Mental Health Acts

Mental Health Act

A nurse who works in a psychiatric hospital or unit should be familiar with the local mental health law. In the Nepali context, it has been developed in line with the House of Representative's declaration from 2063, which aims to rehabilitate those with mental illnesses by promptly treating their illnesses and protecting their basic rights.

 Short Title and Commencement

• This act may be called "Mental Health (Treatment and Protection) Act, 2006".
• It shall come into force on such date as the Government may, by notification, appoint shall be construed as a reference to the coming into force in the Kingdom of Nepal.

Definitions

In this act, unless the contest otherwise requires:

"Mental Disease" means a person who displays abnormal activities due to disorders in the person's mental status, thoughts, intelligence and short term and long term memory.

"Mental Health Services" means an activity for diagnosis, treatment, care and rehabilitation of a person suspected to suffer from mental disorders.

"Psychiatrist" is defined as a doctor with a specialized training in the subject of mental health and registered with the Nepal Medical Council as a doctor.

"Mentally Unhealthy Person" specifies a person suffering from mental disorder and receiving treatment from a Mental Health Worker and the phase also implies to a person admitted in a mental health institution.

"Center" means the National Mental Health Center established and operated in accordance to this act.

"Rehabilitation Center" means an organization established with an objective of rehabilitating the mentally ill person in the society thereby in the process respecting the human rights and dignity of the same.

"Mental Health Examination Committee" implies to the committee organized under clause (4) below.

"Local Body"means the District Government Committee, Metropolis, Sub-metropolis, Municipality, and Village Development Committee or ward authorities and staff.

"Guardian" means a person appointed by the Chief District Officer in accordance to this act to care for a mentally unhealthy person and safeguard and manage his or property.

"Prescribed" or "As prescribed" means prescribed prescribed by rules made under this act.

• Establishment and Operation of the Center
  • A National Mental Health Center will be established in the kingdom of Nepal to provide specialized services in the field a mental health.
  • The Center will be situated in Lalitpur.
  • The mental hospital in operation at the time of this act coming into force will be operated in the name of the National Menta Health Center.
• Organizational Structure
  • A committee comprising of the following members will be organized for the purpose of the Center's management and operation.
  • As per sub clause (1) above, the following will be the structure of the committee:
    • One person nominated by the Government of Nepal                                                                                                Chairman
    • One person nominated by the Government of Nepal from among prestigious women social workers                     Member
    • Representative, Ministry of Health and Population                                                                                                   Member
• Representative District Office, Lalitpur or another person designated by him/her                                                    Member
• Representative, District Development Committee, Lalitpur                                                                                       Member
• Two, nominated by the Government of Nepal under recommendation from the committee
• From among the consultant doctors, inclusive of one women                                                                                   Member
• Chairman, Organization for committee and industry, Lalitpur                                                                                    Member
• Chairman, Nepal Red cross Society, District Branch Lalitpur                                                                                    Member
• Matron from the Center                                                                                                                                              Member
• Director of the Center                                                                                                                                                 Member secretary

The tenure of the members under section (a), (b) and (f) of sub clause (2) shall be of two years.

The Government of Nepal can, with notification in the national gazette, add or remove members in and from the committee or make changes as deemed necessary.

• Work, Duties, and the Rights of the Committee

The work, duties and the rights of the committee shall be as started below:

