The concern over the dire state of many Mental Healthcare Institutions (MHIs) in India has been recently voiced by The National Human Rights Commission (NHRC). As per the NHRC, these MHIs are unlawfully keeping patients even after their recovery, infringing on both individual rights and several international decrees relating to disabled people’s rights which India has ratified.
A Brief Overview of Mental Healthcare Act, 2017
Previously, the management of mental health conditions in India was governed by the 1987 Mental Healthcare Act. However, it was replaced by the Mental Healthcare Act of 2017 aiming to secure better rights for patients and dismantle the negative stigma related to asylums that persisted from the colonial era.
The Improved Protection for Patients: MHA 2017
The Mental Healthcare Act of 2017 defined mental illness in a comprehensive manner. Moreover, the Act affords patients several rights including access to healthcare services, legal aid, protection from inhumane treatment, the right to live in a community, and confidentiality, among others. It also decriminalised suicide attempts, eliminating legal prosecutions for those suffering from severe stress.
Administrative Bodies for Regulation
The act also proposed the establishment of Central and State Mental Health Authorities for better governance and implementation of mental health regulations across the country.
Hurdles in Implementing the Act
Despite the potential benefits, the Act faces numerous implementation challenges. Many states have not established Mental Health Review Boards (MHRBs), or State Mental Health Authorities, neglecting to draft and enforce minimum standards for MHIs. This renders patients unable to exercise their rights or seek recourse in case of rights violations. Additionally, poor budgets, lack of professionals, and the stigma attached to mental health issues often result in subpar services.
The Role of Gender in Mental Health Care
The issue of mental health care is also a gendered one, with women more likely to be abandoned due to societal stigma attached to family disruption and marital discord.
Sourcing Adequate Services and Facilities
Section 19 of the Act recognises the rights of persons to live as part of society without segregation. However, the lack of community-based services, socio-economic opportunities, and homes for assisted or independent living greatly complicates access to rehabilitation.
Global and Indian Initiatives Related to Mental Health
Internationally, initiatives such as World Mental Health Day, WHO’s Comprehensive Mental Action Plan 2013-2020, and Sustainable Development Goals (SDG 3.4) seek to address mental health issues. India-specific initiatives include the National Mental Health Program, Kiran Helpline, MANAS Mobile App, and Manodarpan.
The Way Forward
The Act must undergo regular reviews to remain effective in addressing the changing needs of individuals with mental health issues. Additionally, resources must be allocated to ensure thorough implementation and enforcement of the Act. Public disclosure about mental health issues, reducing stigma, and promoting mental health and well-being should be ongoing endeavours.
Mental health care in India is at a crucial stage where policy changes are essential. These must be supported by a multi-pronged approach inclusive of social awareness, infrastructural evolution, financial backing, and a cultural shift in perceptions towards mental illness.
