Context: 

The National Human Rights Commission (NHRC) in a report flagged the “inhuman and deplorable” condition of all 46 government run mental healthcare institutions across the country. 

Related Facts:

• According to WHO, the burden of mental disorders is maximal in young adults. India being a young country (nearly 50% of its population below the age of 25) will face increased burden of mental illness in the short term.
• An estimated 150 million people across India are in need of mental health care interventions, according to India’s latest National Mental Health Survey 2015-16.

Mental Healthcare Act, 2017:

• The Act lays down that every person shall have a right to access mental health care and treatment from mental health services run or funded by the appropriate government. 
• The right to access mental health care and treatment shall mean mental health services of affordable cost, of good quality, available in sufficient quantity, accessible geographically, without discrimination on the basis of gender, sex, sexual orientation, religion, culture, caste, social or political beliefs, class, disability or any other basis.
• Healthcare service to be provided shall be in a manner that is acceptable to a person with mental illness and their families and care-givers.
• The range of services specified in the Act includes outpatient and inpatient services, half-way homes, sheltered accommodation, supported accommodation, and provisions for child and old-age mental health services. 
• The Act also contains a provision for the notification of a list of essential medicines, providing which will be the obligation of the relevant government.
• The Act also discourages using physical restraints (such as chaining), unmodified electro­convulsive therapy (ECT), and pushes for the right to hygiene, sanitation, food, recreation, privacy, and infrastructure.

Challenges:

• Poor Governance: In a majority of States, State Mental Health Authority and Mental Health Review Boards (MHRBs) are yet to be established or remain defunct.
• Quality: Further, many States have not notified minimum standards which are meant to ensure the quality of MHEs.
• Poor budgetary allocation: Poor budgetary allocation and utilization of funds creates a scenario where shelter homes remain underequipped, establishments understaffed, and professionals and service providers not adequately trained to deliver proper healthcare, she added. 
• Rehabiliatation: The dearth of alternative community based services further complicates access to rehabilitation.

Way Forward: 

• Raising Awareness: Stigma and Awareness need to be addressed in parallel in order to tackle the burden of mental illness in India.
• Deploy Community Health Workers: There is a need to deploy community health workers who, with appropriate training and supervision, effectively deliver psychosocial interventions for the needy.
•  Psychosocial interventions: State governments need to scale up their psychosocial interventions through community health workers.
• Scaling up initiatives: There is a need for scaling up initiatives like Schizophrenia Research India’s (SCARF) mobile bus clinic  through public-private collaboration.                                                                                                                                

News Source: The Hindu