Standing nonchalantly behind the double-paddled, heavy iron gate of the forensic ward of Government Mental Health Centre, Thrissur, Thomas Kutty* looked out. His gaze momentarily wandered across the faces of the visitors and then to the space beyond them.
Hearing someone calling his name, Thomas, dressed in a shabby T-shirt and shorts, looked up. The doctor, who had been attending to him, signalled him towards the gate.
He, however, gave the doctor a blank look before turning towards the grimy wall of the dingy cell. The doctor’s repeated attempts to strike up a conversation with the frail, greying man failed as he dragged himself towards the farthest corner of the cell, away from the world outside.
Government Mental Health Centre, Thrissur.
| Photo Credit:
K.K. NAJEEB
For the past 25 years, Thomas had been confined to this ill-lit cell. The world outside has changed much during this period, but not for him.
Booked for murder, he could not be put on trial as he was found to be of unsound mind. Had he been convicted, he could perhaps have walked out free by now, after completing his jail term.
“He is a silent guy, with no aggression and never gets into any issues with others. Prisoners of unsound mind are admitted to the forensic ward, which is guarded by the police,” says Ajeesh Ramachandran, consultant psychiatrist.
The block is under constant surveillance using a heavy-duty dome camera, mounted on the iron grill ceiling of the courtyard of the building. Stainless steel hand-cuffs could be seen chained to the iron cots lined up on the verandah.
“The highly dependent psychiatric patients need to be restrained during medical treatment. Hence, the hand-cuffs,” explains Dr. Ajeesh.
A huge tamarind tree, with its canopy spread wide, stands tall on the campus, overlooking the buildings of the centre. Weeds have overgrown in many areas of the 12-acre campus. The white patches of bleaching powder sprinkled on some parts of the yard have started dissipating in the overnight rain. It appears all serene on the campus, except for the occasional shrieks of some inmate.
“Please let me go,” pleaded a squeaky voice from a distant cell, as a group of volunteers of the Victim Rights Centre (VRC), an initiative of the Kerala State Legal Services Authority (KeLSA), led by its chairperson Shoba Annamma Eapen, also a judge of the Kerala High Court, passed by.
The unfair life
Life has been really hard for Thomas and his fellow inmates like Joseph,* who has been sentenced for a triple murder. He was shifted to the centre after developing signs of mental illness some 12 years ago.
“The incident took place following an altercation. As I have completed my jail term, I want to go back to my home, where my aged parents are waiting,” demands Joseph.
There are several others with deranged minds and abandoned by their relatives and society. Family members shut the doors on some others who have been cured of their illness. Relapses have forced some others to return to the cells.
Limited facilities
The centre, with its ageing buildings and limited infrastructure, is yearning for help, just like its inmates. Long vines run through the walls and abandoned buildings. Protective nets are fixed around some of the buildings to prevent the entry of snakes into the cells. A derelict multi-storey building, with its mossy walls, stood on one corner of the campus.
Most of the inmates are made to sleep on cold cement floors, sans cots, pillows, bed sheets or ceiling fans. Some were seen lying on grass mats. A toilet, with a pony wall, has been provided in each cell.
“Fans were not installed in the old buildings with low roofs on safety grounds. However, exhaust fans have been provided. It’s risky to provide them with bed sheets as some of them may try to end their lives with them,” explains Ramesh Chandran, consultant psychiatrist.
Abandoned by life
The pungent smell of sanitising agent emanated from the women’s cell where six elderly women lay curled on their beds, oblivious of the world outside.
“Most of these women have been abandoned by their relatives. Recently, I had to sign the consent form for an inmate, in place of her close relatives, for her hip replacement surgery,” says Baby Lakshmi, Superintendent of the centre.
Highly dependent psychiatric patients need to be restrained during medical treatment. Hence, hand-cuffs can be seen on some of the cots.
| Photo Credit:
Illustration: Satheesh Vellinezhi
“Some of the relatives of the patients,” rues a nurse, “even refuse to attend telephone calls from the centre.”
Fifty-five inmates in the Thiruvananthapuram centre and around 40 in Thrissur are fit to be discharged. Yet, with no one to take them home or no place to go, they continue to live in the centres.
By noon, food for the patients, packed in containers, was brought in a hand cart, donated by a charitable organisation. “We are looking for a buggy to deliver food and ferry patients and staff,” says Dr. Baby.
The visit to the centre, happening after a hiatus of around two years, has left Shoba distraught. “The facilities at the centre have not improved over the years,” she says.
“The acute shortage of staff and facilities continues. Several buildings remain unused. The doctors and staff have complained about the presence of snakes on the campus. They have to switch on the flashlights in their mobile phones to navigate the campus during night. Recently, two girls had to be shifted from the women’s cell to another room after a snake entered the cell,” bemoans the judge.
Judicial intervention
Moved by the plight of the inmates in the centres, the Kerala High Court has stepped in to review the functioning of the facilities.
“KeLSA team undertakes visits to jails and mental health institutions to ensure that the inmates are not deprived of their fundamental right to live a life of dignity,” notes its executive chairperson and Kerala High Court judge Jayasankaran Nambiar.
“It has long been recognised in our constitutional jurisprudence that a prisoner and his/her fundamental rights do not part company at the prison gates. After the declaration of privacy, with its integral aspects of dignity and individual autonomy, as a fundamental right traceable to Article 21 of our Constitution, the State cannot look away from or feign ignorance of the reality that exists within its correctional facilities. The authority chooses to function as a human rights watchdog to alleviate the sufferings of such hapless inmates,” says the High Court judge.
A Division Bench of the court comprising Devan Ramachandran and Basant Balaji recently inspected the centres in Thiruvananthapuram and Thrissur. “The approach towards the mental health patients needs to be changed. Currently, most of them are drugged and caged. We are not letting them live or even die,” noted the Bench after the visit.
“Medication for a patient suffering from mental health issues is only one of the attributes; and what would be most salutary would be to give them a milieu in which they can express themselves and find solace through interactions, friendships, distractions, and avocations/matters of interest,” notes the Bench. The patients should 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,” it suggests.
Anil K. Bhaskar, member secretary of KeLSA and district judge, reveals his plans to visit some of the mental health centres in the private sector to learn about the improvements to be introduced in the government-run facilities. “Though expensive, they are considered to be offering better care for patients. We should set a benchmark for our centres too.”
Turn of Life
Parvathi Menon, a practising lawyer and the State coordinator of the VRC, never had any inkling of what awaited her at the centre. “Parvathi miss, do you recognise me?” an inmate sprang a surprise as she walked past the vocational therapy unit. She stood frozen as the inmate, accused of matricide, extended his hands, saying: “you taught me at the law college.”
“I was devastated to see him there. No teacher would ever expect to see her student in such a condition. All I could do was to wish him a speedy recovery and quickly move out of the place to keep my emotions under control,” she says.
Beena Nisar, another volunteer, could not hide her frustration after witnessing the plight of the women inmates. “Many women inmates are in pitiable conditions. There should be some intervention to ensure better care for them,” she suggests.
The other volunteers share her concern. The hapless inmates too are waiting for some interventions to return to normal life.
(*The names of the inmates have been changed to protect their privacy)
