Mental health is a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community. It has intrinsic and instrumental value and is integral to our well-being.
– World Health Organization
Mental health is increasingly acknowledged as a growing priority for public health and development, contributing to 13% of the global burden of disease1 and 37% of healthy years lost due to ill health.Despite this recognition and the availability of effective evidence-based interventions, people with mental illness in low- and medium-income countries do not receive necessary care. Of the estimated 150 million Indian citizens with mental health concerns, 60% of people living with schizophrenia do not receive the care they need.
According to the National Mental Health Survey 2016, the overall treatment gap in India is estimated to be as high as 83%. Further, people with mental illness are excluded from meaningful participation in work, family and community, and face widespread discrimination and abuses of their human rights. Within this broader context of social exclusion, a profound and significant form of oppression facing people with mental illness is long-term institutionalisation in tertiary psychiatric facilities and rehabilitation homes. Modern psychiatric facilities, while varied in their quality of care and rights-based orientation, are remnants of the asylum model of mental health care, and some continue to be characterised by paternalism and restrictive practices.
Irrespective of the quality of care at such hospitals, the institutionalisation of people with mental illness over extended periods perpetrates segregation and their exclusion, distancing them from socio-economic, cultural and political resources and the right to live with dignity.
