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Service Users’ Perspectives on Free Legal Aid Services in India

Article in Indian Journal of Social Psychiatry · June 2018

DOI: 10.4103/ijsp.ijsp_18_17

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Original Article

Service Users’ Perspectives on Free Legal Aid Services in India

Abstract Ragesh G,
Background of the Study: Free legal aid clinics (LACs) are functioning in few hospitals in India Sajitha K,
under the provision of Legal Services Authorities Act, 1987. Currently, no literatures are available Shrinivasa B,
on the service user’s (SUs) perspectives on services at free LACs. Methodology: The current study
aimed to understand the perspective of SUs of free LAC working at National Institute of Mental Priya Treesa
Health and Neuro Sciences, Bangalore, India. Forty SUs were randomly selected, their records Thomas,
were examined, and they were contacted over the phone to understand their perspectives on availed Ameer Hamza
services from LAC. Results: Authors could contact and completed telephonic interviews with Department of Psychiatric
32 SUs. Majority (53.1%) were diagnosed with psychiatric disorders and intellectual disability. Social Work, National Institute
They approached LAC for various legal issues related to property, labor laws, mental health act, of Mental Health and Neuro
family/marital issues, and others. Legal advices and referrals to appropriate centers were the few Sciences, Bengaluru,
among the various services offered. Telephonic calls to understand perspectives of SUs showed; Karnataka, India
legal problems solved (15.6%), in the process (37.5%), not solved (15.6%), and yet to start the legal
process (31.3%). Majority (87.5%) reported LAC service is useful, 65.6% were able to follow the
instructions, 56.3% reported that they do not require any additional help, and 96.9% reported that
they will recommend LAC service to others. An average score of 7.72 (±1.67) on visual analog
scale was rated by the SUs which indicated high satisfaction. Conclusion: Free legal aid services are
essential in hospitals, especially in psychiatric hospitals, to protect legal rights, and to address legal
issues of the poorer sections in the society.

Keywords: Legal aid services, legal problems, psychiatric hospitals, psychiatric social work,
service users

Introduction as tracing families of abandoned PwMI,

India has passed Legal Services Authorities
Act in 1987, and the National Legal
Services Authority has been formed under
the Act to prevent human rights violation
and to protect, promote human rights
of its citizens and to provide legal aid
services.[1] Legal aid services imply giving
free legal services to the weaker sections
of the society who cannot afford services
of lawyers.[1] Mental health Act, 1987 also
provides legal protection for persons with
mental illnesses (PwMI).[2]
Free legal aid clinics (LACs) are opened
under this Act in various states in India,
in different settings such as hospitals,
universities etc. to serve the needy.
Recently, a few hospitals in India (states
of Andhra Pradesh, Bihar, Karnataka,
Maharashtra, Odisha, Tamil Nadu, etc.)
have initiated programmes providing legal
aid services and these clinics provide
various kinds of legal aid services such
Thisisanopenaccessjournal,andarticlesaredistributedundertheterms
of the Creative Commons Attribution‑NonCommercial‑ShareAlike 4.0
License, which allows others to remix, tweak, and build upon the work
non‑commercially, as long as appropriate credit is given and the new
creations are licensed under the identical terms.
For reprints contact: reprints@medknow.com
help in appointing legal guardian, getting
reception order, legal advices, etc.[3‑9]
At National Institute of Mental Health and
Neuro Sciences (NIMHANS), Bangalore,
India, a free LAC was launched in
collaboration with the Karnataka State
Legal Services Authority (KSLSA) under
the provision of Legal Services Authorities
Act, in January 2011.[9] This LAC can
be accessed by not only the persons with
illness and family‑seeking treatment in the Address for correspondence:
institute but also can be utilized by the Dr. Ameer Hamza,
general public walk into the clinic.[9,10] A Department of Psychiatric
Social Work, National Institute
panel of lawyers deputed by the KSLSA, of Mental Health and Neuro
psychiatric social workers (PSW) and Sciences, Bengaluru ‑ 560 029,
forensic psychiatrist on call form the Karnataka, India.
multidisciplinary team responsible for E‑mail: drameerhamza@gmail.
com
providing services in this clinic.[10]
Although the LACs in hospitals provide
various kinds of services to the needy Access this article online
for the last couple of years, there are no Website: www.indjsp.org
literatures available in India regarding the DOI: 10.4103/ijsp.ijsp_18_17
perception of service users (SUs) on the Quick Response Code:
LAC services; such as their feedback on the
How to cite this article: Ragesh G, Sajitha K,
Shrinivasa B, Thomas PT, Hamza A. Service users'
perspectives on free legal aid services in India. Indian
J Soc Psychiatry 2018;34:178-82.

