Health is a state of complete “physical, mental, and social well-being” and not merely the absence of disease or infirmity.] Right to health has been recognized as a fundamental right The right to health includes availability, accessibility, acceptability, and quality, being the interrelated elements. Inclusion of “mental health” in the broad concept of “health” speaks volumes of its significance. Mental health problems range from psychosocial distress to mental illness and mental disorder.
Social care is a sensitive area, so legislation is absolutely crucial to keep those in need of care safe and protected. This is particularly important when working with vulnerable individuals as they may be at risk of being exploited or not having their voices heard.
One of the key pieces of legislation within the UK is the Health and Social Care Act 2012. There are also regulatory bodies throughout the UK, overseeing the provision of care services. These regulatory bodies check social care services and ensure that national standards are being met.
The interface of policy and legislation is crucial in making quality mental health care accessible in an effective manner. Shortage of psychiatrists and other mental health personnel pose a huge challenge in delivering mental health care. The social context is instrumental in subjecting the mentally ill to human rights violations and discriminations with low awareness, denial, and the prevailing social perception of mental illness .
The enormity of problem requires a multipronged approach supported by a robust policy with specific achievable goals. Mental health policy relies on the legal framework to achieve its goals, and ameliorate the lives of persons with mental disorders. Policy and legislation are two complementary approaches for improving mental health care and services. International developments in mental health care have brought a paradigm shift from “charity-” to “rights-” based approach.
There are various mental health concerns that need urgent attention. Exclusion, stigma, exploitation, discrimination, and human rights violations are associated with mental illness and need to be dealt with effectively by providing effective mental health services and efficacious laws. As per estimates, 150 million people require mental health care, both short term and long term. There is an urgent need of galvanized efforts in this regard keeping in view the expansive impact of mental health in all aspects of life, cutting across age, gender, and residence. The “Mental Health Survey 2015–2016” has reported that 15% of individuals above 18 years are suffering from mental disorder that requires active intervention.
The enormity of problem necessitates strategic, integrated, and holistic policy as well as effective legislation for addressing the current mental health issues prevailing in our country and also prioritizes mental health in the developmental agenda. There appear to be two different but closely related issues – one is the care and health aspect and the other is protection of various rights, including the civil and political rights of the mentally ill person. While the psychiatrist is concerned primarily with the diagnosis of mental disorders and the welfare of the patient, the court is often mainly concerned with determination of competency, dangerousness, diminished responsibility, and/or the welfare of society and also with providing legal protection for violation of the rights of mentally ill persons.
From the legal perspective, it is important to balance individual interest with the larger public interest. A person suffering from mental illness, depending upon the severity in terms of harm to oneself and to others, is of crucial concern from the legal perspective. However, the primary concern of the medical fraternity has to be undeniably toward the medical wellness of the person affected by mental health issues, and all those people associated with the care and treatment of the person concerned. Legal capacity of a person with mental illness has been recognized in different contexts with the overriding aim of protecting their interests considering their vulnerable state of mind. The susceptibility of mentally ill persons to neglect, discrimination, violence, and abuse makes it imperative for a protective mechanism to be in place.
Mental health policy development is long overdue in many countries, but it is increasingly gaining the attention of governments. This is partly through a growing realization of the economic and social burden of mental disorder and the significant contribution of mental health to physical disability, partly because of the impetus within the mental health field from professionals, service users, and their families and partly because of the acknowledged illogicality of conducting health sector reforms without inclusion of mental health. Governments wishing to protect and improve the general health of their populations need to consider policies that have both direct and indirect influences on mental health.