Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1698078785155.pdf (Seychelles)
[8th April 2019] Supplement to Official Gazette i MENTAL HEALTH CARE BILL, 2019 (Bill No.

6 of2019) OBJECTS AND REASONS This .Bill seeks to enact a n~w Mental Health Care Act in order to comply with the UN Convention on Rights of Persons with Disabilities.

The Bill seeks to provide mental health care and services for persons with mental illness and' to protect, promote and fulfill·the rights of such persons during delivery of mental health care and for matters connected therewith.

or incidental thereto.


The.Bill is divided into ten parts .

• Part I provides for preliminary matters such as short title, commencement date and interpretation.

Part II provides for determination of mental illness and capacity of persons with mental illness to make mental health care and treatment decisions.

Part ill provides for advance directive and nominated representatives and the duties of nominated representatives.
Part IV provides for rights of persons with mental illness which includes the respect' of the dignity and privacy of persons with mental illness, the right to information and the prohibition against discrimination, exploitation and abuse of such persons.

Part V provides for the care and treatment of persons with mental illness.

This It iµso makes· includes facilitat~d admissions and voluntary admissions.
provisions for the treatment of persons with mental illness found wandering , the streets, emergency treatments and for instances that necessitates 'seclusions and restraints.

This part also'provides for absence without leave of persons admitted as facilitated admission ~d for the treatment of prisoners with mental illness.

Part VI provides for the establishment of a Mental Health Care Board, the functions of the Board, membership of the Board, procedures and duration of term of appointed members.

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· ii Supplement to Official Gazette [8th April 2019] [8th.April 2019) Supplement to Official Gazette iii Part VII provides for the establishment of the mental health care tribunal, its compositim1, terms and conditions of members, the.

powers, appeals procedures and proceedings before the tribunal and other administrative matters.

Part VIII Provides for offences and penalties.

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SECTIONS MENTAi:.


HEALTH CARE BlliL, 2019 (Bill 6 of 2019) ARRANGEMENJ OF SECTIONS PartllX provides for miscellaneous matters such as regulation making powers, savings and transitional and repeals of the MentalHealthAct 2006.

Dated this 4th day of March, 2019.

FRANK D.R.

ALLY ATTORNEY-GENERAL PART I - PRELIMINARY 1.

2.

Short title and commencement Interpretation PART II - MENTAL ILLNESS AND CAPACITT TO MAKE MENTAL HEALTIJ CARE AND TREATMENT DijCISIONS . '

3.

4.
3.

4.

Determination of mental illness Capacity to make mentalhealth care 1µ1d treatment decisions PART m -ADVANCE DIRECTIVE AND NOMINATED REP].IBSENTATIVE Advancedirective Reviewing, altering, modifying or cancelling the advance directive Access to the advance directive 5.

6.

Maintenance of online register 7.

• Advance directive not to apply to emergency treatment 8.

9.

10.

Advance directive for minor 11.

Liability of mental health professional in relation to advance directive 12.
Appointment of nominated representative i 3.

Nominated representative for minor 14.

Dutyofnominatedrepresentative .PART IV - RIGHTS OF PERSONS WITII MENTAL ILLNESS ' • 15.

Rights and duties with respect to persons with mental illness 16.

Respect human dignity and privacy 17.

Respect of right to live in community 18~ Discrimination 19.

20.

Duty to inform of individual rights .


Exploitation and abuse · , iv Supplement to Official Gazette [8th April 2019] [8th April 2019] · Supplement to Official Gazette V .

51.

Offences and penalties PART VIIl - OFFENCES AND PENALTIES PARTIX-MISCELLANEOUS 52.

Regulations 53.

Savings and transitional 54.

Repeal PART V - CARE AND TREATMENrf OF EERSONS Wlffl MENTAL ILLNESS 21.

Admission of persons with mental illness 22.

Voluntary admission 23.

Dischargereports 24.

Facilitated admission 25.


Treatment on facilitated admission an&further steps 26.

Admissionofminors 27.

Person with mental illness at home 28.

Person with mental illness wandering on streets 29.

Emergency treatment 30.

Seclusion and res1r&i.nts ,31.

Rights o{relativ~ and care-givers 32.

Leave to persons admitted as facilitated admission 33.

Absence without leave of pei:sons admitted as facilitated admission 34.

Prisoners with mental illness PART VI - MENTAL HEAE.
'FH CARE BOARD 35.

Establishment of the Mental Health Care Board 36.

Functions of the Board 37.

Membership of the Mental Health Care Board 38.

Secretary to the Mental Health Care Board 39.

Meetings of the Board 40.

Decision by circulation of papers 41.

Members to continue till new members appointed PART VII- MENTAL HEALTH CARE TRIBUNAL 42.

Establishment of the.Mental Health Care Tribunal 43.

MembershipoftheTribunal 44.

Terms and conditions of members 45 .

Jurisdiction 46.

Appeals 47.


Powers of the Tribunal 48.

Proceedings before the Tri_bunal 49.

·Reasons for decisions 50.

Secretary to the Tribunal r • [8th April 2019] Supplement to Official Gazette vii MENTAL HEALTH CARE BD.,L, 2019 (Bill No.
5 of 2019) , ABILL OF AN ACT to provide mental health care and .services for persons with menfal illness and to protect, promote and fulfill the rights of such persons during delivery of mental · health- care and services and for matters connected therewith or incidental thereto.