• Run both short-term and long-term development programs for the facility.
• raise the money and resources required for running and managing the facility.
• establishes the charges for the services the facility offers.
• Defend and uphold the center's tangible assets.
• Present the Center's yearly report to the Nepali government.
• Run additional businesses that will help the Center run more smoothly.
• Assembly (Meeting) and Decision of the Committee
  • The committee's assembly (meeting) must follow the rules established by the chairman.
  • The member secretary will convene the meeting and properly notify the chairman upon receiving a written demand for one from one-third of the members.
  • If the position of chairman is unfilled or if the chairman is not present, the committee member secretary may summon a meeting as needed.
  • A minimum of half of the committee's members must be present at any meeting to meet the quorum requirement.
  • Meetings of the committee shall be presided over by the chairperson, or in his/her absence, a member appointed by the members.
  • Decisions must be made by majority vote, but in the event that there is a tie in the number of votes, the meeting's chairperson reserves the ability to vote for or against the proposal.
  • The member secretary must certify each decision reached by the committee.
  • Every four months throughout the year, the committee must meet at least once.
  • The committee may call any gaze officer of the Government of Nepal or a professional as an observer if it is considered essential.
  • The agenda for committee meetings can be set by the committee itself.
• Treasury
  • The committee shall have its own separate treasury.
    • The treasury shall comprise of the following funds:
    • Donations received from the Government of Nepal,
    • Fund collected from the services provided by the center
    • Funds received from any foreign organization or government, or international organizations or other donor agencies.
    • Funds from any other sources.
  • All expense of the committee shall be borne by the treasury any other sources. mentioned in sub claus (1) above.
  • Funds received for the treasury shall be deposited in any commercial bank of the country.
  • The signatories for the operation of the committee's treasury I shall be the Director of the Center and the Chief of accounts, jointly.
  • Funds received under section (c) of the sub clause (2) must bear the approval from the Government of Nepal and funds received for specific programmes must be spent (utilized) for the stipulated programme.
• Account and Audit
  • The committee's account of revenue and expenses must follow the procedure used by the government of Nepal.
  • The rules for financial management must be followed.
  • The committee's accounts must be audited in compliance with the current legislation of the Nepalese government.
  • The government of Nepal has the right to check the books of account whenever it deems it essential.
• Provision for Staff
  • The committee can, with prior approval from the Ministry, appoint staff, if necessary and the terms and conditions of the service and the facilities provided shall be as prescribed.

                                                                                                                                              Chapter III

                                                                                                                 Mental Health Examination and Treatment

• Mental Health Examination
  • Mental Status Examination of a mentally ill person must be carried out only with his/ her approval or his/her guardian's approval, in case of inability to approve by the mentally ill person.
  • In accordance to sub clause (1), detailed information about the nature of the treatment, period of time involved in the treatment and physical and mental pain involved in the proposed treatment must be offered to the patient or to his/her guardian, in case of his or her inability to comprehend unconsciousness, prior to obtaining approval. or
• Treatment of the Mentally Ill Person
  • Any person with mental illness can be admitted to the center for treatment under the conditions listed below:
    • When a psychiatrist certifies, in accordance to clause 10 that a person needs to be admitted to the center and treated.
    • Based on the recommendation from Local Body, any other center or health organization a person can be admitted to the center and treated if on examination mental illness is found.
    • When a prisoner is sent for a mental status examination, if the prisoner is certified for treatment with admission to the center.
  • Unless stipulated otherwise in this act, in accordance to sub clause (1), a mentally ill person shall not be institutionalized for more than three months, BUT a person receiving treatment from the center shall not be deprived of extended treatment under recommendation from the mental Health Status Examination Committee.
• Discharge and Leave for the patient
  • In accordance to this act, a person admitted and receiving mental health treatment services can be at any time discharged from the center upon recommendation from the mental health status examination committee formed under clause (26).
  • A part from the prisoners, patient admitted and receiving treatment in the center can be taken out on leave for a stipulated time period under stipulated conditions by his or her wife or husband or his or her guardian with written application for the same and only when the psychiatrist of the center believes in the fulfillment of the following criteria:
    • The applicant is able to care for the mentally ill person.
    • The applicant is able to restrain the patient from harming him/her self or others,
    • The applicant can be trusted to bring the patient back to the Center upon completion of the leave.
  • In accordance to sub clause (2), if the patient is not brought back after the completion of the leave period, the Center shall inform the local District Administration Office.
  • In accordance to this clause, the Center shall not be held responsible for any acts or deeds of the patient during the period of leave.
• Patient's Record
  • Following details must be registered for record for all the mentally ill persons admitted and receiving treatment in the Center:
    • Patient's name, family name, age, sex, occupation and address,
    • Nature of the disease,
    • Period for which the patient is admitted and treated for in the Center. 
    • Details of the treatment provided to the patient,
    • In the case of the death of the patient, date, time and the reason for death,
    • Name, family name and post of the psychiatrist and Mental Health Workers involved in the treatment of a patient,
    • Other details as prescribed.
  • The Center must keep all records as prescribed in sub clause (1) safely.

