Forensic psychiatry

Psychiatry– it deals with study, diagnosis, treatment and prevention of mental illness.
Forensic psychiatry- application of knowledge of psychiatry
These are the person who are unable to cope with the ordinary social circumstance

1. FORENSIC
PSYCHIATRY
By
Dr. Faiz Ahmad

2. Psychiatry–it deals with study, diagnosis, treatment and
prevention of mental illness.
Forensic psychiatry-application of knowledge of psychiatry
Administration of justice
in
Insanity-
Unsoundness of mind
ds of mind & personality
Thesearethepersonwhoareunabletocopewiththeordinary
socialcircumstance

3. Insanity or Unsoundness mind
Adiseaseofthemindorthepersonality,inwhichthereisderangementofmental
oremotionalprocesses&impairmentofbehavioralcontrol.
MentallyIllPerson
Anypersonwhoisinneedoftreatmentbyreasonofanymentaldisorderotherthan
mentalretardation.

4. Forensic psychiatrist
a)Provideservicessuchasdeterminationofcompetencytostandtrialinacourt
oflawtofacilitateadjudicativeprocess.
b)Involvedincareofprisoners,bothinjailsandmentalhealthinstitutions.
c)Oftenalsodoresearchworkrelatedtoprison

5. Patients requiring expert mental health professionals opinion in
judiciary
Those harming themselves and others
Those who are incapable of looking after themselves and unable to
handle welfare of their family and properties
Patients who are acting out to be dangerous due to psychiatric
disorders
Spouses of mentally ill patients in cases of divorce, etc
Patients who are having criminal and civil litigation as a
consequence of mental illness
Mental patients who are going for some contract or want to make a
will
Mental fitness certificate of the person is needed for adoption of
child and other issues

6. SOME COMMON PSYCHIATRY TERMS
Abreaction
This is a release phenomenon where old, forgotten things
or events are brought into conscious state again.
Circumstantiality
When a person is not able to answer properly, in a straight
manner, and keeps on giving irrelevant details or wanders
off the subject many times in a conversation, the condition
is called circumstantiality.

7. It is the awareness of the self & environment
Disturbance
Loss
Confusion
Clouding of consciousness
Delirium
Twilight state
Fugue
Disorientation
Coma
Consciousness

8. Delirium
Itisaconditioncharacterizedbydisturbanceofconsciousness
wherethecriticalfacultyisbluntedorlost,associatedwith
impairedorientationandinconsistentorirrelevantthought
contents.
Etiology-: 1. Fever with high temperature
2. Drug intoxication
3. Alcoholic intoxication/Dhatura
Clinically-Person is restless, excited, talkative (irrelevant)
sometimes loss of self control become violent.
MLI-Person in state of delirium is not responsible of
his criminal act.

9. Deliriumtremens
Itispsychoticconditioninalcoholicswhichoccursdue
tosuddenincreaseofdoseandsuddenwithdrawal.
Therearetremor,Insomnia,mentalconfusion,lossof
memory,disorientationandhallucinationofhorror.
Korsakoff’spsychosis
Itisapsychologicalandneurogenicderangedcondition
occurringinsomechronicalcoholicswherethereis
peripheralneuritiswithpolyneuritis,muscular
degenerationwithweakness,disorientation,some
hallucinationandretrogradeamnesia.

10. Drunkenness
Itisthestateofapersonundertheinfluenceofalcoholsuchthathelostcontrol
tosuchanextentthatheisunabletoperformhisdutyinwhichhewas
engagedatthematerialtime.
Dementia
Itmeansdegenerationofmentalfacultiesafterfulldevelopment.Itmayoccur
duetooldage,Alzheimer’sdiseaseinvolvingbrain,etc.
Lossofhighercognitivefunctions&socialinhibition(sexualoffencesagainst
children,shoplifting)

11. Memory It is the ability to store and recall information
Recent Remote
Disturbance in memory is called Amnesia
Retrograde Anterograde
ConfabulationFalse interpretation of some recent events

12. Unconsciousfillingofgapsinmemorybyimagining
experiencesoreventsthathavenobasisinfact,
commonlyseeninamnesticsyndrome.
Confabulationisconsidered“honestlying,”butis
distinctfromlyingbecausethereistypicallynointentto
deceiveandtheindividualisunawarethattheir
informationisfalse

13. Thinking
Thought blocking-sudden break of thought.
Circumstantiality-slow talking with unnecessary details
Derailment of thoughts-sliding of thoughts
Perseveration-repetition of a word/phrase several times
Stereotype-constant repetition of a phrase & behavior in many
different places irrespective of context

14. Delusion
It is a false belief in something which is not a fact, and
which persists even after it’s falsity has been clearly
demonstrated
Characteristics
A normal person can have a delusion, but is capable
of correcting it by it’s reasoning power & by his past
experience
Delusion in a insane person is a symptoms of brain ds
it is mainly found in epileptic, affective & schizophrenic
patients but not seen in anxiety neurosis & other
neurotic illness.

