LAW AND POLICY
Mental Health and Incarceration:
A Note from Bihar
AUTHOR
illustrator
Gurudev Nanda, a social worker at the LAW Foundation, is dedicated to enhancing social well-being and mental health in prisons and communities. With an M.A. in Sociology and Social Anthropology from Tata Institute of Social Sciences, Guwahati, he focuses on empowering marginalised communities and promoting equal mental health and social justice opportunities.
Alice A. Barwa completed her MA in Education from Dr. B.R. Ambedkar Univerity, Delhi (AUD), in 2022, and is from the Oraon Adivasi community, a native of Chhotanagpur Plateau, Chhattisgarh. She has been an advocate for Adivasi rights and voices as a member of an Adivasi youth collective @TheAdivasiPost, and has been an Adivasi youth representative at UN Climate Change Conference in Glasgow, Scotland, in 2021. Her research interests include education, culture, sociology, and linguistics.
‘Within these prison walls, we are unseen and unheard, our minds struggle in silence. Behind these bars, our mental health deteriorates, and we fall into deep despair.’
An incarcerated person during a mental health intervention in one of India’s prisons
The determinants of mental health are vastly different across regions, situations, and individuals. They are even more distinct for prisoners, as their experiences behind bars are shaped by factors almost entirely outside the ambit of ‘normal’ society. But global mental health often overlooks the different ways in which people experience mental well-being or the lack of it and especially disregards the plight of prisoners.
Mental health as a global concern has gained significant attention in recent years. The fundamental aim of global mental health is to promote mental well-being and healthcare for everyone across the world as well as encourage holistic approaches to mental health values and human rights.1 However, although global mental health aims at promoting inclusive, equal access to mental healthcare, these principles are not adequately implemented, especially when it comes to those in prison. There is a higher prevalence of mental illness among prisoners compared to the non-incarcerated population across the world. This might be due to several factors such as socioeconomic disadvantage, histories of trauma, substance abuse, lack of access to mental healthcare, social stigma associated with mental health, overcrowding in prisons, and lack of mental health awareness among prison officials.
In India too, incarcerated individuals continue to face inadequate mental healthcare as well as lack access to it.
Additionally, in India, the inequalities perpetuated by the caste system significantly affect mental well-being, as marginalised individuals face systemic discrimination and limited access to resources. However, global mental health efforts tend to prioritise issues that are more universally recognised, often overlooking the unique challenges of region-specific issues. This extends to marginalised individuals in prisons too, where too caste operates, and so their mental well-being suffers even more. The lack of acknowledgment of societal inequities and the non-inclusion of prisoners’ well-being in global mental health discourse perpetuate the marginalisation of affected communities and undermine efforts to address mental health disparities on a global scale.
This essay strives to explore prisoners’ mental health as a global mental health concern. In addition, this piece will elaborate on a story of a prisoner from the lens of mental health within correctional institutions.
In the state of Bihar, prisons are significantly overcrowded, exceeding their capacity by over 19,000 inmates, which contributes to compromised living standards, limited access to healthcare resources and recreational activities, lack of mental health facilities, etc.2 These factors increase tensions among inmates and impact their overall well-being.3 According to Prison Statistics India’s 2021 report, 80% of unnatural death among prisoners are suicides and are predominantly linked to mental health concerns.4
As a social worker, I frequently provide prisoners with the necessary assistance to enhance their mental health. During my visits and interaction with prisoners, I have observed that incarceration compounds the feeling of isolation and stigmatises the individual, hampering their mental health. A former prisoner said, ‘Once you’re in jail, everything is over. People call you a criminal.’ When individuals leave prison, they are stigmatised, discriminated against, and treated badly in society.5 This fear of social rejection adds to the prisoners’ deteriorating mental health. Moreover, the stigma and labelling associated with seeking mental healthcare contribute to prisoners’ reluctance to receive the necessary treatment and support.6 The absence of awareness about mental health and the care options is yet another barrier to addressing mental health concerns of incarcerated individuals.
From my interactions with prisoners experiencing mental health challenges, I learned that both first-time incarceration and long-term incarceration severely affect the mental health of prisoners. Separation from loved ones exacerbate these issues and cause emotional damage. In such a situation, a non-judgemental listener becomes important for the prisoners to freely share their thoughts and feelings with.
I met Amit Kumar (name changed), a twenty-year-old incarcerated in Phulwari District Jail in Bihar’s Patna city. Though he was initially reluctant to share his experiences and concerns, after multiple interactions, he spoke about his case and his family circumstances and asked for legal assistance. His imprisonment had compelled his elderly mother to sell balloons for survival.
‘I was the sole earner in my family, but I have been in jail for so long. This worries me. I don’t feel like eating. I feel angry. I feel strange’
he told me. I acknowledged all that he was experiencing and listened to him. During each visit, I tried to involve him in activities like storytelling and singing songs and tried to make him laugh. I observed a noticeable change in his behaviour and overall well-being. This story not only highlights the mental health impact of incarceration and being separated from family members but also the significance of mental health support and the positive changes it can bring about in prison environments. Undertaking interventions to improve the mental well-being of prisoners is crucial.
Incarcerated individuals often face more challenges to their mental health as well as significant barriers to accessing adequate care, and this is more so in the case of places like Bihar where the prison infrastructure is poor. The stigma surrounding mental health and incarceration exacerbates these challenges and further alienates prisoners. There is a need for comprehensive strategies to address mental health issues in jails. Efforts have to be made to improve the mental health and well-being of incarcerated individuals based on the principles of global mental health, including access to care, stigma reduction, and addressing social determinants.
View all References
