Diagnostic categories, socio-demographic data, criminal offences and their associations in prisoners admitted to a tertiary psychiatric referral center following Mental Healthcare Act 2017- A retrospective study

Background: The Mental Healthcare Act (MHCA) 2017 introduced a legal framework for the assessment and transfer of prisoners with mental illness to mental health establishments. However, there is limited data examining psychiatric admission patterns and profiles of prisoners following the implementation of the MHCA 2017 in India. Aim: To examine the sociodemographic characteristics, psychiatric diagnostic categories, and legal variables (including IPC sections of alleged offences and conviction status as undertrial or convicted) of prisoners admitted to a tertiary psychiatric institute following the implementation of the MHCA 2017. Materials and Methods: A retrospective analytical study was conducted of all prisoners admitted over a 3-year period (April 2022–March 2025) following the adoption of MHCA 2017. Sociodemographic, clinical, and legal data were extracted from case files and institutional records. Descriptive statistics and associations between variables were analysed. Results: Forty-three prisoners were admitted during the study period; the mean age was 31.86 ± 8.57 years and 90.7% were male. Most were undertrial prisoners (79.07%). Substance use disorders were the most common primary diagnosis (48.84%), followed by adjustment disorders (30.23%) and psychotic disorders (13.95%). Abnormal behavior and risk of self-harm were the most frequent reasons for referral. Prisoners charged with murder or attempted murder were significantly more likely to have psychotic disorders (Fisher’s exact test P = 0.0196; OR = 10.33). Conclusion: This study provides insights into the psychiatric diagnoses and profiles of prisoners requiring psychiatric admission and the pertinence of coordinated forensic mental health pathways particularly de-addiction services.