5th Global Mental Health Summit & Need of Mental Health Policy

5th Global Mental Health Summit & Need of Mental Health Policy

● Former Union Health Secretary K Sujatha Rao has written about how policymakers
need of attention to Mental Health Policy.
● Recently, the 5th Global Mental Health Summit, cosponsored by more than a half-
dozen mental health organizations, was held in Chennai in December 2022 to discuss
mental health in the context of human rights, ethics, and justice.
● It emphasized the importance of mental health and issued a call to action against
society’s general neglect and, in particular, the governments at the federal and state levels.

What is Mental Health?

● Health is critical to a country’s development. The World Health Organization (WHO)
defines health as ” a state of physical, mental, social and spiritual well-being and not
merely the absence of disease or infirmity”.
● WHO defines mental health as mental well-being in which an individual realizes his or
her own abilities, can cope with the normal stresses of life, can work productively and is
able to make a contribution to his or her community.
● In this sense, mental health is the foundation for individual well-being and the efficient
operation of a community.

National Mental Health Survey

● The Government of India conducted a National Mental Health Survey — 2015-16 in
2015 to assess the prevalence of mental health in the country.
● According to the report, mental disorders affect 10.6 percent of people over the age of 18,
16 % of people in the productive age group of 30-49 years old, and 150 million people
have lifetime morbidity, with one percent reporting a high suicidal risk. Even so, human
resources and treatment facilities are woefully inadequate.
● Madhya Pradesh 0.05 psychiatrists per lakh people, and the treatment gap in India is
approximately 80%.
● In 2019, the Union government allocated Rs 600 crore to tertiary institutions such as
NIMHANS and medical college psychiatry departments, leaving only Rs 40 crore for the
District Mental Health Programme and other community-based initiatives, despite an
estimated need of over Rs 93,000 crore investment to address this massive morbidity.
○ Only Rs 2.91 crore of the pitiable sum of Rs 40 crore was spent.

Issues and Concerns

● For policymakers, mental health is a low priority. Indifference among bureaucrats and
politicians is often blamed for such a lack of policy attention.
● In an acutely underfunded sector with overwhelming funding demands, those with the
loudest voices are heard.
● Mental health is uniquely disadvantaged in this regard because its lobbying power is the
weakest.
● A more important reason is the significant “know do” and “how to” gaps in mental health.
● The rights-based National Mental Health Policy of 2014 and the Mental Health Act of
2017 made a decisive shift in policy by requesting that the mentally ill be treated on par
with those suffering from physical ailments and with dignity.
● However, it is unclear how and when the financial and physical resources will be found.

Components of Good Policy

● A good policy has four components:
○ a clear vision with aims, objectives, and goals;
○ the design that outlines how to achieve the vision;
○ the amount of resources — financial, human, and infrastructural, required to
implement the design; and
○ the surveillance, data, monitoring, and evaluation of outcomes at concurrent and
periodic intervals for course correction.

Criticism of India’s Policy Making

● Policy design is the most difficult aspect of policymaking. A common criticism leveled at
India’s policy-making system is the significant gap between what is desired and what is
actually feasible.
● Strategic interventions necessitate a nuanced understanding of the challenges and
constraints that a system faces, based on consultation and dialogue between policymakers
and those affected by the policies that are formulated.
● There were nearly 20 technical resource groups with at least 200 members in NACO for
policy formulation and implementation of the NACP III strategy, including a sex worker
and a top-notch professor of medicine.

Lesson from how India dealt with HIV/AIDS

● The requirement for developing strategic interventions based on epidemiological
evidence from an active surveillance system.
● The significance of modeling different options for addressing the wide range of
interventions required in different geographies and among different target groups in order
to provide data on cost effectiveness as well as efficacy of the interventions required for
scaling up;

● Proactive advocacy of systemic issues among all influencers — the media, judiciary,
politicians, police, and other intersectoral departments whose programs and activities
have a direct impact on the key populations being worked on; and
● The use of peer leaders and civil society, which received more than 25% of the budget.

Need of Mental Health Policy

● Without the active participation of community leaders, implementation among the
poorest and most marginalized, particularly criminalized groups, would have been
impossible.
● Despite the fact that the central government fully funded the central sector program, each
intervention was developed with active participation and dialogue among the states and,
more importantly, the affected constituencies.
● A similar approach is required when developing a good, implementable mental health
strategy. The limitations of the biomedical approach and confining patients in hospitals
are now recognized and supported by evidence.
● Mental health is even more complicated than HIV/AIDS because mental disorders are not
a one-time ailment that can be cured with certain medications.
● It is so intertwined with the type of society we live in — the pressures and stress caused
by poverty and growing inequalities of opportunity, the frustrations of joblessness, the
judgmental and discriminatory environment due to social barriers of caste, gender,
religion, and so on are powerful triggers — that if completely unaddressed, the ailment
can recur despite medication.

