No 'One Size Fits All' Approach To Depression: Times When Supreme Court Stood For Mental Health

Last week, the Supreme Court observed the variations in reacting and coping up with mental health issues. The apex court, remarkably, noted the ¡°mental health of a person cannot be compressed into a one size fits all approach.¡±

The court made this observation while ruling in a suicide case.

Earlier, the Karnataka high court made a wide off-the-mark observation. It had termed a person who died by suicide a ¡°weakling¡± and commented on how people with depression ¡°ought¡± to behave.

The Supreme Court bench, comprising Justices DY Chandrachud and BV Nagarathna, objected to this notion. It noted that such an articulation of a person with depression ¡°diminishes the gravity of mental health issues.¡±

¡°Individual personality differences ??manifest as a variation in the behavior of people,¡± the court said. ¡°How an individual copes up with a threat ¡ª both physical & emotional, expressing (or refraining to express) love, loss, sorrow, and happiness, varies greatly in view of the multi-faceted nature of the human mind and emotions,¡± the judges added.

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In simple terms, the court observed that each individual experiences and responses to depression differently.

The observation is significant to break the stigma associated with mental health, and that "strong people" don't have mental health issues and aren't depressed.

Most often, the complexity of human emotion and mental health conditions are ignored.

Calling out gaps in mental health infrastructure

The Indian legal system is finally taking note of rising mental health issues and the importance of creating awareness around them.

In November last year, the Madras High Court called out the lack of government spending on mental health infrastructure.

It noted the "need of the hour" is to have sufficient psychiatrists and departments at each level.

Mental Healthcare Act (MHCA)

Mental health issues are complicated, distinct, and come in various forms and sizes and mental health laws across the world have evolved over the years. The provisions of the previous and now-repealed Mental Health Act 1987 focused mostly on administrative procedures, instead of an individual approach.

The Mental Healthcare Act (MHCA) 2017 entered into force in May 2018 and has a rights-based approach to regulate mental healthcare and treatment in India.

The MHCA is a milestone because it marks the first time an Indian law recognised the right of all persons to access state-funded mental healthcare services and facilities, without discrimination on any basis.

Insurance cover for mental illness

For a long time, mental health issues were not covered in insurance. However, with time, things changed.

The coronavirus pandemic exacted a heavy toll, and there has been a significant rise in mental health issues throughout the world. It has become imperative that insurance policies cover mental health issues like anxiety and depression.

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In June 2020, the Insurance Regulatory and Development Authority of India (IRDAI) mandated insurance providers to include mental illnesses under the scope of health cover.

According to IRDAI, all insurance providers must offer coverage to persons diagnosed with mental illnesses. It gave all insurance companies in the country ¡ªbe it life, health, or general insurers ¡ª to comply with its instructions by October 1 last year.

The issue of mental illness ¡ª widely prevalent in India ¡ª emerged again after the death of actor Sushant Singh Rajput was widely reported in the media. One in five Indians faces depression in their lifetime, according to the World Health Organisation.

In September 2021, the Supreme Court expressed ¡°serious concern¡± over mental health facilities across the country and ordered states in India to make Covid-19 vaccinations available to everyone detained in a mental health facility and to the staff.

Mental health issues are diverse and complex, and there is no one fixed approach that suits everyone. Healthy discourse is the need of the hour to de-stigmatise mental health issues and highlights how important it is to talk about them.

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