Where can the issue of mental health be found in our laws?

It is intangible. It is not always visible. It is not always obvious. It is not always interpreted correctly. Not all are aware about its cause-effect scenarios. It is not talked about openly everywhere. It is oftenly a hushed topic. It is the topic of mental health issues. Even if the World Health Organisation has already covered the aspect of mental well-being within the factors ascertaining the overall health of a person, many of us are still unwilling to accept it as something as real as any other physical disease. As defined by ‘The National Alliance on Mental Illness (USA)’, “mental illness is a condition that disrupts a person’s thinking, feeling, mood, ability to relate to others and daily functioning.”

We might have heard people shunning the ones who attempt to share how they are actually feeling. Or worse, we have heard them laughing it off, calling it a drama, a wannabe attempt, or attention-seeking. Mental health victims are rarely taken seriously. Even the ones who pretend to understand its gravity refuse to be understanding of the conditions for a continued period because the long exposure to a mentally unhealthy person is bound to exhaust a person’s capacity for empathy.

Mental health is a hot topic today more than it has been in the ancient days because now, there are these interwoven complications created by the global market, competition, class struggle, comparison, unmet expectations, unfulfilled desires, and the subjective concepts of successes and failures. Either we tend to fall for the wrong clickbaits or they are forcibly sold to us. And then mental health problems are born.

This is an evolving civilization. Things are still under our control if we really try. Can the law in any way take the responsibility of lessening this disease of mental health issues that have been infesting us? What such problems can be tackled through proper legislative actions? 

Within the capability of the law

The issues of mental health are spread across a wide variety and range. All of them cannot be judged on the same balance, but none of them can be ignored. The Mental Health Legislation is not just about the hospitalisation, care and medical treatment thereof. It is also concerned about therapeutic treatments, optimism inducing environments, prevention of the actions that trigger mental health deterioration, and special attention to the victims. 

Formal laws can contribute sufficiently to the creation of policies that provide for apt institutions and guidelines for how mental health patients should be cared for and dealt with. Such policies also have the ability to target specific sets of generalised human behaviours that are often catalysts for the generation of mass mental health problems. 

Relevant Facts and Figures

• Depression, anxiety and behavioural disorders are often found leading to disability.
• Age group of 15 to 29 years have suicide as the fourth topmost way to die.
• Severe mental health conditions invite death earlier by even two decades in some cases.
• One in seven 10-19 year olds suffer from mental disorder.

International Efforts

• Universal Declaration of Human Rights (UDHR) 1948, Article 1 has provided “All people are free and equal in rights and dignity”. This statement certifies the human status of mentally ill people as much as the healthy ones are certified.
• The Vienna Declaration 1993 reaffirmed that the domestic governments must do what they can to ensure the protection of the human rights laws in regard to mentally and physically disabled people.
• The International Covenant on Civil and Political Rights (ICCPR) 1966 and the International Covenant on Economic, Social and Cultural Rights (ICESCR) 1966 have demanded enough legal protection to the ones mentally unhealthy from its party states.
• The UN General Assembly, through a resolution, adopted ‘The Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care (MI Principles)’ in 1991 which set out the non-legally binding basic standards of care that should be provided to and the health care systems to be implemented for people diagnosed with mental disorders. 
• “Comprehensive mental health action plan 2013–2030″ is one commitment from all the member states of the World Health Organisation (WHO) that aims for mental health improvement by strong governance, prevention strategies, advanced information, research and evidence system, comprehensive, integrated and responsive community-based care. 
• The World Health Organisation (WHO) started the “WHO Special Initiative for Mental Health (2019-2023): Universal Health Coverage for Mental Health” in 2019 to provide 100 million additional people with access to high-quality, affordably priced treatment for mental health conditions in 12 priority countries.
• The United Nations’ Sustainable Development Goals prioritised mental health and its promotion.
• The UN Declaration on the Rights of Mentally Retarded Persons (1971), The Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care (1991), The Standard Rules for Equalization of Opportunities for Persons with Disabilities (1993), The Declaration of Madrid (1996), The WHO’s Mental Health Care Law:Ten Basic Principles and WHO Guidelines for the Promotion of Human Rights of Persons with Mental Disorders (1996) are other attempts of informal guidelines that are not binding but pronounce the basic behaviours to be shown towards mentally struggling people.

