The Kerala High Court has expressed concerns over the state of infrastructure at the Thiruvananthapuram Mental Health Centre and issued directions to address the issues concerning patient care and management of the centre. A Division Bench consisting of Justices Devan Ramachandran and Basant Balaji, visited the centre and held that the issues have to be considered in the “context of the present era” rather than clinging to the “protocols of the past”.

The court highlighted the shortage in personnel as ‘woefully insufficient’ and noted that the centre was surviving with only 127 attenders against sanctioned 158 posts. Naming them as the ‘mainstay of the institution’, the court observed that attenders not only manage patients’ immediate needs, but also ensure that caregivers and doctors treat patients with dignity. They were found to be taking on additional roles in the kitchen and in cleaning the centre’s premises, spread over 31 acres. The 13 posts of cooks and one dhobi were abolished over time.

The court directed the State to fill all vacant posts of attenders in the Centre and file a report. The competent authorities were asked to furnish reasons for the lack of cooks, dhobis, or enough drivers at the centre. The State was also directed to inform the court regarding the shortage of specialised security personnel. The court assessed that a minimum of 40-50 security personnel may be required to guard the perimeter of the centre, as it lacked proper fencing or compound walls at many points. The State was further instructed to inform whether any sanctioned posts for security personnel remained vacant.

Apprehension about recovery

During the visit, the court observed that most of the patients were confined to their locked rooms or cells, and they reportedly witnessed patients restlessly pacing the cells, with many of them requesting to be set free. The court expressed its apprehension about the patients’ recovery if they are confined to small spaces such as a cell. The court noted that the centre had enough open land to give the patients access to nature, which would be beneficial for their care and treatment. The court also visited the patients who were accused of crimes and were either convicted or under trial, who were housed in a separate section, under the guard of the Department of Prisons.

The court also pointed out that many buildings within the centre were declared uninhabitable by the Public Works department. The construction of a male psychiatric ward and a halfway home was virtually halted, and the condition of the internal roads was “pitiable”, the court observed. Competent authorities of the State were directed to file the proposals for completion of pending constructions, including the maintenance of internal roads, complete with a timeline for the works. The proposals should include the restorations of buildings declared unsafe by the PWD.

The Vocational Training Centre of the establishment was hailed as the most positive feature of the Mental Health Centre, stating that the engagement would enable ‘remarkable recovery’ possible for the patients. However, the centre was found to have insufficient inventory in essential medication such as antibiotics, which the doctors bring in from other institutions.

The court also observed that there were proposals in play to institute treatment facilities for physical ailments of the patients, but it was not found to be in operation during the visit. In this regard, the court directed to be informed on the status of meeting the requirements of medication for both mental and physical conditions. The competent authority of the State was also directed to apprise the court about the reintegration of the patients fit to be discharged with their family and society.

Published - July 24, 2026 09:05 pm IST