14. STATE AUTHORITY • Shall be subject to the superintendence, direction and

control of the state government • Shall be in charge of regulation,
development, direction and co-ordination with respect to mental health
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services under the state government • Supervise the psychiatric hospitals and
psychiatric nursing homes and other mental health service agencies under the
control of the state government • Advise the state government on all matters
relating to mental health
15. CHAPTER III - PSYCHIATRIC HOSPITALS AND PSYCHIATRIC NURSING HOMES

It lays down the guidelines for • Establishment and maintenance of psychiatric
hospitals and nursing homes • Provision for licensing authorities to process
applications for license
16. The Central Government may established or maintain psychiatric hospitals

or psychiatric nursing homes for: • the admission and care of mentally ill
persons Separate psychiatric hospitals and psychiatric nursing homes may be
established or maintained for:  those who are under the age of sixteen years
 those who are addicted to alcohol or other drugs which lead to behavioral
changes in a persons  those who have been convicted of any offence
17. LICENCE • no person shall established or maintain a psychiatric hospital or

psychiatric nursing home • unless he holds a valid licence granted to him • by
Central Government or State Government
18. • Application for licence A person, who intends to establish or maintain a

psychiatric hospital or psychiatric nursing home, shall, unless the said person
already holds a valid licence, make an application to the licence authority for
the grant of a licence • Duration and renewal of licence • A licence shall not be
transferable or heritable • Every licence shall, unless revoked earlier, be valid
for a period of five years from the date on which it is granted
19. CHAPTER IV : ADMISSION AND DETENTION IN PSYCHIATRIC HOSPITAL •

ADMISION ON VOLUNTARY BASIS • ADMISSION UNDER SPECIAL
CIRCUMSTANCES • RECEPTION ORDERS
20. ADMISION ON VOLUNTARY BASIS • Request by major for admission as

voluntary patient • Request by guardian for admission of a ward  Regulation
with respect to, voluntary patient:  On receipt of a request, the medical
officer-incharge shall make an inquiry within a period of 24 hours and if
satisfied, he may admit such application as a voluntary patient  Every
voluntary patient admitted shall be bound to abide by regulations as may be
made by the medical officer
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21.  DISCHARGE OF VOLUNTARY PATIENTS • The medical officer-in-charge on a

request made in that behalf :  by any voluntary patient  by the guardian, if he
is a minor • Discharge the patient within 24 hours of the receipt of such
request • If medical officer-incharge is satisfied that the discharge will not be in
the interest of the patient, he shall: • within 72 hours of a request constitute a
Board consisting of two medical officers and seek its opinion • if the Board is of
the opinion that patient needs further treatment • medical officer should
continue his treatment for a period not exceeding ninety days at a time
22.  ADMISSION UNDER SPECIAL CIRCUMSTANCES: • Any mentally ill persons

who does not, or is unable to, express his willingness for admission • may be
admitted and kept as an in-patient in a psychiatric hospital • on an application
made in that behalf by a relative or a friend of the mentally ill persons • if the
medical officers-in-charge is satisfied that in the interest of the mentally ill
persons it is necessary so to do
23.  RECEPTION ORDERS  Application for reception order: • An application

for a reception order may be made by - the medical officer-in-charge - the
spouse or other relative of the mentally ill  Where a medical officer-in-charge
is satisfied that : • the treatment in the psychiatric hospital is required to be
continued for more than six months • It is in the interests of the health &
safety of the mentally ill person or for the protection of others
24. • The application is to be made to magistrate within the local limits of
jurisdiction of the psychiatric hospital  Every application shall be: • Signed
and verified in the prescribed manner • Shall be accompanied by two medical
certificates • From two medical practitioners of whom one shall in the service
of government
25. Duties of police officers in respect of certain mentally ill persons: Every
officer in charge of a police station – • May take into protection any person
found wandering within the limits of his station whom he believes to be
mentally ill & incapable of taking care of himself, and dangerous by reason of
mental illness • No person shall be detained without being informed, his
relatives or friends, if any • Every person shall be produced before the nearest
Magistrate within a period of twenty-four hours
26.  Admission after Inquisition: • If any district court holding an inquisition

