Analysis of the Mental Health Bill 2016

Context:

Mental Health care bill was up for the discussion in Lok Sabha yesterday. Here are the highlights, analysis and some challenges of the bill.

Mental Health Care Bill 2016

• The bill is being considered 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.

• It is formulated in line with the “Convention on Rights of Persons with Disabilities” adopted in 2006 and ratified by India in 2007 it is necessary to align and harmonise the existing laws with the said Convention.

• The Bill repeals the existing Mental Health Act, 1987, which is vastly different in letter and spirit. The Act of 1987 had been widely criticised for proving to be inadequate to protect the rights of mentally ill persons.

Highlights of the bill

 1. Decriminalisation of Suicide:

• Someone attempting suicide shall be presumed to be suffering from mental illness at that time and will not be punished under the Indian Penal Code unlike before.
• The government shall have a duty to provide care, treatment and rehabilitation to a person, having severe stress and who attempted to commit suicide, to reduce the risk of recurrence of attempt to commit suicide.

2. Rights Based Approach:

• The Bill guarantees every person the right to access mental health care and treatment from mental health services funded by government.
• This right is meant to ensure mental health services of affordable cost, of good quality, of sufficient quantity, are geographically accessible and are provided without discrimination.
• The Bill also recognises the right to community living; right to live with dignity; protection from cruel, inhuman or degrading treatment; treatment equal to persons with physical illness; right to relevant information concerning treatment other rights and recourses; right to confidentiality; right to access their basic medical records; right to personal contacts and communication; right to legal aid; recourse against deficiencies in provision of care, treatment and services.
• Every insurer is bound to make provision for medical insurance for treatment of mental illness on the same basis as is available for treatment of physical illness.

3. Advance Directive:

• The Bill states that every person would have the right to specify how he would like to be treated for mental illness in the event of a mental health situation.
• An individual will also specify who will be the person responsible for taking decisions with regard to the treatment, his admission into a hospital, etc.

 4. Mental Health Authority (MHA)

• The Government would set-up Central Mental Health Authority at national-level and State Mental Health Authority in every State.
• 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.

    Function of MHA

• register, supervise and maintain a register of all mental health establishments
• develop quality and service provision norms for such establishments,
• maintain a register of mental health professionals,
• Train law enforcement officials and mental health professionals on the provisions of the Act
• Receive complaints about deficiencies in provision of services, and
• Advise the government on matters relating to mental health

5. Other Treatment Guidelines

• A person with mental illness shall not be subjected to electro-convulsive therapy without the use of muscle relaxants and anaesthesia. Also, electro-convulsive therapy will not be performed for minors.
• Sterilisation will not be performed on such persons.
• They shall not be chained in any manner or form whatsoever under any circumstances.
• A person with mental illness shall not be subjected to seclusion or solitary confinement. Physical restraint may only be used, if necessary.

Concerns and Challenges with the bill

• Unlike the Act of 1987, the Bill does not provide for management of property of mentally ill persons. This is a serious cause of concern as mentally ill persons could easily be exploited and their property taken away from them, leaving such individuals in a perpetual state of dependency.
• The financial memorandum of the Bill does not estimate the expenditure required for meeting the obligations under the Bill nor does it provide details of the sharing of expenses between the central and state governments. Without the allocation of adequate funds, the implementation of the Bill could be affected.
• Several states face financial constraints, the central government might have to step in to ensure funds for the implementation of the law.

Conclusion

In a much-needed change, the Centre has adopted a medicalised approach to attempted suicide, has adopted a rights-based approach for the mentally ill individuals with an apt governance framework.

The success of this more progressive law brought in to replace the Mental Health Act, 1987, will depend ultimately on the community keeping up the pressure on the designated Central and State authorities to implement it in letter and spirit.

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 Questions:

1. What are some of the features of the Mental Health Care Bill 2016 that makes it progressive change from the past?

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