The vulnerability of prisoners to mental health issues in Delhi's Tihar Jail is aggravated by overcrowding, under-staffing, and disregard for the Mental Healthcare Act.
(Graphic: Arnica Kala/The Quint)
Sohaib is currently out on emergency parole due to the COVID-19 pandemic, but he feels his mind is still incarcerated. He's one among the 18 prisoners The Quint interviewed to understand how Delhi's Tihar prison not only confines the body, but also punishes the soul.
The Quint also moved RTI applications to all the 16 jails of the Tihar Prison Complex, the jail hospital, and the prison legal department, to seek data on how mental illnesses are identified, assessed, and treated by the prison authorities.
Tihar Jail is 'breeding ground' for mental health crisis.
The State is obliged under Article 21 of the Constitution to protect not only the physical, but also the mental health of persons in its custody.
In Accused X v State of Maharashtra (2019), the Supreme Court reiterated this obligation. The apex court highlighted that overcrowding, various forms of violence, enforced solitude, lack of privacy, inadequate healthcare facilities, concerns about family, among others, can take a toll on the mental health of the prisoners.
Tihar Jail is 'breeding ground' for mental health crisis.
The Mental Healthcare Act, 2017, mandates the State to provide adequate, efficient and quality mental health intervention to the prisoners. Section 103 (7) of the Act directs that the mental health establishments inside prisons shall be registered with either the central or the state mental healthcare board – and that they should conform to prescribed standards and procedures.
However, Tihar has completely flouted this mandatory requirement. The Quint reached out to the Resident Medical Officer's office via phone calls and the Director General's office via emails, but received no explanation for non-compliance. Our subsequent RTI seeking clarifications on the implementation of the Mental Healthcare Act, too, did not elicit a response.
Tihar has completely flouted mandatory requirements under the Mental Healthcare Act, 2017.
Further, the Mental Healthcare Act provides for external visits and inspection of prisons by the state mental healthcare board to seek clarifications from the officer in-charge of health services in prison.
Our study shows that the medical establishments in Tihar have been flouting this rule, too, raising serious concerns over transparency and accountability of mental healthcare interventions provided to inmates inside the prison.
It was this lack of access and sensitivity that pushed Sohaib not just to feelings of self-harm, but also drug abuse.
Tihar Jail is 'breeding ground' for mental health crisis.
Sohaib's plight showed us how the language of communicating and understanding mental health completely escapes the most immediate level of prison staff – wardens and guards. Like him, other prisoners echoed narratives of insensitivity and neglect by the prison staff of their most pressing traumatic experiences.
As per Tihar's suicide-prevention circular, the staff is provided training on mental health intervention. However, prisoners believe that such training is 'merely a formality', and the guards and wardens continue to 'shame' and 'disregard' mental health concerns of the inmates.
The observation that resonates in the narratives of all the prisoners is that their attitude towards them needs to change.
Tihar Jail is 'breeding ground' for mental health crisis.
Undertrial prisoners who have just been remanded to custody or whose bail have been rejected are the most vulnerable to self-harm, the jail hospital informed The Quint.
Majority of prisoners belong to socio-economic marginalised groups and have little to no formal education. They are either unaware or do not understand the procedures laid down for identifying mental health issues and seeking mental health examination for the same. They continue to suffer without understanding the source of their suffering.
Tihar Prison informed us that their project 'gumsum panja' is aimed at identifying inmates 'exhibiting suicidal tendencies'. The project involves picking out two to three inmates who are tasked with 'keeping an eye on other prisoners' on rotational basis. However, prisoners revealed that those who are 'picked up' for being on a look-out do not receive any proper training or counselling on how to identify or respond to signs of mental illness.
Women are subjected to a carceral system which was conceived for men and through the male gaze.
The prison system that glosses over serious mental health concerns ends up invisibilising the lived experience of women prisoners, who are further marginalised in the carceral system. Dr Pratiksha Baxi, associate professor, Centre for the Study of Law and Governance, Jawaharlal Nehru University, says that women are subjected to a carceral system which was conceived for men and through the male gaze.
Tihar Jail is 'breeding ground' for mental health crisis.
We could not interview women prisoners for this story as our request was denied by the prison authorities. However, the responses of our other queries by Tihar's women jails paint a picture of woeful neglect of unique mental health concerns of women prisoners.
Women jails do not have a dedicated mental heath ward or establishment.
Women jails do not have a dedicated mental heath ward or establishment. Both the mental health establishments of Tihar are housed in jails for men. Women prisoners complaining about mental health issues are sent to the "medical wing" within the jail.
Dr Vijay Raghavan, Professor of Criminology at Tata Institute of Social Sciences, wrote in his paper that the material realities of prisons in India exacerbate mental health crisis among prisoners.
Dr Raghavan believes that modification of the prison environment that nurtures a positive mental health among prisoners could help in the prevention and early recovery from mental health disorders.
Arjun Kapoor, a Research Fellow at the Centre for Mental Health Law & Policy, told The Quint that the provisions of the Mental Healthcare Act are not being implemented.
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