Citing over 1 lakh patients in Bihar, Patna High Court demands strict compliance with 2017 Mental Healthcare Act

Rising numbers, a concern

• A counter affidavit filed by the additional director, health services, health department, before the Patna High Court on behalf of secretary stated that under the mental health program, during the last three financial years (2022-23, 2023-24, 2024-25), counselling treatment has been provided to more than 99,000 individuals suffering from mental health problems.
• In the year 2022- 23, 14503 patients attended the new OPD of 25 district hospitals while 13612 patients attended follow-up OPD of 25 district hospitals.
• Total 15655 patients attended the new OPD of 25 district hospitals while 14449 patients attended follow-up OPD of 25 district hospitals in the year 2023- 24.

• In the year 2024- 25, 20677 patients attended the new OPD of 25 district hospitals while 20219 patients attended follow-up OPD of 25 district hospitals.
• Further, in the current financial year 2025-26, up to December 2025, a total of 23,494 persons suffering from mental health issues have received counseling treatment across 25 district hospitals of the state.
• Since November 2022, a total of 36,381 individuals suffering from mental health issues have received counselling through Tele-MANAS (Tele Mental Health Assistance and Networking Across States) calls in the state of Bihar.
• Under Tele-Manas program in Bihar, 3 Tele-Manas cells namely (1) IGIMS, Patna, (2)BIMHAS Koilwar and (3) JLNMCH Bhagalpur and one mentoring institute IGIMS Patna have been established.

Next hearing on April 20

• The matter has been listed for further hearing on April 20 before the Patna High Court with directions for senior officials including the state health secretary, DGP, and prison authorities to remain present.
• Advocate General P K Shahi and Additional Solicitor General Dr K N Singh appeared in the matter in the Patna High Court.
• The Amicus Curiae- advocates Raju Patel and Anukriti Jaipuriyar have filed their reports according to the order dated February 18.

• They visited the Bihar State Institute of Mental Health and Allied Sciences (BIMHAS) and accordingly they have given their suggestions in their reports in which they have outlined the duties of BIMHAS as a mental health institution.

Court pushes for rehabilitation, not just treatment

• A key concern flagged by the Patna High Court was the lack of clarity on rehabilitation measures for patients discharged after treatment.
• The court asked the state authorities to assess the “feasibility” of the report submitted by Amicus Curiae over gaps in rehabilitation, institutional functioning, and statutory compliance, while issuing a series of directions to improve care for persons with mental illness.

• While the state submitted that cured patients are sent to half-way homes and provided vocational training, the Patna High Court  noted that no details were furnished on the nature or outcome of such training.
• The court stressed that if patients are trained in specific skills, the government must ensure employment opportunities and financial support to help them become self-sufficient and reintegrate into society.
• It also took note that only two half-way homes exist in Bihar, raising concerns about inadequate rehabilitation infrastructure.

Toll-free helpline, police accountability ordered

• The Patna High Court asked the additional director general of police to establish a 24×7 toll-free helpline for reporting persons with mental illness found wandering.
• Ensure prompt police intervention under Section 100 of the Mental Healthcare Act, 2017.

• Launch public awareness campaigns through print, digital, and electronic media.
• The court further directed police authorities to regularly collect and report data on such cases and the steps taken for treatment and rehabilitation.

Concerns over institutional gaps at BIMHAS

• Despite the state’s claims of improved facilities including free food, medicines, and recreational amenities the court noted multiple issues flagged by court-appointed amici curiae after an on-site inspection.
• Key concerns included non-functional de-addiction centers despite completed construction.
• Absence of an ICU, forcing emergency referrals.

• Shortage of specialists, including anaesthetists.
• Unsafe infrastructure, including open manholes and damp wards.
• Traffic and pollution hazards due to nearby sand mining operations.
• Limited capacity of rehabilitation homes, leading to prolonged institutionalisation.
• The court directed authorities to respond on steps taken to address these issues.

Statutory non-compliance under scanner

• The amici reports also flagged broader systemic failures by the State, including irregular functioning of Mental Health Review Boards (MHRBs).
• Delays in constituting a fully functional State Mental Health Authority (SMHA).
• Failure to create adequate community-based rehabilitation facilities.

• Lack of mental health professionals in schools.
• Poor availability of psychiatric medicines at primary healthcare levels
• The court asked the state to examine and respond to these findings, indicating possible structural reforms.

Legal aid, rights protection under focus

• The bench also directed the BSLSA to submit a detailed report on legal aid provided to patients, especially in light of concerns that a specialised “Mano Nyay” legal services clinic had not been established at BIMHAS.
• Additionally, the court emphasised strict compliance with provisions of the Mental Healthcare Act, including protection of patient autonomy and dignity, regulation of involuntary admissions, safeguards against abusive practices and data showing rising mental health burden.

Prison, police systems also under review

The inspector general of prisons sought time to report on compliance with statutory requirements for mental healthcare of inmates, while the court directed verification of procedures for transfer and treatment of prisoners with mental illness.

Push towards systemic reform

• In its concluding observations, the court appreciated the efforts of the amici curiae but made it clear that piecemeal compliance would not suffice.
• The proceedings signal a broader judicial push to ensure that Bihar’s mental healthcare framework moves beyond institutional care to a rights-based, community-oriented model, in line with the Mental Healthcare Act, 2017.