Initiatives of Government of India

● National Mental Health Program (NMHP): Since 1982, the government has been
implementing the National Mental Health Program (NMHP) to address the enormous
burden of mental disorders and a shortage of qualified professionals in the field of mental
health.
● Mental Health Act: The Mental HealthCare Act of 2017 guarantees every affected
person access to mental healthcare and treatment from government-run or funded
services.
● Kiran Helpline: In 2020, the Ministry of Social Justice and Empowerment launched the
‘Kiran’ toll-free helpline to provide support to people experiencing anxiety, stress,
depression, suicidal thoughts, and other mental health concerns.
● Manodarpan Initiative: This is a Ministry of Education initiative aimed at providing
psychosocial support to students, family members, and teachers for their mental health
and well-being during the Covid-19 pandemic.
● MANAS Mobile App: The Government of India launched the MANAS (Mental Health
and Normalcy Augmentation System) Mobile App in 2021 to promote mental wellbeing
across age groups.

Way Forward

● Organizations such as Banyan, Sangath, CHLP, and others are conducting high-quality
research and developing models of rehabilitation and care for people with mental
illnesses.
● Strategies must be developed based on the data and evidence available. Scaling up
models such as Banyan’s Home Again and Emergency Care Centers, or CHLP’s peer
leader-led interventions, etc., must be investigated.
● Policymakers must provide resources and funding to civil society organizations in order
to implement community-anchored, more affordable interventions.

Hate Speech

● Supreme Court in Pravasi Bhalai Sangathan v. Union of India (2014), defined hate
speech as “an effort to marginalize individuals based on their membership in a group
which seeks to delegitimize group members in the eyes of the majority, reducing their
social standing and acceptance within society.”
● The 267th Report of the Law Commission of India, declared hate speech as an incitement
to hatred primarily against a group of persons defined in terms of race, ethnicity, gender,
sexual orientation, religious belief and the like.
● However, as of now there is no specific legal definition of ‘hate speech’.

Legal Provisions

● Under sections 153A and 153B of the IPC, acts that promote animosity and hostility
between two communities are punishable.
● Under Section 295A of the IPC, acts that deliberately or maliciously insult the religious
sensibilities of a group of people are punishable.
● Publishing or circulating anything that may incite animosity or hostility amongst various
communities is punishable under Sections 505(1) and 505(2) of IPC.
● A person convicted of illegally exercising their right to freedom of speech is prohibited
from contesting an election under Section 8 of the Representation of People’s Act, 1951
(RPA).
● promotion of hatred based on race, religion, community, caste, or language in connection
with elections is prohibited and classified as a kind of corrupt electoral conduct under
Sections 123(3A) and 125 of the RPA.

Changes proposed

● Viswanathan Committee proposed amending the Indian Penal Code (IPC) by adding
Sections 153 C (b) and 505 A, to make special provisions regarding incitement to commit
an offence on the basis of religion, race, caste or community, sex, gender identity, sexual
orientation, place of birth, domicile, language, disability, or tribe.
● The Bezbaruah Committee proposed amending Section 153 C of the IPC to punish
promoting or attempting to promote acts prejudicial to human dignity and make it
punishable by five years in prison and a fine or both, and Section 509 A of the IPC to
punish using words, gestures, or acts to insult members of a particular race, and make it
punishable by three years in prison and a fine or both.

Golden Globes Award

Recently, Naatu Naatu song from SS Rajamouli’s epic movie RRR, won the Best Original Song
in the 80th Golden Globe Awards.

About the Golden Globes Award:
● The Awards are accolades bestowed by the Hollywood Foreign Press Association
(HFPA).
● It started in 1944, recognizing excellence in both American and international film and
television.
● There are 105 members of the HFPA.
● The eligibility period for the Golden Globes corresponds to the calendar year (from
January 1 through December 31).
● Naatu Naatu is the first Asian song to win the Golden Globe honour.
● AR Rahman was the first Indian to win a Golden Globe award in Best Score category for
the film Slumdog Millionaire, a 2008 British drama film by Danny Boyle.
The Hollywood Foreign Press Association (HFPA):
● HFPA or Hollywood Foreign Press Association is the organisation behind the awards.
● HFPA is a non-profit outfit made up of journalists and photographers on the
entertainment beat in different media like newspapers, magazines, books, radio, and TV
broadcasting in the United States.

● As the word ‘foreign’ implies, most of the members of HFPA are non-US citizens.
● At the time of writing this, HFPA consists of 105 members from 55 countries.

Defence Acquisition Council

Defence Acquisition Council (DAC) accorded Acceptance of Necessity (AoN) for three capital
acquisition proposals amounting to ₹4,276 crore.
● It includes Helicopter launched Nag (HELINA), Very Short-Range Air Defence Systems
(VSHORAD) and BrahMos cruise missile launcher and Fire Control System (FCS) for
naval ships.

About DAC:

● DAC is the highest decision-making body in the Defence Ministry for deciding on new
policies and capital acquisitions for the three services – Army, Navy and Air Force, and
the Indian Coast Guard.
● The Defence Acquisition Council is headed by the Defence Minister.
● Members: Minister of State for Defence, Chief of Army Staff, Chief of Naval Staff, Chief
of Air Staff, Defence Secretary, Secretary Defence Research and Development, Secretary
Defence Production, Chief of Integrated Staff Committees HQ IDS, Director General
(Acquisition, Dy. Chief of Integrated Defence-Staff Member Secretary.
● It was formed, after the Group of Ministers recommendations on ‘Reforming the National
Security System’, in 2001, post Kargil War (1999).

