The Crusader of Mental Health

Prisoners’ Ward in NIMHANS

The legal system in India takes many years to investigate and pass judgment on a case; the courts have lakhs of pending cases. In the meantime, the people facing trial are kept for years in prisons, awaiting judgment. Prisoners accused of serious crimes like treason and murder are not eligible for bail, while a vast majority of the prisoners, who are eligible for bail, are not aware of the application procedure or lacks the resources to apply for bail. Convicts who have been sentenced to life imprisonment have to stay in jail for periods up to 14 years, or in rare cases, even longer. Prisoners have to face great mental stress and consequently suffer various mental disorders. As the Deputy Medical Superintendent, CRC was responsible for the prisoners who were admitted to the prisoner’s ward in NIMHANS. He came across many moving cases of prisoners who were innocent but had been arrested on circumstantial evidence and those who had committed crimes under the influence of rage.

Kempegowda, a daily wage worker was sleeping in the verandah of his house to escape the heat inside when the police came and took him to the police station. They accused him of murdering a local drunkard, Shankarappa, and beat him up. Kempegowda did not know Shankarappa well since they belonged to different castes. Whenever he used to earn extra wages, he used to go to the local wine shop for drinks; Shankarappa also used to frequent the bar. The previous night he and Shankarappa had had drinks at the bar and had later gone on their separate ways.

He protested his innocence to cops but they did not believe him. He had an elderly mother at home. His brother had fought with them, taken his share of their father’s little wealth and lived apart. He did not support or care for his mother or bother. Six months passed in the prison, but no one came to visit Kempegowda. His brother did not allow the mother to meet her son. Kempegowda lost appetite, could not sleep at night and would get frequent headaches. Whenever he felt depressed, he cried and would tell himself why he should live, it was better that he should die. Someone heard him say this, and he was asked by the warder to see the jail doctor. The doctor examined him and referred him to NIMHANS.

CRC asked him if he had engaged a lawyer to defend him in court. Kempegowda said that he was too poor to afford a lawyer; his mother was uneducated and would not know where to seek help; and his brother had declared that Kempegowda could languish in jail and die. CRC told him that the government would appoint a lawyer to fight his case. He was put on anti-depressant drugs.

“ I am a laborer and do whatever job comes my way to make my living. One night a man came to me and asked if would work as a loader to shift household goods during the night. He offered me Rs 500. It was good money and I agreed. I got into a tempo in which two laborers were already sitting. I took the man to be the owner of the house. We drove a long distance and reached a bungalow, which was in darkness. I was asked to wait outside. The other men went in and started bringing out boxes, which I helped to load on the tempo. Suddenly the lights came on in the house; I heard some shouting and then gun shots. The man I had taken to be the owner ran out with the laborers and told me that a fight had broken out between the owner and his brother. He asked us to get into the tempo fast.

I was dropped in the outskirts of my town and given Rs 200. The man told me he would pay the remaining amount the next day and told me to keep my mouth shut about what I had witnessed that night. If I told anyone what I had seen, the police would arrest me, he warned me. I was frightened and did not tell anyone.

After four months the police came and arrested me on the grounds of robbery and murder. I learnt that the men I had met were dacoits and they had killed the owner of the house. I was taken to the court four times; each time the judge the ask me to appear again one month later. I was not given a chance to speak. I did not see any of the gang members after that night.

Two weeks ago, two men from my town were arrested for robbery and brought to the jail. They saw me and teased me that I had robbed stuff worth lakhs of rupees and asked where I had hidden the loot. I got angry and abused them. One of them said that my father had slipped and fractured his hip; he was near deathbed. I lamented that there was no one to take care of him. He would die all alone and no one will know, they mocked at me. I was disturbed on hearing this and was overcome with sadness that I was not there for my father. A few days later my father came to see me. There was nothing wrong with him. Realizing that the men had been fooling with me, I fought with them. The warden and guards came to restrain me. I did not know what I was doing – I beat them too. When I came to, I was bound hand and foot. They said I had gone mad and brought me to this place.
“I am not mad, Doctor. The men who committed the crime have got away. I was tempted by the prospect of earning good money, and have been punished. People tell me I will surely be convicted. No one is there to be my witness. I do not know how long I will be in jail”.

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When a man is charged with crime, irrespective of whether he is innocent or guilty, he suffers mental trauma. He becomes anxious about what the sentence would be and duration of imprisonment in case he is proved guilty; how to marshal witnesses in his defense, the effect on his family, and the legal fees involved. He gets a bad name in society and his associates and friends shun him. If he is innocent, the sense of frustration and mental stress is much more.

In prison, man loses his freedom and sense of identity; life becomes regimented. He misses his family; he is tormented by uncertainty, helplessness and insecurity. He has to live in a bad environment without creature comforts; face temptations of substance abuse, resist sexual assaults, and handle violent fellow inmates who are itching for a fight.

He undergoes a series of reactions: shock, sadness, anger, irrational hopes and expectations, fear, and suspicion. After this starts a period of acceptance and he gets some clarity on how to survive in jail and how to fight his case.

The mental disorders which he is likely to suffer are : anxiety disorder, depression, psychosomatic symptoms, reactive psychosis, and substance addiction. Any mental illness he may have had in past is likely to get triggered again.