Aditya Mani Tripathi

Abstract: The article analyses the critical gap in accessibility of mental health facilities in prisons, which violates Article 21 of the Constitution under contemporary judicial precedents. The article proposes a uniform national framework enacted via Article 253 of the Constitution to implement strict mental health benchmarks, considering India’s international and domestic obligations.

Introduction

Prisoners are a percentage of the population that is heavily regulated by the state. The state is hence responsible for ensuring compliance with all the fundamental rights of the prisoners, with mental health being a major concern in Indian prisons.

Section 18 (1) of the Mental Healthcare Act, 2017 (hereinafter MHA) clearly states that every individual has a right to obtain mental healthcare and treatment from mental health services from government-funded sources. Moreover, Section 18(2) of the MHA explicitly states that these mental health services should be of good quality, affordable, sufficient, accessible, and free from prejudice based on sex, gender, religion, sexual orientation, caste, culture, socio-political beliefs, etc.

The concerning issue arose from a report published by the India Justice Report, 2025, which clearly stated that prison occupancy in 2022 was 131% of its total capacity, with 76% of the prisoners being under-trial individuals. It also showed that about 55% of all prisoners were overcrowded and that only 68% of the inmates had an adequate sleeping space. These statistics demonstrate conditions that promote poor mental health norms and violate the statutory, fundamental and human rights of the inmates, especially the under-trial individuals and the first-time offenders.

This article highlights the crucial need to strengthen mental health norms in the domestic prisons of India to uphold the constitutional mandates and international human rights obligations of the state. It analyses the implementation gaps across various state-controlled correctional facilities and proposes a uniform framework enacted while utilising the overriding powers of Article 253 of the Constitution to uphold the inmates’ right to mental health.

The Constitutional and International Framework: Mental Health as an Inalienable Fundamental Right

In the case of Sukdeb Saha v. State of Andhra Pradesh, 2025 SCC OnLine SC 1515, the Hon’ble Supreme Court of India had reiterated that mental health is an integral part of one’s right to life under Article 21 of the Indian Constitution. This, read with Section 18 of the MHA provides robust, enforceable legislative mechanisms for the protection of one’s mental health rights.

It is pertinent to note that, as per the Ramlila Maidan Incident, In re, (2012) 5 SCC 1, the right to sleep was also stated to be an integral part of Article 21 of the Indian Constitution. The Hon’ble Supreme Court had declared in this case that sleep is an essential component for maintaining an individual’s health and survival. It was also stated that disturbance to one’s sleep can therefore be attributed to torture, which is now an accepted human rights violation. Considering the fact that sleep deficiency or a lack of adequate sleeping conditions is also attributed as a factor that exacerbates depression, suicidal tendencies, etc. The documented lack of adequate sleeping spaces and any other related issues that deprive any inmate of their right to sleep would violate both the right to health and the right to sleep, which are an integral part of Article 21 of the Indian Constitution. This further enhances the state’s obligation to take affirmative measures to protect inmates’ rights without delay.

Various International obligations, like Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR), which India has ratified, state that the state parties recognise the rights of people to enjoy the highest attainable standard of both mental and physical health. It is pertinent to note that, as per the Committee on Economic, Social and Cultural Rights (CESCR) General Comment No. 14,  Article 12 of the ICESCR obligates the state parties to ensure the prevention of mental illness and provide timely access to mental health services. With respect to ICESCR, India has constituted the right to health as a fundamental and statutory right, and has set a minimum benchmark of providing this right to the people. The state cannot now arbitrarily derogate from its obligations through the principle of non-retrogression to reduce the current level of enjoyment of this right, which includes the rights of inmates.

The Heightened Vulnerability of Under-Trials and First-Time Offenders

It is imperative to note that prisoners are a vulnerable population that is susceptible to developing mental health issues that need special attention. More significantly, the under-trial population, which consists of the people who are largely presumed to be legally innocent due to a lack of conviction, are more vulnerable to anxiety, depression and somatisation than the convicted prisoners, hence requiring all the state support they can to maintain their mental health.

