Nepal Drafts Mental Health Bill to Ensure Citizen Rights

Kathmandu. The Ministry of Health and Population has prepared a 'Concept Paper on Mental Health Bill' to ensure citizens' mental health rights. The bill is being drafted as the problem is becoming complex due to insufficient importance given to mental health, despite the Constitution of Nepal guaranteeing the right to health, equality, and living with dignity. The principle of drafting the bill was approved by the Council of Ministers meeting on October 19. In the context of Article 35(3) of the Constitution ensuring equal access to health services and Article 16 ensuring the right to live with dignity, the concept paper states that a law is essential to penalize negative behavior and stigma towards individuals with mental health problems. As health service delivery is a shared responsibility of the federal, provincial, and local levels, this specific federal law is necessary for the effective expansion, coordination, and regulation of mental health services. According to the Ministry of Health, the burden of mental health and psychosocial problems in Nepal is continuously increasing, with mental health accounting for approximately 15 percent of the total disease burden. Various study reports indicate that 7.2 percent of individuals in Nepal exhibit suicidal thoughts or behavior. According to the annual report of the Nepal Police for fiscal year 2080/81, 7,221 suicide-related incidents were registered across the country. Various studies have found self-harm to be among the top 10 causes of death in Nepal. Data shows that the mortality rate due to suicide has increased by 0.7 per hundred thousand population in the last decade. For this reason too, an act is necessary to formulate mental health programs. Nepal has an international obligation to fulfill commitments to international documents such as the Universal Declaration of Human Rights, the Sustainable Development Goals, the Mental Health Action Plan (2013-2030), and the Convention on the Rights of Persons with Disabilities by formulating this law. Furthermore, the esteemed Supreme Court has issued mandamus and directive orders in various writ petitions to treat mentally ill prisoners, mandatorily allocate a certain percentage of the budget, and amend and revise discriminatory laws. The National Health Policy 2076, the policy and program and budget statement for fiscal year 2083/084, which the government has been advancing, consider mental health as an integral part of public health. Mental and psychosocial problems account for approximately 15 percent of the total disease burden in Nepal. It is estimated to cause an economic loss of about 0.44 percent of the gross domestic product. Similarly, the concept paper mentions that 78 percent of mental health patients are still outside the reach of treatment, and the increasing number of suicides clearly indicates the need for a new law. By studying India's 'Mental Healthcare Act 2017', Bangladesh's 'Mental Health Act 2018', and Thailand's 'Mental Health Act 2008', Nepal has moved forward with the process of enacting a modern and rights-oriented law. The concept paper states that for the implementation of the law, a separate mental health division or unit will be established at the federal level, and resources will be efficiently utilized through the strengthening and restructuring of existing structures and manpower. After the implementation of this act, it is expected that there will be uniformity in the understanding of mental health, multi-sectoral programs for suicide prevention will be strengthened, stigma and discrimination in society will decrease, and the human rights of persons with mental and psychosocial disabilities will be fully protected. The proposed bill will include comprehensive provisions related to mental health institutions, psychiatrists, emergency treatment, informed consent, supported decision-making systems, suicide prevention, reduction of childhood mental stress, and coordination between federal, provincial, and local levels. The concept paper states that for the implementation of the law, a separate mental health division or unit will be established at the federal level, and resources will be efficiently utilized through the strengthening and restructuring of existing structures and manpower. Through the implementation of this act, the goal is to bring uniformity in the understanding of mental health, promote the mental well-being of individuals, and enhance healthy lifestyles, productivity, and social participation. Furthermore, the mental health system will be strengthened, leading to its effective integration into primary healthcare, an effective referral system, and the expansion of quality services. The subject of expanding quality, accessible, and affordable treatment, care, and rehabilitation services, ensuring equal access to mental health services for all, has been included. The new system is expected to strengthen multi-sectoral programs for suicide prevention and bring a significant reduction in the suicide rate. It is mentioned that by reducing the stigma and discrimination towards mental illness in society, patients will be able to receive services easily, and an environment of cooperation will be strengthened in families, communities, and workplaces. After obtaining the opinion and consent from the Ministry of Law, Justice and Parliamentary Affairs and getting the principle approved by the Council of Ministers, the draft of the bill will be finalized in consultation and agreement with experts, stakeholders, the Ministry of Finance, and the Office of the Attorney General.