The Supreme Court sought response from the Centre and the Insurance Regulatory Development Authority of India (IRDAI) on a plea alleging violation of provisions of mental health law, which deals with right to equality and non-discrimination.

A bench of Justices R.F. Nariman, Navin Sinha and B.R. Gavai issued notice on the plea and sought their responses.

During the hearing, advocate Gaurav Kumar Bansal, appearing as petitioner in-person, said that Section 21(4) of Mental Health Care Act 2017 provides for inclusion of mental illness in insurance policies but till date because of the red tape attitude of IRDAI, the provision has not been complied with. 

He said the failure of IRDAI in not regulating insurance companies to implement section 21(4) of Mental Health Act 2017, is creating a lot of hardship to mentally ill persons.

“That one of the right which Act provides is that insurer is directed to not to discriminate with Person with Mental Illness (PMI) only on the basis of mental illness and as such is further mandated by the Parliament of India to treat Persons with Mental illness alike others as far as medical insurance is concerned,” the plea said.

Mental Health Care Act

The Mental Health Care Act, 2017 was passed on April 7, 2017 and came into force on July 7, 2018. The law was described in its opening paragraph as “An Act to provide for mental health care and services for persons with mental illness and to protect, promote and fulfill the rights of such persons during delivery of mental health care and services and for matters connected therewith or incidental thereto.” 

This Act superseded the previously existing Mental Health Act, 1987 that was passed on May 22, 1987.

According to the Mental Health Care Act, 2017, every person with mental illness shall be treated as equal to persons with physical illness in the provision of all health care.

Also, attempts to commit suicide by a mentally ill person will not be punishable under the law. The Act also prohibits the use of electroconvulsive therapy, referred to as “shock therapy”, without the use of muscle relaxants and anesthesia on a patient suffering from mental illness.

Besides this, such patients cannot be chained in any manner as per the Act.

IRDAI issued order in 2018 

Insurance Regulatory and Development Authority of India (IRDAI) has directed all the insurance companies to make a provision to cover mental illness also in insurance policies.

“As per Sec 21(4) of the said Act, every insurer shall make provision for medical insurance for treatment of mental illness on the same basis as is available for treatment of physical illness,” IRDA said in its order.

The Act says that every insurer shall make provision for medical insurance for treatment of mental illness on the same basis as is available for treatment of physical illness.

National Mental Health Programme

The government launched the National Mental Health Programme (NMHP) in 1982, keeping in view the heavy burden of mental illness in the community, and the absolute inadequacy of mental health care infrastructure in the country to deal with it.

The district Mental Health Programme was added in 1996. The programme was re-strategised in 2003 to include two schemes — Modernization of State Mental Hospitals and Up-gradation of Psychiatric Wings of Medical Colleges/General Hospitals. The manpower development scheme became part of the programme in 2009.

Three main components of NMHP are treatment of mentally ill, rehabilitation and prevention and promotion of positive mental health.

The government is supporting implementation of the District Mental Health Programme (DMHP) in 517 districts of the country for detection, management and treatment of mental disorders/illness. 

At the district level, funds are provided to each district under the DMHP for sensitisation training of community health workers and elected representatives of community at district hospital/community health centre for awareness generation regarding early signs and community health seeking behavior for mental illness. 

Further, the Mental Health Care Act, 2017 says that the government shall take all measures to ensure that the government officials including police officers and other officers are given periodic sensitisation and awareness training.

According to a statement, there are 40 state-run mental health institutions in the country. Also, three central mental health institutions — National Institute of Mental Health and Neuro Sciences, Bengaluru, Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur and Central Institute of Psychiatry, Ranchi have been strengthened for augmenting the human resources in the areas of mental health and to provide quality mental health services in the country.

Further, with a view to increase the number of qualified mental health professionals in the country, the government, under the NMHP, is implementing manpower development schemes for establishment of Centres of Excellence and strengthening/establishment of post graduate  departments in mental health specialties.

The ministry of health and family welfare regularly reviews and monitors the functioning of the three central mental health institutions and the institutions supported under manpower development schemes of NMHP.

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