Background

The Law section of the Mission Report, 2003, had explored the domain of law and mental health, both at the level of legal jurisprudence in this area, as well as the local context. The strengths and limitations of the Gujarat judiciary with respect to the mental health sector were pointed out. Two large consultations were held of the legal officers in the State of Gujarat to sensitive the juridiciary on mental health, during the Mission Report work. The Mission Report proposed that capacity building of the Judiciary system in the State of Gujarat, was an important strategy in strengthening the regulatory environment for mental health.

As a follow up of this, Bapu Trust, Pune, had proposed to conduct 2 trainings in Gujarat, in collaboration with the Judicial Academy, Gujarat, on “Law and Mental Health”. Further meetings and discussions with the leadership of the Judiciary (the State Legal Services Authority and the Judicial Academy) led to the conviction that capacity building had to be done at all levels of the judiciary, including the judges, the public prosecutors, the district and metropolitan judges, the legal aid lawyers and consultants. The law teachers were also seen as a constituency to be trained. In all 6 programs were proposed, including the law teachers. Five programs were successfully completed at the end of the project period in December 2005. The trainees have included: Judges in Training (2 batches), Judges, including District and Metropolitan Judges, Legal Aid Lawyers, Legal Aid consultants, and Public Prosecutors.

This report details a session by session description of the trainings and evaluations done by the trainee legal officers. Where there is repetition between training sessions, detailed reporting has been curtailed.

Introduction

Under the Auspices of the Executive Chair, Hon. Justice Dr. J.N. Bhatt, Hon. Judge Jyotsna Yagnik, Member-Secretary, Offices of the Gujarat State Legal Services Authority and Hon. Justice Kadri of the Judicial Academy, Judges, Legal Aid officers, consultants, Judges in Training, and Public Prosecutors of the Judiciary of Gujarat were trained on the subject of “Law and Mental Health” in the months from January to December, 2005. Initially collaboration with the Judicial Academy was proposed. But later the collaboration was formalised through an offer letter with the Gujarat State Legal Services Authority, Gujarat, due to the warm and enthusiastic and open support of the program by the said Authority. The program was inspired by the dynamic energies and synergies of the Member Secretary, Legal Services Authority, Hon. Judge Jyotsna Yagnik and Professor of Law, Amita Dhanda (NALSAR).

The training programs were conceived in order to fill a gap in the Gujarat legal environment to better address the needs of the restoration of rights and dignity of persons with psychosocial disabilities, who are the most marginalized in our society.

The Legal Services Authority, Gujarat, has always been a dynamic and activist institution, nurtured under the able leadership of Hon Justice JN Bhatt and his associates. The Authority is highly visible in the State, and we have noted with admiration, that they can serve as a model for all other states where the Authority is literally invisible. They run a 24 hour service clinic, a mobile van and have extensive coverage in rural areas, working directly with communities and NGOs on legal awareness and legal redressal. Bapu was proud to be working with this highly efficient and dynamic government agency.

Bapu’s perspective in training

Bapu Trust has been involved in bringing about public visibility, research and advocacy in the field of Law, ethics and mental health. At the same time of doing these trainings, Bapu is also simultaneously involved in engaging multiple stakeholders, including psychiatrists in Gujarat, on developing the domain of “Good practices in Mental health”. It is also involved in doing two research studies on “Quality of care within institutions” and “Stakeholder perspectives in the mental health sector”. A course on “Gender and mental health” was also conducted.

The law and mental health trainings has to be looked at in conjunction with Bapu’s overall work in Gujarat. The ground level practice situation of legal officers was considered in the training vis a vis the larger gender, cultural, ethical and user related concerns in the mental health sector.

Bapu is also clearly committed to the privileging of certain values in the sector (self determination of users, values of liberty, justice and autonomy) over some other values (safety, honour, wellness). The legal trainings is also done at a time when the supreme court, the United Nations, the World Health Organisation and various other law and policy making authorities have accelerated their efforts in the strengthening of the mental health sector.