ENACTED by the President and the National Assembly.

PART I - PRELIMlNARY 1.


This Act may be 9ited as the Mental Health Care Act, 2019 and shall come into operation on such date as the Ministermay, bynoti~e in the Gazette, appoint.

Short title and commencement viii .

Supplement to ciJflcial Gazette [8th April 2019] lnteq,retation 2.
In this Act, unless the context otherwise requires, "advance directive" means an advance directive made by a person under section 5; · "Board" means tge Mental Health Care Board establis~ed under section 35; "care-giver'' means a person who resides with the person with.Jnental ·illness and is responsible for providing care to that person and includes a relative or any other person who performs this function; .
"Consultant~in-oharge" means a specialist psychiatrist or physician appointed to be in charge of one or more mental health facilities; "Director'' means the person for the time being acting in the capacity or performing the functions of the head of the division or section responsible (or children affairs in.

the ministry or department responsible for children affairs; ''mental health care.
or mental health treatment" includes; biologic~l, psychological treatments, social care for mental illness, curative and rehabilitative services1pmyided either in a health or mental heal.th facility or in the community; "mental health fllCility' means a mental health hospital or a part of a hospital or a psycho-geriatric home for mentally ill elderly persons or a clinic or health centre or other place for in-patient or out patient treatment of individuals with mental illness; "Mental Health Professjonal'' means any health professional trained in mental health care or mental health treatn).ent and who are registered with the respective regulatory authority or counc~l; ., [8th April 2019] Supplement to Official Gazette .
ix ''mental illn~ss" means a substantial disorder of thinking, mood, perception, orientation or memory that impairs judgment, behavipur, capacity to recognise reality or ability to meet the ordinary demands of life <including mental conditions associated with alcohol and drugs but does not include intellectual disability fu itself; "Minister'' means the Minister responsible for Health and the term "Ministry'' shall be construed accordingly; "nominated representative" means .
a person nominated or appointedAmder section 12 or 13; and "prescribed" means ,prescribed tiy ,egulation made under the Act; "Tribunal" means ,the Mental Health· Care Tribunal established under section.42; Determination of mental illness PART II - MENTAL ILLNESS AND CAPACITY TO MAKE MENTAL HEALTH CARE AND TREATMENT DECISIONS 3.
(1) Mental -illness shall ,be diagnosed in accordance with such ~ationally or internationally accepted medical standards incluaing the latest edition of the 1htemational Classification of Diseases of1he World Health.Organisation or as maybe prescribed.
(2) Mental illness of a person shall not be diagnosed !Jr I determined on the basis of - (a) political, economical, social status or membership of a cultural, racial or religious group, or for any other reason not directly relevant to mental health status of the person; or .. X Supplement to Official Gazette [8th April 2019] [8th April 2019] Supplement to Official Gazette xi (b) nonconformity with moral, social, cultural, work or political values or.

religious beliefs prevailing in a person's community.
(3) Past treatment or hospitalisation in a mental health facility though relevan~ shaUnot•by itself justify any present'or future diagnosis ordetehnination of the person's mental illness.

( 4) Mental illness of a person shall ·be determined by a mental)health professional and metal illness of a person shall only be diagnosed by a qualified medical practitioner with expertise in mental health.
( 5) The dia:gnosis or determination of a mental illness under this Act shall not be taken to mean that the person is of unsound mind unless he or sho has been declared to be of unsound mind as such by a competent Court.

4.

( I) Every person, including a person with mental .
illness, is deemed to have capacity to make decisions regarding his or her mental health care or treatment unles.s the person is unableto·- Capacity to make mental nealthcare or treatment decision (a) understand,the information that is relevant to take a decis.ion on the treatment, admission ·or personal assistance; or (b) !Ppreciate any reasonably foreseeable consequence of a decision or .lack of decision on the treatment or admission or pe~nal .
assistance; or ( c) communicate the decision under subsection (a) by means otspeech, gesture or any other means.

(2) Toe information referred·f O under subsection (1) shall be given to a person·using simple language, which such' pe,rson understands or in sign language or :visual aids or any other means to enable \lim or her to understand the information.
(3) Where a person makes a decision regarding his or her mental health care or treatment which is perceived by others as inappropriate or wrong, that by itself, shall not mean that the person does not have the capacity to make mental health care or treatment decision, so long·as the person has the capacity to make mental health care or treatment 'decision under subsection (I).

PART ID· ADVANCE DIRECTIVE AND'NOMINATED REPRESENTA'JIVE 5.
(1) Every person, who is not a.-minor, shall have a right to make an advance direc.tive in such manner ~ may be prescribed, specifying any or all ot;the following- Advance directive ( a) (b) ( c) the way in which the person wishes to be cared for or treated for a future mental illness; the way the person wishei n:ot to be cared for or treated for a future mentallillness; the individual.
or individuals, in .the order of precedence, he or she·wants to appoint as his or her nominated representative as provided under section 12.

(2) The person nominated under subsection ( 1) ( c) shall be an adult and shall consentto act as representative.