15. Types of Delusion
1. Delusion of grandeur
Also termed as delusion of exaltation
Pleasant delusion
Feeling of greatness, power & health.
ex-a man imagine himself to be very intelligent,
or rich while in reality is different.
2. Delusion of persecution
Unpleasant delusion

16. The sufferer believe that something bad is going
to happen to him
He fears that he may be killed by somebody.
The life of the person become full of distress & helpless.
Because of this apprehension he may commit suicide.
3. Delusion of influence
The sufferer strongly believe that his thought process,
activities and behaviors all are controlled by some
external supernatural power.

17. Such person on the basis of some imaginary command
from that supernatural power, he may commit some
unlawful act.
4. Delusion of reference
The person believes that people refer to him in a special
way. This may create conflicts with strangers as he may
think that strangers also looking at him & talking about him

18. 5. Delusion of infidelity
Sufferer thinks that his/ her spouse is not loyal
to him/ her
Usually males are sufferer.
The person thinks that his wife does not love him
and she has some intimate relationship with some
other person
For which the sufferer always torture his wife even
he kill her wife & himself commit suicide.

19. It is an unpleasant delusion.
Mainly found in negative attitude persons.
The sufferer always think that world is not exist,
as well as he also not exist.
6. Nihilistic delusion(Cotard syndrome)
7. Hypochondriacal delusion
Modern people are very health conscious
It’s over consciousness create a
delusion that called hypochondriasis

20. Thepersonbelievethatthereissomepathology
orabnormalitywithsomepartorsystemor
organofhisbody,thoughinrealityheisphysically
healthy
Some times he feels depressed by thinking of the
different diseases in his body, he become helpless
& in extreme depression he may commit suicide.

21. 8. Delusion of self-reproach, or self criticism-
It is an unpleasant delusion
The sufferer realizes his fault in past
He blames himself for the failure
That creates depression and the person punish himself
by terminating his own life.
9. Other type-
1.Delusion of jealousy
2. Delusion of religion
3. Delusion of poverty

22. Delusional Misidentification Syndromes
include four types of syndromes
Capgrassyndrome(Delusionofdoubles)-Personholdsa
delusionthatafriend,spouse,parent,orotherclosefamily
memberhasbeenreplacedbyanidentical-looking
impostor[stranger].Familiarpersonisthusseenasa
stranger.
Thesyndromeofsubjectivedoubles-Thepatient’s
ownselfisperceivedasbeingreplacedbyadouble.

23. Thesyndromeofintermetamorphosis-Familiarpersons
arebelievedtohaveexchangedidentities[nostrangeris
involved].Apersonmisidentifieshiswifeashisdeceased
motherand,later,ashislivingsister.
Fregolisyndrome-Delusionalbeliefthatoneormore
familiarpersons,usuallypersecutorsfollowingthe
repeatedlychangetheirappearance.

24. 1.It reflects mental abnormality
2.They will not responsible by their act
3.Suicide is a major risk
4.Partial delusion –doctrine of diminished
responsibility
Medico legal importance

25. Perception
We perceive various things around us through
our sense organ
Sense of perception
Alteration
Sensory distortion Sensory experience
1.Macropsia
2.Micropsia
1.Hallucination
2.Illusion

26. a. Auditory hallucination
A person hears pleasant or unpleasant sounds or voices
out of nothing. He may presume that someone is talking
to him, when there is none.
b. Visual hallucination
A man thinks that he is seeing something where
there is nothing.
c. Olfactory hallucination-
A person smells pleasant & non pleasant odour
when none is present.

27. d. Gustatory -
A person feels sweat, sour, bitter, good or bad taste
In his mouth, though no food is actually present.
e. Tactile (formication or haptic hallucination)
A man imagine rat, mice crawling into his bed.
f. Psychomotor hallucination-
A man will have feeling of movement of some part of
the body in the absence of such movement.

28. Hallucination Disease
Visual Organic brain diseases
(focal CNS lesion)
Auditory Schizophrenia
Gustatory Temporal lobe epilepsy
Olfactory Organic brain disease
Tactile cocainism
MLI-
The persons suffering from hallucination may also commit
suicide or homicide especially in some command hallucination.

