This Act moved mental health from a “clinical” issue to a “Rights-based” legal framework, aligning India with the UN Convention on the Rights of Persons with Disabilities (UNCRPD).
Core Provisions
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- Right to Access: Every person has a right to access mental healthcare and treatment from services run or funded by the government.
- Decriminalization of Suicide (Section 115): The Act presumes that any person who attempts to commit suicide is under severe stress and shall not be tried or punished under the IPC. The government is mandated to provide care and rehabilitation.
- Advance Directive: An individual can state in writing how they wish to be treated (or not treated) for a mental illness and nominate a “Representative” to make decisions on their behalf if they lose capacity.
- Prohibition of Cruel Treatments: * Bans Electroconvulsive Therapy (ECT) without muscle relaxants and anaesthesia.
- Bans ECT for minors (except in extreme emergencies with board approval).
- Bans sterilization as a treatment for mental illness.
- Mental Health Review Boards (MHRB): Quasi-judicial bodies established to protect the rights of patients and oversee “Advance Directives.”
The Implementation Gap: Despite being one of the world’s most progressive laws, India still has a massive shortage of psychiatrists (0.75 per 1 lakh population vs the requirement of 3 per 1 lakh) and low awareness of “Advance Directives.”
REGULATION OF THE HEALTH SECTOR
1. Drug and pharmaceutical
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- Drugs and Cosmetics Act 1990, Consumer Protection Act 2019
- The Central Drugs Control Standard Organisation and the State also have their counterparts
- For medical education and healthcare, the National Medical Commission Act 2019
2. Pricing regulation
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- Central Price Control Order 2013
- Regulation of the National Pharmaceutical Pricing Authority
- Regression of food standard – FSSAI Act 2006
Regulation plays an essential role in any sector, as, according to the World Bank, the quality of service depends on the quality of regulation. The same applies to the health sector; there are four regulatory bodies for the health sector. Its positive side is that India has one of the most significant health sectors. Informal sectors have come among leading countries in recent years, it has made a long stride, making health available to all; however, health sector regulations remain a serious problem due to the following factors:
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- In the drug and pharmaceutical sector, the availability of drugs has not been properly tested
- Drugs and medicines are priced 400 to 500% higher than the manufacturing cost
- In the case of medical education and the healthcare sector, increasing commercialisation of healthcare (a seat is sold in 4 crore), medical negligence, and the unethical conduct of doctors
Banned drugs are supplied in the market, fixed-dose combinations of drugs are not adhered to, and the enhanced care sector medical tests are poorly regulated. Therefore, it is essential to restructure health Care regulation.
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