In December 2014, the international advocacy group Human Rights Watch released a report documenting wide-ranging and intense human-rights abuses involving women in 24 institutions across India that house those perceived to be mentally ill. Most striking amid the blocks of text describing the abuse were the stark images of women and girls forcibly deposited in these institutions. Deepali, a 46-year-old with a perceived mental illness, was pictured on the first page of the document, alongside a quote: “I woke up one night and I couldn’t move; my body was in intense physical pain. A nurse came and jabbed an injection into my body, without even taking off my clothes. You are treated worse than animals.”
Though Deepali described the institution as “an alternate reality,” her situation should not have been reality at all. All institutionalisations for those considered to be mentally ill were, at the time of the report’s release, governed by the Mental Health Act (1987). It offered patients a few basic rights—for instance, it technically allowed people such as Deepali to sue for release within 60 days of their involuntary institutionalisation. Yet, the report said, “in none of the 52 cases … documented … was the woman or girl informed of her right to appeal or provided the opportunity or assistance to do so.” In the realm of mental healthcare, realities on the ground bear little relation to legal frameworks—a rupture that has been central to understanding and evaluating India’s mental-healthcare policy.
Even so, on 30 March 2017, the country received new legislation, the Mental Healthcare Act, which was passed unanimously by voice vote in parliament to jubilation from politicians and activists. The health minister, JP Nadda, called the act’s passage “historic,” while the psychiatrist Soumitra Pathare, who was one of the bill’s drafters, wrote in The Hindu that it marked “a paradigm shift in the care and treatment of persons with mental illness in India.” The renowned psychiatrist and researcher Vikram Patel called a recent version of the bill “one of the most progressive mental health care bills in the world.”
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