regarding any person who is found to be mentally ill • By order such person
shall be admitted and kept as an in- patient in a psychiatric hospital 
Admission and detention of mentally ill prisoner: • An order under Sec. 30 of
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the Prisoners Act, Sec. 330 or Sec. 335 of the Code of Criminal Procedure 1973
• directing the reception of a mentally ill • shall be sufficient authority for the
admission of such person into any psychiatric hospital
27. CHAPTER V - INSPECTION, DISCHARGE, LEAVE OF ABSENCE AND REMOVAL

OF MENTALLY ILL PERSONS INSPECTION: • Not less than three visitors shall at
least once in every month • Make a joint inspection of every part of the
psychiatric hospital • Shall enter in a book kept for that purpose such remarks
as they deem appropriate in regard to the management and condition • The
visitors shall not be entitled to inspect any personal records of an in-patient of
confidential nature
28. DISCHARGE:  Discharge by medical officer  Discharge on application 

Discharge on request • Discharge of person subsequently found on inquisition
to be of sound mind
29.  Discharge by medical officer: • On the recommendation of two medical

practitioners one of whom shall preferably be a psychiatrist • By order in
writing, the medical officer shall direct the discharge of any person from the
psychiatric hospital • Other than a voluntary patient
30. Discharge on application • Any person detained in a psychiatric hospital

under an order and in pursuance of an application • shall be discharged on an
application made in that behalf to the medical officer in charge • Provided that
no person shall be discharged if the medical officer in charge certifies in writing
that the person is dangerous and unfit to be at large
31.  Discharge on request • Any person (not being a mentally ill prisoner)
detained in pursuance of an order ,who feels that he has recovered from his
mental illness, may make an application to the Magistrate, for his discharge
from the psychiatric hospital • The application made shall be supported by a
certificate either from the medical officer in charge or from a psychiatrist • The
Magistrate may, after making such inquiry as he may deem fit, pass an order
discharging the person or dismissing the application.
32.  Discharge of person subsequently found on inquisition to be of sound

mind • If any person detained in a psychiatric hospital in pursuance of a
reception order is subsequently found • on an inquisition to be of sound mind
or • capable of taking care of himself and • managing his affairs • The medical
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officer-in-charge shall discharge such person from such hospital or nursing

home
33. • LEAVE OF ABSENCE • An application for leave of absence may be made to

the medical officer-incharge:-  by the husband or wife of the mentally ill 
relative of the mentally ill person duly authorized by the husband or wife or 
by the person on whose application the mentally ill person was admitted
34.  Every application shall be accompanied by a bond undertaking :- • To

take proper care of the mentally ill person • To prevent the mentally ill person
from causing injury to himself or to others, and • To bring back the mentally ill
person to the psychiatric hospital on the expiry of leave  The medical officers-
incharge may grant leave of absence for such period as deemed necessary •
The total number of days shall not exceed sixty days
35.  REMOVAL • Any mentally ill person other than a voluntary patient subject
to any general or special order of the state government • Be removed from any
psychiatric hospital or psychiatric nursing home to any other psychiatric
hospital or psychiatric nursing home • Within the state, or to any other state
with the consent of the government of that other state. (Dr. Parvaiz Ahmad
Khan, 2016)4
2.1.4 National Mental Health Survey of India 2015–2016
According to National Mental Health Survey of India 2015–2016 (Murthy,

