MENTAL HEALTH CONDITIONS OF PRISONERS IN INDIA

 The degree of civilization in a society can be judged by entering its prisons.

-Fyodor Dostoevsky

India has a population of 1.83 billion people with nearly 5000 psychiatrists catering to such a huge population. There is a significant gap in implementing effective treatment of mental health disorders in our country, moreover, the access to such resources is even more difficult to the vulnerable population such as refugees, pregnant women, migrant labourers and the most neglected part of our society; prisoners.^[1]Contrary to the general belief of our society, prisoners form a heterogeneous group of people who come from diverse and disadvantageous backgrounds. With the lack of basic amenities in prison, limited space, absence of proper healthcare facilities and overcrowding of inmates, the prisons in India predispose the prisoners to various mental disorders which remain neglected. The most disturbing fact is that 68% of the prisoners are under trial, which means they have only been accused of the crime and not held guilty. 

When the prison statistics released by the National Crime Records Bureau didn’t reveal the number of mentally ill prisoners, it seemed as if the prisons did not have such prisoners. This would have been great news considering the state of prisons in India, however, it is not true. This article aims to analyze the laws which exist for mental health illness and provide suggestions for improvement. 

LEGAL STANDPOINT

 In 2014, the NHRC released a report on suicide by prisoners^[2], in which it was stated that a person was 1.5 times more likely to commit suicide while he is in prison. Out of the 4 lakh prisoners, 6000 had odd mental health issues which were ignored. Protection of rights of prisoners who have mental health issues is an obligation of the government under Section 103 of Mental Healthcare Act, 2017. Efforts have been made to improve the state of mental health care of prisoners in the country but a huge gap still remains between the requirement and availability of facilities in the sector.^[3] Section 103 mandates that a prisoner with mental health illness should be admitted only in a mental health establishment and all the necessary arrangements should be made for the person. However, there is no clear mechanism to check and assess the mental health of the prisoner in prison or when he/she is admitted in prison. Chapter 8 of the Prisoners Act also talks about the mental health of the prisoners and how the jailer has to inform the Medical Subordinate about any prisoner whose state of mind or body seems to require attention and thereafter the jailer has to follow the instructions given by the Medical Officer. Further, Article 38 of the Prisoners Act requires the prison authorities to maintain a day to day record of the directions given by the Medical Officer and whether or not those instructions were complied with. Despite these provisions, many such prisoners remain unnoticed and there is hardly any implementation in real life.

Apart from the Indian legislations, international legislations and rules also contain provisions for respecting a prisoners’ right. Article 10 of the International Covenant on Civil and Political Rights states that all persons who have been deprived of their liberties should be treated with humanity and respect. The International Covenant on Economic, Social and Cultural Rights states that prisoners have the right to the highest standard of physical and mental health. The environment in the prison is often one of violence and high-risk lifestyle but it is the duty of the authorities to create an environment wherein individual safety of the prisoner can be guaranteed. 

Sensitization of the staff in the prisons, betterment of the prison environment along with respecting a prisoner’s right to recreation are small yet effective steps which can be taken for improving the deteriorating mental health of the prisoners. 

SUGGESTIONS 

The suggestions for reform mentioned below indicate what can be done at a programmatic level to help in the improvement of mental health of prisoners. 

● Proper evaluation of prisoners: This evaluation should include a mental state history as well as substance use history of the prisoner at the time of entry into prisons. Any prisoner having a history of mental illness should be further evaluated so as to get details of their case and treatment should be meted out accordingly. 

● Provision of basic mental health care: The staff in the prison needs to be sensitized and trained so that they are able to identify the mental disorder. One such way to ensure this is by providing a higher remuneration so that they have enough incentive to carry out their duties effectively. Medications such as antidepressants, antipsychotic medicines, mood stabilizers and anti convulsant medications need to be made available in prisons. Special attention is required to be paid to those prisoners suffering from mental disorders after they are released which includes educating the family members to continue the treatment.^[4]

● General upkeep: Basic sanitation facilities, a clean environment, clean drinking water, adequate food and proper toilet facilities are the fundamental needs of any person. Small improvements will go a long way in bringing improvement in the mental condition of prisoners. 

● Improvement in the mental health resources: Allocation of adequate budget to prison health care is an issue which is generally overlooked. There needs to be at least one doctor for every two hundred patients in prisons. The prison authorities need to have a greater say in the allocation of resources as they are better aware of the ground realities of the situation. They should be given the autonomy to form partnerships with organizations or private institutions to fund prison health programmes. 

● Legislative and Legal Reforms: Apart from all the reforms suggested above, the legislature needs to provide alternatives to imprisonment in case of petty offences. Meditation, community service work, warnings, supervisions are some of the alternatives which can be looked into. Free legal aid to offenders suffering from mental disorders should be provided. 

CONCLUSION

In conclusion, it is the need of the hour to have a strong mental health infrastructure in our prison system. Along with that, there is a need to adopt a reformative approach in order to turn the prisoners into law abiding citizens because punishment, of any manner, should not be a tool to disable criminals and deprive them of their right to live with dignity. People with mental health problems have the right to be treated equally under Article 14 of the Constitution and it is the duty of the government to honour this right, even if it’s of a prisoner. Letting such an alienating prison system thrive in India will lead to violation of the right to life of the prisoners and it will do nothing more than provide retributive justice. It is rightly said that an eye for an eye will turn the whole world blind. 

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^[1] Goyal SK, Singh P, Gargi PD, Goyal S, Garg A. Psychiatric morbidity in prisoners. Indian J Psychiatry (2011)

^[2] “Suicide in Prison: PREVENTION STRATEGY AND IMPLICATION FROM HUMAN RIGHTS AND LEGAL POINTS OF VIEW” National Human Rights Commission, 2014

^[3] “State governments obliged to protect rights of prisoners with mental health issues: NHRC” The New Indian Express( August, 2019)

^[4] Suresh Bada Math, ‘Minds Imprisoned: Mental Health Care in Prisons’ (academia.edu)