The National Mental Health Survey 2015-16 (NIMHANS) found that 15 crore Indians need active mental healthcare, but the treatment gap was 70-92% depending on diagnosis. The NMHS 2.0 (2024 release) shows the gap narrowed to ~57% nationally, largely on the back of Tele-MANAS (90 lakh calls handled by April 2026) and the post-MHCA 2017 expansion of state authorities. The Act is a citizen-rights law — using it requires knowing the buttons.

The Mental Healthcare Act 2017 (Act 10 of 2017, in force 29 May 2018) replaces the old paternalistic Mental Health Act 1987. It is a rights-based statute, drawn up to comply with the UN Convention on the Rights of Persons with Disabilities (which India ratified in 2007). The headline rights are:

• §18 — Right to access mental healthcare: every person has the right to mental healthcare from public-funded or partly-funded establishments. Government must ensure availability, including in rural areas. Free care for BPL persons.
• §5 — Advance directive: any person not currently mentally ill can write an advance directive specifying how they wish to be treated (and not to be treated) for a future mental illness, and who is their nominated representative.
• §14 — Nominated representative: every person can appoint someone (over 18, mentally capable) to take decisions during their incapacity. If none is appointed, family members in a defined order qualify; for unaccompanied/homeless people, a Mental Health Review Board appointee acts.
• §19 — Right to community living: no one shall be detained in a mental health establishment longer than necessary.
• §20 — Right to protection from cruel, inhuman or degrading treatment: including no electroconvulsive therapy without anaesthesia, no ECT for minors except in extreme cases with Board approval, no chaining, no forced sterilisation.
• §21(4) — Insurance parity: every insurer “shall make provision for medical insurance for treatment of mental illness on the same basis as is available for treatment of physical illness”. The IRDAI gave effect via circular 16-Aug-2018 and again 18-Oct-2022. Failure to comply is a regulatory violation.
• §22 — Right to information: patients have the right to know the diagnosis, the proposed treatment plan, side-effects, alternatives and the right to a second opinion.
• §23 — Right to confidentiality.
• §89 / §94 — Independent vs supported admission: voluntary admission is the norm; involuntary admission is only for “high risk” situations and is time-bound.
• §115 — Decriminalisation of suicide: a person who attempts suicide shall be presumed to be suffering severe stress, shall not be prosecuted under §309 IPC, and government must rehabilitate.

The complaint mechanism is the Mental Health Review Board (MHRB) — a quasi-judicial body in every district that hears complaints about violations.

• Every state and UT has a State Mental Health Authority under §45 of MHCA.
• Find: search “[your state] Mental Health Authority” — most have a website (e.g., Karnataka: kmha.karnataka.gov.in; Telangana: smhats.telangana.gov.in).
• The SMHA registers all mental-health establishments, registers advance directives, and maintains professional rolls.
• The District MHRB (one per district, usually shared between 2-3 small districts) hears complaints.
• Or call Tele-MANAS 14416 (Ministry of Health 24×7 free) and ask for your district's SMHA contact.

This is the most empowering step under MHCA. It costs nothing.

• Download Form A (Advance Directive) from your SMHA website. The standard template is also at https://nhm.gov.in/MentalHealthcare/Advance_Directive_Form.pdf
• Fill in:
  • Your name, age, address, signature, photo.
  • The way you wish to be cared for (preferred medications, preferred hospital, preferred therapist, language preferences, religious/cultural needs).
  • The way you do NOT wish to be cared for (medications you've reacted to, ECT yes/no, restraint preferences, hospitals to avoid).
  • Your nominated representative — name, relationship, mobile, address, signature, ID proof.
• Get it witnessed by two adults (any two — friends, neighbours, colleagues; they certify you signed in their presence and were of sound mind).
• Notarise for ₹100-300 (optional but evidentially helpful).
• Submit one signed copy to your SMHA — by post, by email (where accepted) or in person.
• SMHA registers it within 30 days (statutory) and issues a registration number.
• Keep copies: with you, with your nominated representative, in a safe email folder. Show the registration number to any treating psychiatrist at first contact.

