People still receive a raw deal

Mental Health Act crucial for autistic children to live normally
Photo: ActionAid
Bangladesh team
Deputy Manager, Identity and Resource Mobilization

Bangladesh is a signatory to ‘United Nations Convention on the Rights of Persons with Disabilities’, which formally recognises the rights of people with all types of disabilities. The ratification of the protocol by the then ruling party in 2008 has brought the State under the obligation of safeguarding the rights of those who suffer from either physical or mental retardation.

However, the dignified life is still a far cry for this marginalised group of people in Bangladesh. Frequent media reports on humiliation of physically challenged or mentally ill persons only prove government’s utter indifference to the issue. Over the last couple of years, neither of the two major political parties, both of whom claim to represent society in its entirety, have taken any steps to change the situation.

According to the World Health Organization, 16% of the total adult population (0.88 million people) in the country suffers from amental disorder, a major portion of whom are deprived of access to appropriate services as we speak.

ActionAid and other humanitarian organisations working here have long been advocating the issue with a set of demands, including declaration of a comprehensive health policy emphasising mental health, increasing allocation for psychotropic medication in the health budget and enacting new laws besides amendments of existing ones.

According to a WHO report, the percentage of money spent on mental health services by the government health department is less than 0.5% of total health care expenditures. As much as 67 percent of this meagre amount is devoted to one lone mental hospital.

“The National Health Policy of Bangladesh 2010 reiterates the state’s responsibility and obligations under the Constitution but in none of its 15 aims the issue of mental health has been addressed,” said Khandakar Jahurul Alam, Chairman of National Forum of Organisations Working for the people with Disabilities (NFOWD). 

The only law that talks about people who need psychological attention is the ancient Lunacy Act that came to life in 1912.

It is a great disgrace for the whole nation that till date we are recognising mentally ill people as lunatic or insane, disrespecting them as a human

Jahurul Alam lamented. He added that this law in no place ensures the rights of mentally ill people rather it considers them as burdens of society.

“Access to land and property is of utmost importance among the rights for a person with disability to obviate his dependency or his descendents on others. And we have been pursuing the government to incorporate a clause in the upcoming Mental Health Act,” Jahurul Alam noted.

“We need an immediate transformation in the stereotyped mindset of people to evoke a minimum level of sensitivity on how to behave with mentally ill people, how to improve family care and what treatment should be in the community that would be benefitting,” said Badrul Mannan, general secretary of Welfare Society for Mental Health & Rehabilitation.    

Looking at the subcontinent, India replaced the Lunacy Act of 1912 with the Mental Health Act of 1987. In 2001, the Pakistan Mental Health Ordinance came into being which repealed this 1912 Act. These laws discarded terms like ‘lunatic’ and provided more comprehensive set of definitions.

The Lunacy Act, 1912 had far-reaching consequences and impact on the whole system of present mental-health services. Unlike other areas of healthcare, our procedures and systems in the area of mental health continue to be governed by antiquated procedures and rules.

We, the human rights community, hope the government of Bangladesh will look at their neighbouring countries, like India and Pakistan, who are working sincerely to bring tangible change in the scenario of mental health. In India the replacement of the Lunacy Act by the Mental Health Act has brought all mental hospitals under central supervision – a fundamental change in the management. These hospitals were thus removed from the grip of the Inspector General of Prisons.

According to experts, there is little hope for patients in a custodial environment that breeds isolation and exclusion. The patients are deprived of the scope to acquire any skills for daily living and improving on social interaction. There is no counselling to prepare patients for adjustment problems, relapses, re-admission or abandonment. It is needless to emphasise how urgent the changes in the Lunacy Act are in Bangladesh.

As an immediate effort, the government should take necessary measures to raise awareness on mental health issue among people. The only initiative of officially observing World Mental Health Day and conducting dominant discourses on mental illness by the Ministry of Health and other concerned authorities is not sufficient to break the wall of our prejudice-ridden mindset. We expect that the government will realise the importance of the issue and enact the long-awaited Mental Health Act repealing the Lunacy Act immediately and following the principles of the UNCRPD.

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