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Taking an Active Interest in Mental Health Policy
A Brief Guide for Beginners in Mental Health Profession
I have often expressed frustration over the fact that very few psychologists in India take active interest in mental health policies and laws. For instance, the participation of practising psychologists in the drafting and consultation process of documents such as the National Mental Health Policy 2014, the Mental Healthcare Act 2017 and the National Commission for Allied and Healthcare Professions Act 2021 was virtually non-existent.
Although the trepidation of finding a decent employment in an underpaid and undervalued profession like psychology doesn’t leave much time for engaging with the strange world of policy making, the complete neglect by psychologists is inexcusable. A common refrain I hear is: ‘I want to do something but don’t know how to go about it’. The purpose of this article is to answer the “how” from my limited experience.
Let us begin:
Build Knowledge: The first step is, of course, building a strong foundation of existing knowledge in the field. To that end, start with reading the National Mental Health Policy 2014, the Mental Healthcare Act 2017, the National Commission for Allied and Healthcare Professions Act 2021, the National Policy for Persons with Disabilities 2006, the Rights of Persons with Disabilities Act 2016, the Rehabilitation Council of India Act 1992 (along with proposed amendments), the National Health Policy 2017 and the National Education Policy 2020. Read relevant United Nations documents such as the Universal Declaration of Human Rights, the International Covenant on Civil and Political Rights, the International Covenant on Economic, Social and Cultural Rights, the Convention on the Rights of the Child and the Convention on the Rights of Persons with Disabilities. Do a deep dive into the WHO Mental Health Policy and Service Guidance Package. Read every other relevant document you can find. Read the Constitution of India. Just read, read and read.
Spread Knowledge: If you have read everything listed above, you know more than 99.9999% of psychologists in India do. Tell others what you know. Write articles. Post on social media. Start a Substack publication. Author research papers. Tell people good things about a policy. Educate us on the limitations of a law. Inform government officials where the rules are not implemented. Become a beacon of awareness in the darkness of ignorance. It is possible that your writing may be read by a policymaker or someone who has the authority to take an action and may lead to change. For example, one of my articles on Allied and Healthcare Professions Bill was cited by Member of Parliament Bhartruhari Mahtab during a discussion on the Bill in Lok Sabha.
Make Psychology Associations Accountable: Advocacy and lobbying are among the primary goals of any professional association. But the score of psychology associations in India on these counts is virtually zero. Other than organizing an annual conference, most psychology associations do nothing of value. Go to the website of any Indian psychology association and compare it with that of the American Psychological Association. You would see the immense difference. (National Academy of Psychology doesn’t even have a website for many months now. www.naopindia.org is inactive and their leadership is sleeping.) Let us ask the leaderships of Indian psychology associations to speak, write and advocate about mental health policies and laws. Let us ask them to move beyond university auditoriums and step into government offices, Parliament and courts.
Attend Annual General Meetings of Psychology Associations: This point could have been included in the last one also, but I want to place a special emphasis on it. Many students and professionals attend annual conference of one or the other psychology association. Some of them also happen to be members of those associations. However, they are hardly involved in decision making processes of their organizations.
A psychology association usually holds its Annual General Meeting (AGM) at the venue of the conference. But despite hundreds of its members being present at the venue, only a few dozens of them turn up at the AGM. The participants are usually the people who either are/were part of the leadership or aspire to join it. As a result, the associations become cliques and the “outsiders” have little information about their workings.
An AGM is a place where the work of an association is reviewed, and questions are asked by the members. So, to actually know your association and influence its decisions, it is important that you take part in the AGM. (Even if you are not a member, you can participate in the AGM. Just ask the organizers. I have done this multiple times.)
Mental Health in Union and State Budgets: We know that the government expenditure on mental health in India is negligible. Not just expenditure, the attention to this field is also abysmal. For instance, in her 2021 Budget Speech, Union Finance Minister Nirmala Sitharaman mentioned vehicle scrapping policy under 'health and wellbeing' category but not mental health. Read that again: vehicle scrapping policy was part of 'health and wellbeing' in her speech but not mental health!
Question the governments — both state and central — over allocation of funds to the mental health sector in annual budgets. Before the presentation of budgets, ask them to allocate adequate amount of money. Let us not just say ‘increase the budget’; we need to find out how much expenditure on mental health is necessary. Is it 1%–2% of GDP? Or 40%–50% of total health budget? We need to figure this out.
Participate in Public Consultation on Laws and Policies: As I said in the beginning, the participation of practising psychologists in the drafting and consultation process of laws and policies is virtually non-existent. We need to change this scenario. Whenever governments and Parliamentary committees invite public comments on bills and drafts of policies and rules, make sure to submit your comments and ask others to do so too. For instance, the Government of India is currently in the process of amending the Rehabilitation Council of India Act 1992. The date of public comments passed months ago, but you can still write to the Government and Members of Parliament on the final version of the bill, which brings me to my next point.
Write to MPs, MLAs, Ministers and Bureaucrats: Whenever there is an issue which requires the attention of an MP, MLA, minister or a bureaucrat, write to them. Do not hesitate. You may not get a reply, but when hundreds and thousands of professionals write to a policy maker on an issue, they are bound to pay attention. There are many MPs, MLAs and bureaucrats who are interested in mental health, but do not have an in-depth knowledge. Make your expertise available to them. Send them policy and legislative briefs. Help them seek accountability on mental health issues from the government. Submit questions to MPs and MLAs which they can raise in the Parliament and legislative assemblies, respectively.
Make Mental Health an Election Issue: For any issue to become a part of a government’s agenda, it has to first become a part of a party’s election manifesto. In recent years, there have been campaigns to make mental health part of the election manifestos. These campaigns have been successful to an extent. For instance, in the recent legislative assembly elections in West Bengal, the mental health found space in at least two manifestos — those of Bharatiya Janata Party and Left Front.
We need to continue this campaign with more ferocity. Mere mentions of mental health are not enough. We need parties to pledge in their manifestos that their government would allocate a stated minimum percentage of health budget to mental health and that they would hire psychologists for every village, block and district in the state.
If you are a professor/head of psychology department, teach a paper on Psychology, Policy and Law: Isn’t it a shameful scene for our education system that students with bachelor’s and master’s in psychology in India have no in-depth knowledge of mental health laws and policies? Forget in depth, most of the psychologists don’t even have passing knowledge. How can we, then, expect them to comply with regulations in their counseling and psychotherapy practice? How can they participate in the policy making process and help the profession evolve? And how can a profession flourish whose practitioners don’t interact with bureaucrats and lawmakers?
We cannot allow this ignorance to be continued. If you are someone who decides the curricula of psychology degrees, please include a paper on Psychology, Policy and Law in the course.
Make Policy Communication Fun: All of us know this: the legal documents are technical, dry and boring. The professionals may read and understand them, but we need to educate the general public also. Therefore, the policies and laws are required to be communicated in an engaging and fun manner. If you can convey them in an engaging way, please do it. Frankly, I don’t have this skill. The most “fun” thing I could attempt in this article was linking a statement with a favourite Faiz Ahmed Faiz couplet (see second paragraph, if you missed it).
I hope these points will help you start your journey in the policy making process. It is not a one time activity, but a years long endeavour. Many times, there are failures and whatever policy changes we can achieve are only incremental. But over the years, these changes add up and the final outcome is immensely rewarding.
Here, I wanted to provide a link to at least one online course on mental health policy, but I could not find any on platforms like Coursera, Udemy, edX, etc. If you find one, please let me know. I will update the space.
The Centre for Mental Health Law and Policy, Pune runs an International Diploma in Mental Health, Human Rights & Law. The applications are open now.