The World Health Organisation (WHO) defines mental health as a state of well-being that enables individuals to navigate life’s challenges, utilise their skills, learn, work, and contribute to their community. Ensuring mental well-being is integral to overall health.
With the growing population in India, the number of prisoners has also increased over time. While the government has taken steps to meet the needs of the general public, including their overall health issues, many basic rights of prisoners related to the right to life under Article 21 of the Indian Constitution have been found to be violated and one of this right is related to mental health of the prisoners.
In comparison to the general population, prisoners face an elevated risk of both mental and physical health issues, a reality extensively documented through research across various countries. Prisoners are at a higher risk of mental disorders compared to the general population. Overcrowding in prisons is one of the reasons for the increase in mental disorders among prisoners.
Responding to this concern, a panel comprising Justices S Abdul Nazeer and V Ramasubramanian has issued notices to the Central Government, state administrations, and Union Territories in response to a PIL filed by Kush Kalra. Kalra employed RTI applications to expose insufficient mental healthcare infrastructure in 56 state prisons, as mandated by the Mental Health Act of 2017, specifically Section 103(6). Even in court, Jyotika Kalra, representing Kush Kalra, emphasised that the harsh conditions within prisons lead to mental illness among inmates due to isolation and overcrowding. The petitioner highlighted the violation of the Mental Healthcare Act, 2017, and called for Supreme Court intervention through training and awareness programmes for prison staff, as required by various sections of the Act. According to NCRB (National Crime Records Bureau) data, Delhi ranked third in terms of jail suicides. Unnatural deaths, including suicides, within Indian prisons escalated by over 10% in 2019, with the PIL documenting 165 such deaths. The prison statistics report for 2020 revealed overcrowding at a staggering 118%, surpassing the intended prison capacity.
It is equally imperative to underscore that India has one of the highest under-trial populations globally. Even many are not aware of Section 436A of CRPC. Section 436A of the CRPC (Code of Criminal Procedure) plays an important role in the release of undertrial prisoners, stating that an undertrial possesses the right to seek bail after serving half of the maximum potential sentence. Detention in prison cannot exceed the maximum potential sentence duration. However, this provision doesn’t apply to those facing charges punishable by death. Questions arise here about how many undertrial prisoners have benefited from this provision. Despite these provisions, the current data related to undertrial prisoners tells a different story. Even the Probation of Offenders Act, 1958, whose primary motive was to provide a chance for offenders to rehabilitate themselves instead of becoming entrenched in criminal behaviour, seems to have failed in controlling the prisoner population. Section 360 of the Code of Criminal Procedure states that individuals above the age of twenty-one who have not been previously convicted of crimes resulting in imprisonment exceeding seven years or death can be granted probation based on their good conduct. Research is needed to find the actual data on how many accused persons have benefited from this Act.
Tragically, prisoners in India are twice as likely to die by suicide compared to the general population, as reported by the Commonwealth Human Rights Initiative (CHRI). The World Health Organisation and the International Red Cross recognise that factors such as inadequate healthcare, overcrowding, and violence amplify prisoners’ vulnerability to mental health issues. According to the Tata Trusts’ India Justice Report (2020), Indian prisons lack 41% of the required medical staff, and in 35 out of 36 states and union territories, inmate populations exceed 50% of capacity. Kumar and Daria (2013) stress that prisoners suffer from elevated rates of psychiatric disorders due to these circumstances. Furthermore, the criminal justice system falls short in addressing a range of mental illnesses, leading to a larger number of mentally ill prisoners being incarcerated.
To address these concerns, an advisory recommends enhanced identification of prisoners with mental health problems and improved access to authorities for those with psychological issues. However, current mechanisms often prove ineffective. As per the Mental Healthcare Act (MHCA) of 2017, prison medical officers are mandated to report mentally ill prisoners to Mental Health Review Boards (MHRBs) quarterly. These boards have the authority to visit correctional facilities and transfer prisoners to mental health facilities. However, as of October 2020, only three states had established MHRBs. Certain high courts, like those in Delhi, Karnataka, and Kerala, have intervened in this matter. The practical implementation of this recommendation remains uncertain without the presence of these authorities. Recent studies have shown that AI can be used to identify patients at risk of suicide or mental disorders. Even the jail administration can use this technology to identify mental health disorders among prisoners.
In 2019, a PIL was filed in the Madras High Court calling for a dedicated medical wing in the Central Prison to provide specialised mental healthcare. Even Dr. Rabia and Dr. Raghavan emphasised in the Indian Journal of Social Psychiatry (2018) the importance of establishing mental health clinics within prisons for early detection and intervention. They proposed regular visits by mental health professionals and prompt transfers of prisoners to psychiatric facilities. To address these conditions, prioritising the recruitment of psychiatrists, psychologists, and psychiatric nurses is crucial. However, the current situation reveals a stark contrast between the number of prisoners and the limited number of psychiatric professionals appointed to jails. At present, there is only one psychiatrist for every 16,503 prisoners. This data clearly indicates the need for an increased number of psychiatric professionals in prisons.
Data convergence emphasises urgent action to counter overcrowding’s role in prisoner mental health issues. Government responsibility is paramount, with Sections 436A and 360 of the Code of Criminal Procedure offering tools for effective overcrowding mitigation. The courts acknowledgment of prisoners’ mental health rights reinforces the need for prompt intervention. Collaborative efforts are key: mental health review boards, increased psychiatric staff, and AI integration aid in identifying and addressing mental health concerns. This goes beyond legal obligations, reflecting a moral duty to safeguard fundamental rights. By prioritising mental well-being and reforming overcrowding, India can reshape its correctional system to foster rehabilitation and respect human dignity.
Dr. Pyali Chatterjee is the HOD, Faculty of Law, ICFAI University, Raipur Chhattisgarh.