http://indianexpress.com/article/explained/new-mental-health-bill-provisions-rajya-sabha-2964545/

The Mental Health Care Bill, 2013 was passed by Rajya Sabha on Monday,
and is expected to be discussed in
Lok Sabha
 soon. The Bill seeks to replace the Mental Health Act, 1987. In 2007,
India ratified the United Nations Convention on the Rights of Persons
with Disabilities,
which requires signatory countries to change their laws to give effect
to the rights of persons with mental illness. It was believed that the
1987 Act
did not adequately protect these rights, and a need was felt to
provide them with better treatment and improve their access to health
services.

So, what kinds of mental illness are covered under the Bill?

Mental illness was earlier defined as any mental disorder other than
mental retardation. The Bill passed by Rajya Sabha defines mental
illness to mean
a disorder of thinking, mood, perception, orientation or memory. Such
a disorder impairs a person’s behaviour, judgement, capacity to
recognise reality
or ability to meet ordinary demands of life. This definition also
includes mental conditions associated with substance abuse, and does
not include mental
retardation.

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What is the population of the mentally ill in India?

There are no official estimates currently. In 2005, it was estimated
that 6-7% of the population suffered from mental disorders, and about
1-2% suffered
from severe mental disorders such as schizophrenia and bipolar
disorder. Nearly 5% of the population suffered from common mental
disorders such as depression
and anxiety. However, real numbers could be higher, as mental illness
often goes underreported due to the associated stigma. The World
Health Organisation
has recently estimated that 1 in 4 persons will be affected by some
form of mental illness once in their lifetime.

And what are key rights being guaranteed under the Bill?

Manner of treatment: The Bill states that every person would have the
right to specify how he would like to be treated for mental illness in
the event
of a mental health situation. An individual will also specify who will
be the person responsible for taking decisions with regard to the
treatment, his
admission into a hospital, etc.

Access to public health care: The Bill guarantees every person the
right to access mental health care and treatment from the government.
This right includes
affordable, good quality, easy access to services such as minimum
mental health services in every district. Persons with mental illness
also have the right
to equality of treatment and protection from inhuman and degrading treatment.

Suicide decriminalised: Currently, attempting suicide is punishable
with imprisonment for up to a year and/or a fine. The Bill
decriminalises suicide.
It states that whoever attempts suicide will be presumed to be under
severe stress, and shall not punished for it.

Insurance: The Bill requires that every insurance company shall
provide medical insurance for mentally ill persons on the same basis
as is available for
physical illnesses.

And are there any implementation challenges?

The Bill mandates the central and state governments to ensure access
to mental health services in every district. These will include
outpatient and inpatient
services, hospitals, and community-based rehabilitation
establishments. However, the financial memorandum of the Bill does not
estimate the expenditure
required to meet the obligations under the Bill nor does it provide
details of the sharing of expenses between the central and state
governments. Without
the allocation of adequate funds, the implementation of the Bill could
be affected. The Standing Committee examining the Bill had noted that
public health
is a state subject. Since several states face financial constraints,
the central government might have to step in to ensure funds for the
implementation
of the law.

What about guardianship provisions for mentally ill persons?

The Bill as passed by Rajya Sabha does not address issues related to
guardianship of mentally ill persons. The 1987 Act has detailed
provisions related
to appointment and removal of a guardian, and his powers and duties.
The provisions related to guardianship of mentally ill persons are in
the Rights of
Persons with Disabilities (RPD) Bill, 2014, which is pending in
Parliament. If the Bill is passed by Parliament in its current form,
there will be a legal
vacuum with regard to provisions of guardianship of mentally ill persons.

What happens when the provisions of the planned law are violated?

The Bill does not prescribe specific penalties for non-compliance with
several of its provisions. A general punishment of imprisonment up to
6 months or
a penalty of up to Rs 10,000, or both, is provided. The absence of
specific penal provisions might create ambiguities with regard to the
implementation
of the Bill.

What was the scrutiny that the Bill received in Parliament?

The Bill was examined by a Parliamentary Standing Committee, which
made a number of recommendations. Rajya Sabha debated the Bill for
approximately 4 hours,
and 17 MPs participated in the debate. In a 136-clause Bill, the
government moved 134 amendments, giving MPs almost no time to
reconcile the amendments
with the recommendations of the Standing Committee. The Bill will now
be debated in Lok Sabha before it is passed.


-- 
Avinash Shahi
Doctoral student at Centre for Law and Governance JNU


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