2017)“India needs to talk about mental illness;”[2] “Every sixth Indian needs
mental health help;”[3] “8% of people in Karnataka have mental illness;”[4]
“Mental problems more in 30–49 age group or over 60; low income linked to
occurrence of mental disorders;”[5] and “urban areas to be most affected”[2]
were some of the headlines in the mass media.
The NMHS[1] will be a milestone in understanding the epidemiology of mental
disorders in the country. It is against this importance of the survey, the current
commentary places the survey in the historical context, describes the
methodology of the survey, salient findings and discusses the implications of
the survey.
4
Dr. Parvaiz Ahmad Khan, N. H. J., 2016. Linkedin. [Online]
Available at: https://www.slideshare.net/PARVAIZKHAN2/mental-health-act-1987
[Accessed 27 November 2018].
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Psychiatric epidemiology has been an area of great interest among all the
leading psychiatrists. The other similar area of interest is the psychiatric
classifications. In both these fields, there are more “failures” than successes in
the past 60 years.
There have been great times and not so great times in the Indian psychiatric
epidemiology. It has been well reviewed.[6,7] One of the first studies, a
massive plan by Govindaswamy as quoted by[6,7] in the 1st year of the All India
Institute of Mental Health, Bengaluru, was so ambitious in identifying the
causative factors that it did not get off the planning stage. The next major, a
milestone, was the Agra study.[8] This study is significant for the size of the
studied population (nearly 30,000 in one study center, as compared to 30,000 +
in the National Mental Health survey (NMHS), which is in the focus of the
current review) and the identification of factors contributing to mental
disorders (rural–urban differences, migrancy, etc.). There were a number of
small size studies in the 1960s and 1970s. The most important of these was the
“The Great Universe of Kota”[9] considered later.
There was a recognition for the need for a large-scale multicentered
epidemiological study in 1976 and the Indian Council of Medical Research
Department of Science and Technology (DST) project came up.[7] This was a
four-centered epidemiological project in Bengaluru, Baroda, Calcutta, and
Patiala. Initially, the study aimed to “estimate the prevalence of psychiatric
morbidity at different selected centers and investigate the sociodemographic
correlates.” However, midway in the project, the objective was shifted to an
interventional study, “develop and evaluate methods designed to reach, and
offer services to the sick population.”[7]
There was a lull in general population, psychiatric epidemiological studies till
the early 2000. The next major multicentered study using the World Mental
Health Survey (WMHS) occurred in the beginning of the current century. It has
had challenges is clear from the fact that it is being published only after 12
years of completion of the study (published in the current issue).[10]
The background is important to understand as the NMHS is the most expensive
(around Rs. 5 crores), and most ambitious general population epidemiological
study undertaken in the country to date. For this reason, it is important to
understand the findings in detail and draw lessons for the future.
As a scientific discipline, epidemiology has an important place in health
sciences. It was Morris who described the seven purposes of epidemiology.
These are: (i) understanding the magnitude of the mental disorders; (ii) the
causative factors; (iii) calculating the morbid risk; (iv) monitoring the historical
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trends; (v) completion of clinical picture; (vi) identification of new syndromes;

and (vii) treatment utilization in the community.[11]5
2.1.5 Infrastructure facilities in mental health care centres in India
Refers to (Khan, 2015) Appalling infrastructure deepens India’s mental health

crisis, further more India, with the rest of the world, celebrates World Mental
Health Day on October 10, but it has earmarked just a miniscule 0.83 per cent
of the total health budget for mental health. The WHO estimates of 2001
indicate that on an average there is a 22 per cent probability of an individual
developing one or more mental or behavioural disorders in their lifetime in
India.
According to WHOM data, the total number of psychiatrists per 100,000 people
is 0.4, total number of psychiatric nurses per 100,000 people is 0.04 and total
number of psychologists per 100,000 people is 0.02 in India. “For every 1
million people, there are just 3 psychiatrists, and even fewer psychologists.”
Mental illness constitutes nearly one-sixth of all health-related disorders. The

study by the National Commission on Macroeconomics and Health (NCMH)
shows that at least 6.5 per cent of the Indian population has some form of
mental disorders, with no discernible rural–urban differences. The WHO
predicts that about 20 per cent of India’s population would suffer from some
form of mental illness by the year 2020.
There are a total of 43 mental hospitals across the country with a combined
bed capacity of 20,000. The first mental hospital was established in Calcutta in
1786, later another mental hospital was established in Monger (Bihar) in 1795,
primarily for mentally disturbed soldiers. In 1858, the British colonialist
enacted the Lunacy Act, containing guidelines on admissions and treatment of
“criminal lunatics”, which later became the Indian Lunacy Act of 1918.
In 1982, the Centre launched a national mental health programme to improve

