Mental health refers to an individual's emotional and psychological well-being. It is an integral part of our well-being and is more than the absence of mental illness. It affects the way we think, feel, and behave. Therefore, it is important at every stage of life, be it childhood, adolescence or adulthood.
According to the National Mental Health Survey 2015-16, nearly 15 per cent of Indian adults need active professional intervention for one or more mental health issues. As of now, India has only 0.75 psychiatrists per 100,000 individuals. The country is short of mental health experts based on the current population. Moreover, access to mental health services is very problematic for vulnerable populations such as pregnant women, migrant workers and refugees. The said vulnerable population also includes prisoners in Indian prisons. Prisoners come under the bracket of minorities whose mental health needs are usually overlooked.
In August 2019, during a day-long national-level review meeting on mental health, hosted by the National Human Rights Commission (NHRC), the NHRC Chairperson former Chief Justice H L Dattu affirmed the need to safeguard the interests of prisoners with mental illness. He said that protection of the rights of prisoners with mental health issues is an obligation of state governments.
Mental health issues of prisoners have also been addressed by the Supreme Court in the case of accused X v. State of Maharashtra. It was noted that various facets such as overcrowding, violence, isolation, and absence of familial affection could adversely affect a prisoner's mental health. In this case, the accused(X) was convicted for committing the brutal rape and murder of two minor girls and was on death row for almost 17 years. He was eventually diagnosed with a post-conviction mental illness.
The Apex Court observed that post-conviction mental illness is not sufficient to commute the death sentence of a convict. For such computation, the offender needs to have a severe mental illness or disability. The Court laid down a 'test of severity' that can be a guiding factor to recognise those mental illnesses which qualify for an exception. Moreover, the Court directed state governments to work towards building a strong mental health infrastructure in prisons. The three-judge bench keeping in mind that accused(X) had been undergoing some sort of mental irritability since 1994 held that he required care and treatment, hence the sentence of death was commuted to imprisonment for the remainder of his life.
A report by the National Crime Records Bureau (NCRB) reveals that in 2016 alone, about 102 people died by suicide. In 2014, the National Human Rights Commission showed that a person was one and a half times more likely to die by suicide while he or she was in prison. Moreover, out of 4 lakh prisoners, nearly 6,000 have mental health issues. The NCRB report also highlighted the acute shortage of professionals and psychologists to look after the needs of these prisoners.
According to researchers from the Amnesty International (AI), India, 68 per cent of prisoners are under trial, which means that they are awaiting their verdict, they have not been found guilty and have only been accused of an offence. This actually signifies that two-thirds of prisoners in the country are UTPs. Sadly, India ranks among the worst ten nations when it comes to the percentage of UTPs that is 'Under Trial Prisoners'. These prolonged trials can be a major factor behind the erosion of the mental health equilibrium of inmates.
The above statistics clearly indicate that India is in immediate need of a well-reformed and structured prison policy and system to ensure the mental well-being of prisoners. Procedural complexities and an absence of satisfactory health infrastructure coupled with an immense amount of overcrowding and seclusion amounts to a surge in mental health issues among prisoners. Other than that, negative factors such as drug use, violence, apprehension about the future, inadequate health services can deteriorate the mental health of prisoners.
Section 103 of the Mental Health Care Act 2017 makes it mandatory for the state to admit a person having mental health illness to a suitable mental health establishment and to provide all the essential arrangements for the treatment of the person concerned.
Article 10 of the International Covenant on Civil and Political Rights (ICCPR) mandates the state to treat all persons who have been deprived of their liberty with humanity and with respect. Further, it requires reform and social readaptation of prisoners to be an essential aim of imprisonment.
Conclusion and suggestions
It is primarily believed that inflicting rigorous punishment on criminals would make them repent their wrongdoing causing them to be better individuals and law-abiding citizens. However, this notion of retribution does not harmonize with the attributes of 'liberty and justice for all' embodied in our Constitution. Repudiation of rights and dignity to prisoners is a violation of human rights and natural rights. Therefore, it is a legal, moral as well as constitutional duty of the Indian state to secure the rights of each and every prisoner, particularly the one with mental illness and ensure that they are subsisting a dignified life.
The Indian judicial system should aim to reduce the time for verdicts and set up mental health clinics within prisons for early detection and intervention. Medical personnel possessing training in basic mental health will result in timely identification of mental health issues. Frequent interventions such as mental health professionals visiting and interacting with prisoners would benefit from prompt referral for immediate treatment of patients with critical illnesses in a nearby hospital. Moreover, conducting regular mental health awareness sessions for prisoners would make them informed about the importance of mental well-being. A step in the right direction would be to focus on building rehabilitation centres and rehabilitation programs conforming to the needs of patients. Procuring proper mental health services and easy access to them can certainly lead to better mental health of prison inmates.