Patna High Court flags ‘grossly insufficient’ mental health care in Bihar, orders immediate halt to mining near BIMHAS

After the CJ Sahoo and other judges on the state judiciary visited BIMHAS as a part of an awareness drive organised by the legal services authority, a report on the state of the facility — the sole state-run institution dedicated to mental health — was directed to be filed.

‘Only 180 beds’

• BIMHAS’ current inpatient capacity of only 180 beds.
• Additional hospital with 140 beds under construction within the campus.
• Given state’s vast population and expansive geographical area, this single facility is inadequate.
• The high prevalence of mental health issues in the State necessitates the establishment of multiple institutes or branches of BIMHAS across different regions.
• Mental Illness Cured Home, established by the Social Welfare Department under the directives of the Supreme Court, currently has a limited capacity of only 50 beds for male patients and 50 for female patients. This is grossly insufficient.
• Many cured or stabilised psychiatric patients face delays in social rehabilitation, prolonging their institutionalisation and hindering their reintegration into society.
• Capacity needs to be expanded for both males and females.

CJ-led bench heard a suo motu PIL and passed a slew of directions.

Wards for the homeless

The bench further underlined the need to establish dedicated facilities for the homeless who suffer from mental illnesses.

• All medical colleges and district hospitals in Bihar need to establish dedicated facilities or wards for homeless individuals suffering from mental illnesses.
• Currently, there is a lack of such specialised accommodations, leaving vulnerable populations without proper shelter or treatment during recovery.
• Notable lack of coordination between the Social Welfare Department and other government agencies regarding the rehabilitation of the homeless patients following their successful treatment.
• As a consequence, even after full recovery, these persons often remain unnecessarily hospitalised due to insufficient support networks.

The order, therefore, highlighted “an urgent need” to put in place comprehensive training and vocational programmes for the cured or stabilised psychiatric patients to equip them with “employable skills”.

‘Government should promote jobs for cured’

• Government required to actively promote and encourage the employment of cured or stabilised psychiatric patients under various government schemes and programmes.
• A rest house with sufficient capacity needs to be constructed within the campus of BIMHAS to accommodate patients travelling from distant parts of the state or even other regions of the country for their treatment, along with their attendants.

Mining work near BIMHAS to stop

• The operation of the Balu Ghat (sand mining site) and sand storage facilities in the vicinity of the hospital needs to be halted immediately.
• The constant movement of heavy trucks poses a significant risk to the safety of mentally ill patients and staff, with daily footfall exceeding 400 individuals.
• These vehicles create noise pollution, dust, and potential accident hazards, which can exacerbate mental health conditions and disrupt therapeutic environments.
• Relocating these activities would prioritise patient well-being and comply with health and safety regulations.

Parks and recreation

• Playground at BIMHAS needs to be developed on a priority basis to include modern amenities such as sports fields, exercise equipment, and recreational spaces.
• A well-maintained playground would be integrated into rehabilitation programmes, encouraging outdoor activities and contributing to a holistic treatment approach.
• A park needs to be established on the site of the demolished old buildings within the BIMHAS campus to enhance the campus’s aesthetic appeal, support eco-therapy initiatives, and offer a communal area for patients, staff, and visitors to unwind.
• Afforestation and greenery initiatives need to be implemented across the entire BIMHAS campus in collaboration with the Forest Department.
• A greener campus would support mental health through nature-based interventions,
  reduce urban heat effects, and align with environmental sustainability goals, ultimately benefiting patients’ recovery and well-being.

The Patna High Court, as a result, issued notices to the state’s principal secretary, health department, secretary of the State Mental Health Authority, director, BIMHAS, DGP, Inspector General of prisons and the Centre.

All authorities were ordered to respond on the following aspects:

• Whether any Mental Health Review Board has been constituted in accordance with Section 73 (Constitution of Mental Health Review Boards) of the 2017 Act?
• If so, what are the functions being discharged by such Board under Section 82 (Powers and functions of Board) of the 2017 Act?
• How Bihar Institute of Mental Health and Allied Sciences (BIMHAS) is performing its duties and carrying out its responsibilities relating to the admission and treatment of persons with mental
  illness?
• What provisions have been made by the hospital authorities for supplying free food to the patients and attendants, medicines, and to maintain the cleanliness and hygiene of the hospital and to create a positive environment?
• DGP shall submit a report regarding the duties performed by police officers of different police stations of the State in respect of persons with mental illness and their protection as envisaged under Section 100 of the 2017 Act, and also, I.G. of Prisons in respect of the prisoners with mental illness under Section 103 (Prisoners with mental illness) of the 2017 Act.

Besides, while the member secretary of the state legal services authority was directed by the Patna High Court to submit a report on the legal aid facilities to the persons with mental illnesses, particularly those coming to BIMHAS, the health department principal secretary was ordered to provide information about the steps taken by the government for the rehabilitation of the persons suffering from mental illnesses post recovery and discharge.

Advocate General P K Shahi and Additional Solicitor General Dr K N Singh appeared in the matter, whereas advocates Anukriti Jaipuriyar and Raju Patel were appointed amici curiae.

The matter would be heard by the Patna High Court on March 16.