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Mental Healthcare Act, 2017

Context

The National Human Rights Commission (NHRC) in a report flagged the “inhuman and deplorable” condition of all 46 government-run mental healthcare institutions across the country.

About Mental Healthcare Act, 2017: 

• The act provides for the rights of persons with mental illness, including the right to access mental health care and treatment, the right to make decisions about their treatment, the right to confidentiality, and the right to legal aid.
• It establishes mental health services at the district level to provide access to mental healthcare and Mental Health Review Boards (MHRBs) to oversee the treatment of persons with mental illness and to protect their rights.
• It decriminalizes attempted suicide, recognizing that suicide is often a symptom of mental illness, and provides care and treatment for persons who attempt suicide.
• It establishes a Central Mental Health Authority and State Mental Health Authorities to regulate mental healthcare and services and to promote mental health.
• The act prohibits the use of Electro-Convulsive Therapy (ECT) without anaesthesia and the use of seclusion and restraint in mental health establishments, except in exceptional circumstances.
• The act provides for advance directives, which allow individuals to express their preferences for treatment and care in the event that they are unable to make decisions for themselves.
• The Act discourages using physical restraints (such as chaining), unmodified electro-convulsive therapy (ECT).
• This Act makes provision for the appointment of nominated representative by the mentally ill person.
  • In case of absence of any recommendation by the mentally ill person, any relative, care giver, suitable persons may be appointed to act as the nominated representative.
• It provides for the setting up of Central Mental Authority Fund and State Mental Health Authority Fund to keep an account of all the grants, loans, fees, charges, sums etc., made by the authorities under this Act.
• Provision for Mental Health Review Boards – are quasi-judicial bodies shall be mainly responsible for:
  • Registering, reviewing, altering, modifying or cancelling an advance directive appointing a nominated representative.

Impact of Covid-19 on Human Capital

Context

Recently, the World Bank has released a report titled- “Collapse and Recovery: How COVID-19 Eroded Human Capital and What to Do”, stating that the Covid-19 caused a massive collapse in human capital, primarily affecting children and young people.

• It analyzed global data on the pandemic’s impacts on young people at key developmental stages: early childhood (0-5 years), school age (6-14 years) and youth (15-24 years).

What are the Findings of the Report?

• Impact of Pandemic:
  • The Covid-19 caused massive damage to human capital at critical moments in the life cycle, primarily affecting children and young people in underdeveloped and developing countries.
  • The development of millions in low- and middle-income countries has been derailed.
• Impact on School Children:
  • Preschool-age children in multiple countries have lost more than 34% of learning in early language and literacy and more than 29% of learning in mathematics compared to pre-pandemic cohorts.
  • In many countries, even after schools had reopened, preschool enrollment had not recovered by the end of 2021; it was down by more than 10% in multiple countries.
  • Children also faced greater food insecurity during the pandemic.
• Reductions in Healthcare:
  • Millions of children faced reductions in health care—including missed critical vaccines.
  • They also faced more stress in their care environments—orphanhood, domestic violence, suboptimal nutrition—which led to declines in school readiness and declines in social and emotional development.
• Youth Employment:
  • Forty million people who would have had a job in the absence of the pandemic did not have one at the end of 2021, worsening youth unemployment trends. Youth earnings contracted by 15% in 2020 and 12% in 2021.
  • New entrants with lower education will have 13% fewer earnings during their first decade in the labour market.
    • In Brazil, Ethiopia, Mexico, Pakistan, South Africa, and Vietnam 25% of all young people were neither in education, employment, nor training in 2021.
• Challenges in Future:
  • The cognitive deficit in today’s toddlers could translate into a 25% decline in earnings at their prime working age.
  • Today’s students in low- and middle-income countries could lose up to 10% of their future average annual earnings due to the COVID-related education shocks. Globally, this generation of students risks losing USD 21 trillion in potential lifetime earnings.
  • Losses of lifetime earnings at this scale can mean lower productivity, greater inequality, and possibly greater social unrest for decades to come.

What are the Recommendations?

