The State Mental Health Authority has stated before the Bombay High Court that the authority would take immediate steps to computerize details of all patients in the four Regional Hospitals in the State of Maharashtra.
The Division Bench of Justice Nitin Jamdar and Justice Abhay Ahuja was hearing a Public Interest Litigation (PIL) raising the issue of ineffective implementation of the Mental Health Care Act, 2017 as far as the State is concerned.
The counsel for the State Mental Health Authority stated the database would be created with details of the patients including days of stay in hospital, family details, visits of family members, attempts of reunion with family etc. The counsel stated physical registers are being maintained currently and digital format would be created and sufficient safeguards would be adopted to keep the patients’ data confidential to protect their identity and will be password protected.
The High Court’s attention was drawn to the scheme of NALSA (Legal Services to the Mentally Ill and Mentally Disabled Persons) Scheme, 2015. Section 12 of Legal Services Authority Act 1987 defines persons who are disabled in Clause (I) of Section 2 of the Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995 and those who are in psychiatric hospital or in a psychiatric nursing home would fall within the definition of Clause 2(q) of the Mental Health Act, 1987. A representative from the Maharashtra Legal Services Authority was present in Court. He drew the Court’s attention to the part of the scheme which deals with psychiatric hospitals, homes and facilities.
The scheme contemplates that the State Legal Services Authority and a Board of Visitors would review the persons in these hospitals, homes and facilities to ascertain whether there are any cured persons staying there whose families appear reluctant to take them back or are themselves not able to contact their families. The scheme contemplates that whenever the State Legal Services Authorities / District Legal Services Authorities or Board of Visitors find such inmates, these authorities must take necessary steps to facilitate restoration, including providing legal representation in Court to seek orders for restoration of the cured person with the family.
Various measures are provided under the scheme. The details are reproduced herein below :
(i) Legal services institutions shall during their visits to the psychiatric hospitals or homes or facilities ascertain through interaction with inmates, doctors and staff as to whether any of the persons admitted there are victims of forced admission or not. In such cases, legal services shall be given to such persons for their release from the psychiatric hospitals or homes or facilities.
(ii) SLSAs/DLSAs should set up Legal Services Clinics at the psychiatric hospitals, homes and facilities to provide legal assistance wherever required to mentally ill/ mentally disabled persons and their families to address legal issues concerning the mentally ill and mentally disabled persons.
(iii) Such a legal clinic should be manned by para legal volunteers and panel lawyers who are sensitive to such issues and persons.
(iv) It would be quite appropriate to train the doctors, nurses and other para medical staff/administrative staff at the mental health facilities as Para Legal Volunteers so that the best legal services can be provided keeping in mind the welfare of the mentally ill/mentally disabled persons.
(v) The Clinic should also help in ensuring that the homes meant for the mentally ill and mentally disabled persons have all facilities, including for learning appropriate skills for independent and/or assisted living and earning. The legal services institutions may approach the Government, and if necessary the High Court for appropriate directions, to ensure the availability of such facilities.
(vi) The Legal Services Institutions should also connect the mentally disabled persons with the National Trust for Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities so that benefits provided under the “National Trust For Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities Act, 1999” are assured to these persons and their families.
(vii) Legal Services Institutions should involve through the para legal volunteers, the para medical staff/administrative staff and doctors at mental health facilities to identify relatives and homes of those patients in relation to whom such facts are not available on record and take steps through the different legal services institutions to reach to the relatives of the patients to facilitate reunion of the patients with the near an dear ones.
(viii) Patients, who are housed in mental health centres, homes and facilities, away from their domicile and home, must be considered for providing legal assistance to ensure their transit to mental health centres, homes and facilities nearer to their native place. This can be done with the involvement of SLSAs and DLSAs.
The counsel for the State Legal Services Authority and the learned amicus curiae point out that if the efforts of the Maharashtra Legal Services Authority under the scheme are coordinated with the efforts of the State Mental Health Authority, it would assist in resolving the issues highlighted in the petition i.e. all those patients who have remained in Mental Health Institutes despite being cured for various reasons.
The Counsel further states that a meeting of the Authority is scheduled on March 21, 2023 and in this meeting, representatives of the State Legal Services Authority would be invited as a guest so that a plan for coordination can be chalked out.
Senior Advocate JP Sen, amicus curiae, pointed out that various para legal volunteers enrolled by the Maharashtra State Legal Services Authority can assist in the steps to be taken to identify and settle the patients.
“Maharashtra State Legal Services Authority will start working on the said initiative as per the scheme and would apprise the Court of the progress on the next date. Though we have called upon the Maharashtra State Legal Services Authority to carry out this exercise, this would be in addition to the steps to be taken by the State Mental Health Authority and we are not relieving the State and the State Mental Health Authority of their responsibilities,” the Bench observed.
As regards creating a website, the counsel for the State Mental Health Authority stated that a tripartite Memorandum of Understanding (MOU) between State Mental Health Authority, National Institute of Mental Health and Neuro Sciences and National Health Mission, Karnataka Health & Family Welfare Society has been drafted and is in process of being finalized. This MOU contemplates providing technical services to the State Mental Health Authority.
The counsel stated that till March 10, under the portal of Public Health Department of Government of Maharashtra, a website has been created providing for minimum standards and checklist for Mental Health Establishments, Mental Health Establishment Registers, Mental Health Professionals in Maharashtra and also a provision for uploading complaints. The learned counsel for the State Mental Health Authority stated that this is transitional and ultimately a full-fledged portal of Authority is in the process of being created. The learned counsel for the petitioner had stated that, at present, a temporary email address and contact number is provided.
The counsel for the State Mental Health Authority has also handed over a draft program for the activities to be conducted this year. The learned counsel for the petitioner stated that the draft program does not include various important aspects. The learned counsel for the State Mental Health Authority stated that if a note is sent by the learned counsel for the petitioner to the State Mental Health Authority, the same will be taken up in the next meeting that is scheduled on March 21, 2023.
The counsel for the State Mental Health Authority stated that a committee will be formed to draft the Maharashtra State Mental Health Policy with special emphasis on patient’s rights as per Section 18 of the Mental Healthcare Act, 2017.
It is expected by the High Court that the process for formation of this committee would be initiated as early as possible. At least, it should be an agenda item in the meeting scheduled on March 21, 2023. The matter has been listed for next hearing on March 31, 2023.