Psychiatry & Psychosomatic Medicine

A prison, in general, is an extremely negative space from a psychological perspective. Research has indicated that effects of prisonization (institutionalization) are unique for everyone, and these can have serious negative impact on their postprison integration, but in almost all cases these negative effects are reversible. Tihar prison, New Delhi, India is the largest prison complex of South Asia and is styled as a correctional institution. Against a sanctioned capacity of 5200 inmates, the actual strength is around 12,000. While the goals and objective of the Tihar Jail are lofty, overcrowding, lack of modern facilities leads to multiple psychosomatic illnesses in the inmates during the period of incarceration. Another unfortunate reality is the extended and languishing prison stay of under-trials due to slow police investigation processes and even slower judicial systems. These under-trials have to suffer additional psychological stress as compared to the regular inmates because of the daily anxiety, uncertainty, helplessness, powerlessness, and despair involved. The National Mental Health Survey 2015-16, an all-India survey, has revealed that mental health has become a major issue in the country with 4 out of 10 women and 1 out of 10 men suffering from depression. My work with Tihar has shown that the number of cases of depression in the incarcerated exceeds the general population in the same socio-economic strata of society. There is a higher number of prisoners suffering from depression, anxiety and stress and the subsequent illness compared to the general population. My work has also shown that we need to treat these regular and under-trials inmates as highly vulnerable individuals and group therapy combined with some elements of individual counselling can go a long way in helping them integrate comfortably in society upon release. It has also shown that every prison can put in place systems/processes to achieve this without much financial investment.