The role of policy and legislation in mental health care

Abstract

The interface of policy and legislation is crucial in making quality mental health care accessible in an effective manner. Shortage of psychiatrists and other mental health personnel in India poses a huge challenge in delivering mental health care. The social context is instrumental in subjecting the mentally ill to human rights violations and discriminations with low awareness, illiteracy, superstitions, denial, and the prevailing social perception of mental illness in India. The enormity of problem requires a multipronged approach supported by a robust policy with specific achievable goals. Mental health policy relies on the legal framework to achieve its goals, and ameliorate the lives of persons with mental disorders. Policy and legislation are two complementary approaches for improving mental health care and services. International developments in mental health care have brought a paradigm shift from “charity-” to “rights-” based approach which is very much reflected in India's first-ever Mental Health Policy, 2014, and the newly enacted Mental Healthcare Act, 2017. This shift entails a “participatory” approach for developing community-based facilities, services, and rehabilitation provisions. An analytical approach has been adopted to gauge the likely outcome of the combined role of this ambitious policy and law in light of existing mental health-care infrastructure and “social context.” An attempt has been made to highlight the main concerns and challenges in effective implementation of new law while putting forth feasible solutions to attain the policy goals. The paper concludes on a note that legal and health measures should work in tandem and eventual convergence be directed toward the best interest of mentally ill persons.