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by Dr Mohammad Aslam

MENTAL HEALTH ORDINANCE 2001
Effect from 20th day of Feb 2001 
Replace Lunacy Act 1912 to 1933

Psychiatric Facility Mental Hospital 
Approved Psychiatrist M.P. having postgraduate qualification & registered with PMDC ad 
approved by Authority.

Authority Federal Mental Health Authority.
Court of protection District Court having jurisdiction under the ordinance.

Board of Visitors at Provincial Level. 
1 Chair Person Judge of High Court
2. Two Psychiatrist Min experience of 10 years in Govt. Service. 
3. One Prominent Citizen good repute.
4. Two M.P. with min experience of 12 years. One nominee of PMDC.
5. Director General of Health of Province appointed for two year. 
6. No visitor can perform psychiatric duty.

POWER AND FUNCTION OF BOARD. 
1. Board enters and inspects any psychiatric facility within its area of responsibility at any time.
2. Board shall periodically inspect every part of P.F. 
3. Board may make recommendations to P.F, Authority, Govt. Concern for improvement.
4. The Authority may order for visit to any patient for investigating any particular matter.
5. If the Board not satisfy with the maintenance of pt, inform the Authority. Then Authority issue direction to incharge of P.F. 
6. Board shall enter the remarks, in register to be kept for that purpose.
7. Any information obtained by any member in course of his duty shall not be disclosed except the Authority.

ASSESSMENT AND TREATMENT.
Care & Treatment on informal or voluntary basis.

Any person, who himself seeks or brought by relative or referred by M.P. or referred by Authority for forensic Psychiatric Assessment shall be examined by a Psychiatrist or Nominated M.O. who record his finding in writing and decide pt be treated on out 
door basis or otherwise. Any such pt. on withdrawal of his consent may be discharged in accordance with the provision of ordinance. 

DURATION OF PERIOD OF DETENSION.
04 Types of Detention of Pt. 
1. Admission for Assessment.
2. Admission for treatment.
3. Urgent Admission.
4. Emergency Holding.

1. Admission for Assessment sec 8 for pt. Of Mental disorder.
a. Application on prescribed form.
b. Recommendation of two M.P. 

1. M.O. 
2. Psychiatrist if not M.O. having Psychiatry experience.
3. Written statement of opinion.
c. Retained for 28 days.
d. If Psychiatrist deems it fit he may discharge the patient and advise for continue treatment on voluntary basis.
e. The pt., his relative or guardian can file one appeal against the order of detention to the court of protection with 14 days from the date of application. The decision of Court is final.

2. ADMISSION FOR TREATMENT 
SEC II For severe mental impairment.
a. Application on prescribed form.
b. Written recommendation of two M.O. 
1. one shall be approved Psychiatrist 
2. Statement of opinion.
c. Period of detention six month may be permitted by the authority for further six month.
d. One appeal in each order of detention in court of protection.

3. ADMISSION IN CASE OF URGENCY 
Sec 12 urgent application by Relative or M.O. 
Statement of urgency 
Recommendation of one approved Psychiatrist or nominated M.O. 
Urgent application will be finished after 72 hr after admission.
The second Medical recommendation required on sec II and received by the incharge of P.F. within that period of 72 hr. 

4. EMERGENCY HOLDING 
Sec 13
If a pt is under treatment in a P.F. and wishes a attempt to leave and it appear to Medial Officer of P.F.
1. The pt is suffering from Mental disorder of such degree that it is necessary for health or safety or protection of other to be prevented from leaving P.F. 
2. It is not possible to give immediate Medical recommendation by incharge of P.F. or his nominated M.O.
3. The M.O. shall record the fact in writing and pt is retained in P.F. for 24 hr from the time facts are noted or earlier the incharge of P.F. came & examine. 

Emergency Power In emergency when M.O. is unable to get informed consent in writing, he may start treatment due to professional opinion & is necessary for 
i) To safe, the pt. life.
ii) Preventing serious detention of is condition.
iii) Improving serious condition of pt.
iv) Preventing the pt from behaving violently, danger to himself or to other.

Application 
i) Prescribed form by Blood.
ii) IF not by Blood relatives reason 
iii) Application must be a major
iv) Sign & verified.

MENTALLY DISORDERED PERSON IN PUBLIC
1. Officer incharge of P.F. find place such person in public place and if he thinks necessary for the pt or protection of other, he remove the person to a place of safety i.e. P.F. or handover to relative.
2. At place of safety detained for 72 hr for examination by Psychiatrist and arrangement for treatment & care. 


LEAVE OF DISCHARGE NOT MENTALLY DISORDER PRISONER
1. An application on prescribed form by relative to incharge of P.F. for a specified period. Who may allow or not.
2. The application accompanied by undertaking 
a) to take proper care of mentally ill pt.
b) To prevent himself injury & to the other.
c) To bring back to P.F. on expiry of leave.
3. If the pt not returned back after expiry of leave, the incharge of P.F. will send written notice to the pt or his relative of custody.
4. If the pt not returned back after notice the incharge of P.F. shall report to Magistrate to Police pt in back to P.F. 