29. Illusion
Thesearefalseinterpretationofsensorystimulioftenvisualorauditory
whichhasrealexistence.
Theymaybeseeninnormalpersons,indarkorduringemotionalstressand
inorganicbraindiseaseandmaybeassociatedwithhallucination.
E.g. A dog maybe interpreted as a tiger.
A rope maybe mistaken for

30. CompletionIllusion:Whereanunfinishedpatterniscompleted
byillusion.
AffectIllusion:Inthis,moodofthepersonaffectsthenature
ofillusion.
ParabolicIllusion:Whenhumanfacesorimagesareseenin
illusion.
InIllusion,Thepersonmaybecorrectedwhenconfrontedwith
Facts.Herealizesthatitwasamisinterpretationofstimulus.

31. 5. Emotion or mood or feelings (AFFECT)
Symptoms related to Affect are
Panic
Mood
Irritability
Anxiety
Phobia
Obsession
Anxiety
It is the subjective distress may or may not accompanied
by autonomic over activity.
Palpitation
Sweating
Tremors
Dilated pupils
It is the commonest symptoms of various neurotic disorders

32. Acrophobia-fear of high place.
Agarophobia-fear of open space.
Nyctophobia-fear of darkness
Claustrophobia-fear of closed space
Xenophobia-fear of stranger.
Mysophobia-morbid fear of filth or contamination.
Type-
Phobia
It is the unreasonable and irrational fear of a particular
object or situation.

33. Obsession
Itisaconditioncharacterisedbyappearanceofasingleidea,
thought,oremotionwhichconstantlydisturbsthesufferer
whichherecognizesasirrationalbutpersistsinspiteofall
efforttodriveitoutfromhismind.
Usually found in neurotic people.
The ideas are usually associated with some sort of fear
Compulsion
Itisarepetitivebehaviordonebyanindividualinspiteof
knowingthatitisnotcorrect.
Examplesbeing,repeatedlywashinghands,checkinglocked
premisesagainandagain.

34. Panic
It is a state of attack of severe state of anxiety lasting for
minute to hours.
Irritability
It is the unpleasant feeling in which the person feels
an inner discomfort.
Mood
Elevation of mood-the terms are
Feeling of well being
Euphoria
Elation
Exaltation

35. Ecstasy
Mania Abnormal elevation of mood
Mainly found in bipolar disorder.
6. Body function
Appetite-excessive eating-bulimia
decrease appetite-anorexia
Thirst-excessive thirst-polydispia-anxiety.
Sex-loss of libido-seen in depression
hyper sexuality-mania

36. Sleep-insomnia-anxiety
hypersomnia –excessive sleep in night
somnolence-excessive day sleeping
somnambulism-sleep walking
It is aimless wandering with incomplete arousal
from sleep.
Actually the person may get up from bed,
open the door walk out a distance and return
to bed to sleep again,
No recollection of the event the next day.
Somnolentia–sleep drunkenness
Person aroused suddenly from deep sleep

37. Impulse
Def-it is a sudden & irresistible force compelling a person
to the conscious performance of some action without
motive & forethought.
Type-Kleptomania-steal article of small value
Pyromania-to set fire
Mutilomania–mutilate animals
Dipsomania-desire for alcohol drink
Sexual impulse
Suicidal & homicidal impulse.
MLI-
A person if commits some offence which is the result of
impulse, can not be held responsible for his criminal act.

38. Lucid interval
Aperiod of normalcy with normal mental activities may found
sometimes in an insane person
--The symptoms of insanity may cease altogether.
--Person behave absolutely normal
--He is able to judge and foresee the consequence of his act
--He may suddenly returns to his insanity state.
insane insanesane
Lucid interval
This is the sane period of insane. He may held responsible
for his criminal act & it mainly found in mania, melancholia,
SDH

39. Difference between lucid interval in Insanity & head injury
Trait Insanity Head injury
History Of insanity Head injury
Preceding
symptoms
Insanity Of concussion
Following
symptoms
Insanity Of cerebral irritation &
compression of brain
Occurrence Frequent Only once

40. Fugue state
Thepersonbecomesawandererwhokeepsonmoving
fromplacetoplaceinanalteredstateofmind.Hehas
episodesofamnesia.Thisstageisseenindepression,
schizophreniaandothermentaldisorders.
Twilight states
Itisstateofdiminishedawarenessofactsofrelatively
shortdurationofwhichhehasnorecollection.
Oneirophrenia
Itisadreamlikestatewhichmaylastfordaysor
weeks.Thepatientsuffersfrommentalconfusion
,amnesia,illusions,hallucinations,disorientationand
anxiety.

