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Current Status of Mental Healthcare in India

Mental healthcare and issues regarding mental health are as important as physical health. Indian laws have recognized the importance of mental healthcare ever since 1987, but mental health has always been a stigma in the country. Due to the stigma, people are hesitant to talk about it, and therefore, there is a lack of awareness regarding these issues.

Currently, in the pandemic several people are facing mental health issues such as anxiety, depression or having suicidal thoughts, yet they are unaware about the means to seek help. People are unaware of the laws, their rights and the forum to approach for any kind of help. There are several laws and policies in the country governing mental healthcare but the primary law is the Mental Healthcare Act, 2017. This Act replaced the old Mental Healthcare Act of 1987.

Objective of the Act
The main objective of the Mental Healthcare Act,2017 is to protect and promote mental illness, which is a disorder of thinking, mood, perception, orientation, or memory affects the ability to meet the ordinary demands of life. It also includes mental conditions associated with the abuse of alcohol and drugs. It aims at providing a better mental healthcare system and facilities to all citizens.

Rights Available To Persons With Mental-Illness [i]
  • Right to Access Mental Health Care
    Every person irrespective of their caste, creed, sex or religion has the right to access good quality mental health care and treatment at affordable costs. The right to access healthcare services is available only in the manner which is required by the person or their family members.
     
  • Right to Community Living
    Every person with a mental illness has the right to live and be recognized as a part of the society. They should not be separated from the society or be forced to live in a mental healthcare establishment only because they are not accepted by their family or society.
     
  • Right to Protection from cruel, inhuman and degrading treatment
    Every person living in a mental health establishment, has the right to be treated with dignity. In an establishment they should not be subject to any cruel or inhuman treatment and should be living in a hygienic, friendly environment with recreational activities.
     
  • Right to Equality and Non-Discrimination
    All persons who have a mental illness should be treated equally as a normal person with any kind of physical illness. They should not be denied any services and should not discriminated on the basis of their faith, belief, race, caste, sex or religion.
     
  • Right to Information
    Every person who is undergoing treatment or has approached seeking mental health care, has the right to be informed about his mental condition. The person is entitled to know about the treatment and the medications that is being given. Although this information can be shared only when the person is in the state of mind to understand.
     
  • Right to Confidentiality
    Every person who is undergoing treatment has the right to confidentiality. Any information regarding his treatment, mental health should be maintained confidential by the healthcare professionals who are treating them. Only necessary information regarding the patient can be shared with other doctors or professionals, cases when it necessary for the family to know or cases when there could be a threat to the life of the patient or other persons, in such cases necessary information can be shared. The right to confidentiality is also applicable to information stored in the digital form, which means that any photographs of the patients should not be made available to the media, without consent.
     
  • Right to Access Medical Records
    All persons have the right to access their medical records and no information should be withheld by the medical professionals regarding the patient's health. Although, if such an information could harm the patient, the medical professional can withhold information. In case the patient wants to access the withheld information, an application can be sent to the medical board.
     
  • Right to Personal Contacts and Communication
    Every person in a medical healthcare establishment has the right to make phone calls and have personal contacts. The person also has the right to refuse any form of communication through phone calls and emails. Although, important communications from their family, lawyers, judges or government authorities cannot be refused.
     
  • Right to legal aid
    Every person with a mental illness has the right to free legal aid. It is the duty of the medical healthcare professional to ensure that the patients are entitled to free legal aid services mentioned in the various laws.
     
  • Right to file complaints for deficiency in services
    Every person who is not satisfied with the medical services can file a complaint with the medical board or state authority.

Laws And Policies Related To Mental Health In India
Laws:
  1. The Protection of Human Rights Act, 1933:
    This Act provides equal opportunities and prevents unfair treatment on the basis of personal characteristics. Mental illness being a personal characteristic also comes under this Act.
     
  2. Mental Health Act 1987:
    This Act has been replaced by the new Act in 2017.
     
  3. Persons with Disabilities Act, 1955:
    Under this Act, mental illness is considered as a disability and persons with mental retardation or mental illness can gain benefits under this Act.
     
  4. National Trust Act, 1999:
    This is a welfare legislation that was created for persons with autism, cerebral palsy, mental retardation and multiple disabilities. This Act provides opportunities and helps them lead an independent life.
     
  5. Mental Healthcare Act, 2017:
    This Act is the primary legislation dealing with medical healthcare in India.
Policies:
  1. National Mental Health Policy, 2014:
    The Government formulated this policy with the intention of promoting mental health and helping people recover from illness. The main aim of this policy is to de-stigmatize mental-illness and ensures that everyone has access to healthcare. [ii]
     
  2. National Mental Health Programme:
    The Government had launched this programme in 1982 to ensure better availability of mental healthcare. This programme deals with treatment of mental-illness, rehabilitation and promotion of positive mental health. In 1996, a district Mental Health Program was started. The Program was re-strategized in 2003 to and included Modernization of State Mental Hospitals and Up-gradation of Psychiatric Wings of Medical Colleges/General Hospitals. In 2009 a scheme for manpower development was also started.[iii]

Health Insurance Schemes for Mental-illness [iv]:
  1. Ayshman Bharat Scheme by the Central Government:
    This scheme offers an insurance cover of up to 5 lakhs. It has 17 different packages dedicated for mental disorders. This scheme covers all mental health treatment costs in both private and public hospitals.
     
