Answer.

The Mental Healthcare Act 2017 is legislation that aims to provide access to mental healthcare services for all, protect the rights of persons with mental illness, and establish a legal framework for the treatment and care of persons with mental illness.

Here are eight salient features of the Mental Healthcare Act 2017:

1. Right to access mental healthcare services: Every person has the right to access mental healthcare services and treatment.
2. Advance Directive: Individuals can provide directions for their preferred treatment in case of future mental illness.
3. Decriminalization: An attempt at suicide is no longer considered a criminal offense under the Mental Healthcare Act.
4. Mental Health Review Commission: A body is set up to review the functioning of mental health establishments and protect the rights of persons with mental illness.
5. Mental Health Establishments: Registration of mental health establishments to ensure quality and accountability in mental healthcare services.
6. Prohibition of electro-convulsive therapy (ECT) without anesthesia: It cannot be given without the use of muscle relaxants and anesthesia.
7. Establishment of the Central Mental Health Authority: A regulatory body is set up to develop policies and programs for mental health promotion.
8. Punishment for non-compliance: Any person or establishment found to be non-compliant with the provisions of the Act may be punished.

However, there are multiple challenges with the implementation of the act-

1.     Lack of Awareness: Many people are still unaware of their rights under the Mental Healthcare Act.
2.   Limited Resources: Mental healthcare facilities, staff, and resources are inadequate and underfunded. For instance, India has only 0.29 psychiatrists per 100,000 population as per World Health Organization. "Mental Health Atlas 2017.”
3.     Mental illness is still stigmatized in many cultures, with 47% believing it should be kept in isolation. (The Live Love Laugh Foundation. "How India Perceives Mental Health.")
4.     Traditional beliefs and practices may conflict with modern mental healthcare practices.
5.     Inadequate Training: Healthcare professionals may not have adequate training in the diagnosis and treatment of mental illness. For example, a study published in the Indian Journal of Psychological Medicine in 2020 found that only 21% of medical colleges provided adequate training in psychiatry.
6.     Limited Accessibility: Marginalized groups, including women, those living in rural regions, and members of the LGBTQ+ community, may not have access to mental healthcare services. Due to a lack of funding and poor infrastructure, rural populations had limited access to mental healthcare services.
7.     Weak Monitoring and Oversight: The Mental Health Review Commission has not been established in many states, which weakens oversight of mental healthcare facilities. For example, as of 2019, only 18 of India's 29 states had set up the Commission
8.     Resistance to Change: Resistance to change can be a barrier to the implementation of the Act. For instance, mental healthcare professionals may resist changes in treatment approaches or the adoption of modern technology in mental healthcare.

However, despite challenges, the act is crucial in certain respects-

1. Suicide decriminalization: The legalization of suicide under the Act has decreased stigma and widened access to mental healthcare.
2. Advance Directives: The availability of advance directives has given people more autonomy to decide how their mental health will be treated.
3. ECT without anesthetic is prohibited by the Act, which has enhanced patient safety and decreased the risk of injury to patients. For instance, research published in the Indian Journal of Psychiatry in India indicated that the use of ECT without anesthetic significantly decreased after the Act was put into effect.
4. The Central Mental Health Authority has created policies and initiatives to advance mental health in India. For instance, in accordance with the Ministry of Health and Family Welfare, the Authority has started a number of efforts to enhance mental health services and awareness in India.
5. Rights of those with mental illness: The Act has strengthened these individuals' rights and eliminated prejudice.
6.  Community-based mental healthcare: The Act has increased attention on these programs, which are more readily available and less expensive.

Overall the challenges could be overcome by ensuring more awareness regarding mental health issues and mobilizing more resources for strengthening the mental healthcare infrastructure and personnel ecosystem. This would help realize the right to life in India in a substantial sense as the right to mental health is undoubtedly a significant aspect of the overall right to health.