NHRC says all the 46 Government Mental Healthcare Institutions across the country depict a very pathetic and inhuman handling by different stakeholders; issues notices

New Delhi, 25th January, 2023

The National Human Rights Commission, NHRC, India today said that all the 46 Government Mental Healthcare Institutions across the country are in deplorable conditions and depict a very pathetic handling by the different stakeholders. The inhuman and deplorable conditions of the mental health institutes recorded by it across the country, present sorry states of affairs amounting to infringement of the human rights of mentally ill patients. The cured patients are being kept illegally in the hospitals. There is acute shortage of doctors and staff.

The Commission’s observations have come on the basis of the visits of the Full Commission to the four government hospitals in Gwalior, Agra, Ranchi, and the remaining 42 by its Special Rapporteurs in various parts of the country recently to assess the situation on the ground and the status of the implementation of the Mental Healthcare Act, 2017.

The reports of the visits have prompted it to take suo motu cognizance of the matter and issue notices to the Union Health & Family Welfare Secretary, Director General of Health Services, Chief Secretaries and Principal Secretaries, Health, Director General of Police and Commissioner of Police in the metropolitan cities of all the State Governments as well as Union Territories, Directors of 46 mental institutions across the country calling for the specific reports detailed action taken reports within six weeks on the following:

The State Chief Secretaries, Secretaries of Health, and UT Administrators have to submit an Action Taken Report on the following:

(i) How the cured patients are being kept illegally in mental hospitals by curtailing their liberty. All such patients are to be sent back to their homes/halfway homes and dealt with in accordance with in violation of the provisions of Section 19 of the Act, 2017;

(ii) Status of formation of Mental Health Authority, State Mental Health Review Board, State Mental Health Care Rules, and State Mental Health Care Regulation;

(iii) Budgetary allocation and funds released with regard to the mental health institutions;

(iv) State of the infrastructure of the institutes, plan for improvement of the buildings which include various amenities;

(v) Status of the recruitment process of the Health professionals including hospital staff; time frame for that;

(vi) Measures taken to ensure de-crowding of mental hospitals/institutes and create a conducive atmosphere for stay including proper hygiene;

(vii) Appointment of Professors for the course of M.Phil wherever it is necessary with an adequate number of teaching staff;

(viii) Status of emergency services, maintenance of electronic data and medical records, measures and initiatives were taken for reintegration and rehabilitation of the cured patients;

(ix) Statistics to be provided regarding discharged patients of last five years and their rehabilitation, reunion with the family or community, how many of them have become new inmates again, and status of number of such persons staying in the hospital with reasons thereof;

(x) Government-sanctioned amount for food and actual payment;

(xi) Financial or social audit report of last three years.

The Union Health and Family Welfare Secretary and Director General of Health Services have to submit the report on the status of framing rules under the Act, 2017 as contemplated under Section 121 of the Act 2017, as well as the establishment of the Central Authority as contemplated under Section 33 of the Act 2017, and filling up the vacancies of the Central Authority and status of execution of various provisions of the Act 2017 by the Central Govt.

The reports of the Directors of 46 mental institutions response should include the steps taken or proposed to be taken for filling up the vacancies of the Professors and other staff members; records of the discharged patients, who have been cured from mental illness, latest status of the emergency ward and other overall improvement made after the visits of Commission and / or Special Rapporteurs of the Commission with regard to infrastructure, vocational opportunities to the inmates, number of persons released and reunited with the family members with specific statistics.

The Director General of Police and Commissioner of Police in the metropolitan cities respectively of all the States and Union Territories have to submit reports with regard to the status of the complaints received or registered relating to mentally ill persons, regarding non-rehabilitation or non-reintegration with the family and measures taken or proposed to be taken to ensure that cured persons from mental illness should be living with the family and other members of the community. The reports must also contain assistance or other measures taken from District Legal Services Authority or State Legal Services Authority, as the case may be.

The NHRC visit reports suggested that none of the institutes have taken effective and long term measures to ensure that a mentally ill person can exercise his right to community living unfettered, unchallenged and / or without any hindrance.

Issuing the notices, the Commission has noted that it is categorically mandated under Section 19 of the Mental Healthcare Act that where it is not possible for mentally ill person illness to live with his family or relatives, or where a mentally ill person has been abandoned appointed by his family and relatives, the appropriate Government shall provide support as appropriate including legal aid and to facilitate exercise his right to live in a family home.

It has further noted that it is a travesty that provisions of the statute have failed to ignite the consciousness of the appropriate Government(s) to provide adequate support to such vulnerable persons who are suffering from mental illness. The more aggravating factor is that even after the recovery of mental illness, they are not being allowed to reunite or regrouped with the society, family for the purpose of community living which is not only unconstitutional in view of Article 21 of the Constitution but also it is a failure of the State Government(s) to discharge the obligation under various international Covenants relating to rights of persons with disabilities which have been ratified by India. Besides that, Act 2017 grants the power to State to establish and regulate as under:-

Section 45, the State Mental Health Authority - within a period of nine months from the date on which this Act receives the assent of the President.

Section 73, A State Mental Health Review Board

Section 121 (2), the State Government Mental Health Care Rules, with the previous approval of the Central Government for carrying out the provisions of the Act.

And Section 123, The State Mental Health Care Regulations, consistent with the provision of this Act and the rules made there under.

But it is very unfortunate that these aspects have been ignored by most of the State authorities.