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What Rights Are Available To Mental Health Patients In India?

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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.

A History Of Mental Healthcare Laws In India

Representative image.

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 The first Act that was passed in India was The Indian Lunacy Act, 1912, which was repealed on the grounds of violation of human rights.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%.

The Huge Gap Between Laws And Their Implementation

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.

You must be to comment.
  1. Pallerla Srikanth

    Hi,
    This is Srikanth, MPhil, Ph.D. Scholar (Psychiatric social work) at NIMHANS, Bengaluru.
    I have gone through your article,
    very well written about the concept of the rights of PwMI and the logistics challenges to implementing the laws in the field of MH.
    It would have been more useful resource material if you would have focused in detail on the rights of PwMI in this article.
    Promoting awareness about the rights of PwMI and mental health care is the need of the hour in the community among multiple stakeholders.
    You can write back to me through an email (sripharma55@gmail.com)

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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.

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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.

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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.”

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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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