178 © 2018 Indian Journal of Social Psychiatry | Published by Wolters Kluwer - Medknow
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Ragesh, et al.: Legal aid services
services they received, whether the SUs are satisfied with
the services or they require any further help or not, etc.,
In this context, the current study has made an inquiry to
understand the perspective of SUs with particular to the
services provided from free LAC services at NIMAHNS,
Bangalore, India.
Methodology
In the legal aid services at NIMHANS, persons with
illnesses from the discipline of psychiatry, neurology,
and neurosurgery, as well as walk‑in persons without any
neuropsychiatric problems approach for legal aid. The
persons with illnesses identified in the initial assessment
to be requiring legal advice is also referred by the treating
team members; especially PSWs and physicians.
In LAC, the PSWs, at the first contact, independently
assesses the legal issues of the SUs in detail or do assessment
along with lawyers. Details of the SUs were recorded in a
structured pro forma developed by the authors. This contains
nature of reference, type of case (clinical or nonclinical),
age, gender, address and contact details, marital status,
education, reasons for seeking services, service use details,
feedback and satisfaction about services, and follow‑up
details etc.). Many times, the SUs contact the PSWs or
lawyers for follow‑up purposes by person or over phone
and vice versa. Whenever the SUs contacted for follow‑up,
all these details also were documented. The SUs were
informed, and consent was taken to use their contact details
for follow‑up from the service providers’ side.
For the current study, the authors have randomly selected
LAC records of those SUs having telephone number was
available using lottery method and examined the records
of 40 out of 261 SUs sought services from June 2015 to
May 2016. All 40 SUs were contacted over phone by the
authors to collect their feedback on free legal aid services
and to know the status of their cases; after 6 months of
their last visit to the LAC. They were asked six questions
and options to answer to the questions; they were as given
in Table 1.
Randomly selected participants were contacted over the
phone, and when they were not available on the first call,
subsequently maximum of two more attempts was made
to reach them. All the responses from these SUs were
recorded in different sheets and coded and tabulated for
analysis purpose.
Results
Out of 40, 32 SUs were successfully contacted and
completed the interview over phone. Mean age of services
users was 45.96 (±16.48) years, and they were from an age
range of 24–80 years. Sociodemographic and illness profile
of those who were contacted and completed the interview
is given in Table 2. The SUs’ legal problems were related
to various acts [Table 3]. Their perspectives on the availed
Indian Journal of Social Psychiatry | Volume 34 | Issue 2 | April-June 2018
Table 1: Question and answers
Questions Answers
1. What is the status of the case? a. Solved
b. In the process
c. Not solved
d. Yet to start the process
2. Whether they could follow the advice/ a. Yes
instructions given from the LACs? b. No
3. Whether the advice/instructions given a. Yes
were useful? b. No
4. Whether they need any additional a. Yes
help from LAC? b. No
5. Whether they recommend FLACS to a. Yes
others? b. No
6. Their satisfaction level about the
services on a VAS of 0-10
LACs=Legal aid clinics, VAS=Visual analog scale, FLACS=Free
legal aid clinic
services are summarized in Table 4. On an average,
satisfaction on the availed services from the LAC was rated
at 7.72 (±1.67) on VAS with scores ranged from 5 to 10.
Discussion
The present study aimed to understand the perspectives of
SUs on free LAC services provided by a multidisciplinary
team at NIMHANS, Bangalore, India. The records of
SUs showed that only (50%) of the SUs approached
LAC by themselves. This shows that the awareness about
free LACs and legal aid services is not adequate among
general public. Out of 32 SUs, 50% SUs were referred
(40.6% of them were referred by mental health clinicians
from NIMHANS hospital, and the rest of them were
referred from other sources) to the LAC. This indicates that
the mental health (MH) clinicians are sensitive to the legal
issues of PwMI.
With regard to the sociodemographic profile of those SUs
who completed the telephonic interview, both genders have
equally sought services. This is a good indication that the
female gender equal in number to access the legal aid
services. Most (78.1%) of the SUs were married, belong to
Hindu religion (90.6%), from above poverty line category
as reported (68.8%) and were not highly educated. All were
from various occupational backgrounds.
The majority (78.1%) was NIMHANS hospital SUs.
Among the contacted SUs, 53.1% had one or other kind
of psychiatric disorders or intellectual disability. This is
a clear indication that PwMI and their family members
are the potential users of LAC services considering the
vulnerability in the context of exploitation, stigma, and
human rights violations existing in the country.[11] This
strongly indicates the urgent need of having LACs in all
psychiatric hospitals across India.
The reasons for seeking legal aid services were various.
Majority (53.1%) approached for marital and family
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Ragesh, et al.: Legal aid services

