The rights of mentally ill patients have always been a reason for controversy in India. There are a number of cases that have been reported where a mentally ill patient has been treated like an animal. The Erwadi fire incident took place in 2001. Since then, hardly any improvement has been made in the domain of mental health services. Detaining patients without their consent has been the most common practice by hospitals in various societies.
The Constitution of India guarantees several other rights to mentally ill patients, along with the Fundamental Rights. One of the fundamental rights guaranteed to all citizens of India is the right to life. As per this right, each individual is entitled to live their life with dignity, with access to all basic needs that is food, shelter, clothing and healthcare. The second fundamental right is the right to equality. As per this right, every citizen of India is equal and has an equal chance of employment and equal opportunity to fair treatment.
The origin of mental healthcare laws in India can be traced back to the British era. The first Act that was passed in India was The Indian Lunacy Act, 1912, which was repealed on the grounds of violation of human rights. Under this Act, mental asylums were given recognition and people suffering from mental health issues were allowed to be detained. After this, in 1987, Mental Health Act was passed. This Act revolutionised the mental health domain in India by focusing on the cure aspect of illnesses rather than keeping away patients from society.
The Mental Healthcare Act, 2017, focuses on providing mental health services to all, supported accommodation, rehabilitation, right to live in community, protection against degrading inhumane treatments, right to complain when the services are inadequate and other legal remedies. In cases where the patient has been abandoned by their family, it is on the government to provide them shelter and other necessary facilities. Further, a mentally ill patient should be protected from inhumane treatment and provided with a hygienic and safe environment. This law’s roots lie in Article 21 of the Indian Constitution.
According to National Mental Health Survey 2015-16, approximately 7.5% of the Indian population is suffering from a mental disorder. One in every 20 Indians suffer from the most common mood disorder that is depression. In India, the treatment gap between people who are psychologically suffering and those with access to a healthcare system is approximately 70%.
Despite several legislations, the condition of mental institutes and patients has still not improved. There is a huge gap between laws and their implementation in treating patients. The relation between mental health and human rights can be divided into several parts. First, human rights violations such as displacement and torture negatively affect one’s mental health. Second, coercive treatment practices of mental health patients can impact their human rights.
The Erwadi fire case where 48 mental patients were burnt to death in Tamil Naidu raised a lot of questions towards our country’s mental health facilities. The patients who died were tied to their beds and were being treated for mental health disorders under the pretext of supernatural remedy rather than medical treatment. In India, it is a common practice wherein, people who behave abnormally are taken to temples or dargahs for treatment. One of the famous temples that deal with this is in Rajasthan, known as the Mehendipur Balaji Temple. Here, patients are chained and kept in appalling conditions, violating their very basic right i.e. the right to life.
People in India are scared of mentally ill patients and tend to maintain distance from them. In many cases, people who are mentally stable are abandoned by their families. In 2019, the Supreme Court ruled chaining of mental patients as not just inhumane but also a violation of fundamental rights. In a mental asylum in the Badaun District in Uttar Pradesh, patients suffering from psychological disorders were tied with padlocks.
The Supreme Court of India ruled that even in cases where patients are violent, they still cannot be held in shackles. This is not the only case where hospitals have tied violent patients. There are many institutions where patients are kept in one room with no ventilation or access to sunlight.
There are several laws to protect people suffering from mental health issues, but there is a huge gap between what is on paper and what is in practice. Despite repeated recommendations by doctors and policy makers, implementation of policies has been an issue. There are several real challenges that need to be tackled in order to implement recommended steps. These challenges could be: most mental health resources are available in city areas or near metropolitan cities.
Due to this, people living in rural areas have no access to services and the cost of transportation makes it difficult for them to avail help. A majority of Indians believe that mental illness is caused by evil spirits or due to bad karma. Thus, people take family members suffering from psychotic breakdowns to temples and other religious places. This causes delay in treatment or no treatment at all. Many people are ignorant towards mental health and stigmatise mental health disorders. Stigma plays a huge role in delayed treatment of disorders.
If laws are implemented properly, there could be a drastic change in India’s mental health paradigm. Sensitising people would also play an important role in the development of mental health. If we treat patients with love and care, their recovery rate can be better. In the end, I would like to say that mental patients are not a danger to society. With proper care, we can empower them.