HomeLegal ColumnsThe Complex Intersection: Death Penalty And Mental Illness

The Complex Intersection: Death Penalty And Mental Illness


In the realm of criminal justice, where a decision, once taken, is irreversible, we have to live with the consequences of the same throughout. The discourse and the debate surrounding the death penalty is anything but simple. When the factor of mental illness is introduced to this already complex scenario, it sparks more discussion worldwide and draws further attention to ethical, legal and humanitarian considerations. The particularly challenging issue that arises is what should happen when someone who has committed a heinous offence also struggles with mental health problems. The problem that they might be struggling with could be something like schizophrenia, bipolar disorder, or acute severe depression. It’s like they have two struggles, one with their mind and one with the law. Individuals suffering from mental illness are at a greater risk of losing their lives to unfair sentences. International law unequivocally condemns the execution of individuals suffering from mental illness. However, despite this condemnation, numerous countries continue to permit such executions. Furthermore, the defendant’s ability to comprehend and understand the implications of the link between their crime and the ensuing punishment becomes a crucial and challenging concern. It is difficult for the defendant to make a reasonable connection between his crime and the sentence imposed.


The National Alliance on Mental Illness (USA) defines mental illness as a condition “that disrupts a person’s thinking, feeling, mood, ability to relate to others and daily functioning.”[1] Mental illness is not a monolithic concept; it actually encompasses a diverse spectrum of conditions like schizophrenia, bipolar disorder, and depression that can significantly impact an individual’s cognition, emotional well-being, and decision-making abilities and challenge human behaviour and our perception of the same to a great extent. When further discussing mental illness in the context of the death penalty, we are concerned with how these conditions may impact an individual’s culpability for a crime and their ability to understand and participate in their legal proceedings and defend themselves accordingly. According to a survey, over 60% of people who are sentenced to the death penalty are suffering from some sort of mental illness, and the longer they spend in anticipation of their possible execution, the worse their mental health becomes.[2] Advocates of a more thoughtful approach to the death penalty and its consequences believe that mental illness should be a crucial factor in deciding the further course of action of whether someone is guilty, how they should be punished, and whether the death penalty should even apply. Mental health considerations can manifest in one of three ways- the mental disorder/disability could (a) be pre-existing, (b) arise in the course of being on death row, and (c) the mental agony caused by delay.


To further understand the intricacies between mental health and the intersection of it with the death penalty, we need to pay attention to ethical dilemmas and dimensions of the same. It’s not just a legal puzzle, but it’s also an ethical one and making sure that justice is well served and no innocent gets harmed in the due process. The big ethical questions that always come to our mind when talking about mental illness are:

Why All Lives Are Important: One of the main things we wrestle with is whether it’s ever okay for a society to end someone’s life, even when they’ve done something truly awful. This isn’t just a legal issue; it’s a deeply ethical one. It’s about deciding how much we value every human life, even when we’re dealing with heinous crimes on a daily basis. Further adding to this equation is whether it’s truly humane to execute someone who is suffering from mental illness and cannot be the judge of whether something is right or wrong.

Balancing Compassion and Fairness: We also wrestle with questions of compassion and treating people with respect, even when they’ve done wrong or something offensive and heinous to mankind. Is it fair to execute someone who might not really understand what they did or further be the judge of the level of crime they have committed because of their mental illness? These ethical questions force us to balance our sense of justice with our sense of humanity.

Responsibility and Mental Illness: Another big question is about blame. Should we hold someone with a serious mental illness as responsible for their actions as we would someone who doesn’t have that illness? It’s really hard to decide where to draw the line between responsibility and understanding for those who are truly mentally ill.


The Courts, Legislatures and Legal Professionals continually struggle with the legal complexities of mental illness and how it can have a huge toll on the death penalty. They often try to strike a balance between respecting the dignity of the people affected or victims, as well as the rights of individuals with mental illnesses, while upholding the law and making sure justice is served throughout.

Competency to Stand Trial: Courts struggle with assessing a defendant’s competency to stand trial. The legal system must determine whether a defendant comprehends the charges against them and can effectively assist in their own defence. Mental illness can muddle this determination, posing legal complexities.

The Insanity Defence: Legal systems recognize the insanity defence, allowing defendants with severe mental illnesses to plead not guilty by reason of insanity. However, the criteria for this defence vary widely, and its application can be contentious, adding legal intricacies to an already complex landscape. Insanity affects a capital case in the following ways:

  1. When, at the time of the commission of the offence, the defendant is insane, he can be found ‘not guilty’ on the grounds of insanity and institutionalized.
  2. For periods where the defendant is insane or not in his senses, the trial should be suspended until the defendant gains competency.

Execution of the Mentally Ill: The legal challenge of defining who qualifies as mentally ill and to what extent mental illness should be a mitigating factor in death penalty cases varies from jurisdiction to jurisdiction. This leads to a variety of inconsistencies in application and legal uncertainty.

International Human Rights Obligations: Many nations are signatories to international human rights treaties that further prohibit the execution of individuals with severe mental illnesses. Harmonizing these obligations with domestic laws poses a legal conundrum, requiring careful consideration.

Legal Representation: Further, ensuring that individuals with mental illnesses have competent legal representation throughout the legal process is essential. They may require specialized advocacy to address their unique circumstances, further adding complexity to the legal landscape.

If not provided with sufficient legal representations, it creates a looming risk of wrongful convictions. This is one of the gravest concerns intertwined with the death penalty and mental illness. Sentencing an individual with a severe mental illness to death raises serious ethical questions about justice and humaneness. The risk of coerced confessions, unreliable witness testimony, and a lack of comprehension of their legal rights amplify the likelihood of errors, making the prospect of irreversible consequences all the more alarming.


