Purging mental healthcare of neglect

The Mental Health Care Bill, unanimously passed by the Rajya Sabha, is an important legislative measure to deal with a serious but grossly neglected public health problem in the country. Mental disorders are sometimes considered as divine punishment and often mixed up with taboo and superstition. The widespread ignorance and misconceptions about them result in lack of medical care and wrong treatment administered by quacks and others least qualified for the job. Illness is often not recognised in time. An attempt had been made to address some of these problems with the Mental Health Act of 1987. The new bill takes it forward by recognising and seeking to protect the rights of those with mental illness and providing access to healthcare and treatment. It is also in consonance with the UN Convention on the Rights of People with Disabilities which India ratified in 2007. The convention mandated changes in laws by signatory nations to give effect to its provisions.

An important highlight of the bill is the decriminalisation of the attempt to suicide. At present, it is punishable with a jail term or fine under Section 309 of the Indian Penal Code. The bill rightly considers it as a sign of mental illness that requires treatment, unless otherwise proved. The 1987 Act had defined mental illness in narrow terms but the new bill covers a wide range of mental conditions and types of behaviour on the basis of accepted scientific and medical information. It has been formulated on the basis of extensive discussions with experts, social activists and others. It has also laid down some basic norms about treatment, like the ban on administering electric shocks to mentally ill children, and respect for the rights of adults to decide on their form of treatment and protection from degrading treatment. 

As the health minister stated in the House, it is a “humane, progressive and patient-centred” legislation which guarantees every person the right to affordable and quality healthcare and treatment from the government. There are special provisions for women and an emphasis on community-based treatment. But how will the governments, Central and states, discharge their responsibilities? The bill mandates provision of mental health services in every district with all facilities. The existing medical infrastructure is very poor and the number of healthcare professionals are woefully short. At a conservative estimate, about 9 % of the country’s population suffer from some form of mental illness, including about 2% who suffer from acute conditions. It will not be a minor challenge taking medical aid and assistance to all of them.