Table of Contents
INTRODUCTION
Mental health, a major concern worldwide, affects a person’s thinking, mind and behavior. It includes emotional changes in human beings accompanied with psychological changes like schizophrenia, depression,etc. At every stage of life, mental health is important, be it childhood or adulthood.
If a person is suffering from mental illness, there might be various factors that may be the reason for the same, such as stress in one’s life, life experiences, family history, biological factors, etc. It may be a big deal for some and not for others to handle. If life experiences are taken positively and people are made aware of the same, then it may be easy to recover. In order to have an idea of if a person is suffering from such illness, there are various alert signals that may suggest the same, like excessive fear or worry, social withdrawal, bipolar disorder, changes in eating and sleeping habits, and many more. Presently, in order to help these people, there are various mental health care centers.
In our society, a person suffering from mental illness is often viewed and treated differently. Our society holds a very negative attitude toward such persons. They start discrimination against such people and that may lead to mental health stigma. If they are not accepted, they possibly don’t consult a doctor and aren’t able to get any relief from it. Awareness regarding mental illness is the need of this hour.
MENTAL HEALTH CARE IN INDIA
The condition of mental health is very poor in India. According to a study, mental health is a major issue among ages 15-29. In 2019, India reported 381 suicides daily, according to a National Crime Bureau report.[1] Further, the number of people suffering from depression and anxiety are among the highest. In 2017, out of 14.3% of people suffering from various mental problems, 44.9 million were seen to be suffering from anxiety and 45.7 million, from depression.[2]
The allocation of funds towards National Mental Health programs is very less. In 2019, funds for the program were decreased from Rs. 50 Crores to Rs. 40 Crores, out of which only Rs. 5 Crores each was spent. The 2020 budget shows an increase in funds by 7%, but actually, there is no allocation of funds. There is a lack of doctors, resources, equipment tools, and then how a person can cure mental disorders.[3] There is no doubt that 70 to 90% of people didn’t get any treatment for their mental illness. And the utilization of allotted funds was focused more in urban areas, than in rural areas.
To deal with the rising issues around the area, the Indian government decided to enact the Mental Health Care Act, 2017 to do justice with persons who suffer from mental illness. The Act focused on giving the right and service to persons suffering from mental illness. The need for this Act is also necessary since the Mental Health Act, 1987 didn’t adequately protect the rights of persons suffering from a mental disorder. The Mental Healthcare Act, 2017 (MHCA) guarantees every right to a person suffering from mental illness.
SALIENT FEATURES OF THE MENTAL HEALTHCARE ACT, 2017
The Mental Healthcare Act, 2017 focuses on providing mental health care services to all persons suffering from any disorder along with protecting their rights.[4] This Act protects from any cruelty by the community, ill behavior, the right to access their records, and if in case they do not get the proper treatment, to have the right to get compensation from the state. Salient features of the Act include:
- Decriminalization of Suicide: The Act, under Section 115, decriminalizes suicide.[5] It acknowledges the stressful mental situation of a person committing suicide and puts the responsibility on the government to provide proper care and rehabilitation to such persons so as to avoid the recurrence of trying to suicide. This act overrode Section 309, Indian Penal Code (IPC), which had previously criminalized suicide by providing a punishment of imprisonment which is extended for 1 year and also fine or both.[6]
- Right to make a decision: According to Section 5 of the Act [7], every person has the right to make his own decision regarding the treatment of his illness other than the minor. If he is not in a position to make a decision then he has a right to choose a nominee in his/her place, as mentioned in Section 14[8] who may decide on his/her behalf.
