Mental Health Act (1987): Need for a Paradigm Shift from Custodial to Community Care (Report)
People with mental disorders are particularly vulnerable to abuse and violation of their rights (1). If a protective mechanism is not in place, they are susceptible to abuse by anyone in the society (2). In India, mental health care is not perceived as an important aspect of public health care. Hence, mental health legislation will play a very important role in upholding the rights of the mentally ill (2,3). The fundamental aim of mental health legislation is to protect, promote and improve the lives and mental well-being of citizens. Mental health legislations were initially drafted to safeguard the public from dangerous patients by isolating them from the public. A paradigm shift from custodial care to community care has occurred due to (i) Advances in medical technology in assessment and treatment of mental disorders; (ii) the human rights movement; (iii) World Health Organization’s (WHO) definition of ‘health’ (4); and (iv) Promotive, preventive, curative, rehabilitative approaches and mitigation of disability. This shift has given a new perspective to the care of mental disorders and has led to the review of mental health legislations worldwide (4). Discrimination and stigma may impact access to adequate treatment and care as well as other areas of life, including employment, education, marriage and shelter. The inability to integrate into society as a consequence of these limitations can increase the isolation experienced by an individual, which can, in turn, aggravate mental disorder.