The ways foreign laws are addressing it:

• Israeli Penal Law 1977, after an amendment in 1995 has provided that the  punishment for murder may be reduced in cases where “a severe mental disorder” is present. Psychiatrists are employed to asses the impact mental disorders may have on the actions of the murderer.
• The UK’s ‘Mental Health Act 1983’ is an all-encompassing legislation for assessing the conditions of mental disorder victims. It looks after their rights and mandatory treatments.
• The Indian ‘Mental Health Act 1987’ has prohibited the usage of offensive terminologies like ‘insane’. But they can still be found across different legislations and verdicts. 
• In many countries, including the USA, death penalty is banned for the convicts suffering from serious mental illness.

Legislations in Nepal

Nepal too has a few regulatory mechanisms in place. In 1996, a comprehensive mental health policy was formulated and incorporated in the 9th Five-Year Plan with the objective of providing basic level of mental health services, training manpower working round mental healthcare, safeguarding the patients’ fundamental rights and advancing the awareness situation regarding the issue. 

In 2017, a ‘Mental Health Policy’ was drafted by the Ministry of Health and Population that guaranteed citizenry’s constitutional right of leading a mentally stable and dignified life through their psychosocial health observation. The Ministry subsequently developed a Community Mental Health Care Package for the execution of the policy.

After the policy of 1996, mental health related aspects were incorporated in 2019’s National Health Policy as well. But the need for a detailed plan gave way to the formulation of the ‘National Mental Health Strategy and Action Plan’ in 2020.

The strategies have been kept alive through further policies such as ‘Multisectoral Action Plan for the Prevention and Control of Non-Communicable Diseases (2014–2020)’, ‘The Nepal Health Sector Strategy (2015–2020)’ and the Nepal Health Sector Programme-II Implementation Plan (2010–2015). These recent developments are yet to be fully implemented. 

The effort can be seen in the adoption of Nepal’s 15th Five-Year Plan (2019-2024) that gives way to accessible mental healthcare services to all Nepalese citizens. In 2018, The Epidemiology and Disease Control Division of the; Department of Health Services was assigned to oversee mental health programmes conducted under the Non-Communicable Disease and Mental Health Section. This was a response to the commitment to 2015’s UN’s Sustainable Development Goals. 

Mental Health (Treatment and Protection) Act, 2006 was promulgated after HoR declaration in 2063 for the purpose of rehabilitating mental disorder victims into the society by their timely and adequate care.

Constitution of Nepal, in Article 38, grants rights to women which spells out that the subjection of any woman to physical, mental, sexual, psychological or other forms of violation, whatever the ground, shall be a liability incoming.

Several sections of the Muluki Criminal Code 2074 have provisions of reduced punishment for criminals if they had been mentally unsound while committing the criminal act. Mental unsoundness is a ground for mitigating gravity of any offence. Section 189 (1)(b) of the code allows a woman to abort the foetus inside her if it impedes on her mental health. Provision against torture in Section 167 of the same has widened its scope to include mental torture within the definition of ‘torture’.

Conclusion

Progress can be seen across the globe since the matter of mental health awareness is being discussed with much weight. However, patients with mental health conditions still fear coming out because of the human rights violations, discrimination, and social taboos they have to constantly face because of a lack of awareness surrounding the issue.

If the lives and safety of humans is our goal as a civilization, then mental health is at the core of the subject matter. If we are unable to prevent the mental health of the people becoming a ruin, all else shall be a waste. Creating a safe and suitable space where victims, survivors, and caretakers can freely communicate their internal mental battles and ways to cope with them should be the primary concern.