services by upgrading facilities and staff training, and providing care at the
community level. But it was never been implemented properly, especially at
district and rural levels. Prior to 1993, Indian Lunacy Act, 1912 was governing
5
Murthy, R. S., 2017. ncbi.nlm.nih.gov. [Online]
Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5419008/[Accessed 27
November 2018].
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the mental health in India. In 1947, the Indian Psychiatric Society came into
existence, which later drafted a Mental Health Bill that was approved in 1987.
Although it was a seen as a breakthrough from the obsolete Indian Lunacy Act,
experts argue that the 1987 bill excludes WHO guidelines, and that it failed to
remove the power of the criminal court to exert its control over the patients,
there were no provisions for punishing the relatives and officers requesting
unnecessary detention of a person to such hospitals, neither was there any
provision for transportation of an unwilling patient except by police. To make
matters complicated, definition of a “mentally-ill person” does not specify the
types of mental illness to be included in the Bill.
A study by Human Rights Watch exposes the state of mental hospitals in our
country; it documents involuntary admissions and arbitrary detentions of
women in these facilities; overcrowding and a lack of hygiene; inadequate
access to healthcare; forced treatment, including electro-convulsive therapy, as
well as physical, verbal and sexual violence.
With the lack of mental institutions and proper facilities, families are laden
with the responsibility of taking care of the mentally unfit. Social stigma, lack of
professional know-ledge, financial and physical burdens forces people to
mistreat the mentally ill. This is also one of the major reasons why many
families end up abandoning the mentally ill by shoving them into shoddy
government hospitals.
Amid these appalling conditions, women are seen to be more victimised at the
hands of unregulated mental health laws and stigmas. A documentary called
India’s Mental Health Crisis marks out examples of men misusing mental health
laws to gain divorce and women being forcefully admitted to mental hospitals
by their families for as long as a lifetime.
“Stigma and common beliefs restrain people from approaching professionals.

Often people would rather consult a general physician over recurring insomnia
and depression, rather than a psychiatrist. Mental disorders are seen as a sign
of weakness and abnormally, hence no one wants to openly accept and
recognise the need for psychiatric consultations,” says Dr Nuveen Kumar of the
Mamas foundation. n Tomorrow: A phenomenon called madness To use LTE,
Project Loon partners with telecommunications companies to share cellular
spectrum so that people will be able to access the Internet everywhere directly
from their phones and other LTE-enabled devices. Google uses solar panel and
wind to power electronic equipment in the balloon throughout the day.
19 | P a g e
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The source said that Google may operate as technology service provider and
not as Internet service provider. “The Deity committee is looking at various
aspects to facilitate test like identifying locations, coordination with various
agencies. Under the drone project, Google had plans to transmit Internet on
ground using 8 big solar powered drones, but that has not been cleared by the
government yet,” sources added.
3. RESEARCH METHODOLOGY
According to (Chris Hart 2003) Methodology is “system of methods and rules to
facilitate the collection and analysis of data. It provides the starting point for
choosing an approach made up of theories, ideas, concepts, and definitions of
the topic, therefore the basic of a critical activity consisting of making choices
about the nature and character of the social world (assumptions), this should
not be confused with, techniques of research, the application of methodology”.
The methodology is not only the systematic study of methods that can be
applied to the discipline but also the analysis of the principles of methods and
rules employed by that discipline. It is the methods or procedures; moreover it
is the philosophical assumptions that related to a particular study.
The concept of Scientific Research disclosed that the step of attempt to erase
some common misconceptions and the steps involved begins with general
questions and narrowing to focus to the specific aspect and concluding and
generalize to real world.
Source:-(http://www.experiment-resources.com/research-methodology.html)
3.1 The Research Approach, Strategy and Philosophy
The proposed research focused to find out the infrastructure stipulated by law
for mental health care centres and to submit for to improve it in India and the
approach will be deductive with a strategy of empirical and the philosophy will
be positivism.
3.2 Research Design
This proposed research designed to investigate the facts behind the research
question by studying the subject, searching carefully and by methodical
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process. The systematic and logical approach will helps to review the existing
literature and background according to the significance of the research. The
hypothesis and re-examination of theories resolve the controversial issues and
by the improved practice, the outcome can use practically.
3.2.1 The Types and Sources of Data
The proposed applied research will use primary qualitative and quantitative
data and secondary qualitative data.
3.2.2 The Data Collection Tools
The secondary data will collect from published literature and the primary data
will collect from the participants through questionnaires, interviews and emails.
3.2.3 Sampling Techniques
The proposed research will use cluster sampling and each cluster has
representation to the whole population as well as a random sampling technique
will use for which cluster to be considered for the research.
3.2.4 The Techniques of Data Analysis
The proposed research will use qualitative methods and grounded theory for
data analysis.
3.2.5 The Presentation of Data
When reporting the research, the outcome will be the intellectual property of
the researcher and it will be maintained by the client for the agreed period of
time without publishing as well as the plagiarism should be avoided and proper
referencing should be included and further if any assistance from others should
be mentioned and should avoid misrepresentation.
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3.3 The Ethical Implications of the Research
The Research principles associated with professional associations, obviously

