Interview: Why we should care about the mental health of death row prisoners – and their families

Prisoners are a neglected group in India. Indian prisons are traditionally overcrowded spaces, with little attention paid to concerns about health, comfort or privacy. Those problems get even worse when talking about prisoners on the death row. Deemed to not be worthy of living in the society, such prisoners often receive inhumane treatment that entirely ignores their needs.

On October 20, Project 39-A, a research and advocacy centre based at National Law University, Delhi, released a report on the mental health of the death row inmates. The report is based on interviews with 88 death row inmates and a few of their families, to get a glimpse of how the system treats those condemned to the harshest punishment.

Project 39-A’s work focuses on the state of the criminal justice system in India, including a particular focus on how the death penalty actually works in India. Scroll.in spoke to Maitreyi Misra, Project Head and Lead Author of “Deathworthy: A Mental Health Perspective of the Death Penalty” on how they carried out this research, what the findings of the report are, and the conversations which people should pay attention to.

Edited excerpts from the interview below.

What was the idea behind the report? How did you get started?
There are three aims of the report:

• To look at the presence of mental illness among this population, [death row prisoners].
• To look at questions of intellectual disability [defined in the report as “a disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains”], and,
• To understand the mental health consequences of not just living with the death sentence, but consequences of being sentenced to death. So we look at the death penalty per se from a psychosocial perspective.
  

And we were very clear... We did not want it to be only a clinical insight and we wanted to provide social context as well.

What were you expecting to find?
We went in with an idea that there are certainly mental health concerns among death row prisoners. When we did the Death Penalty India Report [in 2016], which was a study on the socio-economic demography of prisoners, interaction with the criminal justice system, we came across prisoners who had mental health concerns.

So, we knew that we will find concerns, but we did not know that the crisis would be so intense and so extreme. For instance, 34 prisoners out of 63... had thought about suicide, at least once in prison and eight had gone ahead and attempted it.

What are the 3-4 major findings of the report?
Most of the prisoners…[had] major depression.

We found that 30 prisoners... had a current episode of depression. This figure is 11 times higher than the presence of depression in the [general] population. We screened six prisoners who had psychosis. Two of them had been provided treatment in prison... [out of which one] was on treatment for depression with abnormal behaviour.

The other finding on issues of mental illness is that on substance use. Substances like tobacco or ganja, they’re contraband in prison. [However], we found that 18 out of the 88 prisoners we interviewed had substance use disorder. [This was] 20% of the [people we interviewed], [whereas the substance use disorder in general metro population] is 24%.

Suicide was not just a result of mental illness. [One prisoner] had attempted suicide because of the stress of having been sentenced to death. Nine out of 83 prisoners were diagnosed with intellectual disability. Over 75%, i.e. 63 out of the 83 prisoners had... deficits in intellectual functioning which creates barriers in reasoning in judgment formation.

Anxiety [was] very, very high, and 19 prisoners were diagnosed with generalised anxiety disorder.

It might seem… not a big deal because they are on death row. But what needs to be understood is that these disorders prevent the person from engaging in prison activities, in building a healthy productive life in prison as well.

What conversations were you hoping to spark with this report? What would the ideal outcome be?
The ideal outcome would be for people to engage with death row prisoners as persons... The death sentence is given a name, but we barely know anything about people who we condemned to this. It is relevant to the law... [which] requires the judge to know in terms of mitigating factors, the context of the individual.

[The other is] to create a discussion and provide a framework for analysis of how should judges look at mitigating circumstances. Because right now in the law, there’s not much clarity on how mitigating factors should be looked at… The law generally has taken a very checklist approach to mitigation.

With intellectual disability, the hope is that the law… [and] courts will take notice that there is a significant population on death row, who possibly should not never be on death row.

The Supreme Court has a very humane jurisprudence on mental and emotional agony on uncertainty of death... which indicates that suffering is not the aim of the death penalty. [However], they [look at this only] after [prisoners] have filed the mercy petition and [are] awaiting decision on that. What we found is that as soon as prisoners are sentenced there, there is immense trauma.

