Mental health has been the most overlooked part of general wellness and healthy living. The importance of mental health is undermined and still remains a stigma in society. This stigma around such ailments leads to limited avenues for discussion, awareness and facilities that can help patients. However, a huge action towards better facilities and development to provide health care for mental wellbeing has been taken when the Rajya Sabha on August 8th 2016 passed the Mental Healthcare Bill 2013.[1] And after this bill being passed by the Lok Sabha will go on to repeal the Mental Health Act 1987.
The new bill has immense potential to create a better healthcare system for those ailing of mental illness in the country. The existing act didn’t necessarily help many who are suffering from mental illness. The new Act has various new objectives. The act as passed by the Rajya Sabha has importantly stated that the new act will help align the laws of the country with that of the protocols adopted by the United Nations under the Convention on Rights of Persons with Disabilities and its Optional Protocols. It came into force on 13th December, 2006 and India had signed and ratified the Convention on 3rd May, 2008.[2] The bill is progressive than the existing laws. It can easily be seen by looking at the change made to the definition of Mental illness itself. Under the 1987 Act, mental illness was any mental disorder other than mental retardation. The definition was vague and unclear. However, under the new bill, mental illness would mean “a substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgement, behaviour, and capacity to recognise reality or ability to meet the ordinary demands of life”. This also includes mental conditions which are associated with abuse of alcohol and drugs.[3]
Various others rights have been bestowed through this bill, for example, the right to access mental health care and treatment from services which are run or are funded by the government. This will increase access to healthcare facilities. Also, those with mental illness will have the right to equality of treatment, protection from inhuman and degrading treatment, free legal services and access to their medical reports.[4]
Another important feature of this bill was the proposal to decriminalise suicide. According to the Indian Penal Code, attempt to suicide is a criminal offence and under section 309 it is a punishable offence with simple imprisonment for a term which may extend to one year with or without fine.[5] This had been a highly debated rule of law for a long period of time and if the bill is passed by the Lok Sabha it would lead to decriminalisation of this offence. According to World Health Organization (WHO) statistics suicide has been accounted as the reason for 1.4 % of all deaths worldwide in the year of 2012.[6] And it ranked as the 2nd leading cause of death among the age group of 15-29 years old.[7] With such alarming statistics, it is important to take steps to prevent it. Due to the criminalization of attempt to suicide it was highly unlikely that cases would be reported of attempts, which would lead to lesser number of people getting help to prevent it. With the decriminalization more number of people will get help in alleviating themselves from the mental disorders or illness which puts them at higher risks for harbouring suicidal tendencies.
Another problem that had to be dealt with was the ill-treatment of a mentally ill person by subjecting them to methods of treatment that progressively worsened their conditions. These treatments were also forced on patients and they had to go through them involuntarily. This bill tackles the issue of patients being admitted in care units and treated against their will forcibly. In such a situation the new Act gives the right to the mentally-ill person to give advance directions on how they wish to be treated. It also allows for a nominated representative who can take decisions on behalf of the patient. This advance directive as stated by the patient will be then registered with the Mental Health Board and or be certified by a medical practitioner.
Other necessities such as administrative bodies have also been directed. These administrative bodies have to do various acts including registering all mental health establishments, develop quality and service provisional norms, receive complaints of deficiencies and advise the government on the matters relating to mental health. Also, the bill calls for necessary registration of mental health establishments under relevant central or State Mental Health Authorities. And to be registered they have to be able to fulfil criteria that have been prescribed under the Bill. Not only this the Bill has also gone on to specify the procedures that have to be followed for admission, treatment and discharge of a person from the hospital. Most importantly the Bill has provisions for a Mental Health Review Commission and Board that will periodically review the procedures and help the government to make advance choices to protect rights of the mentally ill persons.
All of these provisions need to be implemented properly to provide the best treatment possible and avert the ill results of marginalization of people due to mental illness that occurs in India. Mental illness however still remains a topic surrounded with stigma and taboo. But the new reform should help the society move toward a better understanding of mental illness and create awareness about it. There are still areas that this bill could look into further such as the important role of therapists and other steps to help in reduction of stress which is a leading cause of mental disorders. Also, further facilities enabling recovery of patients and helping them to be a part of society rather than being marginalized and deprived of being a part of the society has to be looked at. Better discourse and debate on this is the way to move forward because there is still a long way to go in the spheres of both scientific and social advancements.
By: Anyatama Nayak
[1]Rajya Sabha passes Mental Health Care Bill, Times Of India, August 8 2016, http://timesofindia.indiatimes.com/city/delhi/rajya-sabha-passes-mental-health-care-bill/articleshow/53604134.cms
[2]India ratifies UN Disability Convention, united Nations Information Centre for India and Bhutan, http://www.unic.org.in/display.php?E=872&K=Disability
[3] THE MENTAL HEALTHCARE BILL, 2016, As passed by the Rajya Sabha on August 8th 2016, http://www.prsindia.org/uploads/media/Mental%20Health/Mental%20health%20care%20as%20passed%20by%20RS.pdf
[4] IBID, At p 10
[5] S 390, Indian Penal Code, 1860
[6]Mental Health, Suicide Data, WHO Website, http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/
[7] Media Centre, Suicide Fact Sheet, Reviewed April 2016, http://www.who.int/mediacentre/factsheets/fs398/en/
