A brief overview of how people with mental illness have been addressed in India
India has adopted the term ‘persons with disabilities’ in line with international practice for several decades now. The first legislation on persons with disabilities was in 1995, and while the nomenclature was used, the definition of a person with disability was strictly medical model based – limited to seven impairments, and requiring a certification of having more than 40% of the impairment.
India ratified the UN Convention on the Rights of Persons with Disabilities (UNCRPD) in 2007, and began the process of drafting the Rights of Persons with Disabilities Bill to implement this. The definition of persons with disability was more in line with the CRPD definition in Article 1 of the Convention: “Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.”
India’s mental health laws are much older than the disability rights laws, and are in fact often described as colonial hangovers. The first terminology used to describe persons with psychosocial disabilities was "lunatics", and in 1987 the Mental Health Act, which is presently in force, formally defined the term "mentally ill person" to be “a person who is in need of treatment by reason of any mental disorder other than mental retardation”. Even the latest draft of the Rights of Persons with Disabilities Bill has a definition of “mental illness” to be “a substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgment, behavior, capacity to recognize reality or ability to meet the ordinary demands of life, but does not include mental retardation which is a condition of arrested or incomplete development of mind of a person, specially characterized by subnormality of intelligence.” Whereas other impairments have been defined as specific learning disabilities, locomotor disabilities, etc.
Moving away from the medical model is fairly recent. The 1980 publication International Classification of Impairments, Disabilities, and Handicaps: A manual of classification relating to the consequences of disease by the World Health Organization defined disability to be
“any limitation or function loss deriving from impairment that prevents the performance of an activity in the time-lapse considered normal for a human being”.
Psychosocial disability hasn’t quite moved away from the medical model like other impairments have, and the best example of this can be seen from the prevalence of ‘mental health laws’ all over the world. It is rare to find a legislation governing other impairments. Mental health laws are more focused on the medical treatment of the individual (often, by force) which highlight one of the problems of the medical model approach – it justifies the establishment of infrastructure and interventions to cure the impairment, and at the same time takes away from addressing other barriers which may be hindering that person’s ability to co-exist on an equal basis with others in society.
It is hoped that the community of persons with psychosocial disabilities, as well as their caregivers and family members, popularize the term through their usage. With the Government’s recent adoption of ‘Divyang’, things appear to have gone beyond medical and straight into the charity model of disability, and strong statements regarding our identity have probably never been more timely.
Amba Salelkar is a lawyer based in Chennai, with a special interest in disability law and policy.