# India-Mental illness, choice and rights


October 20, 2012

Harsh Mander, The Hindu

  • Until recently, the law treated persons with mental illness not as persons who deserve treatment and care, but as people who are vaguely dangerous. File Photo: S. James
    Until recently, the law treated persons with mental illness not as persons who deserve treatment and care, but as people who are vaguely dangerous. File Photo: S. James
  • Members of Disabled Rights Group (DRG) and National Alliance on Access to Justice for People Living with Mental Illeness (NAAJMI) staging a protest outside Health Ministry against the Mental Health Care Bill. File Photo: V. Sudershan
    The Hindu Members of Disabled Rights Group (DRG) and National Alliance on Access to Justice for People Living with Mental Illeness (NAAJMI) staging a protest outside Health Ministry against the Mental Health Care Bill. File Photo: V. Sudershan

The new Bill should pitch for free care to mental health patients in public hospitals.

Persons with mental illness have long been subjected to cruelty, neglect, ridicule and stigma. In the last half-century, medical science has made significant strides in finding some cures and palliatives for afflictions of the mind – of emotion, mood, thinking and behaviour. Parallel to this is the evolution in our ethical frameworks: of human rights, and acknowledgment of the equal dignity of all human beings. But changes in the law, social attitudes, and the work of healthcare institutions and psychiatric professionals, have not kept pace with these scientific and normative advances.

The Mental Health Care Bill, 2012, recently released by the government, is an exceptional State-led attempt to correct many of the historical wrongs to which persons with mental illness have long been subject. The draft emerged after a long and engaged process of consultation with persons with mental illness, their care-givers, their organisations, and professionals.

The Bill met immediately with fierce opposition from some radical disability and mental health organisations. Many of their concerns and fears are legitimate. But I believe that this is on balance a humane and progressive Bill, bravely and compassionately navigating difficult ethical and professional terrains.

Until quite recently, it was routine to lock away people with mental illness in jails or jail-like mental hospitals, kept naked or in prison-like uniforms, bound in chains, abandoned and often forgotten for lifetimes. The number of beds in mental hospitals were, however, minuscule, and the large majority of patients were denied any kind of care, except those offered by faith healers and untrained practitioners.

The new Bill contains many protections to persons with mental illness. It bars prolonged hospitalisation, chaining, compulsory tonsuring, forced sterilisation, and electro-convulsive therapy without anaesthesia, and defends rights of patients to privacy, personal clothes and protection from abuse. It also prescribes that all persons with mental illness have the right to dignity, and to live in, be part of, and not segregated from society.

The Bill also mandates that mental health services shall be integrated into general health services at all levels – primary, secondary and tertiary, and that these services shall be available in the neighbourhood. If enforced, this will draw a curtain on the long tragic history of injustices and abuses which characterised large, segregated mental hospitals.

The opening sections of the Bill are forthright in admitting that persons with mental illness suffer discrimination, and that the current law has failed to protect their rights and promote their access to health care. It goes on to assure all persons the right to ‘affordable’ good quality public health care.

I believe this guarantee does not go far enough. In these columns last fortnight, I recounted the story of Rajesh, a young man suffering from hallucinations from full-blown psychosis, badly injured, who was repeatedly refused admission by many major public hospitals in the capital. The story underlines the general experience of growing abdication by professionals and public institutions to take care of impoverished and difficult patients. I believe that the Bill must guarantee nothing less than free care in all public hospitals for all patients who seek or need care, and prescribe deterrent punishments for hospitals and professionals who refuse to provide care.

Against their will

Despite its many progressive and humane features, the Bill is still attacked by some radical associations of persons with mental illness, mainly because it retains provisions in rare cases to admit patients for care, even against their will. This debate has an important history.

Until as recently as 1987, the colonial Indian Lunacy Act, 1912, prevailed, in which persons with mental illness (described as ‘lunatics’ and ‘idiots’), were admitted into mental hospitals through the order of Magistrates. The law treated persons with mental illness not as persons who deserve treatment and care, like any other person who falls ill, but as people who are vaguely dangerous, and therefore it in effect primarily aimed to protect other people from persons with mental illness.

The Mental Health Act of 1987 partially corrected this, by allowing for voluntary admissions, but Magistrates still retained a central role for patients who were admitted to mental hospitals against their will. Mental health activists rightly campaigned against this provision, as it was undignified and stigmatising; and it was on occasion misused to abandon and ‘tame’ assertive and non-conforming women and men.

Radical mental health activists are dismayed because the new Bill still allows involuntary admissions of patients against their will. They are uncompromising that the will of the patient should be absolute regarding whether or not she wishes to accept treatment and care.

