Prisoners acquitted on the grounds of unsoundness of mind and admitted in a mental health establishment – a case series

Abstract

Background: Individuals acquitted on grounds of unsoundness of mind and admitted in a mental healthcare facility as per section 335 of the Criminal Procedure Code (CrPC) represent a unique intersection of psychiatric morbidity and legal oversight. This study details the nature of criminal offence, the psychiatric illness, and related factors in such individuals resulting in prolonged stay in psychiatric establishments after legal acquittal.
Material and Methods: This retrospective case series examined medico-legal records of five individuals admitted to a tertiary psychiatric facility between 2015 and 2022. Data were extracted on sociodemographic characteristics, psychiatric diagnoses, nature of offences, legal proceedings, and duration of stay in the mental health establishment.
Results: All individuals were diagnosed with Schizophrenia and had committed serious offences—primarily homicide—during active psychotic episodes. None had received adequate psychiatric treatment just before the offense. There were delays in rendering the individual fit to stand trial due to chronic severe mental illness, which contributed to a prolonged hospital stay, often exceeding 5 years. Discharge and reunion with family members could not be achieved in these patients due to long-standing mental illness.
Conclusion: This case series highlights the complex clinical and legal journeys of individuals acquitted on grounds of unsoundness of mind. Prolonged inpatient stay remains common, often due to chronicity of illness and limited family support, emphasizing the need for regular psychiatric treatment, developing structured discharge protocols, expanding community-based rehabilitation options, and improving legal awareness among caregivers.