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The stark contrasts in prison mental health care between the UK and India, as explored in a recent BMJ report (2024) [1] and Delhi High Court's landmark judgment [2], respectively, call for a global re-evaluation of our approach to this critical issue. In the UK, a troubling pattern of isolating prisoners with severe mental health needs has been revealed, reflecting a systemic inadequacy in addressing these challenges [3]. This situation is not just a failure of the system, but a reflection of a deeper societal issue, as suicide remains a leading cause of death in prisons, often stemming from untreated mental illness and the profound stresses of incarceration [4].
In contrast, the Delhi High Court's judgment in India signifies a pivotal shift towards prioritizing mental health care and rehabilitation in prisons. The Court's directives highlight the integration of psychiatrists in prisons, staff sensitization, the provision of alternative therapies and meditation facilities, and the development of standard operating procedures for mental health care in prisons. This comprehensive approach, mandated by the Court for the Delhi State Legal Service Authority (DSLSA) to conduct regular mental health workshops in collaboration with Institute of Human Behaviour and Allied Sciences (IHBAS), the country’s premier institute in mental health and neurosciences, showcases an advanced understanding of the role of rehabilitation in correctional facilities. These measures resonate deeply with the principles advocated by the World Health Organization, emphasizing comprehensive mental health care as a fundamental human right [5].
The initiatives in Delhi underscore the importance of recognizing the humanity of those behind bars, providing necessary support, and fostering better mental well-being within India's prisons. This approach is not only about reforming the prison system but represents a broader shift in societal attitudes towards mental health.
The contrasting scenarios in Indian and UK prisons underscore the necessity of a humane and effective correctional mental health care system [6]. The insights from Delhi's initiatives, combined with the findings from the BMJ report advocate for a global reform in prison mental health care. Prisons provide a unique opportunity to address the physical and psychiatric morbidity among inmates, many of whom have limited prior contact with health services.
In conclusion, the lessons from Delhi's initiatives and the findings from global research collectively call for a shift from punitive isolation to rehabilitative approaches in prison mental health care. By integrating these insights, we can aim to improve the well-being of prisoners, reduce recidivism, and foster a more rehabilitative environment globally.
References:
1. Kmietowicz Z. Prisoners with severe mental health needs are too often isolated, say monitoring boards BMJ 2024; 384 :q206 doi:10.1136/bmj.q206.
2. Delhi High Court. (2023). [Sartaj v. State of NCT of Delhi, 2023 SCC OnLine Del 4764, decided on 07-08-2023] https://www.scconline.com/blog/post/2023/08/09/delhi-high-court-issues-d...
3. Birmingham L. The mental health of prisoners. Advances in Psychiatric Treatment. 2003;9(3):191-199. doi:10.1192/apt.9.3.191
4. Anasseril E. Daniel. Care of the Mentally Ill in Prisons: Challenges and Solutions. Journal of the American Academy of Psychiatry and the Law Online Dec 2007, 35 (4), 406-410.
5. Alves da Costa F, Verschuuren M, Andersen Y, Stürup-Toft S, Lopez-Acuña D, Ferreira-Borges C. The WHO Prison Health Framework: a framework for assessment of prison health system performance. Eur J Public Health. 2022 Aug 1;32(4):565-570.
6. Dooley, E. (1990). Prison suicide in England and Wales, 1972–1987. British Journal of Psychiatry, 156, 40-45.
Competing interests:
No competing interests
25 January 2024
Om Prakash
Professor of Psychiatry
Institute of Human Behaviour and Allied Sciences (IHBAS), New Delhi, INDIA
Geriatric Mental Health Division, Department of Psychiatry, Institute of Human Behaviour and Allied Sciences (IHBAS), New Delhi
Reforming Prison Mental Health Care: A Comparative Analysis of UK and Indian Approaches
Dear Editor
The stark contrasts in prison mental health care between the UK and India, as explored in a recent BMJ report (2024) [1] and Delhi High Court's landmark judgment [2], respectively, call for a global re-evaluation of our approach to this critical issue. In the UK, a troubling pattern of isolating prisoners with severe mental health needs has been revealed, reflecting a systemic inadequacy in addressing these challenges [3]. This situation is not just a failure of the system, but a reflection of a deeper societal issue, as suicide remains a leading cause of death in prisons, often stemming from untreated mental illness and the profound stresses of incarceration [4].
In contrast, the Delhi High Court's judgment in India signifies a pivotal shift towards prioritizing mental health care and rehabilitation in prisons. The Court's directives highlight the integration of psychiatrists in prisons, staff sensitization, the provision of alternative therapies and meditation facilities, and the development of standard operating procedures for mental health care in prisons. This comprehensive approach, mandated by the Court for the Delhi State Legal Service Authority (DSLSA) to conduct regular mental health workshops in collaboration with Institute of Human Behaviour and Allied Sciences (IHBAS), the country’s premier institute in mental health and neurosciences, showcases an advanced understanding of the role of rehabilitation in correctional facilities. These measures resonate deeply with the principles advocated by the World Health Organization, emphasizing comprehensive mental health care as a fundamental human right [5].
The initiatives in Delhi underscore the importance of recognizing the humanity of those behind bars, providing necessary support, and fostering better mental well-being within India's prisons. This approach is not only about reforming the prison system but represents a broader shift in societal attitudes towards mental health.
The contrasting scenarios in Indian and UK prisons underscore the necessity of a humane and effective correctional mental health care system [6]. The insights from Delhi's initiatives, combined with the findings from the BMJ report advocate for a global reform in prison mental health care. Prisons provide a unique opportunity to address the physical and psychiatric morbidity among inmates, many of whom have limited prior contact with health services.
In conclusion, the lessons from Delhi's initiatives and the findings from global research collectively call for a shift from punitive isolation to rehabilitative approaches in prison mental health care. By integrating these insights, we can aim to improve the well-being of prisoners, reduce recidivism, and foster a more rehabilitative environment globally.
References:
1. Kmietowicz Z. Prisoners with severe mental health needs are too often isolated, say monitoring boards BMJ 2024; 384 :q206 doi:10.1136/bmj.q206.
2. Delhi High Court. (2023). [Sartaj v. State of NCT of Delhi, 2023 SCC OnLine Del 4764, decided on 07-08-2023] https://www.scconline.com/blog/post/2023/08/09/delhi-high-court-issues-d...
3. Birmingham L. The mental health of prisoners. Advances in Psychiatric Treatment. 2003;9(3):191-199. doi:10.1192/apt.9.3.191
4. Anasseril E. Daniel. Care of the Mentally Ill in Prisons: Challenges and Solutions. Journal of the American Academy of Psychiatry and the Law Online Dec 2007, 35 (4), 406-410.
5. Alves da Costa F, Verschuuren M, Andersen Y, Stürup-Toft S, Lopez-Acuña D, Ferreira-Borges C. The WHO Prison Health Framework: a framework for assessment of prison health system performance. Eur J Public Health. 2022 Aug 1;32(4):565-570.
6. Dooley, E. (1990). Prison suicide in England and Wales, 1972–1987. British Journal of Psychiatry, 156, 40-45.
Competing interests: No competing interests