(3) An advance directive under subsection (1) may be, made by a person irrespective of his or her past-mental illness or · treatment for the same.
( 4) An advance directive made 'UQ.der subsection ·(I) shall.be invokeq only when such person ceases to have capacity to make mental health care or treatment:decisions and, shall .

remain effective until such person regains capacity to make xii Supp~ement to Official· Gazette [8th April 2019] [8thApril 2019] Supplement to Official (]azette xiii mental1health care or.treatment decisions.
following- (5) Any decisions made by a person while he or she has the capacity to make mental health care decisions shall over ride any previously wntten advance directive by such person.

( 6) Any advance directive made contrary to any written law shall be ab initio void.

(7) A person making an advance directive shall be presumed to have ·the capacity to do so until it is proved otherwise.
(8) An advance directive made under subsection (I) may be revoked, amended or cancelled at any time subject to section 8 or in such manne11 as may be prescri~cl, by the person · who made it Mllintcnancc or online register 6.

Any advance directives given under section 5 shall be registered and maintain(:d by the Board and shall be made available online and or by such ot1ier means to concerned mental health professionals as required.
Advance qirective not to apply to emergency treatment Reviewing altering, modifying or cancelling the advance directive .

7.

An advance directive under section 5 shall nQt apply to the emergency treatment givenunder section 29.

8.

( 1) Where a mental health professional or a relative or a care-giver of a person desires not.
to f<?llow an advance directive while treating a person with mental illness, such mental htalth pro'fessional or the relative or- the care-giver of the persQn shall make an application,to the Tcibunal to review, alter, modify or.cancel the advance directive.
(2) Upon receipt of the application under sub-section (]),the Tribunal sliall, after giving an opportunity ofhearing to all concerned parties, including the person whose advance <Urective is in questio~ either uphold, modify, alter or cancel the advance directive after taking into consideration the (a).

whether the advance directive was made by .
the person out of his own free will and free from force, undue influence or coercion; (b) whether the person intended the advance directive to apply to tb'e present circumstances, 'whicti.. may be different from those anticipated; (c) whether· the person was sufficiently well T informed to make the decision; ( d) whether the person had capacity to make decisions relating to his mental health care or treatment when such advanced directive was made;and ( e) whether the content of the advance directive is contrary to any written law or any provision of the Constitution.
9.

The person making-the advance directive and his or her no~ated represen~tive shall have a duty to ensure that the consultant-in-charge or a medical officer, or a mental health professional, as the case may he, has access to the advance directive when required ACCCS!i to ,the advance directive 10.
The parent or legal guardian sball have the right to make an advance directive in writing in respect of a minor and all the provisions relating to advance directive, mutatis' mutandis, shall- apply te such minor until such time he or she attains the age of majority majority.

Advance directive for minor 11.


A medical practitioner or a mental health professional shall not be h~ld liable for ~y unforeseen consequences- a on following a valid advance directive; or Liahili1y of mcotal health professional in relation to adv= directive xiv Supplement to Official Gazette [8th April 2019] ' b not following a valid advance directive.

12.~1) Notwithstanding section 5(1) ( c) every person who is not a minor, shall have a right: to appoint a nominated representative.
Appointment of nominated rep~14tivc .. .. (2) The nomination under subsection { J) shall be made in writing with the person's signature or thumb impression or mark and be witnessed by two persons.

(3) The person appointed as the nominated representative shall not be a minor and s~all be ~ompet~nt.
to discharge the duties or.perform the functions assigned to him or her under this Act, and give his or her consent in writing to ·the mental health professional to discharge his or her duties and perform the functions assigned to him or her wider this Act.
( 4) Where no nominated representative is appointed by a person under subsection (J), the following persons for the purposes of this Act,in the or4er of precedence shall be deemed to be ·the .nominated representative of a person with mental illness- ' (a) arelative; (b) acare~giver; ( c) (d) a suitable person appointed as such by the concerned Tribunal; or ifino such person is,available to .be appointed as a nomiIJ,ated representative, the Tribunal sl¥tll appoint ·the Director o f.- Social Services as the nominated representative of the person with mental illness.
· ' (5) A person who1has appointed any person as his oi:,his nominated representative under this section may revoke or alter such appointment at any time in the same manner [8th April 2019] Supplement to Official Gazette xv provided·underwithsection 12(2).

(6) The Tribunal may, if it is of the opinion that it is in the interest of the person with mental ill~ess tQ,do so, revoke an appointment made by it under this section, and appoint a differentrepresentativeunderthis section.
~ (7) The appointment of a nominated representative, or the non appointment of a nominated representative, shall not be construed as tlie lack of capacity of the person to take decisions about his or her mental health care or treatment.

(8) All persons with mental illness shall ha~e capacity to make mental health care or treatment decisions but may require varying levels of support from their nominated representative to make decisions.

