But 14 years down the line the ministry has not progressed in terms of formulating the legislation, instead several attempts to develop the law have failed. [break]
“There is no separate law,” says Dr Kapil Dev Upadhyaya, former director of Mental Hospital, Patan. “The existing laws and regulations regarding mental health problems are scattered, inadequate, outdated and discriminatory.”
Two years ago a woman from Ramechhap district who was having episodic mental illness was brought to mental hospital in Patan. A teacher by profession, she was there with her husband for treatment. But her husband disappeared after admitting her at the hospital. She was completely cured after a month. There the hospital had problem on sending her back to her home due to the lack of legal provision on what should be done to such patients. The government’s only national level mental hospital sees problem like this often.
Though there are some legal provisions, they do not correctly address the problem. The marriage section four and five of the Muluki Ain (penal code) says that complete insanity is a condition for man to remarry but similar right is not accorded to women.
Similarly, section six of the Ain says that “insane people” should be kept in hospital or in jail for treatment till they are completely cured. Jails do not have treatment facility for such clients. “Mental patients can be cured and they can return back to normal life.” Dr Upadhyaya said, “If they are denied treatment, how patient in jail can be treated?”
Likewise, the law should speak if or if not the property of mentally ill people can be used for their treatment and there should be clear law to certify the mental status of people if in case somebody wants a proof, he said. “There should be law to deal with stigma and discrimination against the mentally ill.”
Upadhyaya says there is necessity of legal framework to protect the rights of mentally ill and to define the responsibility of the government, family and the community.
“But we haven’t yet received any such legal framework,” says Babu Kaji Baniya, legal officer at the health ministry.
According to Dr Upadhyaya there was a national-level gathering of psychiatrists in 1992, which recommended forming a legislation – National Mental Health Act – that would ensure the rights of the mentally ill and ensure their care.
Also in 1994 a seven-member committee was formed with consultant psychiatrist of the Mental Hospital as chairperson and advocate, representative from ministry of health, law commission, institute of medicine and Ministry of Law Justice as members, to draft a mental health legislation.
Likewise, in 2007 also, on the initiation of the Mental Hospital, the World Health Organization extended support for drafting the mental health legislation. After rounds of national level consultations, the proposed draft was submitted to the Ministry of Health. “We submitted another draft,” said Dr Upadhyaya. “But there has been no response till date.”
The national policy says the prevalence of mental illness in the communities of Nepal as well as in other countries is about 20 percent of the general populations at any point of time. At any time at least two percent will be suffering from severe and treatable forms of psychiatric illness. Studies on patients coming to primary health care services under the government health system show that 20 to 30 percent of all adult patients, while often reporting only somatic symptoms, show psychiatric morbidity.
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