Kerala judges find grim conditions at mental health centre

The Kerala High Court has directed the state government to implement urgent reforms at the Government Mental Health Centre in Thiruvananthapuram after judges found conditions inside the facility more akin to a prison than a treatment center.

Judges describe conditions during inspection

A Division Bench of Justice Devan Ramachandran and Justice Basant Balaji visited the center on July 18. They observed patients confined to wards for most of the day with little access to open spaces or social interaction. The environment failed to meet modern mental healthcare standards, which prioritize therapeutic settings alongside medication.

The judges stated patients were given drugs and then forced to remain in restricted areas, except for brief periods in the morning or evening. “What they experience is a sense of imprisonment, not the freedom of openness and choice,” the ruling noted.

The campus had ample land that could be repurposed to create a more humane setting, including areas for nature exposure and outdoor activities. Such changes, the court suggested, could offer comfort instead of confinement.

Staff shortages and infrastructure problems

The inspection found only 127 staff working at the center, though 158 positions were sanctioned. These employees handled patient care while also managing cooking, cleaning, and transporting patients to other hospitals. Several buildings were deemed unsafe, some construction projects remained unfinished, and internal roads were in disrepair.

Fifty-five patients who were medically fit for discharge continued to stay at the center due to lack of alternative arrangements. This situation exposed gaps in rehabilitation and reintegration programs.

As an immediate measure, the court ordered the state to fill vacant attender positions and explain the absence of cooks, drivers, and security personnel. The government must also submit a plan for completing stalled infrastructure, establishing a rehabilitation mechanism for discharge-ready patients, and ensuring adequate psychiatric and general medical care.

Legal action and next steps

The court’s involvement followed a petition by the High Court Legal Aid Committee. The inspection team included the amicus curiae, officials from the District Legal Services Authority, and representatives from the Victim Rights Centre. Advocate V Ramkumar Nambiar acted as amicus curiae in the case.

The judges noted the center had been cleaned before their visit but said the core problems remained serious. The case will resume on August 4, when the state must report progress on the directives.

Mental health advocates have argued that institutional care should balance treatment with dignity. Kerala’s system, like many in India, still relies on custodial models rather than patient-centered approaches. The bench made clear that small fixes would not suffice, though whether the orders lead to lasting change is uncertain.

Conditions at such facilities often escape public scrutiny. Court limits on live footage can further reduce transparency, making judicial oversight critical.