13.
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(l) Notwithstanding section 12, in case-of minors, the parent or person having custody of a minor &hall be th~ir nominated representative unless the Tribunal orders otherwise under subsection (2).
Nominated iq>rescntative for minor (2) Where on an application made to the Tribunal und.er the Children Act (Cap 28), by a mental, health professional or any other person acting in ~e best inte~st of ~e minor, at?-d. on evidence presented before 1t and the Tnbunal ts of the optpton that- (a) (b) the parent or guardian or the person having custody of the minor is.
not acting in the best interests of the minor; or the parent or guardian or the person having custody of the minor is otherwise not fit to act as·the nomin~ted representative, the Tribunal may appoint, any suitable in~vidual who is willing to act, as the nominated representative of the minor with mental illness: Provided that in case no individual is· available for xvi Supplement to Official Gazette [8th April 2019] [8th April 2019] Supplement to Official Gazette xvii appo~ntment ~ a nominated representative, the Tribunal shall a~pomt ~e Director as the nominated representative of the mmor with mental illness.
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14.
A_ nominated representative shaU while fulfilling his or her duties under this Act- · (a) consider the current and past wishes the life history, values., cultural backgrounl and the best mterests of the person with mental illness; (b) give particular credence to the view§ of the ,person with mental illness; ( c) provide support to the person wiih mental illness in making treatment decisions; ( d) have the right to seek inform~tion on diagnosis and treatment to provide adequate support to the persoq with mental illness; ( e) be involved in discharge planning; (t) apply to the mental health facility for facilitated admission; .
(~) apply to the Tribunal on behalf of the person with mental illness for discharge; (h} apply to the Tribunal against violation of rights of the person with mental illness.

PART IV - RIGHTS OF PERSONS WITH MENTAL ILLNESS ' .

~5.

(_l} The rif¥1ts and duties of persons, bodies or 1ns~tut10ns set out m this .Part are in addition to any rights and duties that they may have m terms of any other wrjtten law.

(2) Whosoever is perfonning the duties set Ollt in this J .
P~ shall have regard for the wiil ~nd preference ofthe pe~o~ .

with mental.illness.

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· · 16.

(1)° The di~ity and privacy of every person with · mental illness shall be respected.

• (2) · The care, treatment and rehabilitation St!rvices administered to a person with mental illness shall be based on the principle of the least restrictive alternative.

17.

( 1) A person witl\.mental illness has a right to live iq, be part of, an~ not be segregated from the community.

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(2) Every person with mental illness shall be provided with care, treatment ancLrehabilitation services and community based programs that improve the mental.capacity of that person to develop to full potential and to facilitate his or her.

integration into community life.

R,espect human dignity and privacy Respect of right to live in community 18.

( 1) A person with mental illness shall not be subjectto discrimination on the grounds ofhis or hermental 1health status.

Discrimination ~.
Discrimination ~.

(2) Every person with mental illness shall receive care, treatment and rehabilitation services according to standards equivalent to those applicable to any other health care user.

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Every person, body, organi~tion or health facility provtdmg care, treatment and rehabilitation services to a person with mental illness shall take steps to ensure that- Exploitntion and abuse (a) (b) ( c) the person is protected from exploitation; abuse or any degrading treatment; the person is not subjected to forced labour; and , ·care, treatment and rehabilitation services are not used as punishment or (or ~e convenience of other people.

20.
20.

( I) Subject to subsection (2), every health care Duty of nominated representative JU;hts and duties with respect to persons With mental illness -== - - -== - - - - - - -~ - xviii Supplement to Official Gazette [8th April 2019] [8th.April 2019] Supple1J3ent to Official Gazette xix 'Duty to mfonnor individual nghts provider shall, before initiating or administering any care, treatment or rehabilitation services, inform the person with mental illness in11Il appropriate mannerofh,is or her rights.
(2) Where a person bas b een admitted under circumstances referred to in section 24 or 29, the nominated representative sball be given the infonnation immediately and the person shall be given the infonnation when the person: has recovered mental capacity.

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PART V - CARE AND TREATMENT OF PERSONS Admission of persons with mental illness WITH MENTAL ~LNESS 21.
(1) A person with m~ntal illness may oe treated, as far as possible, at their home or near to their home without requiring care and treatmentin a mental health facility.

(2) Where a person with mental illness requires treatment in a mental health f11cility, it shall be provi~ed on a basis of voluntary admission: .

Rrovided that in the circumstances stated in subsection (3) such person may be cared fo r and treated on facilitated admission.
(3) Where a person' lacks cap~city to make decisions for the person'ij mental healtli care, he or she may qe provided care and treatment at a mental health facility.

Voluntary admission 22.

(l) All admis~ionsin the mental health facility shall, as far as possible, be voluntary admissions except where .

conditions for a facilitated admission exist.


(2) Any person, who is not a minor and who considers himself or herself to have mental illness and desi)-es .to be admitted in any mental health facility .for C!lfe and treatment may make a request to the consultant.

;in-charge for admission.

(3) Where an application is received under subsection I (2)t the ~ ~cal officer or a psychiatrist shall examine the person and make a report to the consultant-in-charge.
(4) The consultant-in-charge ·shall admit the person to .
.the mental health facility ifhe·or she is satisfied that- (a) {b) ( c) the person has a mental illness of a severity requiring admission to a mental health facility; the person is likely to benefit from admission and treatment to the mental health facility; mia the person has understgo<i' the nature and purpose of admission to and treatment in the mental he.alth faoility and bas made the request for admission of his or her own free will, without any duress or undue influence and has the capacity to make mental health care and treatment decisions without suppol'f or requires minimal support from others in inaking such decisions.
(5) If a person is unable to un(lerstand the purpose, nature or likely· effects of the proposed tr:eatment and of the probable ~suit of not accepting the treatment or requires a veey high level of support in making decisions, he or she shall be deemed unable to understand the purpose of the adn).ission and therefore shall not be admitted under this section.

