*The draft Mental Health Care Act, 2010, promises to revolutionise the country’s mental healthcare system. Shabina Akhtar examines the proposed law *
* * *11 August 2011* * * *KOLKATA* : When 25 mentally ill persons were charred to death at a mental home in Tamil Nadu’s Erawdi village 10 years ago, the whole country was shocked. But the most shocking aspect of the horrific tragedy was that the patients had been chained to their beds and hence could not escape when the fire broke out. Today, the government is all set to bring about a sea change in the country’s mental healthcare system. The Mental Health Care Act (MHA), 1987, is being amended, and among the far-reaching changes suggested is a ban on patients being chained during treatment. A new draft act, the Mental Health Care Act, 2010, has been written and is slated to replace the earlier law once it is approved in Parliament. Says Keshav Desiraju, additional secretary, health, Government of India, “It was felt that present legislation does not protect the rights of persons with mental illness and that it can allow unscrupulous doctors or family members to confine a person with mental illness against his or her will.” The new law, he says, takes a rights-based approach and contains safeguards to prevent the mentally ill from being maltreated or discriminated against. The MHA, 2010, is, in fact, far more detailed and elaborate than the current law. For example, the definition of mental illness itself is a much more comprehensive one. It states, “‘Mental illness’ for the purpose of this act, means a disorder of mood, thought, perception, orientation or memory which causes significant distress to a person or impairs a person’s behaviour, judgment and ability to recognise reality or impairs the person’s ability to meet the demands of normal life and includes mental conditions associated with the abuse of alcohol and drugs, but excludes mental retardation.” The 1987 act, on the other hand, defines a mentally ill person merely as someone “who is in need of treatment by reason of any mental disorder other than mental retardation.” The new law also proposes a stiffer punishment for those who violate its provisions. Whereas earlier, offenders would serve a maximum of six months’ imprisonment or a fine of Rs 500, or both, now the fine for such offences has been raised to a maximum of Rs 10,000. Another progressive measure laid down in the new MHA Act is to provide health insurance cover for the treatment of the mentally ill. Section 10, sub-section (ii) states, “Public and private insurance providers shall make provisions for medical insurance for the treatment of mental illness on the same basis as is available for the treatment of physical illness.” This will come as a huge boon to those who fall prey to mental illnesses since at present no health insurance scheme covers problems related to psychiatric conditions. “It’s discriminatory not to provide insurance to mentally ill people. Families often face a huge financial burden to provide care to such a person,” says Dr Soumitra Pathare, a Pune-based psychiatrist who co-authored the draft act. In another significant improvement over the MHA Act, 1987, the new law gives the mentally ill the right to take his or her decisions regarding treatment. It also empowers a person to write an “advanced directive” wherein he or she can make a living will, specifying the way he or she should be treated in case of mental illness. This is one of the best features of the proposed law, stresses Dr Nirmala Srinivasan, founder member of Action for Mental Illness, Bangalore. “For the first time, the law allows mentally ill people to take decisions. It thereby acknowledges the fact that at certain points these people can think and decide for themselves,” says Srinivasan. However, critics point out that the provision for the “advanced directive” in Section 5 of the draft act comes saddled with loopholes. “The whole section is effectively nullified by the provision that the district panel of the Mental Health Review Commission can overrule the advanced directive of a person if it finds it’s not in his best interests,” says Colin Gonsalves, a human rights law expert. “So, if a person says in his advanced directive that he doesn’t want to undergo electro-convulsive therapy or electric shock treatment, it can be overruled. If that is so, what’s the use of such a section?” One other provision that’s drawing flak is that a medical officer of a mental health facility can scrutinise the letters and emails sent by patients. He may also withhold or restrict them if he feels thet they are sent “for an illegal purpose or would cause undue distress to the person to whom they addressed, or would cause danger to any person”. Some consider this a violation of an individual’s right to privacy. As Jayna Kothari, a legal expert from Bangalore, says, “There should be no such restrictions. This section should be done away with as it violates a person’s right to privacy.” Still, most mental healthcare experts welcome the new law for its many positive features. Vandana Gopikumar, founder of The Banyan, a Chennai-based organisation that works for the mentally ill, is all praise for the law. “For the first time the need for community healthcare has been laid down, which also makes it the government’s responsibility to provide proper treatment to those who can’t afford it.” Incidentally, the government has decided to increase investments in community care centres during the 12th Plan period. These are meant for persons with mental illnesses who do not need to be hospitalised. Of course, as Desiraju explains, the draft act is likely to witness some changes before it is passed into law. “It will undergo changes once we consult the ministry of social justice and empowerment. Only then will it be introduced in the Cabinet and then Parliament,” he says. One only hopes that in its final shape the new law will streamline and modernise the country’s mental healthcare system so that tragedies such as the one at Erawdi never happen again. http://www.telegraphindia.com/1110810/jsp/opinion/story_14360931.jsp# -- You received this message because you are subscribed to the Google Groups "Mental Health Advocacy (News 'N Views) India" group. To post to this group, send email to [email protected] To unsubscribe from this group, send email to [email protected] For more options, visit this group at http://groups.google.com/group/MhaNewsViewsIndia?hl=en ------------- Affiliated Groups : MENTAL HEALTH ADVOCACY INDIA [email protected] Discussions on mental health law / policy / plan monitoring / human rights etc [email protected] India-specific news and views related to mental health [email protected] Information and support to carers of people with mental health issues [email protected] Mutual support and sharing of experiential knowledge, skills and social learning amongst peers