On the other hand, many persons with mental illness, and their care-givers, recognise that there are occasions when it is in the paramount interest of some patients to be given care forcefully, even when they refuse it, if the person is in imminent danger of causing harm to herself or to other people. The Bill limits involuntary admissions to only such cases, with many checks and balances. Forced admission is only for 30 days at a time. The Magistrate is removed from the picture completely, and is replaced by mandatory reviews of all such cases by mental health panels, which comprise judges but also administrators and persons with mental illness and their care-givers.

There are moments I have observed – among loved ones, friends and the young people from the streets who are now in our care – when a person is suicidal or hallucinatory, abandons home or is suspicious of loved ones, is compulsively manic, spending or gambling life savings, violent and dangerous to himself or to neighbours. In the name of human rights, no hospital or professional offers them care. But there are deeper human rights in these moments, which cumulatively may temporarily override the right of free choice. These are the rights to empathy, protection, dignity and care. I believe that the Bill is right in the delicate balance it has found, retaining the provisions for involuntary admissions, but limiting these severely with many cautions and checks.

These debates are important, and we need to listen to each other more. But while we discuss, we must welcome a draft law which promises to reverse the cruelty, ignorance and abdication, which still characterises ways the State and professionals still treat people battling demons in their minds and souls, while guaranteeing them empathy, respect, protection and care.

 

Fact Finding Report: Gang Rape of Dalit Girl , Haryana #vaw


Fact Finding Report: Gang Rape of Dalit Girl by Dominant Caste Youth and Suicide of Girl’s Father- Dabra Village, Hisar, Haryana

October 11, 2012

That the Hindus most often succeed in pulling down Untouchables is largely due to many causes. The Hindu has the Police and the Magistracy on his side. In a quarrel between the Untouchables and the Hindus the Untouchables will never get protection from the Police or justice from the Magistrate. The Police and the Magistracy are Hindus, and they love their class more than their duty. But the chief weapon in the armoury of the Hindus is economic power they possess over the poor Untouchables living in the village.
—Dr. B.R. Ambedkar in 1943

On 1st October 2012, National Campaign on Dalit Human Rights (NCDHR) facilitated a fact- finding visit to Dabra Village of Hisar District in Haryana where a Dalit man committed suicide after his minor girl was gang raped by the dominant caste youths.

The fact-finding team comprised Seema Misra Adv., MARG; Adv. Ambalika; Dr. Ajitha WSS ; Ms. Pradnya Deshpande, PUCL; Ms. Sunitha Thakore, Jagori; Mr. Sanjeev Kumar, Delhi Forum; Ms. Asha Kowtal, General Secretary of AIDMAM; Ms. Sumati, JNU; Ms. Abirami, NDMJ; Ms. Savitha, State Secretary, AIDMAM-Haryana; Mr. Rajesh, State Secretary, NDMJ-Haryana .

The team members met the Victim, the family members of the victim, civil society Committee and SP of Hisar.

The key findings of the fact-finding team are:
1. Dabra Village, Police Station – Sadar Hisar, is just around 15 Kms. from District Hisar Head quarter. The common opinion amongst the civil society groups; the people of Daabra and the SP was that the accused were known bad elements. It is surprising that they were not under the radar of the police or any preventive measures were taken.

2. A committee consisting of 21 members including activists, local leaders, 2 advocates has been formed to support the rape survivor by providing legal assistance and monitoring the case till its conclusion to ensure that she gets justice.

3. The victim has been provided 24-hour security by the police and 2 lady constables from 8am to 8pm and two male constables outside the house at night. Inspite of this the fact finding team feels that there is likelihood of the family being pressurized into settling the matter. The family and neighbors of the family revealed that well known local politicians had come to tell them that it was a matter of the village and should be resolved in the village. They also said that outsiders and media should not be allowed to discuss this case. We were also informed that some days ago the some people belonging to the Jat community had broken cameras of a well known television channel’s crew who came to cover this incident.

4. The arrest of the accused was a result of brave and insistent protests of the Dalits group and Women’s group of the village who refused to cremate the body till the immediate arrest of the accused.

5. Dalit’s of this village are still under fear. The relatives of the rape survivor said that after the incident many people had stopped sending their daughters to school even in the village and the older girls to college in Hisar.

6. The community people informed us that the village panchayat met on 20th Sept said that outsiders and media will not be allowed to intervene in this case. The panchayat will take the required actions. They said that outsiders were ruining the atmosphere of the village. The SP, DDPO were present in the panchayat meeting.

7. The rape survivor is 16 and half years old and is a bright girl interested in further studies. She informed the team that her favourite subjects were Economics and Sanskrit.

