It is an incontrovertible that “A healthy mind leads to a healthy body for which it is necessary to keep the most active organ of our body “active”. But it is also inevitable, that with time the mental health issues have also increased. As per World health organisation (WHO), young people majorly including adolescents and young adults between ages 10 to 24 years are more vulnerable to mental health disorders.[1] In the year 2017, 197.3 million people suffered from mental disorder, which was 2.5% in 1990 increased to 4.7% in 2017 in India[2]. Following as per National Mental Health Survey published by NIMHANS (National Institute of Mental Health and Neuro Sciences) 11% of the college students, 7-8% of the high school students have attempted suicide due to mental disorders. It emerged as a major problem for “WE THE PEOPLE” hence consideration was necessary. Time to time the governments prior to the independence made efforts through legislations to safeguard and provide the sufferers a healthy and friendly treatment.
Many laws were introduced by the British crown administration like-
- The Lunacy (Supreme Courts) Act 1858[3]
- The Lunacy (District Courts) Act 1858[4]
- The Indian Lunatic Asylum Act 1858[5]
- The Military Lunatic Act 1877[6]
But with time they all lost their procedural value and it became necessary to bring a new governing legislation. Hence, in 1912 the then British government passed Indian Lunacy act; 1912. The objective of the act was- procedurally address, detain the lunatics following do care in person and property of the sufferers. This act brought into opening of many asylums and making people aware of them. But the major drawback of this law was that it neglected human rights and was only concerned with custodial sentences.
Mental Health care act 1987 hereinafter ref. as (MHA 1987): The objectives and the reasons for which the act was enacted was to considerably change the attitude of the society towards the lunatics particularly when the diagnosis would be at the earlier stage. It was also necessary to have fresh legislation of medical treatment with advancing technology.
It is important to note that the mental health legislations were initially drafted to safeguard the public from dangerous patients by isolating them from the public but a paradigm shift from custodial care to community care has occurred due to-
- medical technology advancement for assessment and treatment of mental disorders
- The human rights movement;
- change in definition of health; “A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”[7]
- To promote preventive, curative, rehabilitative approaches and mitigation of disability.[8]
Suicides due to mental illness and behaviour of the society made it necessary to have curb on them. As per sec. 309 of IPC- Attempt to commit suicide.—Whoever attempts to commit suicide and does any act towards the commission of such offence, shall be punished with simple imprisonment for a term which may extend to one year [or with fine, or with both][9].
It is a point to mention that attempts to curb suicides due to mental issue were taken in the past, but they did not fit with the emerging advancing world effectively. Hence it was necessary to take action and follow in the direction of decriminalising attempt to suicides by people suffering from mental illness, since it is not he who is responsible; it is the society which forces him to do so. Giving a person penal punishment who is unsound, not liable for his acts is nothing but violation of principle of natural justice.
Sometimes the nature mandates us to adopt a humanitarian approach and take actions. Principle of natural justice involves procedural requirement of fairness, thereby a law for justice, law for fairness, law for equal treatment becomes necessary. Taking that into consideration, the Parliament of India “temple of Democracy”[10] took steps in the direction and- A bill was introduced in the upper house titled as “The mental Health care bill 2013, passed by conference committee on 20 November 2013, received President’s assent on 7 April 2017 and came into force on 29 May 2018.
INTRODUCTION
The above mentioned act provides for the persons who are suffering with mental illness with healthcare and services to protect their rights. This act came to existence in order to harmonize and put into alignment the local Mental Healthcare Act 1987 with the Convention on Rights of Persons with Disabilities and its Protocol which was adopted by the UN on December 13th, 2006 and came into force on May 3rd, 2008.
The definition of mental illness has been clearly defined in the act as “a substantial disorder of thinking, mood and perception, orientation, or memory that grossly impairs judgment, behavior, capacity to recognize reality or ability to meet the ordinary demands of life, mental conditions associated with the abuse of alcohol and drugs. But it doesn’t regard mental retardation, a condition of arrested or incomplete development of mind of a person, specially characterized by sub normality of intelligence, as mental illness”[11]
PROHIBITED PROCEDURES
Few procedures which seems barbarian and clearly against human rights are prohibited exclusively. These procedures make mental healthcare seem to be an entirely gruesome experience but these patients need to be aware that these procedures are forbidden and that they need not be scared and come forth with the treatment in a positive attitude.
- Electro-convulsive therapy without the use of muscle relaxants and anesthesia,[12]
- Electro-convulsive therapy for minors[13]
- Sterilization of men or women, when such sterilization is intended as a treatment for mental illness.[14]
- Section 96 of the Chapter XIIV states[15]: No psychosurgery shall be performed until- The consent of the patient on whom surgery is being performed and approval from the concerned board to perform the surgery being taken.
ROLE OF CENTRAL MENTAL HEALTH AUTHORITY
It will enlist and register all the mental healthcare institutions under the control of the Central Government, and will fund and direct quality services that need to be maintained for different types of mental institutions and list of all the medical professionals which are to be contacted in case of emergency[16].
DECRIMINALISATION OF ATTEMPT TO SUICIDE
In section 115(1)[17] notwithstanding anything contained in Section 309 of the Indian Penal Code any person who attempts to commit suicide shall be presumed, unless proved otherwise, to have severe stress and shall not be tried and punished under the said code.
(2) The Appropriate Government shall have a duty to provide care, treatment and rehabilitation to a person, having severe stress and who attempted to commit suicide, to reduce the risk of recurrence of attempt to commit suicide.
This shows how the formation of the act has allowed the sensitive care that has to be taken to such victims of suicide who are mentally stressed and unaware about their well being, this act has allowed now to take special care to such cases wherein the victim has attempted suicide due to stress or mental illness and has provided provisions through which they cater to the needs of mentally unhealthy or unfit personnel[18].
CONCLUSION
The present healthcare system is inefficient and we suffer from lack of infrastructure and professionals in the field, resultant of this causes degraded quality of living and healthcare of the mentally ill. The decriminalization of attempt to suicide is one of the major highlights of the act, along with the concept of Advance Directive and ban on all those treatment procedures that gave these mentally ill persons nightmares, also trying to fix the system of institutions by enlisting them and making sure they work at standards which are prescribed by the authorities in the act.[19]
By; Anirudh Tyagi
B.A.L.LB (4th year)
School of law, Sharda University (Gr. Noida)
[1]World health organization report published on 17th June 2021 https://www.who.int/news-room/fact-sheets/detail/suicide
[2] Published by Statists Research Department, Feb 26, 2021
[3] Passed by British parliament in 1858
[4] ibid.4
[5] ibid.4
[6] ibid.4
[7] Presentation: “Designing the road to better health and well-being in Europe” at the 14th European Health Forum Gasten in 7 October 2011, Bad Hofgastein Austria
[8] Mental health act 1987
[9] Indian Penal Code (45 of 1860)
[10] Prime Minister Narendra Modi during address on 28 May 2014 in parliamentary session.
[11] Mental Health care act 2017 objective resolution
[12] Mental health care act 2017
[13] ibid.12
[14] ibid.12
[15] ibid.12
[16] ibid.12
[17] ibid.12
[18] ibid.12
[19] ibid.12