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( 6) A person who is vo luntarily ·admitted under this section shall not be treated without his or her informed consent.
(7) A person voluntarily adntitted under this section has a right to discharge himself or herself.
from the mental health facility: • I Provided that if the consultant-in-charge of the mental health facility or his or her designated representative is.of the opinion that the person meets the criteria for a facilitated xx Supplement to- Official Qazette [8th April 20f9] admission under section 24, the Consultant in charge may prevent self-discharge for a period not exceeding 24 hours to allow for examination as required under section 24.
Discharge .reports The consultapt-in-charge ofa mental healthifacility .

23. shall, in a prescribed forin, issue a discharge report to the pe~on with mental illness who was admittedfor the purpose of receiving tare, trea~ent and·r~habiHtation services.

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Facilitated admission_ 24.

( 1) In cases where a person with mental illness lacks capacity to make mental health care decisions, that person may be admitted to a mental he~lth facility as a facilitated admission.
(2) An application for a facilitated admission shall be made by a nominated representative.

(3) .

Toe Consultant-in-charge of the men~l health facility shall &dmit the person, with mental illness upon application under subsection (2) if (a} the.person has been independently examined on the day of a<Jmission or in the preceding seven days, tiy two professionals, of which one is a psychiatrist or medical practitioner with· mental health.
experti:;.e and the other being any mental health professiona\, and both independently conclude, based.

on the .
examination and, if apptopriat.e, on the information provided by others; that the person has a mental illness of such severity that.the person - (i) has recently threatened or attempted or is attempting to cause bodily harm to himselfi or herself; (ii) has recently behaved or is behaving violently toward another person or ·has caused, or is causing another person to fear bodily haqn from him·or her; or [8th April 2019] Supp lement to Official Gazette xxi ' (b) (iii) has recently shown or is showing an inability to care .for himself or herself to a degree that places the individual at risk of harm to himself or herself; the psychiatrist or the m.ental health professional or medical practitioner, as the case may be, certify, after taking into account the advance directive, if any, that admission to the mental health facilfty is the least i:e~trictive care option possible; and (c) the person is not eligible to receive care and treatment as a voluntarily admitted person under section 22.
( 4) The psychiatrist or the mental health professional or medical practitioner as the case may be, shall not be related by blood (first degree relative) or marriage to or in a common law relationship with, the person who is being assessed for facilitated admission.

25.

(1) A facilitated admission of a person to ·a mental health facility under section 24 is limited to a period ofl 4 days.
(2) Any person admitted under section 24 shall receive treatment as prescribed by the mental health professional with the consent of the nominated represen~tive or on advance directive, if any.
Treabncnt on facihta!ed admission and further steps (3) · Where the Consultant-in-charge is of the opinion, on the expiry of the 14 days referred to in subsection (1) or earlier, that the person admitted under section 24 no longer meets the criteria for admission under that section, he or she may discharge the person or may continue the admission under sectio n 22.

( 4) If.
( 4) If.

on the expiry of 14 days specified in subsection ( 1), the Consultant-in-charge is of the opinion that the criteria for facilitated admii,sion continues, the Consultant-in-charge xxii Supplement to Official Gazette [8th.April 2019] [8th April 2019] Supplement to Official Gazette xxiii I shall apply to the Tribunal for orders for the continuance of the personiin the mental health facility under section 24.
(5) Where an application uncler ;ubsection (4) is made, the Tribunal shall- (a) holdahearing; (b) ensure that the person himself or herself and his_ or her representative-attend the hearing; (c) hear evidence from the mental heal th professionals; and ( d) make an order either to discharge the person or extend the facilitated admission.
( 6) The order of the Tribunal for extension of the facilitated admission shall be for a period of90 days for the1first time and any subsequent extension, on application may be up to I 20 days at a time.

\ (7) The Consultant-in-charge shall discharge the person, ifl\e or she is of the opinion that during the extended p_eriod, the person with mental illness no longer meets the c!riteria for facilitated admission and inform the Tribunal of the same.

• • Admission of minor 26.


(J·) Admission of a minor with mental illness shall be made on application of the parent or guardian or the person having custody of the minor.

(2) The procedure for facilitated admission under section 24 shall mutatis mutandis apply to-admission of minors.

(3) Minors admitted to the mental health facility shall be accommodated sq>arately from adults.
(4) ·The parent or guardian or the person having custody of the minor of the minor or a person appointed by the parent or legal guardian shall stay with the minor in the mental health facility for the period of their treatment in the mental health facility.

(5) Minors shall be treated only with the cons~nt of the parent or guardian or the person having custody of the minor.

