Of Madness and
Sadness
An Open Letter to
Prime Minister Narendra Modi
Dear Prime Minister,
An abridged version of this Open
Letter was earlier submitted by me to be published in a prominent national daily
to coincide its publication with 6th August, 2015 the day India entered
Fifteenth Year of ghastly monumental Tragedy of Erwadi in Ramanathapuram
District of Tamilnadu. The national
daily to which I had sent the piece boasts itself for right reasons as the one
which prides at “Journalism of Courage” and kept the article with the caveat,
it will wait for a news-peg to coincide with the publishing.
Months passed but the news-peg
did not arrive. Such is the Travesty of Mentally Ill in India.
With 10th October
being World Mental Health Awareness Day, excited expectantly I wrote to the
news paper, here was the biggest news-peg to publish an Op-Ed page article on
Mental Illness. I got the prompt and polite reply; pages are under severe
stress, so it is not possible to publish the article.
The young journalist who had
earlier got published two Editorial Page Articles written by me this year could
not find the Article news worthy. He is
not at fault; it is “We the Nation, People of India,” who have collectively failed
the Mentally Ill of the country.
Mr. Prime Minister I do
understand that the plight of mentally ill in a country obsessed with to eat or
not eat Beef, jungle-raj versus ram-rajya in BIMARU Bihar, a
celebrity carrying a broom in hand, a crown prince absence from Parliament, a
media-trial of a high profile murder case, news of and about Mental Illness
cannot and should not find a suitable news peg
I am also afraid, in the cacophony of
biggest electoral test in Bihar of your charisma, an Open Letter to Prime
Minister, on such a mundane topic can and will get lost to obscurity.
Nonetheless, I try, because that defines me. Also with no time to look for
another news paper, I have decided to use the social media to reach my tech-savvy
Prime Minister
I find it befitting Mr. Prime Minister that we as a nation
or its fifth estate do not care for or have time for Mentally Ill, in size their population
could be more than many European countries taken together, but these are single
biggest chunk of people about which no one cares because they are not a vote
bank. They are largely voice less.
These are the people (men, women
and children) who are branded insane, mad, Pagal, lunatic by the society and
generally kept locked inside asylums, homes, beggar homes, prisons and street
or occasionally roasted alive in chained consider, hapless unable to save their
life like what happened in the fateful wee hours in Erwadi .
Those who lose
their mind and declared so by a court in India, become non-humans and denied
all the rights of a citizen under vaunted Constitution of India, de-franchised under
Representation of Peoples Act and lose the right to hold office under more than
hundred Indian statutes. They also lose right to matrimony and property as many judicial pronouncements are testimony to it.
Those
who are not so declared non-compos-mentis by a Court but are severely mentally
ill, lead a subhuman undignified life bereft of basic human rights. Fundamental
Right is a concept which does not apply to mentally ill. In twenty first
century, the statue which governs their fate is still rooted in Lunacy Act 1858
as 1987 Act is nothing but a window dressed version of Lunacy Act, 1912 and the
later was essentially a consolidating Act of various Lunacy Laws of nineteenth century.
As the World Mental Health
Awareness Day enters India almost incognito in next three days, I go down the
memory lane and am reminded of three small stories, which could have
heralded a definitive shift to the fate of Mentally Ill in India.
Alas! It did not happen.
First was the story of 6th
August, 2010, the seminal day when I lit the first Candle at Rajghat;
unbeknownst to me on that day on my urging, thousands across different cities
of country did the same to observe “India’s First Mental Health Awareness Day
(unofficial). These were “Candles of Hope” on the day we entered tenth year of
monumental tragedy of Erwadi (in Ramanathapuram district, Tamilnadu) in which
27 chained mentally ill men, women and children were roasted alive. Today these hopes have gone with the wind. In
five years that have gone by nothing much has changed on the ground, and the
incidence and severity of mental illness in the country continues to worsen.
Second was the day towards end of
2013, when I along with others entered the temple of our democracy, the
Indian Parliament, to give deposition on world class best practices, Mental
Health Bill, 2013 before Standing Committee of Parliament for Health. The
Committee did unanimously cleared the Bill but sadly for last two years a Bill
which once enacted could have empowered Mentally Ill in many ways and de-criminalized
suicide attempt (Read Section 309 of IPC) languishes in Rajya Sabha. Such a
bi-partisan bill could have been passed by voice vote with support of all
parties. This aspirational Bill requires your urgent personal attention.
Needless to say, Shri Jagat Prakash Nadda, Union Health Minister was a Member
of the Standing Committee of Parliament which approved the Mental Health Bill,
2013. I would also like to add a bit of history of this Bill, the drafting of
the bill had gone through unique model of largest possible stakeholder
consultation (Four Regional Consultations and one National Consultation).
Third Mr. Prime Minister, memory
is also vivid of the third and most important day, that is 10th October, 2014, last World
Mental Health Awareness Day. This was the day when with lot of fanfare, your
government adopted India’s Maiden National Mental Health Policy. Also with this
policy the government had decided “365 Days Action Plan”. Three days from now would have
been the day of the action taken report on the 365 Days Action Plan. I am
painfully aware, eleven member national task force had painstakingly spent days
and months over three years (yours truly was a Member of that National Mental
Health Policy Group) to draft the policy which had come, 67 long years after
Indian Independence. Sadly, as happens with all good polices, it has met with
untimely demise and floundered at the first test of implementation bug.
Mr. Prime Minister, where do we go
from here.
“Desolation
and Despair” defines plight of mentally and is worsening fast. Incarcerated at homes, asylums, prisons and
street they live life of non-humans and sub-humans and abominable stigma keeps
them in permanent funk.
