In India, the law tied to psychiatry institutionalisation is strictly governed by the Mental Healthcare Act, 2017. It strictly prohibits the use of chains, cruel/degrading treatment and unauthorised solitary confinement-prioritising patient autonomy and dignity. This framework heavily regulates and categorises psychiatry institutionalisation into 2 different processes, Independent/Voluntary admission and Supported/Involuntary admission.
Involuntary admission vs. Voluntary admission
Any adult who has the mental capacity to make appropriate medical decisions for themselves can apply to admit themselves in a mental health establishment. Informed consent will be there at every step and the individual can legally discharge themselves at any point of the treatment. The criteria for discharging an adult admitted by Involuntary admission is when the patient regains the ability to make decisions and has stopped self-harming or being violent.
The problem with involuntary psychiatry institutionalisation:
In 2025, United for Global Mental Health released data disclosed by participants in a set of interviews and a survey, and it revealed that people with mental health conditions and psychosocial conditions were often institutionalised for reasons extending beyond clinical. These include poverty, lack of a caregiver, community stigma surrounding mental health etc. In some contexts people, particularly those from the LGBTQIA+ community were institutionalised so that they could be subjected to conversion therapy framed as, "therapeutic interventions".
The Care gap: Another perspective
The legal threshold for involuntary admission is unrealistically high has created a huge care gap, because the criteria for involuntary admission is that an individual must be actively suicidal or violent or completely incapable of making appropriate decisions for themselves. This results in people having to witness their loved ones who refused to get institutionalised suffer until they reach the legal threshold, that is, until they are unstable enough to cause themselves or others harm or are incapable of making appropriate decisions for themselves.
Data surrounding involuntary psychiatry admission in India
In India, the percentage of people involuntarily admitted exceed the percentage of the ones voluntarily admitted, and those once institutionalised in a country like India where stigma still surrounds important topics like mental health, many patients become “long-stay residents” often disowned by their own families and looked down onto by society. Research highlights that 12% of the people that were institutionalised continue to reside in psychiatric facilities long after they have medically recovered.
Protection of the right to refuse medication: Why is it a problem?
If a patient is involuntarily admitted in India, the law still protects their right to refuse medication if they're deemed to have temporary capacity. Caregivers and the psychiatrists working in psychiatry institutions in India report frequently coming across cases where the patient is just confined to a hospital bed and saying that the whole purpose behind institutionalisation is defeated if an individual cannot seek help and is just confined. They cannot leave their bed or do anything for themselves and some psychiatrists describe it as the patients just being held in custody of the institution.
How can the legal framework be made better?
The legal framework tied to psychiatry institutionalisation in India is amazingly progressive, but it is unrealistic and hard to implement in real life. Some suggestions from Indian psychiatrists include:
1)Free legal representation being provided to the involuntarily admitted patients (psychiatrists complain that even though this is included in the law, it's not implemented almost anywhere in India)
2) Medication should not be seen as the only form of treatment, as many patients refuse it (and have the right to refuse too). Psychiatrists suggest using gentler substitutes for treatment, such as community based care and rehabilitation being used in acute crises, when the patient is at extreme risk.
List of mental health resources in India Govt. Mental Health Crisis Helplines – Availability
- Tele-MANAS: 14416 or 1800-891-4416 →24x7, all days
- KIRAN Mental Health Helpline: 1800-599-0019→ 24x7, all days
- NIMHANS Psychosocial Support Helpline: 080-4611 0007→ 24x7, all days
- Emergency Response Support System (ERSS): 112→ 24x7, all days