New Mental Health Care Bill can’t wait any longer

On August 19, 2013, a new Mental Health Care Bill was introduced in the Rajya Sabha. The Bill repeals the Mental Health Act, 1987. Some of the important measures proposed in the bill are: Decriminalisation of attempted suicide, prohibiting electro-convulsive therapy, rights of persons with mental illness, establishment of a central and state mental health authority; advance directive, that is “a mentally-ill person shall have the right to make an advance directive that states how he/she wants to be treated for the illness during a mental health situation and who his nominated representative shall be,” and a mental health review commission and board.

“We have fought a very long battle for the rights of the mentally ill to be recognised. This Bill, is a victory for us, as it insures that the mentally ill deserve to be treated at par with the physically ill. Hence it emphasises on the importance of treatment of people attempting suicide, which as a professional I consider to be a very positive thing,” says Dr Rajesh Sagar, assistant professor, department of psychiatry, AIIMS.

Dr Deepak Aggarwal, assistant professor of neurosurgery at AIIMS, adds: “I support the creation of a Mental Health Review Commission and Board, so that individual cases can be assessed properly by professionals, and these professionals can thereon refer cases for criminal procedures and psychiatric care.” One of the most important and controversial measure proposed in the bill is the decriminalisation of attempted suicide and prohibition of electro-convulsive therapy, which has been hailed by psychiatrists throughout the country.

However, there are many challenges and shortcomings in the Bill that psychiatrists point to. “The proposed bill represents only a cosmetic change, it does not propose viable improvement in services. It does not propose education neither does it make it mandatory for a person with disorders to seek treatment. On the outset it seems like a utopian bill, as there is a complete shortage of both funds and human resource, I am doubtful how the law will be implemented. A person with mental illness has no proper insurance, there are cases of road mishaps, even in such cases the government does not provide a mentally ill person with guaranteed insurance,” says Dr Kushal Jain, Psychiatrist, VIMHANS Hospital.

A paper published in Indian Journal of Psychiatry criticises the Bill, stating that there is no mention about the huge resource-mobilisation that is required to realise various promises that the bill is holding out. Nor could patients and their families seek relief through courts of law. Nor does the bill mention anywhere, about how it would prevent the exploitation of mentally ill persons. “It is very important that legislators consult practising professionals. Most mental health services available in hospitals are not patient friendly and they don’t respect their privacy. It is a challenge to provide adequate care for both long and short term mental illnesses, and hence there is a huge need for investment in human resources as well.

Mental illness is seen as a huge taboo, what we need is a complete overhaul of the system starting from basic education on mental health,” adds Dr Jain. Dr Naveen Kumar of the Manas foundation reiterates the concerns regarding the implementation of the Bill, “No bill can help bring about a considerable change unless the Centre is ready to prioritise mental health and educate the masses about the prevailing psychological pressures and conditions. There is a dire need to spread awareness among the people about mental health,” he said.