Published 2025-09-30
Keywords
- Mental Health,
- Clinical Psychology,
- Interventions
Copyright (c) 2025 Jyoti Tripathy, Deepanjali Tripathy (Author)

This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
The Mental Healthcare Act (MHCA), 2017 marked a paradigm shift in India’s mental health landscape by reframing mental illness through the lens of rights, dignity, and person-centered care. While the Act enshrines psychosocial interventions as an essential component of treatment, implementation remains uneven, hindered by workforce shortages, systemic biomedical bias, financial inaccessibility, and weak ethical oversight. This commentary critically examines the interface between MHCA 2017 and psychosocial care, highlighting gaps in service delivery, the persistence of harmful practices such as conversion therapy, and the neglect of adverse outcomes in psychotherapy. It argues that without structural reforms including integration of the National Commission for Allied and Healthcare Professions Act, 2021, expanded insurance coverage, stronger accountability mechanisms, and recognition of allied professionals psychosocial interventions risk remaining marginalized. The article emphasizes the urgent need for rights-based, culturally sensitive, and ethically sound practices to realize the transformative vision of MHCA 2017. Strengthening psychosocial care is not ancillary but central to building a mental health system grounded in equity, recovery, and human dignity.
References
- Barlow DH. Negative effects from psychological treatments: a perspective. Am Psychol. 2010 Jan;65(1):13–20. doi:10.1037/a0015643. PMID: 20063906.
- Beutler LE, Consoli AJ, Lane G. Systematic treatment selection and prescriptive psychotherapy. In: Norcross JC, Goldfried MR, editors. Handbook of psychotherapy integration. 2nd ed. New York: Oxford University Press; 2005. p. 121–43.
- Bystedt S, Rozental A, Andersson G, Boettcher J, Carlbring P. Clinicians’ perspectives on negative effects of psychological treatments. Cogn Behav Ther. 2014;43(4):319–31.
- Council on Minority Mental Health and Health Disparities. Position statement on conversion therapy and LGBTQ+ patients. Washington (DC): American Psychiatric Association; 2024 May–Jun.
- Crawford MJ, Thana L, Farquharson L, Palmer L, Hancock E, Bassett P, et al. Patient experience of negative effects of psychological treatment: results of a national survey. Br J Psychiatry. 2016 Mar;208(3):260–5. doi:10.1192/bjp.bp.114.162628. PMID: 26932486.
- Epstein RS, Simon RI. The exploitation index: an early warning indicator of boundary violations in psychotherapy. Bull Menninger Clin. 1990 Fall;54(4):450–65. PMID: 2268752.
- Government of India. Mental Healthcare Act, 2017. New Delhi: Ministry of Law and Justice; 2017.
- Government of India. The National Commission for Allied and Healthcare Professions Act, 2021. New Delhi: Ministry of Law and Justice; 2021. Gazette No. 14 of 2021.
- Gururaj G, Varghese M, Benegal V, Rao GN, Pathak K, Singh LK, et al. National Mental Health Survey of India, 2015-16: prevalence, patterns and outcomes. Bengaluru: National Institute of Mental Health and Neuro Sciences; 2016. (NIMHANS Publication No. 129).
- Hoffman L. Boundaries and boundary violations in psychoanalysis. 2nd ed. Am J Psychiatry [Internet]. 2016 Aug 1 [cited 2025 Aug 4];173(8):841–2. Available from: https://doi.org/10.1176/appi.ajp.2016.16040417
- Lilienfeld SO. Psychological treatments that cause harm. Perspect Psychol Sci. 2007 Mar;2(1):53–70. doi:10.1111/j.1745-6916.2007.00029.x. PMID: 26151919.
- Linden M. How to define, find and classify side effects in psychotherapy: from unwanted events to adverse treatment reactions. Clin Psychol Psychother. 2013 Jul–Aug;20(4):286–96. doi:10.1002/cpp.1765. PMID: 22253218.
- Mahdanian AA, Laporta M, Bold ND, Funk M, Puras D. Human rights in mental healthcare: a review of current global situation. Int Rev Psychiatry. 2023 Feb-Mar;35(2):150–62. doi:10.1080/09540261.2022.2027348. PMID: 37105153.
- Maulik PK, Kallakuri S, Devarapalli S, Vadlamani VK, Jha V, Patel A. Increasing use of mental health services in remote areas using mobile technology: a pre-post evaluation of the SMART Mental Health project in rural India. J Glob Health. 2017 Jun;7(1):010408.
- Patel V, Saxena S, Lund C, Thornicroft G, Baingana F, Bolton P, et al. The Lancet Commission on global mental health and sustainable development. Lancet. 2018 Oct 27;392(10157):1553–98.
- Rozental A, Kottorp A, Boettcher J, Andersson G, Carlbring P. Negative effects of psychological treatments: an exploratory factor analysis of the Negative Effects Questionnaire for monitoring and reporting adverse and unwanted events. PLoS One. 2016 Jun 3;11(6):e0157503. doi:10.1371/journal.pone.0157503.
- Treuer T. Ethics in psychotherapy and counseling: a practical guide. 3rd ed. Prim Care Companion J Clin Psychiatry. 2008;10(1):79. PMCID: PMC2249822.
- United Nations Human Rights Council. Practices of so-called "conversion therapy". A/HRC/44/53. Geneva: UNHRC; 2020.
- Wampold BE. The great psychotherapy debate: Models, methods, and findings. Mahwah (NJ): Routledge; 2001.