41. Automatism (automatic behaviour)
Acting without volition
It is a conduct that is performed by a person whose
consciousness is impaired to such an extent, that he is
not fully aware of his actions.
There may be no consciousness at all of the actions in
question, or there may be awareness that fall below
the level of N consciousness.
Followed by amnesia
Causes-Concussion or cerebral disease, Epilepsy,
Alcohol/Drug usage, Hypoglycaemia, During sleep
(Somnambulism)
MLI-Defencein a criminal charge.

42. Psychopath
It is a personality disorder, where the person has recurrent
episode of impulsive behavior, which is not acceptable to
social structure.
They are neither Insane nor mentally defective
Characteristics
They always offend against society.
Lack of sympathy
Behavior not modified by experience & punishment

43. Emotionally cool
Incapable to understand the feelings & motivation of other
They may have temper outburst, may make verbal or
physical attack without sufficient provocation.
MLI-: They are criminally responsible for their act.

44. Mental age
Mental development with age
I.Q –Intelligent Quotient-
Mental age
Chronological age
100
Level of intelligenceI.Q range
a)Idiot
b)Imbecile
c)Moron
d)Normal
e)Genius
0—24
25—49
50—69
90—109
> 140

45. Psychosis
It is a state of mental illness which is characterized by
Disorder of behavior being withdrawal from reality
Insight –absent
Empathy-lacking
Contact with reality-lost
Neurosis
It is a state of mental illness where the patient suffers
from emotional or intellectual disorders, but his insights
remain intact and the sense of reality also present.
No change in personality
No disorder of thinking
It is the reaction against conflicts & stress in mind.

46. Difference between psychosis & neurosis
Trait Psychosis Neurosis
Severity Major Minor
Genetic
predisposition
Present Absent
Insight absent Present
Contact with
reality
Lost Present
Empathy Lack of empathy Present

47. Psychosis associated with organic ds
Dementia-degeneration of memory, loss of power of
judgment
senile ->65 yrs
pre senile -<65yrs
pseudo dementia-Alzheimer ds
Drugs induced psychosis-
Barbiturate
Amphetamine
Cannabis
Cocaine
L.S.D

48. Deficiency of vitamins-
Cyanocobalamin
Niacin
GPI- General paralysis of insane
Found in meningo vascular syphilis.
Epilepsy-It is due to head trauma,
tumor or parasitic infestation.
Alcoholics-
Alcoholic blackout
Delirium tremens
Alcoholic hallucination
Korasakoff’s psychosis
Delusion of jealousy.

49. Classification of mental diseases(WHO 1965)
Psychosis
Neurosis
Personality
disorder
Sexual
perversion
Drugs
dependence
organic
functional
schizophrenia
Affective
disorder
a)Anxiety neurosis
b)Obsessive compulsive neurosis
a)Dementia
b)Intra cranial inf.
c)Metabolic/endocrinal ds.
a)Manic depressive psychosis
b)Involutional melancholia

50. ICD-10 BY WHO(1992)
CLASSIFICATION OF MENTAL AND BEHAVIOURAL
DISORDERS
1.ORGANIC MENTAL DISORDERS
DELERIUM,DEMENTIA
2.MENTAL DISORDERS DUE TO SUBSTANCE ABUSE
ALCOHOL,COCAINE,CANNABIS
3.SCHIZOPHRENIA,SHYZOTYPAL AND
DELUSIONALDISORDERS
SCHIZOPHRENIA
4.MOOD DISORDERS(AFFECTIVE )
MDP,MANIC DISORDER,DEPRESSION.

51. 5.NEUROTIC, STRESS RELATED AND SOMATOFORM
DISORDERS
ANXIETY,PHOBIC STATES ,
OBCESSIVE COMPULSIVE DISORDERS
6.BEHAVIOURAL SYNDROMES ASSOCIATED WITH
PHYSIOLOGICAL DISTURBANCES
EATING DISORDERS
SLEEP DISORDERS
SEXUAL DYSFUNCTIONS
7.DISORDERS OF ADULT PERSONALITY AND BEHAVIOUR
PERSONALITY DISORDERS

52. 8.MENTALRETARDATION
9.DISORDERSOFPSYCHOLOGICAL DEVOLOPMENT
SPEECHANDLANGUAGE DISORDERS
10.BEHAVIORALDISORDERSOFCHILDHOODAND
ADOLESENCE
HYPERKINETICDISORDERS
TICDISORDER
11.UNSPECIFIEDMENTALDISORDERS

53. Functional psychosis-
Schizophrenia-Split personality
Disorder of thought
Affective -MDP
Diagnosis of mental diseases-
1.Proper history.
2.Signs & symptoms
3.Other lab investigation
4.Observation
Mental condition
1.General appearance
2.Talk
3.Speech
4.Writing
5.Behavior
6.Mood
7.Memory
8.Sleep
9.Gait
10.Thought content.

