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Fwd: Mental Health Care Bill cleared for tabling at next Parliament session !

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  • Thiagarajan Arunachalam
    From: *Vaishnavi Jayakumar* ** Changing minds *13-June-2013* *It will take more than a new law to battle entrenched attitudes to mental illness* The draft
    Message 1 of 1 , Jun 17, 2013
      From: Vaishnavi Jayakumar


      Changing minds


      It will take more than a new law to battle entrenched attitudes to mental illness

      The draft mental health bill, scheduled to come up before the Union cabinet on Thursday, is a welcome step forward from the Mental Health Act of 1987, currently in place, which is a limited, paternalistic document. One of the act's stated objectives is to "protect society" from the presence of potentially dangerous mentally ill persons. The provisions of the draft bill, more closely aligned with international norms, seem to suggest a new understanding of mental illness. It focuses on rights and protections for the mentally ill, giving them greater agency in decisions regarding treatment. Though it signals a welcome change in approach, however, a new law alone may not be enough to address the myriad problems faced by mental health patients in India.

      Persons with such illnesses are usually segregated from the mainstream, shunned by peer groups and prospective employers. Ossified social attitudes have been shored up by decades of institutional apathy and discrimination, whether it is in a court of law or a police station. Government-run mental hospitals, mostly inherited from the colonial era, are nightmarish spaces. Many of these institutions are converted prisons, with practices of incarceration and punishment still embedded in them. Patients lack basic facilities such as adequate nutrition and sanitation. Even government sources acknowledge a large "treatment gap", that is, a disparity between the number of patients and the number of hospital beds and trained professionals to staff the institutions.

      Greater awareness about mental illness would go a long way in doing away with the discrimination that is entrenched in our society and institutions. The government must also focus on capacity building in the hospitals and running them as proper medical facilities. A law is only lip service to change.


      Cabinet clears Mental Health Care Bill

      Aarti Dhar

      NEW DELHI : The Union Cabinet on Thursday cleared the Mental Health Care Bill, 2013 that makes access to mental health care a right of all persons. Such services should be affordable, of good quality and available without discrimination, it said. The proposed law decriminalises suicide.

      The Bill, in consonance with international laws, has the provision of Advance Directives — described as a progressive and far-sighted step. No person who has recorded an Advance Directive to State that he or she should not be admitted to a facility without consent can be so admitted.

      A rights-based Bill also has a provision wherein a person with mental illness can appoint a nominated representative to take decisions for him or her. Under the provisions of the Bill, government has an obligation to provide half way homes, community caring centres and other shelters for mentally ill people. This has been planned under the District Mental Health Programme in the 12th Plan.

      In 2005, the National Commission on Macroeconomics and Health reported that 10-12 million or one to two per cent of the population suffered from severe mental disorders such as schizophrenia and bipolar disorder, and nearly 50 million or five per cent from common mental disorders such as depression and anxiety, yielding an overall estimate of 6.5 per cent of the population. The prevalence of mental disorders was higher among women, those who were homeless, poor and living in urban areas, Union Health and Family Welfare Minister Ghulam Nabi Azad told The Hindu.

      The new Bill, once approved by Parliament, will repeal the Mental Health Act, 1987, which had vested extraordinary power in the hands of the treating psychiatrists. There was enough evidence of misuse and unscrupulous families collaborating with psychiatrists in addition to badly functional or non-functional Central and Mental Health Authorities primarily because of lack of funds.

      Under the proposed new law, there is provision for voluntary admission with supported admission limited to specific circumstances; appeals can be made to the Mental Health Review Commission, which will also review all admission beyond 30 days and free care for all homeless, destitute and poor people suffering from mental disorder. The Bill provides right to confidentiality and protection from cruel, inhuman and degrading treatment, in addition to right to live in a community and legal aid. It bans the electric-convulsive therapy without anaesthesia and restricts psychosurgery, Mr. Azad said.

      He said the Bill tries to address the needs of the families and caregivers, and the needs of the homeless mentally ill. It provides for setting up Central and State Mental Health Authorities, which would act as administrative bodies, while the Mental Health Review Commission would be a quasi-judicial body to oversee the functioning of mental health facilities and protect the rights of persons with mental illness in mental health facilities.

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