- India’s Mental Health Care Act is a significant victory in the battle against the stigmatization of mental health.
- But its improper enforcement reduces its effectiveness in protecting the rights of people with mental illness.
Recently, a review of the living conditions for mentally ill inmates in psychiatric hospitals in India has uncovered a disturbing reality. These individuals are living in neglected conditions, deprived of their basic human rights, and often held against their will.
Similarly, an inquiry into the lives of people with mental health conditions who are incarcerated has also revealed a crisis in mental health care. Despite India’s Mental Health Care Act (MHCA) being in place, experts warn that the mental health landscape of the country is in peril.
India’s Mental Health Care Act (MHCA)
The 2017 Mental Health Care Act in India represents a significant step toward recognizing the importance of mental health in India and ensuring that people with mental illness receive appropriate care.
Aiming to provide a legal framework for the rights of people with mental illness, it prioritizes access to mental healthcare and treatment for all, with a focus on community-based care.
It guarantees patients’ rights to confidentiality, privacy, and informed consent. Its novelty lies in decriminalizing attempted suicide and indiscriminate use of treatment options like electro-convulsive therapy (ECT).
The MHCA is also the first one of its kind to promise psychoeducation, destigmatization of mental health through public discourse and awareness, and set standards for mental health professionals (MHPs) and facilities providing mental health services.
However, due to a lack of psychiatric infrastructure and official enforcement, the provisions of the act are not properly enforced.
Self-disclosure And Patient Privacy In Mental Health Care
Self-disclosure in the mental health domain comprises disability disclosure and coming out with a mental illness in a therapeutic session. People with mental health conditions are encouraged to speak openly and honestly about their mental distress with their therapists or loved ones.
Disclosing information about oneself, receiving feedback from a medical practitioner, and working to improve oneself is the recommended course of action when it comes to mental health treatment and recovery.
Nonetheless, mental illness and self-disclosure do not always work well. Mental illness affects sociability and the ability to communicate openly. Coupled with the stigma around mental healthcare, many have trouble disclosing negative personal experiences or mental health struggles.
Many people cope with perceived stigma by withholding their illness and disability. In fact, people with introverted personalities, social anxiety, or eating disorders—even those who live in communities—have difficulty self-disclosing for social support.
Provisions for patients’ rights and dignity in the MHCA
The MHCA is designed to promote the rights and dignity of patients with mental illness and ensure that they receive timely, proper, and respectful care. The rights enshrined include the right to access mental health care and treatment from government-funded services.
Patients also have the right to access their medical records and be informed about their diagnosis, treatment options, and care. They have the right to refuse treatment or give consent, and their decision must be respected unless they lack capacity.
The confidentiality and privacy of mental health information and treatment are also protected under the act. Patients must be treated with dignity, respect, and without discrimination, with reasonable accommodations made for disabilities related to mental illness.
They can seek a second opinion and file complaints if needed. Additionally, patients have the right to access legal services to protect their interests and rights.
Threats To Privacy In Mental Health Care
While privacy is a critical aspect of mental health care, several threats can compromise patient confidentiality, including:
- Inadvertent or intentional disclosing of sensitive information and breaching patient confidentiality by medical professionals themselves.
- Technological failures, like hacking and unauthorized access to patient information stored in electronic medical records and online communication.
- Risk of mental health information being used against patients in legal or employment contexts, leading to discrimination and stigma.
Maintaining Privacy As An MHP
Consider the following tips to ethically and professionally maintain patient confidentiality as an MHP:
- Establish clear confidentiality policies and procedures.
- Obtain informed consent from patients before the latter’s self-disclosure or sharing of their information for treatment purposes.
- Use secure record-keeping systems to protect patients’ personal information.
- Limit access to personal information to those who have a legitimate need to know.
- Use secure communication methods to protect patients’ personal information.
- Provide regular education and training on confidentiality and privacy issues for healthcare providers.
Maintaining Privacy As A Patient Availing Mental Healthcare
Consider the following tips on maintaining privacy when availing treatment for mental health issues in India:
- Be mindful of the information you share with others, including family and friends.
- Research the privacy policies of MHPs or institutions before seeking care.
- Consider seeing an MHP who operates under a code of ethics that prioritizes patient privacy.
- Use encrypted communication methods, such as secure messaging apps, when communicating with MHPs.
- Be cautious about sharing sensitive information on social media or other public platforms.
- Consider using a pseudonym or an alias when participating in online mental health forums or support groups.
- Educate yourself on your legal rights regarding medical privacy, such as those outlined in the Mental Health Care Act.
Therefore, enforcing India’s Mental Health Care Act is crucial for protecting patient confidentiality. Without proper enforcement, patients with mental health conditions are at risk of having their personal information and medical records exposed, leading to stigma and discrimination.
Upholding patient confidentiality not only respects the patient’s privacy but also promotes better mental health outcomes.