54. THE MENTAL HEALTH ACT, 1987
Act was passed by the Indian Parliament in 1987.
The aims and objectives
Toconsolidateandamendthelawrelatingtomentally
illpersons
Theirbettertreatmentandcare,bettermanagementof
theirproperty,andtheiroverallbetterprotection
Itchangedcertainobjectionableandstigmatictermsinto
moreacceptableterms

55. Mentallyillpersonisdefinedasapersonwhoisinneedof
treatmentbyreasonofanymentaldisorderotherthanmental
retardation[S.2(l)]

56. Establishmentandmaintenanceofpsychiatrichospitalsor
psychiatricnursinghomescanonlybewithlicense[S.6]which
hastoberenewedevery5years[S.94]
Thelicensewillberevokedifthehospitalisnotmaintained
accordingtoprovisionsoftheAct[S.11]
Ifhospitalisrunwithoutlicense,thepenaltyisimprisonmentof
3monthsand/orfineof`200forfirstoffence,6mand/or1000
forsecondoffenceandifhospitaliscontinuedtorunwithout
licenseevenafterthat,apenaltyof`100perday[S.82]

57. RegularinspectionofpsychiatrichospitalsbyInspecting
Officers
Inordertoknowthatpsychiatrichospitalsareworkingwellandin
accordancewiththeAct,theStateGovernmentorlicensing
authoritywillappointan‘InspectingOfficer’whoatanytimecan
enterandinspectanypsychiatrichospital,inspectitsrecordsand
talktopatientsinprivate.Ifworkingofhospitalnotfound
satisfactory,hewillreporttothelicensingauthoritywhowilltake
appropriateaction[S.13]

58. Appointment of visitors and monthly inspection by them
Foreverypsychiatrichospital,theGovtshallappoint5or
morevisitors(oftheseatleastoneshouldbeamedical
officer,preferablyapsychiatrist,twoshouldbesocial
workersandtwoothers)[S.37]
Everymonththreeormorevisitorswillmakeajoint
inspectionofeverypartofthepsychiatrichospitaland
examineeveryminoradmittedasavoluntarypatient,and
preferablyeveryothermentallyillpersonadmitted[S.38]
Regularvisitsbyinspectingofficersandvisitorsensurethat
psychiatrichospitalsarerunsmoothly

59. RESTRAINT OF THE MENTALLY ILL
Restraintofthementallyillreferstolawfulrestraintofa
mentallyillperson,whoisadangertohimselforothers.
(A)Immediate restraint
(B)Admission in a psychiatric hospital.

60. [A]Immediaterestraintmeanstakingamentallyunsound
personintoimmediatecontrolwhoseillnesshasexacerbated
acutely,orwhohassuddenlybecomeviolent.
ThereisnospecificprovisioninMHA1987forimmediate
restraint.ItisdoneU/s81,IPC[actdonetopreventother
harm]
Prerequisites–informedconsentofguardianmustbeobtained.
Ifconsentnotobtainableforanyreason,personcanberestrained
withoutconsent,butonlyaslongasdangerexists.
Method–bysafelylockingupinaroomunderimmediate
personalcareofattendants.

61. [B] Admission in a Psychiatric Hospital
Proceduresforadmissioninapsychiatrichospitalhavebeen
madesonopersonmayexploitthelaw.
Ifapersonisaggrievedoveranunfavorablewillmadebya
relative,hemaytrytoprovehimmentallyillbygettinghim
admittedtoapsychiatrichospital.
Acriminalmayhimselfgetadmittedinordertoclaimbenefit
ofS.84,IPC

62. [1] Admission on a voluntary basis
Anyperson>18ywhoconsidershimselfamentallyillperson
anddesirestobeadmittedtoanypsychiatricnursinghomefor
treatment,mayrequestthedoctorinchargeforbeingadmittedas
avoluntarypatient[S.15].
Incaseofpersons<18y,requestismadebyguardian[S.16].

63. Procedure
Thedoctorin-chargeshallmakesuchinquiry[examinationetc]as
hemaydeemfitwithin24handifsatisfiedthattheapplicantor
minorrequirestreatmenthemayadmithim[S.17]
Comments
Astraightforwardprocedure.Thepossibilityofpatient
malingeringillnessispreventedbydoctorhimselfexamining
suchperson.
Veryfewpatientsareadmittedunderthislaw.