I think one other thing that we often forget, when we’re talking about the death penalty is that it is not what the law calls only the extremely culpable people who are given the death sentence. Out of the 88 prisoners, 19 prisoners were ultimately acquitted. And 33 prisoners, [their] sentences were commuted. And a large number of them had mental health concerns…

You mention in the report that researching these issues is extremely challenging. Can you tell us about what these challenges are?
Research in prisons is very difficult, but research with death row prisoners even more difficult. To interview death row prisoners, we spend around one and a half years waiting for permissions. We could only cover five states.

This project would absolutely not have been possible without the support of the university and the vice chancellor at that time.

[Prison authorities] are scared that something negative might be written about them... Anonymity was a big concern for death row prisoners as well. Another big challenge was actually to convince prisoners and families that even though we are not here to talk about the case... it is still relevant for it is important for them to talk to us.

One family for instance told us they didn’t want to speak to us because they thought we were from the CBI. Another family didn’t want to speak with us because they thought we were from Crime Patrol (the TV show).

There are constant reminders of privilege in prison. So for instance, in a few prisons, prisoners would not be allowed to sit on chairs while we would be given chairs….

We were ready to accord absolute legitimacy to the experiences [of death row prisoners, which was]... a very novel experience for them.

Did you get any sense that mental health issues for prisoners are being genuinely discussed and grappled with by authorities?
Mental health issues generally in our society are not seriously taken. So in prison, you can understand the situation. Having said that, there were certain prison officials [who] concerned and providing treatment. But was it quality treatment?

For people who were diagnosed with depression and anxiety... the illness was not something that prison officers even understood. So a lot of the times they were just being given sleeping tablets.

And sometimes treatment is looked at as privileged as well, that this is a privilege that you have, and I can take away this privilege at any point.

What is the position of law in terms of protection that is supposed to be given to prisoners with mental illnesses?
For no good reason, it is unclear what the exact position is. It is unclear whether persons who have severe depression, where the persons who have attempted suicide, are going to get the benefit of this humaneness of law. What is clear is that the court is trying to grapple with the fact...

But the lack of awareness about issues of mental illness and the inability of law to accommodate that has created this vagueness on what are the kinds of mental illnesses that would get considered. That is what is very unclear in law, and why is that lack of clarity is also anybody’s guess.

In the report you mention how death row prisoners are treated differently from other prisoners. Can you tell us about that?

There are certain conditions of the death row that are contributing to their mental illness. For instance. Prison rules prevent death row prisoners from working. What that means is that the prisoner is constantly thinking negative thoughts.

Another consequence of being on the death row is the clouding of memories. Because slowly, prisoners start chipping away at their past... [and] that leads all of that leads to deterioration of mental health.

Institutional discrimination seeps into interpersonal discrimination. [One prisoner] speaks about how the moment before he was sentenced to death, all the prisoners were talking to him properly, but as soon as he was sentenced to death, everyone started looking at him differently.

You also interviewed the families of the inmates. What kind of an impact does getting a death row sentence have on an inmate’s family?
I think with the families of prisoners, what we have to understand is that often we hold them guilty by association.

Their experiences largely comprise their houses being razed, them having to flee the house that they may have lived in for decades, relocate, [and] hide their identities... There are a lot of instances of people [from families] falling physically and mentally ill.

One of the biggest groups that suffer the most, in that sense, are the children. Children have to often relocate, they have to stop going to school, they have to stay inside the house for months together till the... story dies own. Otherwise, they might be the subject of that fury. And in some cases, they’re not even told [about the sentence]... The death penalty isn’t been restricted to that one individual. It has intergenerational impact on children and their future prospects.

What follow up research on this subject would you like to see?
It would be really useful if we could understand better the longitudinal history of mental health history of the prisoners, to very carefully charted out from the time that they were children or even before that… That’s something we weren’t able to do both as, by reasons of time, and finances…What we looked at was the current episode of mental illness, but we weren’t necessarily able to identify a history of mental illness.

I think another is: what are the consequences going to be for these children whose parent is on death row?

It would be useful to conduct proper research on the consequences of being wrongfully sentenced to death… What are the mental health consequences of being sentenced to death and suddenly being acquitted and set at liberty?