In the case of first-time offenders, it was noted that first-time incarcerated people are especially susceptible to chronic psychological vulnerability. Moreover, the chances of depressive illness in first-time incarcerated people were reported to be about 20 times higher than those of repeated long-time incarcerated people. Major reasons for this vulnerability include the shock of entering a prison facility for the first time.

It is a clinically accepted fact that most suicides are largely related to psychiatric diseases, depression, psychosis and other mental health issues. Data from the National Crime Records Bureau (NCRB) showed that suicides in Indian prisons had doubled during the period between 2001 and 2019. Senescence, negative thoughts regarding imprisonment and depression are the major reasons for suicidal thoughts among inmates.

These empirical statistics clearly depict the need for the state to ensure proper implementation of the various legislations that advocate for ensuring an adequate quality and quantity of mental health-related services and treatments to the incarcerated population, especially to the under-trials and the first-time offenders. This is even more important considering that the objectives of imprisonment primarily include rehabilitation, correction, reform and secure custody, and for the proper realisation of these goals, it is asserted that an incarcerated person should be subjected to adequate mental health facilities to instil reform and rehabilitation of one’s conscience.

Law on Paper, Crisis in Practice: The Implementation Deficit in Prison Mental Healthcare

It is contended that, according to the India Justice Report 2025, a mere 25 psychiatrists/psychologists are available to engage in the reduction of mental health issues of inmates and other related issues for about 1,330 prisons throughout the nation. This data equates to about 1 mental professional being available for every 22,929 inmates. These statistics deviate considerably from the recommendations made by the Ministry of Home Affairs in their Model Prison Manual, 2016, which clearly states that one counsellor or psychologist must be there for every 500 inmates. While this is not legally binding, these guidelines hold a persuasive value for proper governance.

India is also a signatory to the UN Nelson Mandela Rules, which have inspired the creation of the above-mentioned Model Prison Manual, 2016; hence, it is pertinent to note that Rules 24-25 of the UN Nelson Mandela Rules dictate that the state is responsible for providing the same level of healthcare as available in the regular society to the inmates. Moreover, it also states that every prison facility will consist of a unit dedicated to promoting, protecting, and improving the mental and physical health standards of the prisoners. These UN Nelson Mandela Rules, while not binding, still offer a persuasive value to the state to improve mental health standards in prisons.

Data from the National Crime Records Bureau (NCRB) in the year 2022 revealed that a total of 25 states and union territories combined did not have any standing mental health professional (like a psychologist or a psychiatrist) and hence lacked an active professional who dealt with mental health issues of the inmates.

The Mental Healthcare Act Rules, 2017, clearly state that prisons should keep a detailed record of the medical history and current medical status of the inmates. With respect to this, only 1 Union Territory (UT) and 6 States have mandated the creation of detailed records/accounts of mentally ill inmates.

These findings highlight that despite the presence of comprehensive domestic and international legal frameworks, the implementation of the right to mental health is a critically under-addressed crisis in Indian prisons. This issue is of critical contemporary importance because the right to mental health is a fundamental right under Article 21 of the Indian Constitution, and hence, the state is obligated to take positive measures to alleviate the above-mentioned issues.

Constitutional Obligations: Article 253 of the Constitution and the Case for Uniform Legislative Action

The data and statistics presented in this article clearly indicate an implementation and pragmatic deficiency regarding the proper enjoyment of one’s right to mental health amongst the inmates. It is important to note that issues, including the lack of mental health professionals and inadequate sleeping space, especially for the undertrial inmates and the first-time convicts, are a violation of Article 21 of the Indian Constitution, the Mental Healthcare Act, 2017 provisions and India’s International ratifications like the International Covenant on Economic, Social and Cultural Rights. Positive action by the state on the aforesaid would also conform to Article 47 of the Indian Constitution, a directive principle of state policy, that dictates the state to improve public health as one of its primary duties. The state is hence mandated to institute positive measures to secure a minimum benchmark for every inmate to provide them with adequate mental health facilities and treatment.

