Progressive step

Healthcare for India’s mentally ill is poised to take a leap forward if a proposed bill on their treatment is passed by Parliament.

 The bill envisages humane treatment of the mentally ill and makes access to affordable mental healthcare a right of all citizens. It vests in the patient the right to decide the mode of treatment. It decriminalises suicide by the mentally ill and forbids painful treatment procedures such as administration of electric shocks without anaesthesia.

 Roughly 6.5 per cent of India’s population suffers from some form of mental illness. Unfortunately, a large section of them are denied medical treatment as mental health facilities are available in major cities only. In many instances, ignorance determines how the mentally ill are treated. They are chained and left to live in isolation. Many are abandoned by their families and ‘punished’ for ‘bad behaviour.’ They are denied food, water and clothing and even left wallowing in excreta. The proposed bill takes a step towards ensuring that patients are not subjected to degrading and inhumane treatment. They have a right to medical care and families who deny them this can be hauled up for violating their rights.

An important feature of the legislation is that it puts the patient at the centre of his/her own treatment. It forbids admitting a mentally ill person to a hospital without his consent. Thus it underscores a consultative treatment process. Some mental health professionals have criticised the bill for giving too much power to the patient in decision making. They point to cases where a patient is incapable of informed decision making. While there is some truth to their argument, we must bear in mind that treatment of the mentally ill is most successful when the patient is part of the decision making process.An important stumbling block in the way of mental health treatment is the social stigma associated with mental illness.

 Often patients and their families are reluctant to avail treatment as they do not want their illness to be made public. While the proposed legislation addresses the question of keeping a patient’s treatment confidential, it does not talk about a sustained public campaign to rid mental illnesses of their stigma.  Medical understanding of mental illnesses has taken giant strides in recent decades as has its treatment. Treatment promises a fulfilling life which patients must avail. 

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