Sunday, January 18, 2009
ACT NOW..
Call for Action
“Why should the Public know of what’s happening in IMH?”
“Let NGOs do good work and not question the Government...”
“NGOs cannot work with Government”
“It’s like Prison. Things like beating, chaining and locking up are bound to happen”.
These words were from the decision makers at the IMH Chennai. These words were uttered to cover up the appalling conditions prevailing in the IMH, Chennai, when 1.over 20 million Indians suffer from serious mental ailments and 50 million more from milder forms, 2. Mental illness is all set to take over from cardiovascular diseases as the number one health risk in India in the next two years.
What is happening at the Mental Health Institutes?
Violation of Constitutional Rights like:
Right to life with dignity, Right to life in a healthy atmosphere, and Right against violence and sexual abuse.
Case Studies:
1. A Joint Audit conducted by a team from TAP Chennai along with The Banyan in 6 Blocks of Ward 6 as recently as 3rd of October 2008 measured specifics like availability of basic amenities to evaluate living conditions, which revealed that:
a) there are just 2 Bath rooms and 18 toilets with 8 functional taps for approximately 277 people. Most toilets were not used because of lack of water facility. Except for a plate that is used for food, there are no mugs, buckets of any kind for basic ablutions. People used the same plate to wash themselves after attending to nature's call. b) Sanitation is poor. People reported toilets being cleaned once in a month by staff. No cleaning materials are available for people to clean it themselves either. c) A majority had bath outside with soap mixed water that was provided in the 6 functional taps available outside. Most people roamed naked after Bath, because there was just one set of clothes available and needed to wait for it to dry before clothing themselves.
2. There is lack of adoption of a basic humane approach, acknowledging fellow human beings as living people and not inanimate objects. We have heard and seen many instances of violence and abuse.
Warders move around with lathis’ and have been seen to use it to intimidate.
During a visit by The Banyan team, a woman, unclothed, was tied up in her own feces.
In the visitor's committee meeting held on 31st October, a woman was found with pus oozing from her badly injured head. The visitor's committee ignored the condition completely until one of The Banyan representatives asked for her to be called back for a review. It was revealed that earlier that week she was masked with a cloth and mercilessly beaten on the head by many warders because she had tried to escape. The incident was brushed aside in the visitor's committee.
There is a process termed as 'lock up' that occurs on a daily basis, where patients are locked up by evening irrespective of their prognosis – a person, well or unwell, is locked up seemingly as punishment for his/her 'crime of mental illness'.
Custodial deaths. 4 people suddenly died overnight in IMH in November 2008. The reason stated first by the Director, IMH was dysentery which was later retracted to say that they died of cardiac arrest. Whether the source of failure was lack of early detection or lack of emergency care or drug related remains unclear.
Violation of the Mental Health Act, 1987
People continue to be committed under the Indian Lunacy Act of 1912. A few months back, close to 100 people from other parts of Tamil Nadu were committed to the institution under the Indian Lunacy act of 1912.
There is no 90 day review that allows for review of the “involuntary” commitment for discharge or extension of stay voluntarily, that is required under the Mental Health Act.
IMH suffers from inadequate staffing and poor staff orientation and training. At any given point of time, we have seen 50% of the posts at the Institute of Mental Health to be vacant. There seems to be no intention, leave alone move, to fill up these posts.
At the outset of the paradigm shift in the disability movement from the charity / institutional model to the human rights model, we find that much needs to be done in the area of psycho social disorder, where people with such disorders are treated as objects / criminals / or often violated of their basic human rights.
Therefore we propose to protest against the human rights violations faced by our fellow human beings in the mental health institutions beings across the country by way of:
Human Chain across the country with the following demands:
1. At least 3 NGO’s must be allowed to work in the IMH with an MOU.
2. A monitoring committee must be constituted with representation from right based organizations/groups such as HRLN, HRF, SPG etc, disability activists, activists from the women’s movement, parents and people with mental health issues. The powers and responsibilities must be clearly discussed and spelt out.
3. Must ensure the implementation of the 90 day trial for discharge for involuntary commitments into the IMH.
4. Give a definite deadline may be by 31st of Jan 2009 to ensure human rights of the inmates are not violated and their basic needs are met.
5. Bring about policy level changes in lines with the UNCRPD.
Sending faxes and email of the situation on hand in government run Mental Health Institutions across the country to the Health Minister Mr. Anbumani Ramdoss, Ms. Sonia Gandhi, Chair Person UPA, Mr. Manmohan Singh, Prime Minister of India and Justice K.G. Balakrishnan, Chief Justice, Supreme Court of India.
Consultations to bring about policy level changes in lines with UNCRPD (United Nations Convention on the Rights of Persons with Disabilities) across the country.
“Why should the Public know of what’s happening in IMH?”
“Let NGOs do good work and not question the Government...”
“NGOs cannot work with Government”
“It’s like Prison. Things like beating, chaining and locking up are bound to happen”.
These words were from the decision makers at the IMH Chennai. These words were uttered to cover up the appalling conditions prevailing in the IMH, Chennai, when 1.over 20 million Indians suffer from serious mental ailments and 50 million more from milder forms, 2. Mental illness is all set to take over from cardiovascular diseases as the number one health risk in India in the next two years.
What is happening at the Mental Health Institutes?
Violation of Constitutional Rights like:
Right to life with dignity, Right to life in a healthy atmosphere, and Right against violence and sexual abuse.
Case Studies:
1. A Joint Audit conducted by a team from TAP Chennai along with The Banyan in 6 Blocks of Ward 6 as recently as 3rd of October 2008 measured specifics like availability of basic amenities to evaluate living conditions, which revealed that:
a) there are just 2 Bath rooms and 18 toilets with 8 functional taps for approximately 277 people. Most toilets were not used because of lack of water facility. Except for a plate that is used for food, there are no mugs, buckets of any kind for basic ablutions. People used the same plate to wash themselves after attending to nature's call. b) Sanitation is poor. People reported toilets being cleaned once in a month by staff. No cleaning materials are available for people to clean it themselves either. c) A majority had bath outside with soap mixed water that was provided in the 6 functional taps available outside. Most people roamed naked after Bath, because there was just one set of clothes available and needed to wait for it to dry before clothing themselves.
2. There is lack of adoption of a basic humane approach, acknowledging fellow human beings as living people and not inanimate objects. We have heard and seen many instances of violence and abuse.
Warders move around with lathis’ and have been seen to use it to intimidate.
During a visit by The Banyan team, a woman, unclothed, was tied up in her own feces.
In the visitor's committee meeting held on 31st October, a woman was found with pus oozing from her badly injured head. The visitor's committee ignored the condition completely until one of The Banyan representatives asked for her to be called back for a review. It was revealed that earlier that week she was masked with a cloth and mercilessly beaten on the head by many warders because she had tried to escape. The incident was brushed aside in the visitor's committee.
