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Table 4 Key omissions in Indian legislation in areas of otherwise good concordance with the World Health Organization’s “Checklist on Mental Health Legislation” (WHO-RB) (World Health Organization, 2005)

From: Concordance of the Indian Mental Healthcare Act 2017 with the World Health Organization’s Checklist on Mental Health Legislation

Legislative issue WHO-RB designation Key omissions
Preamble and objectives A2a Failure to emphasise non-discrimination outside of healthcare
Definitions B3 No discussion of personality disorder
No clear definitions concerning substance misuse
Access to mental healthcare C1 No clear plans for funding services
Rights of users of mental health services D5
No minimum conditions for mental health establishments
Superficial consideration of privacy
Competence, capacity and guardianship F4-7 Lack of clarity and review process concerning limited guardians
No clear duration or systematic review for nominated representatives
Emergency situations M4
No concept of emergency admission
No guidelines for appealing against emergency treatments
Special treatments O1a
No explicit protection from abortion without informed consent
Lack of guidance on medical treatments
Seclusion and restraint P3-4
Potential for prolonged and repeated seclusion. No human resource strategy to minimize use of seclusion and restraint
Oversight and review mechanisms R1ai
Not all involuntary admissions are automatically reviewed
Long-term voluntary patients have no right to external review
No review for treatments against an individuals will
No guidelines on the collection and publication of statistics
Protection of vulnerable groups Z2a
The privacy of women is not given special consideration
Women are not guaranteed separate sleeping facilities from men