LEGAL ASPECTS OF INSANITY

Lecture by :

Prof . Dr Shahid Hanif

 Legal Aspects of Insanity
Psychiatry :
Psychiatry is branch of medical science which deals with the study,
diagnosis, treatment and prevention of mental illness.

Forensic Psychiatry:
Forensic psychiatry deals with the correlation and application of
knowledge of psychiatry and psychology to the purposes of Law.

Mainly two types of issues are to be addressed.

On civil side
On civil side issues like competence as a witness or competence to
be partner in contract and property disputes are dealt with.
On criminal side

Responsibility or other wise for a criminal act like murder is dealt with.
 Important Terms
Delusion
False but firm belief in something which is not a fact.
Hallucination
False perception without a sensory stimulus.
Illusion
False interpretation of a stimulus or object. Stick for snake

Lucid Interval
This is an interval or period in the course of mental diseases during which
there is complete cessation of symptoms of insanity. It is commonly seen in
Depression and Mania (bipolar disorder) and in Head injuries.
Medico legal significance
During this period
He can make a valid will
Can appear in the court of law as witness, his evidence is legally valid
He is held responsible for all his actions hence can be punished if he commits a
crime
 Neurosis
Condition in which patient suffers form emotional or intellectual
disorder but does not loose touch with reality.

Psychosis
Disorder characterized by withdrawal from reality as if living in world
of fantasy. These are delusions and hallucinations.

Psychopath
Personality disorder. Behavior does not conform to normal social
standards. Disruptive behavior, feelings are not normal. Impulsive
and compulsive type of personality.
 Classification of Mental Disorder
Mental Retardation
Mental sub normality, Mentally handicapped

Organic psychoses
a) Dementia
b) Drug induced psychoses
c) Psychoses following epilepsy, pregnancy, delivery,
Trauma & General Disease
Functional psychoses
Schizophrenia, Paranoid states, Affective disorders (mania & depression)
Neurotic Disorders
Obsession , Compulsion
Personality disorder (Psychopath)

Sexual deviations
 Testamentary Capacity

It is the capacity of a person to make a will which is valid.

According to section 59 of succession Act

``Every person of a sound mind and not a minor may dispose his

property by making a will. Further , an insane person may make

a will during the lucid interval when his mind is sound ``

Presence of Sound mind

usually depends upon the following
a. Mental perception about his property.
b. Ability of mind to make a rational judgment.
c. Ability to exercise will power in accordance with rational thinking.
d. Individual should not be under the influence of drugs.
Following questions may be asked :
What is his name ?
where he is living ?
who are his legal heirs, ? what is his estate / Property , ? how he
wants to dispose it off and why?
Also take blood sample to rule out he is not under the effect of a
drug

Definitions
Obsession
This is thought , image feeling or movement which an individual feels and
compelled to carry out usually repeatedly, in spite of a strong urge to resist .

Phobia : Condition characterized by an abnormally intense fear in the

presence of an object or situation e.g.
. Fear of open or closed spaces
Fear of Height

Non compos Mentis : Person of un sound mind

Automatism : conduct is automatic when consciousness of the person is
impaired to such a degree that he is unaware of what he is doing.
Automatism may be product of
• Disease – Epilepsy
• External factors (concussion)
• Psychological stress (Hysteria)
• In take of drugs / chemicals Barbiturates , Alcohol

UNFITNESS TO PLEAD
When a person under trial or a prisoner is insane and this fact is brought
to the notice of the court . The court has power (District judge) to
suspend the proceedings. Accused person can be detained in the
asylum till his mental state is declared normal by the forensic
psychiatrist. It is regarded as unjust to have a trial against an individual
who is . unfit to plead ‘ But the doctor must keep in mind that mutes
may
be of “Malice ”or because of the diseases such as
schizophrenia, Depression, hysteria.
Section 464 / 465, 466,467 of Cr- PC give power to District Judge to
declare an accused person unfit to plead’__+????---
Rules of criminal Responsibility Mc Naughtan's Rule
In U.k and Pakistan law Regarding criminal responsibility (In which accused
takes defense of insanity ) is based on Mc Naughtan's Rules which state “ At
the time of committing an act if the accused was suffering from such a defect
of reason due to disease of mind because of which he did not know the nature

of his act or if he did, that he did not know what he did was either wrong or
contrary to the law then he cannot be held responsible for his act hence
cannot be Punished ”

Sec 84 (PPC) is based on these rules.

The irresistible impulse rule

This rule has been in use in various states of U.S.A for many years. It is also
called policeman at the shoulder test . According to this even if the accused
knows what he is dong is wrong and contrary to the law but he cannot resist
it because of his mental disease so he should not be Punished.
Durham’s Rule
According to this concept there cannot be any fixed Rule of criminal
responsibly of a mentally ill defendant. It is left for the jury to decide
whether the accused was suffering from a mental disease / defect or
not ?

