Kelly Brendan D
Department of Psychiatry, Trinity College Dublin, Trinity Centre for Health Sciences, Tallaght Hospital, Dublin, Ireland.
Indian J Psychiatry. 2016 Dec;58(Suppl 2):S168-S174. doi: 10.4103/0019-5545.196822.
The Mental Health Care Bill 2013 was introduced to the Rajya Sabha (India's upper house of parliament) in August 2013 and following 134 official amendments, passed in August 2016. Properly implemented, mental health legislation such as this plays a key role in protecting the rights of the mentally ill, ensuring access to care, and promoting social justice for the mentally ill, their families and carers. In this context, the 2006 United Nations' Convention on the Rights of Persons with Disabilities (CRPD) presents a real opportunity to improve the position of people with disabilities and those disabled by long-term mental illness. The CRPD also presents many challenges to mental health legislators and service-providers, especially in relation to involuntary care, mental capacity, and substitute decision-making. Nevertheless, the CRPD has still generated strong incentive for reform and is an opportunity that should not be missed. Legislation along the lines of India's 2013 Bill offers much that is positive and progressive in terms of standards of care, revised processes for involuntary admission, and enhanced governance throughout mental health services. In this way, this kind of legislation, although imperfect in certain respects, promotes the principles of the CRPD (as outlined in the preamble to India's 2013 Bill). It is important that such initiatives focus not only on the right to liberty but also on rights to treatment, social care, social inclusion, and political empowerment of the mentally ill. Globally, the mentally ill have been neglected for far, far too long. It is time to fix this.
《2013年精神卫生保健法案》于2013年8月提交给印度议会上议院（联邦院），经过134项正式修正案后，于2016年8月获得通过。像这样的精神卫生立法若得到妥善实施，在保护精神病患者权利、确保获得护理以及促进为精神病患者及其家庭和护理人员提供社会正义方面将发挥关键作用。在这方面，2006年联合国《残疾人权利公约》（CRPD）为改善残疾人和因长期精神疾病而致残者的状况提供了切实机遇。CRPD也给精神卫生立法者和服务提供者带来了诸多挑战，尤其是在非自愿治疗、心理能力和替代决策方面。尽管如此，CRPD仍有力地推动了改革，是一个不容错过的机遇。印度2013年法案这类立法在护理标准、非自愿入院修订程序以及加强整个精神卫生服务治理方面有诸多积极和进步之处。这样一来，这类立法尽管在某些方面存在不足，但仍促进了CRPD的原则（如印度2013年法案序言中所概述）。重要的是，此类举措不仅应关注自由权，还应关注精神病患者的治疗权、社会护理权、社会融入权和政治赋权。在全球范围内，精神病患者被忽视的时间实在太长了。是时候解决这个问题了。
