Mannekote Srinagesh, Pillai Ajayan, Harbishettar Vijaykumar
Department of Psychiatry, Northwell University Hospital, Queens, Brooklyn, New York, USA.
Department of Quality Management, Kingsboro Psychiatric Center, Brooklyn, New York, USA.
Indian J Psychiatry. 2019 Apr;61(Suppl 4):S821-S826. doi: 10.4103/psychiatry.IndianJPsychiatry_81_19.
The policies and procedures for the treatment of psychiatric patients are within the boundaries of ethical and legal principles of medical practice, with equal importance to human rights and values. Both in India and the USA, the Mental Health Legislation/Act guides psychiatrists in performing their duty toward the patients within this framework. The objective of this review was to compare the Indian Mental Healthcare Act (MHCA) of 2017 with mental health legislations currently existing in the USA, taking New York State Mental Hygiene Law as an example. The evolution of the American mental health legislation over the years was reviewed, including the aspects of involuntary admissions and segregating the psychiatric patients from the community. Over the years, the assessment and treatment approaches inclined toward patient's "rights and liberty" such as assessment of competency to make decisions, the involvement of family members and mandatory requirement of procedure to be followed during admission, inpatient care, and discharge. The current American mental health system is compared and contrasted with MHCA 2017. In the context of existing American mental health legislation and practical issues, this review tried to anticipate possible shortcomings or difficulties that can occur during the implementation of MHCA 2017. Several differences and similarities exist between the two legislations. Added to this, in America itself, there are smaller variations in mental health legislation in each state, albeit the general principles remain the same. Whether this is going to be the case in India once the individual states form the rules is worth a consideration.
精神科患者的治疗政策和程序符合医疗实践的伦理和法律原则,对人权和价值观同等重视。在印度和美国,《精神卫生立法/法案》都在此框架内指导精神科医生履行对患者的职责。本综述的目的是以纽约州精神卫生法为例,将2017年印度《精神卫生保健法》(MHCA)与美国现行的精神卫生立法进行比较。回顾了多年来美国精神卫生立法的演变,包括非自愿入院以及将精神科患者与社区隔离等方面。多年来,评估和治疗方法倾向于患者的“权利和自由”,例如对决策能力的评估、家庭成员的参与以及入院、住院护理和出院期间必须遵循的程序要求。将当前美国的精神卫生系统与2017年MHCA进行比较和对比。在现有的美国精神卫生立法和实际问题的背景下,本综述试图预测2017年MHCA实施过程中可能出现的缺点或困难。这两项立法之间存在一些差异和相似之处。此外,在美国国内,每个州的精神卫生立法也存在较小差异,尽管总体原则相同。一旦印度各邦制定规则,情况是否会如此值得考虑。