There is a process termed as 'lock up' that occurs on a daily basis, where patients are locked up by evening irrespective of their prognosis – a person, well or unwell, is locked up seemingly as punishment for his/her 'crime of mental illness'.
Custodial deaths. 4 people suddenly died overnight in IMH in November 2008. The reason stated first by the Director, IMH was dysentery which was later retracted to say that they died of cardiac arrest. Whether the source of failure was lack of early detection or lack of emergency care or drug related remains unclear.
Violation of the Mental Health Act, 1987
People continue to be committed under the Indian Lunacy Act of 1912. A few months back, close to 100 people from other parts of Tamil Nadu were committed to the institution under the Indian Lunacy act of 1912.
There is no 90 day review that allows for review of the “involuntary” commitment for discharge or extension of stay voluntarily, that is required under the Mental Health Act.
IMH suffers from inadequate staffing and poor staff orientation and training. At any given point of time, we have seen 50% of the posts at the Institute of Mental Health to be vacant. There seems to be no intention, leave alone move, to fill up these posts.
At the outset of the paradigm shift in the disability movement from the charity / institutional model to the human rights model, we find that much needs to be done in the area of psycho social disorder, where people with such disorders are treated as objects / criminals / or often violated of their basic human rights.
Therefore we propose to protest against the human rights violations faced by our fellow human beings in the mental health institutions beings across the country by way of:
Human Chain across the country with the following demands:
1. At least 3 NGO’s must be allowed to work in the IMH with an MOU.
2. A monitoring committee must be constituted with representation from right based organizations/groups such as HRLN, HRF, SPG etc, disability activists, activists from the women’s movement, parents and people with mental health issues. The powers and responsibilities must be clearly discussed and spelt out.
3. Must ensure the implementation of the 90 day trial for discharge for involuntary commitments into the IMH.
4. Give a definite deadline may be by 31st of Jan 2009 to ensure human rights of the inmates are not violated and their basic needs are met.
5. Bring about policy level changes in lines with the UNCRPD.
Sending faxes and email of the situation on hand in government run Mental Health Institutions across the country to the Health Minister Mr. Anbumani Ramdoss, Ms. Sonia Gandhi, Chair Person UPA, Mr. Manmohan Singh, Prime Minister of India and Justice K.G. Balakrishnan, Chief Justice, Supreme Court of India.
Consultations to bring about policy level changes in lines with UNCRPD (United Nations Convention on the Rights of Persons with Disabilities) across the country.
TRIAL NEGLECT- CASE STUDY
Shocking cases of under trial neglect in Tezpur Mental Hospital comes to the attention of the NHRC : Notices issued to Assam Government
New Delhi, 10th June 2005
The National Human Rights Commission has issued notices to the IG (Prisons) and Chief Secretary , Assam asking them to submit reports of 5 undertrial prisoners presently lodged at the LGB Regional Institute of Mental Health, Tezpur, Assam. They have been given 2 weeks to replyThe 5 cases are that of Machang Lalung who has been a undertrial prisoner for 54 years , Khalilur Rehman who has been lodged in the Mental Hospital for 35 years, Anil Kumar Burman a undertrial prisoner for 33 years, Sonamani Deb a undertrial prisoners for 32 years , and a woman Parbati Mallik who has been a undertrial prisoner for 32 years.
The plight of these undertrial prisoners were reported to the NHRC by its Special Rapporteur Shri Chaman Lal who had visited the LGB Regional Institute of Mental Health on 31st March and 1 st April 2005.
Machang Lalung was admitted on 14th April 1951 at the age of 23 years as a Undertrial Prisoner (UTP) of Guwahati jail u/s 326 IPC. As per records for 15-16 years he was regularly produced before the Board of Visitors and at their instance letters were written from time to time to the Magistrate Kamrup and Guwahati showing him unfit to defend himself. The Board on 9th Aug. 1967 wrote to Magistrate Kamrup Guwahati informing that Shri Lalung was fit to stand trial. On 10th Aug.1967, the Superintendent wrote to the Secretary to the Govt. of Assam saying that he was fit for trial and should be taken back to the jail. The Secretary wrote back on 5th Sept. 1967 asking for particulars of his case. No reply was sent. Instead each year a letter was sent certifying his insanity. On 3rd Nov.1994, he was declared fit in a letter addressed to the CJM Guwahati. Nothing happened. His file then shows a letter dated 2nd Feb. 2002 from the Secretary to the Govt. of Assam to the Suptd. Jail Guwahati asking him to go through the jail records and produce the UTP before the Magistrate. Nothing has been heard from that end till date. Machang Laung is now 77 years and works in the hospital garden without communicating with anybody. The Medical Supdt. has stated that he is not on any psychotropic medicine for several years and is free of any active signs of mental illness. He has received no visitors for more than 40 years. As per information, prima facie the accused was never produced in the trial court for trial even though he was fit to stand for trial after 9th Aug. 1967. He still remains an UTP for 54 years in a case u/s 326 I.P.C.
Khalilur Rehman was admitted on 1st Dec.1969 as a prisoner from Nagaon Dist. Jail. He has been in judicial custody since 1963. His file shows that his conviction u/s 302 IPC was set aside by the High Court on 30th April 1968 i.e. before his admission to mental hospital and has wrongly been treated as a prisoner all these years. In fact, he was entitled to receive treatment for mental illness as a free man. The Institution it was shown had written to his family in July 1984 about his discharge. On 10th Aug. 1984, the family wrote back saying that they will take him if he is fit. However, a month later they informed the institute they are too poor to take him back. The institute then requested the IG (Prisons) on 5th Sept. 2000 for his repatriation since he was fit for discharge. On 14th Sept.2001, the Suptd. Jail Nagaon wrote to Officer Incharge, Police Station Lakhimpur to take charge of the patient. On 8th April 2001 the IG (Prisons), Assam wrote to the Officer Incharge of the Police Station concerned to locate his family or nearest relative. No progress was made after this. Rehaman is now 70 years old and he has been in the Mental Hospital for 35 years even after gaining fitness for discharge. It appears that the prison authorities have failed to take appropriate action in the matter of release of the convict after his conviction u/s 302 I.P.C. was set aside by the High Court on 30th April 1968.It also appears to have wrongly treated him as a prisoner instead of a free person while undergoing treatment for mental illness in the hospital, and failed to discharge him. As a result, the victim has remained in the mental hospital, although cured for over two decades, in violation of his human rights.In the case of Anil Kumar Burman he was admitted on 9th Dec 1972 as a case received from Dhubri Jail. The file contains the judgment dated 15th July 1969 acquitting him of the charge. His family wrote to the Secretary to the Government, Assam on 20th April 1974 followed by a reminder dated 2nd July 1974 requesting for his release. As there was no response from any authority, he seems to have been written off by his family. On 31st Oct. 1996 the Institute wrote to the Superintendent Jail requesting him to arrange for his release. The Supdt. wrote back on 13th Nov.1996 expressing helplessness since his record was not traceable. The Institute took special interest in his case and based on information collected from him kept writing to certain persons in his village. Ultimately a letter written to the Headmaster of his village school produced results. His son-in-law came along with some villagers and got him released on 30th March 2005. This man was admitted in the Mental Hospital as a convict on 9th Dec.1972 after being acquitted in a murder case ordered on 15th July 1969. The file shows that he was fit enough to be discharged at least from 20th April 1974 onwards. Even if that was not possible, he should have been kept as a non-criminal mentally ill person and not in the Jail Ward. His detention in hospital as a prisoner for 33 years is a sad commentary on the state of human rights of mentally ill persons in our country. The information recorded on his file prima facie shows violation of human rights of an alleged mentally ill person, Shri Anil Kumar Burman, who having been acquitted of the charge of murder on 15th July 1969, had not been discharged till 30th March 2005, though he was fit to be discharged from 20th April 1974 onwards.
