According to a rough estimate 60 million Indians suffers from mental health difficulties. Nearly 1-2% of the population suffers from severe mental disorders, such as Bipolar disorder and Psychosis, and 5% suffers from common mental disorders like depression, anxiety and stress. These numbers are based on a research conducted by National Commission for macroeconomics 2005.
However these figures are in all likelihood a significant understatement, as most of the times psychological difficulties are unreported due to either lack of awareness, or stigma, or a combination of the two. This is also associated with lack of competent psychiatric consultations or simply the unavailability of qualified and trained persons to tackle these issues. There are only 3800 psychiatrists, 898 clinical psychologists, 850 social workers and 1500 psychiatric nurses across a nation of 1.2 billion people.
Mental Health Care Act 2017 (hereby referred to as The Act) passed in the upper house on 27th March, 17 is a big step in the right direction taken by the government. The mental health legislation that it replaces is outdated, and not fit for purpose. Since India is a signatory to the United National Convention for Rights of People with Disabilities (UNCRPD), the law had to be updated to make it compliant with this international rights convention. Some key provisions under the Act are:
- Rights of person with mental illness: Every person will have the right to access mental healthcare services which are funded or operated by the government. People will have the right to equality of treatment, right to protection from inhuman treatment, right to access free legal service and right to complain with regards to any discrepancies.
- Advance Directive: It empowers the patient to decide how he/she would like to be treated and the right to choose a nominated representative.
- Mental health establishments: This provision empowers mental health establishments with the right to get registered with state or central government authorities provided they fulfill the required norms. As of now, under the earlier legislation, certain government institutions were not required to register themselves or maintain the same standards that private institutions were required to maintain.
- Mental health review and commission board: This will be a four member body and the President and members of this commission shall be appointed by the President of India on the recommendation of selection committee. The role of this commission board will be to review the procedure of making advance directives and also advise the government on protection of patient’s rights.
- Decriminalizing suicide – The section 309 of Indian Penal code has been scrapped and any person who commits suicide shall presumed to be under severe stress and shall not be punished unless proved otherwise. Although the law was rarely ever actually applied, until now, it was against the law to attempt suicide, and this resulted in individuals being reluctant to seek the appropriate help that they needed.
- Insurance coverage and discrimination – The Act prohibits insurance companies from discriminating against patients with psychiatric conditions. Currently, the same insurance companies that cover psychiatric conditions all over the world, in India refuse to pay out if an individual develops a mental health condition, using the argument that ‘all psychiatric conditions are pre-existing conditions’. This is something that they will no longer be able to do and they will have to provide the same benefits that they provide in the Western world.