Editorials/Opinions Analysis For UPSC 10 December 2025
Content: Care as disability justice, dignity in mental health Charting an agenda on the right to health Care as disability justice, dignity in mental health Why is in News? A recent opinion piece by practitioners from The Banyan highlights: Deep gaps in India’s mental health-care model The limits of a purely biomedical and deficit-based approach The urgent need for a dignity, equity, and disability justice–centred framework The article gains policy relevance due to: Persistently high suicide burden 70–90% global mental health treatment gap Rising concerns over: Institutional abuse Homelessness Continuity of care failures Relevance GS-2: Governance, Constitution & Social Justice Right to mental health under Article 21 (Right to Life) State responsibility for: Rehabilitation Continuity of care Institutional accountability Failure of: Community mental health integration Aftercare & housing support Mental health as a rights-based welfare obligation, not charity GS-3: Health Sector & Human Development India’s 70–90% treatment gap in mental health care Structural neglect: Severe shortage of psychiatrists, psychologists, social workers Over-reliance on: Tertiary hospitals Pharmacological solutions Weakness of: District Mental Health Programme (DMHP) Practice Question Mental health is no longer merely a medical issue but a question of governance, dignity, and social justice.”Critically analyse.(250 Words) What is meant by Mental Health & Psychological Disability? Mental Health (WHO understanding) A state of: Emotional well-being Ability to handle stress Productive functioning Meaningful social participation Psychosocial Disability Disability arising from: Mental illness plus Social barriers (stigma, exclusion, poverty, institutional neglect) Recognised under: Rights-based disability frameworks UN Convention on Rights of Persons with Disabilities (UNCRPD) Article’s Core Arguement Mental health suffering: Cannot be captured by statistics alone Requires attention to: Lived experience Trauma histories Social abandonment Present system: Focuses on “fixing the patient” Ignores: Broken families Violence Homelessness Caste, gender, class marginalisation The article calls for: A shift from clinical correction → dignity, justice, and relational care Data Points From National Crime Records Bureau (NCRB) suicide data: ~33% suicides → Family problems ~10% suicides → Relational breakdowns Key emotional drivers (largely invisible in data): Shame Rejection Alienation Abandonment Insight: India’s distress is relational and social, not just clinical. Critical Gaps in Current Mental Health Care Model Deficit Lens People seen as: “Maladaptive” “Unmanageable” Not as: Survivors of: Abuse Structural neglect Over-medicalisation Bias Excess focus on: Neurotransmitters Diagnosis Pills Under-focus on: Meaning Purpose Belonging Human relationships Continuity of Care Failure Many patients: Drop out Lose faith in institutions Slide into: Homelessness Chronic despair Context Blindness Social causes not integrated: Housing insecurity Economic precarity Gender violence Caste exclusion Queer marginalisation Intersectional Model The article rejects single-cause explanations and supports overlapping causation: Domain Examples Biological Neurotransmitters, inflammation Psychological Trauma, learned helplessness Social Isolation, poverty Cultural Loss of meaning systems Political Oppression, weak welfare Historical Intergenerational trauma, colonial legacy Key Point: These act simultaneously, not in competition. Disability Justice Disability justice goes beyond: Hospital access Medication availability It demands: Dignity Equity Inclusion Context-sensitive care Care becomes: A relational process Not a transactional service Reimagining Care From Treatment → Meaningful Life Shift from: “Symptom reduction” To: “What does this person need to live the life they want?” From Linear Recovery → Non-linear Healing Accept: Setbacks Relapses Long-term dependence on support From Institutional Control → Relational Justice Trust building Honest collaboration Dialogic care From Specialist Monopoly → Lived Experience Practitioners Recognise: Peer supporters Community caregivers Provide: Training Remuneration Institutional backing Combined Necessity Material Needs Relational Needs Housing Belonging Income Trust Medication Purpose Food Identity The article asserts: You cannot heal only with a house, and you cannot heal only with medicines. Implications for Mental Health Education and Research Education Must Train For: Sitting with uncertainty Navigating social complexity Celebrating small recovery wins Ethical discomfort handling Research Must Shift Toward: Implementation science Micro-level care processes Transdisciplinary methods Real-world sensitive evidence Longitudinal trust-based outcomes Conclusion India’s mental health crisis: Is not only a medical challenge It is a social, ethical, economic, and governance crisis True reform requires: Moving from clinical efficiency → moral responsibility From symptom control → dignified living Without addressing: Poverty Violence Social abandonment Discrimination → Mental health systems will remain fragmented and ineffective Charting an agenda on the right to health Why is in News? The National Convention on Health Rights (11–12 December 2025) is being held in New Delhi, timed between: Human Rights Day – Dec 10 Universal Health Coverage (UHC) Day – Dec 12 Organised by Jan