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)
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 D6a | 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 M7 | No concept of emergency admission No guidelines for appealing against emergency treatments |
Special treatments | O1a O2 | No explicit protection from abortion without informed consent Lack of guidance on medical treatments |
Seclusion and restraint | P3-4 P5 | Potential for prolonged and repeated seclusion. No human resource strategy to minimize use of seclusion and restraint |
Oversight and review mechanisms | R1ai R1aiii R1aiv R2aiii-iv | 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 Z2b | The privacy of women is not given special consideration Women are not guaranteed separate sleeping facilities from men |