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Stigma, inclusion and India’s Mental Healthcare Act 2017

Richard M. Duffy (Trinity College Dublin, Dublin, Ireland)
Gautam Gulati (University of Limerick, Limerick, Ireland)
Niket Kasar (KEM Hospital Research Centre, Pune, India)
Vasudeo Paralikar (KEM Hospital Research Centre, Pune, India)
Choudhary Laxmi Narayan (AN Magadh Medical College, Gaya, India)
Avinash Desousa (Lokmanya Tilak Municipal General Hospital and Medical College, Mumbai, India)
Nishant Goyal (Central Institute of Psychiatry, Ranchi, India)
Brendan D. Kelly (Trinity College Dublin, Dublin, Ireland)

Journal of Public Mental Health

ISSN: 1746-5729

Article publication date: 14 June 2019

Issue publication date: 13 September 2019

541

Abstract

Purpose

India’s Mental Healthcare Act 2017 provides a right to mental healthcare, revises admission and review procedures, effectively decriminalises suicide and has strong non-discrimination measures, among other provisions. The purpose of this paper is to examine Indian mental health professionals’ views of these changes as they relate to stigma and inclusion of the mentally ill.

Design/methodology/approach

The authors held nine focus groups in three Indian states, involving 61 mental health professionals including 56 psychiatrists.

Findings

Several themes relating to stigma and inclusion emerged: stigma is ubiquitous and results in social exclusion; stigma might be increased rather than remedied by certain regulations in the 2017 Act; stigma is not adequately dealt with in the legislation; stigma might discourage people from making “advance directives”; and there is a crucial relationship between stigma and education.

Practical implications

Implementation of India’s 2017 Act needs to be accompanied by adequate service resourcing and extensive education, including public education. This has commenced but needs substantial resources in order to fulfil the Act’s potential.

Social implications

India’s mental health legislation governs the mental healthcare of 1.3bn people, one sixth of the planet’s population; seeking to use law to diminish stigma and enhance inclusion in such a large country sets a strong example for other nations.

Originality/value

This is the first study of stigma and inclusion since India’s 2017 Act was commenced and it highlights both the potential and the challenges of such ambitious rights-based legislation.

Keywords

Acknowledgements

Conflicts of interest: there are no potential conflicts of interest. Research funding: no funding was received for this project.

Citation

Duffy, R.M., Gulati, G., Kasar, N., Paralikar, V., Narayan, C.L., Desousa, A., Goyal, N. and Kelly, B.D. (2019), "Stigma, inclusion and India’s Mental Healthcare Act 2017", Journal of Public Mental Health, Vol. 18 No. 3, pp. 199-205. https://doi.org/10.1108/JPMH-02-2019-0021

Publisher

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Emerald Publishing Limited

Copyright © 2019, Emerald Publishing Limited

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