Swasthya Abhiyan (JSA), a nationwide civil society coalition active in 20+ States. Around 400 public health professionals, activists, and community leaders will: Review lessons from COVID-19 Oppose commercialisation and privatisation of health care Renew demands for Right to Health as a Fundamental Right Relevance GS-2: Governance, Constitution & Social Justice Right to Health under Article 21 State vs Market in welfare provisioning Regulation of private health sector Federal health financing gaps Discrimination in service delivery GS-3: Health, Economy & Human Development Public health expenditure crisis Insurance vs public provisioning Medicine price regulation Health workforce as economic infrastructure Climate & pollution as health risks Practice Question India’s mental health crisis reflects the failure of community-based and continuity-driven care.Discuss with reference to homelessness, relapse, and disengagement from treatment. (250 Words) What is Right to Health ? Constitutional Status in India Not explicitly a Fundamental Right Interpreted under: Article 21 – Right to Life Strengthened through: Directive Principles: Article 38 – Social justice Article 39 – Health of workers Article 47 – Duty of State to improve public health International Basis Universal Declaration of Human Rights (1948) – Article 25 International Covenant on Economic, Social and Cultural Rights (ICESCR) – Article 12 Embedded in Universal Health Coverage (UHC) principle: Access to quality health services without financial hardship Core Message of the Convention “Health care for people, not for profits.” The convention argues that: India’s health system is being pushed towards privatisation This threatens: Affordability Equity Universal access Health must be treated as: A public good Not a market commodity Issue 1: PRIVATISATION & PUBLIC–PRIVATE PARTNERSHIPS (PPPs) What is happening? Medical colleges & public health facilities being: Handed over to private players Expansion of: PPP-based healthcare delivery Why is it problematic? Weakens: Public hospitals Primary Health Centres (PHCs) Increases: Out-of-pocket expenditure (OOPE) Converts: Patients → paying customers Ground Resistance Movements Andhra Pradesh Karnataka Mumbai Madhya Pradesh Tribal Gujarat Issue 2: UNREGULATED PRIVATE HEALTH SECTOR Private healthcare expansion driven by: Domestic & foreign investment Pro-corporate health policies Regulation remains weak despite: Clinical Establishments (Registration and Regulation) Act Consequences for Patients Overcharging Unnecessary procedures (especially C-sections) Opaque pricing Violation of patient rights Convention Demands Rate standardisation Transparent pricing Mandatory enforcement of: Charter of Patient’s Rights Accessible grievance redressal systems Issue 3: CHRONIC UNDERFUNDING OF PUBLIC HEALTH Current Public Health Spending Only ~2% of Union Budget allocated to health Annual per capita public health spending ≈ $25 Among the lowest globally Structural Outcome High Out-of-Pocket Expenditure (OOPE) Insurance-heavy model without: Strengthened public hospitals Convention’s Key Critique Govt health insurance schemes: Claims > Reality Demand shifting to: Higher direct public spending Reduced OOPE Universal free public provisioning Issue 4: JUSTICE FOR HEALTH WORKERS COVID-19 Exposed: Dependence on: Doctors Nurses Paramedics Sanitation & support staff Persistent Problems Low wages Insecure contracts No social security Unsafe working conditions Convention Demand: Decent work, legal protection & workforce rights as a pillar of resilient health systems Issue 5: ACCESS TO MEDICINES Key Data Medicines = up to 50% of household medical spending >80% of medicines outside price control Market Failures Irrational drug combinations Unethical marketing High retail mark-ups Convention Proposals Stronger price regulation Remove GST on medicines Expand public sector drug manufacturing Enforce rational prescription norms Issue 6: SOCIAL DISCRIMINATION IN HEALTH CARE Special focus on: Dalits Adivasis Muslims LGBTQ+ persons Persons with disabilities Problems: Denial of care Poor quality treatment Stigma & structural exclusion Convention Lens: Health is not just biological — it is deeply social and political Issue 7: SOCIAL DETERMINANTS OF HEALTH Health linked with: Food security Air & water pollution Climate change Housing Employment Convention Approach: Inter-sectoral health governance “Health in All Policies” framework Parliamentary Engagement Convention timed during: Winter Session of Parliament Delegates will engage directly with: Parliament of India Aim: Influence legislative debate on: Right to Health Public health financing Medical regulation Workforce laws 25 Years of Jan Swastya Abhiyan Active since 2000 Worked across: Women’s movements Rural groups Science collectives Patient rights platforms Known for: Pro-people health advocacy Public sector defence Medicines access campaigns Conclusion The National Convention on Health Rights, 2025 represents: A direct ideological challenge to health commercialisation A renewed civil society push for universal, publicly funded health care Central message: India cannot achieve Universal Health Coverage through privatisation, insurance alone, or weak regulation. The future of Indian health must rest on: Strong public systems Adequate government financing Workforce justice Medicine affordability Social inclusion Only then can health truly become a Fundamental Right in practice, not just in principle.