Objectives of our training:

We aimed that each of our trainings would enable the participants to:

• Appreciate the scope and the role of the courts in determining the course and lives of persons with psychosocial disabilities
• Be informed about the enormous weight of law on persons with psychosocial disabilities and be informed about the evidence base in this area
• See their own role as moral agents balancing different values in the MH sector
• See their own role as interpreters of the law in the interests of persons with psycho-social disabilities
• Be oriented to concepts and attitudes in dealing with persons with psycho-social disabilities
• Examine case law in the context of law, human rights and values
• Explore the scope of law with respect to medical opinion and legal capacity
• Have an understanding of some current debates on the UN Disability Convention
• Negotiate the legal and interpretive spaces provided between the Disability laws and the mental health laws in the country

Participants:

Judges in training - 67
Judges (district, metropolitan, civil) – 34
Legal Aid Lawyers -47
Legal Aid consultants and public prosecutors - 32

Methodology:

Training methodologies that the trainers believe in and profess are mutual dialogue, debate and persuasion, methods that expand the imaginative possibilities of the training group. Evidence base was presented in the form of reading materials. Case study, moot court and interactive methodologies were used throughout. Challenges were posed by presenting hypothetical situations for debate. Relevant and comprehensive books, handouts and reading materials were given out. Lecture presentations, Question Answer mode, open house methods were also used. The trainings were consistently interactive, with didactic methods serving to set the pace and tenor for the interactive sessions. Since each training was with a different type of legal officers, each program was tailored to the needs of the training group.

Pilot:

As this was the first time that such a series was being done in India, the program was conducted in a self reflexive way, as a pilot. The learnings for the trainers were also consolidated in each session and appropriate changes made for the next session. A set of curricular materials (essential readings, handouts and case studies) was developed during this period.

Press meet and inaugurations

On the 7th of January, a press conference was called at the Clinic of the Gujarat State Legal Services Authority, where around 30 members of the press (newspapers and TV) attended. Hon Judge Jytosna Yagnik and Dr Bhargavi Davar conducted the press conference. The details concerning the forthcoming programs in the area of Law and Mental Health were announced to the press. The local TV covered the evening’s event and aired the news concerning the program the next evening.

Every program was preceded by a formal inauguration, and ended with a valedictory, as this gave us an opportunity to co-opt members of the highest level of the judiciary in Gujarat into the mental health movement. Our programs have been inaugurated by Hon. Justice Mr JN Bhatt, Hon. Justice Kshitij Vyas, Dr. Amarjit Singh (Health Commissioner, Gujarat), Hon. Justice Jayant Patel, Hon. Justice Shetna, Hon. Justice MR Shah, Hon. Justice DN Patel, Hon Justice BJ Shethana, Shri Gautambhai Shah (renowned industrialist and Chairman, Rotary International).

Inauguration, 8th January, 2005

The entire program was inaugurated by Hon. Justice JN Bhatt, under whose leadership this program was started. Mr JP Dave’s book in Gujarati on the new laws for the layman was released. Hon Judge, Member Secretary GSLSA, Mrs Jyotsna Yagnik welcomed everybody, after Vandemataram. She termed the program a “red letter day” in the history of the GSLSA and the program as a “feather” in its cap. She introduced the facilitators, Prof. Amita Dhanda and Dr. Bhargavi Davar, and also Mr. JP Dave as an eminent and learned intellectual in the field of law at the national level. Hon. Justice Dr. JN Bhatt was introduced as the “Champion for the cause of legal service”. He was the Chairman of GSLSA and served as the Judge of Gujarat High Court. He was now being appointed as the Chief Justice of the Patna High Court. He has compiled the Treasures of Bhagavad Gita, and is also an eminent and learned writer in international circles. The inaugural lamp was lit by His Lordship and other members on the dais.

Hon. Justice Bhatt released Mr JP Dave’s book. He introduced his book as being useful for judges as well as lay persons, and his wish was that it should reach every village, so that the people will know the procedure, how to access justice.

In her inaugural speech, Prof. Amita Dhanda gave a few “Glimpses of the forthcoming trainings” in Gujarat. In describing the training program, Dr. Dhanda called it a mutual learning process, where we shared experiences and knowledge.

She talked about the interphase between law and mental health, and the proactive role being played by the GSLSA in the mental health sector and the need to strengthen the partnership between law and mental health. This partnership, especially the role of the judges and the courts, was important to establish and protect the rights of persons with psychosocial disabilities. The legislation provides the general principles, but the administration of justice is an individualized matter. The law gives a negative connotation to persons with psychosocial disabilities, seeing them as dangerous to themselves and to society. This stereotype should be challenged. Single instances of dangerousness cannot be viewed as representative of the constituency as a whole.

Further, wherever courts determine “unsoundness of mind” a link to capacity is made. The courts main role is seen as finding a guardian for the person. We have to question whether a diagnosis of mental illness automatically leads to canceling capacity. The court does, in case law, appreciate the politics of “insanity”. This appreciation should lead to further critical engagement.

