As the world gears up to observe Human Rights Day on 10 December, commemorating the adoption of the Universal Declaration of Human Rights, the moment demands more than just a ceremonial nod to freedom and dignity. It compels us to confront the stark human rights crisis festering within the very heart of our society, a crisis often hidden in plain sight: the profound neglect and suffering of persons with mental illness in India. We count our dogs, meticulously track the numbers of our tigers and elephants for conservation and policy, yet there remains no reliable, national enumeration of the thousands of mentally challenged individuals abandoned, destitute and left to wander the streets and byways of our cities and villages. This glaring absence on our census sheets is a chilling testament to the systemic devaluation and dehumanisation of a segment of the population whose basic rights, like the right to health, dignity and life itself, are routinely violated.
The pervasive stigma associated with mental illness remains the primary, unyielding barrier. Across India, mental suffering is often wrongly perceived as a personal failing, a spiritual deficiency or a character weakness, rather than a medical condition. This societal judgment often leads to the isolation and abandonment of individuals by their own families, who are crippled by shame and a lack of resources.
In recognition of India’s obligation under the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), the country enacted the progressive Mental Healthcare Act (MHCA) of 2017. This landmark legislation marked a significant shift from a custodial approach to a rights-based approach to mental health. The Act’s core philosophy is to protect, promote and fulfil the rights of persons with mental illness during the delivery of mental healthcare and services. Furthermore, the MHCA 2017 decriminalised the Attempt to Commit Suicide, presuming the individual to be under severe stress and requiring treatment rather than investigation or prosecution. It also details the Right to Protection from Cruel, Inhuman and Degrading Treatment, prohibiting practices like compulsory tonsuring, chaining and forced isolation, while also ensuring rights like informed consent, confidentiality and free legal aid.
While the legal framework exists, the gap between the law’s lofty intent and its grim reality remains vast. The government has attempted to bridge this gap through initiatives like the National Mental Health Programme (NMHP), launched in 1982 and subsequently re-strategised to expand community-based care through the District Mental Health Programme (DMHP). More recently, the launch of Tele Mental Health Assistance and Networking Across States (Tele MANAS) in 2022 offers a promising digital lifeline, providing 24/7 free mental health support through a national toll-free helpline. These programmes, alongside the integration of mental healthcare into primary health services under the Ayushman Bharat Health and Wellness Centres, demonstrate a clear, policy-level acknowledgement of the crisis. However, the Achilles’ heel of these initiatives is the cripplingly low budgetary allocation for mental health, which is a fraction of what is spent in developed nations, compounded by a severe shortage of qualified mental health professionals like psychiatrists, clinical psychologists, and social workers.
The lack of a simple census for this most vulnerable group means their needs are not quantified, not budgeted for and not addressed in a meaningful, targeted way. They are statistically invisible and therefore, politically irrelevant.
India must treat the human rights of its mentally ill population as a national emergency, not a niche social welfare concern. A national-level, urgent census of the destitute mentally ill on our streets must be mandated and executed to ensure that every forgotten soul is counted, rescued and provided the dignified care they are legally and morally entitled to.
The writer is a former college principal and founder of Supporting Shoulders, an NGO.