Mental Health Care Bill (MHC), 2016

On 8 August, 2016, the Mental Health Care Bill, 2013 was passed in the
Rajya Sabha. Many people on social media rejoiced and it is, indeed, a cause
for celebration. The largely-neglected field of mental health finally got some
much-needed attention. The new bill, when passed in the Lok Sabha, will
replace the rather outdated Mental Health Act of 1987, and when compared
to the existing law, it is definitely reformist.
The definition of mental illness is no more any mental disorder other than
mental retardation. It is broader and more inclusive. Mental illness is
defined as a substantial disorder of thinking, mood, perception, orientation
or memory that grossly impairs judgment, behaviour, capacity to recognise
reality or ability to meet the ordinary demands of life, mental conditions
associated with the abuse of alcohol and drugs, but does not include mental
retardation which is a condition of arrested or incomplete development of
mind of a person, specially characterised by sub normality of intelligence.
One of the salient features of the new bill is that it decriminalises the
attempt to suicide. This repeals Section 309 of the Indian Penal Code which
provided for a year-long imprisonment for a failed suicide bid. This law had
been criticised for a very long time. In 1971, the Law Commission had tried
to do away with it. The Janata Party had tried to implement the
recommendation in 1978, but it fell before both Houses could pass that Bill.
Proposing that attempted suicide will not be criminally prosecuted helps the
world look at suicide in a more kindly light. In order to understand why,
picture this scenario: Saras a young girl who recently moved to a new city
to pursue further studies. Not being as well-off as the rest of her classmates,
she had to spend most of her time by herself because she could not afford to
eat out and party as frequently as the rest of her peers. Adjusting to the
new environment had been tough. The long distance took a toll on her twoyear long relationship, and her boyfriend finally broke up with her over the
phone. To make matters worse, the semester results were announced, and
Sara discovered that she had failed two papers. When her mother called her
in the evening, Sara was just not able to break the disappointing news to her
parent.
Things cant get any worse, thought Sara. My life is not worth living. In a
fit of impulse, she consumed a bottle of phenyl. When she was discovered in

her room, people immediately rushed her to the hospital. The hospital
authorities were reluctant to admit her, due to the legal complications that
rose with a suicide attempt, nevertheless, after some coaxing, they began
treatment until the police arrived. If Sara made it out alive, in the old
scenario, the gift of being alive would be presented to her with a one year
imprisonment for attempting to end her life! This would just add to more
trauma and stigma of having to deal with police and courts. Criminalising
suicide attempts actually stops many people from reporting, and this hinders
people in distress from receiving the help that they need.
The new law actually recognises suicide as a cry for help, and stresses on
the immediate need to reach out and help the person overcome their issues.
It does not treat the person as a criminal.
The bill does not allow psychosurgery unless it is approved by the district
medical board. The bill also bans the use of shock therapy for treating
children with mental illness. It is still permissible for adults provided theyre
given anaesthesia and necessary muscle relaxants.
However, the most remarkable feature of this bill is the introduction of
advance directives this gives people suffering from a mental illness the
right to choose their mode of treatment, and by nominating representatives
who will ensure that their choices are carried out. Giving people diagnosed
with a mental illness the freedom to choose conveys a strong message to
the masses that suffering from a mental disorder does not rob an individual
of decision-making capacities. It instils in the citizens that everyone, even
those diagnosed with a mental illness, are entitled to a life of dignity, and
they must not have to live in isolation, away from their families or the
community, at large.
The bill identifies inhuman and degrading treatment of the mentally ill as a
crime, and for the first time, tackles the issue of mentally ill patients often
admitted in institutionalised care forcibly, against their will.
However, no matter how progressive the new bill is, it is still just a baby-step
in the direction of reform. The bill only recognises the role of psychiatrists in
the treatment of a mental illness. It still does not acknowledge the roles of
counsellors and psychologists who also work with patients suffering from
mental and emotional distress. Also, the bill largely addresses requirements
of those people in mental healthcare facilities, but not every person

diagnosed with a mental illness needs institutionalisation. While the bill

mandates insurance companies to provide medical insurance or the mentally
ill on the same grounds that they would issue insurance for physical
illnesses, counselling services would probably not be covered even in the
new insurance schemes.
Implementation of the Act will also pose to be a problem. There is a
shortage of mental health professionals in our country. For every four lakh
Indians, there is only one psychiatrist, Dr Rajesh Sagar was quoted as
saying in DNA. With budget cuts in the health sector, how will state
governments successfully implement the dictates of this new law?
The new bill largely adopts a biomedical model to treat mental illness. It
does not talk about newer modalities like arts-based therapy, for instance,
which helps people cope with stress, and speeds the recovery process. The
bill provides facilities to the mentally ill, but how far does it address the
stigma and discrimination a person with a diagnostic label is forced to
endure? To what extent does it shape the nation into adopting a healthier
attitude towards the issue of mental health? Only time will tell.