Mental Health And Law: A History Of The ‘Suicide Law’ In India

TW: The article addresses suicide.

Did you know that until a year ago, a suicide attempt could land Indians living with mental illness in jail? Imagine being depressed enough to attempt ending your life, and landing in prison instead of a care facility. This was the reality for many until the Mental Healthcare Bill decriminalised suicide in 2018.

Amidst the (welcome) deluge of mental health awareness articles on social media, it is easy to forget that, until recently, mental health care laws in India heavily penalised individuals with mental illnesses, leaving them no recourse for treatment. The fight to bring mental health to the forefront of political discourse has been long and hard-fought. Let’s look at the history of mental health laws in India.

The Indian Lunacy Act, 1912

As is evident from the year, this particular act was a British invention. The act, echoing the sentiments of the era it was created in, stressed on the importance of “lunatics” to be “locked away” in asylums. It focused more on removing the mentally ill from society instead of their treatment or cure. Naturally, this out-dated act needed to go, and in 1950, members of the Indian Psychiatric Society (IPS) came together to draft a bill to replace it.

Section 309 Of The Indian Penal Code (IPC)

When India’s constitution came into effect, mental health in the country was still governed by the Lunacy Act of 1912. Section 309 of the IPC further stigmatised India’s people with mental illness by penalising any person who attempted suicide with an imprisonment term of up to a year, or fines, or both. This law contributed significantly to the already rigid stigma surrounding mental illness in India, leading to isolation and discrimination of individuals with mental illnesses as well as their caregivers. In 1971, and again in 2008, the Law Commission of India suggested the deletion of Section 309, but the discourse around suicide remained dominated by pity instead of an understanding of mental health.

Mental Health Act, 1987

After IPS submitted their mental health bill to the government, it took several years for the bill to be passed in 1987, and it wasn’t until 1993 that the Mental Health Act finally came into force. The act laid the foundation for establishing Central and State mental health care authorities and services in the country, as well as safeguard the rights of mentally ill individuals. The act, however, wasn’t without flaws. Not only did it fail to categorise mental health care on the same level as primary health care, but it also took no steps to spread awareness in society.

Mental Healthcare Bill (MHC), 2016

The MHC Bill was first introduced in the Rajya Sabha in 2013 by the then Health Minister Ghulam Nabi Azad. The bill marked a significant departure from previous legislation because, for the first time, political discourse around suicide ventured into understanding mental illness and the rights of individuals with mental illnesses. The bill, first and foremost, decriminalised suicide attempts. It also preserved the rights and dignity of mentally ill individuals by allowing them a say in their treatment and directing the government to provide them access to mental health care services. After the UPA-led Lok Sabha dissolved, the MHC Bill was reintroduced by the NDA-led Lok Sabha in 2016 with several amendments and subsequently passed in 2017.

The Mental Healthcare Act, 2017

The Mental Healthcare Act, passed in 2017, came into effect in May 2018 and replaced the Mental Health Act of 1987. To the joy of most Indian medical practitioners and advocates of mental health, the act decriminalised suicide attempts in India. It also included WHO guidelines in the categorisation of mental illnesses. The most significant provision in the act was “advanced directives”, which allowed individuals with mental illnesses to decide the course of their treatment and also appoint someone to be their representative. It also restricted the use of electro-convulsive therapy (ECT), and banned its use on minors, finally introducing measures to tackle stigma in Indian society.

However, the BJP government’s amendments to the MHC bill has led to some gaping holes in the Act. The exact procedure to execute an “advanced directive”, for example, which laid out details about how and when individuals with mental illness could dictate the terms of their treatment, are missing. The Act also fails to include psychotherapists and counsellors within the purview of mental health professionals, while Ayurvedic and homeopathic doctors make the cut.

Challenges Ahead

Decriminalising suicide is just one step towards alleviating the crushing isolation felt by people with mental illnesses in our country. Passing laws is one thing while implementing them is another.

The stigma around mental illness isn’t just social, it is built into our very systems of politics and healthcare. Until we push for a change in every sphere, there’s still work to do in tackling the epidemic of suicide in India.

Note: The author is part of the current batch of the Writer’s Training Program

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

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A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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