The Curren's Rule

According to this concept law should not be concerned with the definition
of mental disease. It is the province of the psychiatrist.

This rule states “ The jury must be satisfied that at the time of committing
the prohibited act, the defendant as a result of mental disease or defect
lacked substantial capacity to keep his conduct to the requirements of
the
law which he is alleged to have violated”-
MENTAL HEALTH ORDINANCE 2001
Sec.3 Establishment of Federal mental health authority
--------------------------------------
Consisting of ……… chairperson and not more than 14 members
1) Secretary Health ……… Federal
2) D.G health ……………… Federal
3) Provincial health secretaries …… 4
4) One member from A.M.C
5) Seven Eminent Psychiatrists

Authority will recommend, prescribe and take measures to improve

(Existing ) and to set up new M.H services / facilities.
Will advise the govt. in all matters of promotion of M. health and
prevention of Mental- Disorder
constitution of Board of visitors at provincial level
This Board will consist of :
a) Chair person – who is or has been judge of high court
b) Two psychiatrists -- minimum experience of 10 years service.
c) One prominent citizen of good standing
d) Two medical practitioners
e) DGHS. Province or his nominee.

Powers and functions of the provincial Board

1. Any time can enter / inspect any Psychiatric facility of the province and
inspect the record-
2. Will inspect every part of psychiatric facility and every patient / prisoner
periodically .
3. Recommendations for improvement of Psychiatric facilities.
4. Authority may order the Board to look into matter of any patient ‘s
affairs. Board may visit such facility.
Establishment of Psychiatric facilities by the Govt:
Both Federal and provincial governments in their areas of jurisdiction
can establish and maintain. Psychiatric facilities for assessment
admission treatment, rehabilitation , care and after care of mentally
disordered patients.
 Assessment and Treatment
Section 7 care in the community
Community based M.H services shall be set up for guidance, education
rehabilitation after care and other supportive measures for mentally
disordered people and for those who are involved in their care.

Section 8. care and treatment on an informal or voluntary basis

Any person who voluntarily seeks or is a referred case by RMP,
psychianst, Forensic Psychiatrist will be examined in the health facility
and after this decision will be made whether he requires outdoor
treatment / admission.

Duration of periods of detention for assessment , treatment urgent

admission and Emergency holding.

a) For assessment up to 28 days

b) For treatment – up to six months
c) For urgent admission- up to 72 hours
d) Emergency holding in a hospital up to 24 hours
5. Admission for assessment in cases of urgency
Application By Relatives, M.O with statement that urgent

assessment is Required It should be recommended by an approved

psychiatrist or His Nominated medical officer. Duration of

admission 72 Hours

Emergency Holding
When an admitted patient in a psychiatric facility wishes or attempts to
leave but in the opinion of the medical officer hi is not fit enough, he can be
detained for 24 hours till the arrival of psychiatrist

1. Admission and transfer and removal of these persons shall be under

control of I.G (prisons ). The provincial Board is authorized to inspect
these Institutions.
 Admission for assessment
An application by the relatives guardian or himself with written
recommendation in the prescribed form by two RMP ( one to be
Psychiatrist) . He can be detained up to 28days unless subsequent valid
orders are issued by the competent authority . Where a psychiatrist deems
fit he can discharge the the Patient advising him outdoor treatment.

Admission for treatment

Procedure
1) Application for a Patient by the Relative ) Guardian giving ground / reasons that
he is suffering from mental illness and may be dangerous for himself or others so
may be admitted in Psychiatric facility

2. Supported by Recommendation of two RMPs ( one to be Psychiatrist )

3. Can be detained not more than six months unless the authority for his
detention is renewed .
Section 19 mentally Disordered Person found
in Public Places
If officer in change of a Police station finds in a Public place a person who in

his opinion suffering from mental disorder – dangerous to himself or for

other. He is empowered to move him to place of safety I-e Government run

Health facility, Govt. Run psychiatric facility , or hand him over to any suitable

relative willing to receive temporarily. Such person can be detained there for

72 hours-, During this period arrangements are made for examination by

approved Psychiatrist and admission or other wise .

 Forensic Psychiatric services
1. Forensic Psychiatric services

1. Special security forensic Psychiatric facilities shall be developed by the

Government to house mentally disordered Prisoners , mentally disordered
offenders.

2. Admission Transfer or removal of Patient concerned with criminal

proceedings in such facilities shall be under the administrative control of
Inspector General of Prisons.

3. The Board of visitors shall have an access to such persons admitted in

forensic Psychiatric facility in accordance with the Provision of the
ordinance. .