Sonamani Deb was admitted on 5th July 1972 at the age of 16 years. His file shows that in the judgment of the case u/s 302 IPC delivered on 8th Nov. 1971 the Sessions Judge, Lakhimpur had found him 'not guilty on account of being insane at the time of occurrence'. The order said that he should be lodged in jail for treatment and observation. Since he was not convicted, he was to be admitted as a free person and not as a prisoner but yet he has been suffering the unjust treatment of being wrongly treated for 32 years
Sonamani Deb, a destitute was wrongly treated as a prisoner after 8th Nov.1971, when the Sessions Judge, Lakhimpur found him "not guilty" of the offence. The information available also does not indicate the present status of his mental illness and the steps taken for his rehabilitation in case he is fit for discharge. At present he does not show any active signs of mental illness and helps in ward activities.
The sole female UTP at the Institute Parbati Mallik of P.S. Silchar, Dist. Cachar was admitted on 9th May 1977 when she was 21 years old. As per records, she was a UTP in connection with the murder of her mother four years back. Noticing her response to treatment, a letter was written to the Supdt. Dist. Jail, Silchar on 23rd Jan.1978 declaring her fit for trial and requesting for relevant papers regarding her case. Her file throws no light on what happened till 31st Sept.1986 (8 years) when another letter declaring her fit for discharge (not asking for any papers) was written. Thereafter on 3rd Jan.1996 she was shown unfit for discharge. This was repeated in the letter dated 25th May 2000 and 14th Aug.2001. On 31st Oct. 2002, IG (Prisons), Assam was informed that she was fit for discharge and can take OPD treatment from Tezpur Jail. On 16th Nov. 2002, IG (Prisons) asked the Director, I.M.H. about the relevant court orders by which she was shifted to the Mental Hospital, Tezpur and whether OPD treatment in Silchar Medical College was possible. On 6th Dec.2002, the Institute wrote to the IG (Prisons) that her case file contains no court papers other than four medical certificates and that OPD treatment in Silchar Medical College was possible. There was no response from the IG (Prisons) till March 2004 when the Institute wrote letter dated 23rd March 2004 requesting for her discharge and return to the jail. IG (Prisons), Guwahati wrote back and again asked for the relevant court orders. The Institute replied on 1st April 2004. Her file shows no progress after that. The Commission's Special Rapporteur during his recent visit saw this patient in the female ward and found her quiet and withdrawn. The Doctor Incharge of Unit III Dr. K. Pathak, and Sr. Resident, Dr. Mrs. Oli Roy Chakraborty, were of the opinion that her continued hospitalization is not necessary. Had she been discharged in early years of hospitalization, her case could have been decided. Even if she had been convicted of murder, in all probability she would have been granted premature release by this time. She has been a UTP for 32 years, found sometime fit and sometime unfit for defending herself.
Mental Health care:
30. There is a huge gap in manpower. Psychiatrists are mostly concentrated in urban areas and that too in four or five metros. In the rural areas, the situation is a cause for serious concern. The same holds true for clinical psychologists, psychiatric nurses and community social worker working in this area.
31. NHRC has taken up the issue with MCI to increase the seats and NIMHANS has also worked out strategy to train the manpower, that needs to be accelerated.
32. World over, on an average 32% of all prisoners suffered from mental illness. If one includes substance abuse, the figure goes beyond 60%. Hence there is a need for focused attention on mental health. There is a need for early identification of mental illness among prisoners and for taking consequent steps.
33. There is little documentation of the problems of psychiatrically ill prisoners, problem of escorts for referrals/ discharge, inadequate follow up and after care while in prison, disappear from psychiatric ttreatment after discharge from prison etc.
34. Little formal training of prison staff in mental health
35. Need to move from custodial care to community care. Integrate mental health care through District Mental health care programme.
36. Diet to be fixed based on `calorie' rather than monetary terms to offset inflation.
37. NHRC to continue with monitoring of mental hospitals, community care and also pursue with related Ministries.
38. Mental health care audit of all institutions of child care to be taken up by NHRC.
New Delhi, 10th June 2005
The National Human Rights Commission has issued notices to the IG (Prisons) and Chief Secretary , Assam asking them to submit reports of 5 undertrial prisoners presently lodged at the LGB Regional Institute of Mental Health, Tezpur, Assam. They have been given 2 weeks to replyThe 5 cases are that of Machang Lalung who has been a undertrial prisoner for 54 years , Khalilur Rehman who has been lodged in the Mental Hospital for 35 years, Anil Kumar Burman a undertrial prisoner for 33 years, Sonamani Deb a undertrial prisoners for 32 years , and a woman Parbati Mallik who has been a undertrial prisoner for 32 years.
The plight of these undertrial prisoners were reported to the NHRC by its Special Rapporteur Shri Chaman Lal who had visited the LGB Regional Institute of Mental Health on 31st March and 1 st April 2005.
Machang Lalung was admitted on 14th April 1951 at the age of 23 years as a Undertrial Prisoner (UTP) of Guwahati jail u/s 326 IPC. As per records for 15-16 years he was regularly produced before the Board of Visitors and at their instance letters were written from time to time to the Magistrate Kamrup and Guwahati showing him unfit to defend himself. The Board on 9th Aug. 1967 wrote to Magistrate Kamrup Guwahati informing that Shri Lalung was fit to stand trial. On 10th Aug.1967, the Superintendent wrote to the Secretary to the Govt. of Assam saying that he was fit for trial and should be taken back to the jail. The Secretary wrote back on 5th Sept. 1967 asking for particulars of his case. No reply was sent. Instead each year a letter was sent certifying his insanity. On 3rd Nov.1994, he was declared fit in a letter addressed to the CJM Guwahati. Nothing happened. His file then shows a letter dated 2nd Feb. 2002 from the Secretary to the Govt. of Assam to the Suptd. Jail Guwahati asking him to go through the jail records and produce the UTP before the Magistrate. Nothing has been heard from that end till date. Machang Laung is now 77 years and works in the hospital garden without communicating with anybody. The Medical Supdt. has stated that he is not on any psychotropic medicine for several years and is free of any active signs of mental illness. He has received no visitors for more than 40 years. As per information, prima facie the accused was never produced in the trial court for trial even though he was fit to stand for trial after 9th Aug. 1967. He still remains an UTP for 54 years in a case u/s 326 I.P.C.
