Provisions of Mental Healthcare Bill 2016, its application in prisons and the prescribed Nelson Mandela Rules for Prison inmates.

GS IV: Public/Civil service values and ethics in public administration: Status and problems.

Caring for our prisoners’ minds

Prisoners cannot become a default facility for those with mental illness.

National Crime Records Bureau (NCRB) statistics in 2015 identified a total of 5,203 inmates (1.2% of total inmates) as those having mental illness.

Issues:

  • Prisons receive little or negligible attention.
  • There is social apathy towards the institution and its inmates.
  • Prison officials command less recognition than their peers which leads to a plunge in morale.
  • As a result, prisoners with mental illnesses are grossly ignored which further enhances their disabilities.

Nelson Mandela Rules on Healthcare:

  • A lot of prisons are in crisis. Many are overcrowded, others are inadequate.
  • Across the world, prisoners face health risks, violence, high rates of recidivism*, as well as emerging threats, such as violent extremism in prisons.
  • All of these challenges have added to the complexity of combining security, safety and human dignity within prison systems.
  • The rules with respect to Prison Health are:
    1. As the state bears responsibility for those it deprives of their liberty, healthcare must be provided in prison and offered at the same level of care as in the community.
    2. In line with good practice, prison healthcare should be organised in close cooperation with community health services, including to ensure continuity of care.
    3. The role of healthcare professionals in prison must be clearly separate from that of the prison administration.
    4. Healthcare staff must not be involved in prison management issues, such as disciplinary measures, and their clinical decisions must not to be overruled or ignored by non-medical prison staff.
    5. Prison healthcare staff have a duty to report any signs of torture or other inhuman treatment.
    6. When prisoners see a doctor they are patients just like they would be in the community. Patients must give their informed consent to any medical interventions and examinations, and their medical records are confidential.
    7. The competent public health body should regularly inspect and advise the prison director on a variety of issues impacting on the health and well-being of prisoners – as well as prison staff.

The Union govt. has recently passed the Mental Healthcare Bill. One of the prime features of the bill is that it seeks to provide proper health-care, treatment and rehabilitation of mentally ill persons “in a manner that does not intrude on their rights and dignity.”

  • Salient Features of the Mental Health Bill, 2016:
    1. Decriminalises suicide attempt by mentally ill people. Section 309 of the IPC will not be applicable to them .
    2. Rights of persons with mental illness: This provision states that every person will have the
      • right to access mental healthcare from services which are operated or funded by the government.
      • It also includes good quality, easy and affordable access to services.
      • It also provides for the right to equality of treatment,
      • seeks to protect such persons from inhuman treatment,
      • access to free legal services, their medical records, and
      • the right to complain in the event of regarding deficiencies in provisions.
    3. Advance Directive:  Explains how she/he wants to be treated for the requisite illness and who her/his nominated representative shall be.
      • This directive has to be vetted by a medical practitioner.
    4. Every mental health establishment has to be registered with the respective Central or State Mental Health Authority.
    5. The bill also outlines the procedure and process for admission, treatment and subsequent discharge of mentally ill persons.
    6. Mental Health Review Commission and Board:
      • This is a quasi-judicial body responsible for reviewing procedure for making advance directives.
      • It will also advise the government on the protection of mentally ill persons’ rights.
      • It further states that the body in agreement with the state governments constitute Mental Health Review Boards in states’ districts.
    7. Electro-convulsive therapy, which is allowed only with the use of anaesthesia, is however out of bounds for minors.

Conclusion:

  • The needs of inmates with mental health-care are more vulnerable than others.
  • Adapting to the prison environment is challenging.
  • Prisons are not designed for therapeutic care and cannot become a default facility for those with mental illness.
  • Equally significant is to train prison staff and reimagine prisons as ‘correctional centres’ in order to bring about transformative changes and reduce recidivism.
  • Reviewing our criminal justice system would invariably have to include a transformation of our approach from its current punitive form to a rehabilitative and reformative one, which would facilitate social reintegration of inmates.
  • In the words of Madiba, “a nation should not be judged by how it treats its highest citizens, but its lowest ones”.

Update Your Vocabulary:

Recidivism: a tendency to relapse into a previous condition or mode of behavior; especially :  relapse into criminal behavior.

Eg: high recidivism rates observed after cessation of smoking.

Image Source: The Dialogue

Source: The Hindu, Indian Express, Nelson Mandela Rues available on UN office on Drugs and Crime website


 

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