Horror movie: Kerala HC on dehumanising conditions at Thrissur mental health centre

The Kerala High Court on Wednesday expressed shock over the dehumanising conditions observed at the Government Mental Health Centre in Thrissur.

Days after ordering reforms at the Thiruvananthapuram Government Mental Health Centre, Justices Devan Ramachandran and Basant Balaji had inspected the Thrissur centre over the weekend and found the conditions there even more troubling.

The Bench today said that what they witnessed inside the centre during their inspection on July 26, especially in the isolation cells, were deeply distressing and dehumanising.

The Court said that it was not assigning blame for the state of affairs. The conditions were the result of years of neglect, it observed.

"What we saw, particularly in these isolation and confinement areas, which are called cells, was so shocking and dehumanising that words fail us. Again, we add a disclaimer that we are not blaming, because we are certain that this has been continuing for the last several decades, since there have been no changes offered, perhaps because the patients are voiceless and their bystanders are unable to open up on account of fear of social stigma or ridicule," said the Court.

Regarding the condition of the buildings which house the facility, the Court said that the premises were run down, unkempt, with peeling paint, algae on the walls and other clear signs of neglect.

"The perfect setting for a scene from a horror movie," the Court described.

It is the isolation cells at the centre that particularly raised alarm bells for the judges.

The Court recorded that the patients housed in the isolation cells showed signs of acute fear and panic, with many having lost touch with reality altogether. Doctors informed the judges that a significant number of these patients were also vulnerable to self-harm and suicide.

The Court said that the cells were tiny, prison-like, with barely any privacy for toilets, their design reminiscent of colonial times.

"The cells were prison-like, if not worse, with iron grills and were tiny, dark and poorly ventilated. The design of these cells are unmistakably colonial and belong to centuries past, with the atmosphere there being very turbid and virtually revolting.”

It also observed that the patients housed at these facilities were made to live an existence that was cut-off from modern-day advances.

“How can one forget that the people inside these facilities are our own brethren- father, mother, sister, brother, husbands - protected by the same constitutional guarantees as we are all blessed with?  But alas, they are made to live an existence which is so startling that an intervention becomes absolutely unexpendable and it should start from now. The future is always decided by what we do today. But when it comes to these centers, we find that modernity has never entered its walls, entered its gates, and it remains trapped in the languid situation it was in several decades ago.”

The Court was also highly critical to the practice of housing patients prone to self-harm in isolation cells, observing that such confinement was more likely to leave lasting psychological scars than to aid recovery.

The Court, however, was quick to clarify once again that the doctors and nurses are not to blame, describing them as devoted and well-qualified, and noting that many patients had formed a genuine bond with them.

On the overall experience of the visits to both Thrissur and Thiruvananthapuram, the judges remarked that no one who witnessed the sights, sounds and smells inside these centres could walk away unaffected.

“The sum total of our experience is that no human being who enters the medical health centers in either Thrissur or Thiruvananthapuram and who are exposed to the sights, sounds and smells there would come out with their sensibilities intact. If otherwise, such person cannot be a human.”

Regarding the Thrissur facility, the Court noted that the women's wards needed the most urgent intervention. It pointed out that there were at least three buildings on the campus that could be restored and put to prompt use for the benefit of women at the centre.

"We have little doubt that in any other scenario, particularly where affluent citizens are involved, such buildings would have been immediately repaired and put to use; but in the case of these poor and hapless patients, we saw that the response is pachydermic and absolutely slow that snails would be put to shame," the Court added.

The Court ultimately directed the State government authorities to respond to each of the points of concern raised by it today and file an affidavit on steps taken to address the same. The affidavit is to be filed by August 18.

The Court also made it clear that it would not accept any excuses from the government, not even those of financial constraints, as this is a matter of human rights.

"We direct the authorities to bestow the priority as required to ensure the most basic least fundamental rights and human rights to the patients and the bystanders. No excuses, including financial, can come in the way of ensuring that basic human rights are affirmed and ensured and this is the most rudimentary desideratum of any working democracy. More so in the case of one like ours, which is guided by the most powerful and meticulous constitutions in the world," the Court said in its order.

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