A life of dignity: New mental health care law is imminent and it will help fill a yawning treatment gap

The National Mental Health Survey 2016 published by NIMHANS recently showed that 13.7% of Indians are likely to have a mental illness during their lifetime. The survey also highlighted the huge treatment gap for mental illness ranging from 28-83%. Treatment gap refers to the proportion of people who need treatment for a mental illness but do not get it. Stigma, discrimination and violation of rights are everyday occurrences for persons with mental illness and their families.Research has shown that mental illness is associated with poverty and we will not meet the sustainable development goals on good health and well-being (SDG 3) and ending poverty (SDG 1) unless we address the health and social needs of persons with mental illness and their families and ensure their inclusion in all development activities.
The Mental Health Care Bill 2013, which was passed by the Rajya Sabha in August 2016, addresses some of these important issues. The Bill, which now awaits the approval of the Lok Sabha before it becomes law, aims to ensure that persons with mental illness receive the treatment they need in their own communities and are enabled to live a life of dignity .
It makes provision for a range of effective mental health services to be provided at public health facilities in each district. It also provides for free treatment of homeless persons with mental illness and those living below the poverty line. All medicines for treatment of mental illness on the essential drugs list will be made available free of charge at government health facilities.
Recognising the importance of Ayurveda and other Indian systems, the Bill provides for free AYUSH treatment for mental illness in government facilities.The Bill also makes it mandatory for insurance companies to provide medical insurance for mental illness treatment on an equal basis with insurance for physical illness.
Government also recognises that an adequate number of trained mental health professionals are required to reduce the treatment gap. India needs more psychiatrists, clinical psychologists, psychiatric nurses, psychiatric social workers, professional caregivers and counsellors. To begin with, government is committed to training all medical officers in public health facilities to provide emergency mental health services. The Bill also commits the government to make all necessary efforts to increase the number of mental health professionals to international levels in the next ten years. All these measures will usher a new era in the treatment of mental illness in our country , reduce the financial burden on patients and their families and reduce the treatment gap for mental illness in our country .
Government has delivered on its promise of decriminalising suicide in the new Bill, a longstanding demand of professionals, patients, families and recommended by the Law Commission of India. Government is acutely aware that suicide is an emerging health priority in India and the Mental Health Care Bill requires central and state governments to launch suicide prevention programmes and broad public health measures to reduce suicides. The health and family welfare ministry is committed to do all it takes to stop the suicide epidemic especially amongst young people in this country .
Advance Directive is one of the most innovative provisions of the Bill. For the first time in India, persons with mental illness will have the right to specify in advance their choice of treatment and name their own representative to ensure their treatment wishes are carried out when they are acutely ill and not able to decide themselves. This provision is in line with government's belief that people should have more control over their own treatment and doctors should implement people's treatment wishes.
I have no doubt that when the Mental Health Care Bill is passed by the Lok Sabha and becomes law, it will be implemented by government in letter and spirit. This will change the face of mental health care in India and help us meet our commitments under the WHO Action Plan 2013-2020. I call upon everyone, including mental health professionals, patients and caregiver organisations and individuals to join hands with the government in implementing the Mental Health Care Act, 2016 and enable persons with mental illness to live a life of dignity and hope.
The writer is Union health minister

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