BENGALURU: ALMOST three years after it was introduced in the Upper House of Parliament, The Mental Health Care Bill, 2013, was passed in Rajya Sabha on Monday, repealing the three-decade-old Mental Health Act and paving the way for decriminalisation of suicide.
Doctors and professors in Karnataka have welcomed the Bill that includes access to affordable, good quality mental health treatment, free legal services (which was not the case earlier) and access to medical records.
“A mentally ill person has the right to make an advance directive on how he wants to be treated and nominate a representative for the same. The directive should then be certified by a medical practitioner or registered with the Mental Health Board,” according to PRS Legislative Research, a not-for-profit research initiative.
The Bill also provides for a central and a state mental health authority that are administrative bodies required to register, supervise and maintain a register of all mental health establishments, receive complaints about deficiencies in services and advise the government on matters relating to mental health. The decision to be admitted in a mental health establishment rests with the patient, except in unavoidable circumstances.
The Mental Health Review Commission will be a quasi-judicial body that will periodically review the use of advance directives and advise the government on protection of rights of mentally ill persons. Most importantly, a person who attempts suicide is no longer liable for punishment under the Indian Penal Code and will be presumed to be suffering from mental illness at that time. The use of electro-convulsive therapy (ECT) on adults is permitted only along with anaesthesia and muscle relaxants and is prohibited on minors. In ECT, small electric currents are passed through the brain, intentionally triggering a brief seizure. It was believed to cause changes in brain chemistry that can quickly reverse symptoms of certain mental illnesses.
Dr Soumitra Pathare, who was entrusted with the responsibility of advising amendments to the Bill by the Health Ministry, is a consultant psychiatrist and coordinator at the Centre for Mental Health Law and Policy, Pune. In an email to Express, he said, “In the Mental Health Act, 1987, a reception order is required from the district magistrate, which is no longer the case in the new law.”
Under the current Act, mentally ill prisoners, when requiring admission in a psychiatric facility, have to be admitted only by a reception order of a judicial magistrate, and convicts, by warrants issued by the Government to jail superintendents and the superintendent of the hospital.
Dr L N Suman, professor, clinical psychology, NIMHANS, said, “When patients themselves don’t know what their problem is, the advance directive will fail. Even the educated are ignorant about the many aspects of mental health.” Vikram Patel, Professor of International Mental Health, Centre for Chronic Conditions and Injuries, Public Health Foundation of India, said the Bill was very aspirational in nature.