Authors' reply

The logistical challenges of meeting India's mental healthcare needs are substantial, but not insurmountable. Many Indian clinicians are highlighting potential paths forward; often utilising and building upon pre-existing resources. Trained lay counsellors,¹ and peer support workers² are two good examples of what is possible. Financial and infrastructural investment is also essential particularly to facilitate treatment within the community; half-way homes, sheltered accommodation and supported accommodation are an unmet need.

The incorporation of Ayurveda, yoga and naturopathy, Unani, siddha and homoeopathy into the Mental Healthcare Act presents a unique opportunity. The reality on the ground is that many individuals with mental illness attend practitioners of traditional medicine, who are often highly skilled.³ The exclusion of traditional practitioners from the Act would have been unlikely to stop the use of such services; consequently, their inclusion facilitates their regulation and registration. It brings their establishments under the remit of the Mental Healthcare Act and provides individuals attending their services with the same patient-centred rights-based protections.

Section 106 of the Mental Healthcare Act prohibits mental health professional (including traditional practitioners) from recommending ‘any medicine or treatment not authorised by the field of his profession’. This will hopefully prevent all healthcare providers from practising outside of their field of expertise. In meeting the high standards put forward in the Mental Healthcare Act traditional practitioners may need to increasingly collaborate with psychiatry and this presents all parties with opportunities to enhance their treatments and better serve their patients.