The mental health care bill proposed in 2016 has been passed through parliament. The bill has a number of key aims. Foremost amongst these are the decriminalisation of suicide and the provision of free government provided mental health care for the homeless and poor.
The bill will be “patient centric” and to “compel the state to have a mental health programme and it empowers the individual” claims Health minister JP Nadda. Indeed with the ability to walk into government health care facilities and, supposedly without identification of being below poverty levels, be provided with free mental health treatment, is a huge step forward if effectively put into practice.
A person may give an “advance directive” on how they wish for the treatment to proceed states the bill. This will take the form of a written letter: effectively a means of written consent and guidance for future care. This advance directive can be written by an assigned representative of the person, and must be approved by a medical practitioner before being given to the medical board.
In theory, this bill should place far more control in the hands of the patient and their family, with the ability to dictate exactly how treatment will be applied. The oversight of a doctor is also of considerable benefit, allowing for a person educated on the matter to not only approve but to advise on the best course of action.
Bringing forward specific laws regarding mental health treatment also ensures protection from discrimination, at the very least from a professional standpoint. Should a doctor refuse treatment based on gender, sexuality or religion, the law can step in to resolve the issue, with fines and prison sentences noted as potential punishments.
Treatment of patients in a dignified manner is also a priority. The bill makes it illegal to perform shock therapy on children, and on adults only when anaesthesia is applied. Forced sterilisation is to be made illegal, and use of chains or other cruel treatment is also banned. Living conditions for residents of mental hospitals is also to be strictly upheld to higher standards, with the assurance of clean environments, leisure facilities, wholesome food and access to privacy mentioned in the bill.
The decriminalisation of suicide is also a key aspect of the bill. No longer is suicide an arrestable offence, instead those who attempt but fail will be treated as in a state of “severe stress”. “Suicide is a mental disease. It will not be a criminal act, it will decriminalised. It recognises that it is done under severe mental stress,” said JP Nadda
The stigma attached to mental illness has previously been two-fold, socially it is often misunderstood, with many casting the mentally ill out from communities. Perhaps worse, stigma was attached in a legal sense. While suicide was illegal, it dissuaded many from seeking help regarding their illness, which can worsen conditions such as depression by adding to feelings of isolation.
With an estimated 75 million Indians suffering from mental health conditions this bill has the potential to provide access to the services that many of these people have previously feared seeking, or simply could not afford.