Are You Well In Body And Mind?

October 10th is World Mental Health Day. While this day has been so designated to promote awareness of mental illnesses there is no proper understanding amongst us about this kind of illnesses. There is certain indifference that this is a problem of the western countries. Mr.P.K.Kuruvilla, a psychiatrist from Kerala wrote in the Indian Express commenting on the problem of mental health as follows:

“The serendipitous discovery of modern psychopharmacological medicines in 1950s and 1960s ushered in new hopes for effective care and better outcome of mental disorders.  Egged on by all these, investigators in institutes in India undertook meticulous studies and proved that major psychiatric illness is as much prevalent at home as elsewhere although culture determines the manifestation.  Previously held misconceptions were thus dispelled.  Just to illustrate this point, the prevalence of Schizophrenia is 3 per every thousand. An average town of one lakh would have 300 of those smitten by this malady.  Imagine this on a national scale! Mind boggling, isn’t it? Now add to this, the number of those with other psychiatric diseases”.

Going in search of places like Erwadi(1) and Gunaseelam(2) or slapping the stigma of a madcap on those who happen to consult psychological experts – only these are practical realities  (1) - (erwadi, considered a holy place by the muslims, is a place where people from various parts of the country irrespective of their religion, bring the mentally-challenged in the belief that the dharga situated here can cure the illness  On 6th August, 2001, the hutments in which 43 people were housed, chained to their beds, caught fire. 11 women and 14 men died when the fire broke out early in the morning. 3 persons died later in the hospital), (2)-(The name of the place Gunaseelam derives from "Gunam" (meaning cure) and "Seelam" (meaning place), meaning the place in which illness is cured)  There was a cruel incident with a view to ridding Kanyakumari of beggars, the District Collector had them deported and got them admitted in the Institute of  Mental Health at Chennai in 2008 (A division bench of the high court took exception to admitting 115 persons being certified by the doctors  at a stroke that all of them suffer from bi-polar disorder and on the orders of the local magistrate all 115 persons were brought to Chennai and were admitted in the Institute of Mental Health, Kilpauk, Chennai for further treatment. ...).  We are not in a position to enquire about anyone’s mental illness mental health. “Are you well in body and mind?” is a question reserved only for Thillaanaa Mohanambals of Tamil films.

The “Indian Lunacy Act” brought in force by the colonial administration in 1912 was annulled and the Parliament enacted the Mental Health Act in 1987. This act stipulated that only a medical board including a psychiatrist would have the authority to determine who is a person with mental illness. The certificate issued by this medical board is final. While there are different kinds of psychological problems, the act stipulates that only a person afflicted by mental illness which is incurable alone can be declared a mentally ill person.

A woman by name Thamizharasi, who was working in an ‘anganwadi’ in a village in Thoothukudi District (T.N), was removed from service on the orders of the District Collector. This post-graduate used to provide teaching assistance to the poor children during her spare time. Because of some misunderstanding between her and the District Planning Officer, she was suspended on a plea that she was suffering from ‘schizophrenia’ and was also later removed from service on the basis of a certificate of a doctor with no legal authority.

While dealing with a petition filed by her the High Court sought clarification from the Head of the Department of Mental Health in the Government Rajaji Hospital in Madurai. She was kept under observation as an impatient for four weeks. After the examination, the concerned Department Head certified that she was not suffering from any serious ailment which could make her ineligible to be in employment and that with proper medicines she could work as any other normal person.

On the World Mental Health Day in 2007, Madras High Court delivered an important judgement. It condemned the government’s action to remove Thamizharasi from service without any basis or proper enquiry. It also ordered that she be taken back to service with full back-pay. It also slapped a fine of rupees five thousand on the District Collector for his total lack of awareness of mental illness.

If a government employee faces mental disability which would make it difficult for continued productive employment, the government cannot remove the employee from service. Because under Section 47 of the 1995 Persons with Disabilities Act, there is a bar on removing or dismissing an employee with mental disability. This was also pointed out for the first time in this judgement.