Khalilur Rehman was admitted on 1st Dec.1969 as a prisoner from Nagaon Dist. Jail. He has been in judicial custody since 1963. His file shows that his conviction u/s 302 IPC was set aside by the High Court on 30th April 1968 i.e. before his admission to mental hospital and has wrongly been treated as a prisoner all these years. In fact, he was entitled to receive treatment for mental illness as a free man. The Institution it was shown had written to his family in July 1984 about his discharge. On 10th Aug. 1984, the family wrote back saying that they will take him if he is fit. However, a month later they informed the institute they are too poor to take him back. The institute then requested the IG (Prisons) on 5th Sept. 2000 for his repatriation since he was fit for discharge. On 14th Sept.2001, the Suptd. Jail Nagaon wrote to Officer Incharge, Police Station Lakhimpur to take charge of the patient. On 8th April 2001 the IG (Prisons), Assam wrote to the Officer Incharge of the Police Station concerned to locate his family or nearest relative. No progress was made after this. Rehaman is now 70 years old and he has been in the Mental Hospital for 35 years even after gaining fitness for discharge. It appears that the prison authorities have failed to take appropriate action in the matter of release of the convict after his conviction u/s 302 I.P.C. was set aside by the High Court on 30th April 1968.It also appears to have wrongly treated him as a prisoner instead of a free person while undergoing treatment for mental illness in the hospital, and failed to discharge him. As a result, the victim has remained in the mental hospital, although cured for over two decades, in violation of his human rights.In the case of Anil Kumar Burman he was admitted on 9th Dec 1972 as a case received from Dhubri Jail. The file contains the judgment dated 15th July 1969 acquitting him of the charge. His family wrote to the Secretary to the Government, Assam on 20th April 1974 followed by a reminder dated 2nd July 1974 requesting for his release. As there was no response from any authority, he seems to have been written off by his family. On 31st Oct. 1996 the Institute wrote to the Superintendent Jail requesting him to arrange for his release. The Supdt. wrote back on 13th Nov.1996 expressing helplessness since his record was not traceable. The Institute took special interest in his case and based on information collected from him kept writing to certain persons in his village. Ultimately a letter written to the Headmaster of his village school produced results. His son-in-law came along with some villagers and got him released on 30th March 2005. This man was admitted in the Mental Hospital as a convict on 9th Dec.1972 after being acquitted in a murder case ordered on 15th July 1969. The file shows that he was fit enough to be discharged at least from 20th April 1974 onwards. Even if that was not possible, he should have been kept as a non-criminal mentally ill person and not in the Jail Ward. His detention in hospital as a prisoner for 33 years is a sad commentary on the state of human rights of mentally ill persons in our country. The information recorded on his file prima facie shows violation of human rights of an alleged mentally ill person, Shri Anil Kumar Burman, who having been acquitted of the charge of murder on 15th July 1969, had not been discharged till 30th March 2005, though he was fit to be discharged from 20th April 1974 onwards.
Sonamani Deb was admitted on 5th July 1972 at the age of 16 years. His file shows that in the judgment of the case u/s 302 IPC delivered on 8th Nov. 1971 the Sessions Judge, Lakhimpur had found him 'not guilty on account of being insane at the time of occurrence'. The order said that he should be lodged in jail for treatment and observation. Since he was not convicted, he was to be admitted as a free person and not as a prisoner but yet he has been suffering the unjust treatment of being wrongly treated for 32 years
Sonamani Deb, a destitute was wrongly treated as a prisoner after 8th Nov.1971, when the Sessions Judge, Lakhimpur found him "not guilty" of the offence. The information available also does not indicate the present status of his mental illness and the steps taken for his rehabilitation in case he is fit for discharge. At present he does not show any active signs of mental illness and helps in ward activities.
The sole female UTP at the Institute Parbati Mallik of P.S. Silchar, Dist. Cachar was admitted on 9th May 1977 when she was 21 years old. As per records, she was a UTP in connection with the murder of her mother four years back. Noticing her response to treatment, a letter was written to the Supdt. Dist. Jail, Silchar on 23rd Jan.1978 declaring her fit for trial and requesting for relevant papers regarding her case. Her file throws no light on what happened till 31st Sept.1986 (8 years) when another letter declaring her fit for discharge (not asking for any papers) was written. Thereafter on 3rd Jan.1996 she was shown unfit for discharge. This was repeated in the letter dated 25th May 2000 and 14th Aug.2001. On 31st Oct. 2002, IG (Prisons), Assam was informed that she was fit for discharge and can take OPD treatment from Tezpur Jail. On 16th Nov. 2002, IG (Prisons) asked the Director, I.M.H. about the relevant court orders by which she was shifted to the Mental Hospital, Tezpur and whether OPD treatment in Silchar Medical College was possible. On 6th Dec.2002, the Institute wrote to the IG (Prisons) that her case file contains no court papers other than four medical certificates and that OPD treatment in Silchar Medical College was possible. There was no response from the IG (Prisons) till March 2004 when the Institute wrote letter dated 23rd March 2004 requesting for her discharge and return to the jail. IG (Prisons), Guwahati wrote back and again asked for the relevant court orders. The Institute replied on 1st April 2004. Her file shows no progress after that. The Commission's Special Rapporteur during his recent visit saw this patient in the female ward and found her quiet and withdrawn. The Doctor Incharge of Unit III Dr. K. Pathak, and Sr. Resident, Dr. Mrs. Oli Roy Chakraborty, were of the opinion that her continued hospitalization is not necessary. Had she been discharged in early years of hospitalization, her case could have been decided. Even if she had been convicted of murder, in all probability she would have been granted premature release by this time. She has been a UTP for 32 years, found sometime fit and sometime unfit for defending herself.
Mental Health care:
30. There is a huge gap in manpower. Psychiatrists are mostly concentrated in urban areas and that too in four or five metros. In the rural areas, the situation is a cause for serious concern. The same holds true for clinical psychologists, psychiatric nurses and community social worker working in this area.
31. NHRC has taken up the issue with MCI to increase the seats and NIMHANS has also worked out strategy to train the manpower, that needs to be accelerated.
32. World over, on an average 32% of all prisoners suffered from mental illness. If one includes substance abuse, the figure goes beyond 60%. Hence there is a need for focused attention on mental health. There is a need for early identification of mental illness among prisoners and for taking consequent steps.
33. There is little documentation of the problems of psychiatrically ill prisoners, problem of escorts for referrals/ discharge, inadequate follow up and after care while in prison, disappear from psychiatric ttreatment after discharge from prison etc.
34. Little formal training of prison staff in mental health
35. Need to move from custodial care to community care. Integrate mental health care through District Mental health care programme.
