Introduction:
In The High Court Legal Aid Committee v. The State of Kerala and Others [WP(C) No. 16603 of 2026], the Kerala High Court highlighted the urgent need to improve the functioning and infrastructure of the Government Mental Health Centre at Thiruvananthapuram. A Division Bench comprising Justice Devan Ramachandran and Justice Basant Balaji, after personally inspecting the institution along with amicus curiae Advocate V. Ramkumar Nambiar and government officials, expressed serious concern over the conditions prevailing at the Centre and directed the State Government to initiate immediate corrective measures.
The proceedings formed part of a public interest matter concerning the welfare and rights of persons receiving treatment at the Mental Health Centre. During the inspection, the Court examined the institution’s infrastructure, staffing, patient care facilities, rehabilitation measures, and overall living conditions. While acknowledging certain improvements made before the visit, the Bench observed that significant deficiencies continued to exist, particularly in relation to patient care, shortage of staff, inadequate infrastructure, and outdated methods of managing patients.
The Court stressed that mental healthcare in the present era must be guided by dignity, compassion, rehabilitation, and modern therapeutic practices rather than outdated custodial approaches. Observing that many patients remained confined inside locked rooms despite the availability of large open spaces within the campus, the Court noted that such conditions were inconsistent with the objectives of effective mental healthcare.
Arguments of the Parties:
The petition, initiated through the High Court Legal Aid Committee, sought judicial intervention to ensure that patients admitted to the Mental Health Centre receive treatment consistent with constitutional values and modern standards of mental healthcare. The concerns placed before the Court related to inadequate infrastructure, shortage of essential staff, poor maintenance of the premises, insufficient rehabilitation mechanisms, and the prolonged institutionalisation of patients who had already been declared fit for discharge.
During the inspection, information placed before the Court revealed that although the sanctioned strength of attenders was 158, only 127 were presently working. The shortage had forced attenders to perform multiple duties beyond their designated responsibilities. Apart from attending to patients, they were required to transport patients to other hospitals, maintain cleanliness of the premises, undertake security functions, and perform duties ordinarily assigned to cooks, washers, and other support staff because those posts remained vacant.
The materials placed before the Bench further indicated that several infrastructural deficiencies continued to affect the functioning of the institution. Incomplete construction works, damaged internal roads, overhanging tree branches posing safety risks, and inadequate facilities for treatment of physical ailments were among the concerns highlighted before the Court.
The State Government and the officials informed the Court about the functioning of the institution and also pointed out certain positive developments. One such encouraging feature was the vocational training centre where patients were engaged in activities such as making soaps, umbrellas, and other useful products. These programmes were intended to promote rehabilitation and improve the patients’ confidence and independence.
However, the information also disclosed that nearly fifty-five patients had already been certified fit for discharge but continued to remain in the institution because their families had not come forward to receive or support them after discharge.
Court’s Judgment:
After examining the condition of the Mental Health Centre firsthand, the Kerala High Court observed that the institution required substantial reforms to ensure that patient care meets contemporary standards of mental healthcare.
At the very outset, the Division Bench remarked that although visible cleaning and preparation had apparently been undertaken before the judicial inspection, the overall condition of the institution remained deeply disturbing. According to the Court, patient care in a modern mental healthcare facility cannot continue to be governed solely by outdated protocols when advances in medicine and psychology now recognise the importance of rehabilitation, dignity, and therapeutic environments.
One of the Court’s primary concerns related to the acute shortage of staff. The Bench noted that while 158 attenders had been sanctioned, only 127 were presently available. The absence of cooks, washers, drivers, and security personnel had resulted in attenders performing multiple unrelated duties. Instead of devoting their full attention to patient care, they were simultaneously required to prepare food, wash clothes, transport patients to hospitals, maintain the premises, and provide security services.
The Court observed that such an arrangement inevitably affects both the quality of care provided to patients and the working conditions of the staff. It therefore directed the State Government to urgently fill the vacant posts of attenders at the earliest available posting opportunity.
The Bench also expressed deep concern regarding the manner in which patients were being accommodated. During the inspection, it found that most patients remained confined inside locked rooms or cells with little opportunity to move freely despite the institution possessing substantial open land.
The Court noted that many patients were seen repeatedly pacing within confined spaces, while several personally requested the visiting judges to allow them to go outside. According to the Bench, prolonged confinement within enclosed rooms is inconsistent with the therapeutic goals of mental healthcare.
The Court observed that nature itself possesses considerable healing potential. It remarked that access to open spaces, fresh air, trees, sunlight, and a peaceful environment could significantly improve the emotional well-being of patients and contribute positively to their recovery. Rather than remaining confined within closed spaces, patients should be encouraged to spend time outdoors wherever medically appropriate.
The Bench therefore urged the Government and healthcare authorities to rethink the existing model of patient management and adopt more humane and progressive practices suited to present-day mental healthcare.
The Court also highlighted various infrastructural deficiencies that demanded immediate attention. During the inspection, it noticed incomplete construction projects, damaged internal roads affecting movement within the campus, and dangerously overhanging tree branches that posed safety risks to patients and staff alike.
Recognising the urgency of these issues, the Court directed the State Government to file a detailed affidavit explaining the status of incomplete constructions, road repairs, and other infrastructural improvements proposed for the institution.
Another important concern related to the rehabilitation of patients who had already been declared fit for discharge. The Court observed that nearly fifty-five such patients continued to remain in the institution solely because their families had failed to take responsibility for them.
The Bench noted that indefinite institutionalisation of persons who no longer require psychiatric admission raises serious concerns regarding their dignity and right to lead a normal life. It therefore directed the competent authorities to place before the Court comprehensive proposals indicating how such patients could be rehabilitated and reintegrated into society.
The Court further observed that the Mental Health Centre should gradually become self-sufficient in providing essential medicines as well as treatment for physical ailments suffered by patients. It emphasised that individuals admitted for psychiatric treatment often require comprehensive healthcare, making integrated medical services within the institution highly desirable.
To ensure accountability, the Court directed the concerned authorities to file affidavits explaining why essential posts such as cooks, washers, drivers, and security personnel remained vacant despite their obvious necessity for the institution’s functioning.
At the same time, the Bench appreciated the vocational training activities conducted within the Centre. It noted that patients were being trained in manufacturing soaps, umbrellas, and similar products, describing these programmes as positive initiatives that encourage rehabilitation, improve self-esteem, and prepare patients for eventual reintegration into society.
Overall, the High Court’s interim order reflects a rights-based approach to mental healthcare. Rather than viewing persons with mental illness through a purely custodial lens, the Court recognised that they are entitled to treatment in an environment that promotes dignity, freedom, rehabilitation, and humane care. The judgment underscores that mental healthcare institutions must evolve beyond mere confinement and instead become centres of healing, recovery, and social reintegration.
By directing the Government to address staffing shortages, improve infrastructure, utilise open spaces more effectively, strengthen rehabilitation mechanisms, and ensure better institutional management, the Court has laid down an important roadmap for improving public mental healthcare in Kerala while reaffirming the constitutional obligation of the State to protect the dignity and well-being of vulnerable individuals.