• Countries should act urgently to recover these losses and invest better in their people.
• Human capital is a key driver of poverty reduction and inclusive growth. It is imperative for building resilience in the face of current and future crises and shocks.
• Some of the Policy Actions can include,
  • Vaccinations and nutritional supplementation campaigns; increasing coverage of parenting programs; increasing access to pre-primary education, expanding coverage of cash transfers for vulnerable families.
  • Increasing instructional time; assessing learning and matching instruction to students’ learning level; and streamlining the curriculum to focus on foundational learning.
  • For youth, support for adapted training, job intermediation, entrepreneurship programs, and new workforce-oriented initiatives are crucial.
• In the longer term, countries need to build agile, resilient, and adaptive human development systems that can better prepare for and respond to current and future shocks.

Special Marriage Act, 1954

Context

The Supreme Court rules in a same-sex marriage case that there is no absolute concept of a man or woman.

Details

• The Supreme Court rejected the government's "value judgement" that a person's private parts determine whether he or she is a man or a woman.
• According to the court, there is no "absolute concept of a man or an absolute concept of a woman" and that gender is "far more complex" than one's private parts.

No absolute concept of man or women

• The court stated that there is no definitive concept of a man or a woman... A man or a woman is not defined by their private parts; it is significantly more complex.
• The court emphasised that even when the Special Marriage Act mentions "man" and "woman," the concept of a man and a woman is not absolute in terms of what private parts people have.

Special Marriage Act

About

• It is a law that provides a special form of marriage for people of different religions or castes in India.
• It also allows for the registration and divorce of such marriages.

Objectives

• The main objective of this Act is to facilitate inter-religious and inter-caste marriages.
• To protect the rights of the couples who choose to marry under this Act.

Process of Registration of Marriage under the Act

• Step 1: The parties who want to marry under this Act have to give notice of their intention to the Marriage Officer of the district where they reside at least 30 days before the date of marriage.
• Step 2: The Marriage Officer has to publish the notice in a conspicuous place and invite any objections to the marriage within 30 days.
• Step 3: If no objection is received or if the objection is dismissed by the Marriage Officer or a competent court, the marriage can be solemnized by the Marriage Officer in the presence of three witnesses.

Important provisions

• The marriage is registered by the Marriage Officer in a Marriage Certificate Book and a certificate is issued to the parties.
• Marriage under this Act is valid throughout India and also applies to Indian citizens abroad.
• The marriage under this Act does not affect the personal laws of the parties regarding succession, inheritance, adoption, etc.
• The parties can seek restitution of conjugal rights, judicial separation, nullity of marriage, or divorce on various grounds as specified in the Act.

Significance of the Special Marriage Act

• It allows inter-faith and inter-caste marriages without any conversion or ceremony.
• It provides a uniform and secular law for marriage and divorce for all citizens of India.
• It protects the rights and interests of both the husband and wife in matters of property, maintenance, custody, etc.
• It simplifies the process of registration and documentation of marriage.

Conclusion

• The Special Marriage Act is a progressive legislation that recognizes the right of individuals to marry according to their choice and conscience. It also provides legal recognition and protection to such marriages and safeguards the interests of the spouses and their children.

Keywords

Value Judgement

• A value judgement is an assessment of something based on a set of criteria, standards or preferences.
• It can be positive, negative or neutral, depending on how the thing being judged meets or fails to meet the expectations of the evaluator.
• Value judgements are often subjective and influenced by personal values, beliefs and emotions.
• They can also be objective and based on factual evidence or logical reasoning.
• Value judgements are common in everyday life, as well as in academic, professional and ethical contexts.
• They can have significant implications for decision-making, behaviour and communication.

Genetic Information and Privacy

Context

The Supreme Court of India has ruled that children have the right to protect their genetic information from being revealed in DNA tests without their consent.

Right to protect Genetic Information

• The right to protect genetic information is a fundamental right that recognizes an individual’s autonomy and control over their own personal and intimate genetic data.
• It allows individuals to make informed decisions about their health, privacy, and identity.
• In India, the Supreme Court has also held that children have the right to protect their genetic information from DNA testing in divorce proceedings, as it is part of their fundamental right to privacy.
• This is guaranteed under Article 21 of Indian Constitution.
• This right is recognized under various international human rights instruments, including the Universal Declaration of Human Rights and the International Covenant on Civil and Political Rights.

Key takeaways from the Judgment

• The court ruled that-

1. Genetic information is personal and intimate
2. Children have the right to privacy and bodily integrity
3. Children are not to be regarded like material objects and should not become the focal point of the battle between spouses
4. Allowing DNA tests would also harm the reputation and dignity of the mother

Basis of this judgment

• The court drew attention to the rights of privacy, autonomy and identity recognised under the United Nations’ Convention on the Rights of the Child.
• It acknowledged the control that individuals, including children, have over their own personal boundaries and the means by which they define who they are in relation to other people.
• Children are not to be deprived of this entitlement to influence and understand their sense of self simply by virtue of being children.

