INDIA'S MENTAL HEALTHCARE ACT

• The report notes that the facilities are illegally keeping patients long after their recovery, in what is an "infringement of the human rights of mentally ill patients".
• These observations were made after visits to all operational government facilities, to assess the implementation of the Mental Healthcare Act 2017 (MHA).

3. About Mental Healthcare Act 2017

• The MHA, 2017 centred on the agency of individuals, acknowledged their right to live as part of a community (under Section 19) and focused on rehabilitation.

• The Act also discourages using physical restraints (such as chaining) and unmodified electro-convulsive therapy (ECT) and pushes for the right to hygiene, sanitation, food, recreation, privacy and infrastructure.
• More importantly, the Act recognised that "People have a capacity of their own unless proven otherwise".
• Additionally, under Section 5, people are empowered to make "advance directives".
• They can nominate a representative for themselves, thereby potentially helping to eliminate absolute forms of guardianship in favour of supported decision-making.
• This barring cases where the person needs a higher degree of care and support.
• Experts note this was the first time a psychosocial approach to mental health was adopted.
• The Act acknowledged that external factors such as income, social status and education impact mental well-being; therefore, recovery needs psychiatric and social input.

4. Challenges

• While the MHA safeguards the rights of people in mental health care establishments, enforcement challenges remain.
• Almost 36.25 per cent of residential service users at state psychiatric facilities were found to be living for one year or more in these facilities.
• Under the MHA, all States are required to establish a State Mental Health Authority and Mental Health Review Boards (MHRBs) bodies that can further draft standards for mental health care institutes, oversee their functioning and ensure they comply with the Act.
• The majority of States are yet to be established or remain defunct Further, many states have not notified minimum standards which are meant to ensure the quality of MHEs.
• The Act takes on a human rights lens by shifting the obligation of care onto different stakeholders including caregivers, government institutions, police officials and mental health practitioners.
• Poor budgetary allocation and utilisation of funds create a scenario where shelter homes remain underequipped, establishments understaffed and professionals and service providers are not adequately trained to deliver proper healthcare.
• While Section 19 recognises the right of people to "live in, be part of and not be segregated from society", there have been no concrete efforts towards implementation.
• The dearth of alternative community-based services further complicates access to rehabilitation.

For Prelims & Mains