• Brain Booster Articles

MENTAL HEALTH- A HUMAN RIGHTS ISSUE

Author: Sameer Afzal Ansari, III year of B.A.,LL.B. from Guru Gobind Singh Indraprastha University


Introduction

The tconcept tof tHuman tRights tattracts tas tno tother tbranch tor tfield tof law. tThis tconcept thelped tus trealize tthat tlaw tis tvery tvast, tdynamic tand unparalleled. tThe tway tHuman tRights tencompasses tand tdeals twith tvarious topics twhich tare totherwise tignorant tappeals ta tlot. tThe tdenial tof trights to the tmentally tdisabled tcommunity tis ta tbig tquestion tmark ton tthe tvery foundation tstone tof tHuman tRights. tThis tdenial tmust tbe teradicated tand hence tour tsensitivity, tconcern tand tknowledge tmust tbecome ta tconnecting platform tthrough twhich twe tcan tdeliver tour tservices tto tthe tdeprived.


But tthe tirony tlies tin tthe tfact tthat tHuman trights tare tavailable, tthey tare also trecognized, tbut tthey tare tnot taccessible tto tthe tpeople twho twant them tmost. tIt tis ttotally tagreed tthat tthe twomen tand tthe tchildren tare very tprone tto tthe tviolation tof trights tas tthey tare tconsidered tweaker tin the tsociety tbut tthe tmost tprone tare tmentally tdisabled tpeople twho themselves tare tnot taware tof ttheir trights.


Every tperson tother tthan tthat tof tthe tmentally tdisabled tis tcapable tof availing tthe tremedies tavailable tto tthem. tThese tpeople tare tmost vulnerable tas tthey tpossess tthis tunique tability tto tremain tsilent tafter tbeing a tsubject tof tviolation tand texploitation tin ta tclosed tfour-walled troom.


The trelationship tbetween tmental thealth tand thuman trights tcan tbe teasily divided tinto tthree tparts. tFirst, thuman trights tviolations, tsuch tas displacement tand ttorture, tnegatively taffect tmental thealth. tSecond, coercive treatment tpractices tof tmental thealth tpatient tcan timpact thuman trights. t


Finally, tthe tadvancement tof thuman trights tleads tto tthe tbenefit tof tmental health, ti.e. tcan tsay ttheir tadvancement twalk-in tcooperation. tThere tare thus economic tand tclinical treasons, tas twell tas tmoral tand tlegal tobligations, tto advance thuman trights tin tmental thealth tcare.


Mental Health as a human right

As thuman tbeings, tour thealth tand tthe thealth tof tour tloved tones tis ta matter tof tdaily tconcern. tRegardless tof tour tgender, tage, tsocio-economic background, twe tconsider tour thealth tto tbe tour tmost tbasic tand tessential asset. tThe tdevelopment tof tmental thealth tis tsomehow trestricted tdue tto social, tpsychological tand tbiological tfactors.

  • Recent treport tby tWorld tHealth tOrganisation ton tright tto tmental thealth, tpointed tout tthat tdespite tevidence tthat tone tcannot tlive thappy twithout tmental thealth, tand tthere tcannot tbe tfit tand thealthy twithout tmental thealth, tnowhere tin tthe tworld tdoes tmental thealth tenjoy tequality twith tphysical thealth tin tterms tof tbudgeting, tor tmedical teducation tand tpractice. tAccording tto tWHO testimates tfrom t2014 tglobally, tonly tseven tper- tcent tof thealth tbudgets tare tallocated tto taddress tmental thealth.

  • The tUnited tNations tHuman tRights tOffice treport tpoints tout tthat tpeople twith tmental thealth tconditions tand tthose twith tpsycho-social tdisabilities texperience tdisproportionately thigher trates tof tpoor tphysical thealth, tand thave treduced ttheir tlife texpectancy– ta t20-year tdrop tfor tmen tand t15 tyears tfor twomen t tcompared twith tthe tgeneral tpopulation.


Pertinent Laws

In tthis tarticle, twe twill tbe tdiscussing tprovisions tof tcertain tInternational Conventions tto tprotect tthe trights tof tmentally till tpeople tand tparticularly focussing ton tthe tprovisions tembedded tin tthe tConstitution tof tIndia tto protect tsuch tpeople tfrom tthe tadversities tof tsociety.


