Dear All here are my comments addressed only to Javed and hence quoted him below. regards nirmala
*Javed" Well number of issues that we need to get straight. The first is that in 1995 the nation passed the disabilities act of 1995 where the nation said, for the first time said, that people with mental illness are as much as people with disabilities as anyone else. In spite of that the issue continues to remain under the Health Ministry, in spite of that the Ministry of Social Justice has not taken cognizance of the issue. " Nirmala " There is something absurd and vague in JA's observation. 1995 PD Act has recognised MI as a Disability. That does not mean it is only a disability and that there is no ongoing illness. As such, any illness belongs to the health portfolio . I cant imagine the Disability ministry running hospitals let alone mental hospitals. Let us be very clear and perhaps javed needs to be reminded that in the Health Ministry, MI is classified as a NCD; secondly, just as the Ministry runs the hospital for the Blind and Ortho , similarly for MI. Why is Javed stigmatising mental illness. It is an illness of the brain and the brain needs to be treated as brain and not as a Soul. So the MoH has to be vestedw ith the medical aspects of the illness as far as treatment modalities go." In fact, the truth is that the Disability depts in State govts are not able to run the Rehab facilities for MI because they have neither the exposure nor the training that goes with rehab care and recovery strategies." Javed " How it doesn't protect the rights of the people with mentally illness is that it gives them rights with the left hand and takes them away with the right hand. The issue of legal capacity is still not very clear in this particular bill...... "Without their consent and the bill supposedly talks about advanced directives, but then it also says that the advance directive can be taken away by a family member or a psychiatrist" "This is how I would like to be treated or this is how I would not like to be treated. Now that is my legal capacity. If I don't have the right to make that decision and if in spite of my advance directive, that advance directive can be taken away by a mental health professional by making an appeal to so called mental health authority." Nirmala: I think there is a leap in logic on Javed's part. We should thrash out the Bill step by step. Once we do it, it is clear that no one can snatch away the rights in advance directives unless the person needs treatment on medical grounds. unfortunately perhaps Javed has not heard of psychiatric advance directives which predates this Bill . This talks about the compelling medical circumstances where the rights have to be withdrawn to safeguard the mental health of the person. This si true of other illness as well wherein the informed consent of the patient is overlooked by medical obligations of the expert. Most importantly, is this possibility not true of Disability Act as well? There are millions of disabled persons who are not suffering from any mental disorder but yes, their rights are snatched away by NGOs as much as family members ! In fact in many cases, family members and govt officials have been the saviors of the disabled form NGO institutions. Further, legal capacity is not clear in this Bill because this Bill is dependent on the Disability Rights Bill to define legal capacity.Moreover, it will be further elaborated by way of Rules that follows any enactment. " JA "Absolutely, and let me very quickly concise that in less than one minute. We are talking in post CRPD era. The entire world is talking about de-institutionalisation, all the nations are struggling with that. And we are prompting institutionalisation, in last 10 years more than 500 institutions have come up. .....No, we certainly don't need institutions" Nirmala" My dear J, do you know that in Hungary, Australia , UK , Argentina , NZ, and several other countries not only have a separate Mental Health Act but have also endorsed the Concept of Guardianship as per their countries specific needs and requirements. You know very well that Gabor (** [email protected]* <[email protected]>*) Gambos who did a grand tour of India to scrap Full legal capacity and Substituted guardianship in his own country because the government saw the consequences of not having one. USA is urging federal governments to reconsider the right to refuse treatment after the Virginia shoot out and recently the Spiderman film episode. So please do not mislead yourself or worse still others by giving selective and distorted information." JA "Again to that extent I would agree with Dr Desai, but is it not a fact that in the last one decade alone more than 400 such private establishments have come up across the urban landscape of India. And not all of them are good success stories. Without inspection. And if you are caught the only penalty is Rs 50,000. So, I mean, any person or nay organization can setup a so called mental institution without any inspection, without any registration." Nirmala " I request Dr.Desai to permit Javed to stay in the acute crisis, ICU and regular wards for sometime----- not just few hours for media exposure. WE AS CAREGIVERS, ACTIVISTS AND WELL WISHERS OF THE PERSONS WITH MENTAL ILLNESS FULLY SUPPORT THIS BILL . WE NEED INSTITUTIONS IRRESPECTIVE OF ANY BILL. BUT WE SHALL ENSURE THAT NO BILL EVEN IN THE NAME OF CRPD , BE THEY FROM THE HEALTH MINISTRY OR THE DISABILITY MINISTRY WILL SNATCH AWAY RIGHTS. THIS HAS NOTHING TO DO WITH THE BILL BUT WITH OUR ROLE AS CITIZENS OF CIVIL SOCIETY TO DO ETERNAL VIGILANCE." * *On Sat, Oct 20, 2012 at 1:36 PM, **<**MhaNewsViewsIndia@googlegroups*.com<[email protected]> > wrote: > Today's Topic Summary > > Group: http://groups.google.com/group/MhaNewsViewsIndia/topics > > - MHCB > 2012<https://mail.google.com/mail/html/compose/static_files/blank_quirks.html#13a7d35dccbf0b24_group_thread_0>[1 > Update] > > MHCB > 2012<http://groups.google.com/group/MhaNewsViewsIndia/t/a1711d452fc6a52e> > > Amrit Bakhshy <[email protected]> Oct 19 03:14AM -0700 > > *Report For those who missed watching* > > > > * * > > *Panel Discussion on Mental Health Care Bill 2012* > > * * > > CNN IBN in their *Face the Nation *Programme telecast on Thursday the > 18thOctober 2012 presented a Panel Discussion on > *Mental Health Care