Law on Mental Illness in India: A Rights-Based Legal Framework

I. Introduction

The legal understanding of mental illness in India has undergone a remarkable transformation over the past few decades. From the colonial‐era custodial approach under the Lunacy Acts to the rights-based, autonomy-driven framework of the twenty-first century, Indian law now seeks to balance care, liberty, and dignity. The enactment of the Mental Healthcare Act, 2017 (MHCA) and the Rights of Persons with Disabilities Act, 2016 (RPwD Act) represents a decisive step toward compliance with the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), 2006, which India ratified in 2007. Together, these statutes guarantee equality, non-discrimination, and access to quality mental healthcare, marking a constitutional realization of the right to health and dignity under Article 21.

II. The Mental Healthcare Act, 2017

A. Scope and Definition

Section 2(s) of the MHCA defines mental illness as a substantial disorder of thinking, mood, perception, orientation, or memory that grossly impairs judgment, behaviour, or ability to meet the ordinary demands of life. Importantly, it excludes mental retardation (now termed intellectual disability). The Act establishes a comprehensive framework for treatment, rights protection, and oversight through Mental Health Review Boards (MHRBs).

B. Rights-Based Orientation

The MHCA marks a paradigm shift from institutionalization to rights protection. Section 18 guarantees every person the right to affordable, accessible, and good-quality mental healthcare. The State is mandated to establish facilities in every district and integrate mental health into general healthcare services. Section 20 recognizes the right to live with dignity, prohibiting cruel, inhuman, or degrading treatment. Section 21 ensures confidentiality, privacy, and protection of personal information.

C. Advance Directive and Nominated Representative

Under Sections 5–13, any person may issue an advance directive specifying preferred treatment and appointing a nominated representative (NR). These instruments uphold autonomy and informed consent, limiting arbitrary or coercive treatment.

D. Decriminalization of Suicide

Section 115 presumes that any person attempting suicide is under severe stress and therefore not punishable under Section 309 of the Indian Penal Code (IPC). The State is obliged to provide care, treatment, and rehabilitation—a progressive human-rights interpretation of mental distress.

E. Regulation and Oversight

The Act mandates registration of all mental health establishments (Sections 65–69) and introduces judicially reviewable procedures for involuntary admission (Sections 89–90). MHRBs function as quasi-judicial bodies to safeguard patients’ liberty and rights.

III. The Rights of Persons with Disabilities Act, 2016

The RPwD Act operationalizes India’s obligations under the UNCRPD. It recognizes mental illness as one category of disability and provides wide-ranging entitlements:

Equality and Non-Discrimination – Sections 3–5 prohibit discrimination on the ground of disability and guarantee equal protection before law.
Reservation and Employment – Persons with benchmark disabilities (≥40 %) are entitled to reservation in education and public employment (Sections 32–34).
Reasonable Accommodation – Employers and institutions must ensure accessibility and adapt to individual needs.
Legal Capacity – Section 13 affirms that persons with disabilities, including those with mental illness, enjoy legal capacity on an equal basis with others.

The Act reinforces the constitutional guarantee of equality (Article 14) and the right to livelihood and participation (Articles 19 and 21).

IV. Criminal Law and Mental Illness

A. Substantive Law: Section 84 IPC

Section 84 of the IPC embodies the McNaughton Rules by exempting from criminal liability a person who, by reason of unsoundness of mind, was incapable of understanding the nature or wrongfulness of the act. The burden of proof lies on the accused, but courts interpret it liberally when medical or behavioural evidence supports insanity at the time of the act.

B. Procedural Law: Bharatiya Nagarik Suraksha Sanhita, 2023

Sections 365–371 of the BNSS (formerly Sections 328–339 CrPC) govern inquiries into the mental condition of accused persons. These provisions empower magistrates to order medical examination, treatment, and conditional release, balancing due process with public safety.

V. Insurance and Economic Rights

Section 21(4) of the MHCA mandates parity between mental and physical illness in health insurance coverage. The Insurance Regulatory and Development Authority of India (IRDAI) has enforced this through circulars in 2018 and 2020. In Shikha Nischal v. National Insurance Co. Ltd. (2021 SCC OnLine NCDRC 263), the National Consumer Disputes Redressal Commission held that exclusion of mental illness was unlawful and violative of Section 21(4), thereby affirming mental-health parity.

VI. Employment and Service Jurisprudence

Judicial recognition of mental-health rights in employment has grown steadily. In Union of India v. Devendra Kumar Pant (2009 14 SCC 546), the Supreme Court emphasized that termination on grounds of mental illness must be reasonable and medically substantiated. The RPwD Act further prohibits discriminatory dismissal and requires employers to provide rehabilitation or reassignment where feasible.

VII. Judicial Developments and Constitutional Dimensions

The judiciary has played a transformative role in expanding the constitutional meaning of mental health:

B.K. Parthasarathi v. State of A.P., AIR 2000 AP 156 — upheld privacy and autonomy in psychiatric treatment.
Navtej Singh Johar v. Union of India, (2018) 10 SCC 1 — recognized mental well-being as intrinsic to dignity under Article 21.
X v. Union of India (2022) — directed implementation of suicide-prevention and district mental-health programs.

These decisions align mental-health jurisprudence with constitutional morality and human-rights principles.

VIII. International and Comparative Perspective

India’s mental-health law mirrors the UNCRPD’s emphasis on autonomy, non-discrimination, and community inclusion. The MHCA’s provisions on advance directives and supported decision-making echo the Mental Capacity Act (UK, 2005) and similar global standards. However, implementation challenges—scarcity of mental-health professionals, inadequate funding, and social stigma—continue to impede realization of these rights.

IX. Challenges and the Way Forward

Despite progressive legislation, the gap between law and practice remains wide. Major concerns include:

Infrastructure Deficit: Many districts lack functional mental-health services.
Awareness and Stigma: Public and institutional stigma discourages treatment and disclosure.
Implementation of MHRBs: Delays in constituting Boards undermine accountability.
Integration with Primary Healthcare: Mental health remains segregated from general health policy.

Strengthening institutional capacity, enhancing training, and ensuring budgetary allocation are vital for effective enforcement.

X. Conclusion

The Indian legal framework now enshrines mental health as a matter of right, not charity. The MHCA 2017 and RPwD 2016, read with constitutional guarantees of equality and dignity, establish that persons with mental illness are full legal subjects entitled to care, autonomy, and participation. The Supreme Court’s jurisprudence reinforces this shift from custodialism to empowerment.

However, realization of these rights demands sustained political will, institutional reform, and public awareness. Only when mental health is treated with the same seriousness as physical health will India fulfil both its constitutional promise and its international commitments under the UNCRPD.

References:

Mental Healthcare Act, 2017 (No. 10 of 2017).
Rights of Persons with Disabilities Act, 2016 (No. 49 of 2016).
Indian Penal Code, 1860, s. 84.
Bharatiya Nagarik Suraksha Sanhita, 2023, ss. 365–371.
Shikha Nischal v. National Insurance Co. Ltd., 2021 SCC OnLine NCDRC 263.
Union of India v. Devendra Kumar Pant, (2009) 14 SCC 546.
B.K. Parthasarathi v. State of A.P., AIR 2000 AP 156.
Navtej Singh Johar v. Union of India, (2018) 10 SCC 1.
UN Convention on the Rights of Persons with Disabilities, 2006.

ASHOK KUMAR SINGH

Monday, October 20, 2025