Punishing the Soul: Tihar Jail is Breeding Ground for Mental Health Crisis

We interviewed 18 inmates to understand how Tihar Jail is not only confining the body, but also punishing the soul.

I don't even know what 'depression' is. I just know that my father died and they (prison authorities) didn't let me attend his funeral. I've never forgiven myself for it, I never will. I want to cry, but don't know how. I don't think I want to be happy, I never will be. I'll just die here.

Sohaib Ahmad, serving a life sentence in Delhi's Tihar Jail

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.

Our study exposes the mental health crisis in the various jails of the Tihar Prison Complex. The vulnerability of prisoners to mental health issues is aggravated by overcrowding, under-staffing, and disregard for obligations under law by the prison authorities.

A 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.

However, the avenues to seek mental health support are scarce and virtually inaccessible for prisoners incarcerated in Delhi.

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.

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.

The absence of visits has prevented periodical identification of mentally ill persons by a statutory body who may still be incarcerated in regular cells, barracks, or wards.

It was this lack of access and sensitivity that pushed Sohaib not just to feelings of self-harm, but also drug abuse.

I didn't even know what drugs look like when I went to prison. But inside, everything changed. I had to numb my pain, had to stop thinking about my father. Drugs saved me from ending my life, it made me feel okay for being worthless. I survived, but now I'm hooked, all because of them (prison staff).

Sohaib

Rise in Suicidal Tendencies

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.

They (guards) know nothing about 'mental health', 'depression'. They think we are creating 'drama'. That's why most prisoners have given up on raising their concerns with them. If we approach them, they shoo us away, saying, 'pagalpanti band kar' (stop this lunacy)... 'ladki ki tarah mat ro' (don't cry like a girl).

Karam Singh, a prisoner sentenced to life, currently out on emergency parole

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.

They will only take you seriously if you tear your clothes, start screaming, and slapping yourself. Otherwise, they shame you for approaching them. They say, 'Tujhe jab sab pata hai toh kyun bheje doctor ke paas' (why should we send you to the doctor when you already know everything).

Hussain, completed 14 years of his life sentence in Tihar

The observation that resonates in the narratives of all the prisoners is that their attitude towards them needs to change.

If you don't change their mindset, their attitude, nothing would change the mental health problem. Look at the words they use for us. Even for mundane things, they use abusive language. Unless you change that attitude, the training will remain on paper. Just to show the judges who visit prisons that, 'look, we care'.

Ravi, prisoner sentenced to life currently out on emergency parole

Undertrial Prisoners Most Vulnerable to Self-Harm

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.

Despite such assessment, the prison authorities have failed to curb the suicide rate in jails. From three reported cases of suicide in 2016, the number increased consistently since then – reaching 10 in 2020. Therefore, an overwhelming majority of prisoners who succumb to suicide are those who are yet to be proven guilty of any offence.

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.

Invisibilising Unique Suffering of Women Prisoners

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.

Our study reveals that undertrial women prisoners are the most vulnerable to self-harm inside the prison. Between 2015 and 2020, a majority of custodial deaths inside women's jails were due to suicides. Moreover, all the women prisoners who succumbed to suicide were undertrial prisoners awaiting conclusion of their trial.

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. 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.

The history of mental health concerns inside women jails are also institutionally invisibilised. The jail authorities do not maintain data on the number of women who have complained about mental health issues, the number of women who have requested for psychological intervention, and the number of women who are transferred to mental healthcare establishments under section 30 of the Prisons Act.

The Culture of Punishing The Soul

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.

Apart from the psychiatric disorders and drug use, there are negative factors that can affect the mental health of prisoners such as overcrowding in prisons, exhaustion of prison facilities, different forms of violence, lack of privacy, feelings of isolation and uncertainty about future, lack of meaningful activities, and scarce health services.

Dr Vijay Raghavan

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.

The mental health review boards, which are supposed to monitor implementation of these provisions and inspect prisons, are still not functional in the country. With respect to mental health professionals, most prisons are severely under-staffed with several sanctioned posts lying empty. As a result, mental health problems of most prisoners go undetected unless they begin to show serious signs or symptoms of mental illness.

Arjun Kapoor

Prisoners, who have languished in various jails of Tihar Prison Complex, believe that the institution is designed to "punish them emotionally, mentally". They said that most of the inmates lose hope in the staff, and recognise the need for looking out of each other.

We sort of take care of each other, like a society, or extended family. If we see someone is feeling low, we cheer them up, or if someone's stopped eating, we try to get him food. We have to look out for each other.

Gaurav, recently released from Tihar after serving 16 years of sentence.