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Pemmwith mental illness at home 27 .~l) Where a person at home is suffering from mental illness of such a degree that in the opinion of the nominated representative warrants care and treatment and that person is not willing to go to a mental health facility for that purpose, the nominated representative may make a request to the neare~t health facility for an assessment at home.
(2) Where a req\lest is received under subsection (1 ), a health pr:ofessional from the health facility shall visit the pe~n with mentallillness and make an assessment.
(3) If the mental health professional o.nassessmentis of the opinion that the person is suffering from mental illness and is neglecting himself or ,herself to an extent which puts their O'Yfi- lives, or the safety of others at risk, the menta~ health professional may request a police officer for assistance in moving the person to the nearest mental health facility .
(4) A.spolice officer to whom a.,request is made under subsection (3 ), shall give all the necessary assistance to the health professional for moving the person to the nearest mental health facility.

28.

A police officer shall, on being informed by a member of the public or on seeing a person suspected of having ipental illness wandering in a pul>lic place, convey such person to fu:e nearest mental health facility for assessment.

29.
(1) Notwithstanding qther provisions of this Act, any · treatment for mental illness may be provided by any registered medical practitioner to a person with mental illness either at a mental b~alth;facility or in the connnuruty with or without the consent of the J)Crson with mental illness if it i~ immediately necessary to prevent- Pcminwith mental illness wandering on streets Emergency treatment xxiv Supplement to Official Gazette [8th April 2019] (a} de~th or irreversible harm to the health of the person;ol' (b} the person from inflicting serious harm to self oroUiers.
{2) Emergency treatment under subsection (1) includes transportation of the person with mental illness to the nearest mental health facility for assessment.

(3) Any emergency treatment under this section shall be limited to i4 hours.

30.

(1} A person with mental illness shall not be subjected to seclusion or physical restraint unless it is the only means available to prevent immediate or imminent.harm to the person concerned orto others.
Seclusion and restraints (2) Physical restraint- (a) (b) ( c) ( d) shall be done in an accredited mental health facility; shall be authorised by a psychiatrist or medical practitioner with expertise in m~ntal health; shall not be used as a means of punishment or for the conveniebce of the staff; and reasons and duration of each shall be recorded in a data base and made available to the Board on a regular basis; (3} Physical restraint on each instance shall be , restricted to a maximum period of three hours.
( 4) The family members, care giver or nominated representatives shall immediately be informed, when· the person with mental illness is physically restrained.

31.
(1) Nominated representatives, relatives and care- , .. [8th April 2019~ Supplement to Official Gazefte givers of~ person withmental illness shall.have the.right- (a} (b} ( c} ( d} to visit the person with mental illness in the mental health f~cility; to provide feedback to the mental health including comp\aints about· any facility deficiency in services; to support from mental health services to enable them to effectively perfonn their care giving role; and to social assistance on an equal basis as provided by care-givers of persons with physical illness.
Rights or relatives end care giver.i .

(2) Nominated representatives, relatives and care- givers as the case may be, shall be involved insetting treatment goals, planning for treatment, discharge, care and treatment after discharge from.the mental health facility.
(3) The involvement of nominated representatives, relatives and care-givers under subsection (2) in the case of voluntarily admitted perso~ shall be done with the consent of the person wit4 mental illness and in the case ,of persons under facilitated admission with the consent of the person making application under section 24 (2) .

. "

32.
. "

32.

(1~ The Consultant-in-charge of the mental health facility may grant leave to q person admitted as a facilitated admission in a mental health facility for a period not exceeding seven days at a time: (2) Th~ Consultant-in-charge of the mental health facility may, at any time revoke the leave ifhe or she is satisfied that it is necessary for the improvement of, or .to prevent deterioration of the mentaJ health of the person.
~ Leaves to penons admitted as facilitated admission (3) Where a person with mental illness who has been granted leave unde11 subsection ( 1} refuses on revocation of the leave or on the expiry of the leave to come back to the mental xxvi Supplement to Official Gazet~e [8th April 20.19] [8th April 2019] Supplement to Official Gazette xxvii Absence , without leave of persons admitted as facilitated admission PrisoneB with mental illness- health facility, the €onsultant-in-charge may follow the procedures specified in section 33 for his or her return to the mental health facility.
33.

{ 1) Where a person with mental illness admitted as a facilitated admission is missing :fi:.om the mental health facility without being granted leave, the Consultant-in-charge of the mental health facility shall infonn the police and the person who had made the application for admission of that person.

(2) The police shall have the responsibility to convey the·person back to the mental health facility.

34.
34.

{ 1) Where an officer in charge of a prison is of the opinion that a prisoner is suffering from mental illness, the officer shall make an application to the Consultant-in.

:.charge of a mental health facility for .transfer of the pri~oner to the mental health facility for assessmentby a psychiatrist.

(2) On !

}le directions of the Consultant-in-charge of the mental health facility, the psychiatrist shall assess the person · and may recomrnend- • (a) outpatient treatment and send.
the prison~r back to prison; or (b) admission to tlie mental health facility either as a voluntary admission or a facilitated admissiqn, as the case may be.

f3) Where a prisoner is admitted to the mental health facility under subsection (2), the tiµie sgent by the prisoner at the mental health facility shall be treated as time spent in prison.
( 4) When a prisoner is discharged after treatment in the mental health facility, he or she shall be sent back to prison for -continuation of their sentence or discharge by the prison service if the sentence has peen served.

• ' PART VI - MENTAL HEALTH CARE BOARD 35, There is establi~ed· a Board to be knoM1 .

as the MentallHealth Care Board.

