The long-awaited Mental Health Care Act 2017, which came into force on May 29 following a health ministry notification, is expected to bring about a sea change in the country’s mental healthcare scene and empower millions of people suffering from psychological disorders to access therapy without discrimination, experts say.
Healthcare professionals and patient rights advocates who have been working day in and day out to take the stigma out of mental ailments are upbeat as the new Act decriminalises attempt to commit suicide, bans the usage of electroconvulsive therapy without muscle relaxants or anesthesia and makes insurance cover available for mental illnesses just like in the case of physical disorders.
The new Act, passed by Parliament last year, has replaced Mental Health Act 1987. “The old regulation had several flaws and gaps and lacked provisions to protect the identity or privacy of the individual suffering from mental illness. Measures such as decriminalisation of suicide attempt are progressive which would give such people opportunities for rehabilitation,” said Naveen Kumar, director of Manas Foundation, a Delhi-based non-profit organisation striving to de-stigmatise mental health issues. Founded by a group of health professionals from the fields of clinical psychology and psychiatry, Manas offers a range of last-mile mental health services to support marginalised communities. “The notification regarding the new Act has just come and we are yet to go through all the details,” he added.
Under the new Act, a person with mental illness has the right to confidentiality in respect of his mental health and treatment. A photograph or any other information pertaining to the person cannot be released to the media without his consent. It also allows individuals to provide advance directions on the kind of treatment they would want in case they are diagnosed with a mental illness in the future.
“The right to access mental healthcare and treatment shall mean mental health services of affordable cost, of good quality, available in sufficient quantity, accessible geographically, without discrimination on the basis of gender, sex, sexual orientation, religion, culture, caste, social or political beliefs, class, disability or any other basis and provided in a manner that is acceptable to persons with mental illness and their families and care-givers,” the Act states.
The appropriate government is directed to make sure that an individual will not “continue to remain in a mental health establishment merely because he does not have a family or is not accepted by his family or is homeless or due to absence of community-based facilities”
“The new Act will certainly help a mentally ill person live with dignity. It allows involuntary admissions for only a specific period, and that also with strict conditions. Patients cannot be chained in any manner or form whatsoever. For the first time, the focus is on the rights of the patient,” Rajeshwari Ayyer, founder of Roshni, an NGO active in the mental health sector, told Pharmabiz.
The new Act empowers the government to set up a Central Mental Health Authority at national level and State Mental Health Authority in every State. It should be constituted within a period of nine months. All mental health institutes and mental health practitioners including clinical psychologists, mental health nurses and psychiatric social workers will have to be registered with this agency. The Authority can cancel the registration of any institution if it is found violating norms.
A Mental Health Review Board also will be constituted to protect the rights of persons with mental illness and manage advance directives. It can conduct inspections and take actions to protect the rights of mentally ill patients.
According to a report published recently by the World Health Organisation, around 56 million Indians or 4.5 per cent of the country’s population suffer from depression and another 38 million have anxiety disorders. Almost 7.5 per cent of Indians suffer from major or minor mental disorders that require expert intervention, the report shows.
“But only a miniscule percentage of patients seek professional help thanks to lack of resources, dearth of trained health-care providers and social stigma associated with psychological problems. Many of the sufferers are unaware of their condition and even if the family knows about it, we still have a habit of sweeping it under the rug,” Ayyer opined.