In Indian forensic psychiatry under the Mental Healthcare Act 2017, which provision specifically prohibits the use of seclusion and restraint as a treatment modality, and what is the permitted use of physical restraint?

• A Seclusion is completely prohibited; physical restraint is also completely banned under any circumstance
• B Both seclusion and restraint are permitted as standard treatment with 24-hour ward doctor approval
• C Seclusion as a treatment modality is prohibited; physical restraint is permitted only as a last resort to prevent immediate harm to self or others, must be time-limited, documented, and monitored ✓
• D Seclusion is permitted for voluntary patients; restraint is prohibited for involuntary patients

Explanation

The Mental Healthcare Act 2017 (MHCA 2017), Section 97, explicitly prohibits seclusion (confinement alone in a locked room) as a treatment modality. Physical restraint is not absolutely banned but is permitted only as a temporary, last-resort safety measure to prevent imminent harm — it must be the minimum necessary, applied with dignity, documented in the medical record with time of application and reason, reviewed regularly, and discontinued as soon as the emergency resolves. Restraint for punitive purposes or staff convenience is illegal. These provisions align MHCA 2017 with the Convention on the Rights of Persons with Disabilities (CRPD).

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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