Prevalence of mental health issues in prisons

Reading time : 6 minutes 

It is common knowledge that with surge in crimes, the number of convicts in prisons has also shot up exorbitantly. With preventive and deterrent theories of punishment being enforced, criminal wrongdoers are conducted into prisons to serve their sentence. Though the main idea behind this is wholly moral in nature and is for the progress of the society, a question arises here: are such punishments truly ethical to the inmates? Indeed it is agreeable that the intended purpose is to disable prospective crimes and to reform the lawbreakers. But from the standpoint of an inmate, how much of the purpose of reformation is actually achieved? Prison inmates, being locked up in dingy cells with no socialization, suffer from constant states of anxiety, PTSD, depression, stress (1) and a myriad of other mental health issues. Psychiatric morbidity faced by past traumatic survivals and female inmates are social issues worth bringing up. The need for validating mental health issues has been pointed out by former Chief Justice of India HL Dattu (2).

Serving a sentence is a punishment in itself; it doesn’t mean their mental health should be undermined. This is a clear cut violation to Article 21 of the Indian Constitution, which enshrines that right to life also includes right to health and medical aid.

Why prisons deteriorate mental health?

Guilt ridden convicts, when curbed in closed and congested space, fail to mentally function and process thoughts plainly. The following reasons affect the prisoners mentally to an extent of taking their lives:

  1. Lack of social life
  2. Being in an atmosphere with people of similar criminal past
  3. Poor mental health facilities that is, lack of therapy sessions
  4. Detachment from loved ones
  5. Constant sense of guilt
  6. Inadequate privacy
  7. Violence in prison cells
  8. Relentless mental agony
  9. Obligatory solitude and isolation
  10. Insecurity about future prospects

How incarceration causes enduring harm to mental health?

All inmates are mentally wired differently, and thus incarceration affects each of them in diverse ways. Nevertheless, every one of the prisoners should be provided with equal treatment for it. The mental torture of imprisonment is beyond intense for cellmates with inherent childhood trauma. Statistics have proven that rates of childhood and adult trauma are high among incarcerated persons. In the United States, 1 in 6 state male inmates reported being physically or sexually abused before turning 18. About 56% of the inmates were reported experiencing childhood physical trauma (4). Such experiences of trauma continue to persist within the prison cells. This can be seen in cases where the said persons had undergone abandonment during their childhood, which is a form of emotional trauma. The effects of this traumatic condition are manifested into their adulthood in prisons. Events in jail like separation of inmates from their loved ones, forceful locking them up in cells and denial from any sort of social interaction elicit the childhood emotional trauma, thereby worsening their mental health condition. A famous 1998 article in Behavioural Sciences & the Law pointed out that, women incarcerators, who were also mothers, suffered more mainly because of separation from their children. Further studies on female inmates showed that around 6% of them identified themselves with early suicidal symptoms during their sentence. Moreover, 22% of such separated mothers suffered extremities of depression and anxiety.

Being imprisoned in closed areas limits one’s choice of activities. As a result of which, they are forced into feeling bored, hopeless and in a continuous state of dreariness. A 2003 research made in England (5) reported that a monotonous life of such prisoners results in elevated emotions of rage, frustration and unease.

Harmful effects of Solitary Confinement on the brain

Solitary confinement is a type of imprisonment where the convict is locked up in a cell for 22-24 hours, with least amount of social interaction. Section 73, Indian Penal Code, 1860 defines the term solitary confinement. Unfortunately, this mode of imprisonment has an everlasting impact on the human brain. Studies have proved that even during their post-release period, they still endure the irreparable damage caused by solitary confinement.

Even if someone without prior mental health issues goes into confinement, he can later develop the symptoms of specific psychiatric syndrome. As per the findings of Dr. Stuart Grassian, the early symptoms include hallucinations, frequent panic attacks, hard time fixating their minds on things, emotional impassiveness, loss in interests and many more (6).

A change in perspective has to be brought upon where solitary confinement is seen as a hindrance to humanity, rather than an elucidation. Being a pure violation of Articles 20(2) and 21 of the Indian Constitution, the need for uprooting solitary confinement is higher than ever. Quoted in the case of Sunil Batra v. Delhi Administration (7), “prisoners are entitled to all fundamental rights which are consistent with their incarceration.”

Solitary confinement is a definite violation of Article 21 that is, right to live with human dignity. Compelling a human to confine in isolation with known alarming consequences defeats the mentioned right. Being unconstitutional in nature, the practise of solitary confinement should be abolished in India. Furthermore, Section 30(2), Prisoner’s Act, 1894 which goes, “Every such prisoner shall be confined in a cell apart from all other prisoners, and shall be placed by day and by night under the charge of a guard.” and Section 56 of Prisoner’s Act, 1894 stating, “Whenever the Superintendent considers it necessary for the safe custody of any prisoners that should be confined in irons, he may, subject to such rules and instructions as may be laid down by the Inspector General with the sanction of the State Government, so confine them.” are abusive of the prisoner’s right as enshrined in the Indian Constitution.