International Policies

UN tPrinciples tfor tthe tProtection tof tMental tIllness tand tHealth tCare( tThe MI tPrinciples t1994). The tMI tprinciples twere tadopted tby tthe tUnited Nations tGeneral tAssembly tin t1991. tThe tMI tprinciples tprovide tthe tnon-binding tstandards twhich tthe tmental thealth tsystems tof tthe tcountries should tmeet tto tcure tthe tmental tdisorder tof tthe tpeople. tBasically, tthere are t25 tprinciples tprovided tby tthe tdocument tfor tthe tprotection tof tthe rights tof tthe tpersons twith tmental tillness. tSome tof tthe tmajor tprinciples are tdiscussed tbelow:


Fundamental tfreedoms tand tbasic trights: tThis tprovision tcontains tnot tonly a tsingle tprovision tin tit tbut ta tlot tof tother tprovisions tembedded tin tit. They tare:

  • Every tperson tshall tenjoy tthe tbest tavailable tmental thealth tcare, twhich tshall tbe tpart tof tthe thealth tand tsocial tcare tsystems.

  • Every tperson twith ta tmental tillness tshall tbe ttreated twith thumanity and tdignity.

  • All tpersons twith tmental tillness, thave tthe tright tto tprotection tfrom teconomic, tsexual tand tother tforms tof texploitation.

  • There tshall tbe tno tdiscrimination ton tthe tgrounds tof tmental tillness. t“Discrimination” tmeans tany texclusion tor tpreference tthat thas tthe teffect tof tnullifying tor tdestroying tequal tenjoyment tof trights.

  • Every tperson twith tmental tillness tshall thave tthe tright tto texercise tall tcivil, tpolitical, tsocial, teconomic tand tcultural trights tas trecognized tin tUniversal tDeclaration tof tHuman tRights tand tother tconventions.

  • If ta tperson tdue tto tmental tillness tlacks tlegal tcapacity, ta tperson tshall tbe tappointed, tafter ta tfair thearing tby tan tindependent tand timpartial ttribunal. tThe tperson twho tis tincapable tof tmaking trationale tdecision tshall tbe tentitled tto tbe trepresented tby ta tcounsel. tIf tthe tperson twhose tcapacity tis tat tconcern tdoes tnot thimself tsecure tsuch trepresentation, the tshall tbe tprovided twith tservices twithout tpayment tto tthe textent the tdoes tnot thave tsufficient tmeans tto tpay tfor.

  • Where ta tcourt tor tother tcompetent ttribunal tfinds tthat ta tperson twith tmental tillness tis tunable tto tmanage this tor ther town taffairs, tmeasures tshall tbe ttaken tso tfar tas tif tnecessary tand tappropriate tto tthat tperson’s tcondition, tto tensure tthe tprotection tof this tor ther tinterests.

  • Medical tExamination: tNo tperson tshall tbe tcompelled tto tundergo tany tmedical texamination tto tdetermine twhether the tor tshe thas ta tmental tillness texcept tin taccordance twith tthe tprocedures testablished tby tthe tlaw.

  • Consent tto ttreatment: tA tperson tshould tnot tbe tgiven ttreatment twithout this tfree tconsent. tConsent tis tsaid tto tbe tfree twhen tit tis tnot tinduced tunder tany tinfluence tof tanother tperson. tIn tcase tof tan temergency tor turgent tmedical tpractitioner tis tauthorised tby tlaw tto tgive ttreatment twithout tthe tprior tconsent tof ta tpatient tto teradicate tthe timminent tdanger ton tthe thealth tof ta tpatient.


Where ttreatment tis tgiven tto tan tindividual twithout this tprior tconsent tevery tsort tof teffort tshould tbe tmade tby tan tindividual tto tinform tthe tpatient tthe tnature tof tthe ttreatment tand tpossible talternatives talso tto tinvolve tthe tpatient tin tthe ttreatment tplan.

  • Rights tand tconditions tin tmental thealth tfacilities: tEvery tperson tin ta tmental thealth tfacility tshall thave tthe tright tto tfull trecognition tbefore tthe tlaw tand thave tthe tfull trespect tfor ttheir tprivacy tand thave tfreedom tof tcommunication twhich tincludes tfreedom tto tcommunicate twith tanother tperson ti.e. tshould thave tthe tfreedom tto tsend tand treceive tuncensored tprivate tcommunication.

  • Procedural tSafeguards: tThe tpatient tshall thave tthe tright tto tchoose tand tappoint ta tcounsel tto trepresent tthe tpatient tin tcase tof tany tsource tof tviolation tor tcomplaint tprocedure tor tappeal tand tthe tpatient tshould tbe tprovided tfree tlegal taid tto tthe textent tthat the tis tnot table tto tpay.