36. Diet to be fixed based on `calorie' rather than monetary terms to offset inflation.
37. NHRC to continue with monitoring of mental hospitals, community care and also pursue with related Ministries.
38. Mental health care audit of all institutions of child care to be taken up by NHRC.
WHAT WE CAN DO..
Promoting the rights of people with mental disorders
What can you do?
Promoting and protecting the rights of people with mental disorders requires the
concerted and unified effort of multiple stakeholders.
Policy makers
• Improve and increase the financial and human resources allocated to mental
health
• Be familiar with international and national human rights standards and norms
related to people with mental disorders
• Ensure that policies in the education, labour, criminal justice system and
general health care system all act to promote mental health and protect human
rights
• Include coverage for mental health care in both public and private insurance
schemes
• Implement mental health policies and laws that promote human rights,
deinstitutionalisation, integration into general health care and development of
community care
• Set up monitoring mechanisms to ensure that human rights are being respected
in all mental health facilities
Health care workers
• Respect the dignity, protect the rights, and promote the autonomy and liberty
of people with mental disorders
• Ensure that informed consent of people with mental disorders is the basis for
all treatment provided
• Involve people with mental disorders in the development of their treatment
plan
• Involve families in the treatment and care of their relatives with mental
disorders.
• Inform decision makers what resources and other support is needed in order to
provide good quality mental health care
Mental health service users
• Denounce human rights violations including outdated and inhuman forms of
treatment, poor service delivery, inaccessible care and abusive use of
involuntary admission and treatment.
• Advocate for your participation in the development and implementation of
policies and laws to improve human rights and mental health services
• Be familiar with your human rights under international human rights law and
national laws.
• Join forces with other mental health service users in order to support each
other and carry out activities to change attitudes towards people with mental
disorders and combat stigma and discrimination.
User groups, family groups, advocacy organisations and other NGOs
• Sensitize and educate the public about mental health and mental disorders and
raise awareness on the rights of people with mental disorders
7 December 2005 - Information Sheet No. 2
• Advocate for the provision of good quality mental health services in primary
health care, general hospital settings and in the community
• Advocate for your participation in the development and implementation of
policies and laws to improve human rights and services for people with mental
disorders
• Organise informal community mental health services such as counseling, selfhelp
groups both for individuals with mental disorders and for families, dropin
centres, community re-integration programmes, case management, outreach
programmes and crisis services
• Provide preventive and promotive services, such as school-based mental
health promotion programmes
• Collaborate with other NGOs that share similar goals within the country,
region and world
Foundations
• Support the development and implementation of country mental health
policies, plans and laws that promote and protect human rights
• Support the development of mental health services in primary health care,
general health care settings and in the community
• Support the creation and activities of mental health service user, family and
advocacy organizations
• Support research to evaluate the impact of mental health policies and laws.
• Support research to develop effective mental health interventions in primary
care, general health and community facilities
Academic institutions
• Provide policy and health systems training for mental health policy makers
and planners
• Provide appropriate mental health training for primary health care and
community workers
• Incorporate training on mental health and human rights issues into
undergraduate and post graduate curricula for health and mental health
professionals, including those in primary care
• Conduct research into mental health policy and service planning, including
evaluation of policy implementation, and models of service organisation and
planning
• Conduct research on effective mental health interventions at primary care and
in the community facilities;
• Provide up-to-date undergraduate and post-graduate curricula based on
evidence-based approaches, in keeping with policy priorities
• Provide specialist supervision for both the delivery and planning of mental
health services through primary care and community care
Professional Organizations
• Contribute to the debate on policy and legislation development
• Set quality standards for mental health workers at all the levels; ie in hospitals,
primary health care and community settings
• Raise awareness of constituencies on mental health and human rights issues
• Provide accreditation for mental health professionals
• Support the change of roles among primary health care staff from working
predominantly with physical disorders to a more holistic approach to health
care that incorporates physical and mental health.
• Support the change of roles among mental health staff from working in
predominantly institutional settings to predominantly community-based
settings.
Media
• Avoid stereotypes, sensationalism and perpetuating myths and misconception
when reporting on mental health issues
• Present the mental health issues with compassion, highlighting what can be
achieved with adequate financial and human resources.
• Highlight the human rights of people with mental disorders
What can you do?
Promoting and protecting the rights of people with mental disorders requires the
concerted and unified effort of multiple stakeholders.
Policy makers
• Improve and increase the financial and human resources allocated to mental
health
• Be familiar with international and national human rights standards and norms
related to people with mental disorders
• Ensure that policies in the education, labour, criminal justice system and
general health care system all act to promote mental health and protect human
rights
• Include coverage for mental health care in both public and private insurance
schemes
• Implement mental health policies and laws that promote human rights,
deinstitutionalisation, integration into general health care and development of
community care
• Set up monitoring mechanisms to ensure that human rights are being respected
in all mental health facilities
Health care workers
• Respect the dignity, protect the rights, and promote the autonomy and liberty
of people with mental disorders
• Ensure that informed consent of people with mental disorders is the basis for
all treatment provided
• Involve people with mental disorders in the development of their treatment
plan
• Involve families in the treatment and care of their relatives with mental
disorders.
• Inform decision makers what resources and other support is needed in order to
provide good quality mental health care
Mental health service users
• Denounce human rights violations including outdated and inhuman forms of
treatment, poor service delivery, inaccessible care and abusive use of
involuntary admission and treatment.
• Advocate for your participation in the development and implementation of
policies and laws to improve human rights and mental health services
• Be familiar with your human rights under international human rights law and
national laws.
• Join forces with other mental health service users in order to support each
other and carry out activities to change attitudes towards people with mental
disorders and combat stigma and discrimination.
User groups, family groups, advocacy organisations and other NGOs
• Sensitize and educate the public about mental health and mental disorders and
raise awareness on the rights of people with mental disorders
7 December 2005 - Information Sheet No. 2
• Advocate for the provision of good quality mental health services in primary
health care, general hospital settings and in the community
• Advocate for your participation in the development and implementation of
policies and laws to improve human rights and services for people with mental
disorders
• Organise informal community mental health services such as counseling, selfhelp
groups both for individuals with mental disorders and for families, dropin
centres, community re-integration programmes, case management, outreach
programmes and crisis services
• Provide preventive and promotive services, such as school-based mental
health promotion programmes
• Collaborate with other NGOs that share similar goals within the country,
region and world
Foundations
• Support the development and implementation of country mental health
policies, plans and laws that promote and protect human rights
• Support the development of mental health services in primary health care,
general health care settings and in the community
• Support the creation and activities of mental health service user, family and
advocacy organizations
• Support research to evaluate the impact of mental health policies and laws.
