Mental health bill is set to decriminalise suicide in IndiaBMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f5349 (Published 30 August 2013) Cite this as: BMJ 2013;347:f5349
The much deliberated and long awaited Mental Healthcare Bill was introduced to the Rajya Sabha, the upper house of India’s parliament, in the third week of August.
The bill, intended to replace 1987 legislation, includes provisions to decriminalise attempts at suicide and supports advanced directives to allow people to express how they would like to be treated should they lose the mental capacity to make decisions for themselves.
India has been a pioneer among developing nations in identifying mental health as an important issue. It launched the National Mental Health Programme in 1982 to increase accessibility to “minimum healthcare for all” and encourage the development of mental health services in the community. However, the implementation of services did not start until the mid 1990s, and the needs of people in India with mental illnesses are still largely unmet.
Government figures put the prevalence of common mental disorders at 6-7% and severe mental disorders at 1-2%.1 A report by the Ministry of Health and Family Welfare predicted that the incidence of mental health problems would rise from 650 cases per 100 000 population in 2005 to 800 per 100 000 in 2015.2 The report indicated a treatment gap of 70-80% for mental disorders.
The Mental Healthcare Bill aims to reform services and improve the quality of care provided in mental care facilities and also to reduce the stigma faced by people with mental illness, “who were often victims of inhuman and degrading treatment, abuse, and ridicule.”2
It proposes decriminalising attempts at suicides by amending relevant criminal laws. Section 124 of the bill states, “Notwithstanding anything contained in Section 309 of the IPC [Indian Penal Code] (which states punishment for attempts to [commit] suicide), any person who attempts suicide shall be presumed, unless proved otherwise, to be suffering from mental illness at the time of the bid and shall not be liable to punishment under the said sections.” Figures from the National Crime Records Bureau show that the number of recorded suicides in India rose by 25% in a decade, from 108 506 in 2001 to 135 585 in 2010.3
The bill also gives people with mental illness various rights, such as the right to refuse or receive visitors, phone calls, or letters while in a mental healthcare facility and the right to education, recreation, and religious practices. It also contains provisions to ban certain archaic medical practices, including electroconvulsive therapy without anaesthesia, chaining of mentally ill patients, and enforced sterilisation.
The bill makes it a legal duty for the government to implement mental health programmes at all levels of the health system and to make available the provision of affordable and quality mental healthcare facilities to all. There are also provisions for establishing regulatory authorities to monitor the private sector and to register all institutions.
The bill, after it is passed by the Lok Sabha, parliament’s lower house, and is given presidential assent, will bring Indian law in line with the 2008 United Nations Convention on the Rights of Persons with Disabilities.
Cite this as: BMJ 2013;347:f5349
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