Kerala High Court Expunges Mental Health Review Board Caution Against Doctor Over Lapses In Mental Healthcare Act Compliance; Observes He Acted In A Professional Manner
Isabella Mariam
The High Court of Kerala Division Bench of Justice Devan Ramachandran and Justice M.B. Snehalatha allowed an appeal and removed a formal caution issued by the Statutory Mental Health Review Board against a psychiatrist, while directing that he must comply with the Mental Healthcare Act, 2017 in future cases. The caution had been recorded on the ground that he admitted a patient on a subsequent occasion without obtaining valid consent and without conducting a statutory capacity assessment, and he had also stated during proceedings that he was not fully aware of the Act’s requirements. The patient alleged repeated hospitalisation and treatment without necessity, whereas the doctor, citing a nearly four-decade career, challenged the warning as unwarranted.
The appeal arose from an order of the Statutory Mental Health Review Board constituted under the Mental Healthcare Act, 2017, formally cautioning a psychiatrist for alleged non-compliance with Sections 4 to 8 of the Act relating to capacity assessment and informed consent. The appellant challenged the caution on the ground that the finding was entered without proper appreciation of materials.
The complainant alleged that he had been admitted to the appellant’s hospital on two occasions. The first admission occurred on 11.05.2024 at the request of his mother, and he underwent treatment for about 35 days. The second admission took place on 22.08.2024 when he was again brought by relatives and treated for a similar duration. The Review Board found the first admission justified based on documented symptoms described as psychotic, including delusions and mood elevation. However, regarding the second admission, the Board concluded that no proper consent had been obtained and that a formal assessment of capacity under Section 4 had not been conducted.
The appellant relied on a consent form allegedly signed by the patient’s mother. During examination before the Board, she expressed uncertainty regarding the signature on the second consent form. The Board found procedural non-compliance and issued a formal caution.
The Court observed that the appellant had been cautioned because he was allegedly not careful while admitting the patient on 22.08.2024 and that the finding was based on absence of proper consent and failure to perform capacity assessment.
Referring to the first admission, the Court recorded that the Review Board found it “seems justified” because the documented symptoms were “Psychotic symptoms, including delusions and mood elevation.”
With respect to the second admission, the Court noted that the Board concluded there was no consent and no evaluation of capacity. The Bench then stated: “We must say that we obtain justified reasons to differ from the conclusions of the ‘Review Board’, which we will presently state.”
On the factual circumstances, the Court recorded that the patient had been brought to the hospital by relatives and that “there was no role attributable to the appellant in such.” It further observed that the findings of the Review Board were “rather conjectural and speculative in nature” in view of the materials.
Regarding the omission of formal capacity assessment, the Court stated: “It may be possible, from a very hyper-technical standpoint, to find that the appellant had not acted as per the law, or that he was guilty of not being aware of the requirements under the ‘Act’, as has been admitted by him.”
The Bench then posed the question whether the appellant had acted contrary to professional obligations or for oblique reasons. It recorded: “When the Review Board themselves have found that the patient was suffering from irritability and restlessness – severe enough for his relatives to respond by taking him to the hospital - we are persuaded to the view that a doctor cannot then be pinned down to technical requirements before providing care.”
The Court clarified: “Of course, this is not to mean that doctors under the ambit of the ‘Act’ can disregard the statutory provisions or imperatives, but solely that since the 1st respondent was exhibiting certain symptoms, we cannot find that the decision taken by the doctor - which was based on his expert opinion - to subject him to further treatment was actuated by malice or questionable reasons.” It also noted that even the Review Board had not concluded that there was malice.
The Bench finally recorded: “We are of the sure opinion that this is a case where, even when we are in favour of the findings of the ‘Review Board’ that the appellant did not act strictly in accordance with the provisions of Section 4 of the ‘Act’, he should be given the latitude of having acted fairly and bona fide.”
The Court ordered: In the afore circumstances, we allow this Appeal and expunge the caution recorded by the‘Review Board’ in the impugned order against the appellant; however, directing him to ensure that, in all future cases, he complies with the requirements of the ‘Act’ implicitly and without any violation.
Advocates Representing the Parties
For the Petitioners: Sri. V.V. Asokan, Senior Counsel; Smt. Uthara Asokan; Smt. T.K. Sreekala; Smt. S. Parvathi; Smt. Nikitha Susan Paulson; Shri. Anand Geo; Sri. V.V. Asokan (Sr.)
For the Respondents: Smt. S. Sujini; Shri. K.R. Ranjith, Government Pleader; Smt. Pooja Venkat; Sri. V. Ramkumar Nambiar, Amicus Curiae
Case Title: Dr. Haiderali Kalliyath v. Jasif Kattekkadan & Others
Neutral Citation: 2026: KER:9382
Case Number: MFA (MHA) No. 2 of 2025
Bench: Justice Devan Ramachandran and Justice M.B. Snehalatha
Commentary: A Necessary Distinction Between Judicial Findings and Consequential Relief Re: Dr. Haiderali Kalliyath Vs. Jassif Kattekkaden & Others While the headline of this commentary suggests a wholesale expungement of the Mental Health Review Board’s (MHRB) position, a granular reading of the Division Bench's judgment reveals a more nuanced legal outcome. As a former Chairperson of an MHRB, I believe it is vital for the medical and legal fraternity to distinguish between the merits of the finding and the nature of the relief granted. 1. Affirmation of Statutory Lapses: The Hon’ble High Court did not set aside the MHRB's finding that the appellant failed to strictly comply with Section 4 of the Mental Healthcare Act. In fact, Paragraph 22 explicitly states: "we are in favour of the findings of the ‘Review Board’ that the appellant did not act strictly in accordance with the provisions of Section 4." Mental Health Care Act,2017. 2. Relief Based on Equity, Not Exoneration: The expungement of the "caution" was an exercise of judicial discretion based on the doctor’s 40-year career and the absence of mala fides (malice). The Court substituted a punitive "caution" with a prospective "directive" to ensure implicit compliance in the future. 3. The Legal Precedent: The judgment actually reinforces the MHRB’s authority to identify lapses. By directing the appellant to comply "implicitly and without any violation" henceforth, the Court has upheld the mandatory nature of Section 4. Conclusion: The title of the journal article may inadvertently lead medical practitioners to believe that technical non-compliance with Section 4 is permissible if one acts in "good faith." On the contrary, the High Court has re-affirmed the Board's findings of statutory violation; it merely shielded a senior professional from the career-long stigma of a formal "caution" due to his tenure and the specific clinical circumstances of the case. Jinan K R Former District Judge & Former Member (Judicial), NCLT Former Chairperson, MHRB Mob 9446476133