Thousands of people who have been cured of mental illness are being “illegally detained” in 43 mental hospitals across 24 states as only two states have constituted mental health review boards (MHRB). These are meant to review all cases of people who have been held in an institution for 30 days. According to the report of a Task Force constituted by the health ministry, over 36% of patients in mental hospitals have been there for one year or more.

Advocate Gaurav Kumar Bansal , who has filed a public interest petition on the issue in the Supreme Court, pointed out that ever since the Mental Healthcare Act of 2017 was enacted, the state is supposed to provide services that will help integrate those who come out of these hospitals in society. “Holding them indefinitely in the hospital amounts to illegal detention,” said Bansal seeking the court’s intervention to ‘free’ these patients and order states to provide them services to help integrate them in society.

In February 2017, the Supreme Court had told the central government that it could not allow people to be kept in mental asylums or nursing homes after they are fully cured. “They have to be brought back to civil society. You will have to frame a policy,” said the bench. The government had sought time to frame guidelines for the rehabilitation of mentally ill persons.

However, during the hearing of the current petition the court was informed that despite the centre sending more than half a dozen reminders to the states, only two states (Sikkim and Tripura ) have functional mental health review boards. Most haven’t framed regulations for the implementation of the Act and only 10 have notified State Mental Health Authorities and appointed all the members to complete the authority. Several are in the process of doing so.

“The Act was passed in May 2017, but it was notified only in 2018 to give governments time to set up structures. It is two and a half years since the Act came into force and there is no sign of anything happening. If MHRBs, which mandatorily include civil society, a person with mental illness and/or caregivers, had been constituted, they would have insisted on community rehabilitation plans for the patients who didn’t need hospitalization. Under what provision are thousands of patients being kept in hospitals? For all practical purposes, they are being illegally detained and it is a civil rights issue,” said a senior psychiatrist involved in rehabilitation of persons with mental illness.

Since the Task Force report was submitted in 2018, 191 people have been moved out from hospitals, said Vandana Gopikumar of Banyan, an organisation that works on supporting persons with mental illness. Banyan was also part of the task force. “Kerala, Andhra Pradesh and Uttarakhand have started the process of putting community-based support structures in place. However, Maharashtra , instead of moving them out to an inclusive set up, put them in beggars’ homes, which is worse. We don’t want such knee-jerk reactions and surface-level response. We need district-level mental health programmes which can give them ongoing care and track their progress,” said Gopikumar. She added that all the support services would be less expensive than keeping them in hospitals. It also frees up hospital space for those who need it.