About Dabra Village
Dabra Village is located about 15 Kms of Hisar District Head quarter.It is populated with more than 6,000 people, comprising about 800 Jat households, 150 Chamar households, 150 Dhanuk households, 10 Nai households, 5 Valmiki households, 8 Baniya households, 10 Khati households, 6 Lohar households and other communities. The Chamar community is largely economically dependent on the Jat population in their village for their regular livelihood based on farming.

About the incident:
1. On 9th September when the Dalit girl namely XYZ (16) D/o Kishan, belonging to Scheduled Caste (Chamar) community, r/o Dabra village, Hisar, was on her way to her uncle’s house , she had been kidnapped by around 8 dominant caste youths to a nearby field situated on Tosham road. A youth gave her some tablets and later seven persons raped her while the other five were guarding the area. Due to fear the girl didn’t disclose this matter to her family members on the same day.

2. On 18th September, 9 days after the incident, the victim XYZ revealed this unpleasant incident to her mother after her mother continuously enquired why she was so subdued and quiet. Her mother who then informed her husband Krishan, a labourer. Krishan raised the issue with the elders of the village who then started questioning the boys allegedly involved in the incident. The accused allegedly threatened the family that they would make the girl’s objectionable pictures public if the matter was reported to the police. Apprehending public humiliation, Krishan allegedly consumed poison and died on 18th September.

3. An FIR has been registered under section 376-G, 506 IPC and u/s 3(1)(x), 3(1)(xii), 3(2)(v) SC & ST (PoA) Act against accused Sonu, Ajay, Pawan and Vikas, residents of Dabra village and eight other unknown persons.

4. As the police officials did not arrest any accused till 21st September, the angered residents of Dabra village who on 22nd September staged a protest demanding the immediate arrest of all the accused. It was only after assurances by Deputy Commissioner Amit Kumar Aggarwal and SP Mr. Sateesh Balan did the protesters allow the body of the girl’s father to be taken for post-mortem. The body was cremated at his native village on 23rd August 2012.

5. Till now the police department has arrested 11 accused. The family informed us that a cheque of Rs. 65,000/- was received . We were informed, by SP that Police Security has been provided to the victims and it will be continued until needed. The Administration has assured free education till she completes her higher studies and also assured job. SP informed us that a Child Psychologist visits the victim regularly and is providing counselling. The accused have been arrested through the active support of the villagers including a few people fromJat community.

Our Demands
We urge you to make use of your good office to initiate intervention to provide justice and protect the Dalit victim. Hence forth, we pray that;

1. Charge sheet should be filed immediately as per S. 167 CrPC and Rule 7 (2) of SC/ST (PoA) Rules 1995.

2. Ensure that the relief and compensation money is put in a bank account in the rape survivor’s name or in a fixed deposit to be used after she becomes an adult.

3. Proper Compensation of Rs. 3,00,000 /- be paid to the rape survivor. as per Rule 12(4) r/w Annexure I S.NO.10, 12, 20 of SC/ST (POA) Rules 1995. [3(1)(x) – 60,000, 3(1)(xii) – 1,20,000 and 3(ii)(v) – 1,20,000 ]

4. The case be tried in the courts set Exclusive Special Court to be set up for Speedy Trial.

5. An experienced criminal lawyer be appointed as special public prosecutor for this case as provided under the SC/ST (POA) Act.

6. The rape survivor be provided a legal counsel of choice to her throughout the trial as per the decision of the Supreme Court in Delhi Domestic Workers Case.

7. Ensure that a conducive atmosphere is created in the court while the rape survivor is deposing so that she can do so without fear and pressure. During examination and cross examination of the girl in court a screen is provided so that she does not have to see the accused.

8. That the economic support promised by the administration to the family that is job for the brother and higher education and job for the rape surviour be given. Besides this to provide rehabilitation to the family as per their wishes.

9. Take steps to ensure the girl’s security so that she is able to attend school regularly as per her wishes.

10.Take all necessary steps to ensure that the family is not pressurise into a compromise . The National Commission for Women should appoint an observer for the trial.

11. Provide adequate protection to the victim’s family and prevent from appraisal.

12. TA/DA to be given to the victim as per Rule 11 of SC/ST (PoA) Rules 1995.

13. As the number of rape cases in Haryana are increasing day to day the State and the police must take proactive steps to create an atmosphere and environment to ensure that girls and women are safe. One suggestion is creating awareness and spreading the message, through posters, wall writings and radio and television messages that any sexual harassment and assault on women will is an offence and strict action will be taken.

14. To establish State level SC/ST commission in Haryana

15. NHRC should conduct a Haryana State level public hearing and include the cases of violence against Dalit women to depose before the jury.