• Support research to develop effective mental health interventions in primary
care, general health and community facilities
Academic institutions
• Provide policy and health systems training for mental health policy makers
and planners
• Provide appropriate mental health training for primary health care and
community workers
• Incorporate training on mental health and human rights issues into
undergraduate and post graduate curricula for health and mental health
professionals, including those in primary care
• Conduct research into mental health policy and service planning, including
evaluation of policy implementation, and models of service organisation and
planning
• Conduct research on effective mental health interventions at primary care and
in the community facilities;
• Provide up-to-date undergraduate and post-graduate curricula based on
evidence-based approaches, in keeping with policy priorities
• Provide specialist supervision for both the delivery and planning of mental
health services through primary care and community care
Professional Organizations
• Contribute to the debate on policy and legislation development
• Set quality standards for mental health workers at all the levels; ie in hospitals,
primary health care and community settings
• Raise awareness of constituencies on mental health and human rights issues
• Provide accreditation for mental health professionals
• Support the change of roles among primary health care staff from working
predominantly with physical disorders to a more holistic approach to health
care that incorporates physical and mental health.
• Support the change of roles among mental health staff from working in
predominantly institutional settings to predominantly community-based
settings.
Media
• Avoid stereotypes, sensationalism and perpetuating myths and misconception
when reporting on mental health issues
• Present the mental health issues with compassion, highlighting what can be
achieved with adequate financial and human resources.
• Highlight the human rights of people with mental disorders
INDIAN STATS: MENTAL ILLNESS
30 lakh people suffering from mental illness in India: report
October 12, 2008
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Over thirty lakh people in the country are suffering from mental illness and it is set to overtake cardiovascular diseases as single largest ailment by 2010, a report has said. "About 30 to 35 lakh people need hospitalisation at any time for mental illness. In contrast there are about 29,000 beds available in various hospitals for their treatment," the National Human Rights Commission said. The NHRC, expressing concern over rise in number of mentally ill people, said there was a need to augment health care infrastructure in India to protect rights of such persons. "The huge treatment gap with 50 to 90 per cent people not being able to access services is a serious human rights issue," it said. The human rights body said morbidity on account of mental illness will overtake heart diseases by the year 2010. "According to National Institute of Mental Health and Neuro Sciences (NIMHANS), there are over two crore people in India who are in need of treatment for serious mental disorder and about five crore people who are affected by common mental diseases," the report said. Noting that there is a dearth of facilities in India to provide treatment to these people, it said stigma-related discrimination faced by persons with mental illness also makes it a "matter of deep concern" to the Commission. The Commission said there is a need to focus on preventive, curative and other dimensions of mental health to protect the rights of persons with mental illnesses.
http://www.nation.com.pk/pakistan-news-newspaper-daily-english-online/International/12-Oct-2008/30-lakh-people-suffering-from-mental-illness-in-India-report
October 12, 2008
window.google_render_ad();
Over thirty lakh people in the country are suffering from mental illness and it is set to overtake cardiovascular diseases as single largest ailment by 2010, a report has said. "About 30 to 35 lakh people need hospitalisation at any time for mental illness. In contrast there are about 29,000 beds available in various hospitals for their treatment," the National Human Rights Commission said. The NHRC, expressing concern over rise in number of mentally ill people, said there was a need to augment health care infrastructure in India to protect rights of such persons. "The huge treatment gap with 50 to 90 per cent people not being able to access services is a serious human rights issue," it said. The human rights body said morbidity on account of mental illness will overtake heart diseases by the year 2010. "According to National Institute of Mental Health and Neuro Sciences (NIMHANS), there are over two crore people in India who are in need of treatment for serious mental disorder and about five crore people who are affected by common mental diseases," the report said. Noting that there is a dearth of facilities in India to provide treatment to these people, it said stigma-related discrimination faced by persons with mental illness also makes it a "matter of deep concern" to the Commission. The Commission said there is a need to focus on preventive, curative and other dimensions of mental health to protect the rights of persons with mental illnesses.
http://www.nation.com.pk/pakistan-news-newspaper-daily-english-online/International/12-Oct-2008/30-lakh-people-suffering-from-mental-illness-in-India-report
Human Rights Violation in Mental Health Hospitals:
Human Rights Violation in Mental Health Hospitals:
Enjoyment of the human right to health is vital to all aspects of a person’s life and well being, and crucial to the realization of many other fundamental human rights and freedoms. It is explicitly mentioned in the Universal Declaration of Human Rights in Article 25(1) that ‘Everyone has the right to a standard of living adequate for the health and well being of himself and his family, including food, clothing, housing and medical care and necessary social services’. The inclusion of “Health” and “medical care” in the UDHR has led to an Article each in the ESCR Covenant(Article 12), 3Though, the figures given in W.H.O. Report,2001 indicates that Human rights violation occurs in case of persons with mental illness across the world, and India is not an exception.
India is a vast country with multiple models of health care services operating within the country. These include government services, private services and non governmental services. Mental Health Services includes long term hospital services and community mental health services. “The Indian experience with institutionalization has not been edifying. A report prepared for the National Human Rights Commission (NHRC,1999), after an empirical study of mental health hospitals in the country, made a damning
indictment of the state of mental health institutions. The findings reveal that there are predominantly two types of hospitals,” the report said. “the first type does not deserve to be called ‘hospitals’ or mental health centers. They are ‘dumping grounds’ for families to abandon their mentally ill member, for their economic reasons or lack of understanding and awareness of mental illness. The living conditions in many of these settings are deplorable and violate an individual’s right to be treated humanely and live
a life of dignity. Despite all advances in treatment, the mentally ill people in these hospitals are forced to live a life of incarceration”. “The second type of ‘hospitals’, the NHRC report continues, are those that provide basic living amenities. Their role is predominantly custodial and they provide adequate food and to keep patients manageable and very little effort is made to preserve or enhance shelter.”(NHRC (India) Report, 1999)”4. On the contrary, the families hesitate to take their kin back because,“according to the Dr. C. Ramasubramanian, a psychiatrist and member of the District
Mental Home Regulatory Committee, many of them consider the homes a convenient place to abandon their mentally ill wards in order to escape the stigma attached to mental illness. As a result, such institutions have proliferated.”5 The conditions of persons with mental illness in institutions have been cause for human right concern.
Human Rights of Persons with Mental Illness.
In many hospitals in India, there are anecdotal reports of violation of human rights of the persons with mental illness. Human rights nothing more than entitlement due legally and morally, to an individual. “All Human beings are born free and equal in dignity and rights ”6 It has led in the preamble of the ICCPR and ICESCR, “recognizing that these rights derive from the inherent dignity of human person “7 The dignity of persons with mental illness is not respected in mental health institution. Sometimes they are found in worst condition like naked, in dirty and old clothes, unhygienic conditions,
sometimes women were found in dreadful condition, not “wearing any undergarments and intimate parts of their bodies could be seen through the ill fitting clothing.”8 Not Providing the necessary clothes, to protect personal dignity, and not providing items to maintain menstrual hygiene, are both human rights violations.
