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Prisoners and mental health

In ordering the release of undertrial prisoners confined to mental hospitals wherever their stay had exceeded the maximum period of sentence for the alleged offence, the Supreme Court has asserted the inviolable nature of human rights for all. It is deeply disturbing that some prisoners of Kerala and Uttar Pradesh have been languishing in mental hospitals for over three decades when they should have been freed many years earlier. Evidently, the provision in the legal system for periodic reviews to assess the mental health of accused and for their transfer to regular prison facilities while facing trial is not working well; the trial courts have also been remiss in safeguarding prisoners’ interests in this respect. While the Supreme Court has struck a blow for prisoners’ rights, it is for the government to review the functioning of the prison health system in its totality. Civilised penal systems acknowledge the right of prisoners to have the same level of health care as other members of society.

The existing framework provides for referral of a prisoner with symptomatic mental illness to a hospital, with a system of review by legal and medical officers. Health needs of prison inmates are complex and the difficulties faced even in developed countries point to the usefulness of integrating prison health services with the public health network. The value of close monitoring has been recognised in containing infectious diseases such as HIV in prisons. It is equally important in handling mental illness. But the bigger challenge is with regard to those who are ready for release, such as those covered by the Supreme Court order. Community and family support for such individuals with a history of mental illness may be weak or absent in many States and the network of qualified institutions available to care for them, patchy. But institution-based mental health care cannot depend on charitable and voluntary initiatives, which can at best be supplementary; the onus is on the state to provide support. The public health system has to take full responsibility for mental health and commit the necessary financial and human resources to offer care to all those who need it.

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