The Mental Healthcare Bill, 2016, opts for a progressive approach by clearly laying down responsibilities of the state and empowering individuals with more powers
The stigma associated with mental illnesses in our country is so strong and forceful that it is often ignored or goes unnoticed. While physical injury is visible; and can be cured immediately through set procedures, treating mental illnesses is far more complex and difficult. It involves breaking patterns that have resulted in self-harm and self-destruction, thereby allowing space for the development of new thoughts and habits. Often, mentally-ill people have to fight unseen reality that, perhaps, only they can understand and relate to.
In this context, with the passage of the Mental Healthcare Bill, 2016, the archaic Mental Health Act, 1987 has been replaced. Thus, several the age-old notions and recommendations have been revised in light of the situations, circumstances and pressures that people face today. Mental health has finally taken the center-stage after having been relegated to the sidelines for decades in India.
Statistics on mental health related problems in the country have made a strong case for it in the last few months. The impact of the issue emerges as we consider the numbers, only to find that there is a noticeable dearth in the availability of mental health services as against the number of people requiring them.
The new Bill seeks to fulfil India’s international obligation to the Convention on the Rights of Persons with Disabilities and its optional protocol, which it ratified in October 1, 2007. This convention is the first comprehensive human rights treaty of the 21st century and is the first human rights convention to be open for signature by regional integration organisations.
The new Bill redefines mental illnesses as “a substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgement, behaviour, capacity to recognise the reality or ability to meet ordinary demands of life, mental conditions associated with the abuse of alcohol or drugs but does not include mental retardation which is a condition of arrested or incomplete development of mind of a person, specially characterised by sub normality of intelligence”.
This broadening of definition has highlighted various aspects of disordered, cognitive, emotional or behavioral functioning which impacts an individual’s ability to perform his primary functions.
Most importantly, the new Bill decriminalises suicide, which was previously a punishable offence. According to statistics from the World Health Organisation, average suicide rate in the country is 10.9 for every one lakh people. This recognition of suicide as a mental health problem is aimed to facilitate a greater dialogue on the issue. Additionally, it gives the mentally ill patients the liberty to openly speak about what is tormenting them and seek effective advise that can help them recover without facing the risk of legal action. It also allowed them room for greater empathy, understanding and ensured that the dignity of the mentally ill individuals is kept intact.
The Bill adopts a radical approach as it empowers the patients to make decisions about his/her mental healthcare or treatment. The Bill also proposed to introduce insurance in the mental health sector to help ease the cost burden. In addition to this, the Bill stated that psychosurgery could only be performed after it is approved by the district medical board, and ECT for adults is allowed only with proper care provision. lastly, the Bill criminalised the inhuman treatment of the mentally ill.
Some estimates place the prevalence rate of mental health related problems at five per cent, or roughly 50 million individuals in our country. Mental health contributes to 11.6 per cent of the global burden disease while only 14.52 per cent of those afflicted, approximately 7.26 million, receive treatment. While mental illnesses eats away the well-being of an individual and family, lack of adequate mental health and infrastructural services lead to debilitating consequences that cost the state significantly.
This is because productive human resource loses its ability to perform. Easy access to provisions of comprehensive mental health services can directly ensure continued health of the citizens, overall economic well-being and productivity for the country.
The mental health sector employs the services of numerous types of professionals, besides psychiatrists and clinical psychologists, who find a place in the Bill; however it is important to recognise the role of other professionals such as counsellors, psychoanalysts and art therapists. In order to provide consistent support and effective treatment, more academic institutes need to engage in training a larger number of professionals to address the issue.
A number of interventions such as skill building, coping and life skills, installation of crisis helplines for people struggling with stress, and imparting awareness to improve quality of life needs to be focused upon immediately. lastly, the efficacy of the mental healthcare Bill would depend on the support of various stakeholders to undertake strategic interventions through effective public-private partnership models. But one cannot overstate the fact that the introduction of the Bill is an essential, forward-looking step by the Government.
(The writer is director, Mental Health and Behavioural Sciences, Fortis Healthcare)