Understanding the judicial framework is not just about rules and regulations that are to be followed. It’s also about making sure that the rights and dignity of every individual are respected and protected even while facing one of the most serious consequences. There has been a stark change in the Indian legal system while dealing with patients with mental illness when the death penalty is in question. The intricate journey of balancing fairness and compassion within the boundaries of law is tough but not impossible.

Some of the significant landmark rulings of the judicial system for maintaining fair trials for all are:

Yakub Memon v. State of Maharashtra (2015): In this case, Yakub Memon was convicted for his involvement in the 1993 Bombay bombings. His case received significant attention due to debates over his mental health at the time of his execution. The Supreme Court of India held a late-night hearing to decide on his last-minute appeal, which raised questions about procedural fairness and the consideration of mental health issues in death penalty cases.[3]

X v. State of Maharashtra (2019): In this landmark judgment the identity of the defendant is hidden so as to maintain and respect his privacy. The Hon’ble Supreme Court held that post-conviction severe mental illness would be a mitigating factor for commuting the death sentence. The Court laid down a ‘test of severity’ which posits that the mental illness should be so severe that the prisoner is unable to “understand or comprehend the nature and purpose behind the imposition of such punishment”.[4]

Shatrughan Chauhan v. Union of India (2014): This case challenged the execution of death row prisoners on the grounds that they had suffered prolonged delays in the review of their mercy petitions, which caused mental anguish. The Supreme Court acknowledged that such delays could cause significant mental distress and declared that inordinate and inexplicable delays in carrying out the death penalty were grounds for commutation.[5]

The cases mentioned above highlight the evolving jurisprudence in India concerning mental health and the death penalty and how mental health is getting recognized now. They underscore the importance of considering mental health as a factor in sentencing, ensuring fair legal procedures, and recognizing the potential mental anguish faced by individuals on death row.


To prevent misuse of the defence of mental illness and get out of any crime unscathed even when you are not suffering from the same. The Hon’ble Supreme Court has said that the “burden will be on the accused to prove “by a preponderance of clear evidence” that he is suffering from severe mental illness.”[6] This historic verdict by the Hon’ble Supreme Court had given the ray of hope to people suffering from mental illness and post-conviction mental illness.

Furthermore, Before 2019, Indian death penalty jurisprudence was not clear about how courts would consider the question of mental illness, which developed post-conviction. In Accused X v State of Maharashtra[7], the Hon’ble Supreme Court held that post-conviction severe mental illness would be a mitigating factor for commuting the death sentence. The Court laid down a ‘test of severity’ which posits that the mental illness should be so severe that the prisoner is unable to “understand or comprehend the nature and purpose behind the imposition of such punishment”. The test of severity is passed will become the mitigating factor. A medical professional would have to consider the illness to be “most serious,” approving that the person was incapable of understanding the nature or purpose behind the imposition of the death penalty.


The issue of the death penalty and mental health, when intertwined, have a huge effect on our society. Death punishment serves as a deterrent and a “response to the society’s call for appropriate punishment in appropriate cases”.[8] How should we treat people with mental health problems becomes one of the big questions of society while dealing with something as severe as death for a heinous crime committed, but what if the person that committed the crime couldn’t understand the severe and dire consequences of what they are doing and the culpability of the same.

Families of victims and defendants alike bear the emotional and financial weight of the toll death row has on them. Cases involving death row and mental health can shape the opinion of society at a large scale and affect the same in the process. They can lead to protests, inspire advocacy for policy changes, or ignite movements for or against the death penalty.


We need to be more vigilant and aware of the mental health facilities of inmates and how it can affect the death row penalties on a large scale. The legal process and prison life can put a huge strain on mental health. Specialized service care might be needed for inmates, impacting our mental health care systems. Striking the delicate balance between ethical considerations of compassion, dignity, and moral responsibility, alongside the legal complexities of competency, insanity defences, and international obligations, challenges our legal systems to their core. Ultimately, these delicate discussions implore us to critically scrutinize our definitions of justice and our commitment to upholding it, especially when faced with the complex reality of mental illness within the realm of the death penalty.

[1] About mental illness (2021) NAMI California. Available at: https://namica.org/what-is-mental-illness/ (Accessed: 02 September 2023).

[2] Goyal, K. (2021) Over 60% of prisoners on death row were found to be enduring mental illness: Study, TheQuint. Available at: https://www.thequint.com/opinion/over-60-prisoners-on-death-row-were-found-to-be-enduring-mental-illness-study (Accessed: 02 September 2023).

[3] (2015) 9 SCC 352

[4] (2019) 7 SCC 1

[5] (2014) 3 SCC 1

[6] Pti (2019) Mental illness of death row convicts ground to spare them from gallows: SC, BusinessLine. Available at: https://www.thehindubusinessline.com/news/mental-illness-of-death-row-convicts-ground-to-spare-them-from-gallows-sc/article26877579.ece (Accessed: 02 September 2023).

[7] (2019) 7 SCC 1

[8] Death penalty and humanizing criminal justice: Editorial Analysis: Next IAS (no date) NextIAS. Available at: https://www.nextias.com/editorial-analysis/29-10-2022/death-penalty-and-humanising-criminal-justice (Accessed: 02 September 2023).

Ananya Tiwari
Ananya Tiwari
Ananya Tiwari is currently a second year law student pursuing my B.A. LLB (Hons.) from Dr. B.R. Ambedkar National Law University, Sonepat and still discovering her passion for law. Her interest in law varies from Human Rights to Intellectual Property.


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