36.
The functions of the 'Board are- ; , (a) (b) (c) (d) (e) (t) (g) to oversee the planning and· management of mental health care and treabnent in the Seychelles; Establishment oflhe Menial HealthCare to nromote standards of best practice and Board efficiency ofmental health care services; Functions of lhe Board to set standards for accreditation of mental health care facilities; f to set criteria and standards for specific mental health care .services: interventions, and treat;ments as necessary; to inspect with sufficient frequency every mental health care facility to ensure that the conditions, treatment and care of patients comply with the provisions of this Act; to review the use of restraints in mental health care facilities; and to advise and assist the Government on other matters related to mental health care and treatment in the Seyclielles.
37.

{1) The Board shall C<?nsist of the following members- the Principal Secretary.
Ministry responsi~le · for,Health (ex-officio); the Chief Medical Officer, Ministry responsible for Health (ex-officio); the Consultant-in-charge of Mental Health Services~·Ministryresponsible for Health (ex- officio); Membership of the Menial HealthCare Board (a) (b) {c) ~ xxviii Supplement to Official Gazette [8th April 2019] ( d) (e) the Director of Social Services, Ministry responsible for Social Affairs (ex-officio); the Chairperson, National Council for the Disabled (ex-officio);_ ( t) the ChiefNutsing Officer (ex-officio); (g) the Chief Allied.Health Officet (ex-officio); (h) a user of mental health services; (i) G) a family member or care-giver of a person with mental illness; and two representatives from civil society with an interest and knowledge of mental health issues.
[8th April 2019] .Supplement to Official Gazette xxix convening of all meetings o6the:Board, maintaining records of the ,Board, implementing the decisions of the Board, and qo all such things ·as the Board or the Chairperson may lawfully require the Secretary to do.

39.

{l~ The.Board snall meet at least six times a year but otherwise- ( a) as the Chairperson may direct; or · (b) as may be requested in writing to the Chairperson by not less than six members of theBoard.
· (2} The tjme and place of a meeting of the Board shall be determined by ~e Chairperson.

(3) Seven members of the Board shall constitute a quorum for a meeting.

Secretary to the Mental Health Care Board Meeting Gr the Board (2) 1Tbe Minister shall appoint the members of the Board on such tenns and conditions and such allowances and remuneration as may be prescribed.

(3) The MiBister shall appoint one of the members of ' the Board Chairpetson o£the Board.

. '
. '

( 4) A meeting of the Board shall be presided over by the Chairperson but in the absence of the Chairperson the members present at the meeting shall elect.

a member to preside over the meeting and that member sh .. 11 have all the powers of the Chairperson at the meeting .

.

(4) The·appohltment of the Ghairpef<>D and members of the Board shall be published by nqtice in.tlie Gazette.
(5) The members of the Board who ~e not ex-officio members shall hold office for three years and are eligible for reappointment for a maximum of two consecutive tenns.

(6) A member, except an ex-offici<;> .member, may resign from office'by letter addressed to the Munster for Health.

(7) Where a person is appointed to rep~a~e another person ut1der subsection (6) on the person so appointed shall serve as a member for the remaining period of office of the person replaced.

· 38.
· 38.

( 1) There shall be a Secretary appointed by the ~oard.

(2) The Secretary shall be responsible for the t 5) All matters for determination by the Board at a meeting shjillibe decided by a simple majority of votes of the members present and voting thereon.

( 6) Each member has one vote and in the event of an equality of votes the member presiding at the meeting shall have a casting vote.
(7) A member who has a direct interest in a matter that falls to he decided at a meeting of the Board shall notify the Chairperson or~ if the member is the Chahperson, the Secretary, of the interest and shall not be present or vote at the meeting where the matter is ,considered or decided unless the Board authorises otherwise.

(8) The.Board shall, through the Chairperson, submit Supplement to Official Gazette [8th April 2019] [8th April 20.19] Supplement•to Official Gazette xxxi ~.
an annualreport ofits activities to the Minister.

40.

Where a matter requires a decision of the Board and it is not convenient or possible for the Board to meet to determine the matter, the Secretary sha)l, on the instructions of the Chairperson, circulate pcwers regarding.the matter·to afl members for conside~Jion and de~ision or approv~l and if the .
members unanimously approve a decision or resolution by signing it, the decision or resolution shall have the same effect as a decision or resolution passed at a meeting of the Board.

41. .

Notwithstanding section 37(5} where at the end of the period, specified in that sectiont all the members of the ~oard vacate office and the new members of the Board have not been appointed, the persons va~ating as members shall continue until the aP.pointment of the new members of the Board or for.

a further period.
a further period.

of three months, whichever occurs first.

PART VII - MENa'~ ,HEtfl.TH CARE TRIBUNM.

42.

There is hereby established a Tribunal to be known the Mental Health €are Tribunal.

.. Decision by circulation ~ of paper i Membcrs1to continue till new members appointed or special expertise·in mental health care and treatment.

(3) The name of the Chairperson and members shall be puhlishetl in the Gazette.
( 4) A meµiber shall hold office for a term of three years and may be reappointed for one further: term. '

(5) A member of the Tribunal shall not take part in any hearing in relation to a matter in which the member has a direct interest.