the incorporation with the professional bodies and the requirements of
ethical research and the oversight of ethical issues and a variety of
research to be submitted for clearance to the professional bodies, as a
result of the informed consent, the participants can know about the
research and purpose as well as the sponsor and how long their
participation take place and is it voluntary or not also knows the right of
participants to withdraw their participation at any time (Alan Bryman,
2003).
The proposed research will be carried out with the responsibility of an ethical
researcher such as without any unnecessary interaction, behave with integrity,
following the appropriate code of conduct and without plagiarism as well as to
be with an eye of an ethical researcher, further more maintain the right of
participants such as right to not participate, right to withdraw, right to get
informed consent, right to anonymity and also will maintain the confidentiality
and accessibility of data.
The research and the ethics principles interrelated to the client, supplier and
the participants, when conducting the research, appropriate evidence
collection will be followed as well as the integrity and honesty should be
maintained. When processing the data such as using human subjects and
sampling, data accuracy and protection should be maintained and the process
should be according to the principles of research ethics.
3.4 Schedule for the Proposed Research

Figure 1- Time Table
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3.5 The Reflection on Personal Development
The research will helps the researcher to collect more information about the
subject and can view the subject matter in a different view point as well as
develop new knowledge, besides that the participant researcher and surveyor
get a internship certificate from the Centre for Human Rights, NUALS, Kochi,
hands on experience in data processing and legal research.
Bibliography
Books
Hart, C. ((1998) 2008(Re-Print)). Doing A LiteratureReview. London, United Kingdom: Sage
Publication Ltd.
23 | P a g e
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Reports
Journal Articles
Kestor. K.o, A. M. (2008). INFORMAL COMMUNICATION CHANNEL AS

DETERMINANTS. LASU Journal of Humanities. ,Vol. 5, 35 to 46.
http://artslasu.org/human/vol5/kester.pdf
Web Pages
Bishop, L. ,. e., 2011. Patients as healthcare consumers in the public and private sectors: a
qualitative study of acupuncture in the UK. Volume doi:10.1186/1472-6963-11-129.
Dr. Parvaiz Ahmad Khan, N. H. J., 2016. Linkedin. [Online]
Available at: https://www.slideshare.net/PARVAIZKHAN2/mental-health-act-1987
Hart, C., 1998. cuzproduces.com. [Online]
Available at: https://www.cuzproduces.com/producinganew/files/resources/HART_Doing
%20a%20literature%20review_1988_ch1.pdf
Murthy, R. S., 2017. ncbi.nlm.nih.gov. [Online]
Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5419008/
NIH, 2018. National Insstutute of Health. [Online]
Available at: The National Mental Health Act (1946) became law
[Accessed 25 Novomber 2018].
Shikha, C. L. N. a. D., 2013. ncbi.nlm.nih.gov. [Online]
Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705679/
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http://www.ehow.com/way_5787251_effective-communication-methods-global-
companies.html#ixzz18BnltGuz (Accessed on 25/06/2013)
M/Swansea Brown Bovary

