Byline: James. Antony The recent editorial, “Mental Health Care Bill (MHCB): a Boon or Bane,” states that the “Bill”[sup][1] is progressive and rights-based in nature.[sup][2] May be, a wide definition for mental illness, along with the enumeration of many patients' - rights has kindled optimism in its authors. But, generous offers by a Law are unlikely to persuade many to admit their mental illness. The reason: the devastating effects that stigma has in our society. The editorial [sup][2] has rightly observed that “the Bill tries to be over inclusive in its approach, stretching beyond the legislative limits and despite noble intentions behind it, would be a challenge to stakeholders whether the contents of the Bill are legislation, program, policy or even a treatment guideline.” The main defect of this draft law is this style of packing it with many vague, unenforceable “policies and treatment guidelines,” much in the fashion of some propaganda material. Any practisimg psychiatrist in India would expects the editorial to comment on this lack of focus and precision, a little more forcefully. However, the editorial has not only failed to do this; it is as though its learned authors want the Bill to go further, with its propaganda-style, in more areas! They state in paragraph two of the editorial that “priorities of mental health care have to be shifted from psychotic disorders to common mental disorders and from mental hospitals to primary mental health centers.”[sup][2] The reason given is an increase in “invisible” mental problems! Indeed similar views on these matters have been expressed by some authors earlier, as well.[sup][3],[4] But, this approach, of wanting to give an emphasis to “community” in relation to “hospital” or giving attention to “invisible problems”, in a new law is quite unfortunate. These may indeed be good ideas, which could possibly be taken up, when a new mental health “policy” or “programme” is formulated. A law must always be clear, unequivocal and focussed. It is rather cruel to have a view that psychotic patients in this country are getting some “priority treatment”! And, as for mental hospitals, where is this priority when centuries old dilapidated buildings are still waiting to be pulled down and re-built? The editorial also says that “places like juvenile homes, destitutes or beggars' homes and religious places, where mental patients are housed need not have license.”[sup][2] This statement in an editorial of the official publication of the Indian Psychiatric Society is unfortunate. One expects the Journal to speak for the sake of the mentally ill, rather than for those who run mental health establishments. Maybe, they are making this suggestion, equating various “care-homes” with general hospital psychiatry units. But, sparing general hospitals, from the hassles of a license is a different matter; a bystander would be there to secure the rights of a patient, and this has been pointed out, earlier.[sup][5],[6] But allowing people to run institutions for chronic psychotics, without supervision is not acceptable. The danger of this approach has been elaborately dealt with, recently.[sup][7] Not only license, such places must also have close, on-going supervision. It is painful when senior psychiatrists are mocking at the need for surveillance of all kinds of care homes, by saying it will bring-in a “Licence Raj.”[sup][2] How could Indian psychiatrists forget that huge man-made national shame called “Erwadi tragedy?”[sup][8],[9],[10] The important thing that should worry practicing psychiatrists, with regards to MHCB-2016 is that it would repeal the existing law, the Mental Health Act-1987. …
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Oct 13, 2021
Dr C L Narayan 
Open Access
