‘Appointing Mental Health Review Board members without plan is foolhardy’

Floyd Gracias, Dr Sanjay Kumavat and Rajeshwar Panchal

The state government recently appointed members to the Mental Health Review Board (MHRB) via a notification. However, psychiatrists and lawyers say it's hogwash, as the core infrastructure, including the official website and budgetary provisions, have not been made yet. With no infrastructure in place, the board will not be able to function under the Mental Healthcare Act, 2017, they argued.

Experts said that the sudden appointment of members to the board is just a knee-jerk reaction by the government to the series of reports in mid-day, which highlighted the non-implementation of MHRB in Maharashtra, and the need for having the same introduced at the earliest. According to Solicitor Stuti Galiya, Maharashtra will have eight MHRBs, which will serve 36 districts of the state. "The MHRBs will consist of a district judge, representative of district collector, psychiatrist, caregiver and a medical practitioner," said Galiya.

Floyd Gracias, counsel, Supreme Court, said that while the notification is a major step forward in "providing mental healthcare and legal remedy" to citizens, there were two major concerns. "Firstly, the procedures for application and the relevant forms have not been notified, so save and except for the Act and Rules, there is no application procedure for the state. Further, the places where the boards will function from have not been notified either, which means, a person who needs to file an application will be unaware of the prescribed form for filing and the place at which it ought to be filed. Secondly, the circles, as notified, are seemingly wide, and the jurisdiction of the circles may create operational difficulties for patients and their caregivers, especially till such time that an online mechanism becomes operational."

He feels that another notification that remedies these problems will be on its way. "This will hopefully provide much-needed clarity to the present notification." Dr Sanjay Kumavat, a senior consulting psychiatrist and former deputy director of Mental Health Services, Maharashtra, said the state government should be holding meetings with mental health care professionals and organisations, and take their help in implementing the Mental Healthcare Act, 2017. "The various stakeholders, including the police, judiciary and caregivers need to be sensitised," he said.

Advocate Rajeshwar Panchal, who practices in the Bombay High Court, was more critical of the notification. "Mental Healthcare is a serious issue that needs to be addressed seriously. It needs infrastructure and allocation of budget. However, all these factors haven't been considered by the government. The statutory body at the state and district levels should include experts."

Galiya, however, feels that more concrete steps will be taken in the near future for constitution of the MHRBs. "A lot more needs to be done, to ensure that effective steps are taken by the state to deal with mental health issues of citizens, especially during these challenging times. It is also important that a user-friendly and seamless interface is put in place, so that people who are already mentally ill or their representatives do not have to bear additional burden, stress and frustration arising out of an inefficient system."

Why we need the Mental Health Review Board

Stuti Galiya

The MHRB will function as a quasi-judicial body, set up by the State Mental Health Authority. "The board will hear any dispute with regards to treatment of patients with mental illness. This would mean that the MHRB will now hear disputes, which earlier directly went to the consumer courts, Human Rights Commission or civil courts. Any person with a mental health illness or his nominated representative or a representative of a registered NGO, with the consent of such a person, can make an application to the board seeking redressal or appropriate relief. The application can be made orally or over telephone from a person admitted to a mental health establishment. Further, according to the MHCA, citizens also have the right to advance directives, explaining how they want to be treated for the illness, and who their nominated representative shall be, in case of any future eventuality," Galiya added.