People with mental ailments have been subjected to discrimination throughout history. A clear example of this embedded prejudice is institutional apathy. Systemic measures implemented by the State can, in effect, reinforce social stigma against those battling mental illnesses. For instance, the asylums of 18th-century Britain served as penal centres owing to the then perception that those suffering from mental disorders are criminals. Even advancements in medical sciences, which led to the changes in terminology over the years — the colonial ‘lunatic asylum’ transitioned to ‘mental hospital’ and, eventually, to today’s ‘mental healthcare institution’ — have failed to root out the deeper biases against patients. A classic manifestation of this is the neglect of the mentally ill inside India’s psychiatric institutions. In fact, a 1982 report on the Central Institute of Psychiatry, Ranchi, had revealed shocking human rights violations committed against the inmates — patients were denied basic facilities, offered badly cooked meals, and were made to inhabit poorly ventilated and ill-lit cells and so on. Dishearteningly, not a lot seems to have changed. Recent findings by the National Human Rights Commission show that the old malaises remain intact. According to the NHRC, all 46 government mental healthcare institutions in the country present an ambience that is expressly inimical to the well-being and the dignity of inmates. This is just the tip of the iceberg. The ratio of mental healthcare professionals to citizens is very poor. The staff in care institutions often lack basic training, leading to ill-treatment of patients. The scope of societal rehabilitation is limited as a result of persistent stigma. As a result, even those who are medically fit to be released from care facilities end up leading incarcerated lives. A National Mental Health Survey conducted four years before the pandemic had revealed that almost 80% of Indians with mental disorders had no access to care. This is only to be expected in a country which, according to one survey, has 0.8 psychiatric hospital beds per 100,000 people.

All this is especially alarming in the light of the fact that India, experts believe, is expected to face an avalanche of mental ailments in the near future. Yet, the implementation of the provisions of the Mental Healthcare Act, 2017 has not been uniform across states. Budgetary allocation for mental health remains abysmal — of the meagre 0.8% spent on mental healthcare, only 3% is allocated for mental institutions. Will the upcoming budget rectify this glaring gap?