In the movie The Shawshank Redemption, after completing a 50-year sentence, Brooks Hatlen is released from prison. When he re-enters mainstream society, the ways of the world have changed; he doesn’t feel at home. Using a sharp knife, he writes on the wall of his room, “Brooks was here” and then, he dies by suicide.Recently, the Madras high court held that the medical examination of an arrestee is necessary before making an arrest for remand. The judgment places a duty on the authorities to act in accordance with Sections 100-105 of the Mental Healthcare Act, 2017. Such duties are fulfilled during the stage where the prisoner is either about to enter or is already in prison. However, this article refers to the transition stage; where the prisoner has formally cut ties with the prison because their sentence was completed or they were granted bail, but has not yet healthily reintegrated with mainstream society. This is called ‘transitional health’.It can be argued that the health-related responsibility of the jail authorities does not end on the release of the prisoner; the jail needs to continue sharing the responsibility of ensuring the transitional health of prisoners as well.Also read: Poor Medical Care for Prisoners Explains Why Number of Custodial Deaths Is Only RisingPrisoners are two to three times as likely to die by suicide than the general population; they need mental healthcare more than the general population does, not only within the confines of the prison, but also when they move out and attempt to re-join society. Their mental illness does not cease to exist on their release from prison. Indian laws surrounding prisoners’ fundamental right to health exist in a context where the prisoner is serving their prison sentence. In orders such as Re – Inhuman Conditions in 1382 Prisons (2017) and landmark cases like Sunil Batra v. Delhi Administration (II) and Ajay Singh v. State of Maharashtra, it was held that when a prisoner is in custody, it is the duty of the state authorities to provide healthcare to the prisoners because they retain their fundamental right to health, guaranteed under Article 21 of the constitution, even while in custody (though some “shrinkage” of rights does happen). Prisoners continue to be considered human beings even when incarcerated. In fact, they stand in greater need of healthcare because they face a double handicap. Prisoners are more prone to develop health issues because of the unhealthy environment in which they are held and, because their liberty remains restricted, they do not have the same access to medical expertise that free citizens do. Hence, society owes a greater duty to such persons. Illustration: Pariplab ChakrabortyDevelopment of law in this way leaves a policy gap in deciding who is responsible for the prisoners’ transitional health. The United Nations Standard Minimum Rules for the Treatment of Prisoners (Nelson Mandela Rules) require a pre-release regime to be provided to prisoners within the prison or in some other institution. The idea is that a prisoner should be ready to re-enter mainstream society successfully. In cases that can be be seen in India, this idea is far from certain even after they have completed the pre-release regime.According to Delhi Prison Rules, 1857, “If any prisoner becomes a patient of Mental Illness immediately before the expiry of his sentence, he shall be handed over to his relatives or friends on the expiry of his sentence, failing which he may be sent to Institute of Human Behaviour & Allied Sciences or any other Government Hospital, for treatment.” But what if the person did not incur mental health illness just before the expiry of the sentence and only incurred it during the period of leaving prison and re-entering mainstream society? Where does the responsibility of prison authorities end in relation to the health of prisoner?Also read: Set up Mental Health Unit in at Least One Prison: Kerala HC to GovernmentIt may be argued that Section 18(1) of the Mental Healthcare Act, 2017 provides that “Every person shall have a right to access mental healthcare and treatment from mental health services run or funded by the appropriate Government,” according to which even a “prisoner with mental illness” can exercise his right to procure mental healthcare after leaving the prison. However, such legal analysis operates on the assumption that prisoners will actively self-manage and self-medicate after their release. What such analysis overlooks is that the prisoner will need assistance to go to mental health institutions for treatment. Holding jail authorities being solely responsible for the health of the prisoner will be too big a demand to make. An intersectoral response is needed for the health of the persons who get released from jail. The jail authorities, in coordination with mental health institutions, need to provide mental healthcare to the released prisoners. This need is felt especially by those who have served long sentences. After spending a sentence of say, ten years, the person may become institutionalised and may face mental health problems while reorienting to a ‘new’ life outside of prison. According to Prison Statistics India 2019, of the total of 1,44,125 convicted prisoners, 53.54% were sentenced to life imprisonment, 14.4% were sentenced to more than 10-13 years, and 7.77% were sentenced to 7- 9 years. Though data on the mental health of released prisoners is currently unavailable – probably because of legitimate policy reasons – a significant number of prisoners are likely to have weak transitional health.The following problems are faced by people re-entering society after a long sentence in prison:Adjustment and stress related disordersAnxiety and mood disordersSubstance withdrawal related complicationsSelf-harm attemptsSomatoform disordersWhat’s more, the above-mentioned problems can worsen or precipitate mental health problems and lead to relapse.Also read: In India and Around the World, Prisoners’ Rights Violated During Pandemic: ReportJail authorities will need to work in coordination with mental health institutions, owned by the concerned governments. Such institutions may need to prescribe rules under Section 18(4)(b) of the Mental Healthcare Act for half-way homes, sheltered accommodation, supported accommodation and so on. These are the kind of institutions – though not limited to these – that prisoners may need for the transition. One concern may be that the privacy of inmates may get infringed upon if jail authorities have access to information regarding released prisoners. This is a valid concern, however, the intersectoral approach will allow mental health institutions to follow fair data-sharing practices between jail authorities and mental health institutions, which will also insulate the data from public access. Because prisoners, after completing a long sentence, often remain stuck in some kind of limbo, they may formally be out of prison but won’t stand fully integrated with mainstream society. Jail authorities need to be given a ‘responsibility window’ during which they would be required to provide mental healthcare to the released prisoner through mental health institutions. And beyond such a window, the responsibility of jail authorities will cease to exist. Husain Aanis Khan is a lawyer and Research Fellow at Vidhi Centre for Legal Policy, New Delhi.