Kerala High Court judges inspect mental health centre; flags prison like conditions

The Kerala High Court on July 21 ordered the State government to undertake urgent reforms at the Government Mental Health Centre in Thiruvananthapuram after a judicial inspection found that the institution was grappling with acute manpower shortages and inadequate facilities. [The High Court Legal Aid Committee v The State of Kerala].A Division Bench of Justice Devan Ramachandran and Justice Basant Balaji personally inspected the centre on July 18 only to discover that patients in the facility spent most of the time locked inside wards with little opportunity to move around or interact with others, what the Court proceeded to describe as conditions akin to a "prison".They said that such environment was inconsistent with modern mental healthcare, which requires patients to have access to open spaces, social interaction and meaningful activities in addition to medication."The patients are administered drugs and then forced to confine themselves to spaces, except for a few minutes or hours in the morning or evening, as the case may be. During the time that they are so confined, what they experience is a sense of being in prison, rather than in the freedom of openness and choice," the Bench stated.Treatment for persons with mental illness extended beyond medication and require a therapeutic environment and the mental health centre could utilise open spaces available in the campus to create a more humane environment, the Bench underscored."In a facility like the Mental Health Center, Thiruvananthapuram – where there is enough space in terms of open land for patients to be given access to nature, to trees, to the wind, to sights and smells, that would certainly have a sobering effect, offering them a sense of solace rather than being constrained and forced to be terrified of closed spaces – much can be done, if the Government and stakeholders think out of the box," the Court opined..The Court issued the directions in a petition initiated by the High Court Legal Aid Committee.The judges had inspected the centre on July 18 along with the amicus curiae, officials from the District Legal Services Authority (DLSA) as well as the Victim Rights Centre (VRC) and other stakeholders..Patients are administered drugs and then forced to confine themselves to spaces, except for a few minutes or hours in the morning or evening.Kerala High Court.After inspecting the centre, the Court said that even though the institution appeared to have been cleaned up before their visit, the condition of the centre remained alarming.It found that only 127 staff were in service against the sanctioned strength of 158. They were not only taking care of the patients but also performing multiple other duties, including cooking, cleaning the campus, accompanying patients to other hospitals etc.The Court noted that several buildings on the campus were declared unsafe, some constructions remained incomplete and internal roads were in poor conditions. 55 patients who were medically fit for discharge, continued to remain at the centre because they had nowhere else to go.Thus, there is a need for systemic reforms for the rehabilitation and reintegration of patients into society, the Court said. As an immediate measure, directed the State to immediately fell vacant attender posts and explain the absence of cooks, drivers, security personnel etc.It also asked the State to file a roadmap for completing stalled infrastructure projects, formulate a rehabilitation mechanism for patients fit for discharge and a report on measures to ensure adequate psychiatric and general medical care.The matter will be considered again on August 4..Advocate V Ramkumar Nambiar served as the amicus curiae..[Read Order]