How can one get the tests done?

• Family courts should direct for a DNA test only in expedient situations and in the interest of justice, as a last resort, said the judgment.
• This should be practised as the option of last resort.

Trends in Maternal Mortality: UN

Context

• In 2020, an alarming statistic emerged - approximately 800 women lost their lives globally from preventable causes related to pregnancy and childbirth, translating to one woman dying every two minutes.

Background

• The Sustainable Development Goal (SDG) 3, specifically target 3.1, aims to achieve a reduction in maternal mortality to less than 70 deaths per 100,000 live births by the year 2030.
• The United Nations Maternal Mortality Estimation Inter-Agency Group (MMEIG), a collaboration involving WHO, UNICEF, UNFPA, the WB Group, and the UNDESA/Population Division, has recently published a report that covers estimates and trends in maternal mortality from 2000 to 2020.

Global Trends

• The global maternal mortality ratio (MMR) in 2020 stood at an estimated 223 maternal deaths per 100,000 live births. This figure marks a notable reduction from 227 in 2015 and a significant decrease from 339 in the year 2000. This represents a substantial decline of 34.3% over the entire 20-year period.

Country-Specific Findings:

• In the year 2020, three countries reported particularly high maternal mortality rates:
  1. India recorded 24,000 maternal deaths.
  2. DR Congo reported 22,000 maternal deaths.
  3. Ethiopia had 10,000 maternal deaths.

India's Progress:

• According to the Sample Registration System (SRS) report by the Registrar General of India (RGI), India made significant progress in reducing maternal mortality. The Maternal Mortality Ratio (MMR) dropped from 130 per 100,000 live births in the period of 2014-16 to 113 per 100,000 live births in 2016-18.

Strategic Framework for Ending Preventable Maternal Mortality (EPMM):

• The report underscores the importance of implementing a strategic framework for Ending Preventable Maternal Mortality (EPMM).

Relevance to UPSC 2020 Mains:

• This data and the broader issue of maternal mortality underscore the necessity of robust healthcare policies, especially in the domains of geriatric and maternal healthcare, as integral components of social development.

World Athletics Bans Transgender Women

Context

• Recently, transgender women have been barred from competing in the female category by World Athletics (WA)(the international governing body for track and field)

Major Points 

• WA has followed the path of FINA, the international swimming federation, which enforced a similar ban in June last year.
• The ban & research:
  • Transgender women who have experienced male puberty will not be able to compete in the female competition after March 31 this year. 
  • However, the World Athletics Council has set up a working group to conduct research “to further consider the issue of transgender inclusion”.
• Previous rules:
  • Under the previous rules, there was no blanket ban, but transgender women had to reduce the amount of blood testosterone to 5 nanomoles per litre (nmol/L) and maintain this level for 12 months in order to participate.
    • WA had previously come up with the ‘preferred option’ for transgender women. 
    • Instead of a complete ban, WA said it would allow transgender women to compete in the female category but would reduce the blood testosterone limit to below 2.5nmol/L for two years basically cutting it down by half, and doubling the time period before they become eligible to compete.

Reasons for ban

• WA focuses on the physical advantages men have over women post-puberty. 
• The substantial sex difference in sports performance that emerges from puberty onwards means that the only way to achieve the objectives set out is to maintain separate classifications (competition categories) for male and female athletes.
• Events leading to the decision:
  • The debate has raged since New Zealand weightlifter Laurel Hubbard competed in the women’s 87-kg class at the Tokyo Olympics, although she had participated in the men’s category earlier.
  • NCAA swimmer Lia Thomas used hormone replacement therapy and moved from the men’s category to the women’s category. She started breaking records in the IVY League competition before FINA stepped in.

Other sports with similar bans for transgender female athletes?

• Rugby:
  • It was World Rugby in 2020 which became the first international sports federation to bar transgender women from female competition. 
  • Following this, Rugby Football League and Rugby Football Union also banned transgender women from female competition.
• Triathlon:
  • Last year, British Triathlon implemented a similar ban.
• Olympics:
  • The International Olympic Committee’s Framework on Fairness released in November 2021 stated that “athletes are not excluded solely on the basis of their transgender identity or sex variations”.
  • But the IOC had put the onus on sports federations to put in place rules.