Source: Sanhati

 

Koodankulam Update: 9 October, 2012


 

Update: 9 October, 2012
As told to  nityarand jayaraman by a source in Tirunelveli

Koodankulam protestors, and some others who just happened to be in the wrong place at the wrong time on September 10 and subsequent dates, had been picked up by the Police, arrested and remanded to judicial custody in Tirunelveli, Vellore, and Tiruchi jails. Yesterday, they were produced before the Magistrate in Valliyoor. This is the second instance that an extension on their remand has been granted.

The arrested people that were brought to the magistrate’s court from Vellore and Tiruchi were not given food, water or allowed to answer nature’s calls throughout the trip. In the earlier instance, when they were produced before the magistrate, they had been brought in hand-cuffed. The Magistrate had taken a very serious view of this, and reminded the police of the supreme court orders on the matter. Unlike the last visit, the arrested people were allowed to meet their relatives yesterday thanks to the presence of about 6 local lawyers who complained to the Magistrate. The magistrate in turn chastised the police and invited the relatives to meet the arrested people inside the court, and hand over food and clothing.

Two disturbing events arose.
1. Thirumani a.k.a Joseph, aged 29 (as per FIR), s/o Lincoln Nadar, Village Koodankulam is a mentally challenged person. On September 10, 2012, a new Sub-Inspector (name awaited) from the Koodankulam Police Station arrested Thirumani. His arrest was not noticed by anybody. He was produced before the Nanguneri Magistrate, who is the same person that helped the police with the remand of Mugilan. In this case too, the Magistrate (name awaited) remanded the arrested person to judicial custody. When solidarity activists in Tirunelveli found out about it, they applied for bail for the young man and requested that the youngster be sent in for immediate treatment. The matter had come up for hearing on 7 October (Saturday), when the Magistrate directed that Mr. Thirumani should be moved to the Tirunelveli Government Hospital, and sought a medical opinion. Yesterday, the medical opinion confirming Mr. Thirumani’s mental state was presented to the Magistrate. The magistrate questioned the Public Prosecutor in open court as to how the Nanguneri Magistrate had been convinced to remand a visibly mentally challenged person. The magistrate told the lawyers to move a bail application immediately. To move a bail application, the sureties produced (such as property papers etc) need to be certified by the Village Administrative Officer. All 5 VAOs and Tahsildars in Perumanal, Idinthakarai and Koodankulam have been instructed to not issue any certification and have refused to do so since the time that sureties were being readied for the release of Sathish Kumar and Mugilan a few months ago. In this case too, Koodankulam VAO Mr. Suresh flatly refused to issue any certification and directed the applicants to approach the District Collectolr. The Lawyers pointed this out to the Magistrate. Considering the mental state of the arrested person, the Magistrate has issued bail on the basis of patta tax payment receipts of 2010. The bail has now been granted, but only because the Magistrate was willing to accept our case only because Thirumani is mentally challenged. For the other persons, bail applications are likely to be a problem because the VAO is unlikely to certify surety papers.

2. Mr. Udayaselvan, s/o Sudalaimani, aged 25, Koodankulam village, is in no way connected to the ongoing protests. The following narrative is a paraphrased version of his oral testimony to the Valliyoor Magistrate on 9 October, 2012. On September 10, he was returning from having picked up clothes from a tailor shop in Koodankulam town where he had given clothes for stitching for a wedding of his close relative. On his way back, he was stopped by policemen. He told them he had to go home to drop off the clothes. The same policemen who had allowed him were joined by several more by the time he happened back. Despite his protests that he had nothing to do with the protest on the beach, he was picked up by three policemen — Police Constable Pal Pandi, Police Constable Lakshmanan and Sub Inspector Anand Raj. All three policemen were reportedly part of the escort that accompanied DSP Bidari and the ADGP. Udayaselvan was dragged into the thorny bushes, and was beaten up badly. One would slap him on his face, while the other would punch him on his head, and the third would hit him on his legs. This went on until he thankfully lost consciousness. Another person, also arrested on the same day from the same location, confirms that he saw Udayaselvan being dragged by his feet and hands and loaded on to the police vehicle. According to Udayaselvan, the Sub Inspector Anand Raj was particularly vicious.  As Udayaselvan was narrating this, his mother who was present in the court fainted.

Mr. Udayaselvan said that he did not narrate these beatings on the first occasion for fear of upsetting his mother and sister. But since then (about 15 days back), he has lost all appetite and the effects of the beatings are seriously affecting his health. According to his mother, he has never appeared so weak. His request for medical attention has been granted, and the Magistrate reportedly ordered him to be relocated to the hospital immediately.

According to the person who narrated all this to me, the presence of a number of lawyers appearing on behalf of the arrested people made a big difference to counter the intimidation of the police and bring in a semblance of fairness to the proceedings.
However, even since the time when bail sureties were being readied for the release of Sathish Kumar and Mugilan two months ago, the Village Administrative
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