Around 14% of Indians suffer from some sort of mental illness, that roughly comes up to 19 million people. Now, as compared to this, our nation is home to only three psychiatrists, and even lesser number of psychologists for every million people in India, which is 18 times fewer than the commonwealth norm of 5.6 psychiatrists/100,000 people. The simple answer to manage this economies of scale or to some extent even to reduce the number of people suffering mental illnesses, is to make fundamental changes by producing more trained personnel or to create conditions that lead to healthy minds. But with India nothing is as simple as it sounds, even more so when you are talking about such massive societal and health changes. And that’s where the law interferes.
In this article, we will explore the creation, evolution and most importantly identify legal provisions for the mentally ill. In India, as of 2020, mental health patients or any individual seeking help for mental health come under the purview of the Mental Healthcare Act, 2017.
The roots for legal provisions for the mentally date back to 1851(Lunatic Removal Act, like seriously) under British India. In the following years, the Indian society saw additions like Indian Lunatic Asylum Act 1858, the Military Lunatic Act 1877 and the Indian Lunacy Act (ILA) 1912. If one was to read and sum up these provisions of the law, one would realise that they were created to protect the society from the mentally ill and not the other way round. The non-pragmatic thinking could be blamed on the lack of awareness, but with changing times a more progressive outlook gave birth to the Mental Healthcare Act of 1987 and now the updated MHA of 2017.
To understand the motive behind these changes in the system, let’s have a look at the purpose of the Act— “to provide for mental healthcare and services for persons with mental illness and to protect, promote and fulfil the rights of such persons during delivery of mental healthcare and services and for matters connected therewith or incidental thereto.” Thus, the system now lays emphasis on the ideology of caring for individuals rather than their custody. Criticisms pertaining to personal liberty and human rights in relation to the Act of 1987 led to the amendment, which eventually culminated in the Mental Healthcare Bill 2013 and came into force by March of 2017.
When going through the provisions, it is interesting to understand the areas which lawmakers have taken into consideration. Here’s a list of things that you can keep in mind when dealing with situations in which you might need help of legal measures.
- The definition of mental illness is much larger than you think. It includes substantial disorder of thinking, mood, perception, orientation, or memory that largely impairs judgment or ability to meet the ordinary demands of life, mental conditions linked to the abuse of alcohol and drugs.
- Advance Directive. This simply means that a person suffering from any kind of mental illness can choose the manner in which he/she wishes to be treated.
- Rights of a person suffering from Mental Illnesses. Emphasis on right to live with dignity in a community, right to accessible and affordable treatment, protection from cruel and inhuman treatment, right to legal aid, right to be treated as equal to a physical illness and many more.
- Role of the Police and other organisations. Keep in mind that sources of help have been enabled by the provisions.
- Prohibition of electroconvulsive therapy (ECT) without the use of muscle relaxants and anaesthesia and big NO for use on minors
- Decriminalises attempt of suicide by a mentally ill individual and also ensure that a situation like that doesn’t rise again, thus providing rehabilitation care.
- Setting up of relevant authorities, both Central and State
The points mentioned are just major reliefs provided by the union. However, with this I just aim to make a little bit more aware than you already are. The effect and the potential of the implementation of these provisions still have a long way to go. Considering India, our people and our diversity, mental health is still something which hasn’t been properly addressed. Till date India, as compared to other nations, spends the least on mental health from the total health budget (0.06% compared to 4%). Even with progressive measures, the system still fails to identify methods to reduce social stigma, inequalities, increase awareness and thus establish a much more inclusive society. One criticism that stands out is that there is not enough stress on prevention and intervention at a nascent stage. Though the Act provides scope for a relatively modern thought, we can only wait for better implementation efforts.
Sources: The Mental Health Care Act, 2017-PRS India https://www.thehindu.com/news/national/all-you-need-to-know-about-the-mental-healthcare-bill/ article17662163.ece https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932926/ https://dghs.gov.in/content/1350_3_NationalMentalHealthProgramme.aspx?format=Print https://blog.ipleaders.in/legal-rights-of-persons-with-mental-illness/ https://europepmc.org/article/PMC/5618879
By Misri Kothari , Content and PR member at L2S + India