Prof Dhanda emphasized the two points, one about the stereotypical perceptions about the “mentally ill”, and the other, about exclusion and discrimination, due to the determination of “unsoundness of mind”. She called for a paradigm shift, where parity, participation, inclusion and empowerment are the values determining the sector. She talked of their right to make decisions, not just wise ones, but foolish ones too. Afterall, learning is by trial and error, and making mistakes and learning from that is any human being’s opportunity for growth. Why do we set higher standards for persons with psychosocial disability, when we say that they cannot decide, because they will falter? Dr Dhanda outlined the design of the program and talked about preparing a road map to make the justice system address the needs of persons with psychosocial disability.

Hon. Justice Bhatt in his key note address said that mental health care in a country like India is in a very rudimentary condition, compared to the western and European countries. There is a wide canvas for us to begin work, the legal, as well as the forensic. IPC Section 84 provided for the acquittal of a person committing a crime in a state of unsoundness of mind.

Justice Bhatt referred to a distinction between pity and duty, and talked about the duty to bring persons with a psychosocial disability in the mainstream. Everywhere in the world, including China and America, such persons were mainstreamed. He emphasized the need to see this group as a vulnerable group needing special protections from law. In doing case work, he talked about the need to collect full and sufficient history of the mental condition before analysis and pronouncements.

The process of institutionalization shows that being a “mentally ill” person is a type of punishment without doing any crime. Old methods of treatments are required to be reviewed and changed. We have to talk about de-institutionalization and normalization, and about bringing the mentally ill into the mainstream society. By the direction of the High Court of Gujarat, no mentally ill person should be restrained in the mental hospital. Also, force as a method of treatment, should be stopped. He talked about the urgency to address the needs of the 6% population of Gujarat, suffering from a psychosocial disability.

Dr Bhargavi Davar in her concluding remarks, talked about care and treatment rights of people with psychosocial disabilities. She cited the World Health Report, 2001, brought out by the World Health Organisation, which gives staggering data about the extent of the problem. She described the suffering of people living forced lives within institutions, and the poor standards of treatment and care. Mortality rate among people living within institutions is high. The people here also suffer from a high level of disability and forcefully given shock treatments. There is also a growing dissatisfaction among the users of mental health services leading to greater litigation. She emphasized the need to develop a realm of positive rights, where persons with psychosocial disabilities are not excluded from society, enjoy full legal capacity like others, hold jobs, and receive good quality and voluntary mental health care. She talked about the need to foster multi-disciplinary work in the sector, which will strengthen voluntarism and user consent to treatment. The work of the Gujarat Mental Health Mission and the Mental Health Support Program was described.

Vote of thanks was duly given after this.

Follow up and future activities

As the law teachers came within the University system, it was decided that this activity would be taken up next year, in collaboration with the University / law faculty in the state of Gujarat as well as the Legal Services Authority. Proposals have been received by the Gujarat State Legal Services Authority from a local Law College to this effect. The Gujarat State Legal Services Authority has offered all co-operation necessary to sustain the program in the long run. Some ideas suggested have been:

1. Faculty training
2. Training of Trainers in Gujarat
3. Bringing out a training manual for the future

Since this training, we have also received offers from other State Judiciaries, notably Maharashtra and Andhra Pradesh, where we can provide similar programs. We are very satisfied that the pilot has proved to be an extremely challenging and fruitful learning experience for us. There was also a seamless and enriching quality to the collaboration with the Gujarat State Legal Services Authority, and we have learnt much from the dynamism of this department in terms of working together.

Impact of our work

• Establishment of rapport and goodwill with the GSLSA and the promise of future collaboration
• A more informed judiciary on the topic of law and psychosocial disability, at all levels of legal functions, though the scope of the work is enormous and needs to be continued
• The creation of a valuable set of curricular materials suited to diverse groups of legal officers
• Inter-sectoral good will and dialogue process established between the health department and the judiciary through mutual exchanges as key resource persons or chief guests in Bapu programs in Gujarat
• Visits by the legal officers including the Chief Justice of Gujarat High Court to the Ahmedabad Mental Hospital and creating awareness about the Legal Services Authority to the patients through interaction and activities
• Creation of a legal aid cell for persons with psychosocial disabilities
• Growth of the trainers during the training process, in terms of capacity to train this group of people, being clearly sited in the practice needs of the training groups, and working together in an easy, mutually supportive and grounded manner
• Ideas and plans for future trainings of this nature in other States