You can revoke or amend the directive any time by writing to the SMHA with revised Form A.

• Talk to the person you want as your representative before you write them in. Make sure they understand:
  • They will be contacted if you are admitted involuntarily.
  • They have the right to attend any review hearing of your case before the MHRB.
  • They can demand a copy of your treatment plan and second opinion.
  • They can object to treatment that violates your advance directive.
• Give them a copy of the Act's relevant sections (§14, §15, §20-23) for reference.

• Tele-MANAS 14416 (24×7 free, 20 languages) — for first-line counselling, crisis support, referral to nearest psychiatrist.
• District Mental Health Programme (DMHP) clinic at your district hospital — free OPD by a psychiatrist + clinical psychologist + psychiatric social worker + psychiatric nurse, usually 1-2 days a week.
• Government medical college psychiatry OPD — free.
• NIMHANS Bangalore (national centre): tele-OPD and second-opinion clinic.
• iCall helpline — 9152987821 (TISS, free counselling).
• Vandrevala Foundation — 1860-2662-345 (24×7 free).
• Aasra — 9820466726 (24×7 suicide prevention).

If a private hospital refuses you admission citing “no beds for psych” while general beds are open, that is a §21 violation — file an MHRB complaint.

• When buying any health insurance policy after 8 August 2018, check that mental illness is not excluded and that there is no waiting period longer than physical illness.
• If your existing policy still has a “psychiatric exclusion” clause, write to the insurer citing §21(4) MHCA + IRDAI HEALTH/REG/RP-MHC/2018 + IRDAI circular 18-Oct-2022. The insurer must add the cover (no fresh underwriting required if you are already a policyholder).
• If insurer refuses or imposes a higher premium loading specifically for mental illness, file a complaint:
  • Internal grievance with insurer (15-day SLA).
  • IRDAI Grievance: https://igms.irda.gov.in or Bima Bharosa portal.
  • Insurance Ombudsman in your zone (free, binding up to ₹50 lakh claim).

The MHRB is your statutory grievance forum for any MHCA violation:

• Wrong / forced admission, denial of advance directive, denial of nominated representative's right, restraint without record, ECT without proper consent, denied right to information, denied right to confidentiality.
• Complaint by the patient, the nominated representative, family member, or any registered mental-health professional.
• Form: each state SMHA publishes the MHRB complaint form; usually a one-page document.
• Submit by post, by email or in person.
• MHRB shall hear within 7 days of an urgent matter (admission/discharge dispute) and within 30 days otherwise.
• Orders are quasi-judicial — appealable to the High Court within 30 days.

• §115(1) explicitly states: “Notwithstanding anything contained in §309 IPC, any person who attempts to commit suicide shall be presumed, unless proved otherwise, to have severe stress and shall not be tried and punished”.
• If a hospital files an FIR under §309 (still happens occasionally despite the 2017 Act) — invoke §115 in writing to the SHO and the Magistrate; copy to the SMHA and the State Human Rights Commission.
• Government has a duty under §115(2) to provide care, treatment and rehabilitation to reduce risk of recurrence.

If you are ever admitted under §89 (high-risk involuntary admission), the law guarantees:

• Maximum 30 days for first-time admission; further extension only after MHRB review.
• Two independent psychiatrists must certify the necessity.
• Nominated representative must be informed within 24 hours and consents on your behalf.
• MHRB review of your admission within 7 days for under-18s and within 21 days otherwise.
• Right to a second opinion from a psychiatrist of your (or your representative's) choice — at the establishment's cost in government hospitals.

