Mental Health Bill: Some good news from Parliament

Last Updated: Wed, Mar 29, 2017 13:08 hrs
Mental Health Bill: Some good news from Parliament

In a rare show of bipartisan unity, the Mental Health Care Bill, originally introduced in the Rajya Sabha in 2013, was passed in Lok Sabha after a health discussion by leaders of all parties. The Bill, which effectively replaces the Mental Health Care Act 1987 is being lauded by many for important provisions which look at mental health care as a right and decriminalises of suicide attempts. In the context of India’s ratification of the United Nations Convention on Rights of Persons with Disabilities in 2007, the stated objective of this legislation is 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

Significantly, law which recognises that the right to mental health care is universal and explicitly states that there can be no discrimination to access care.

right to access mental healthcare and treatment shall mean mental health services of affordable cost, of good quality, available in sufficient quantity, accessible geographically, without discrimination on the basis of gender, sex, sexual orientation, religion, culture, caste, social or political beliefs, class, disability or any other basis and provided in a manner that is acceptable to persons with mental illness and their families and care-givers

It also provides a person with powers to issue advance directives, which therefore puts the patient in control of the treatment, as he or she can specify how they would like to be treated and also nominate a person of their choice who will assist them during their care. Keeping in mind, the poor and homeless, the law states that in case no such representative is available, the Director of the Social Welfare Department will be the designated representative, putting the responsibility on the government. A Mental Health Review Board will be constituted to manage this.

The New Indian Express reported that J.P Nadda, the Minister for Health and Family Welfare, said that the new approach is based on community support while the 1987 legislation focused on institutional interventions. Replying to concerns about the lack of institutional support to implement the law, the Minister was quoted as saying –

the government would replicate the expansion of model of the AIIMS with NIMHANS, Bengaluru, as the mentor for such institutions in various parts of the country.

The implementation of the legislation will largely be overseen by a Central and State Mental Health Authority who will advise the government as well as receive and act on complaints relating to deficient or denial of services. NDTV summarises the role of the authority -

Every mental health institute and mental health practitioners including clinical psychologists, mental health nurses and psychiatric social workers will have to be registered with this Authority.These bodies will register, supervise and maintain a record of all mental health establishments, develop quality and service provision norms for such establishments, as well as a register of mental health professionals, train law enforcement officials and mental health professionals on the provisions of the Act

According to this editorial in The Hindustan Times, the Bill takes a humane and a reformist approach. Referring to the large number of suicides, the decriminalisation of suicide attempts is a huge relief. Under Section 309, attempt to commit suicide is a crime punishable with a one year prison sentence.

With the National Crime Records Bureau recording 1,31,666 suicides in 2014, up 15.8% since 2004. It is also the leading cause of death among young Indians between ages 15 and 29 . Since a person undertakes such an extreme step under enormous mental stress –usually triggered by mental illness —to criminalises suicide will be a double blow to the victim. A person who is so depressed that he doesn’t want to live, needs empathy and not incarceration.

This article by Anoo Bhuyan in The Wire also points out that the way in which the Bill was passed ought to serve as a model legislative process for the future. This, especially in contrast to the way in which the Finance Bill was sought to be passed.

The Mental Healthcare Bill stands out for its wide consultations, rigorous debate both in parliament and in the Standing Committee, and its incorporation of a large number of stakeholder views as well as recommendations and changes. The Bill was debated at the regional and central levels, with stakeholders and mental health professionals. Nearly all the suggestions of the Standing Committee were incorporated in the Bill and the Rajya Sabha passed it in 2016 with several amendments accepted as well.

Zee News noted the healthy exchange of ideas and gratitude between Congress leader Shashi Tharoor and Minister J.P Nadda. Tharoor also pointed out that the Act must include provision of psychotherapists and counsellors in all educational institutions.

Tharoor during his emotional speech had said that he knows from his personal experience that there is nothing sadder than witnessing a close and loved person with mental illness at close quarters. Participating in the discussion on the bill, Tharoor had said if India wants a modern and progressive society, there is a need for this law while adding that people suffering from any mental disorder carry the stigma that "yeh toh pagal hai (he/she is mad)

There were other points brought up during the discussion. Asaddudin Owaisi had some suggestions about the constitution of the review board, taking objection particularly to the inclusion of members from the judiciary.

It is indeed encouraging to note that there was a healthy discussion on the law and the underlying issue it seeks to address, but like any other legislation the country will have to wait for sometime before effective and efficient implementation.

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