Transgender

• The Transgender Persons (Protection of Rights) Act, 2019 defines “Transgender person”, as a person whose gender does not match with the gender assigned to that person at birth and includes trans-man or trans-woman (whether or not such person has undergone Sex Reassignment Surgery or hormone therapy or laser therapy or such other therapy), a person with intersex variations, genderqueer and person having such socio-cultural identities as Kinner, hijra, aravani and jogta.

The legal status of Transgender Community in India

• The Supreme Court in National Legal Services Authority (NLSA) v. Union Of India, famously known as the NALSA Case, has directed Centre and State Governments to grant legal recognition of gender identity whether it be male, female or third-gender.
  • Further, it declared that hijras and eunuchs can legally identify as “third gender”.
• Fundamental Rights:
  • In recognizing the third gender category, the Court recognized that fundamental rights are available to the third gender in the same manner as they are to males and females. 
• Self-identification:
  • The Court upheld the right of all persons to self-identify their gender.
  • Thus, it held that no third-gender persons should be subjected to any medical examination or biological test which would invade their right to privacy.
• Socio-Economic Rights: 
  • Recognising third-gender persons as a “socially and educationally backward class of citizens”, entitled to reservations in educational institutions and public employment.

Challenges faced by Transgender Community:

• Lack of acknowledgment: 
  • Even in this era of scientific pragmatism and logical empiricism, we see society’s refusal to acknowledge the LGBTQIA+ community on par with the “heteronormals”.
• Extensive problems:
  • Problems of sexual abuse, familial dysfunction, peer rejection, juvenile delinquency, societal taboo, sexual disharmony, unsafe sexual behaviour and drug abuse are rampant amongst this community while growing up. 
  • Unrecognised marital status, hazards of adoption, housing, property inheritance, difficulty finding regular employment, discrimination and harassment at the workplace, etc., are recurring and diabolical features of their daily lives. 
• Mental and physical consequences:
  • The mental and physical consequences of these prejudices take a toll on their lives. Ageism and sexual discrimination are other hassles.
  • Increasing evidence points out that depression, suicides, self-harm and substance abuse are twice as common in LGBTQIA+ individuals compared to heterosexual people.
• Bias & discriminatory attitudes:
  • Even healthcare professionals and institutes show alarmingly high rates of homophobic bias and discriminatory attitudes.

Initiatives for Transgender Persons in India:

• SMILE Scheme: The Department of Social Justice & Empowerment launched the Central Sector scheme “SMILE: Support for Marginalised Individuals for Livelihood and Enterprise”.
  • This umbrella scheme is designed to provide welfare measures to the Transgender community and the people engaged in the act of begging.
• Transgender Persons (Protection of Rights) Act, 2019:
  • The law passed by the Parliament aims to end discrimination against transgender persons in accessing education, employment and healthcare and recognise the right to self-perceived gender identity.
• Transgender Persons (Protection of Rights) Rules, 2020: 
  • It has been framed by the government to give effect to the provisions of the Transgender Persons (Protection of Rights) Act, 2019.
• National Council for Transgender Persons: 
  • In pursuance of the Transgender Persons (Protection of Rights) Act, 2019, the National Council for Transgender Persons has been constituted to advise the Central Government on the formulation and evaluation of policies, programmes, legislation and projects for the welfare of the transgender community.
• Reservation for the transgender community: 
  • The Union government is planning to bring reservations for the community under the OBC category in employment.
• National Portal for Transgender Persons:
  • It is a portal by the Ministry of Social Justice and Empowerment which assists persons of the transgender community in applying for a Certificate and Identity card digitally from anywhere in the country.
  • Through the Portal, they can monitor the status of their application which ensures transparency in the process.
• Garima Greh:
  • The scheme aims to provide shelter to Transgender persons, with basic amenities like shelter, food, medical care and recreational facilities.
  • Besides, it will provide support for the capacity-building/skill development of persons in the Community, which will enable them to lead a life of dignity and respect.

Conclusion and Way Forward 

• There is a need to sensitise the society that the community is a part of us and are co-equals.
• Sensitising law enforcement: There is also a need to sensitise the legal and law enforcement systems towards the challenges of the community.