Special thanks to

• Hon Justice JN Bhatt
• Member Secretary, Hon Judge Jyotsna Yagnik for unconditional warmth, love, hospitality and support throughout the programs
• Project officers, Mr PC Thaker and Mr SG Pathan, and all the GSLSA staff for total involvement and support to our programs
• All the participants for the stimulating discussions

Co-ordinator from the GSLSA, Hon Judge Jyotsna Yagnik

Hon. Judge Yagnik worked as Principal in IM Nanavati Law College, Ahmedabad, and was Prof in charge of PG Center in Law from 1998 – 99; has taught law subjects to diverse student groups on various laws.

Was appointed as conciliator and trainer for ADR in the Panel of the International Center for ADR, New Delhi and has served many years as conciliator and mediator in social organizations, institutions and Lok Adalats; given talks and lectures in many courses; also in the media

• Practiced in Gujarat High Court, City Civil Court, Small Cause Court, Criminal Courts, Rural Courts and various tribunals from 1986 – 1999
• Conducted many educational programs of the Lady Advocates Wing (Gujarat) in the capacity of Secretary
• Was City Civil and Additional Sessions Judge at City Civil and Sessions Court, Ahmedabad; Secretary and Joint Secretary of Ahd Bar Association for 5 years; Deputy Director, Gujarat State Judicial Academy; presently Member Secretary, Gujarat State Legal Services Authority, Ahmedabad
• Presently working to finish a Ph. D. on the CEDAW
• Has given many, many lectures and published academic papers in national and international forums, on diverse topics such as women and law, ADR, gender diversity, and has been awarded the international award “UNO 2004”, for excellence in Women, Empowerment and Human rights.

About the course co-ordinator

• Prof. Amita Dhanda, Ph. D., is a Professor and teacher of Law in the law faculty of NALSAR
• Author of Legal order / mental disorder, from Sage Publishers and edited, written scholarly books and papers on various topics relating to disability, psychosocial disability, women and poverty.
• Member of SC appointed committee for inquiry into the status of mental and related custodial institutions in West Bengal in the Sheela Barse case in 1989.
• Chairperson of the National Amendment Committee (PWDA,1995) and authored a report with recommendations pending before the Parliament.
• Founder Trustee of Bapu Trust, Pune.
• India Representative at the Ad Hoc Committee meetings of the UN Convention of Disabilities, through Bapu Trust and the World Network of Users and Survivors of Psychiatry.
• Well known expert in the field of international and national disability laws

About the co-trainer

• Dr. Bhargavi V Davar finished her Ph.D. from the Indian Institute of Technology, Mumbai, in the field of the Philosophy of Psychiatry.
• Researcher, having published Psychoanalysis as a Human Science (1995), Mental Health of Indian Women (1999) and edited Mental health from a gender perspective (2001). Has published in various peer reviewed journals and chapters of books in the area of policy, gender, culture and mental health.
• Founder and Managing Trustee of Bapu Trust, Pune; Director of the Center for Advocacy in Mental Health, Pune; Advisory to Seher, a mental health service program of Bapu Trust.
• Course co-director of the Gender and Mental Health program of the Bapu Trust and trainer in various Bapu Trust training programs for government officers and civil society.
• Presently involved in various research projects in social sciences, culture, policy and mental health as principal investigator at the Bapu Trust.

Further details of the reports may be obtained from our library and documentation center. Details are given below:

Project Title: Enabling Mental Health Environment in Gujarat , 2003-2005

Draft reports of
1. Trainings of Judges in Training, 8th and 9th January, 2005
2. Trainings of Judges in Training, 13th and 14th February, 2005
3. Trainings of Legal Aid Lawyers, July, 2nd and 3rd, 2005
4. Trainings of Judges, July 23rd and 24th, 2005
5. Trainings of Legal aid consultants and public prosecutors, 9th and 10th December, 2005

Course Co-ordinator: Dr. Amita Dhanda, NALSAR, Hyderabad
Co-trainer: Dr. Bhargavi Davar, Bapu Trust, Pune

In collaboration with the Gujarat State Legal Services Authority, Gujarat.

Venue: Old High Court Building, Offices of the GSLSA, Gujarat.
Leadership: Hon. Justice Jyotsna Yagnik

Draft report by Bhargavi Davar

Submitted to : MHSP Co-ordinating office, Ahmedabad
December, 2005

Center for Advocacy in Mental Health
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