- Right to access healthcare services: Every person suffering from mental illness has the right to access healthcare services from the government-funded hospitals. These services should be provided without any discrimination based on caste, color, sex, religion, etc. If a person is unable to get services in his district, then it is the responsibility of the government to don the arrangement of another hospital nearby and also pay all the expenditure of treatment.[9]
- Right to access free mental healthcare services: The people who are not in a position to afford healthcare services or who are below the poverty line have the right to access healthcare services and treatment free of cost in government-funded hospitals. The government should also ensure that services provided to the person below the poverty line are of equal quality provided to general or without any discrimination.[10]
- Right to life: Article 21 of the Constitution guarantees the right to live with dignity to every citizen, and this act also ensures this right to every person who is suffering from a mental disorder. This act ensures the right to live in the community i.e., with his family or relatives, and if his family didn’t accept him than it is the responsibility of the government to provide legal aid and all facilities to that person.[11] This act also guarantees every person protection from any cruel behavior by the community or any humiliating treatment or torture.[12] This act also guarantees the right to equality means they should also be treated equally without any discrimination.[13]
- Right to information: A person suffering from mental illness has the right to know about his admission, his treatment plans, and his nature of mental illness and also side effects of treatment. If a person is not in a position to understand all the things then all this information should be given to his nominee.[14] All the information related to his mental illness should be confidential; no person can access his information without his knowledge.[15]
- Establishment of Authorities: According to this act, there should be the establishment of authority both at the center [16] and at the state [17] level. The functions of these authorities are to provide services to all people with good quality and standards and also to ensure the proper implementation of provisions.
FLAWS IN THE MENTAL HEALTHCARE ACT, 2017
- This act does not clearly define mental illness. Section 2(s), which defines mental illness, applies only to those people who have a substantial disorder of thinking, mood, perception, etc, and are unable to recognize and are dangerous for society, this section does not cover all the people suffering from mental illness. This section does not include people suffering from mental retardation. Section 3 states the determination of mental illness according to national and international perspectives. The Act, further, does not cover personality disorders.
- According to the Act, a person suffering from mental illness should know all the facts and also has the power to choose treatment for himself. In our country, it is hard to find any person other than a psychiatrist who has complete knowledge about the mental disorder or what treatment will be suitable for a diseased person. If a person chooses the wrong treatment for himself then it will be difficult for the doctor. And the same with his nominee or relative who is also not aware of all these things. There is a need to amend this provision.
- As per the Act, only a person suffering from mental illness has the right to choose a nominee for himself, if a person is not in a situation to make a decision then how he will be able to choose and might not make a good decision. The Act does not provide a clear procedure for this as well.
- This Act does not cover family support or care to the mentally ill person at any point of treatment. But if the family of that person is not going to support him then how will the society be able to accept him or might not do any injustice with the person. One should believe that family support will help the person to become emotionally and physically fit. There is a need for the provision of family care at the time of treatment and after the treatment as well.
- This Act restricts the electro-convulsive therapy (ECT); this therapy is used for patients who suffer from severe depression. According to this act, ECT will not be used in the case of minors as well. In case if there is an emergency of using ECT then the psychiatrist has to take approval from the concerned board and after their approval only, they can use ECT. Such a process will probably take a longer time and meanwhile, anything could happen to the patient. The procedure should be such that it can benefit the person. There is an urgent need of amendment in this provision, for saving one’s life with the help of ECT.
- There is also a lack of resources in rural areas. According to this Act, the burden of the Government has been increased as this Act states the government should provide good quality services to all patients. However, owing to improper allocation of funds and limited workforce, the same seems impossible. There is also a need for the development of the workplace.
- This Act does not clarify the allocation procedure for funds between the centre and the state government.
- According to the Act, if after discharge, the patient suffers from any problems, the psychiatrist shall be responsible for it. The same, however, is not justifiable because this shall not be the ground of negligence on part of a psychiatrist, even the family can also be responsible for this under given circumstances. There should be a need for a compulsory community treatment order (CTO) which will provide family support to the patient and also to his family, but the Act is silent about this provision.
- This Act provides a provision for the appointment of an expert committee for proper implementation of the provisions but the efficacy of the expert committee is still pending.