                                                                                                                                             Chapter-IV

                                                                                                                Benefits and Protection of a mentally ill person

• Provide protection
  • All mentally ill persons must be provided with proper protection by his or her family or the guardian appointed or designated by the local District Administration Office.
  • In the case of a patient with out any family members or relatives, the Local Body shall provide the protection.
• Protection and Use of Property
  • The husband or wife or the guardian of a mentally ill person can apply to the Local Administration Office for investigation, protection and management of such person's fixed or liquid properties.
  • Upon receipt of application as per sub clause (1), the Local Administration Office can order for the patient to be present or to be presented on specific date, time ant place.
  • For the purpose of this clause, the local administration office can appoint a committee comprising two or more than two people to investigate and inquire about the mentally person's property and upon completion of the same, the local administration office shall record the following:
    • If the person alleged to be mentally ill is in fact mentally ill,
    • If the alleged mentally ill person is in the state of taking care of his/her self and protect and manage his or her property.
  • Upon recording the fact, in accordance to clause(3), that a mentally person is not in the capacity to take care of his/her self and protect and manage his/her property, the local administration office can appoint a guardian from among the patient's family or relatives or any other person deemed fit for the purpose.
  • If any point during the process of appointment of a guardian for a mentally ill person, the local administrative officer believes that the person alleged to be mentally ill or unfit is on the contrary fit and can take care of one's self and protect and manage one's property, the local administration office has the right to discontinue or cancel the process at any given time.
• Duties and Facilities of a Guardian
  • A guardian appointed in accordance to clause (10) of this act must take proper care of the mentally ill person and protect and manage his/her property.
  • The guardian may make use of a mentally ill person's property for his/her benefit and betterment but may not sell, use as collateral against loan, transfer right of ownership, gift, exchange or destroy in any way with out the prior permission from the local administration office.
  • In accordance to this act, the appointed or designated guardian may receive a monthly salary as fixed by the local administration office for taking care of patient and protecting and managing his or her property.
  • The guardian must produce a quarterly report of the details of the patient's property to the local administration office.
• Act against discrimination and maltreatment
  • No person is authorized to make any kind of discrimination towards a mentally ill person.
  • No adverse effect on the physical or mental health of a mentally person shall be exercised by means of use of force, coercion and beating or other.
  • Contrary to what is prescribed in sub clause (2), this clause shall not prove hindrance to taking control of the mentally ill person, using humane methods, who poses a threat to him/her self, others or the peace and security itself or under valid reasons of foreseen damage to self or others.
• Act against the use of mentally ill person for Health Status Examination and Research. A mentally ill person shall not be used for research except under the following condition.
  • That such research proves beneficial for the treatment or cure of the patient.
  • That the patient gives consent, in the case of this ability to do so, or his or guardian does so,
  • In condition as prescrihed.
• Act against Forced Labor A mentally ill person shall not be made to work with out providing him or her salary or wages or against his or her will.
• Maintenance of Secrecy
  • The secrecy of mentally ill person being treated or admitted for the same in the Center or a rehabilitation center and that of betterment or cure after receiving treatment shall not be disclosed at any time by any one. BUT, providing details under the following condition shall be treated as disclosure of secrecy:
    • Upon consent of the related person,
    • pon demand for details of the mental health of a person from the local administration office, related police office, his or her wife or husband or his or guardian.

In accordance to sub clause (1) above, the Center, may furnish the following details with regards to mentally ill person:

• If the patient required about is admitted in the Center or not,
• If the patient is admitted in the center, discharged from the Center or in the case of death, the date and details regarding the death.
• The nature of the patient's disease.
   
• Supervision
  • For the purpose of betterment and security of the mentally ill person, the place and life style of the patient must be inspected and supervised.
  • For the purpose of sub clause (1), above, a committee comprising of the following shall be formed.
    • A human right officer appointed by the Government of Nepal                                                                     Coordinator
    • Representative, Ministry for Women, Children and Social Welfare                                                             Member
    • Representative, Local District Administration Office                                                                                    Member
    • Representative, Nepal Bar Association                                                                                                       Member
    • Ward president for inspection                                                                                                                      Member
  • The committee started in sub clause (2) above, shall inspect and supervised at least two times a month.
  • The committee formed under sub clause (2) reserves the right to make necessary arrangements for the mentally ill persons, benefit and security, if the committee, during the inspection and supervision as per clause (3), believes that the facility where the patient kept or the behavior towards the patients from his or family or guardian is not based on minimal human values.
  • As per this clause, the committee shall submit a report of the inspection and supervision to the National Human Rights Commission and the Ministry for Women, Children and Social Welfare.
  • Other arrangements for inspection and supervision shall be prescribed.

