Centre for Mental Health Law and Policy, Pune
CMHLP views mental health legislation as a tool to achieve the goal of a mental health policy that is in keeping with the UN Convention on the Rights of Persons with Disabilities (UNCRPD), of which India is a ratified member. One of the aims of the UNCRPD is to protect and promote the rights of people with disabilities in all policies and programmes, and to adopt legislative practices that are non-discriminatory. An increasing number of countries are undertaking reform of their mental health services and mental health laws. In this context, CMHLP hopes to provide valuable national and international assistance to countries in West, South East and East Asia – that lack such centres, for the most part – in developing and implementing their mental health policies and legislation. The Centre, part of the Indian Law Society, is based in Pune.
CMHLP’s aims include: advocacy for a mental health policy and legislation which protect and promote the rights of persons with mental disorders; promoting a rights-based approach to mental health policy and legislation; research in these areas; sensitizing service providers and stakeholders, including the general public, to the rights of persons with mental disorders.
These several aims drive the Centre’s activities. A major activity is the designing and conducting of long-term diploma and masters courses as well as short-term certificate courses. Its flagship course is an International Diploma in Mental Health Law and Human Rights, while short-term courses for the different target audiences are planned – for instance, for the judiciary, police officers, bureaucrats, international agencies, and governmental as well as non-governmental organizations.
Other activities of CMHLP include legal aid and advice related to mental health; technical assistance, nationally and internationally, to judiciary, international agencies, institutions and governments; a resource library with articles and books related to mental health policy and legislation; research projects in the field of mental health policy and legislation; workshops for target audiences.
Projects with MHI
The Atmiyata project is funded by Mariwala Health Initiative and by Grand Challenges Canada. It is a community-led mental health innovation that complements the public healthcare system by integrating professionals working at the community, primary and tertiary care levels.
Atmiyata is both a preventative and a curative model of mental health intervention. The approach combines mental health care with psychosocial recovery. It works through developing the capacity of community volunteers to provide primary support and counselling to persons with common mental disorders. Community volunteers also help people with mental health issues to access social benefits.
Capacity building and creating community awareness are done using a digital approach. Each community volunteer is provided a smartphone on which videos relevant to mental health are uploaded. These videos help train volunteers as mobilizers to promote well-being, detect cases of mental illness and apply referral and follow-up techniques, guided by the core values of community mental health.
The project aims to reduce the treatment gap for mental health disorders – particularly in rural India, improve mental health outcomes, enhance quality of life, reduce disability for people with common mental health issues, and increase community awareness of these issues. The Atmiyata project is being implemented in 500 villages in Mehsana district of Gujarat, from April 2017 to March 2019.
Capacity Building Program on the Mental Health Act, 2017
The Mental Health Act (MHA), 2017, repealed the old MHA of 1987, signalling a paradigm change by bringing in a rights-based approach to the treatment and care of persons with mental illness.
The new MHA, which has been in force since January 2018, recognizes the rights of all persons to access mental healthcare provided by the appropriate government and, in particular, the capacity of all persons with mental illness to make decisions regarding their treatment (subject to the provisions of the Act). It also prescribes the duties and responsibilities of mental health professionals, service providers and users, caregivers, government authorities. It codifies concepts such as “capacity”, “informed consent”, “nominated representative”, and lays down procedures involving different authorities. Many of these concepts and processes are new to the various stakeholders, which has created a demand for capacity building initiatives on the intricacies of the MHA, and its implementation in different contexts.
CMHLP’s Capacity Building Program on the MHA proposes to meet this felt need through training programs and modules, reference guide – including a Code of Practice publication, and a mobile app for stakeholders. The app will be contextualized to local areas, carrying information regarding the authorities set up under the Act, and details regarding mental health establishments and mental health professionals. The app would also contain an easy reference guide to the MHA.
The Centre has been at the forefront of the drafting and enactment of the MHA, with its Director, Dr Soumitra Pathare, as lead draftsperson. Additionally, researchers contributing to the Centre’s activities have academic and professional experience in the areas of law, mental health and human rights. Thus the Centre is particularly equipped to design and carry out this Program.
Contact and Safety Planning Project (CASP)
CMHLP’s Contact and Safety Planning (CASP) project is funded by the Mariwala Health Initiative. It will be implemented in Balod and Rajnandgaon districts of Chhattisgarh, the state that has the second-highest rate of suicide in the country. The project aims to reduce repeat suicide attempts through contact safety planning intervention delivered by the public health system and generate evidence for scaling up. Contact and Safety Planning (CASP) is an evidence-based technique which involves period visits (“Contact”) to individuals at risk for suicide and the provision of safety planning cards (“Safety Planning”), which uses WHO’s recommended Brief intervention and contact (BIC) technique.
The project works through building the capacities of emergency ward nurses and community health officers (CHOs) to deliver CASP interventions to individuals who have attempted suicide in district and sub-district hospitals. Post discharge, trained CHOs follow-up with participants and their families at regular intervals. The study will aim to identify the feasibility of implementing CASP in the public health system, its acceptability to all stakeholders and the enablers and barriers to scaling up CASP across all districts in the state.
The project aims to reduce treatment gaps by training existing community health workers, understanding challenges and generating evidence for the possible integration of this model in other existing health care systems.
To know more about CMHLP, click here.