64. [2] Admission under special circumstances [application by
relative or friend]
If mentally ill person is unable to express his willingness for
admission
(i)Patient may be admitted for up to 90 days on an application
by relative or friend [S.19(1)]
(ii)Application should be on prescribed form
(iii)It should be accompanied by certificates from 2 medical
practitioners [allopath, homeopath, or ayurveda(S.2k)], one
of whom should be a Govtdoctor
(iv)Each doctor should have examined the MIP separately within
10 days prior to application[S.30]
(v)If above certificates are not attached, the doctor in charge
may appoint 2 doctors working in the hospital to examine
him [S.19(2)].

65. [3] Reception order on application
Receptionorder[RO]–meansamagisterialorderforMIPtobe
“received”,admittedandkeptinhospital.
Applicationbydoctorincharge
Ifdoctorthinksthattreatmentisneededfor>6mordetentionis
neededforpatient’sownsafetyandthatofothers,hewouldmake
anapplicationtomagistrateforareceptionorder[S.20(2)].

66. Application by husband, wife or relative
Husbandorwifeofpatientcanmakeanapplicationto
magistrate.
Ifthereisnohusbandorwifeoriftheyareillorabsentorcan
notmakeanapplicationforwhateverreason,anyrelativeof
patientcanmakeanapplication[S.20(3)].
Hemuststatewhythehusbandorwifeisnotmakingthe
application.Heshouldalsoindicatehisrelationshipwiththe
patient,andthecircumstancesunderwhichtheapplicationis
beingmade[S.20(4)].

67. Allpersonsmakingapplicationunderthisprovision[husband,
wife,relative]mustbe>18yandmusthaveseenthepatient
within14daysofmakingapplication[S.20(5)].
Theapplicationmustbeinprescribedformandmustbe
accompaniedbycertificatesfrom2medicalpractitioners,one
ofwhommustbeaGovtdoctor[S.20(6)].

68. Eachmedicalpractitionershouldexaminethepatient
independently[S.21(a)]
ThecertificateshouldstatethattheMIPissufferingfrom
mentaldisorderofsuchanatureanddegreethathistreatmentin
thepsychiatrichospitalisrequiredandthatsuchdetentionis
necessaryintheinterestsofthehealthandpersonalsafetyof
patientorfortheprotectionofothers[S.21(b)].

69. [4]Receptionorderonproductionofmentallyill
personbeforeMagistrate
[a]Wandering or dangerous mentally ill person
Apoliceofficerinchargeofapolicestationmaydetainany
wanderingmentallyillperson(WMIP)[whoiswandering
aimlessly]ordangerousmentallyillperson(DMIP)[whois
dangeroustohimselforothersduetohisviolent
behavior][S.23(1)].

70. ThePoliceofficerwouldimmediatelyinformhimwhyheis
beingdetained.IfWMIPorDMIPisincapableof
understanding,theirrelativesorfriendsmustbeinformed
[S.23(2)].
SuchWMIPorDMIPmustbeproducedbeforeamagistrate
within24hofdetention.Theperiodofjourneyisnotincluded
[S.23(3)].

71. In respect of examination -Magistrate shall
(a) examine the person personally
(b) cause him to be examined by a doctor
(c) make any other relevant enquiries [S.24(1)].
In respect of admission –Doctor must certify the person to be
mentally ill.
Ifhe feels that patient may be malingering and needs sustained
observation or there is some other difficulty in on-the-spot
diagnosis, he may ask the magistrate to pass a temporary order
for detention for observation of a period of up to 10 days
[S.28(1)]

72. Ifdiagnosiscannotbemadeduringthatperiod,twomoresuch
orderscanbepassed
Thedoctormustmakeadiagnosiswithin30days[S.28(2)]
Ifaftermedicalcertificatefromdoctorthemagistrateis
satisfiedoftheneedofhistreatmentorforprotectionof
himselforothers(a)hemaymakeaRO.

73. Ifanyrelativeorfriendwantshimtobeadmittedtoa
particularlicensedpsychiatrichospitalandagreestobearcost,
anddoctorin-chargeofthathospitalconsents,anROforthat
particularhospitalismade.
IfrelativeorfriendsfurnishesabondensuringthatWMIPor
DMIPwouldneitherinjurehimselfnorothers,andagreesto
keephim,themagistrate,insteadofmakinganRO,would
handoversuchpersontotherelativeorfriend[S.24(2)].

