Constructing Mentally Ill – Implementing the Mental Healthcare Laws

Mental Healthcare
Illustration by Michael Driver

While everyone has periods of difficulty and some mental flaws, being diagnosed as mentally ill is different. The Diagnostic and Statistical Manual of Mental illness (DSM-5) defines a mental illness as a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning.

Mental illness causes you to think outside of normal reasoning conceptions, meaning one thinks in different ways. While there may be a tendency to act violently or have reduced intelligence, by and large, can live similarly to the norm, though they may need some special accommodation. Most people misunderstand what it means to be mentally ill. Being mentally ill, on the other hand, does not imply that a person is unreasonable, but rather that their reasoning is of a different kind. It does not mean except in exceptional circumstances, that a person is violent or a person’s IQ is lowered. It also doesn’t mean that a person is unable to function regularly in life, though they may require some special aid or accommodations.

People suffering from mental illness have to go through many struggles. They have to fight battles in society and sometimes in the legal world too for acceptance. The construction of the mentally ill contains both legal and social dimensions. This article deals with the same.

Social Perspective

Do you ever wonder how is life for a person with mental illness? Are they as easily accepted into social life as someone who is not a sufferer? Mentally ill people are frequently considered to be violent, however, this isn’t always the case. Many people with mental illnesses are nonviolent; only a small percentage of them are in danger of committing violent acts. While there isn’t much violence among patients, there are a lot of other issues. Racism, prejudice, poverty, homelessness, and hopelessness are all problems that people with mental illnesses face.

People with mental diseases struggle to hold a career, communicate with others, or receive social support. This could make their life incredibly stressful and challenging. Stress brought on by a mental illness can lead to an increase in alcohol, tobacco, and drug usage, as well as a poor diet and risky sexual behavior. Mental illness sufferers are also at significant risk of suicide as a result of social stress. When you have a mental illness, many aspects of your life can be affected, including your social life.

A mental illness can cause a person to become isolated and cut off from the rest of the world. A mental disease can cause reality to distort, putting those who care for the sufferer under additional stress. Many people who suffer from mental illnesses isolate themselves from the outside world or attempt to drown their problems in other substances rather than seeking the care they require. 

Hence, it is apparent that mental illness has a massive negative impact on a person’s social life.

Legal Perspective

Mental Healthcare

In the United States and the United Kingdom, the Americans with Disabilities Act of 1990 and the Mental Capacity Act of 2005 are regarded as comprehensive mental healthcare laws that recognize the rights of mentally challenged people in their respective countries. In India, the Mental Healthcare Act has been formulated by the Parliament of India to provide for mental healthcare and services for persons with mental illness and to protect, promote and fulfill the rights of such persons during delivery of mental healthcare and services and for matters connected therewith or incidental thereto. Mentally ill people in India have rights that are drawn from a diverse set of legislation and Constitutions.

All of the fundamental rights provided to regular citizens by the Indian Constitution are available to mentally and physically disabled people. There is no law that prevents them from exercising these rights. The most significant constitutional rights for mentally challenged people are the protection against discrimination and the right to health. Article 15(2) of the Indian Constitution states that no person, including those with mental disabilities, can be denied access to public goods. They must also be given equal opportunities to succeed in life. The right to life and personal liberty is guaranteed by Article 21 and also accrues to mentally ill people.

The right to health is inextricably linked to the right to life, as the top court has ruled in numerous cases.  There are disability rights also under International Laws. The UN General Assembly adopted the Declaration on the Rights of Mentally Retarded Persons in 1971. The proclamation was the first step in giving mentally ill people disability rights. The proclamation established some criteria for mentally ill people to follow, among other things. Some of these included the recognition of mentally ill people as a distinct category of physically challenged people and providing them with certain safeguards, the member nations must ensure the economic security of mentally ill people by devising appropriate programs so that they can earn a living, and special consideration must be given to these people in any state social planning.

The 1996 convention by the WHO on Mental Healthcare Laws laid down ten basic principles that every member nation needs to adopt for the betterment of mentally challenged people. It was suggested that developing countries open a big number of asylums with the best healthcare facilities. The nations were advised to reform their own legislation in order to provide specialized treatment for mentally ill people. It was felt that there was a need to raise public awareness about the condition of mentally handicapped people. The most notable advice, however, was for all governments throughout the world to evaluate their mental healthcare laws and make necessary adjustments in order to mold them in the best interests of mentally challenged persons. It was suggested that special categories and reservations be formed in jobs for these people and that every state acknowledge the disability rights of mentally ill people. As a signatory country to both schemes, India must act in the best interests of the mentally challenged persons in the country. 

The Declaration of Hawaii was adopted by the General Assembly in 1992. Many inmates in mental asylums have been subjected to grave human rights violations at the hands of authorities for many years. In many countries, the asylums were in deplorable conditions, with food and water being scarce in certain cases. Aside from that, the patients lacked privacy, there were no facilities for amusement or leisure activities, and they were sometimes forced to perform hard labor. In truth, no attempt has been made to cure the mentally ill. In the Hawaii Declaration, it was stated that an atmosphere of love and care should be maintained in asylums. The amount of seclusion and confinement used to treat these persons should be kept to a bare minimum. The statement was the first international treaty to recognize the human rights of people with mental illnesses.

Legal Mental Healthcare Provisions in India

In India, we have the Persons with Disabilities (Equal opportunities, protection of rights, and full participation) Act 1995. This act was the first to recognize the need to give equal opportunities and increase the participation of mentally challenged people in society. In this regard, landmark steps were taken, including the establishment of special schools for the education of mentally disabled children, the right to free education until the age of 18 for mentally disabled children under this Act, and the approval of a 3% employment reservation for disabled (Including mentally disabled) in government jobs. The Indian judiciary has taken a sympathetic stance toward mentally ill people as well. The judiciary has often recognized infringements of these people’s rights and provided them with proper legal remedies. 

Despite the above-mentioned provisions, India still needs to work on the loopholes in the system. Firstly, there is a lack of asylums in India. Despite being a subscriber to numerous conventions and treaties, India still requires a sufficient number of mental healthcare asylums. In an ideal world, each district would have one asylum. The majority of the country’s operating asylums are substandard. The plight of mentally challenged people is made worse by a lack of facilities, as well as employees and doctors.

Secondly, there is a lack of awareness. There must be aware of any right to deliver on substantive aims. The rights of mentally challenged people are currently unknown to the majority of the country. Thirdly, the majority of the country’s present laws make mentally handicapped persons incompetent. They are unable to enter into contracts or legally marry. These issues must be addressed. And lastly, there is a lack of proper implementation of the Mental Healthcare Legislation and granting rights to the mentally disabled is another major issue to be tackled. In this sense, the legislature should take the lead.

Is it time for reform in the Mental Healthcare Laws?

People with mental disabilities are just as much a part of society as anyone else. Despite the existence of mental healthcare laws and precedents guaranteeing them certain rights, there is a perceived need for reform. Because this isn’t a politically charged topic, it hasn’t gotten the attention it deserves. Furthermore, blaming the regime will not solve the problem; after all, it is up to us to step forward and assist these people in obtaining their rights. Its high time for implementing efficient mental healthcare laws and incorporating a reproductive justice framework into discourses on mental health.