It was in 1983 when authorities first initiated the process of formulating an updated mental health act. But 32 years later, as we enter 2016, even a draft act is yet to get the nod from the ministries concerned.
Mental health specialists say the British era’s Lunacy Act of 1912 has lost its effectiveness and appropriateness. A new act is desperately needed not only to protect people from mental illness but also to ensure comprehensive mental health services for all.
Prof Golam Rabbani, president of Bangladesh Association of Psychiatrists, said the delay was mostly because the proposed act had been at the bottom of the ministry’s priority list for all these years.
However, it was good to see the issue gain some momentum recently when the process was finally progressed from the Law Commission to the Health Ministry this July, he said.
But joint secretary (hospital) of Health Ministry, Zakia Sultana, said the raw draft still requires quite a few changes before it can be okayed.
“Still we have the raw draft in our hands. Although we met twice in this regard, but more meetings will be needed as there are several points to be modified. Soon we will arrange meetings with different stakeholders to make a final draft,” Zakia added.
However, she did not clarify about what modifications needed to be made.
A 32-year-long process
Even before work on the proposed act began, local mental health specialists – with suggestions from WHO expert Narendra Narayan – started working on a regulation to protect mental health in 1982, said Prof Rabbani.
The following year, the process of formulating a mental health act began. “We only had the Lunacy Act 1912 and Mental Health Act of England and Wales to follow. So we had to put an extra effort to make the Health Ministry aware about the importance of mental health,” he said.
A law is required to bring mental illnesses under a legal framework as it involves many debatable issues like guardianship and forced treatment, the psychiatrists association president said.
“So we are following the most recent and most modern act enacted in India. However, Pakistan has a mental health act which was not properly enacted, while Sri Lanka still has no act regarding mental health” Prof Rabbani told the Dhaka Tribune.
Monira Rahman, founder and chair of Innovation for Wellbeing Foundation, said Bangladesh still follows the Lunacy Act 1912 which considers a person with mental illness as a “lunatic” and the act tries to save the society from these “mad” people.
This shows the state’s attitude towards mental health issue, she said.
Monira added that the act was being delayed because of sensitive matters in the proposed draft, including the perspectives of rights and accountability for the professionals.
Prof Rabbani, however, said: “It [the act] will not limit their [patients and professionals] rights, rather it will see mental health from a wider perspective.”
According to Monira, there are only 200 psychiatrists, 50 clinical psychologists and less than 24 educational and counselling psychologists offering treatment in Bangladesh.
The solution to this crisis can be achieved through an overhauling of the traditional mental healthcare structure, better training for professionals, awareness raising, and better accountability, health sector specialists said.
