The plight of persons living with mental illness in India is a National Emergency.
One in five people in India live with mental illness. Of these millions face significant
disability due to the impact of illness. But perhaps more disabling than the illness
is the stigma, humiliation, the helplessness and the isolation that a person living
with mental illness faces everyday. Many thousands of persons living with mental
illness are locked up in Institutions. A significant majority of them have not had
visitors for years. Many people are kept in cells, many do not have clothes and
many are treated in a degrading manner. Communal baths are common. While thousands
are still incarcerated in Institutions many live in a virtual hell in the community.
Many persons living with mental illness are abandoned by the family. Exploitation,
rape and physical abuse are not unheard of.
There as a many as fifty two laws that use the words insanity, unsoundness of mind
or incompetence to curtail the rights of persons living with mental illness. When
these laws (including the Mental Health Act, Persons with Disabilities Act and The
National Trust Act) are reviewed, amended or replaced with laws that are harmonized
with UNCRPD, the lives of persons living with mental illness will see a new dawn.
The era of civil death of persons living mental illness will end. Unfortunately,
the society and the state remain oblivious to the needs and rights of persons living
with mental illness.
In October 2007, India ratified the landmark
United Nations Convention on Rights
of Persons with Disability. Ratification makes it obligatory for the Government
to harmonize all its laws and policies to ensure
Inclusion and
Self-determination
for disabled people. The convention recognizes persons living with mental illness
as ‘disabled’- citing social, attitudinal and legal barriers that must be diluted
in order to end historical isolation of persons living with disability including
mental illness from civic life.
This could have been an opportunity to correct centuries of neglect and invisibilization
of persons living with mental illness as the present laws unfortunately sanctions
discrimination. There is also a vacuum of mental health policy. There is not enough
resource allocation. There are too few mental health professionals in India. This
leads to the fact that ninety percent of those who need treatment, rehabilitation
and support do not have access to it.
However, the response of the Indian Government has been tokenistic. The Government
has hastily initiated Amendments to the archaic Mental Health Act of 1987, outsourcing
the job to the Indian Law Society, Pune. MHRG strongly opposes the process and content
of the proposed amendments.
The amendments are
contrary to the spirit of the UNCRPD as they continue
to engage with the person living with mental illness only through the lens of their
illness and not the lens of their
rights.
The process of the amendments is non-participatory and discriminatory. There
has been no capacity building of persons living with mental illness as to what entitlements
they have under the UNCRPD. There has been
no attempt to inform and include
their voice in writing a law that will determine their lives.
The process is ill conceived and mismanaged as
there is no attempt to consult with
the Nodal Ministry for the affairs of disabled persons, the Ministry of Social Justice
and Empowerment, which is in the process of formulating a comprehensive
law for the rights of all Persons with Disability. It will mean that either persons
living with mental illness will be addressed through two very different paradigms
or that their rights will not be addressed at all in any of the laws.
The amendments do not address the civil political rights of persons living
with mental illness like the right to life, the right to non discrimination, right
to inclusion and participation, access to justice, equal recognition before the
law and right to privacy and the right to franchise.
The amendments
overlook peopleís rights for independent living, employment,
habilitation and rehabilitation, managing property and financial affairs, access
to education, right to have a family life and right to vote.
The amendments continue to
focus on institutionalization and not on
access
to community mental health services. This is bound to lead to the incarceration
and isolation of more and more people. This will also further strengthen the stereotype
that persons living with mental illness are dangerous and incapable.
The amendments are
silent on policies for preventive care, awareness raising, stigma
mitigation, and integration and long term care in the community.
The amendments are likely to make the
human resource gap for mental health
permanent by defining the mental health professional in a restrictive manner.
In the present amendment document there is no judicial sanction required for involuntary
admission. The law could be used to
admit people against their will and suspend
the rights of any individual who is showing some features of mental illness by mental
health professionals. Persons living with mental illness will continue to be the
only people in the country who can lose their liberty through a non legal process.
The appeal regarding such involuntary admission would not be heard for seven days.
Even criminals need to be produced before a magistrate after an arrest within twenty
four hours.
Children living with mental illness would come under jurisdiction of this
law instead of being treated as children in need of care and protection under the
Juvenile Justice Act, which is the universal law for all children. This law also
gives the power to the professionals to recommend that a parent not be a guardian
to the child again this would mean a lack of due legal process for loss of custody
of your own child.
The amendments put
no responsibility on the government to support the families living
with mental illness. The stigma and isolation of the family will continue.
There is
no assumption of universal capacity, and no plan to provide
support
to people in making informed choices regarding their own affairs. Instead
the amendment document proposes to install nominated representatives and special
representative who, through ‘legal’ provisions like ‘if the person is not competent
then...’, will be allowed to take over the rights of the person living with mental
illness.
Immediately stop the Mental Health Act Amendment process and withdraw the current
draft.
Constitute a Think Tank to write a White Paper on Mental Health in India.
Information and support to participate actively in the decisions regarding one’s
own lives specifically writing of the present law.
Parity for mental health and health services.
Parity for persons living with mental illness with other persons with disabilities.
Access to long term support for Independent Living in the community.
Access to Livelihood, Relationships, Education and Political participation.
Inclusion and training of diverse cadres of professionals in the bracket of
Mental
Health Professional to address the significant human resource gap for mental
health services.
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