2. UN Convention on Rights of Person with Mental Disabilities

The tUnited tNations tConvention ton tthe tRights tof tPersons twith Disabilities was tadopted ton t‘13 tDecember t2006’. tThe tConvention tincludes tthe twider category tof tpersons twith tdisabilities tand treaffirms tthat tall tpersons twith any ttype tof tdisabilities tmust tenjoy tall thuman trights tand tfundamental freedoms.


It tclarifies thow tall trights tapply tto tthe tpersons twith tdisabilities tand identifies tareas twhere tchanges tto tbe tmade tin tlegislation tof tvarious countries tto teffectively tenforce tthe trights tof tmentally till tpersons twith proper tprotection tof ttheir tinterest.


The tBasic tprovisions tmentioned tin tthe tconvention tare tas tfollows.

  • “Respect tfor tthe tautonomy tof tan tindividual tand tinherent tdignity tincluding tthe tfreedom tto tmake tone’s town tchoices, tand tindependence tof tpersons.

  • The tadmitted tpatients tshould tnot tbe tdiscriminated tin tthe tsociety ton tthe tbasis tof ttheir tmental tillness. t

  • There tshould tbe tfull tand teffective tparticipation tof tthe tpeople tsuffering tfrom tthe tproblem tof tmental thealth tin tsociety.

  • Respect tfor tdifference tand tacceptance tof tpersons twith tdisabilities tas tpart tof thuman tdiversity tand thumanity.

  • The topportunities tprovided tto tan tindividual tto tgrow tshould tnot tbe trestricted tdue tto tthe treason tof ttheir tmental tillness tand tdisability.

  • The tindividuals tshall thave tthe tproper taccess tto tthe tfacilities tand tthe trights tprovided tthem tto texercise tconsciously tand teffectively.

  • The tindividuals tshould tnot tbe tdiscriminated ton tthe tbasis tof ttheir tgender ti.e. ton tthe tbasis tthat twhether tan tindividual tis ta tmale tor tfemale, tage, tcolour tetc. t

  • Respect tfor tthe tevolving tcapacities tof tchildren twith tdisabilities tand trespect tfor tthe tright tof tchildren twith tdisabilities tto tpreserve ttheir tidentities.”


The tConvention tmarks ta tstandard tshift tin tthe tattitudes tand tapproaches tto tpersons twith tdisabilities. tIt ttakes tto ta tnew theight tthe tcapability tof ta tperson tsuffering tfrom tmental tillness tto tclaim this trights tand tbecome tan tactive tmember tof tthe tsociety.

Indian Constitution

The tConstitution tof tIndia tdoes tnot tdiscriminate tany tperson tand tapplies uniformly tto tevery tlegal tcitizen tof tIndia, twhether tthey tare thealthy tor disabled t(physically tor tmentally). tBut, tprovisions tof tmentally till tpatients have tbeen tneither tspecifically tmentioned tin tany tcode tnor tspecifically elaborated tor tprescribed tby tthe tjudiciary tin tIndia. tUnder tthe Constitution of tIndia, tthe tdisabled thave tbeen tguaranteed tthe tfundamental trights which are tas tfollows.

  • The tConstitution tsecures tto tall tthe tcitizens tof tIndia tincluding tthe tdisabled, ta tright tof tjustice, tliberty tof tthought, tbelief, texpression, tworship, tequality tof tstatus tand tof topportunity tand tfor tthe tpromotion tof tfraternity.

  • Article t15(1) tinstructs tthe tGovernment tnot tto tdiscriminate tany tcitizen tof tIndia t(including tdisabled) ton tthe tground tof treligion, trace, tcaste, tsex tor tplace tof tbirth.

  • Article t15 t(2) tStates tthat tno tcitizen t(including tthe tdisabled) tof tIndia tshall tbe tsubjected tto tany tliability, trestriction tor tcondition ton tany tof tthe tabove tgrounds tin tthe tmatter tof ttheir taccess tto tplaces tof tpublic tentertainment, tuse tof twells, ttanks, tbathing tGhats, troads tand tany tplace tfully tor tpartly tmaintained tby tGovernment tfunds. tBenefits tcan tbe tgiven tto tthe twomen, tchildren tand tthose tbelonging tto tthe tsocially tand teducationally tbackward tclasses tthrough tprovisions tof tspecial tlaws.

  • Every tindividual t(including tthe tdisabled) tshall tbe tprovided tequal opportunity tin tmatters trelating tto tpublic temployment tunder tthe State.

  • No tperson tincluding tthe tdisabled tirrespective tof this tbelonging tcan be ttreated tas tan tuntouchable. tIt twould tbe tconsidered tas tan toffence under tlaw tas tprovided tby tarticle t17 tof tthe tIndian tConstitution.

