Many years ago I received a phone call from CMO Dehradun to immediately stop hospitalisation of psychiatric patient in my nursing home or i will have a case on my hand.The mental health act though passed in 1987 was begun to be enforced somewhere in 2000 .This bill was similar in nature to clinical establishment act and postulated that the mental health authority in each state was to periodically inspect all psychiatric nursing homes in the states and licence them and see to it that the mental patients are being cared for properly.All this happened after some mental patients who were enshakeled in erode district of south india in a shrine for faith healing,died in a fire incident.The Supreme coart taking sui moto conigence of the incident directed the home secretatry that no mental patient was to be admited any where in India except in govt approved facilities.
To be fair , the CMO was friendly and asked me that i have to apply for a licence and i will get it .But worried about beurocratic interventions i closed the nursing home and continued with my OPD practice.But the point i am trying to make is different.
Have the patients or other stake holders benifitted from this knee jerk law enforcement.No! Now some of these patient who come to me or try to find other alternatives,and have to stay in dehradun till they are improved,where do they stay.They stay in nearby Dharamshallas and Hotels and some of them go to Nasha mukti Kendras being run by land lords.These nasha mukti Kendra persons have no bearing on psychiatric illness and at times resort to beat psychiatric patients in the hope of calming them down.The Uttrakhand Govt is still unble to provide indoor domiciliary care even in selakui mental hospital whre patients can be admitted only if they have an attendant.
The point is that has mental health act has resulted in psychiatric patients being subjected to living in far lesser standards than they would have got in a nursing Home all over India and were denied just because of stupid laws.Has Gujarat anti alcohol act,or anti dowry act,or laws on rape made in a knee jerk reaction helped the person in distress.The first has encuoraged smugling of alcohol,the second has broken more families than helped them and the third has resulted in lots of frivolous complaints.
Still the Indian Psychiatric society has kept up the pressure on the Govt to repeal the archaic act of 1987 and you must have read in the news about the decriminalization of suicide which has been due to the untiring efforts of IPS workers.I have attached the proposed bill and it should be read to understand that standing commitee of parliamentary affirs does it work if all the stake holders are ready to cooperate and work.The result is a new and improved mental health bill which needs further improvement but is none the less an improvemnt.It shows that Clinical establishment act can be amended if there is a long and persistent fight by the IMA like IPS did.