INDIAN LEGAL FRAMEWORK ON MENTAL HEALTH CRISIS DUE TO COVID-19
This article is authored by Priyanshi Dewan, fifth-year law student at Manipal University, Jaipur. And co-authored by Srishti Jain, fourth-year law student at Symbiosis Law School, Noida.
We might have come across such statements in our lives but they certainly do not hold true. ‘Positivity, wellness, and mental health are paramount at this time.’ Globally COVID-19 has caused humanitarian emergencies disrupting public mental health leading to numerous psychiatric and mental health-related problems like anxiety, loneliness, frustrations, depression, etc.
According to the definition of the World Health Organization (WHO), "Mental health is a state of happiness. In this state, a person can realize his own abilities, can cope with normal life pressure, can work efficiently, and be able to contribute to his community.”
India is under a mental health epidemic, one in seven people in the country suffers from mental health illness, with no consultation or even consideration about their mental health in-sight. There is a vicious cycle of lack of awareness, shame, or fear of being tagged as lunatic, suffering, and then isolation of the patient. There is a scarcity of resources and India is in dire need of immediate redress. Due to lack of awareness and not being sensitive enough about the issue, a stigma is observed in people suffering from mental health problems which results in underutilization of the available services and resources, the problems continue to compound and persist. The pandemic continues to pose challenges to our medical care facilities, socio-political settings, economy, and infrastructure, therefore severely affecting the mental health of people along with physical health.
MENTAL STATE OF INDIA
India has the maximum count of suicides in the world, drug addiction and high crime rate also creates a link with the mental health crisis. The novel Coronavirus has unseeingly magnified these issues. Mental health illness is a major reason which costs the global economy heavily every year. Lack of productivity due to depression and anxiety are the most common mental health problems seen among people.
Due to lockdowns imposed all over the world, there has been a rise in the cases of domestic violence towards children and women, leaving them with no escape from their abuser during quarantine. Frequent suicide cases of migrant labourers, healthcare workers, and those in isolation centres have been continuously reported ever since the pandemic began to change the lives of each and every person in India.
The frontline warriors across the globe are working round the clock under outrageous pressing factors in such unprecedented times, making incomprehensible choices and confronting psychological wellness troubles subsequently. The drastic changes in the daily schedule are exorbitantly hard to manage for the youngsters, old people, and isolated individuals. The shutdown of organizations and incapacity of spending time with their loved ones has negatively affected the psychological state of everyone. The geriatric populace and the marginalized communities in India have been recognized as the most vulnerable groups to COVID-19.
The world is coming together to fight the novel Coronavirus and its implications, mental health crises being a major one. WHO has published several guidelines and advisories for combating the existing mental health crisis. To cope up with this predicament, many countries have devised different strategies.
China has been actively involved in the effective handlingof emergency psychological crises caused due to Covid-19; interventions were made to diminish the negative impact on the mental conditions of the public.
The U.S. Government during the pandemic has passed major relief packages as of March 2020. The Families First Coronavirus Response Act was passed to provide paid sick leave to people suffering from COVID-19 or are in quarantine or are taking care of any ill family member. Another Act passed was The Coronavirus Aid, Relief, and Economic Security (CARES) Act which was a $2 billion incentive allocated to different institutions, clinics, administrations to address increased suicidal tendencies, emergency psychological responses, and other issues.
The way New Zealand handled the Covid-19 outbreak is an outstanding example to the world. Lockdowns all over the world were a major reason for deteriorating mental health along with other health consequencesbut managed to overcome the pandemic by adopting non-pharmaceutical interventions by high level testing, beforehand preparedness, reduction of the number of people in gathering and implementing strict restrictions.
EXISTING LAWS AND POLICIES ON MENTAL HEALTH IN INDIA
The scope of Article 21 of the Indian Constitution has been extended to include the right to health. People with mental illness must have access to satisfactory healthcare facilities so that they can live in proper dignified living conditions because, “there is no health without mental health.”
The Mental Health Act 1987 has not been accepted by the public since its inception and is subject to constant criticism. Following the 2014-2016 National Mental Health Survey, the 1987 Act became the new Mental Health Act 2017, as amended, focusing on the rights of people with mental illness but at the same time ignoring the presence of other programmes related to mental health.
National Mental Health Policy (NMHP) amended in2014 is another policy existing in the legal sphere which was launched back in 1982. So far there is only a roadmap towards implementations; they are more reactive than proactive policies. All the states should be directed to adopt NMHP and the State shall be held responsible for the actions. The way forward for the protection of infringement of mental healthcare rights is through implementing this programme uniformly throughout the country.
To help India overcome these crises and provide more psychological help which is easily accessible as well as affordable is the need of the hour and which can be achieved by appropriate interpretation, understanding and implementation through various awareness campaigns such as Swach Mansikta Abhiyan.
The District Mental Health Program (DMHP) was amended in 2003 to include two crucial schemes of Up-gradation of Psychiatric Wings of Medical Colleges/General Hospitals and Modernization of State Mental Hospitals. A Central mental wellness team has also been established to regulate and execute the programme known as the Mental Health Monitoring System (MHIS).
India has also concocted different arrangements, one such model within the government hemisphere known as ASHA wherein health workers form a bridge to educate women and children about mental illness and help them to get consultation from the right experts within their community.
During the time of Covid-19 the Indian Government launched a toll-free number for ‘Behavioural Health’ working 24*7 and providing free assistance in respect of emotional well-being in these trying times. The Government of India launched Aarogya Setu mobile application which not only informs the citizens about the infection in their radius but also connects essential health care services along with prescribed Ayurvedic remedies, breathing practices and relevant advisories issued by the Department of Health for containment of COVID-19. PM-CARES FUND was introduced to strengthen India’s fight against COVID-19, aiming to provide quality treatment, advance research and fulfill other shortcomings of the healthcare infrastructure.
NIMHANS proposes that- ‘Psychological intervention medical teams’ ought to be framed for aiding individuals affected by pandemics and should be made part of the overall clinical group. Support activities to keep in check the mental health of the forefront fighters should be carried out to guarantee the same.
The Union Budget FY 2021-2022 set aside a budget of Rs. 597 Crore for healthcare; 7% of which has been allocated to NMHP i.e. Rs. 40 Crore, same as last budget. The remaining amount was set aside for the following institutions - Lokpriya Gopinath Bordoloi Regional Institute of Mental Health in Tezpur – Rs. 57 Crore and NIMHANS - Rs 500 Crore.
India requires active policy-making and implementation along with an appropriate allocation of government resources. There is a need to promote support groups, create awareness and educate the masses about the chronic mental health issue. Mental health should be put under the same lens as that of physical health, and should be covered under Health care policy too. Time to time intervention and easy access to professional assistance are the best methods to conquer this emergency in India. It requires combined effort and pooling of resources of the public as well as private industries and an effective engagement of communities in preventing and promoting the psychological state of the population.
There is an urgent need for implementation and formulation of these policies, encouraging people to speak about their mental well – being and having the ability to reach out to a psychiatrist or therapist, just in case they have to. All things considered, beginning with our own lives, we all have the joint obligation of influencing change and rousing others to attempt to do the same. Let us all dedicate ourselves to raising mental health awareness in our society, community and family. We should proliferate to 'get the message out' with the ultimate aim of eliminating the stigma.