The Bill provides for protection and promotion of rights of persons with mental illness, offering better delivery of healthcare in institutions and in the community.
The Indian government in 2007 ratified the United Nations Convention on the Rights of Persons with Disabilities, which required the laws of the country to align with the convention. To that effect, the Mental Health Care Bill, 2013, was first introduced in the Rajya Sabha to repeal the existing Mental Health Act, 1987.
Mental Health Care Bill, 2013, seeks to decriminalize acts of suicide by linking them to the state of mental health of the person attempting the act. According to the bill, a person who attempts suicide shall be presumed to be suffering from mental illness at that time and will not be punished under the Indian Penal Code (IPC). Section 309 of the IPC makes any attempt to commit suicide a punishable offence for which imprisonment could extend up to a year.
The Bill also prohibits electro-convulsive therapy for minors, while allowing it for adults only along with the use of muscle relaxants and anesthesia.
The debate to repeal the penal provision under section 309 of the IPC began 45 years ago when the 42nd report of the Law Commission in 1971 called for decriminalizing attempt to suicide. Subsequently, the Indian Penal Code (Amendment) Bill, 1978 was passed by the Rajya Sabha omitting Section 309 of IPC. However, the proposed law did not see the light of the day as the Lok Sabha was dissolved before the Bill could be passed.
The Law Commission changed its stand in the 156th report submitted in 1997, where it recommended retaining the provision.
The commission report came after the Supreme Court’s famous pronouncement upholding the constitutional validity of Section 309 in Gian Kaur versus State of Punjab case in 1996.
The verdict, authored by former judge J.S. Verma, however, did not look into the wisdom of retaining or continuing the provision in the statute.
Finally, in 2008, the Law Commission, in its 210th report, called for decriminalizing and humanization of attempt to suicide. It was here that the attempt to suicide was suggested to be regarded as a manifestation of a diseased condition of mind deserving treatment and care rather than an offence to be visited with punishment.
In a reply to a debate shared on Twitter, health minister Jagat Prakash Nadda said that the bill was a historical step comprising a progressive and humane approach.
Nadda added that the Mental Health Care Bill, 2013, is patient-centric and focuses on how more facilities and support could be provided to patients. Various stakeholders, including the academia, experts and various political establishments, were consulted while formulating the bill, he added.
Nadda mentioned that around 6-7% of the country’s population suffered from some kind of mental illness, while 1-2% suffered from acute mental diseases.
There were 134 official amendments to the bill, which were unanimously passed clause-by-clause by the upper house. According to the Mental Health Care Bill, every person shall have the right to access mental healthcare and treatment from services run or funded by the government. The bill also allows for provision of an advance directive to be furnished in writing by a person, irrespective of his mental illness, stating how he wants to be treated for the illness in case he falls mentally ill in future and who his nominated representative shall be.
The Bill provides for the establishment of a State Mental Health Authority and a Central Mental Health Authority along with a Mental Health Review Commission to regulate the sector and register institutions.
The Bill aims to encourage community-based admissions, while safeguarding the rights and interests of the mentally ill person, Nadda said. Among various objectives, the bill provides for ensuring healthcare, treatment and rehabilitation of persons with mental illness “in a manner that does not intrude on their rights and dignity".
Nadda stated that the bill accommodates special provision for women and children. It states that women can only be separated from children under medical circumstances. The bill also seeks to include the recognition of the role of caregivers as a statutory provision as one of the amendments, he said.
In line with the discussion, members of the house highlighted urgent steps to address the lack of infrastructure and shortage of psychiatrists in the country. The debate brought out the shortage of mental healthcare experts in the country in comparison to the number of people suffering from mental illness. Nadda admitted deficiency of medical staff dealing with mental health in the country and said that the government is trying hard to have more such specialists.