How We Can Make the Best Use of the Mental Healthcare Act

India, like the world, is currently in the middle of a crisis. Apart from the explicit facets such as paucity of healthcare resources, food insecurity and economic slowdown, there is also the latent crisis of declining mental health of the citizens.

But we can deal with it.

There are a lot of policy-based tools, which you can use to your advantage. However, they are not only limited, but also unknown in most cases. It is almost like paying an exorbitant price for dessert after realising it was complimentary. All you had to do, was know.

But before we nosedive into the available resource, let’s take a look at some very real statistics. India accounts for 15% of the world’s mental health disorder. Over a sixth of the country’s health-related problems are mental illnesses, according to a WHO report from 2019. The same report also predicts that by the end of 2020, a fifth of our population will be affected by at least one mental illness, a massive leap from the current 7.5%.

The ‘treatment gap’, which refers to the prevalence of mental illness and the proportion of patients who receive treatment, sits at a gaping 70%.

Not a surprising number, considering we only have 4000 mental health professionals. But these figures are well within our realm of change. With careful steps and a well implemented plan, India can be on its way to mental health revival.

In 2017, the government of India implemented the Mental Healthcare Act, a well-intentioned (nearly revolutionary) law that empowers an Indian citizen to seek not just physical, but also mental health insurance; provides the option for proxy decision-making; brings informed consent to the centre of psychological practice and decriminalises suicide; among other things.

Lists, loopholes, liaisons

Although the Act is remarkably progressive in its approach, as the state places greater freedom in the hands of the individual, it makes room for shirking its own responsibilities. The first of those would be the partial privatisation of mental health establishments. Compulsory admissions were earlier possible only by public facilities. This has now been split between public and private establishments making admission costs higher, and the facilities less accessible.

Also read: How to Look After Your Mental Health

There are also marked concerns around the appointment of a nominated representative (NR). This allows patients to choose a family member to be a proxy decision maker for them. Such a provision not only discriminates against patients with no families, but also places power in the hands of a member who may or may not be willing to take responsibility for someone with an illness. A single statement by an NR can make admission into an establishment valid or invalid.

Moreover, if the NR is not acting in the best interest of the patient, the Act mentions no procedure for the removal of said NR. These concerns may be seemingly minor, but could add up to be major hassles for a patient seeking immediate remedy.

The upside: mental healthcare for all

While the law comes with its own problems, it partially compensates with its commitment to parity.
It states that a Person with Mental Illness (PMI) below poverty line, is entitled to free mental health services and free prescribed medicines from a state or government funded facility.

And to put it more explicitly, under its Section 21.1a, the Act prohibits any discrimination based on gender, sex, sexual orientation, religion, culture, caste, social or political beliefs, class or disability.

Besides, it bans performing ‘shock therapy’ without providing muscle relaxants and anesthesia. Seclusion and solitary confinement are also prohibited.

With India’s yet-to-grow psychological infrastructure and workforce in mind, the Act promises more than it can currently provide. And in the very breath it relieves a patient, it also hands them a pinch of its own unaccountability. However, it is undeniably a step committed to reform, headed in a legally sound direction.

With our awareness streamlined, we must remember to claim this complimentary dessert and reap the care we rightfully deserve.

Samreen is in her final semester of Postgraduate Psychology, and writes about human idiosyncrasies, policy structures and art in the everyday language, thanks to the insight her subject brings.

Featured image credit: Annie Spratt/Unsplash