Mental health and much-needed prison reforms

That sound mental health is essential for emotional, psychological, social and financial wellbeing of an individual, and thereby the society at large, goes without saying.

According to the World Health Organization, approximately 1 in 8 people worldwide are living with one mental disorder or the other. Psychological conditions – like depression, anxiety, schizophrenia, bipolar disorder, borderline personality disorder, etc – lead to an unhealthy society, characterised by deviant behaviours such as intolerance, anger, crime, etc.

World Mental Health Day is observed annually on the 10th of October for raising awareness about the disorders; encouraging conversation, prevention and intervention; advocating for financial resources – all meant for fostering a healthy society.

While our society, in general, is not too caring, compassionate and tolerant towards people with mental disorders, it is our prisons that need a special mention in the context of treating – i.e. ill-treating – mentally unwell people.

Pakistan inherited colonial prisons laws, viz. Prisons Act 1894 and Prisoners Act 1900 which focus on retributory treatment to the prisoners rather than the rehabilitative one. Sindh, however, is the only province in the country that has come up with a progressive and reformed law namely Sindh Prisons & Corrections Service Act & Rules 2019. This act delineates better mental health of prisoners as part of overall health conditions. Section 2 of the law ensures good mental health to prisoners, apart from dignity, self-respect, rehabilitation, etc. Section 43 provides exercise opportunity for good physical and mental well-being. Section 48 and 49 provide for early discharge from the prison in case of certain medical conditions. Section 50, read with section 52, ensures prisoners' well-being and rehabilitation via provision of better health services. Moreover, the Government of Sindh has notified rules under Section 80 of the mentioned Act. Chapter 32 of the rules especially delineates prisoners' wellbeing and rehabilitation in which mental health aspects form the core.

Practically though, a lot is lacking in the context of the provision of mental healthcare in prisons across the country. Our prisons need to have a whole system in place as regards treating people with mental ailments, beginning with the availability of a psychologist for inmates. No strategies can be effective in dealing with the complex challenge of mental health, unless psychologists are appointed in the prisons in sufficient numbers. Psychologists are supposed to: work for a comprehensive assessment of prisoners; train the staff with the required skills, especially those related to trauma care and various therapies; help with peer support programmes and family engagements; prepare a schedule of activities like life skill training, recreation and physical activity; and help ensure prisoners' access to resources.

According to official data as of September 2024, there are 43 prisons in Punjab and 22 in Sindh province with an authorised capacity of 37,563 and 13,578 inmates respectively. As against this, the prisons in Punjab and Sindh are respectively accommodating 67,648 and 23,000. Similarly, the 30 prisons in Kyhber-Pakhtunkhwa and 12 in Balochistan are accommodating 13,718 and 2,764 inmates, even though they have an authorised capacity of 14,038 and 2,887 respectively.

And to cater to these huge numbers, there are only 93 sanctioned posts of junior and senior psychologists in Punjab; 12 in Khyber-Pakhtunkhwa and only 4 in Balochistan. Astonishingly, Sindh does not have any post of psychologist even four years after the passage of a progressive prisons law.

This Mental Health Day is a befitting opportunity to remind the relevant authorities in Sindh to introduce at least 30 posts for the provision of mental health care to inmates and staff alike. Small steps like this may make a big difference in the context of making our prisons real rehabilitation and reforms centres.