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India must act on its new Mental Health Care Act

india Updated: Aug 17, 2016 16:26 IST
Sanchita Sharma, Hindustan Times
Mental Health Care Act

A mentally challenged youth holds a placard during a protest outside the Indian Health Ministry in New Delhi. (AFP Photo)

The leaked photos of bound men curled up naked on the floor are not of detainees at a high-security prison or an illegal detention camp, but of people getting treated for psychiatric and mental illnesses at the West Bengal state-run Berhampore Mental Hospital.

The horror that volunteers from the NGO Anjali witnessed at Berhampore Mental Hospital on India’s 70th Independence day is what the new Mental Health Care Bill 2016 passed on August 8 plans to fix by replacing the outdated Mental Health Act of 1987 that focused on institutionalised care where the mentally-ill were abandoned by their families and forgotten by society.

In India, an estimated 8-10% of the population lives with some kind of psychiatric disorder, ranging from depression and anxiety to schizophrenia and alcohol and drug abuse.

Only one on 10 of them get treated, reported The Lancet in Matythis year. One reason is the stigma -- families would rather lock away a loved one than admit to the world there is someone in their family that needs psychiatric treatment.

The other is the lack of specialists to treat mental disorders. India has just 0.3 psychiatrists for 100,000 people, compared to 1.7 psychiatrists per 100,000 people in China .

New promises

India’s reformist Mental Health Care Act empowers people with mental health disorders to choose the mode of treatment , to say no to institutionalization, and to nominate a person to ensure their wishes are carried out.

It makes inhuman and degrading treatment of the mentally ill as a crime, bans the use of shock therapy for treating children and allows it for adults only after it’s approved by the district medical board and done under anaesthesia.

The new Bill decriminalizes attempted suicide on the grounds that a person attempts to kill themselves under high mental duress and cannot be imprisoned for a year under Section 309 of the Indian Penal Code.

In India, suicide is among the top 10 causes of death, with the National Crime Records Bureau recording 1,31,666 suicides 2014, up 15.8% since in 2004. The decadal population growth in the period was 14.6%.

Since fear of police action kept people who attempted suicide away from seek counselling and treatment, decriminilisation will make it easier for thousands to seek help.

Bill of rights

Rights: Right to equality of treatment, protection from inhuman and degrading treatment, free legal services, access to medical records, and complain against deficiencies in care.

Advance Directive: Right to make an advance directive certified by a doctor registered with the Mental Health Board to choose the kind and mode of treatment and nominate a person to ensure your choices are carried out.

Central and State Mental Health Authority: Administrative bodies to register and supervise all mental health establishments, develop quality and service norms, register mental health professionals, train law enforcement officials and doctors, and register complaints.

Free Will: Only patients can make the decision to be admitted to a mental health establishment, except in cases where they are unable to make an independent decision or conditions exist to make a supported admission unavoidable.

Decriminalise suicide: One attempting suicide is presumed to be suffering from a mental illness at that time and will not be punished under the IPC.

Shock therapy: Banned for treating children and allows it for adults only after it’s approved by the district medical board and done under anaesthesia.