What lies behind the closed doors of mental health institutions in India

Whether government run or privately manned, these institutions continue to be a place of horror for the human conscience and a life-long prison for most women and girls with disabilities incarcerated inside them. The recently launched report by the Human Rights Watch (HRW) released in 2014, titled, "Treated worse than animals: Abuses against Women and Girls with Psychosocial or Intellectual Disabilities in Institutions in India", brings to light the various aspects of the harsh realities within the confines of these so called institutions of care.

Unfortunately, things have not changed much since the fire incidence that took lives of some 25 mentally challenged persons in a mental asylum at Ervadi in Tamil Nadu; because they were left chained to their beds (In Re: Death of 25 Chained Inmates in Asylum Fire in Tamil Nadu vs Union of India & Ors, (2002)3 SCC 31). Even with elaborate orders from the apex court regarding the maintenance of humane conditions, safety, and regular monitoring, the situation remains bleak. 

A report by HRW highlights that many women are still forcibly incarcerated in these institutions without the need for judicial review. This saga of being forced against their will, without their informed consent includes forced medication, forced treatment, electroconvulsive therapy (ECT), and even continued incarceration. In many places, ECT is also used as a threat to forcibly make them take medication.

Equally terrible are the housing conditions of such places. Most accommodations are occupied beyond their permissible limits of capacity, such as the Government run Asha Kiran Home for the intellectually disabled in Delhi - nearly three times over its capacity. Many women and girls sleep on the floors in these places in close proximity to each other leading to gradual transfer of lice - a common problem affecting women at such centres. What is worse is that instead of improving the personal hygiene of women, their heads are shaved off - with no regard to their sense of dignity. Clothing is in loose sizes and in many places, when the clothes go for washing, the inmates are even left naked. Hygiene and sanitation remain absent.

Adding to regular neglect is a lack of medical facilities. Abuse of different kinds is the harsh reality of such institutions. Most suffer abuse at the hands of their caretakers and have no mechanism for redressal. In this respect, a complete absence of monitoring and accountability violates human rights by manifolds.

Cut off from the outside world, many women and girls are dumped into such institutions for a lifetime by their families. This situation is further compounded by the fact that the Indian legal system also takes away their legal capacity on account of their unsound state of mind - leaving no say for them even before the law.