Mental Health Care Bill 2016: Need to Wait and Watch

BENGALURU: The Mental Health Care Bill, which was first introduced in the Rajya Sabha in August 2013 and passed in August 2016, was finally debated and passed in Lok Sabha earlier this week. The Bill was introduced in the light of the provisions in the United Nations Convention of Rights of Persons with Disability (UNCRPD), an international convention ratified by India in 2007.

The Mental Healthcare Bill 2016 makes provisions to ensure, protect and promote the rights of persons with mental illnesses and ensures aims to ensure that all individuals have access to mental health care facilities – irrespective of their socio – economic background.

The historical Bill has been appreciated by several groups and individuals; however, it might be too soon to draw conclusions on the success or failure of the new law. Mental Health in India has a very long way to go, for which even the foundation has not been entirely set up. While the new Bill makes several provisions, it provides no guidelines or rules of implementation. At present, the country has no data regarding the prevalence of mental illness, and there is glaring lack of mental health facilities and professionals in the country.

Provisions regarding the decriminalisation of suicide and the provision to file an ‘advanced directive’ are progressive and welcome, but the Bill in its entirety cannot be hailed as historical, and is not indicative of a nuanced and rights based approach towards mental health. Other salient features of the Bill are that it speaks of informed consent, and prohibits the use of Electro – Convulsive Treatment (ETC) on minors, however, allowing it on adults under the influence of muscle relaxants and anaesthesia.

The Bill focuses on the rehabilitation of persons with mental illness; however, it lays down no guidelines as to what rehabilitation must comprise of or how an individual with mental illness must be incorporated into mainstream society following the treatment and recovery. The Bill also speaks of creating awareness, but fails to mention how.

Swati Maliwal, Delhi Commission for Women chief, on her visit to Asha Kiran in Delhi earlier this year, witnessed the gross human rights violations that are rampant in homes for persons with mental illness. Inhabitants have often been found living in deplorable and unhygienic condition. Over the years several such cases have come to light, in which persons with mental illness have been found living naked, malnourished, infested with lice and in their own excreta. Despite the very evident and gross human rights violation, these centres are rarely held accountable nor are feasible guidelines for implementation laid down.

India has a growing population of persons with mental illness, who are more than often affected and their situations aggravated due to socio – economic and cultural factors, such as lack of access to health care, superstition, lack of understanding and awareness, stigma and discrimination. The Bill does not lay down any provisions addressing these factors. Despite its progressive nature, it fails to recognise the several other factors which disable persons with mental illness; even though the new law seeks to align itself with the rights based perspective, the Bill continues to look at mental illness from a very medical lens.

The Bill is a welcome step towards ensuring rights of persons with mental illness, but must be approached with caution given that the State does not have its basics covered. Another important factor to keep in mind is that the Bill is not evidence based; rather it is merely a move to fulfil international commitments. The lack of data and field research leaves the State ill – equipped with information of what is really required on the ground, kinds of mental illness, number of persons with mental illness and other challenges. In absence of these numbers and data, it is worth wondering how the State plans to effectively and strategically intervene and address the growing epidemic of mental illness in the country.

The true effectiveness of this new law will only become known in the years to come and will largely dependent of how committed the State is about ensuring and protecting the rights of persons with mental illness.