On Mental Health, Supreme Court Cancels "One Size Fits All" Order

Upholding the need for judges to be ‘sensitive to the gravity of mental health issues’, the Supreme Court has said the judiciary should not treat the mental health of a person with a “one-size-fits-all” approach.

• The top court's judgment came on an appeal filed by Karnataka against the high court decision to quash a case of abetment of suicide against a government officer.
  • Karnataka High Court quashed criminal proceedings against a government official in a case of abetment of suicide.
• A bench of justices DY Chandrachud and BV Nagarathna said the observation of the high court that there is no material to corroborate the allegations made in the suicide note is erroneous.
• The Single Judge, other than deciding on the merits of the case while exercising the power under Section 482 of the CrPC, has also made observations diminishing the importance of mental health. The mental health of a person cannot be compressed into a one size fits all approach.
• The top court said it is not a consideration for the high court while exercising its power under Section 482 of the CrPC, particularly because the trial has not begun.

What is Mental Health?

• Mental health is an integral and essential component of health.

• Mental health is a state of well-being in which an individual:
  • realizes his or her abilities
  • can cope with the normal stresses of life
  • can work productively
  • can contribute to his or her community
• Mental health is fundamental to a person’s collective and individual ability as humans to think, emote, interact with each other, earn a living, and enjoy life.
• On this basis, the promotion, protection, and restoration of mental health can be regarded as a vital concern of individuals, communities, and societies throughout the world.

• Multiple social, psychological, and biological factors determine the level of mental health of a person at any point in time.
  • For example, violence and persistent socio-economic pressures are recognized risks to mental health. The clearest evidence is associated with sexual violence.
• Poor mental health is also associated with
  • rapid social change
  • stressful work conditions
  • gender discrimination
  • social exclusion
  • unhealthy lifestyle
  • physical ill-health
  • human rights violations

• lack of awareness
• social discrimination, and stigma
• a paucity of appropriate resources
• India has nearly 0.29 psychiatrists and around 0.07 psychologists per 100,000 population, compared to a median of 0.3-0.5 in low-mid income countries and 9-11 in high-income countries. 
• Additionally, India has only 1.43 hospital beds available for mental health patients per 100,000 population, compared to a median of seven in low-income countries and 50 in high-income countries. 

• NMHP: The Government of India launched the National Mental Health Programme (NMHP) in 1982. 
• Mental Healthcare Act (MHCA) 2017: The Mental Healthcare Act (MHCA) 2017 entered into force in May 2018. This legislation adopts a rights-based approach to regulate mental healthcare and treatment in India.
  • It draws on the guiding principles of the UN Convention on the Rights of Persons with Disabilities (CRPD).
    • India ratified the CRPD in 2007. 
  • Insurance coverage: In June 2020, the Insurance Regulatory and Development Authority of India (IRDAI) mandated insurance providers to include mental illnesses under the scope of health cover.
  • World Mental Health Day: India observes 10 October as World Mental Health Day every year. The day is significant because mental health issues have remained under-invested and under-appreciated.

• In 2013, the World Health Assembly approved a "Comprehensive Mental Health Action Plan for 2013-2020".
• The Plan is a commitment by all WHO’s Member States to take specific actions to improve mental health and to contribute to the attainment of a set of global targets.

• Investment: Urgent investment is required in mental health across sectors, to support a whole-of-society approach to prevention, promotion, and care.
• Strategizing solutions: Urgent investment in strategies to promote good mental health including the prevention of gender-based and other forms of violence
• Effective intervention: Integrating interventions across health, education, and social protection sectors - including parenting programs and ensuring schools support mental health
• Breaking the ice: Breaking the silence surrounding mental illness, through addressing stigma and promoting a better understanding of mental health.
• Technology solution: Technology solutions can also be used to bridge the capacity gap by leveraging tele mental health programs to provide training to physicians and other healthcare workers. 
• Inclusive Government policies & schemes promoting mental health solutions

Today, mental health is just as important as physical health. It deserves adequate support systems that will enable people to be healthy, and productive. It is time that the governments and public and private sector partners work in effective collaboration to promote mental health for all children, adolescents, and caregivers, protect those in need of help and care for the most vulnerable.

Mental health issues are diverse and complex, and no one fixed approach suits everyone. Healthy discourse is the need of the hour to de-stigmatize mental health issues and highlights how important it is to talk about them.