IMPACT OF COVID-19 ON MENTAL HEALTH
While COVID-19 has affected everyone differently, it has given rise to more and more mental health problems. Firstly, people are suffering from mental health issues because of the lockdown; some have faced severe depression problems because of stress due to various reasons, including loss of jobs, exams etc. Secondly, the fear of the spread of COVID-19 and the absence of any vaccine or medication also contributes to growing mental health issues. Furthermore, owing to the lockdown, domestic violence cases have also increased. Because of severe depression, people have developed suicidal tendencies. Women also suffer from severe stress and depression because of increased household work coupled with various instances of domestic violence. Loss of jobs and financial crises are leading to issues relating to mental health. The persons who work on daily wages, in the pandemic have lost their work and are worried about their day to day requirements. These factors are leading to mental health problems in society. Most of the people are suffering from depression and anxiety.
ALL YOU NEED TO KNOW ABOUT DEFAMATION
MENTAL HEALTH AWARENESS
There is an urgent need for mental health awareness. Everyone knows that if a person is not mentally fit then he is prevented from applying his/her cognitive faculty and unable to do anything in the right way. If physical fitness is important than mental fitness is more important. There is a need for an awareness campaign in order to aware of our society about mental health issues and also how one should be treated if suffering from any mental disorder in order to help him get cured. Society should support him as a normal person and should help him to overcome his problems. The Mental Healthcare Act also provides some provisions regarding awareness. According to the Act, it is the responsibility of the government to promote mental health and its preventive program as well.[18] The government must create mental health awareness and also how to reduce the stigma of mental illness. This is not only the duty of the government to create awareness; people should also be involved in the process and support the government. These steps need to be taken for the benefit of persons facing mental issues.
CONCLUSION
Fitness is a very important aspect of one’s life, whether it is physical fitness or mental fitness. If a person is not mentally fit, he is unable to do the right things for himself, and if he is not physically fit, then also unable to do things according to his own will. So a person should be fit both physically and mentally. There is a need for amendment in The Mental Healthcare Act, 2017 which shall be great for our society.
REFERENCES
[1] Kalpana Sharma, “The soaring rate of teen suicides: What can we learn?”, Times of India, https://timesofindia.indiatimes.com/life-style/health-fitness/de-stress/the-soaring-rate-of-teen-suicides-what-can-we-learn/articleshow/78032936.cms (last visited on September 7, 2020).
[2] 1 in 7 People in India Suffer From Mental Illness: Lancet, available at: https://fit.thequint.com/mind-it/mental-health-burden-india-states-lancet-study (last visited on September 7, 2020).
[3] Diksha Munjal, “Huge gap in India’s mental health budget”, The Hindu, https://www.thehindubusinessline.com/news/national/huge-gap-in-indias-mental-health-budget/article30733494.ece (last visited on September 7, 2020).
[4]Mental Healthcare Act, 2017- PRS India, available at: https://www.prsindia.org/uploads/media/Mental%20Health/Mental%20Healthcare%20Act,%202017.pdf (last visited on September 8, 2020).
[5] The Mental Healthcare Act, 2017 (No. 10 of 2017), s. 115.
[6] The Indian Penal Code, 1860 ( Act 45 of 1860), s. 309.
[7] The Mental Healthcare Act, 2017 (No. 10 of 2017), s. 5.
[8] The Mental Healthcare Act, 2017 (No. 10 of 2017), s. 14.
[9] The Mental Healthcare Act, 2017 (No. 10 of 2017), s. 18.
[10] The Mental Healthcare Act, 2017 (No. 10 of 2017), s. 18(7).
[11] The Mental Healthcare Act, 2017 (No. 10 of 2017), s. 19.
[12] The Mental Healthcare Act, 2017 (No. 10 of 2017), s. 20.
[13] The Mental Healthcare Act, 2017 (No. 10 of 2017), s. 21.
[14] The Mental Healthcare Act, 2017 (No. 10 of 2017), s. 22.
[15] The Mental Healthcare Act, 2017 (No. 10 of 2017), s. 23.
[16] The Mental Healthcare Act, 2017 (No. 10 of 2017), s. 33.
[17] The Mental Healthcare Act, 2017 (No. 10 of 2017), s. 45.
[18] The Mental Healthcare Act, 2017 (No. 10 of 2017), s. 29.
BY- Nidhi | Geeta Institute of Law, Delhi (NCR)