Mental Health Care Bill Passed by Parliament

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The Parliament passed the ‘Mental Healthcare Bill’ in the Lok Sabha that decriminalises suicide attempt by mentally ill people and provides services for people with mental illness. One of the provisions of the bill is to protect and restore property right of mentally ill persons.

Bill decriminalises suicide because a person who attempts suicide should be presumed to have severe stress, and shall not be punished. Now it will be the Government’s duty to provide care, treatment and rehabilitation to a person who attempts to commit suicide and to reduce the risk of its recurrence. The provisions of the Indian Penal Code can no longer be invoked in this regard.

The bill said, “Notwithstanding anything contained in section 309 of the Indian Penal Code, any person who attempts to commit suicide shall be presumed, unless proved otherwise, to have severe stress and shall not be tried and punished under the said Code.”

Important provision in the Bill is that a person with mental illness can make an advance directive on how he/she wants to be treated and nominate a representative. The Bill has a provision to protect and restore the property rights of mentally ill people. With its focus on community-based treatment, the Bill is a deviation from the 1987 Mental Act that focused on institutionalisation of mental healthcare interventions.

One of the prime features of the bill is that it seeks to provide proper health-care, treatment and rehabilitation of mentally ill persons “in a manner that does not intrude on their rights and dignity.”

Main provisions of Mental Healthcare Bill:

1. Rights of persons with mental illness: This provision states that every person will have the right to access mental healthcare from services which are operated or funded by the government. It also includes good quality, easy and affordable access to services. It also provides for the right to equality of treatment, seeks to protect such persons from inhuman treatment, access to free legal services, their medical records, and the right to complain in the event of regarding deficiencies in provisions.

2. Advance Directive: This provision empowers a mentally-ill person to have the right to make an advance directive that explains how she/he wants to be treated for the requisite illness and who her/his nominated representative shall be. This directive has to be vetted by a medical practitioner.

3. Mental Health Establishments: This provision states that every mental health establishment has to be registered with the respective Central or State Mental Health Authority. For registration, the concerned establishment needs to fulfill different criteria as mentioned in the Bill.

4. Mental Health Review Commission and Board: This is a quasi-judicial body responsible for reviewing procedure for making advance directives. It will also advise the government on the protection of mentally ill persons’ rights. It further states that the body in agreement with the state governments constitute Mental Health Review Boards in states’ districts.

5. Decriminalising suicide and prohibiting electro-convulsive therapy: The most notable of all is this provision effectively decriminalises suicide attempt under the Indian Penal Code by mentally ill persons by making it non-punishable. Electro-convulsive therapy, which is allowed only with the use of anaesthesia, is however out of bounds for minors.

6. The bill also outlines the procedure and process for admission, treatment and subsequent discharge of mentally ill persons.

A recent study by ICMR reveals that in India, the rate of psychiatric disorders in children aged between 4 and 16 years was about 12 per cent. Every year only 550 doctors passed out in the discipline of psychiatry. This amounts to a shortage of 87 per cent. The shortage of psychiatrists and psychiatric social workers is to the extent of 67 per cent and 96 per cent respectively.

According to a recent report by the MHFW, “Seven per cent of the population suffers from mental disorders. Over 90 per cent remain untreated. There is less than one psychiatrist available for every four-lakh population.”

Though the Bill has the potential to promote the well-being of mentally ill persons, mental healthcare planners and policymakers face several challenges. The main challenge is the lack of qualified professionals.

Currently the mental health workforce in India is composed of trained professionals in the fields of psychiatric social work, clinical psychology, psychological counselling, medicine (including psychiatrists) and psychiatric nursing.

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