74. Features True /real Feigned insanity
Onset Gradual Sudden
Motive Nil Presence of crime
Predisposing factorsPresent Absent
Signs & symptoms Uniform Present only when being
observed
Facial expression Vacant look Frequently changing
Insomnia present Absent
Exertion Absent Present
Habits Dirty Not so
Skin & lips Dry Normal
Frequent examinationDoes not mind Resists for fear of
detection
Difference between real & feigned insanity

75. [b] Cruelly treated mentally ill person
Policeofficer–mayinformmagistrateifaMIPisinthe
custodyofrelativeorguardian,andisbeingcruellytreatedby
him[cruellytreatedmentallyillperson,CTMIP][S.25(1)].
Anyprivateperson–cansimilarlyinformmagistrate
[S.25(2)].

76. ThemagistratewouldcallCTMIP,relativewhoiscruelly
treatinghimandpersonwhoislegallyboundtomaintainsuch
CTMIP[S.25(3)].
Magistratewouldorderthepersonwhoislegallyboundto
maintainsuchCTMIPtotakehispropercare.Ifhewillfully
neglectstocomplywiththeorder,hecanbefinedupto`2,000
[S.25(4)].
Ifitappearstomagistratethatdespitefineetc,theCTMIP
wouldnotbeproperlylookedafter,hewouldmakeanRO,
undersameproceduralguidelinesaswithWMIPandDMIP
above[S.25(5)].

77. [5] Discharge of a mental ill person in asylum
1.Avoluntarypatientmustbedischargedwithin24hrs
ofreceiptofrequestfordischargemadebythepatient
himselforbytheguardian
2.Admissionbyapplicationcanbedischargedby
requestbutitmustfirstbemadecertainthatthe
patientisfittobedischarged.
3. The O.I.C of psychiatric hospital can order the discharge of
any patient, on the recommendation of two medical practitioner
one of whom should be a psychiatrist.

78. 4. A relative of a mentally ill person can make an
application for his discharge even if he is not fully
cured, provided that he is not dangerous to society.
5. A person detained on a reception order can
be discharged if a judicial inquisitions finds him of
sound mind.

79. Civil & criminal responsibility of an insane person
Responsibility of mentally ill
Civil
Criminal
Management of property
Contract
Marriage & divorce
Adoption
Competency of witness
Validity of consent
Testamentary capacity
Mc Naughten rule
Section 84 I.P.C
Durham's rule
Curren;s rule
The Irresistible impulse
act
The American Law
Institute act
Doctrine of diminished
responsibility

80. Civil responsibility
1. Management of property & affairs of the insane
Judicial inquisitionregarding alleged mentally ill person
possessing property, custody of his person
and management of his property. Apply in
Court for
inquiry
To prove the person
Is mentally ill or not
Court will send the case for medical examination to
a psychiatrist & wait for his report regarding the insanity

81. That the
extent of mental
illness
Whether the person is capable of looking after
his property or not
Court will decide as follows
1.The court may order for the appointment of guardian to
take care him & his property.
2. When the court find that person is mentally ill but he can
take care of himself but can not manage his property then
it may issue an order for management of his property

82. 3. The court may order to sell the property for the
purpose to meet up the expenses. (debt, maintenance,
payment of the cost for any judicial inquisition)
4. The manager has no power to mortgage or sell such
properties without permission of court.
5. If it is reported that the person has improved or cured
then another inquiry by court
If court satisfy
All the proceeding
will be stopped

83. 2. Contracts
Only a person of sound mind is competent to contract
When is a person said to have sound mind
Ifatthetimewhenhemakesthecontract,heiscapableof
understandingitandofformingarationaljudgmentastoits
effectuponhisinterests
Ifotherpartycanshowitdidnotknowthementalconditionof
theotherparty,andthecontractwasfair"Contractmaybe
heldvalid

84. If mental illness develops after contract is signed
Contractisvalid,untilandunlessmentalillnessmakesthe
otherpartyunabletoperformservicerelevanttocontract.
Contractcanbemadeduringlucidinterval
Asaneman,whoisdeliriousfromfeverorwhoissodrunk
thathecannotunderstandthetermsofacontractorforma
rationaljudgmentastoitseffectonhisinterests,cannot
contractwhilstsuchdeliriumordrunkennesslasts

85. 3.Marriage and divorce
Either party is incapable of giving valid consent due to
unsound of mind.
Recurrent attack of insanity or epilepsy.
Divorce can be granted if either party prove unsoundness
of mind.
4. Adoption
Any Hindu male who is of sound mind and is not a minor
can adopt a child with the consent of his wife.

86. 5. Government service
A mentally ill person cannot enter a govtservice.
6. Inheritance
Mentally ill person cannot be disqualified from inheritance to
any property
The situation is less clear if a mentally ill person commits
murder.