In furtherance of this, the Parliament should consider amending the Mental Healthcare Act, 2017, while invoking Article 253 of the Indian Constitution, to impose strict deadlines that ensure a healthy mental health professional-to-prisoner ratio and properly track the mental health status of the inmates, especially of the under-trial and first-time convicted population. Alternatively, by virtue of Article 253 of the Indian Constitution, a separate piece of legislation that prescribes mandatory mental health benchmarks, adequately trained and qualified mental health professionals, etc., should be enacted. Moreover, mandating the Model Prison Manual, 2016, which was curated while considering the United Nations Nelson Mandela Rules, vide the use of Article 253 of the Indian Constitution, can also be a viable option to ensure the right to mental health of inmates throughout the nation is secured and upheld.

Critics might argue that Entry 4, List II (State List) of the Seventh Schedule, read along with Article 246 of the Constitution, places prisons and correctional institutions under the jurisdiction of their respective state governments. While this would normally mean that uniform legislative instruments (such as the one proposed by this piece) would infringe upon the autonomy of the state governments, this issue is effectively resolved by the principles of cooperative federalism, as stated in Article 253 of the Indian Constitution. This Article explicitly empowers the Parliament with overriding powers by virtue of which it can enact legislation on the State list subjects to effectuate India’s international obligations, like the ICESCR and the UN Nelson Mandela Rules.

Invoking the same constitutional authority to create uniform legislation regarding mental health provisions and their implementation mandates to govern the whole of India would not hamper the federal equilibrium of the nation. Rather than encroaching on state domains, it would establish a minimum benchmark to ensure equitable mental health provisions, such as a mandatory mental health professional-to-inmate ratio and a systemised inmate screening and record-keeping protocol for every inmate across India’s prisons. On the other hand, the state governments would continue to perform their federal functions, including regular administrative tasks, implementation, localised budget allocation, recruiting professionals and allied personnel, security regulations, and pharmaceutical procurement. This division of power would enable a better realisation of human rights with state autonomy and hence uphold social justice, the spirit of cooperative federalism and the inmates’ right to mental health. Such a legislative mechanism would also conform with the ICESCR’s principle of non-retrogression and progressive realisation, thus further advocating the need to implement it.

This overriding power of the parliament that intends to provide mechanisms for the fulfilment of India’s international obligations and ratifications can and should be used to reinforce the right to mental health of the incarcerated population to uphold various persuasive and binding statutes like the ICESCR and the United Nations Nelson Mandela Rules, while also upholding the fundamental rights of the inmates by the same state action.

Conclusion

Ultimately, the incarcerated population remains subjected to the control of the state. The state’s exercise of total control over correctional facilities confers a significant ethical and legal duty to uphold its obligations under Article 21 of the Constitution, thus protecting the fundamental rights, dignity and mental well-being of the incarcerated population.

This state’s duty of care further becomes non-negotiable, especially for the vulnerable inmates, such as undertrials and first-time convicts. Inclusion of the right to mental health as a fundamental right transforms it into an enforceable right rather than being a mere administrative option, hence requiring mandatory state action swiftly.

Depriving these inmates of their right to mental health poses a serious risk to the goals of the penal system. The goal of the state to reform and rehabilitate the convicts can easily be subverted due to the intense psychological degradation that would be caused or exacerbated by deficient mental health facilities.

To alleviate this mental health crisis, the state must fulfil its domestic and international obligations to ensure that all inmates are subjected to a minimum benchmark of mental health provisions. The definitive solution here requires the Parliament to invoke its authority under Article 253 of the Indian Constitution to devise a uniform national framework. This would enable the state to enforce binding compliance criteria, including a healthy professional-to-prisoner ratio and systemised mental health records.

Consequently, these benchmarks must be implemented uniformly throughout the nation to ensure that an equitable and dignified benchmark of mental health facilities exists, regardless of an inmate’s geographical place of confinement.

Aditya Mani Tripathi is a 3rd-year B.A.LL.B. student at Lloyd Law College, Greater Noida and has a keen interest in constitutional law.