+-----------------------------------+--------------------------------------+
| Advance directive registration    | FREE at SMHA. Notary optional ₹100-  |
| (Form A) with State Mental Health | 300. Witnessed by 2 adults. Valid    |
| Authority                         | until you revoke.                    |
+-----------------------------------+--------------------------------------+
| Mental healthcare at govt /       | FREE for BPL; subsidised for others. |
| DMHP / govt medical college       | OPD + IPD + medication free.         |
+-----------------------------------+--------------------------------------+
| Tele-MANAS 14416                  | FREE 24x7, 20 languages.             |
+-----------------------------------+--------------------------------------+
| Insurance parity (§21(4))         | Mandatory — same terms as physical   |
|                                   | illness. No higher waiting period.   |
+-----------------------------------+--------------------------------------+
| MHRB complaint                    | FREE. Heard within 7 days (urgent)/  |
|                                   | 30 days (other).                     |
+-----------------------------------+--------------------------------------+
| §115 protection after suicide     | FREE. Police cannot prosecute u/§309 |
| attempt                           | IPC. Government must rehabilitate.   |
+-----------------------------------+--------------------------------------+
| §80DDB tax deduction for mental   | ₹40,000 (₹1 lakh for senior          |
| illness treatment of self/family  | citizens) per year — flat deduction. |
| dependent (specified diseases)    |                                      |
+-----------------------------------+--------------------------------------+
| RTI to SMHA / IRDAI / MHRB        | ₹10 by IPO. BPL = free.              |
+-----------------------------------+--------------------------------------+

• Hospital says “we don't follow advance directives”. Illegal under §11. They must — non-compliance is a complaint to MHRB. Carry the registration number; the SMHA can verify on the phone.
• Insurer adds a “mental illness waiting period” of 4 years while physical illness is 30 days. Direct violation of §21(4) + IRDAI 2018 circular. Internal grievance → IRDAI → Ombudsman.
• Police file FIR u/§309 for a suicide attempt. §115 of MHCA reads it down — write to the SHO citing §115; copy to the Magistrate and the State Human Rights Commission. The case will not stand at the Magistrate.
• Family rejects your nominated representative. §14(2) gives the patient's choice priority over default family order. The MHRB will uphold your appointee.
• Private hospital refuses to disclose your file to your nominated representative. §22 + §23 require disclosure to NR with patient consent. MHRB complaint.
• DMHP clinic in your district has a vacant psychiatrist post for months. Common in rural districts. RTI to SMHA for the vacancy date and recruitment status; copy DM and Health Secretary.
• You want ECT for relief but parents refuse. ECT requires informed consent of patient if capable + nominated representative + MHRB approval if patient lacks capacity. Capacity is a clinical determination.
• Tele-MANAS connection drops repeatedly. Try the IVR option for “callback” — they call you back within 30 minutes. Persistent issues: email telemanas@nimhans.ac.in.

• Every notified mental-health establishment must have a designated MHCA nodal officer.
• Best for: bedside disputes, treatment plan disagreements, request for second opinion.

• 24×7 free; 51 cells across 20 states/UTs.
• Best for: immediate counselling, crisis support, referral within the public system.

• Find via the state Health & Family Welfare Department.
• Best for: advance directive registration, registry of professionals + establishments, regulatory complaints.

• District-level quasi-judicial body under §73.
• Best for: any rights violation under MHCA — admissions, ECT, advance directive, NR rights, confidentiality, second-opinion denial.
• Free; orders binding.

• National regulator under §33 MHCA.
• Address: Ministry of Health & Family Welfare, Nirman Bhawan, New Delhi.
• Best for: cross-state issues, regulatory failure of an SMHA, policy disputes.

• For insurance parity violations.
• IRDAI Bima Bharosa: https://bimabharosa.irdai.gov.in
• Insurance Ombudsman (free, 17 zonal offices, decisions binding up to ₹50 lakh): https://www.cioins.co.in

The SMHA, every MHRB, the CMHA, every government mental-health establishment, the District Mental Health Programme office, the Ministry of Health (MoHFW), IRDAI, and notified private establishments receiving any government grant are public authorities under §2(h) of the RTI Act 2005.

