It was an eventful week with Erawady tragedy. One day two Indian express reporters Ms. Sreelatha Menon and Ms.Sanchitha sharma wanted to talk to me about PWDEA act 1995 and The National trust act 1998 as they are going to interview Ms.Menaka Gandhi who was heading the Social justice Ministry which handles these two acts.They have already interviewed the Union Health Minister Shri CP Thakur who was sympathetic to the cause of mentally ill and also inclusion of disabled due to Mental illness in the National trust act. They not only talked to me at length but also saw the condition of my daughter and was convinced about the inclusion of psychosocial disabled in the National trust act 1998 when they found out that my daughter has been receiving treatment from AIIMS,NIMHANS, and CGHS Delhi and various other private Psychiatrists ,Psychologists,God men for the last 15 years by the year 2001. Their interview of Ms.Menaka Gandhi should be an eyeopener for all as I find no change in the attitude of the Ministry of Social Justice even today. The link to that interview is below.
Ms.Menaka Gandhi's Op ed in Indian express 2001
The best coverage about that incident came in the Frontline magazine of that time with a good background material.The link is below
I want to post the Supreme court order of Feb 2002 issued in a nutshell on that case(No W.P.(C) NO 334 OF 2001)in which it took suo moto action.
1. District wise survey of all registered and unregistered bodies purporting to offer mental health care. Licence to be granted or refused depending on whether minimum prescribed standards are fulfilled or not. Process of survey and license must be completed within 2 months of the order and comprehensive compliance report within 3 months. Further the compliance report must state that no mentally challenged person is chained in any part of the state. 2.The Chief Secy. shall be the nodal agency to coordinate implementation of MHA, The Persons with Disabilities Act 1995, National Trust for Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities Act 1999. 3.The Union of India shall file an affidavit within one month of the Policy of Central Govt. towards setting up at least one Central Govt. run mental hospital in each state and U.T. and State Govt. if not even one State run exists, to give a definite time schedule for establishment of the same. 4.Govt. shall undertake comprehensive awareness campaign with special rural focus to educate people as to provisions of law relating to mental health. 5. Every State shall file an affidavit stating whether State MHA exists and details thereof.
It again issued another order on 12th April 2002.The contents in nut shell are
1.Every State shall undertake a Comprehensive Need Assessment Survey of estimated availability of Mental Health Resource Personnel, Type of Mental Health Delivery System in both public and private sector, coupled with an estimate of Mental Health Services that would be required for the population of the state and incidence of mental illness.
2. The Chief Secy shall state whether any minimum standards have been prescribed for licensing of Mental Health Institutions, whether these institutions private or run by the state meet such minimum / prescribed standards as on date of passing the order and steps taken for compliance.
3. How many unregistered bodies offer mental health care exist in the state and whether any of them comply with minimum standards and steps to close down the same. Whether any mentally challenged person is found chained. The Need Assessment Survey shall be submitted by 1st. July to Health Secy and filed in court by 15th. July.
4. Union of India is directed to frame a policy and initiate steps for establishment of at least one Central Govt. run Mental Hospital. Also the UOI was asked to examine the feasibility of formulating uniform rules regarding standard of services in both public and private sector. It also asked UOI to constitute a committee to give recommendations on care of abandoned mentally challenged persons. It also asked UOI to frame norms for NGO's to ensure that the services run by them are supervised by qualified / trained persons.
5. State Govts. are also directed to frame policy and initiate steps for establishment of at least one State run Mental Health Hospital. Pertinently, it calls for establishment of an exclusive full fledged hospital and does not include a psychiatric ward in medical college or Govt. run hospital.
6.Legal Aid: S.C directed that two members of the Legal Aid Board of each state be appointed to make monthly visits to such institutions to enquire whether further treatment is required and assist in discharge.
7. Rights: Patients and their guardians shall be explained their rights by a team of 2 members of the Legal Aid and a Judicial officer. Also formation of a Board of Visitors (Sec 37 -inspection of hospital). Besides the stated membership of the board in Sec 37, additionally, The Additional District Judge/ CJM and or President of the Bar Association of that area AND State Disability Commissioner or his or her nominee.
8. A scheme for rehabilitation process like a quarter way home be envisaged.
The UOI had been directed by the S.C. to file an affidavit on four issues viz. Frame policy and initiate steps to form one mental hospital in each state, examine feasibility of formulating uniform rules for private and public sector and frame norms for NGO's, constitute committee to look into issues of care of abandoned mentally ill and collate information of all states regarding Need Assessment Survey.