http://www.abb.com/ (Accessed on 25/06/2013)
Small Business Management, Communicating within the organisation,

http://www.bizmove.com/skills/m8m.htm (Accessed on25/06/2013)
Intercultural Business Communication
http://www.kwintessential.co.uk/intercultural-business-communication/tool.php
(Accessed on 125/06/2013)
24 | P a g e
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EXPERIMENT-RESOURCES.COM
Research Methodology
http://www.experiment-resources.com/research-methodology.html . (Accesses on
25/06/2013)
Zachary Fennel (2010), Effective Communication Methods in Global Companies,

eHow.com. http://www.ehow.com/way_5787251_effective-communication-methods-
global-companies.html#ixzz18BnltGuz (Accessed on 25/06/2013)
http://www.abb.com/ (Accessed on 10/12/2010)
Small Business Management, Communicating within the organisation,

http://www.bizmove.com/skills/m8m.htm (Accessed on 25/06/2013)
Intercultural Business Communication
http://www.kwintessential.co.uk/intercultural-business-communication/tool.php
(Accessed on 125/06/2013)
Kestor. K.o, A. M. (2008). INFORMAL COMMUNICATION CHANNEL AS DETERMINANTS.

LASU Journal of Humanities. ,Vol. 5, 35 to 46.
http://artslasu.org/human/vol5/kester.pdf
EXPERIMENT-RESOURCES.COM, Research Methodology
http://www.experiment-resources.com/research-methodology.html . (Accessed on
25/06/2013)
http://www.globalfamilydoctor.com/AboutWonca/brief.aspxAccessed on 25/06/2013
Source. http://www.nuffieldtrust.org.uk/data-and-charts/uk-spending-public-and-private-
health-care (Accessed on 25/06/2013)
Source:http://www.kantar.com/public-opinion/policy/140712-attitudes-to-public-and-
private-health/(Accessed on 25/06/2012)
_____________________________________________
1. National Mental Health Survey of India, 2015-2016 Prevalence, Patterns and Outcomes,
Supported by Ministry of Health and Family Welfare, Government of India, and
Implemented by National institute of Mental Health and Neurosciences
(NIMHANS) Bengaluru: In Collaboration with Partner Institutions; 2015-2016.
2. Afshan Y. India needs to talk about mental illness, The Hindu, 23 October. 2016
3. The National Mental Health Survey of India, 2015–16, Insights, 31, December. 2016
4. Every sixth Indian needs mental health help: report, Matters India, 12 October. 2016
5. Health survey reports released, Deccan Herald, December 28. 2016
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6. Gururaj G, Girish N, Isaac MK. Mental, neurological and substance abuse disorders:
Strategies towards a systems approach. In: Rao S, editor. NCMH Background Papers:
Burden of Disease in India. New Delhi: Ministry of Health and Family Welfare; 2005.
7. ICMR-DST(1987) Collaborative study of severe mental morbidity. New Delhi: ICMR;
1987. pp. 623–54.
8. Dube KC. A study of prevalence and biosocial variables in mental illness in a rural and an
urban community in Uttar Pradesh – India. Acta Psychiatr Scand. 1970;46:327–
59. [PubMed]
9. Carstairs GM, Kapur RL. The Great Universe of Kota. London: Hogarth Press; 1976.
10. Sagar R, Pattanayak RD, Chandrasekaran R, Chaudhury PK, Deswal BS, Singh RK, et al.
Twelve-month prevalence and treatment gap for common mental disorders: Findings from
a large-scale epidemiological survey in India. Indian J Psychiatry. 2017;59:46–55.
11. Morris JN. Uses of Epidemiology. 3rd ed. Edinburgh: Churchill Livingstone; 1975.
Appendices
List of Figures
Figure 1- Time Table................................................................................................................23
List of Tables
26 | P a g e

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CHR- Winter Internship Program 2018- Infrastructure Stipulated by Law for Mental Health Care Centres

