The effects of mental illness are often felt only by those suffering from it. Except for extreme cases, they do not manifest themselves in physical symptoms. This has led to it being deeply stigmatized and not talked about. Though we are still a long way from giving our mental health and welfare the importance they deserve, proactive action like this is a step in the right direction was held while disposing of a Writ Petition filed in public interest regarding the mental health of Tamil Nadu’s prisoners in the case of KR Raja vs State of Tamilnadu,WP(MD) 16484/2020 were division bench of the Madras HC was shocked to discover that India is the most depressed country in the world. According to a report by the World Health Organization (WHO), over 90 million Indians suffer from some form of mental illness.
The petitioners filed the WP praying that a writ of Mandamus be issued to mandate that a mental healthcare facility be set up either in Madurai or Trichy Central Prison. It was found that several prisoners there suffered from different forms of metal illness, but they were unable to receive treatment due to the complete lack of facilities.
The bench looked into mental illness and rightly opined that almost all mental ailments were treatable, curable and preventable if the illness was diagnosed early and treated, and the patient was then appropriately rehabilitated. However, the incidence of mental illness in the country has nearly doubled over the past 10 years, largely due to a lack of awareness and the stigma surrounding it. Other reasons the Court found for these alarming rates of mental illness are high costs of treatment, lack of treatment facilities and an insufficiency of human resources.
It was found that India’s mental healthcare budget in 2018 was Rs.52,80,00,000/-, but this was reduced to Rs.40,00,00,000/- in 2019. It has been noted that the actual amount spent by the Govt. on mental health was a mere fraction of the budget, Rs.5,00,00,000/-. The division bench made some concerning discoveries. “The amount spent on mental health comes to 33 paisa for mental health patient, given the number of 150 million people requiring urgent care. It is reported in Parliament in March 2020 that a sum of 48 Crores Rupees only has been spent on mental health in the year 2018-2019, which approximately comes to Rs.2.40/- per patient in a year or approximately, 20 paisa per month per patient.”
Furthermore, there is only one specialized mental healthcare research facility in the country, NIMHANS. The numbers of mental health professionals are also below the required levels; only one psychiatrist is available for every lakh of the population even though the recommended ratio is 3:1,00,000. The Government passed the Mental Healthcare Act in 2017 but a lack of awareness programs coupled with stigma around the subject meant that this legislation has largely flown under the radar.
The bench agreed that it was essential for a mental healthcare facility to be set up in the Trichy and Madurai Central Prisons in accordance with S.103 of the Mental Healthcare Act. In consideration of how often the subject is overlooked, they decided to extend the scope of the petition beyond Tamil Nadu to issue directions to the Central Government, State Governments and Medical Council of India to “identify the patients at the earliest by diagnosing the disease to give proper treatment by improving the infrastructures, like, establishment of hospitals, increasing the number of psychiatrists, psychologists, psychiatrist social workers and allocation of more funds towards mental health, including the conduct of regular surveys.”
Looking into the prevalence of fresh cases, the Court held “it is the need of the hour to have a Psychiatry Department in every District Headquarters Hospital and a Psychiatrist in every Taluk Level Hospital.” They also stated that rehabilitation was essential to treatment, but as it is not a profit-making venture, private players would be hesitant to enter the market. The onus would thus fall upon the Government to take the necessary steps to establish and promote rehabilitative infrastructure.