In a progressive move, the The Lok Sabha passed the Mental Healthcare Bill of 2016, that decriminalises suicide and provides for mental healthcare and services for persons with mental illness. The bill also has a provision to protect and restore the property right of the mentally ill people.
The bill has been termed patient-centric and aims in empowering patients suffering from mental illnesses. The current progressive bill aims in focusing the effect of mental health on the community as a whole. The bill ensures that every person shall have a right to access mental health care and treatment from mental health services run or funded by the appropriate government. It also guarantees free treatment for those suffering if they are homeless or poor, even if they do not possess a Below Poverty Line card.
The bill also decriminalises suicide, stating that a person who attempts suicide should be presumed to have severe stress, and shall not be punished. And that it will be the government’s duty to provide care, treatment and rehabilitation to a person, having severe stress and who attempted to commit suicide, to reduce the risk of recurrence of any attempt. The person can also make a directive as to how he wishes to be treated for the illness and nominate a representative.
Other features of the bill include ban on use of electric shock therapy for treating children with mental illness, conditional use of shock therapy on adults, after being given anaesthesia and muscle relaxants and emphasises on ensuring no intrusion of rights and dignity of people with mental illness.
Approximately 6-7% of the country’s population suffers from some kind of mental illness, while 1-2% has an acute condition. Of the 8000000 suicides that take place in the world every year, close to 17.5% are Indians. 64% women commit suicide due to stress caused by domestic violence; however, more men than women in India die of suicides every year and about 8% of total suicides are committed by people suffering from schizophrenia.
There are special provisions in the bill for women which was drafted after consulting various stakeholders, including academia, experts and the political establishment. The bill doesn’t call for necessary separation of a child from a woman even if the woman suffers from mental illness until absolutely necessary.
“There are two kinds of suicides or suicide attempts- a deliberately planned one where the person feels that there’s no other way out of his problems- financial, love life or failure, the other one being taken in a matter of seconds or instantaneous behaviour. Now, it is in very rare cases that people are saved in either scenario. If a person’s mind is strong, they may let go off the suicidal thoughts but if there’s chance of even slight mental cloudiness, chances are that the person may attempt it again. There are instances where patients wish they would survive the attempt once the act is committed like hanging themselves or slitting their wrist. However, post the failed attempt the feelings are usually of agony, diseased or loss of dignified, especially if the act is criminalized. And this is when a counsellor’s role is crucial. But this new bill ensures that the person isn’t humiliated and therefore it is sort of a relief, if not a long-term solution,” says city-based counsellor who has worked in rehab centres, Usha H.
“The passing of the Mental Healthcare Bill displays the seriousness with which our law makers view the mental health challenge that India faces. The Bill also establishes the government’s role as a critical stakeholder by placing the onus on the government to ensure care, treatment and rehabilitation to those facing mental health issues. It is important that sufferers are adequately informed of their rights so that they can gain access to the support that they need. The clause decriminalising suicides is a move that’s been long awaited and its impact will be far reaching,” says Anna Chandy, Chairperson, Board of Trustees, The Live Love Laugh Foundation.
“This is just a small, baby step towards mental health not being seen as something to be isolated or not discussed. Finally, mental can be perceived as curable- this is a right step by the government to that effect. Those suffering from mental illnesses will not be seen as people to be chained and given shock treatment. Instead, if we form a right kind of an atmosphere and a support group, it can even be treated without medicines when in the initial stages. However, now, the government faces an equally challenging step- to regularize and monitor medication related to mental health. Sometimes, psychiatrists prescribe without proper analysis. Not only this, it is often not followed up on or the patient and their reaction to the pill isn’t monitored. Medication needs to be altered according to the patient’s reaction to its chemical composition and his/her progress. These things need to be ensured for optimum mental health care. Sometimes, it is the undesired chemical reaction that causes patients to commit suicide and these are more or less actions taken without any thought on part of the patient- just a matter of seconds before they decide to jump off a building or slit their wrists. On the other hand, certain behaviour issues can be treated only with lifestyle changes like inclusion of yoga, meditation, incorporating the right diet, counselling, physiotherapy etc. So, in case of those with acute mental problems, caretakers should constantly be asked to observe the patient and regulations or guidelines like these need to be enforced by the government,” says Sonali Pradeep, a psychologist.
Somnathan CP, a psychiatrist says, “Appropriate solutions and counselling should be meted out to those who attempt suicide due to other issues like love failure or financial loss- emotional and financial support should be made available where applicable. As for shock therapy, yes, it shouldn’t be meted out to any patient with mental illnesses, but only to those with acute depression with suicidal thoughts and those with bi-polar disorders or schizophrenia where the medication isn’t effective. In the case of acute depression, we cannot wait till the medication kicks in-this takes about two weeks- as it can be a threat to the patient’s life. And today with advancement in psycho-pharmacology, ECG or electroconvulsive shock therapy is administered in a way that the person receiving it too, isn’t aware of the convulsions as anaesthetics and muscle relaxants are being given. But it was a great move by the government to include it in an official bill so that the practice is regularized. However, one should understand that the need for ECT isn’t something to be shameful, but only a part of a treatment- just like surgery. The dosages for ECT in a patient need to be monitored carefully and regularized as per their progress in recovery, or it might just leave them to be lifeless bodies. But on the whole I am glad that the outlook towards mental health is changing and not as portrayed by other media like books and movies.”
A positive step, however small, is surely one towards progress. With celebrities like Ileana D’Cruz and Deepika Padukone talking openly about mental health, here’s hoping that the stigma around it will finally be gone.
Cover image courtesy by Dashu83 – Freepik.com