The Rajya Sabha passed a bill seeking to provide better healthcare for people suffering from mental illnesses as members across the political spectrum sought urgent steps to address the lack of infrastructure and shortage of psychiatrists in the country. The Mental Health Care Bill 2013, which provides for protection and promotion of rights of persons with mental illness during the delivery of health care in institutions and in the community, was passed unanimously by a voice vote. There were 134 official amendments to the bill, which took almost an hour to be passed clause by clause.
Replying to a debate on the legislation, Health Minister J P Nadda termed it as “humane and progressive” and said its focus was to provide better support and facilities to the people suffering from various kinds of mental illnesses. “This is a historic and progressive Bill. It has been a long standing effort. It is patient-centric and focusses on how more facilities and support could be provided to the patients,” Nadda said.
He said around 6-7 per cent of the country’s population suffered from some kind of mental illnesses, while 1-2 per cent suffer from acute mental disease. He also admitted that there was shortage of medical staff dealing with mental health in the country and the government is trying hard to have more such specialists.
Various stakeholders including academia, experts and political establishment were consulted while formulating the Bill, Nadda said, adding “the Bill focusses on community based treatment. Special provisions for women and health have also been provided for in the Bill.” Among the various objectives, the bill provides for ensuring healthcare, treatment and rehabilitation of persons with mental illness “in a manner that does not intrude on their rights and dignity.”
It also allows adults to make an advance directive on how they wish to be treated in case they suffer from mental illness in future. A person can also chose a nominative representative who would take care of him or her. Earlier, Congress member T Subbirami Reddy raised a point of order saying the bill had as many as 134 amendments and sought to know if a new bill could be drafted. He was supported by his party colleague Jairam Ramesh, with even Deputy Chairman P J Kurien observing that the point of order raised by Reddy was “very valid” but asked them to raise the issue when the measure was taken up for passage.
Initiating the discussion on the Bill, Madhusudan Mistry (Cong) said there was an urgent need to upgrade the mental healthcare infrastructure in the country and increasing the number of psychiatrists and care-givers. He said there was no data in the country on the number of persons suffering from mental illness, but broadly it was considered to be around one per cent of the population. “There is a need to also look into the social stigma attached with mental illness and how to end it,” he added.
Another crucial issue, Mistry said was that the bill does not shed much light on the treatment and availability of cheap medicines. Welcoming the bill, Vikas Mahatme (BJP) said there were about seven per cent people in the country suffering from mental illness. Quoting WHO figures, he said around 27 per cent of India’s population suffered from depression.
“We have only around 5,000 psychiatrists to treat such a large number. This bill rightly addresses this issue,” he said, adding that the measure would also raise the number of institutions for treating mental illness. Vishwambhar Prasad Nishad (SP) said India faced a huge shortage of mental health experts and urged the government to initiate necessary steps to overcome the shortages. He said India had only 3,500 psychiatrists whereas at least 8,500 more were needed.
A K Selvaraj (AIADMK) said it was a matter of concern that barely one psychiatrist was available for every 4 lakh population. Terming the gross negligence of the sector as unfortunate, he said barely one per cent of health budget was alloted for mental health in sharp contrast to other countries where even 18 per cent of the budget was allocated for it. He said situation was so grim that 3 persons in every 100 in urban areas suffered from depression and one in every three was neurotic. As per estimates, India would have 38.1 million people with mental illnesses by 2025, Selvaraj said.
Ahmed Hassan (Trinamool Congress) referred to chaining of mentally ill patients in some places and advocated “sweeping reforms” in the sector. He sought banning of “cruel treatment” like chaining and electro-convulsive treatment. Kahkashan Parveen (JD-U) asked the government to pay attention to the plight of destitute women and warned that some provisions of the bill could be utilised against women by in-laws, who could escape arrest after driving women to suicide in the name of mental illness.
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