87. 7. Competency as a witness
An insane person is not competent to give evidence.
But if he understand the obligation of an oath is competent
to give evidence.
At lucid interval he can competent to give evidence.
8. Consent
Consent is not valid in case of rape, causing death or
grievous hurt/MTP
9. Testamentary capacity
It is the capacity to make a valid will or it is the mental
ability of a person to make a valid will.

88. Will denotes as a testamentary document.
Components
1.An understanding of the nature of will
2.A knowledge of the property to be disposed
3.An ability to recognize those who may be
have justifiable claims on the property.
Silent points regarding testamentary deposition
Must in writing
Signed by the testator in presence of two witness
An executor is appointed under the will by the
testator to carryout it’s term after his death
Will can be modified by the testator any time before
his death
The testator must be of a sound mind, not being
minor,

89. Will is invalid when
1.If it is taken under influence of other person
2.Loss of judgment due to extreme age
3.In excessive drinking state
4.Insanity
Will is valid when
1.In lucid interval
2.If testator commit suicide immediately after making
the will in the absence of evidence of mental ds.
3. Delusion not affecting any way for disposal of
property.

90. Criminal responsibility of the insane
A mentally ill person is not punished for his crime as he devoid
of free will, intelligence, and knowledge of the act
The murderer
Take the plea of mental illness
For escape from capital punishment
Mc Naughten rule
A 29 yrs Scottish had been suffering a delusion of persecution
That the party in power were constantly following him,
harassing him, planning conspiracy against him

91. So he decide to kill the Prime minister in power that
Sir Robert peel so he made a plan for the crime. He wait from
distance of the prime minister residence
Suddenly he found that the Prime minister came out with
some other officers then he started firing to the P.M but
mistakenly he shot his private secretary Henry Drummond
In court found him as insane as
not guilty by reason of insanity he was sent to
Psychiatric hospital for treatment for life.

92. Anaccusedpersonisnotlegallyresponsible,ifitisclearly
provedthatatthetimeofcommittingthecrimehewassuffering
fromsuchadefectofreasonfromabnormalityinmind,thathe
didnotknowthenature&qualityoftheacthewasdoingorthat
whathewasdoingwaswrong.
Section 84 IPC
Nothingisanoffencewhichisdonebyapersonwhoatthe
timeofdoingit,bythereasonofunsoundnessofmindis
incapableofknowingthenatureoftheactorthatheisdoing
whatiseitherwrongorcontrarytolaw.

93. 2. Durham Rule (1954)
“an accused person is not criminally responsible, if his
unlawful act is the product of mental disease or mental
defect.”
3.Curren’s Rule (1961)
“an accused person is not criminally responsible, if at
the time of committing the act, he did not have the
capacity to regulate his conduct to the requirements of
the law, as a result of the mental disease or defect.”

94. 4. The Irresistible Impulse Test (New Hampshire
Doctrine)
“anaccusedpersonisnotcriminallyresponsible,evenifhe
knowsthenatureandqualityofhisactandknowsthatheis
wrong,ifheisincapableofrestraininghimselffrom
committingtheact,becauseoffreeagencyofhiswillhas
beendestroyedbymentaldisease.”
5. The American Law Institute Test (1972)
“a person is not responsible for criminal conduct if at the time
of such conduct, as a result of mental disease or defect he
lacks adequate capacity either to appreciate the criminality of
his conduct, or to adjust his conduct to the requirement of the
law.”

95. Insanity and Murder
If the mental disorder impairs the cognitive faculties
of the accused, he is not held responsible for his acts.
If insanity affects only emotions and the will, but not
the cognitive faculties, the person is held responsible
for his acts.

96. Doctrine of Diminished Responsibility
If an unlawful act is committed by a person who is suffering
from some degree of mental illness, should not be treated like
a sane person who committed an unlawful act.
According to this theory, such mentally ill persons have
diminished responsibility.
Punishment for them for commission of an unlawful act
should be less.

97. Responsibility of Intoxicated Persons
InCivilcases
Ifanyintoxicatedpersoninvolvesinanycivilresponsibility,
thenthecasewillbeconsideredaccordingtothenatureofthe
workandmeritoftheconsequences.
InCriminalcases
Anintoxicatedpersonmaynotbeheldresponsibleforhisact,
ifatthetimeofcommission,duetotheeffectofintoxication,
hedidnotunderstandthenatureandqualityoftheactandits
consequencesandlegalposition
Ifthepersonhastakentheintoxicatingagentonhisownand
withamindtoperformthecriminalacteasily,hewillbeheld
responsibleforitscommission.

98. THE END