Mental Health Care Bill 2012

• Proposes to align Mental Health Act 1987 to standards set by the United Nations.
• Complete prohibition on Electro Convulsive Therapy (ECT) or shock therapy without muscle relaxants and anaesthesia in adults. Complete ban of ECT for minors.
• Mental illness is to be treated equal to physical illness.
• Stipulates that public and private insurance companies will make provisions for medical insurance for treatment of mental illness on the same basis as is available for treatment of physical illness.
• Complete ban on tonsuring (shaving the head) and uniforms in psychiatric institutions.
• A Proof of a person’s current or past admission / treatment in mental hospitals will not itself be a ground for granting divorcee.
• During judicial proceedings, if a proof of mental illness is raised, the matter will be referred to state Mental Health Review Commission.
• If a person attempts suicide because of mental illness, no complaint, investigation or prosecution shall be entertained against the person, notwithstanding anything in IPC.
• Introduces Advance Directive concept, in which any adult with or without history of prior mental illness, has the power to declare in advance his or her preferred method of treatment, in the advent of a mental health problem. A person even has the authority to refuse treatment.
• An individual also has the right to “nominate a representative”, who will take decisions for him or her in the advent of any mental illness. The nominated Representative works as legal guardian of the patient.
• Gives right to seek complete information about mental illness treatment.
• Bars prolonged hospitalisation, chaining. All persons with mental illness have the right to dignity, and to live in, be part of, and not segregated from society. Provisions of Forced admission in rare cases of mental illness.
• Mental health services shall be integrated into general health services at all levels – primary, secondary and tertiary, and that these services shall be available in the neighbourhood.
• Proposes Mental Health Review Commissions at district, state and national levels.
• Bill proposes imprisonment ranging from six months to two years and/or fine from Rs 10,000 to Rs five lakh in case of violation of the law.

Critical Analysis

• It is estimated that there are over two crore Indians suffering from mental health problems. However, this medical area remains a subject of dread, shame and silence amongst many Indians, obfuscated by erroneous notions and outdated ideas of ‘madness’ caused by magic, karma, etc.
• Many mental health issues are caused by chemical imbalances, curable through therapies and medication. However, uninformed fears lead to mental health becoming a taboo for public discussion, patients left without proper treatment, abandoned or even unscrupulously bundled off to institutions where they’re kept out of society’s sight.
• Such care is frequently unregulated – and often, evident from instances of chaining and sterilization, brutally handled. The proposed and recently approved Mental Health Care Bill 2012 prepared by the law and health ministries takes a step in the right direction to ensure that patients suffering from mental health ailments don’t get lodged in hospitals or asylums for more than six months and are not given electric shocks without their consent.
• By going through the provisions of the bill, we find that there three vital aims of this bill.
• To accord dignity to patients of mental illness while enabling their families to take responsible, well-informed choices. It makes access to mental health care a right of all persons. Such services should be affordable, of good quality and available without discrimination
• To make treatment of mental illness at par with Physical illness
• Decriminalize the suicide attempt by a mentally ill person
• The two more vital provisions are of the Advance Directive and of Nominated Representative. The Advance Directives is a progressive and far-sighted step. No person who has recorded an Advance Directive to State that he or she should not be admitted to a facility without consent can be so admitted. The provision that a person with mental illness can appoint a nominated representative to take decisions for him or her, is also a far sighted step.
• Despite these provisions there have been some lacunae. For example the Bill retains provisions in rare cases to admit patients for care against their will. In what conditions, the case would be rare is not clear.
• Bill takes away judicial safeguards present in the Act, and entrusts too much authority to the treating psychiatrist, opening a potential area of misuse.

The bill has also not taken care of the demand that all rights of people with psychosocial disabilities should be covered under the Rights of Persons with Disabilities Bill, 2012.