Today 10% Indians suffer from
mental illness (3% seriously so) and pandemonium lurks-WHO predicts 1 in 4 will
suffer sooner. You are their only Hope.
Let us look at some statistics
which I know a karma-veer in will take notice of-
One, Mental illness accounts for
37% of Disability Adjusted Lost Year (37%) of non-communicable-diseases (NCD)
and Harvard-World Economic Forum (2011) study puts annual direct and indirect global
economic costs of mental illness including lost productivity at $2.5 trillion.
By 2030, it will be $6 trillion, — more than cancer, diabetes, and respiratory
diseases combined. Left unattended, India will be global leader in this absurd avoidable
theatre of human suffering. And time to act was yesterday. Mentally ill and
their care givers are already tethering at bring, and any more delay will be disastrous.
Two, On30th April.
2014 your friend Barrack in “Presidential Proclamation” declaring May as
America’s Mental Health Awareness Month, succinctly described travesty of
Mental Illness. He said-“For sufferers, mental illness is “enemy within” – an assault on the self more agonizing than most physical ailments....Also
about 90 per cent of those who kill themselves also suffer from mental illness.
Suicide is a silent plague: As many people in the world die from suicide as
from homicide and warfare combined”
What an eloquent elaboration of
queen of all mind-maladies which we collectively call –“Insane, Lunatic, Pagal,
Idiot, of Unsound Mind”. Travesty is- what is true for America is truer for
India. Time is ripe for purposive,
collective and imaginative action in Mission Mode to stir the same soul-force
to change life of mentally ill, which Mahatma Gandhi used to give us
independence using non-violent means.
And there is Hope. Following simple
acts can usher in Change India needs-
One, take the ordinance route to
convert Mental Health Care Bill, 2013 to Statute now and then use bipartisan support to
get it passed in parliament in Winter session. As I said earlier union Health Minister
Mr. Nadda was in Parliamentary Standing Committee which cleared the bill
eighteen months back. It will be a game changer Bill t
Two, your government unveiled on
10th October, 2014 unveiled a futuristic National Mental Health
Policy along-with “365 Days” Action plan. Sadly both proved still born.
Initiate fast-forward sustainable modular action taking all stakeholders along.
Three, evidence suggests mental
illness affects poor, those at margin, in conflict and disaster zones more
viciously. Provide immediately free quality mental health care to this
vulnerable cohort. This will be a smart
investment in inclusive economy. This will also be national war cry to give “Dignity”
to Mentally ill at the bottom of pyramid. Dignity is the buzz world of World
Mental Health Awareness Day
Four, societal problems regarding
stigma against mental illness are nuanced and far-reaching. Only you can
turbo-charge carpet-bombing of sustained measures involving all. Awareness matters. Let the big-bang
communication start with baby-step- your “Man-Ki
-Baat” and you motivate all game changers to be part of this immediate change
which India needs. Tomorrow will be too late
Five, 90% suicides are
attributable to mental illness. WHO reveals India tops Global suicide table and
majority who lose life are youth. It is time to obliterate Section 309 of IPC from
statute-book (there has been enough talk) and decriminalize suicide. Bigger
reforms in IPC can wait, but time for barbaric Section 309 to go is now- only
India, Bangladesh and Pakistan have this in their statute book-today it is the
biggest impediment to socio-psychological-medical aid to survivors of suicide
attempts
Six, all health insurance covers
exclude mental illness coverage-statutorily force insurance parity between mental illness and physical illness.
Make this a personal prestige issue. Today Mental Illness is precluded from
cover even in policies issued by public sector insurance companies
Seven, we need more financial resource
than present lip-service, we also need to dramatically increase mental health
personnel at all levels and to convert mental
hospitals from “Home of Darkness and Death” to “Centre of Excellence”. I can
write pages on this topic, but start the reform on these fronts immediately.
All it needs is will
Lastly, declare 6th
August as National Mental Health Awareness Day and August as the Mental Health
Awareness Month in addition to October 10th as World Mental Health
Awareness Day. The month of August has
meaning for nation. Also give nation a pledge- “War against Mental Illness is a
“Hundred Year War”.
But let baby-steps start evolutionary revolution, which
country needs badly”
Mr. Modi take a cue from the
following Presidential Declaration by your friend Barrack, made on 30th
April 2014-
“I, BARACK OBAMA, President of
the United States of America, by virtue of the authority vested in me by the
Constitution and the laws of the United States, do hereby proclaim May 2014 as
National Mental Health Awareness Month. I call upon citizens, government
agencies, organizations, health care providers, and research institutions to
raise mental health awareness and continue helping Americans live longer, healthier
lives.
For sufferers, mental illness is
the “enemy within” – an assault on the self more agonizing than most physical
ailments. Moreover, according to the World Health Organization, mental
illnesses account for 38 per cent of all ill health in high-income countries.
Heart disease, stroke, cancer, lung disease and diabetes together account for
only 22 per cent in these countries. Yet, perhaps because of the stigma of mental
illnesses, health systems and employers largely ignore the severity of
these effects.
Above all, mental ill health is
today overwhelmingly the most important form of sickness affecting children and
adults of working age
That the illness are vastly
greater than those of physical illness, not to mention the life-long damage
done by mental illness in childhood. An extraordinarily high proportion of
those in prison, for example, suffer from mental illness. About 90 per cent of
those who kill themselves also suffer from mental illness. Suicide is a silent
plague: “As many people in the world die from suicide as from homicide and
warfare combined”
This is now your turn Mr. Prime
Minister. Stand out for Mentally Ill of the Country whom I call –“Mad and Sad”.
Do to India what Barrack Obama
did to USA-because you are the only hope
-Akhileshwar Sahay, Author, a
Mental Health Activist was a Member of Government of India, National Mental
Health Policy Group