DISCHARGE OF PATIENT.
1. Incharge of P.F. may order in writing at any time he deems it appropriate for a pt.
2. Any person admitted in a P.F. may be discharged by an application under this ordinance, but not unfit pt.
3. If the pt is admitted by referring of Authority, after discharge, the incharge of P.F. will inform Authority.
4. If the admitted pt feels that he is recovered from mental disorder he may made application to Magistrate. He made an inquiry and made order for discharge or dismiss.
5. Information of discharge by incharge of P.F. to relative 7 days before discharge.

APPLICATION OF GUARDIAN & MANAGER. 
Of the property of mentally ill person.
When such person have property, Court of protection is made in the residing area by Advocate General of Province by application of is relative & consent in writing.

APPOINTMENT OF GUARDIAN
When mentally disordered person is incapable of taking his care himself, the court may appoint any suitable person to his guardian in order to look after & maintain in P.F. 

MANAGEMENT OF PROPERTY 
When such person has property and he is unable of maintaining it, the court shall appoint any suitable person to the manager of such property.
No person, who is legal hair of the property of Mental disorder person become Manager or Guardian unless the court recorded in writing the reason that such appointment is benefited for mentally disordered person.

INSPECTION OF MENTALLY DISORDERED PRISONER
When any person is detained under the provision of Sec 466 or Sec 471 of the code of criminal procedure 1898 (Act V of 1898) Sec 130 of Pak Army Act 1952. Sec 143 of Pak Air Force 1953 or Sec 123 of Pak Navy Ordinance of o1961.

IF THE ACCUSED IS IN JAIL 
the Inspector General of Pakistan will 
1. Visit once in six month to ascertain the state of mind. IF the accused in P.F. may be visited by Board or two member of Board and made report about state of mind to the authority under whose order the accused is detained.
2. Govt. may empower the officer incharge of Jail, all or any of the function of Inspector General of Prisons.

FORENSIC PSYCHIATRIC SERVICE.
1. Special Security Forensic P.F. shall be developed by the Govt. to house mentally disordered prisoner, M.O. offender or may be prescribed.
2. Admission, Transfer or removal pt. concerned with criminal proceeding in such P.F. shall be under the administrative control of the Inspector General of Prisons.
3. The Board of Visitor shall have an access to such person admitted in Forensic P.F. in accordance with the provision of this ordinance.

DISEASE OF MIND.
As not to know the nature and guilty of act or if he know that he was doing, he did not know that it was wrong or coutrary to law.

TESTIMENTARY CAPCITY 

1.59 Every person of sound mind and not a minor may dispose of his property by “will”

EXPLANATION An lusauc may make a valid will during an internal in which he is of sound mind.

LEGAL ASPECT 
Mind has two function
1. Memory
2. Understanding.

Both function should be sound to create a capacity for making a “will”

MEDICAL ASPECT 
The sumtotal of memory and understanding in intelligence.

WHAT IS CRIME ?
Any social harm which has been defined and made punishable by LAW.

Analysis of Crime. 
Mens Rea Actus Reus.

Mens Rea
Means guilty mind. Evil intention which requisite to guilt. It has two elements.
Accused must have acted voluntarily without the effect of drug illness or influence
Accused must have thought about the consequence of act of made some necessary preparations before committing a crime. Without these it will be an involuntary act.

ACTUS-REUS (Means an action)
In evil addition to evil intention there must be an ACTION. So for crime both elements must be 
present.

Mens Rea + No Actus Reus No crime
No Mens Rea + Actus Reus No crime.
Mens Rea + Actus Reus Crime.


MC’ NAUGHTEN’S RULE
U.K. in 1843 Mr. Denniel Mc’ Naughtens killed Mr. Drammond under a delusion of persecution. Mr. Mc accused and tried evidence. Mr. Mc suffering from in save delusion of persecution and acted under influence of acquitted (not found guilty) decision disturbance penal 
of judge 

a. That at the time of crime the accused has defect of reasoning.
b. That the defect of the reason was due to the disease of mind.
c. That by reason of such disease of mind
i) He did not know nature of his action.
ii) If he did know, that he did not know, he was doing was wrong.

RULE
Is that at the time of committing the act, the accused was suffering from such a defect of reason from 

MEMORY DEPEND 
1. Registration 
2. Retention 
3. Recall. Recall is very important.

Therefore memory necessary to recall 
1. Extent of state.
2. Hairs.

Understanding means knowledge of relationship to testator and their claim upon him

Doctor’s duty in such case
Testator has intent memory, understanding at the time of making a valid will and is not under any influence of intoxication or delusion.
He may access his capacity by asking simple questions.
1. What is his name?
2. Where he is living?
3. What is the Extent of estate?
4. Who are the legal hair, & why
5. How he is intending to dispose his property by sale or other wise.

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