  • Every tperson, tincluding tthe tdisabled, thas this tright tto tlife tand liberty tguaranteed tunder tarticle t21 tof tthe tConstitution.

  • Article t23 tof tthe tIndian tConstitution tprohibits ttraffic tin thuman beings, tincluding tthe tdisable tand tany tengagement tin tany tkind tof forced tlabour.

  • Article t24 tof tthe tConstitution twhich tprohibits tthe temployment tof tchildren tbelow tthe tage tof t14 tyears tto twork tin tany tfactory tor tmine tor tto tbe tengaged tin tany tother thazardous temployment talso tincludes tthe tdisable tchildren tin tit. tEven ta tprivate tcontractor tacting tunder tthe tambit tof tGovernment tcannot tengage tany tchildren, twhether tnormal tor tdisabled tbelow t14 tyears tof tage tin tsuch temployment.

  • Evry tcitizen tof tIndia tis tguaranteed tfreedom tof treligion tunder Article t25 tof tthe tConstitution. tEvery tdisabled tperson t(like tthe normal tcitizen) thas tthe tfreedom tof tconscience tto tpropagate tand practice this treligion tsubject tto tproper torder, tmorality tand thealth.

  • Any tperson tin tIndia, tincluding tthe tdisabled, tcannot tbe tcompelled tto tpay tany ttaxes tfor tthe tpromotion tand tmaintenance tof tany tparticular treligion tor treligious tgroup.

  • No tDisabled tperson twill tbe tdeprived tof this tright tto tthe tlanguage, script tor tculture twhich the thas tor tto twhich the tbelongs.

  • Every tdisabled tperson thas tthe tright tto tmove tto tthe tSupreme tCourt of tIndia tto tenforce this tfundamental trights tguaranteed tby tarticle t32.

  • No tdisabled tperson towning tproperty t(like tthe tnon-disabled) tcan tbe deprived tof this tproperty texcept tby tauthority tof tlaw, talthough tthe right tto tproperty tis tnot ta tfundamental tright. tAny tunauthorized tor forcible tdeprivation tof tproperty tcan tbe tchallenged tby tsuit tand tfor relief tby tway tof tdamages.

  • Every tdisabled tperson tas tevery tnormal tperson ton tthe tattainment of 18 tyears tof tage tbecomes teligible tfor tinclusion tof this tname tin tthe general telectoral troll tfor tthe tterritorial tconstituency tto twhich the belongs.

Implementation gap in the policies

Maximum available resources

Despite tthe timpact tof tmental thealth tconditions ton tindividuals, tfamilies and tcommunities, tthere tis tan tinsufficient tinvestment tof tboth tfinancial and human tresources tin tthe tarea tof tmental thealth. tGlobal tannual tspending on tmental thealth tis tless tthan t$2 tper tperson tand tless tthan t$0.25 tper person tin tlow-income tcountries. tThis taffects tthe tprovision tof tservices, tas inadequate tnumbers tof tstaff, toften twith tinsufficient ttraining, tespecially tin the tarea tof thuman trights, tare trequired tto tdeliver tservices twhich tare tin accordance twith thuman trights tstandards.


A poorly informed public

Very tlittle tinformation tis tavailable tto tthe tpublic ton tany tof tthe tissues relating tto tmental thealth, twhether tit tis ton tmental twell- tbeing, tprotecting against tdepression tor tidentifying tsymptoms tof tserious tmental tillness. They tare teven tless taware tof ttreatment tfacilities tand ttheir trights. tWithout information, tthere tis tno tadvocacy. tWithout tadvocacy, tthere tis tnot enough demand tfor tservices tand tsystem taccountability tto tprovide tequitable tand good tquality tmental thealth tcare.


Provision of services in a segregated manner

Although tthere thas tbeen tprogressing tover tthe tlast tfew tdecades, tthe segregation tand tcentralization tof tmental thealth tservices taround psychiatric hospitals tand tinstitutions tcontinue tto tpose ta tchallenge tin tcertain important trespects. tThe tfailure tto tintegrate tinterdisciplinary tmental health services tinto tprimary tcare trenders ta t“whole tperson” tapproach textremely difficult.


Conclusion

Mentally tdisabled tpeople tare tmost tvulnerable tto texploitation tas tthey tare incapable tof tunderstanding tthe tnature tof tactivities. tThough tvarious principles tare tlaid tdown tby tInternational tConventions, tthey tare tvague tas they tare tnon- tbinding ton tthe tstates. tBut tthese tconventions tbring tthe paradigm tshift tin tthe tattitude tand tapproaches tto tpersons twith disabilities.