A recent study by the World Health Organisation (WHO) presented that 7.5% of Indians suffer from some Mental Health Conditions. However, India has less than 4,000 medical practioners to tackle this problem. The prevalence of mental health issues and the amount of people who actually get treated, also known as the Treatment Gap, is more than 70 per cent. These statistics clearly reflect the poor conditions of Mental Healthcare in India. But when the general public is out through so much, one can only imagine the situations of the one’s from the weak classes. Mental Health in India is surely a luxury. But the price gets higher and higher when one looks into the lower to lower vulnerable sections of people with no people to look after or pity. But who are these people? They can include the transgender community, the refugees, the migrant labourers or the least liked section of them all, the Prisoners.
It is an established fact that prison conditions are poor in India. According to the reports published in April i.e. the Prison Statistics India 2016, by the National Crime Records Bureau (NCRB), around the end of 2016, 68% of the prisoners were actually under trials. This clearly shows how poor the legal system of our country is and how unnecessarily under trials are put in to these prisons. This represents how maximum prisoners are put to prisons due to faulty arrest and ineffective legal aid system. Another thing to find out is the under use of Section 436A of the Code of Criminal Procedure. According to this section, any under trial prisoner is eligible to be released if he serves half of the tenure of the total tenure of prison he would face if the crime accused on him was proved. In 2016 for instance, only 929 prisoners were released from prison when in reality, 1557 under trial prisoners matched the eligibility. This can be accounted to the fact that most of the prison officials are unaware of such provisions. This was found out through a research by Amnesty India where it was found out that most of the prison officials were unaware of this section and were therefore unwilling to apply it.
Prisoners constitute of a large class of people, unlike what the general notion remains. As we are aware, prisoners consist of the accused and the convicted. These people come from various different classes of the society, from different states of India and are forced to live together. They are already at a vulnerable part of their lives, and are pushed forward to more than they can expect. But what is forgotten is also the fact that they come from different stages or levels of mental health. They may be disturbed from previous life experiences, or may be struggling from guilt of conviction. They may also be unable to accept this new change of life and/or are sent to a shock state. Prisoners also suffer through a lot mentally, and just like any other citizen, have their ‘Right to Mental Health Care’. It was observed by a study that from 2015 to 2016, the percentage of suicide had increased with a percentage of 28% among Prisoners. By a report by the NCRB, it was found out that for every 21,650 prisoners, there was only one mental health professional. Only six states and a union territory had psychologist or psychiatrist with states like Odisha, Madhya Pradesh and Uttar Pradesh, that have the greatest number of prisoners with mental health problem had none. These data are enough to spark a conversation about the problem of mental health care of prisoners in India. The dialogue for their rights can only begin when an elaborate study regarding their conditions are put out, and the general public gets a hang of their problems.
To identify the present mental health condition of the prisoner
To analyse the laws protecting the mental health of prisoners.
To identify the common problem in relation to the mental health of the prisoner
To analyse other countries mental health system
What are the different laws in relation to the mental health of prisoners?
What is the present mental health condition of prison population in India?
What are the changes that are needed to improve the mental health of the prisoners?
Why is it important to ensure the mental health of prisoners?
How do other countries support the mental health of their prisoners?
The research methodology used for this paper is Non-doctrinal or empirical form of research. Primary sources i.e. Data collected through various surveys are being analysed. Heavy emphasis is put on the researches that have been made by various Psychiatric Commissions for better understanding about general mental health. References have been made to other documents for the data regarding other countries. Case studies have also been conducted.
Table: Prevalence of Psychiatric Disorders in Prisoners
Disorders %Psychiatric Disorders 33Schizophrenia3.4Bipolar Affective Disorder2.5Delusional Disorder0.8Depressive Disorders16.1Generalized Anxiety Disorders6.0Obsessive Compulsive Disorders2.5Drug Abuse/Dependence 58.8Somatoform Disorders 1.7
The above-mentioned table presents the major psychiatric disorders prisoners face of and the amount it has affected the class. The study shows the prevalence of Drug Abuse or substance abuse as the most spread mental illness with more than 50% of the affected people suffering from it. In fact, it is said that the data could higher as some prisoners were hesitant in pointing this problem out. Similar data had been found in surveys done in other Indian as well as western scenarios for the same.
