Mental health can be defined as a state of well-being in which individuals can cope with normal stresses of life and function productively. Whereas, mental illness can be described as a mental condition during which an individual is negatively affected in the way they think, feel and behave. At the same time, mental healthcare is the most neglected part of the healthcare routine among Indians. It is also a highly misunderstood form of illness owing to the social stigma around it.
Mental illness is still dismissed as an illness not warranting timely professional intervention due to a lack of awareness of its severity. This is substantiated by the fact that more than 50 per cent of the respondents in a survey, held in 2018, reported that they have never consulted any mental health professional (MHP).
Statista database reveals that as per a study done in 2017, one in seven Indians was affected by a mental disorder. Mental disorders could be of varying degrees and forms and if left untreated, could eventually lead to extreme levels of depression, anxiety and sometimes even suicide. The numbers tell a very grim story, that the suicide rates in India have risen by 10 per cent in 2020 as compared to 2019 according to the Accidental Deaths & Suicides in India Report 2020 issued by the National Crime Records Bureau.
The erstwhile Mental Healthcare Act (MHA) 1987 was drafted from the perspective of protecting the public from mentally ill persons who were considered to be dangerous. This led to inhuman practices like isolating persons under treatment, chaining them up, and using electroconvulsive therapy (ECT) without giving anaesthesia, thus violating their basic human rights. Moreover, there were instances of holding back people in the mental health centres even after they were fully cured.
As opposed to this, the MHA 2017 is a patient-centric and rights-based Act that aims to protect the rights of persons who are under treatment for mental illness. The 2017 Act brought about a paradigm shift from custodial care to community care, as a result of India’s commitment to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) in October 2007.
Striking down the inhuman ways of treating persons with mental illness, the new Act brought in much-needed provisions such as banning ECT for minors, necessitating the use of anaesthesia and muscle relaxants before ECT is done, prohibiting sterilisation of men or women, when such sterilisation is intended as a treatment for mental illness, and prohibiting chaining of the patients. In addition to this, the Act provides persons having mental illness, the right to access quality mental healthcare at affordable prices, the right to community living, the right to live with dignity, the right to protection from cruel, inhuman and degrading treatment, right to equality and non-discrimination i.e., they should be treated equal to persons with physical illness; right to receive information about reasons for admission and the treatment procedure, right to refuse or receive visitors or phone calls, and the like. The Act also entitles these persons to receive free legal services to exercise any of their rights given under this Act. Another landmark development of this Act is the decriminalisation of attempt to suicide which used to be a criminal offence under the Indian Penal Code.
While the MHA 2017 advances a progressive and a more humane policy as compared to the erstwhile Act, it still has many challenges on the implementation front mainly due to a lack of awareness of citizens about the importance of mental health, and the rights available to persons under treatment. Another possible loophole in the Act is the misuse of decriminalisation of suicide for dowry-related burning or attempted homicide. Such criminal activities can be framed as attempted suicide. Besides these, the implementation faces the challenge of having a severe shortage in the availability of mental health professionals. According to the World Mental Health Atlas (2014), there were 0.3 psychiatrists per lakh of the population in India. The socio-economic and the cultural factors, such as lack of access to healthcare, superstition, stigma, and discrimination further contribute to the gaps in the implementation of the Act. In order to ensure that persons with mental illness have a more civilised status in society and to truly help them exercise their rights, it is necessary to address these policy gaps.
 Survey conducted by Ipsos in 2018, on the frequency of visits to Mental Health Professionals (MHP)
April Suzanna Varkey is an Associate, Research at CPPR. She is a CA finalist and a B.Com. graduate with majors in Accountancy and Finance. As part of the chartered accountancy course, she did her three years of articleship from Sankar and Moorthy Chartered Accountants, Trivandrum. Her association with CPPR began with a two months’ internship as Research Intern. April is interested in engaging in activities that create a social impact. She has volunteered in the audio recording of books for The Kerala Federation of the Blind, edited a book on creating awareness among teachers and parents on online abuse of children and cyber security laws, for the Kerala Police Academy and has participated in the International Conference for Gender Equality – II as a rapporteur.