The Madras High Court recently reiterated concerns over there being inadequate facilities for the treatment of mental illness and insufficient funding for mental healthcare in India (KR Raja v. State of Tamil Nadu and Others)The Court, therefore, appealed to the government to allot more budgetary funds and set up more mental health care institutions in the country. It also called for setting up a psychiatry department in every medical college.
A Division Bench of Justice N Kirubakaran (now retired) and Justice B Pugalendhi passed the order in a public interest litigation (PIL) petition that sought the establishment of a mental healthcare wing in either Trichy Central Prison or Madurai Central Prison for the benefit of prisoners with mental illnesses. While the Court did not issue any direction with respect to this prayer, the Bench flagged several concerns on a broader level. The Court took note of reports that indicated that India was one of the most depressed countries in the world and that about 7.5% of the country's population was suffering from some form of mental illness, according to a survey by the World Health Organization (WHO).
Despite the passage of the Mental Healthcare Act in 2017, sufficient awareness programs have not been conducted, the Court opined. There exists no centralized portal for the treatment of mental disorders, the Court observed further. The court's order that the taboo/social stigma attached to persons with mental illness prevents the people to take proper treatment. Therefore, it is required to dispel the stigma attached to the mental illness or taking treatment under a psychiatrist or counselling with a psychologist by anti-stigma awareness plans.It went on to urge the government to take steps to identify mental health patients at the earliest, improve infrastructure including through the establishment of hospitals and the recruitment of more psychiatrists, psychologists, social workers, etc., and allot more funds for mental health. The court said that there is no sufficient budgetary allocation for mental healthcare which is required to be increased as one among seven persons is suffering from mental health disorders … considering the higher number of people suffering from mental illness, the Central Government shall allot more funds for the mental health care.
It further opined that a psychiatry department should be in place in every district-headquarter hospital and that a psychiatrist should be appointed in every taluk level hospital. The Court has also called for the establishment of more central health institutions, like the National Institute of Mental Health and Neuro Sciences (NIMHANS), with one in at least in each zone of the country at the earliest. Further, the Court also called for conducting regular surveys for the assessment of mental health and the establishment of a department of psychiatry in every medical college so that more people become psychiatrists.
The court observed that The Mental Health Force also is very low in India and it is stated that there are about only 9000 psychiatrists, viz., one psychiatrist for every one lakh people alone is available, whereas the required number of psychiatrists is three for every one lakh people. It is stated that there is a shortage of 18,000 mental health doctors or psychiatrists and our country requires about 2700 new psychiatrists every year. That apart, only 49 child psychiatrists are there to take care of children of the entire country.
Pertinently, the Court urged the government to sensitize people about the availability of insurance coverage to patients with mental illness under Section 21(4) of the Mental Healthcare Act, 2017. The court said that under Section 21(4) of the Mental Health Care Act, 2017 there is a provision for insurance coverage of mental illness, it is not known to the general public. Therefore, it is the bounden duty of the Respondents to sensitize the people about the availability of insurance coverage to the patients with the mental illness.