Ways to treat mental illness in prisons

Mental illness has indeed been a prevailing issue that has to be brought to the spotlight of the society. Nevertheless, numerous interim solutions have been propounded to alleviate the burden of such psychiatric morbidity. These include:

  1. Offering appropriate and timely treatment for precarious mental issues
  2. Encouraging the practice of jail diversion programs
  3. Implementation of use of assisted outpatient treatment (AOT)
  4. Boosting cost studies
  5. Instituting intake screening
  6. Mandate release planning (8)
  7. Preventive measures like regular counselling and therapy, effective grievance redressal mechanism
  8. Initial means of treating mental ailments
  9. Arrangements undertaken by the State for treatment of mentally ill prisoners in private hospitals if government hospitals are occupied
  10. Prisoners should be made mindful of their rights to seek medical assistance before being locked up in the prison
  11. Quarterly report of under trial mentally ill prisoners should be sent to the relevant Court
  12. Proper efforts should be taken to rehabilitate people, without family or friends, who regain soundness

Can post-conviction mental illness be an alleviating factor in death penalties?

The emotional status of the prisoners has to be monitored regularly, with proper validation and treatment. The cell authorities should not disregard and turn a blind eye towards such persistent mental issues.

The Apex Court held that convicts suffering from cases of mental illness shall be given an opportunity to have their death sentence commutated. In a verdict, by three-judge bench of Justices N.V. Ramana, M.M. Shantanagouder and Indira Banerjee, goes as, “…the petition is allowed to the extent that the sentence of death awarded to the Petitioner is commuted to imprisonment for the remainder of his life sans any right to remission.”

The judgement also included that “state prisons to set up a mental health establishment in the medial wing of at least one prison in each State and Union Territory, and prisoners with mental illness may ordinarily be referred to and cared for in the said mental health establishment.”  Further added by the Court, “in this state (mental illness), the accused cannot be ignored and left to rot away, rather, he requires care and treatment.” (10)

Is treatment for mental illness in prisons effective?

With the dawn of various treatments for resolving mental illness as mentioned above, the issue is finally being documented and is brought under the spotlight. Some of the measures have indeed proven to be quite effective. Evaluation by Randomised Control Trials (RCTs) has shown that psychological therapies in jails and prisons have actually helped to detect and also mend the mental concerns to a certain extent. Treatment measures like CBT (Cognitive Behavioural Therapy) and regular therapy sessions have scaled down the frequencies of anxiety and depressive episodes.

CBT is a form of modern form of therapy, where emphasis is given on the patient’s thoughts process rather than the circumstances around him. In most cases, CBT has been successful in treating conditions of anxiety and depression.

With an advanced department of the medical teams, early symptoms of mental illness in prison cells are being detected and rectified before the patient is completely engulfed by it. Early detection and acknowledgement of such signs is great start to wholly getting rid of mental instability.

“Ideally, we try to spot early signs of illness in [offenders] these men before there is a need to send them to the [Regional Treatment Centre].” – According to a renowned psychiatrist Dr. James Hillen. (11)

Need for mental health courts (MHC) in India

Mental health courts are set up in the United States, intended to focus on convicts with mental health struggles. Such courts are a necessity in India, given the emotional brawls faced by the inmates. Offenders, in MHCs, have to undergo mentally rejuvenating programmes for releasing them from chains of aggravated emotions. Each programme is custom-made for each person as per their needs and lacks. One of the distinctions between mental health courts and traditional prison programmes is that to complete off the mental health programme, the individual has to showcase visible improvement in terms of his mental health condition by meeting a set of targeted objectives (12). Inculcating such beneficial establishments in Indian criminal justice system would make a ground-breaking difference in rate of recidivism. It is about time that India start implementing the practise of mental health courts.

Conclusion

Encapsulating the whole article into a nutshell, it can be said that introducing mental illness treatment in prisons has struck a balance between humanity and justice. With further operation of such treatments and programmes, soon prison cells will finally serve its purpose of reforming criminals; rather than being an asylum with untreated victims. In this era where cases of constant anxiety and depression are shooting up, incorporating medical facilities for the same is the first step towards doing away with mental sickness. It is highly appreciated that the offenders are finally considered as a part of the human race, and not treated callously. One must grasp that in this above case, the convicts are the victims here, and their mental health issues too have to be recognized and validated. And this is what brings the reformation process into action. Without proper and comprehensive mental health, there is undoubtedly no point in initiating reformation in criminals. With their mental health being restored, and their character being reformed, the society will gradually transform into a humane place to inhabit.  

  • Bill Rankin, “Criminal Justice” 2(8) Visions Journal 27-292005.
  • Stephen Allen, “Mental Health Treatment and the Criminal Justice System” 4 Journal of Health and Biomedical Law 184-185 2008.

Author: Elita Anna Sheen, Third year, Mar Gregorios College of Law, Kerala

Editor: Kanishka VaishSenior Editor, LexLife India.Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s