All’s not well

With mental health disorders threatening to reach epidemic proportions, the first draft of the new Mental Health Care Bill has been formulated at a time when the country is finally waking up to the enormity of the disease. While many psychiatrists and members of the mental health policy group under the Union Health Ministry say this will revolutionise the existing system and repeal the Indian Mental Health Act of 1987, activists say the changes are only cosmetic and the new Bill is partial towards the private sector.

SEVERAL FIRSTS

The draft Bill, which is expected to be soon brought before the Cabinet for its final clearance, introduces several new concepts.

It completely prohibits electric shock therapy without muscle relaxants and anaesthesia in adults, and bans it altogether for minors. However, Dr Roy Abraham Kallivayalil, national president of Indian Psychiatry Society, said, "Banning of Electro Convulsive Therapy (ECT) or shock therapy altogether in minors can be a problem because many a time it is an emergency life-saving procedure. Say a 16-year-old with severe depression is wheeled into the OPD with indications of suicidal ideation, do we not give him ECT? The legal provisions should not affect the medical aspects of care."

He said the "over legalisation" of psychiatry could end up isolating patients more and harbour further stigma. "There is no scope for general hospital care of psychiatry. Mentally ill persons have to be treated in separate registered institutions when the emerging disease trends in India are of psychosomatic disorders such as depression and anxiety rather than the traditional concept of mentally-ill. Why should these patients be isolated? General hospital care of psychiatric problems should be recognised and they should be treated like any other diseases," he added.

Under Section 10, the Bill states that person with mental illness shall be treated equal to physical illness, and stipulates that public and private insurance providers "shall make provisions for medical insurance for treatment of mental illness on the same basis as is available for treatment of physical illness".

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