Changing minds

It will take more than a new law to battle entrenched attitudes to mental illness

The draft mental health bill, scheduled to come up before the Union cabinet on Thursday, is a welcome step forward from the Mental Health Act of 1987, currently in place, which is a limited, paternalistic document. One of the act's stated objectives is to "protect society" from the presence of potentially dangerous mentally ill persons. The provisions of the draft bill, more closely aligned with international norms, seem to suggest a new understanding of mental illness. It focuses on rights and protections for the mentally ill, giving them greater agency in decisions regarding treatment. Though it signals a welcome change in approach, however, a new law alone may not be enough to address the myriad problems faced by mental health patients in India.

Persons with such illnesses are usually segregated from the mainstream, shunned by peer groups and prospective employers. Ossified social attitudes have been shored up by decades of institutional apathy and discrimination, whether it is in a court of law or a police station. Government-run mental hospitals, mostly inherited from the colonial era, are nightmarish spaces. Many of these institutions are converted prisons, with practices of incarceration and punishment still embedded in them. Patients lack basic facilities such as adequate nutrition and sanitation. Even government sources acknowledge a large "treatment gap", that is, a disparity between the number of patients and the number of hospital beds and trained professionals to staff the institutions.

Greater awareness about mental illness would go a long way in doing away with the discrimination that is entrenched in our society and institutions. The government must also focus on capacity building in the hospitals and running them as proper medical facilities. A law is only lip service to change.

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