  2. Biju Swasthya Kalyan Yojna by the Odisha Government:
    This scheme offers free treatment in all government and empaneled hospitals for a sum of 5 lakhs for male members and 7 lakhs for female members. It covers the cost of treatment of psychiatric disorders in government hospitals.
Amendment to the Act
In 2018, the Government declared that attempt to suicide is not a crime under the mental Healthcare Act. As per Section 115 of the Mental Healthcare Act, it would be presumed that the person who attempted suicide was under stress or was suffering mental issues and therefore should be treated with compassion. The Government also banned electric shock treatment to mentally-ill children.[v]

Recent Judicial Decisions
  • SHIKA NISCHAL V. NICL
    In 2021, the Delhi High Court held that there should be no discrimination between physical illness and mental illness. It was also held that all insurance companies should provide for mental health insurance. [vi]
     
  • ORDER OF THE SUPREME COURT
    In 2020, the Supreme Court held that depression is not considered as unsoundness of mind and cannot be used as a defense for crimes.[vii]
     
  • NAVTEJ SINGH JOHAR V. UNION OF INDIA
    In 2018, the Supreme Court held non-conformity towards social norms cannot be considered as a mental illness under the Mental Healthcare Act.[viii]
     
  • EERA V. STATE OF DELHI
    In 2017, the Supreme Court stated that mental retardation is different from mental illness. Mental retardation is the slow growth of the mind, which can be considered as a disability of the person, but mental illness is a state of mind.[ix]

Places To Approach For Help
  1. Incase of violation of rights- As per the Mental Healthcare, the Medical Board and State Authorities can be approached.[x] With the help of lawyers, the Supreme Court or High Courts can be approached for violation of rights.
  2. For deficiency in medical services- Consumer Redressal Forums can be approached by virtue of the Consumer Protection Act.[xi]
  3. For help related to mental health-the government toll free help-line number 1800-599-0019 can be approached.[xii]
  4. For other resources- Various non-governmental portals can also be approached for help.[xiii]

Conclusion
Though mental healthcare has been a stigma in India, times have changed and people have started accepting mental health issues. India has several laws and policies regarding mental health and has seen various developments with the evolvement of time. These laws and policies can have a greater impact on people and can be implemented in better ways.

The first step towards greater impact would be by raising awareness about these laws and rights and ensuring that each person facing mental health problems can seek for help and can good quality treatment. Raising awareness about these issues would benefit people in many ways and also save lives. Therefore, the Government should take initiatives to spread awareness about these laws and the importance of good quality healthcare and treatment of mental disorders.

Awareness can be spread through social media, newspapers, radio and television so that it reaches people of all regions. Further, in the pandemic, steps can be taken to create online portals where people can share their problems and seek any kind of help. Since mental healthcare is one of the major issues faced by people of all ages groups, initiatives can be taken by individuals and NGOs as well to spread awareness and bring about the required change.

End-Notes:
  1. Mental Heathcare Act, 2017, Chapter V, No.10, Acts of Parliament, 2017.
  2. New Pathways New Hope, National Mental Health Policy of India, Ministry of Health and Family Welfare, 2014, http://nhm.gov.in/images/pdf/National_Health_Mental_Policy.pdf.
  3. National Health Portal, https://www.nhp.gov.in/national-mental-health-programme_pg (last visited Aug.4, 2021).
  4. Om Prakash Singh, Insurance for mental illness: Government schemes must show way, Indian Journal of Pyschiatry, Mar.2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6425797/.
  5. Government decriminalises suicide, notifies new law, NDTV, (Jun.3,2018) https://www.ndtv.com/india-news/government-decriminalises-suicide-notifies-new-law-1861575.
  6. Gayatri Joshi, Confirmity of Mental Health Insurances with the Mental Healthcare Act, 2017, Mondaq, https://www.mondaq.com/india/healthcare/1070482/conformity-of-the-health-insurance-policies-with-the-mental-healthcare-act-2017 (last visited Aug. 4, 2021).
  7. Mehal Jain, Depression Not Unsoundness Of Mind For S. 84, IPC: Supreme Court Dismisses Appeal Against Dismissal By Ex-Army man [Read Order], Bar and Bench, ttps://www.livelaw.in/top-stories/depression-not-unsoundness-of-mind-for-s-84-ipc-sc-junks-appeal-against-dismissal-by-ex-armyman-165257 (last visited Aug.4,2021).
  8. (2018) 10 SCC 1.
  9. (2017) 15 SCC 133.
  10. Mental Healthcare Act, 2017, 28, No.10, Acts of Parliament, 2017.
  11. Consumer Protection Act, 2019,  2(11), No. 35, Acts of Parliament, 2019.
  12. Special Correspondent, Centre launches 24/7 toll free mental health helpline, THE HINDU, (Sept.7, 2020), https://www.thehindu.com/sci-tech/health/centre-launches-247-toll-free-mental-health-helpline/article32545325.ece.
  13. https://indianhelpline.com/SUICIDE-HELPLINE/.

    Award Winning Article Is Written By: Ms.Jyothsna Nanda Kishore
    Awarded certificate of Excellence
    Authentication No: SP125665481263-13-0921

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