ONLINE PSYCHIATRY: MEDICINES, CONSENT, PRIVACY & YOUR RECORDS

This guide explains what to expect from an online psychiatric consultation in India, including prescribing limits, confidentiality, consent, decision-making capacity and clinical records. It is general information, not a promise that any particular medicine or treatment will be prescribed.

WHAT ONLINE PSYCHIATRIC CARE CAN PROVIDE

Online care may include assessment, diagnosis, psychoeducation, psychotherapy, prescriptions where legally permitted, follow-up reviews and a written treatment plan.

Teleconsultation has limits. If a physical examination, closer observation or emergency assessment is necessary, you may be advised to attend an in-person appointment or the nearest appropriate healthcare facility.

WHICH MEDICINES CAN BE PRESCRIBED ONLINE?

Prescribing depends on the type of consultation, whether it is by video, audio or text, whether this is a first consultation or follow-up, and the legal category of the medicine.

• List O: Low-risk medicines used for common conditions. These may be prescribed through any permitted mode of teleconsultation.

• List A: Selected medicines with relatively low misuse potential. They may be prescribed during a first consultation only when the consultation is a live video consultation. Continuation or refill may be possible during follow-up.

• List B: Additional medicines that may be prescribed during follow-up after an earlier in-person assessment for the same condition, subject to the current rules and clinical judgement.

• Prohibited online: Schedule X medicines and medicines controlled under the Narcotic Drugs and Psychotropic Substances Act cannot be prescribed through teleconsultation.

IMPORTANT FOR ADHD CARE

An online ADHD assessment does not automatically mean that ADHD medication can be started online. Methylphenidate is a Schedule X medicine and cannot be prescribed solely through an online consultation. Non-stimulant options such as atomoxetine or clonidine also remain subject to the applicable prescribing category, prior assessment and clinical suitability.

Medication lists and government notifications may change. Dr. Mitra will explain whether a medicine can legally and safely be prescribed online or whether an in-person consultation is required.

WHAT CONFIDENTIALITY MEANS

Your mental-health information—including electronic and digital records—is private. Information is not ordinarily shared without your permission.

Indian mental-health law permits limited disclosure when it is necessary:

• to a nominated representative so that they can carry out their legal role;
• to other professionals directly involved in your care;
• to protect you or another person from serious harm, violence or a threat to life;
• when required by a Mental Health Review Board, court or another legally authorised body; or
• when disclosure is required in the interests of public safety and security.

Where disclosure is necessary, only the information reasonably required for that purpose should be shared.

WHAT CONSENT MEANS

Consent is a voluntary, informed and specific agreement to an assessment or treatment. Before deciding, you should receive understandable information about:

• what is being proposed;
• expected benefits and important risks;
• reasonable alternatives;
• what may happen without treatment; and
• the limitations of online care and confidentiality.

You may ask questions, decline an option or withdraw consent. Withdrawing consent may mean that a particular assessment or treatment cannot continue, but it does not remove your right to appropriate information, emergency guidance or referral.

When a patient initiates a teleconsultation, consent to the consultation may be implied under the telemedicine guidelines. Explicit consent is documented where required. Consent to treatment is separate from consent to record a session.

ARE ONLINE SESSIONS RECORDED?

Sessions are not routinely audio- or video-recorded. Any recording requires explicit consent from every person involved, together with agreement about why it is being made, where it will be stored, who may access it and how long it will be retained. Patients and accompanying persons should not record or share a consultation without prior agreement.

WHAT CAPACITY MEANS

Having a mental-health diagnosis does not automatically mean that a person lacks capacity.

Capacity concerns a particular decision at a particular time. The assessment considers whether the person can understand the relevant information, appreciate the reasonably foreseeable consequences of deciding or not deciding, and communicate a choice. Information should be provided in simple language and with appropriate support.

A choice that other people consider unwise does not, by itself, prove that the person lacks capacity. Capacity can also change over time or differ between decisions.

CHILDREN, ADOLESCENTS AND CAREGIVERS

For children and adolescents, consent from a parent or legally authorised guardian may be required. The young person should still receive an age-appropriate explanation and be involved in decisions as far as possible. The psychiatrist will also clarify when a caregiver or nominated representative may participate in an adult patient’s consultation.

WHAT RECORDS ARE MAINTAINED?

Clinical records may include:

• identity verification, age and contact information;
• the date, time and mode of consultation;
• teleconsultation and treatment consent;
• the names and roles of other people present;
• presenting concerns and relevant psychiatric, medical, medication and substance-use history;
• mental-state, risk, safety and capacity assessments where relevant;
• diagnosis or clinical formulation;
• investigation reports, documents and images reviewed;
• prescriptions, treatment options and the agreed plan;
• referrals, safety advice and follow-up recommendations;
• clinically relevant messages and consultation logs;
• psychological-assessment and psychotherapy records; and
• copies and register details of medical certificates issued.

HOW LONG ARE RECORDS RETAINED?

As a practice policy, clinical records are retained securely for at least three years from your last consultation, and longer where a clinical, legal or regulatory reason requires it. Information is not retained longer than necessary without a lawful or clinical reason.

CAN I OBTAIN MY RECORDS?

You may request available clinical records after your identity and authority to receive them have been verified. The practice aims to respond to routine outpatient requests within 72 hours.

In limited circumstances, specific information may be withheld if releasing it would be likely to cause serious mental harm to the patient or harm to another person. If this applies, your rights and the available review process should be explained.

EMERGENCIES

Online consultation is not an emergency service. If there is immediate danger, suicidal intent, severe self-harm risk, violence, delirium, a severe medication reaction or another urgent medical concern, contact local emergency services or attend the nearest emergency department. Do not wait for a scheduled online appointment.

OFFICIAL SOURCES

Telemedicine Practice Guidelines, 2020:
https://www.nmc.org.in/ActivitiWebClient/open/getDocument?path=%2FDocuments%2FPublic%2FPortal%2FGazette%2FEthics-12.05.2020.pdf

NIMHANS–IPS–TSI Telepsychiatry Operational Guidelines, 2020:
https://nimhans.ac.in/wp-content/uploads/2020/12/Telepsychiatry-Operational-Guidelines-2020.pdf

Mental Healthcare Act, 2017:
https://www.indiacode.nic.in/handle/123456789/2249

CDSCO Drugs Rules, including Schedule X:
https://cdsco.gov.in/opencms/resources/UploadCDSCOWeb/2022/drug_rules/Drugs%20Rules%201945_2024%2009.pdf

Digital Personal Data Protection Act, 2023:
https://www.meity.gov.in/static/uploads/2024/02/Digital-Personal-Data-Protection-Act-2023.pdf

Last medically and legally reviewed: 22 August 2026. Prescribing categories and legal requirements may change. This page will be updated when relevant guidance changes.