Human Rights in Article 25(1) that ‘Everyone has the right to a standard of living adequate for the health and well being of himself and his family, including food, clothing, housing and medical care and necessary social services’. The inclusion of “Health” and “medical care” in the UDHR has led to an Article each in the ESCR Covenant(Article 12),9 Article 47 of Indian Constitution in part IV directive principles of state policy explicitly mentioned that it is duty of the State to raise the level of nutrition and the standard of living and to improve public health. “The Supreme Court
has also laid down the maintenance and improvement of public health is one of the obligations that flow from Article 21 of the Constitution. This means that mentally ill have the fundamental/human right to receive equality mental health care and to humane living conditions in the mental hospitals. The right to life in Article 21 of the Constitution means something more than survival of animal existence.”10 On the contrary, the mental illness has not got enough attention by the state in health policy and programs. These people are deprived from their right to treatment and health services. Only Hospitals for Mental health and some District Hospitals are main sources
for treatment. But “study conducted by NHRC in 37 mental hospitals during November 2001 and January 2002 reveals that even most of the hospitals have inadequate infrastructure, staffs, clinical services, availability of medicines and treatment modalities, quality of food, availability of clothing and linen, recreational facilities, vocational rehabilitation facilities.”11 The other sources of mental illness related treatment are mental home or asylum are run by religious institution and traditional healing is main practice for treatment purpose.
For example, Moideen Badhusha Mental Home Erwadi, at where 27 people died in fire accident in 2001. The people are treated inhuman way, sometimes they are chained and malnourished. There is no attention on
treatment part and beating is the only treatment. The “Article 6 (1) of the Mental Health Act prohibits the running of a home without license and Article 11 (1b) says, the licensing authority can revoke the license if the maintenance of the home is being carried on in a manner detrimental to the moral, mental or physical well being of the inpatients”12 Even though illegal mental home are running in the country and less intervention have been done by the state authority and this is the place where the chances of human rights violation is high.
Article 5, UDHR states no one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. This article is included in article 7 of the ICCPR which is explicitly says, No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. In particular, no one shall be subjected without his free consent to medical or scientific experimentation. These people often treated in human and degrading treatment. Sometimes there is question about their right to
autonomy or self determination in case, when they are not informed or consented for treatment of ECT and any side effects of any drugs. “Intervention for violence among rehabilitating patients must include both prevention aspect as well a crisis management.
Method such as anger management, communication skills, healing crisis, sedation and more human ways of dealing with violence can be implemented”13 Article 22 UDHR and Article 9 of the ICESCR recognizing the rights of everyone, as member of society, has the right to social security for his/her dignity and the free development of his personality. Article 66(1) of Persons with Disability Act states, “The appropriate Governments and the local authorities shall within the limits of heir economic capacity and development undertake or cause to be undertaken rehabilitation
of all persons with disabilities.”14 Mental Illness is also recognized as disability according to the section 2 of the PWD Act, 1995. Persons with mental illness is not treated as disabled person and they have not been benefited by any social security benefits like concession, scholarship for education etc. comparing to other categories of disabled people. Some of the state doesn’t have budget allocation for social security, social insurance of persons with mental illness. It is assumed that civic rights are suspended during admission in a mental hospital(Curran and Harding,1978). Among
others rights can be suspended during hospitalization are right to vote, right to enter into a contract, right to drive a car, right to practice profession and right to marry and social life and privacy. Institutionalization put ends in social life and there is no any rights and freedoms to enjoy human life.
Conclusion:
The incident of Erwadi has opened up the eyes of Government and civil society. Government took lots of affirmative actions to improve mental health sector in country like district wise “survey of all registered and unregistered bodies purporting to offer mental health care and licence to be granted on standards are maintained”15.
Government has implemented District Mental Health Program which incorporates with WHO Community Mental Health Car model. It focuses on Treatment availability at primarily level, Community awareness and Renovation and construction of Hospital for Mental Health in the state. It also covers training components for human resource development in the field of mental health. Government should take as much as
necessary steps to improve mental health sector keeping in mind other barriers; sigma and discrimination prevailing in the society, second one is the wrong public health choice in the matter of allocating money for mental health. Most of the money are spent on mental health institutions which were supposed to take care of mentally ill patients but basic human rights are violated. The most important intervention strategy is community based. It explains why people don’t seek treatment. If the only option is a psychiatric hospital, very far from village and one that is terribly maintained, people
will turn to strange healing system. The third barrier is not having enough specialist like Psychiatrists, Psychologists, Social workers, nurses, health workers to deal with the problems of mental illness. The forth important barrier is discrimination of persons with mental illness. For example Insurance schemes are not recognizing the parity between physical and mental illness and only reimburse expenses on physical ailments
but not mental ailments. The problem is huge in a country but its solutions are available at very little cost. We need more awareness among politicians, policy makers, NGOs working in health and disability sectors, and civil society about the consequences of non treatment rather than treatment. Only by doing so, there is some hope of reaching close to the realistic goal of protection of human rights of persons with mental illness in the
country.
References:
Frontline Volume 21 –Issue 05 February 28- March 12, 2004.
http://www.iapp.co.in/PIL.doc. accessed on 31/09/07
http://www.ijsp.in/issues.htm accessed on 29/09/07
Indian Persons with Disability Act 1995
International Human Rights Documents (2006), P.R Gandhi, Oxford University Press
Janardhan & Bitopoi (2003), Mental Health Services in India: A snapshot, Express
Health Management Pgs 17.
Mental Health Act (1987)
Ramya and Bhargavi,Life (2005)Behind Walls, Human Rights within Institutions.
References:
Enjoyment of the human right to health is vital to all aspects of a person’s life and well being, and crucial to the realization of many other fundamental human rights and freedoms. It is explicitly mentioned in the Universal Declaration of Human Rights in Article 25(1) that ‘Everyone has the right to a standard of living adequate for the health and well being of himself and his family, including food, clothing, housing and medical care and necessary social services’. The inclusion of “Health” and “medical care” in the UDHR has led to an Article each in the ESCR Covenant(Article 12), 3Though, the figures given in W.H.O. Report,2001 indicates that Human rights violation occurs in case of persons with mental illness across the world, and India is not an exception.
India is a vast country with multiple models of health care services operating within the country. These include government services, private services and non governmental services. Mental Health Services includes long term hospital services and community mental health services. “The Indian experience with institutionalization has not been edifying. A report prepared for the National Human Rights Commission (NHRC,1999), after an empirical study of mental health hospitals in the country, made a damning
indictment of the state of mental health institutions. The findings reveal that there are predominantly two types of hospitals,” the report said. “the first type does not deserve to be called ‘hospitals’ or mental health centers. They are ‘dumping grounds’ for families to abandon their mentally ill member, for their economic reasons or lack of understanding and awareness of mental illness. The living conditions in many of these settings are deplorable and violate an individual’s right to be treated humanely and live
a life of dignity. Despite all advances in treatment, the mentally ill people in these hospitals are forced to live a life of incarceration”. “The second type of ‘hospitals’, the NHRC report continues, are those that provide basic living amenities. Their role is predominantly custodial and they provide adequate food and to keep patients manageable and very little effort is made to preserve or enhance shelter.”(NHRC (India) Report, 1999)”4. On the contrary, the families hesitate to take their kin back because,“according to the Dr. C. Ramasubramanian, a psychiatrist and member of the District
Mental Home Regulatory Committee, many of them consider the homes a convenient place to abandon their mentally ill wards in order to escape the stigma attached to mental illness. As a result, such institutions have proliferated.”5 The conditions of persons with mental illness in institutions have been cause for human right concern.