Mental Disorders are in fact higher in prisoners as compare to the general population. Studies have found out that 33% of Prisoners have some mental disorder. This comes after the expulsion of Drug or Substance Abuse. Depressive disorders also form a big part of the Problem.
A lot of times, prisoners already suffer from some kind of mental health issue. These could include weakened judgement skills, absence of impulsive control, suspicion, the absence of inhibitions, bizarre ideas, trust issue with people in general, hallucination and delusion. Few of them, as much as 3.4% in our data, suffer from Schizophrenia. Other times, they start suffering from such issues, after getting admitted.
The Constitution is the guarantor of its citizens right. Out of the thirty-two fundamental rights, the right that holds supreme importance, the most vital for a democracy, is Article 21 which provides us with Right to Life and Personal Liberty. The Supreme Court has held that right to life includes the right to live with human dignity. And this, along with the Directive Principle of State Policy established the right to protection of health as a Fundamental Right, ought to be held by the government.
Due to this, there have been various instances where it has been witnessed, that, when a government hospital does not provide on-time health care facility, it is a violation of the person’s fundamental right.
Major cases highlighting the importance of Right to Health include cases like CESC Ltd. v. Subhash Chandra Bose. In this case the Supreme Court stated that Right to Health did not only mean the absence of sickness. The court felt that medical facilities do not only provide a person against various kinds of sickness but also ensures a stable manpower to the country’s budget. The Supreme Court felt that leading a health life, or getting provided for it was a type of Social Security. The court finally stated that Right to health is the basic right of a workmen.
Another case highlighting the importance of health care is the case of Mahendra Pratap Singh v. Orissa State. This case highlighted that people are entitled to adequate healthcare. The case mainly focused on the fact that every person has the right to basic health care, if not a fancy hospital, a Primary Health Centre. It was stated by the courts that achievements can only be unlocked by people if they live a healthy life. The lack of healthy life means the lack of achieving these dreams.
A person’s mental health, is also an inseparable part of their healthy being. A person not treated for having a mental issue is as much a violated of his right as a person with physical ailment. A prisoner, is as much a citizen of India, as a general person is. Violating his mental health is a violation of his Fundamental Right. Therefore, it is necessary for the government to make provisions for his right.
Factors affecting the Condition
But before looking in for actions, we should look into the reasons behind the poor mental health conditions of the prisoners. To examine this issue, we should begin with the prison conditions to which these people are exposed to.
Prison overcrowding is a big issue for India. Prison overcrowding basically means that the number of prisoners in the prisons are more than the actual capacity. According to The Week, the capacity of holding prisoners in India was 3.78 lakhs when the actual amount was 4.19 lakhs in 2017. Due to this overcrowding, prisoners start facing suffocation. This suffocation leads to many health problems, but on the mental per say it creates mental instability for them. New prisoners face a lot of problem in adjustment. They leave their homes, and are therefore already in a vulnerable state. In these times, when they are forced to live in small spaces with people who they are not acquainted with, it causes a lot of stress emotionally and mentally. They are unable to concentrate or do normal activities like fellow people. They lose sleep, which also affects them mentally. Anxiety, depressive feelings, losing interests, excessive amount of stress and strain and the inability to enjoy life comes in picture.
Another major issue, which is also a vicious cycle is the treatment of fellow inmates. When kept in an enclosed space, one has two options. The first is to isolate oneself from the fellow mates. This can cause social isolation and lead to personality disorders. The other option is to join in a group. These groups are not fun, social groups. These refer to the gangs that are made up. These groups cause detrimental effects to a new comer. The gangs do not treat fellow prisoners well, which means that they suffer due to the bad behaviour or join them to also start creating problems for the fellow inmates. Hence, a vicious cycle is created. Something to protect oneself, but at the cost of others.