Introduction

The Mental Health Act repeals the Mental Treatment Act Cap 249 and provides for;

1. Establishment of the Uganda Mental Health Advisory Board and to provides for its composition, tenure and functions,
2. Mental health treatment at primary health centres,
3. Emergency admission and treatment, involuntary admission and treatment and for voluntary and assisted admission and treatment,
4. Referral for examination and examination in mental health units,
5. The admission and treatment of persons with mental illness who are not ordinarily resident in Uganda,
6. The requirement to consent to treatment,
7. The protection of the rights of patients,
8. The right to appoint personal representatives and for orders for custody, management and guardianship, and,
9. Mental health treatment for prisoners and other offenders.

Highlights of the Act

1. The Act provides for the establishment of the Uganda Mental Health Advisory Board. The purpose of establishing the Board is to monitor the implementation of the Act under the general supervision of the Minister of Health.
2. The Act provides for the treatment and admission of persons with mental illness. The Act provides that a person shall not be provided with care and treatment or be admitted at a health unit or a mental health unit except in accordance with part three of the Act. Part 3 provides for treatment of persons with mental illness at Health Centers, the requirement for consent before treatment, provides for the voluntary admission of patients and exceptions thereto.
3. Emergency admission and treatment. The Act provides for emergency admission and treatment of persons with mental illness and circumstances under which they may be admitted. Under the Act, a person qualifies for emergency admission and treatment where that person has a mental illness and as a result of which he or she is likely to inflict serious harm on himself or herself or on another person; or has behaviour which may lead to a serious financial loss to himself or herself; lasting or irreparable harm to an important personal relationship held with another person as a result of damage to the reputation of the person; serious damage to the reputation of the person; or damage to property.
4. The Act provides for involuntary examination, assessment and admissions of persons with mental illness into a hospital and circumstances under such an admission may be effected. Involuntary admission may be carried out on written request by a person who is mentally ill, the husband or wife, or by a relative.
5. The Act provides for the powers of police in effecting a voluntary or emergency admission of a person with mental illness. A police officer may enter any premises without a warrant, where the health and safety of a person who is suspected of having mental illness and of a person who has contact with a person suspected to have a mental illness may be in danger if admission is not affected immediately.
6. Admission of patients not ordinarily resident in Uganda. Under section 38, a person who is not ordinarily resident in Uganda, who requires admission and treatment for mental illness while in Uganda, shall, before being admitted or receiving treatment, produce medical reports concerning the treatment issued by the medical authorities of the country of origin of that person. The exception to this provision is in cases of emergency or involuntary treatment.
7. Consent to mental treatment. Section 42 of the Act provides for the requirement for consent before treating a person who is voluntarily admitted to a mental health institution. The section also provides for the parameters of the nature of the consent and information that is supposed to be given to the patients. Section 43- 45 provides for the procedure under which a patient can consent.
8. The Act regulates the provision of special treatment options. Special treatment options catered for under the Act are electroconvulsive therapy, the seclusion of patients and, mechanical, bodily restraint and bodily restraint.
9. The Act provides for the protection of persons with mental illness. The Act spells out the different rights of persons with mental illness and reemphasizes their protection and observance.
10. The Act provides for the right of a person with mental illness to manage their affairs, conditions under which their capacity to manage their affairs may be revoked and their right to appoint a personal representative.
11. The Act provides for the mental treatment of suspects and prisoners. The Act provides a detailed framework for treating persons with mental illness who are in the custody of police or in prison and children with mental illness who are admitted in a remand home.

Key Issues

1. The Act is a progressive legislation towards mental health and the provision of mental healthcare. It repeals the colonial and outmoded Mental Treatment Act, which was wholly derogatory and took a punitive approach towards people with mental illness.
2. The language used in the Act is progressive and sensitive towards the subjects of the Act, who are persons with mental illness.
3. The Act addresses the lacunar that existed in the old law. The old did not provide for voluntary treatment and consent, did not provide adequate protection to persons with mental illness who were involuntarily admitted in mental institutions and wholly stigmatized persons with mental illness.
4. The old law lacked a mechanism for persons with mental illness to contest involuntary treatment. This Act addresses this by providing for the right of a person who is under involuntary admission or treatment to appeal against such.
5. The Act creates the Mental health advisory board, which was nonexistent. The Board comprises persons from different sectors, thus ensuring that persons with mental illness are adequately protected and catered for.
6. The Act provides for the protection of the rights of persons with mental illness, which is in line with international instruments. The old Act wholly neglected the rights of persons with mental illness and contributed to their being disregarded and undermined.
7. The Act regulates the use of special treatment options. This was not provided in the old legislation, and patients were usually left at the mercy of medical practitioners who would implement any treatment plan for whatever reason.
8. The Act provides for the recognition of persons with mental illness before the law, provides for the protection of their property and interests and puts in place safeguards in cases where they cannot make such decisions.
9. The Act provides for the provision of mental health care at health centres which was not the case before. The provision of mental health care was originally limited to specific mental health institutions, which made mental health care services inaccessible to many people due to accessibility or due to stigma that comes with one checking into a mental health institution.

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