                                                                                                                                Chapter V

                                                                                                             Penal Codes and Penalties

• Crime

Following cases shall be considered a crime as per this act: 

• False or misleading certification by a medical officer or a h worker of a mentally healthy person to be mentally ill Or mentally healthy after treatment or kept under control for mental misbalance or a mental ill person to be mentally healthy.
• For not providing care and protection by the guardian to the mentally ill person as per clause
• For damaging or destroying the property of the mentally i person by not managing and protecting it as per clause 11,
• Forced into labor with out salary as per clause 15,
• For breach of secrecy as against clause 16.
• For any action or deed against the spirit of this act.
   
• Penalties
  • A penalty of five thousand to twenty five thousand shall be levied on a person who commits a crime stated in clause (22) above.
  • Besides sub clause (1), in the case of a guardian destroying or damaging the property of a mentally ill person, an amount double that of the property destroyed or damaged shall be recovered from the guardian and the recovery shall be treated as a government recovery.
• Right of law suit
  • Convicted under this act, a legal suite shall begin, proceed and be resolved in the related district court.
• Government as plaintiff
  • In legal hearings for conviction under this act, the government shal be the plaintiff.

                                                                                                                         Chapter- VI

                                                                                                                        Miscellaneous

• Mental Health Examination Committee
  • For the purpose of this act a mental health examination committee comprising of the following shall come into force:
    • Chief psychiatrist from the Center                                                                                                                                                                                Chairman
    • Government of Nepal appointed or nominated psychologist.                                                                                                                                       Member
    • One Government of Nepal nominated female medical officer or health workers from among the mental health workers                                           Member

The work description, duties and rights of the committee formed in accordance to sub clause (1) shall be as prescribed. The committee formed in accordance to sub clause (1) shall meet as and when deemed necessary.

• Work description, Duties and right of the Mental Health Status Examination Committee.
  • Unless expressed other wise in this act, the work description, duties and rights of mental health status examination committee shall be as mentioned below:
    • Mental health status examination and certification,
    • In case of controversy of the psychiatrist's report regarding the certification of a mentally ill person, the committee shall issue a certificate after a re-examination of the same case.
    • Other works as prescribed.

In accordance to section (a) of sub clause (1), if a question on the written certification of a controversy on the mental health of a person arises, the committee is liable to perform the examination of such person for the second time and issue a certificate accordingly.

• Establishment of a Rehabilitation Center
  • If a mentally ill person receiving treatment from a mental health organization or the Center is recombined by the committee formed under clause (17) to be kept under supervision of a psychiatrist or a mental health worker or a psychologist for a fixed period of time, the government of Nepal shall establish and operate a rehabilitation center for the benefit and welfare of the mentally ill persons.
  • The rehabilitation center thus established as under sub clause shall providing the following services and facilities:
    • Facilities for games, physical exercise and different entertainment and refreshments,
    • Provision for purchase of different mediums of information and media of daily need,
    • Appropriate treatment by doctors qualified in related subject or trained health workers.
    • Medical supply and regular treatment services,
    • Other facilities and activities as published and prescribed from time to time in the gazette paper by the Government of Nepal.
• The operation of the rehabilitation center establishes in accordance to sub clause (1) shall be as prescribed. reserves the right to frame rules for achievement of the objectives of this act.
   
• Right to frame rules
  • The Government of Nepal reserves the right to frame rules for achievement of the objectives of this act.
• Repeal and Saving
  • The ordinance of National Psychiatrist Center Development Committee (organization) 2059 and the rules and regulations under the same is hereby dissolved.
  • National Act, treatment....Number is dissolved.
  • All fixed and moveable property, rights and liabilities, contracts and agreements of the mental hospital development committee organized under the mental hospital developed committee (organization) ordinance 2059 is shifted to Patan.
  • Staff currently working mental hospital development shall be reallocated to the Center organized in accordance to this act.
  • All work and procedures completed in accordance to the mental hospital development committee (organization) ordinance 2059 shall be considered as completed in accordance to this act..