Human Rights of Persons with Mental Illness.
In many hospitals in India, there are anecdotal reports of violation of human rights of the persons with mental illness. Human rights nothing more than entitlement due legally and morally, to an individual. “All Human beings are born free and equal in dignity and rights ”6 It has led in the preamble of the ICCPR and ICESCR, “recognizing that these rights derive from the inherent dignity of human person “7 The dignity of persons with mental illness is not respected in mental health institution. Sometimes they are found in worst condition like naked, in dirty and old clothes, unhygienic conditions,
sometimes women were found in dreadful condition, not “wearing any undergarments and intimate parts of their bodies could be seen through the ill fitting clothing.”8 Not Providing the necessary clothes, to protect personal dignity, and not providing items to maintain menstrual hygiene, are both human rights violations.
Human Rights in Article 25(1) that ‘Everyone has the right to a standard of living adequate for the health and well being of himself and his family, including food, clothing, housing and medical care and necessary social services’. The inclusion of “Health” and “medical care” in the UDHR has led to an Article each in the ESCR Covenant(Article 12),9 Article 47 of Indian Constitution in part IV directive principles of state policy explicitly mentioned that it is duty of the State to raise the level of nutrition and the standard of living and to improve public health. “The Supreme Court
has also laid down the maintenance and improvement of public health is one of the obligations that flow from Article 21 of the Constitution. This means that mentally ill have the fundamental/human right to receive equality mental health care and to humane living conditions in the mental hospitals. The right to life in Article 21 of the Constitution means something more than survival of animal existence.”10 On the contrary, the mental illness has not got enough attention by the state in health policy and programs. These people are deprived from their right to treatment and health services. Only Hospitals for Mental health and some District Hospitals are main sources
for treatment. But “study conducted by NHRC in 37 mental hospitals during November 2001 and January 2002 reveals that even most of the hospitals have inadequate infrastructure, staffs, clinical services, availability of medicines and treatment modalities, quality of food, availability of clothing and linen, recreational facilities, vocational rehabilitation facilities.”11 The other sources of mental illness related treatment are mental home or asylum are run by religious institution and traditional healing is main practice for treatment purpose.
For example, Moideen Badhusha Mental Home Erwadi, at where 27 people died in fire accident in 2001. The people are treated inhuman way, sometimes they are chained and malnourished. There is no attention on
treatment part and beating is the only treatment. The “Article 6 (1) of the Mental Health Act prohibits the running of a home without license and Article 11 (1b) says, the licensing authority can revoke the license if the maintenance of the home is being carried on in a manner detrimental to the moral, mental or physical well being of the inpatients”12 Even though illegal mental home are running in the country and less intervention have been done by the state authority and this is the place where the chances of human rights violation is high.
Article 5, UDHR states no one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. This article is included in article 7 of the ICCPR which is explicitly says, No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. In particular, no one shall be subjected without his free consent to medical or scientific experimentation. These people often treated in human and degrading treatment. Sometimes there is question about their right to
autonomy or self determination in case, when they are not informed or consented for treatment of ECT and any side effects of any drugs. “Intervention for violence among rehabilitating patients must include both prevention aspect as well a crisis management.
Method such as anger management, communication skills, healing crisis, sedation and more human ways of dealing with violence can be implemented”13 Article 22 UDHR and Article 9 of the ICESCR recognizing the rights of everyone, as member of society, has the right to social security for his/her dignity and the free development of his personality. Article 66(1) of Persons with Disability Act states, “The appropriate Governments and the local authorities shall within the limits of heir economic capacity and development undertake or cause to be undertaken rehabilitation
of all persons with disabilities.”14 Mental Illness is also recognized as disability according to the section 2 of the PWD Act, 1995. Persons with mental illness is not treated as disabled person and they have not been benefited by any social security benefits like concession, scholarship for education etc. comparing to other categories of disabled people. Some of the state doesn’t have budget allocation for social security, social insurance of persons with mental illness. It is assumed that civic rights are suspended during admission in a mental hospital(Curran and Harding,1978). Among
others rights can be suspended during hospitalization are right to vote, right to enter into a contract, right to drive a car, right to practice profession and right to marry and social life and privacy. Institutionalization put ends in social life and there is no any rights and freedoms to enjoy human life.
Conclusion:
The incident of Erwadi has opened up the eyes of Government and civil society. Government took lots of affirmative actions to improve mental health sector in country like district wise “survey of all registered and unregistered bodies purporting to offer mental health care and licence to be granted on standards are maintained”15.
Government has implemented District Mental Health Program which incorporates with WHO Community Mental Health Car model. It focuses on Treatment availability at primarily level, Community awareness and Renovation and construction of Hospital for Mental Health in the state. It also covers training components for human resource development in the field of mental health. Government should take as much as
necessary steps to improve mental health sector keeping in mind other barriers; sigma and discrimination prevailing in the society, second one is the wrong public health choice in the matter of allocating money for mental health. Most of the money are spent on mental health institutions which were supposed to take care of mentally ill patients but basic human rights are violated. The most important intervention strategy is community based. It explains why people don’t seek treatment. If the only option is a psychiatric hospital, very far from village and one that is terribly maintained, people
will turn to strange healing system. The third barrier is not having enough specialist like Psychiatrists, Psychologists, Social workers, nurses, health workers to deal with the problems of mental illness. The forth important barrier is discrimination of persons with mental illness. For example Insurance schemes are not recognizing the parity between physical and mental illness and only reimburse expenses on physical ailments
but not mental ailments. The problem is huge in a country but its solutions are available at very little cost. We need more awareness among politicians, policy makers, NGOs working in health and disability sectors, and civil society about the consequences of non treatment rather than treatment. Only by doing so, there is some hope of reaching close to the realistic goal of protection of human rights of persons with mental illness in the
country.
References:
Frontline Volume 21 –Issue 05 February 28- March 12, 2004.
http://www.iapp.co.in/PIL.doc. accessed on 31/09/07
http://www.ijsp.in/issues.htm accessed on 29/09/07
Indian Persons with Disability Act 1995
International Human Rights Documents (2006), P.R Gandhi, Oxford University Press
Janardhan & Bitopoi (2003), Mental Health Services in India: A snapshot, Express
Health Management Pgs 17.
Mental Health Act (1987)
Ramya and Bhargavi,Life (2005)Behind Walls, Human Rights within Institutions.
References:
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