UOI has filed affidavit stating 1. Establishing New Mental Health Hospitals : The S.C. may consider reviewing it's directions for establishing mental health hospitals in each state by the Central Govt as such a step will run counter to the current scientific thinking among mental health professionals the world over, including India (UNCRPD is a direct result of this thinking). 2. Uniform rules for public and private sector mental health institutions and norms for NGO's working in the field of mental health. The affidavit concedes that the Rules are equally applicable to the Govt. and non Govt. sectors. In order to formulate norms for NGO, govt is setting up an expert group to examine and submit it's report within a period of six months of it's constitution. 3. Care of mentally ill persons who have no immediate relatives: A committee has already been set up and the recommendations are being examined and will be placed before the S.C. in due course. 4. Conclusions on Need Assessment Survey reports Distribution of mental health services between and within states is uneven, there is major shortage of trained manpower in all categories, deficiencies in infrastructure clinical and rehabilitative services. It has suggested three corrective ways a) Reduce and minimize hospitalization to a max of 30 days, involve families in patient care b) Prolonged hospitalization is counter productive c) community based care is a cost effective option. It also suggests that in service health personnel be trained in short term training programs at reputed institutions.
I asked Col Goel (rtd)who was Mental health Advisor in the Union Health Ministry at the time of Erawady about this affidavit and i quote him below.
Date: Monday, 26 July, 2010, 5:18 AM
""Dear Capt Jahanan,
Thanks. The counter affidavit referred to by you had been filed on behalf of the Union of India and you may direct your queries/concerns to the nodal Ministry, the Ministry of Health & FW. I imagine the Hon'ble Supreme Court must have taken into considerations all affidavits and other material filed by the IPS, IAPP and other stake-holders while arriving at its decision, assuming that the final judgement of the Hon'ble Court in this matter has been handed down. I had relinquished my assignment in Nirman Bhawan in Oct 2005, and have been away from the country since. It will be, therefore, inappropriate on my part to comment on the points raised by you mainly, it appears, on the basis of Dr Nagpal's letter written almost 8 years ago, in Nov 2002. I would, however, like to point out that you appear to have equated the Hon'ble Supreme Court's interim direction regarding "...the Policy of Central Govt. towards setting up atleast one Central Govt. run mental hospital in each state and U.T. and State Govt. if not even one State run exists,..." with 'NIMHANS type institution in every state capital'.
D S Goel
ERAWADY HAPPENED IN 2001.SUPREME COURT OF INDIA WHICH NORMALLY FUNCTIONS AS THE DISABILITY MINISTRY FOR ORDINARY CITIZENS LIKE US HAS PASSED ITS ORDERS DURING 2002.
BUT STILL THE DISABLED DUE TO MENTAL ILLNESS ARE TO BE INCLUDED IN THE NATIONAL TRUST ACT 1998.NEITHER REHABILITATION COUNCIL TRAIN ANY REHABILITATION PROFESSIONALS TO LOOK AFTER DISABLED DUE TO MENTAL ILLNESS.
OF COURSE A HOSPITAL LIKE NIMHANS OR AIIMS IN EVERY STATE IS A DISTANT DREAM AS THE PRIVATE SECTOR HOSPITALS HAVE STIFLED UNION HEALTH MINISTRY IN SPITE OF INCREASE IN THE MENTAL HEALTH BUDGET WHICH IS NORMALLY SPENT ON SEMINARS FOR VISITING PROFESSIONALS OR FOR INDIAN PROFESSIONALS ATTENDING SEMINARS IN FOREIGN COUNTRIES.DISTRICT MENTAL HEALTH PROGRAMME DOES NOT COVER ALL DISTRICTS and UNCRPD IS CITED FOR HOME BASED TREATMENT.UNCRPD IN FACT DOES NOT AFFECT THE WEALTHY WHO KEEP THEIR WARD IN POSH PRIVATE SECTOR HOSPITALS INDEFINITELY OR TAKE THEM TO SWITZERLAND
MENTAL HEALTH BUDGET IS RUPEES 987 CRORES FOR A POPULATION OF 1OO CRORE PEOPLE WHILE THE SAME UNION OF INDIA SPENDS RUPEES 40,000 CRORES FOR COMMONWEALTH GAMES AND OUR BILLIONARE MUKESH AMBANI SPENDS HIS OWN MONEY OF RUPEES 3000 CRORES FOR HIS PERSONAL HOME.ANOTHER BILLIONAIRE SPENDS 1000 CRORES IN HIS F1 SPORTS PURSUIT.
Union of India has NOT even bothered to consult family or user representatives before filing its affidavit while it has consulted 3000 member Indian Psychiatric society.So as THE 10th anniversary of 6th august approaches i implore users and carers of India to ponder deeply ABOUT ERAWADI on National Mental health Awareness day.