INFRASTRUCTURE STIPULATED BY LAW FOR MENTAL

AN APPLIED RESEARCH PROJECT

INFRASTRUCTURE STIPULATED BY LAW FOR MENTAL

(The Centre for Human Rights, National University

This report provides an analysis and evaluation of what infrastructure

1- Introduction and background of the Research

1.1 Aim of the Research

The topic data or evidence collection is significant and analyzing and

The research objectives set for the research topic are:-

1.3 The Scope of the Research

1. It will provide answers to raised questions and superior improved

Moreover the research outcome has commercial value in knowledge based

The limitations of the proposed applied research are as follows:-

Refers to (Hart, 1998) Literature review is, “the selection of available

2.1 A review on relevant Theories of Literature

“There is a dynamic relationship between the concept of mental illness, the

2.1.1 The constitution of India

According to the Representation of People Act, 1950 (sec 16), a person is

2.1.2 Indian laws regulating treatment of persons with mental disorders

5. • Chapter IV: Deals with the procedures of admission and detention of

6. • Chapter VII: It deals with the maintenance of mentally ill persons in a

7. OBJECTIVES OF THE ACT 1. To establish central and state authorities for

8. 6. To regulate procedure of admission and discharge of mentally ill persons

expenses 11. To change offensive terminologies of Indian Lunacy act to new

9. CHAPTER I - PRELIMINARY  TERMS USED • DISTRICT COURT: a city Civil

10. • MAGISTRATE: - Metropolitan Magistrate; the Chief Judicial Magistrate,

13. CENTRALAUTHORITY • Shall be subject to the superintendence, direction

14. STATE AUTHORITY • Shall be subject to the superintendence, direction and

15. CHAPTER III - PSYCHIATRIC HOSPITALS AND PSYCHIATRIC NURSING HOMES

16. The Central Government may established or maintain psychiatric hospitals

17. LICENCE • no person shall established or maintain a psychiatric hospital or

18. • Application for licence A person, who intends to establish or maintain a

19. CHAPTER IV : ADMISSION AND DETENTION IN PSYCHIATRIC HOSPITAL •

20. ADMISION ON VOLUNTARY BASIS • Request by major for admission as

21.  DISCHARGE OF VOLUNTARY PATIENTS • The medical officer-in-charge on a

22.  ADMISSION UNDER SPECIAL CIRCUMSTANCES: • Any mentally ill persons

23.  RECEPTION ORDERS  Application for reception order: • An application

26.  Admission after Inquisition: • If any district court holding an inquisition

27. CHAPTER V - INSPECTION, DISCHARGE, LEAVE OF ABSENCE AND REMOVAL

28. DISCHARGE:  Discharge by medical officer  Discharge on application 

29.  Discharge by medical officer: • On the recommendation of two medical

30. Discharge on application • Any person detained in a psychiatric hospital

32.  Discharge of person subsequently found on inquisition to be of sound

officer-in-charge shall discharge such person from such hospital or nursing

33. • LEAVE OF ABSENCE • An application for leave of absence may be made to

34.  Every application shall be accompanied by a bond undertaking :- • To

2.1.4 National Mental Health Survey of India 2015–2016

According to National Mental Health Survey of India 2015–2016 (Murthy,

trends; (v) completion of clinical picture; (vi) identification of new syndromes;

2.1.5 Infrastructure facilities in mental health care centres in India

Refers to (Khan, 2015) Appalling infrastructure deepens India’s mental health

Mental illness constitutes nearly one-sixth of all health-related disorders. The

In 1982, the Centre launched a national mental health programme to improve

“Stigma and common beliefs restrain people from approaching professionals.

3.1 The Research Approach, Strategy and Philosophy

3.3 The Ethical Implications of the Research

The Research principles associated with professional associations, obviously

3.4 Schedule for the Proposed Research

3.5 The Reflection on Personal Development

Kestor. K.o, A. M. (2008). INFORMAL COMMUNICATION CHANNEL AS

M/Swansea Brown Bovary

Small Business Management, Communicating within the organisation,