(6) A member of the Tribunal or any other person acting under the direction of the Tribunal shall not be under any civil or criminal liability in respect of anything done or purported to be done in good faithin pursuance of this Act.

44.
44.

Members shall be appointed on such terms and conHitions and such allowances and remuneration· as may be prescribep by regulations.

· 43.

( 1) The Chairperson of the Tribunal sliall be a hear ap.d determine mental health matters.

4S.

( 11) 'Fhe Tribunal shall have exclusive jurisdiction to Establishment of the Meiiil HealthCare Tribunal Membership of the Tribunal • Magistrate nominated by the Chief Iustice.
(2) The Minister shall appoint four other members who shall serve on the Tribunal, which shall consist of the following- (a) a consultant psychiatrist or a medical practitioner with training and experience in mental health ofat le.astten years'; (b} a representative from the Attorney 'General's Chambers; ( c) a representative fromthe Minis!IY ofHealth; (d) a civil society repre~ntative with an interest (2) Without prejudice to the generality of the foregoing, the Tribunal shall liear and determine - .
( a)' appeals by·person~ with mental illness against facilitated admission; (b) appeals on renewal or extension of.facilitated admission; ( c) complaints regarding violation of rights of persollS' with mental illness in mental health care facilities.

Tenns and conditions of members Jurisdiction 46.

Any person aggrieved by a decision of the Tribun1;tl · xxxii Supplement to Official Gazette [8th April 2019] [8th April 2019] Supplement to Official Gazette .
xx.xiii may appeal to the Supreme ~ourt subject to the same conditions as appeals from a decision of the Magistrates' Court.

(b) observe the rules ofnatural,justice.

Appeals Powers ol the Tribunal 47.

The Tribunal shall have powers to- ( a) summon any person to appear before it; (b) examine on oath, affirmation or otherwise a witness or any person appearing before it; and ,( c) require any person to produce any document which the Tribµnal.considers relevant.

48.
48.

(1) The Tribunal shall sit as and when there is a matter for the Tribunal t o adjudicate upon and laws relating to evidence shall be applicable to witnesses or persoqs appearing befot:e the Tribunah (2).

Thtee·members oftheJribunal, of whom one shall be the Chairperson, shall constitute the quorum.
· Procecdmp before the Tribunal (3) Each member of the Tribunal shall have an equal vote and decisions shall be reached by a \majority vote and in the event of equality of votes the Chairperson shall have· a casting vote.

( 4) A decision of the Tribunal shall.have the same force and shall be ~xecuted in the same manner as a judgment or order of.the Supreme Court under the Seychelles Code of Civil Procedure Act.
(5) A ·party before the Tribunal may be represented by an attorney-at-law or by a representative of the patfy or any other person as the case may be.

.... (6) The :J'ribunal shall, before making a decision- ( a) afford the parties tpe opportunity to be heard; and .. (7) Notwithstanding the foregoing, the Tribunal shall have power to conduct proceedings in whatever manner it considers most appropriate.

49.
49.

At the conclusion.ofthe proceedings, the Ttjbunal shall prepjlte and deliver its decision together with the reasons for such decision.

50.
'Fhe Minister shall appoint a Secretary to the Tribunal who shall be responsible for- ( a) ensuring the overall smooth running of the Tribunal; (b) convening the sittings of the Tribunal after consultation with the Chairperson and ,members; ( c) the issuing of summonses and notices on behalf of the Tribunal; Reasons for decisions Secretary to the Tribunal (<I) the implementation of d.ecisions made by the Tribunal; (e) taking appropriate steps to enable the 'Fribqnal to enforce its orders; and (t) ensuring that orders or directions given by the Tribunal are complied with.
PART VIlI - OFFENCES AND PENALTIES l 51.

(1) Any person who willfully falsifies an advance directive or falsifies an appointment of an appointed representative shall be guilty of an offence and liable on Savings and tnlnsitional Repeal xxxiv Supplement to Official Gazette [8th April 2019] [8th April 2019] Supplement to Official Gazette conviction to imprisonment for a term of 5 years or a fine not exceeding SCR50,000 or with both such imprisonment and fine.

54. repealed.
54. repealed.

The Mental Health Act (Cap 127), is hereby r Olfence:i and penalties (2) Any person who commits any act of cruelty to, or abuse or willful neglect of, any patient with mental illn~s shall be guilty of an offence and liable on conviction to imprisonment for a term of 15 years or a fine not exceeding SCR50,000 or with both such imprisonment and fine.

PART IX - MISCELLANEOUS 52.


( I) The Ministermay make regulatio.ns for carrying out the purposes of this Acl (2) Without prejudice to the generality of the provision of subsection ( l ), regulations may provide for- (a) standards for determination ofillness; Regulations (b) manner of making an advance directive; • (c) manner ofrevoking, amending, or cancelling an advance directive; and .

(d) form of discharge report under section 23.


., (3) Regu]ations made under this section may create offences and provide that contravention of or failure to comply with any sueh·regulations shall be an offence and such offences shall be punishable with imprisonment or fine or with both such imprisonment and fine.

53.
53.

All acts done under the Mental Health Act (Cap 127), decisions taken prior to the dale of commencement of this Act, shall continue to have ef{ect until it is amended, annulled or withdrawn in accordance with the provisions of this Act.