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Court Question:

Q: Please tell the Court what is the line of treatment that is given to Vijay Pratap Singh.

A: He is on medication for schizophrenia. He is being regularly followed up and treated by the IMH Psychiatrist through video call and in person too, for his complaints like auditory hallucinations. The medical report dated 12.09.2021 that was given by me to the Superintendent, Central Prison I, Puzhal, Chennai and the file copy of the same is marked as Ex.C4.” Evidence of Dr. Poorna Chandrika (C.W.2) “I have completed MBBS, DCH and MD (Psychiatry). I joined Government service in 1996. At present, I am the Director (Full Additional Charge) of the IMH, Kilpauk. I was posted as Assistant Professor in the IMH, Kilpauk in 2007 and since then, I am continuing to work in the IMH, Kilpauk at various levels. The IMH, Kilpauk, was started in the year 1858 and it is run by the State Government. It is a premier organization in the country for treating mental illness and is the second largest mental hospital in Asia. Both https://www.mhc.tn.gov.in/judis/ outpatient and inpatient treatments are available for treating patients with mental illness with a bed capacity of 1,800. It is the only hospital in the State of Tamil Nadu, which is treating criminally mentally ill patients. Vijay Pratap Singh was first produced by the prison authorities before the IMH, Kilpauk on 11.10.2014 and he was treated as outpatient. On 25.10.2014, he was examined at the IMH, Kilpauk and was diagnosed as a case of schizophrenia and appropriate medications were started and he was advised to come with Reception Order for admission. On 13.11.2014, he was admitted in the IMH, Kilpauk, as per the Reception Order of the Judicial Magistrate, Thirukazhukundram (Ex.C3). The patient's wife Sudha Singh visited the IMH, Kilpauk on 28.11.2014 and history of the patient elicited from his wife showed that he was suffering from sleep disturbances, suspiciousness and hearing voices since 2007 and he was on irregular treatment. He was taken to a private psychiatrist in Varanasi in March 2012 and was started on anti- psychotic tablets Risperidone, Nitrazepam, Benzhexol and Olanzapine. He was on these medications for one year. His wife submitted prescriptions and copies of the same are marked as Ex.C5 (series) (18 nos.). From the prescriptions, it is seen that he had taken treatment in Phoneix Hospital, Allahabad also during July 2014 for psychiatric disorder. While he was an inpatient in the IMH, Kilpauk, Mental State Examination was conducted and it revealed that he suffers from delusion of persecution that everyone is scolding him, they are using magic system and walkie-talkie to scold him and hiding everything from his vision. He also had auditory hallucinations as if he was hearing male and female voices scolding him. Based upon the history and the findings in the Mental State Examination, he was diagnosed as a case of paranoid schizophrenia (major mental illness) and appropriate treatment was started. A copy of the report, from our records, is marked as Ex.C6. On 29.05.2015, his discharge from the IMH, Kilpauk was approved by the Visitors' Committee and the same is marked as Ex.C7. On 23.06.2015, the patient was discharged and sent back to the Central Prison, Puzhal, with advice that he should be brought regularly for review as outpatient for treatment. The discharge summary is marked as Ex.C8. Doctors from the IMH, Kilpauk, visit the Central Prison, Puzhal, Chennai, twice a month for examining mentally-ill patients. Accordingly, Dr.V.Jaikumar had examined him regularly at the Central Prison, Puzhal, Chennai. Thereafter, the Judicial Magistrate, Thirukazhukundram, called for an Observation Report, for which the Observation Report dated 02.09.2015 was issued by me and the https://www.mhc.tn.gov.in/judis/ same is marked as Ex.C9. He was last examined in the IMH, Kilpauk on 17.07.2021 and he is being brought by the prison authorities periodically for review. Since his admission as inpatient, he was under my treatment as I was the Unit Head in the IMH, Kilpauk, Chennai.” Q: From your examination and treatment of Vijay Pratap Singh and from his previous medical records, could you offer your opinion as to whether he would have opened fire on account of his auditory hallucinations and delusion of persecution? A: Yes. I am offering this opinion on the ground that the patient was in continuous medication for his mental illness since 2012 in Varanasi and Allahabad. The previous prescriptions show that he was treated for his mental illness on 05.07.2014. As and when he discontinues taking his medicines, he turns violent. On account of his frequent transfer and shift change, it appears that he was not regular in taking his medicines and that is why, he would had a relapse and suffered delusion and hallucinations and opened fire. On 29.11.2014, when his wife and son visited him at the IMH, Kilpauk, they told me that he had taken his medicines and reached Kalpakkam, but whether he took medicines was not known to them as when she (wife) used to speak over phone to him, he had told her that he feels sleepy and that is why, he was not taking the medicines. I have recorded this contemporaneously in my case sheet. (The Court perused the case records of IMH and found this entry therein).”

“The above described patient was assessed as per Ref.(3).

At present, he has auditory hallucination (hearing voices), threatening in nature and scolding him, delusions of persecution (his department people talking over mike and broadcasting over wireless to disturb his sleep).

From the above findings, he still exhibits symptoms of paranoid schizophrenia (a major mental illness). He requires long term treatment. Further, he needs regular medication with periodical follow-up from Psychiatrist. If medications are discontinued or irregularly given without follow-up assessment, he may exhibit violent behaviour.” (emphasis supplied)