India’s evolving conversation on disability and mental health law reflects both constitutional promise and structural neglect. Over the past two decades, two major statutes — the Mental Healthcare Act (MHA), 2017 and the Rights of Persons with Disabilities (RPwD) Act, 2016 — have sought to move policy from charity to rights, from institutional care to community inclusion. Yet, in practice, the gaps between legislative intent and stakeholder experience remain wide. A close review of these frameworks, informed by fieldwork at a centre that provides long-term care for adults with intellectual and mental disabilities, highlights both progress and persistent shortcomings in India’s approach to persons living with disability and mental illness.
Shifting legal landscape
The Mental Health Act of 1987, itself a replacement for the colonial Lunacy Act of 1912, was drafted in a custodial era when people with mental illness were seen primarily as a risk to be contained. The MHA, 2017 replaced this framework after India’s ratification of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), 2006. It reimagined the person with mental illness as a rights-bearing citizen entitled to dignity, informed consent, and state-supported care. The Act created Mental Health Review Boards, guaranteed access to mental health services, and sought to eliminate coercion in treatment.
The RPwD Act, 2016, which broadened India’s earlier 1995 statute, recognised 21 categories of disability, from physical and sensory to intellectual and psychosocial. It enshrined affirmative action in education and employment, emphasised accessibility in public infrastructure, and recognised the legal capacity of persons with disabilities to make decisions for themselves, replacing substitute decision-making with supported decision-making.
Both Acts embody the spirit of the UNCRPD: autonomy, inclusion, and non-discrimination. Yet, together they reveal the central paradox of Indian disability law — two parallel statutes that rarely intersect where they are most needed.
The grey zone
The most vulnerable citizens fall in the legal and practical gap between these Acts: those living with both intellectual and psychiatric disabilities, or those whose cognitive challenges undermine their capacity for self-care and decision-making.
The MHA, 2017 provides for temporary incapacity — someone who, in a period of illness, cannot make or communicate decisions. The RPwD Act, 2016 does not explicitly address permanent or developmental absence of capacity, such as in intellectual disability or autism spectrum disorder. Nor does it clarify how guardianship, property management, and supported decision-making should operate when autonomy is structurally limited.
The result is a policy blind spot. Families, caregivers, and institutions that support individuals with both mental illness and intellectual disability often navigate overlapping bureaucracies with little legal clarity. In interviews with professionals — including psychiatrist Dr. K.V. Kishore Kumar (The Banyan), activist Dr. T.M.N. Deepak (December 3 Movement), advocate R. Prabhakaran (Lincoln Law Associates), and psychologist R. Giridhar (Director, Swami Dayananda Krupa Care) — a common concern emerged: the law is rights-rich but operationally poor. While autonomy is rightly celebrated, there remains no realistic guidance for those permanently incapable of autonomous decision-making.
Myth of inclusion
Both the MHA, 2017 and the RPwD Act, 2016 endorse community-based rehabilitation. Yet the infrastructure for such rehabilitation is rudimentary. For many families, institutional care remains the only viable option, not out of neglect but necessity.
At Swami Dayananda Krupa Care, a purpose-built facility housing over 40 adult men with intellectual disabilities, staff provide lifelong residential care. The residents’ needs range from help with self-care to behavioural management. Families visit when possible; some residents have lived there for decades. For them, the institution is home.
Experts caution against romanticising deinstitutionalisation. Dr. Kishore observes that India “is not yet ready” for large-scale community care without adequate state funding, professional support, and local acceptance. Activists like Dr. Deepak counter that inclusion must begin with attitude change — access, empathy, and the dismantling of stigma. The truth lies somewhere in between: institutional care will probably remain necessary for a subset of individuals, but it must be humane, accountable, and rights-respecting.
Learning from Europe
A comparison with European and particularly Swedish law offers useful perspective. The Social Services Act (SFS 2001:453) in Sweden enshrines autonomy, least-restrictive care, and state responsibility. Institutionalisation is permitted only when all community alternatives fail, and decisions must consider the individual’s best interests. The Swedish system integrates social welfare, legal guardianship, and disability support under one coherent rights framework — something India’s fragmented legislation has yet to achieve.
The European Union, though lacking a single mental-health directive, operates within the Charter of Fundamental Rights and the UNCRPD, ensuring that dignity, privacy, and inclusion are non-negotiable. In contrast, India’s laws remain aspirational: progressive on paper, but poorly funded and unevenly implemented across states.
Guardianship, capacity, and the law
Perhaps the most complex area is guardianship. The Guardians and Wards Act of 1890, still in force, predates modern concepts of autonomy and rights. While courts can appoint limited guardians, the process is slow and inconsistently applied. Families express anxiety about “what happens after us” — a question unanswered by either modern statute. The absence of streamlined procedures for appointing, reviewing, or transferring guardianship leaves thousands of families in limbo.
Mr. Prabhakaran points to a deeper flaw: disability law in India sits within the Directive Principles of State Policy, not the justiciable Fundamental Rights chapter of the Constitution. As such, enforcement relies on the goodwill of governments, not the authority of courts.
From law to lived reality
Field observations and expert testimonies gleaned during my vacation internship reveal three urgent challenges:
Community infrastructure deficit: without supported housing, vocational training, and inclusive workplaces, the vision of community living collapses into rhetoric.
Monitoring and accountability: The absence of oversight mechanisms breeds neglect and potential abuse in institutions.
Public awareness and legal literacy: even families and professionals often lack clarity about rights, procedures, and entitlements.
Bridging these gaps requires not new laws but integration, implementation, and information. Laws must speak to each other, not past each other.
New legislation
In 2024, India’s disability rights landscape underwent a critical shift from policy neglect to judicial enforcement. In Rajive Raturi v Union of India, the Supreme Court ruled that accessibility standards are mandatory, non-negotiable mandates rather than mere “recommendations”, striking down rules that allowed for self-regulation. Simultaneously, the Seema Girija Lal case addressed “dismal” implementation, setting strict deadlines for States to appoint commissioners and establish special courts. While the NHRC exposed “inhuman” conditions in mental health institutions, affirming these rights as fundamental under Articles 14 and 21 of the Constitution, the community faced a new setback following the Puja Khedkar “fake certificate” scandal. This controversy triggered a bureaucratic crackdown that has slowed the certification process for genuine applicants. Collectively, these developments transform disability protections into enforceable human rights while highlighting the persistent administrative barriers that hinder actual progress.
Moving from just symbolism
India’s disability and mental health laws mark an ethical evolution — from protectionism to empowerment. Yet empowerment without structure risks becoming symbolism. The challenge now is to operationalise dignity: to create legal, administrative, and community systems that uphold the rights of those who cannot speak for themselves. True inclusion lies not only in writing progressive laws but in ensuring they reach the most invisible citizens among us — the ones who live between Acts, between capacities, and often, between hope and neglect.
Yajur Krishnamoorthy is a third-year BBA LL.B. (Hons) student at Jindal Global Law School, Sonipat. Views expressed are personal