Table 2: Profile of legal aid clinic service users Table 3: Legal issues and management from legal aid
Variables Frequency (%) clinic
Mode of referrals Variables Frequency (%)
Self 16 (50.0) Reasons for seeking help
MH professionals 13 (40.6) Pertaining to medical certificates 2 (6.3)
Other hospitals 2 (6.3) Property issues 3 (9.4)
Others 1 (3.1) Labor laws related/job related 2 (6.3)
NIMHANS hospital SUs Reception order/MH act related 3 (9.4)
Yes 25 (78.1) Family/marital issues 17 (53.1)
No 7 (21.9) Other multiple issues (legal issues under 5 (15.7)
Gender juvenile justice act, theft/robbery, banking
Male 16 (50.0) related, and multiple legal issues come under
different acts)
Female 16 (50.0)
Management of issues
Age group
Referred to appropriate centers 8 (25.0)
18-28 2 (6.3)
Advices given 16 (50.0)
29-38 12 (37.5)
Other measures (contact family of 8 (25.0)
39-48 6 (18.7)
abandoned PwMI, help/arrangements to get
49-58 6 (18.7) reception order, referrals to MH clinicians,
59-68 2 (6.3) supportive counseling to the distressed, etc.)
69 and above 4 (12.5) PwMI=Persons with mental illnesses, MH=Mental health
Marital status
Married 25 (78.1) issues. It is observed that the marital or family distress
Unmarried 2 (6.3) are associated to various psychiatric disorders, and these
Separated 2 (6.3) mental disorders have number of social consequences for
Widow/widower 3 (9.3) the PwMI and their families such as divorce or decrease in
Education number of years of marriage etc.[12,13] The higher number
Up to 10th standard 11 (34.4) of family or marital issues reported to LAC can be seen in
Up to PU 6 (18.7) the context of increasing rate of divorce in India.[14] Other
Up to degree 1 (3.1) reasons for SUs approaching LAC were issues related to
Degree and above 11 (34.4) availing medical certificates, property issues, labor laws
Not available 3 (9.4) related/job‑related, under MH Act (procuring reception
Occupation order, nominating the legal guardian and other provisions),
Details not available 3 (9.4) 1987 and other issues involving multiple legal issues. These
Unemployed 4 (12.5) observations go along with the news reports on LACs in
Homemaker 4 (12.5) other states and observations made by Math and team in
Coolie 3 (9.4) their report in the year 2013.[3,6,10]
Self‑employed 3 (9.4)
Government employees 1 (3.1) The free LAC at NIMHANS works for 2 days in a week
Private employees 10 (31.2) at present. The legal aid services would be provided or
Retired 4 (12.5) appropriate actions would be taken as soon as possible
Religion based on the nature of legal problems. The LAC has
Hindu 29 (90.6) provided various kinds of services to the SUs such as legal
Christian 3 (9.4) advices, referrals to appropriate centers, other measures
Socioeconomic status such as contacting family of abandoned PwMI in the
BPL 10 (31.3) hospital, arranging/helping to get reception order, etc.,
APL 22 (68.7) There are newspaper reports on similar kinds of services are
Psychiatric and neurological disorders in being provided at LAC in hospitals in other states also.[3,6]
SUs However, referral to MH clinicians when there were no
Mood disorder 9 (28.1) legal implications in the case and providing single session
Psychotic disorder 6 (18.7) supportive counseling to the persons in distress who sought
Intellectual disability 2 (6.3) LAC services by the PSWs in the LAC at NIMHANS
Neurological disorders 1 (3.1) are very unique. Qualified social workers trained in MH
Psychiatric diagnosis not reported 14 (43.8) can provide sociolegal, psychosocial interventions, and
NIMHANS=National Institute of Mental Health and Neuro Sciences, appropriate referrals to other MH clinicians, especially
SUs=Service user’s, BPL=Below poverty line, APL=Above poverty when there is a person comes with MH issues where there
line, MH=Mental health are no legal actions were indicated.