RTI helps here when:

• Your advance directive is registered but the SMHA hasn't issued a registration number after 30 days — RTI to PIO SMHA for the status of your application.
• You want statistics on MHRB hearings in your district (pendency, average disposal time) for advocacy or to push your own pending complaint — RTI to PIO MHRB.
• Your insurer's “psychiatric exclusion” is being defended despite IRDAI 2018 circular — RTI to PIO IRDAI for the insurer's compliance certificate filing.
• DMHP psychiatrist post in your district has been vacant for months — RTI to PIO of the State Health Department for the recruitment timeline + interim arrangements.
• A private mental-health establishment is operating without registration — RTI to PIO SMHA for the registry of notified establishments and inspection reports.
• You want the MHRB order in your case in writing — RTI to PIO MHRB.

See: RTI in 12 simple steps.

RTI does NOT help here when:

• You disagree with your clinical diagnosis — that is a clinical decision; second opinion / MHRB is the route.
• You want to force admission of a relative against their will. Involuntary admission has tight statutory triggers and only a treating team + MHRB can authorise; RTI cannot.
• For another patient's records or treatment — protected confidential information under §8(1)(j) RTI + §23 MHCA.
• For the personal medical opinion of a government psychiatrist on a hypothetical case — RTI is for “information held”, not for new opinions.
• For an insurance claim payout — that is a contractual matter, route via Ombudsman not RTI.

Q. I'm not currently mentally ill. Should I still write an advance directive?
Yes — that is precisely the point. The directive is meant to be written when you have full capacity, so that future-you is protected if a crisis comes. Many people in high-stress jobs, pregnant women (for postpartum), and those with family history of mental illness write one preventively.

Q. My family doesn't agree with my advance directive. Does it still bind?
Yes. Under §11 the advance directive prevails over family preference except where a Mental Health Review Board orders modification on a specific clinical ground after hearing both sides.

Q. Can I include “no electroconvulsive therapy” in my directive?
Yes. ECT is one of the most commonly directed-against treatments. Note that emergency ECT (to save life in catatonia) may still be administered with MHRB review — but elective ECT will respect your refusal.

Q. Does §80DDB tax deduction cover mental illness?
Yes — for “specified diseases” under Rule 11DD, which includes chronic / severe mental illness as certified by a neurologist / psychiatrist. Deduction up to ₹40,000 (₹1 lakh for senior citizens) per year, against actual expenditure, with a Form 10-I from the specialist.

Q. I'm a student under 18 with depression — what care can I claim?
DMHP child & adolescent OPD; school counsellor (mandatory in CBSE schools per 2022 NEP guidelines); Tele-MANAS has a dedicated youth line. Insurance is via your parents' family floater — §21(4) parity applies.

Q. Will mental health treatment show on my employment record?
No employer can ask for mental health history at recruitment (§21 prohibits discrimination). For roles where psychological fitness is statutorily required (Armed Forces, Pilots), separate frameworks apply, but routine private-sector employment cannot demand disclosure.

Q. The MHRB hasn't been constituted in my district. What now?
A nearby district's MHRB has jurisdiction until yours is constituted (SMHA notifies). RTI to SMHA for the constitution status + the substituting MHRB. Complaint to CMHA / High Court writ if delay is gross.

• RTI in 12 simple steps — for first-time filers
• All Indian government helplines — one master directory
• Niramaya disability insurance — apply guide
• Claim disability employment reservation under RPwD
• RTI template for delayed UDID / disability certificate
• Apply for a child's disability certificate — 2026 guide
• Voluntary blood donor registration — 2026 guide
• How to pledge organs — NOTTO 2026 guide

Last reviewed: 26 April 2026 by RTI Wiki editorial team. MHCA rules and IRDAI circulars are revised periodically; verify current rules with your State Mental Health Authority or write to admin@bighelpers.in if you spot a stale figure.