On mental health rights protection in Bangladesh

The statistics on mental health situation is alarmingly critical in Bangladesh. According to the WHO’s Special Initiative Country Report, 18.7% of adults and 12.6% of children in the country are at risk of mental illness, while approximately 92.3% of adults with mental disorders do not receive necessary treatment. This crisis is not only attributable to lack of accessible treatment but also to the combined effects of a truly rights-based legal approach, weak implementation of policies, and patent lack of social sensitivity.

Notably, Bangladesh has adopted several legal and policy frameworks; nonetheless, mental health remains inadequately protected. The Mental Health Act of 2018 replaced the old Lunacy Act (1912). However, the Act by and large operates within a medical/clinical conceptual framework of understanding mental health and ignores the societal and structural barriers that individuals face in accessing required healthcare services. Similarly, the Bangladesh’s National Mental Health Strategy Plan (2020-30) sets out plans for mental health integration, patient confidentiality, and capacity building in primary healthcare. However, the implementation pathway remains unclear and largely discretionary for the relevant authorities.

Social and cultural stigma surrounding mental health is critically strong in our society as well. School and college students, especially adolescents, are barely confident to disclose mental health sufferings. In addition, working men and women are reluctant to seek treatment due to fear of vulnerability in the workplace, drawing criticisms from colleagues and supervisors, and lack of faith in the management or the human resources.

The Mental Health Act of 2018 replaced the old Lunacy Act 1912. However, the Act by and large operates within a medical/clinical conceptual framework of understanding mental health and ignores the societal and structural barriers that individuals face in accessing required healthcare services.

Thus, mental health issues receive patently condescending attention, if at all, from both our policy-legal framework and the society in our country at large. However, mental health is not merely a matter of personal convenience or condescension, it is a fundamental human right. The failure to guarantee access to mental healthcare and psychologically safe workplace conditions constitutes a violation of this right. International experience shows that several countries have protected mental health through human rights-based legislation. The UK’s Mental Health Act 1983 and its 2007 Amendment enunciate legal provisions protecting the rights of individuals with mental disorders. Similarly, Australia’s National Mental Health Workforce Strategy aims to improve patients’ rights and access to healthcare services.

In my opinion, it is high time we located mental healthcare within our existing social barriers and emergent vulnerabilities. Besides the district-level mental health review and monitoring committee (that the 2018 Act provides for), an effective and independent central monitoring system should be put in place. This may involve patient representatives, health professionals, human rights experts, and civil society actors to oversee implementation of the laws and policies. Moreover, specific allocations and training for mental health services must be made through government budgets. At the same time, trained mental healthcare professionals must be progressively ensured across all districts. Similarly, it is necessary to make mental healthcare mandatory in schools and colleges and to formulate clear laws so that microaggression or discrimination based on mental health issues at the workplace can be adequately prevented and remedied. It is also important to mandate mental health awareness campaigns across workplace and various educational institutions.

Surja Mandal

LLB student at the World University of Bangladesh.