India @70-Mental Health Remains Orphan in National Budget

My interest in Mental Health is existential.  I have battled Bipolar Disorder for decades. Have been a Mental Health Advocate and Activist for a decade and I  have also served on the Government of India, Mental Health Policy Group for four years.

Every year I have some wish list on Budget Day. This year wish list was limited to have the presence of two words Mental Illness) the budget speech of Finance Minister, Arun Jaitley

I also had a prophecy Mr. Finance Minister would not utter these words. I was very sure that would not even occur to him, that there exists a category of Indian population, for whom the word “Mental Illness” is a question of life and death.

Mr. Jaitley, proved me right.

How could he have broken the glorious Indian tradition of seventy years that too in Parliament, temple of Indian Democracy. Finance Minister is an erudite lawyer and his knowledge of Constitutional Law of India is impeccable. He knows that the word “Of Unsound Mind” is the basic tenet of Constituent of India. It was his forefathers in the Constituent Assembly, who in 1948, the  first year of independence, even before the Indian Constitution was promulgated, first defined all types of Indians suffering from Mental illnesses as those with “Unsound Mind”. There was only one small caveat, court could declare a sufferer of Mental Illness  to be of “Unsound Mind” and such a classification robbed the sufferer of human rights, fundamental rights and debarred him/her under more than 160 Acts/ Statutes of the country.

A Mentally Ill declared to be “Of Unsound Mind” becomes a non-citizen and the Budget is for citizens, naturally they are proscribed from the provisions. Even those who are not declared to be of “Unsound Mind” formally, but suffer from severe Mental Disorders, they too are de-facto in the same category.

But I am a die-hard optimist deep within my heart I wanted two words -“Mental Illness” to be truly part of annual budget speech. And my optimism had various reasons

  1. Though National Mental Health Policy Group was set up by the UPA Government in 2011, recommendations of the Policy Group were accepted by the NDA Government and on 10th October, 2014, India’s maiden Mental Health Policy was announced by the Union Health Minister. It indeed was a day of small celebration for eleven of us who had tirelessly worked for three years to frame best practices, forward-looking policy. It is a different matter altogether that the policy, has collapsed at the first hurdle of implementation as neither central government nor state governments are serious about taming the scourge.
  2. .In 2016 August, India’s first National Mental Health Survey, brought the scary news out of the closet that at any given point of time today 10.6% of Indians suffer from one or other Mental Illnesses and the life time occurrence already is a high 16%. Another finding of the survey was the incidence and severity of mental illness is rising fast.
  3. The World Health Organization postulates that in life time of us Indians, at least 1 out of 4 will suffer from one or the other mental illnesses.
  4. On 8th August, 2013,  Mental Health Care Bill, 2013 was passed by Rajya Sabha. Sadly it has not yet become Law as Lok Sabha is yet to pass it even though it was listed as no 1 bill to be passed in Winter Session (which was washed out) and its passage in the Budget Session is eagerly awaited. The Bill is close to my heart for many reasons. First, I is truly transformative and path breaking Bill which puts Mentally ill at the centre. Second, I have been personally closely involved with evolution of the Bill included having given my submissions on the same, to Parliamentary Committee on Health way back in 2013.

The above four reasons should have been sufficient to do at least lip service to the subject of Mental Illness that is turning out to be national calamity and which faces extreme level of stigma. Worse, availability and accessibility of treatment is severely crippling  the Nation and there are host of other serious problems associated with it.

There was a more contemporary reason. WHO has taken a bold decision, by dedicating this years World Health Day (7th April) to Depression  with a strong message “Depression Let Us Talk”

Sadly nothing is sufficient to wake up the government.  Health in any case is not the priority sector, because government knows those dying or ill will spend from their pocket and it is no surprise that  though national health expenditure is 6% of GDP, government merely spends 1% and 5% is out-of-pocket expenses of families.

Let us look at this year health Budget Rs. 48000 Crore for 125 Crore people, it converts to shocking 384 rupees per person per annum. If  that does not shock you enough, let us assume Mental Health Budget is 1% of Health Budget (will be rather happy to know if it is 1%), then the per person per annum Mental Health Allocation by Government of India is Rs. 3.84 or say, Rs 4 per person annually. Can there be a more sorry affair. Or I have got my numbers wrong. Or Mental Health has to be the worry of bankrupt state governments, because Health is a State Subject.

I wonder, with Rs. 384 per person per annum how government will achieve its this year goals of eliminating Kala Zaar and Filarasis by 2017, Leprosy by 2018, Measles by 2020 and intractable TB by 20125

It is clear that government cannot even tackle the physical ailments. Clearly Mental Illness is neither their priority or within the capability profile.

So it is time people of Indian Nation, to come together and fight this beast known as Mental Illness or Mental Disorders.

No point looking at government for looking for solution of some thing whose existence it has decided to deny but here I say, Join Hands-Together We Win

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