India's Disability and Mental Health Law: A Review

India's conversation on disability and mental health law reflects the nation's constitutional promise and ongoing structural lacuna. Despite progressive legislation like the Mental Healthcare Act (MHA), 2017 and the Rights of Persons with Disabilities (RPwD) Act, 2016, gaps persist between legislative intent and the lived experiences of stakeholders.

Legislative Framework

• The Mental Health Act of 1987 focused on containment rather than rights, originating from the colonial Lunacy Act of 1912.
• The MHA, 2017 reimagined individuals with mental illness as rights-bearing citizens, emphasizing dignity, informed consent, and state-supported care:
  • Established Mental Health Review Boards. 
  • Guaranteed access to mental health services. 
  • Aimed to eliminate coercion in treatment.
• The RPwD Act, 2016 expanded on the 1995 statute, recognizing 21 disability categories and promoting:
  • Affirmative action in education and employment. 
  • Accessibility in public infrastructure. 
  • Supported decision-making over substitute decision-making.
  • Both Acts embody the spirit of the UN Convention on the Rights of Persons with Disabilities (UNCRPD): autonomy, inclusion, and non-discrimination.

Challenges and Gaps

• Legal and practical gaps for those with both intellectual and psychiatric disabilities.
• The MHA, 2017 covers temporary incapacity but lacks clarity on permanent intellectual disabilities like autism.
• Deficiencies in infrastructure for community-based rehabilitation and the reliance on institutional care.
• Complexities in guardianship under the outdated Guardians and Wards Act of 1890.
• Disability law enforcement relies on state policy, not constitutional authority, leading to inconsistent application.

Expert Insights

Interviews with professionals reveal concerns about the legal framework:

• Lack of state funding and support for community care.
• The need for societal attitude changes towards inclusion.
• The issue of disability law not being part of the justiciable Fundamental Rights.

Comparative Perspective and Recommendations

• Sweden's integrated approach under the Social Services Act contrasts with India's fragmented system.
• The European Union prioritizes dignity, privacy, and inclusion under the Charter of Fundamental Rights and UNCRPD.
• Recommendations for India include:
  • Improving community infrastructure for housing, vocational training, and inclusive workplaces. 
  • Enhancing monitoring and accountability to prevent neglect and abuse. 
  • Increasing public awareness and legal literacy about rights and entitlements.

Recent Legal Developments

In 2024, the legal landscape saw a shift towards judicial enforcement:

• Rajive Raturi v Union of India: The Supreme Court ruled accessibility standards as mandatory.
• The Seema Girija Lal case: Addressed poor implementation, requiring states to appoint commissioners and establish special courts.
• The NHRC highlighted "inhuman" conditions in mental health institutions, affirming rights under Articles 14 and 21 of the Constitution.
• Challenges with the Puja Khedkar "fake certificate" scandal, causing delays in certification processes.

Conclusion

While India's disability and mental health laws have evolved ethically from protectionism to empowerment, operationalizing dignity remains a challenge. True inclusion requires not only progressive legislation but also effective implementation and support mechanisms that reach the most vulnerable individuals.