About HELINA Missiles

● Missile is developed by Defence Research and Development Organisation (DRDO).
● It is helicopter-launched version of the Nag Anti-Tank Guided Missiles (ATGM).
● Air Force variant of NAG missile is known as ‘Dhruvastra’.
● It’s a third generation ‘fire-and-forget’ class missile.
● It can be mounted on Advanced Light Helicopter (ALH).

Features of HELINA Missiles:

● Missile system has all- weather day and night operational capabilities.

● It can defeat battle tanks with conventional amour as well as explosive reactive amour
(ERA).
● Missile can engage targets both in direct hit mode as well as top attack mode.
● Top attack mode: It requires to climb sharply after launch and travel at a certain altitude
then plunge on the top of the target.
● Direct hit mode: It travels at a lower altitude directly striking the target.

About Very Short-Range Air Defence Systems (VSHORAD):

● It is designed and developed indigenously by DRDO’s Research Centre Imarat (RCI),
Hyderabad, in collaboration with DRDO laboratories and Indian Industry Partners.
● It meant to kill low altitude aerial threats at short ranges.
● India has been in talks with Russia since 2018 to procure the Igla-S air defence missiles
at a cost of $1.5 billion under the VSHORAD programme in a bid to replace the Russian
Igla-M systems.

Features of VSHORAD:

● It is a man portable Air Defence System (MANPAD).
● It is a robust and quickly deployable system, which will strengthen India’s air defence
capabilities.
● Missile is propelled by a dual thrust solid motor—incorporates many novel technologies
including miniaturized Reaction Control System (RCS) and integrated avionics.

Under Constitution, law declared by the Supreme Court is binding on all

Vice President Jagdeep Dhankhar questioned the landmark 1973 Kesavananda Bharati case
verdict that gave the basic structure doctrine, saying it set a bad precedent and if any authority
questions Parliament’s power to amend the Constitution, it would be difficult to say ‘we are a
democratic nation’.

What did the SC say?

● Vice-President’s public criticism of the National Judicial Appointments Commission
(NJAC) judgment may be seen as comments by a high constitutional authority against
“the law of the land” (Art. 141).

● That is, as long as the NJAC judgment, which upholds the collegium system of judicial
appointments, exists, the court is bound to comply with the verdict.
● The Parliament is free to bring a new law on judicial appointments, possibly through a
constitutional amendment, but that too would be subject to judicial review.

What is Article 141?

● Article 141 provides that the law declared by the Supreme Court shall be binding on all
courts within the territory of India.
● The law declared has to be construed as a principle of law that emanates from a
judgment, or an interpretation of law or judgment by the Supreme Court, upon which, the
case is decided.
● This article forms the basis of Doctrine of Precedent in India.

What has the VP accused the judiciary of?

● Dilution of Parliamentary Sovereignty: The Vice-President had remarked that judicial
review, as was done in the case of the NJAC law, diluted parliamentary sovereignty. He
had used terms like “one-upmanship”.

● Curb on Legislature: The Vice-President had said he did not “subscribe” to the
landmark Kesavananda Bharati judgment of 1973 which limited the Parliament’s power
under Article 368 to amend the Constitution.

● Disregard to the mandate of people: Dhankhar said no institution can wield power or
authority to neutralise the mandate of people.

Notes for Aspirants

A classic observation in this regard was made by Chief Justice Patanjali Shastri in State of
Madras versus V.G. Row (1952). Justice Shastri’s words were reproduced by Chief Justice J.S.
Khehar in his lead opinion for the Constitution Bench in the NJAC case in October 2015.

(1) Actual nature of Judicial Review

● Justice Shastri said judicial review was undertaken by the courts “not out of any desire to
tilt at legislative authority in a crusader’s spirit, but in discharge of a duty plainly laid
down upon them by the Constitution”.
● The Kesavananda Bharati verdict (1973) had made it clear that judicial review is not a
means to usurp parliamentary sovereignty.
● It is a “system of checks and balances” to ensure constitutional functionaries do not
exceed their limits.

(2) Limitations to Article 368

● Article 368 postulates only a ‘procedure’ for amendment of the Constitution.

● The same could not be treated as a ‘power’ vested in the Parliament to amend the
Constitution so as to alter the ‘core’ of the Constitution, which has also been described as
the ‘basic structure’ of the Constitution.

Back2Basics: Doctrine of Precedent

● Any judicial system’s structure places a high priority on the notion of precedent.
● It suggests that a judgement made by a court at the top of the judicial food chain binds
courts below it.
● According to Article 141 of the Indian Constitution, all lower courts must abide by the
Supreme Court’s interpretation of the law.
● Similar to this, a State’s High Court’s decision is binding on all Lower Courts within that
state, and a division bench of a State High Court’s ruling is binding on the Justices sitting
singly in that High court.