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Ragesh, et al.: Legal aid services

Table 4: Perspective of service user’s on the legal aid awareness program and encouraging the public to avail free
clinic services legal aid services; arranging training programs for health‑care
Variables Frequency (%) professionals on legal aspects; ensuring the services of
Status of the case qualified and trained social workers preferably trained in MH
Solved 5 (15.6) to provide psychosocial care in LACs etc., can be the few
In the process 12 (37.5) recommendations to enhance the functioning of the LACs
Not solved 5 (15.6) and to make it more accessible by the public in India.
Yet to start 10 (31.3) The present study has some limitations as the sample
Usefulness of advice/instructions given size is too small (only 32 SUs were able to contact) and
Yes 28 (87.5)
the contact was made over the phone which might have
No 4 (12.5)
minimized the possibility to understand the broader views
Satisfaction on VAS of 0-10
of the SUs. Still, as there is no report on the perspective
Score 5 5 (15.6)
of SUs of LACs in India, this study can be considered
Score 6 2 (6.3)
as a preliminary report highlighting the need for further
Score 7 7 (21.9)
investigations on the perspectives of SUs in terms of
Score 8 8 (25.0)
enhancing the functioning of LACs in India.
Score 9 3 (9.4)
Score 10 7 (21.9)
Conclusion
Able to follow the instruction given
Yes 21 (65.6) Free legal aid services are essential to the poorer sections
No 11 (34.4) in the society to protect their legal rights. PwMI and their
Additional help required family members are more vulnerable for legal issues and
Yes 14 (43.8) exploitation. LACs in hospitals are a promising innovation
No 18 (56.3) to address legal issues of the general public as well as
Recommend to others PwMI and families. Multidisciplinary team can provide
Yes 31 (96.9) better services. Periodic evaluation and audit of free legal
No 1 (3.1) aid services and formal feedback from SUs are strongly
VAS=Visual analog scale recommended to understand the perspectives of SUs and
to improvise functioning of these clinics. Further studies
The telephonic calls made to understand the perspectives are highly recommended to understand the perspective
of the SUs showed that 15.6% SUs reported that their of SUs of LACs involving all LACs across India for
legal problems were solved, 37.5% of them reported that developing a better legal aid policies, programmes and
they were in the process, 15.6% reported that their legal services.
problems were not yet solved, and 31.3% of SUs have Acknowledgment
reported that they were yet to initiate the legal procedures
from their side (though the LAC has already provided We convey our sincere thanks to SUs, lawyers, Karnataka
suggestions and advices to address their legal problems). State Legal Services Authority and staff and trainees in the
Majority (87.5%) reported that this LAC service was useful free LAC, NIMHANS, Bangalore, India.
and 65.6% of them were able to follow the instructions Financial support and sponsorship
provided by the LAC team, 56.3% reported that they do not
require any additional help and 96.9% reported that they Nil.
will recommend this service to the others in need of legal Conflicts of interest
aid services. Out of the total 32 respondents, 56.3% gave
a score of 8 and above. On an average, satisfaction on the There are no conflicts of interest.
availed services from the LAC was rated at 7.72 (±1.67) on References
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182 Indian Journal of Social Psychiatry | Volume 34 | Issue 2 | April-June 2018

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