Bill 2012. *The panellists were Dr. Nimesh Desai, > Harish Mander, Javed Abidi, Akhileshwar Sahay and Vandana Gopikumar. > The > programme started with referring to the high rates of suicides > including > that of Varsha Bhonsle. Some basic statistics were given about the > high > number of mentally ill in our country and a low percentage getting > treatment. Lower third was effectively used in giving salient features > of > the Bill and also the views of the Human Right Activists. Even Help > Line > numbers were being displayed. Care was taken in the visuals to blur > the > faces. Sagrika Ghose the hostess had done her home-work. She nicely > summed > up the views of the panellists and ensured that all the panellists got > equal opportunity to speak. > > > > Javed Abidi was not at his best and lacked punch for which he is > known. > Sagrika made him leave the bureaucratic issues concerning the two > ministries and address substantive issues in the Bill. Javed alleged > that > the bill gave with one hand and took away with the other. The Advance > Directive and the appointment of a nominated representative could be > over > ruled on a request from a mental health professional or a relative. He > was > critical of provisions in regard to involuntary admissions. He agreed > with > Nimesh Desai about coming up of outreach models but said that for each > such > success story there were 10 black sheep (sic). Disagreeing with > Akhileshwar > about the need to increase the number of beds, he said that along with > beds > come solitary confinement and chaining. > > > > Javed agreed with some of the points made by Vandana and Akhileshwar. > He > was led by Sagrika to accept that it would be wrong to say that every > word > and every paragraph in the bill was wrong. *Some parts in the Bill > were > extremely good and extremely progressive and nobody was saying that > the > entire bill was bad.* It was a big departure from the stand that the > Bill > should be dropped altogether and the Disability Bill alone was good > enough. > > > > > On being prompted by Sagrika, Javed complained about the bias in > favour of > private sector and government promoting institutionalisation even post > CRPD. In the last 10 years, there was mushroom growth of 500 private > mental > health facilities. He admitted briefly the institutions might be > needed but > soon corrected himself to say that not institutions but mental health > facilities were needed which could be community based. He said that > beds > meant chaining. He criticised registration based merely on an > application > on a piece of paper, without any inspection and a penalty of only Rs. > 50,000 for unregistered facilities. He got away with his half- truths. > > > > Akhileshwar Sahay gave credit to his wife for his recovery and > highlighted > the importance of doctors and the family in recovery. He cautioned > that > missing on medicines was an invitation to lunacy. Young persons who > claimed > that they could manage without medicines could end up in asylums. The > number of beds which was 10,000 in 1946 had only doubled to 20, 00 in > over > 60 years which was highly inadequate. He disagreed that beds meant > chaining > and said that the Draft Bill had banned chaining and restraints and > seclusion could be used only when there was a risk of physical injury. > > > > Accusing the critics of not reading the bill properly, Akhileshwar > said > that the institutionalisation was the last resort for persons with > mental > illness in need of high support. There were enough built in safe > guards > including review by mental health commission. He also stressed on the > need > for de-stigmatisation, non-discrimination and access to treatment. He > said > that Advance Directive and setting up of Mental Health Commission were > the > 2 revolutionary provisions of the Bill. > > > > Vandana spoke with passion and stressed that the Bill focused on > providing > mental health care at the grass root level by extending the coverage > from > 123 districts to the all 614 districts in the country. The rights have > to > be understood in a broader sense. The right to access to care and > treatment > was more important than any other right. The Bill promoted continuous > care > and mandated community care. Only in exceptional cases, where the > admission > was inevitable, provision was made for institutional care with a right > to > appeal against such admission. > > > > Harish Mander who was introduced as a social activist and as the one > who > approved the Bill said that the Bill addressed the rights of the > persons > with mental illness and provided dignity to them. There would be > periods > when there would be need for involuntary care and treatment. He shared > concern of Javed about the danger in the growth of private > institutions, > which could prompt forcible admissions for the sake of profiteering > and > making up of the bottom lines of psychiatrists and wanted that the > provision for affordable care should be replaced with free care. > > > > Nimesh Desai said that the Bill attempted to provide treatment to more > persons. Where there was severe illness and lack of capacity, a > balancing > act was required vis-à-vis their human rights. He stressed the need > for a > continuous dialogue. He agreed with Javed that there was a potential > danger > of the Bill usurping the rights of primary caregivers and provisions > in > regard to Advance directives needed fine tuning. He said that on > positive > side in the last 10/12 years good successful outreach models outside > institutions had been developed. > > > > The discussion contributed in a big way in creating awareness about > the > Bill. Kudos to CNN IBN for an educative show on Mental Health Care > Bill and > to Sagrika for anchoring it so well. > > > > > > > > -- > > > > You received this message because you are subscribed to the Google Group > MhaNewsViewsIndia. > You can post via email <[email protected]>. > To unsubscribe from this group, > send<[email protected]>an empty message. > For more options, > visit<http://groups.google.com/group/MhaNewsViewsIndia/topics>this group. > > -- > 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 > -- nirmala srinivasan(ashoka fellow) director, ACMI bangalore -india +91 9886031659 -- 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
