The Mental Health Care Bill, 2016, passed by the Rajya Sabha, can be applauded for some innovative aspects even as it has introduced many issues detrimental to mental health care (Editorial, Aug.13). It has treaded on areas which are best left to professionals. For example, why should the law say what type of treatment a physician should adopt in certain cases? All will agree that it is a purely technical decision whether a child should be given electroconvulsive therapy or have a patient undergo psychosurgery. It is too western a concept to think of people with high illiteracy to give advance directives with regard to what type of management should be given. We have lost a great opportunity to delink general hospital and outpatient psychiatry units from custodial care. Such a bold step would have reduced stigma and encouraged the public to seek mental health services without hesitation. I hope the Bill will receive enough attention when it comes up for discussion in the Lok Sabha. The decriminalisation of suicide is a welcome change.
Dr. N.N. Raju,
Visakhapatnam
The Bill is mute over the issue of an awareness of psychiatric problems especially in suburban and rural areas. The ground reality in a traditional country such as India is that people in the rural areas do not as yet understand mental illness and still think of it as some kind of supernatural force. An awareness about psychiatric problems and the need for psychologists in our primary health centres are musts if the Bill is to truly address the issue of mental health.
Karan Dange,
Allahabad
The passage of the Bill marks the beginning of a sensitive governmental response to the gaping inadequacies plaguing our mental health system. The UN report on Mental Health Matters 2014 lists 20 per cent of youth across the world as suffering from at least one mental condition, with those from low- and middle-income countries at particular risk. It also highlights a cyclical relation between poverty and mental health disorders. This has a bearing on India with vast numbers of its population still living below the poverty line and a large percentage of its population who are very young. The challenge lies in providing universal access to mental health facilities at the community level and in public health centres. Dissemination of awareness, preventive measures and encouraging better surveillance of patients are critical steps. Having mental health wards with qualified staff as mandatory in community health centres will be a major step forward. The decriminalisation of suicide shows a sensitive and humane approach to suffering. It also highlights the need to alleviate the social and economic causes of mental stress.
Rosen Brar,
Patiala, Punjab
