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
These are the person who are unable to cope with the ordinary
social circumstance

3. Insanity or Unsoundness mind
A disease of the mind or the personality, in which there is derangement of mental
or emotional processes & impairment of behavioral control.
Mentally Ill Person
Any person who is in need of treatment by reason of any mental disorder other than
mental retardation.

4. Forensic psychiatrist
a) Provide services such as determination of competency to stand trial in a court
of law to facilitate adjudicative process.
b) Involved in care of prisoners , both in jails and mental health institutions.
c) Often also do research work related to prison

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
It is a condition characterized by disturbance of consciousness
where the critical faculty is blunted or lost, associated with
impaired orientation and inconsistent or irrelevant thought
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. Delirium tremens
It is psychotic condition in alcoholics which occurs due
to sudden increase of dose and sudden withdrawal.
There are tremor, Insomnia, mental confusion, loss of
memory, disorientation and hallucination of horror.
Korsakoff’s psychosis
It is a psychological and neurogenic deranged condition
occurring in some chronic alcoholics where there is
peripheral neuritis with polyneuritis, muscular
degeneration with weakness, disorientation , some
hallucination and retrograde amnesia.

10. Drunkenness
It is the state of a person under the influence of alcohol such that he lost control
to such an extent that he is unable to perform his duty in which he was
engaged at the material time.
Dementia
It means degeneration of mental faculties after full development. It may occur
due to old age, Alzheimer’s disease involving brain, etc.
Loss of higher cognitive functions & social inhibition(sexual offences against
children, shoplifting)

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

12.  Unconscious filling of gaps in memory by imagining
experiences or events that have no basis in fact,
commonly seen in amnestic syndrome.
 Confabulation is considered “honest lying,” but is
distinct from lying because there is typically no intent to
deceive and the individual is unaware that their
information is false

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.  The person believe that there is some pathology
or abnormality with some part or system or
organ of his body, though in reality he is physically
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
 Capgras syndrome (Delusion of doubles) -Person holds a
delusion that a friend, spouse, parent, or other close family
member has been replaced by an identical-looking
impostor [stranger].Familiar person is thus seen as a
stranger.
 The syndrome of subjective doubles - The patient’s
own self is perceived as being replaced by a double.

23.  The syndrome of intermetamorphosis - Familiar persons
are believed to have exchanged identities [no stranger is
involved]. A person misidentifies his wife as his deceased
mother and, later, as his living sister.
 Fregoli syndrome -Delusional belief that one or more
familiar persons, usually persecutors following the
repeatedly change their appearance.

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
 These are false interpretation of sensory stimuli often visual or auditory
which has real existence.
 They maybe seen in normal persons, in dark or during emotional stress and
in organic brain disease and maybe associated with hallucination.
E.g. A dog maybe interpreted as a tiger.
A rope maybe mistaken for

30.  Completion Illusion: Where an unfinished pattern is completed
by illusion.
 Affect Illusion: In this, mood of the person affects the nature
of illusion.
 Parabolic Illusion: When human faces or images are seen in
illusion.
In Illusion, The person may be corrected when confronted with
Facts. He realizes that it was a misinterpretation of stimulus.

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
It is a condition characterised by appearance of a single idea,
thought, or emotion which constantly disturbs the sufferer
which he recognizes as irrational but persists in spite of all
effort to drive it out from his mind.
Usually found in neurotic people.
The ideas are usually associated with some sort of fear
Compulsion
It is a repetitive behavior done by an individual in spite of
knowing that it is not correct.
Examples being, repeatedly washing hands, checking locked
premises again and again.

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
A period 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
The person becomes a wanderer who keeps on moving
from place to place in an altered state of mind. He has
episodes of amnesia. This stage is seen in depression,
schizophrenia and other mental disorders.
Twilight states
It is state of diminished awareness of acts of relatively
short duration of which he has no recollection.
Oneirophrenia
It is a dream like state which may last for days or
weeks. The patient suffers from mental confusion
,amnesia, illusions, hallucinations, disorientation and
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 - Defence in 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 intelligence I.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.MENTAL RETARDATION
9.DISORDERS OF PSYCHOLOGICAL DEVOLOPMENT
SPEECH AND LANGUAGE DISORDERS
10.BEHAVIORAL DISORDERS OF CHILDHOOD AND
ADOLESENCE
HYPERKINETIC DISORDERS
TIC DISORDER
11.UNSPECIFIED MENTAL DISORDERS

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
 To consolidate and amend the law relating to mentally
ill persons
 Their better treatment and care, better management of
their property, and their overall better protection
It changed certain objectionable and stigmatic terms into
more acceptable terms

55.  Mentally ill person is defined as a person who is in need of
treatment by reason of any mental disorder other than mental
retardation [S.2(l)]

56.  Establishment and maintenance of psychiatric hospitals or
psychiatric nursing homes can only be with license [S.6] which
has to be renewed every 5 years [S.94]
 The license will be revoked if the hospital is not maintained
according to provisions of the Act [S.11]
 If hospital is run without license, the penalty is imprisonment of
3 months and/or fine of `200 for first offence, 6 m and/or 1000
for second offence and if hospital is continued to run without
license even after that, a penalty of `100 per day [S.82]

57.  Regular inspection of psychiatric hospitals by Inspecting
Officers
In order to know that psychiatric hospitals are working well and in
accordance with the Act, the State Government or licensing
authority will appoint an ‘Inspecting Officer’ who at any time can
enter and inspect any psychiatric hospital, inspect its records and
talk to patients in private. If working of hospital not found
satisfactory, he will report to the licensing authority who will take
appropriate action [S.13]

58. Appointment of visitors and monthly inspection by them
 For every psychiatric hospital, the Govt shall appoint 5 or
more visitors (of these at least one should be a medical
officer, preferably a psychiatrist, two should be social
workers and two others) [S.37]
 Every month three or more visitors will make a joint
inspection of every part of the psychiatric hospital and
examine every minor admitted as a voluntary patient, and
preferably every other mentally ill person admitted [S.38]
 Regular visits by inspecting officers and visitors ensure that
psychiatric hospitals are run smoothly

59. RESTRAINT OF THE MENTALLY ILL
Restraint of the mentally ill refers to lawful restraint of a
mentally ill person, who is a danger to himself or others.
(A) Immediate restraint
(B) Admission in a psychiatric hospital.

60. [A] Immediate restraint means taking a mentally unsound
person into immediate control whose illness has exacerbated
acutely, or who has suddenly become violent.
There is no specific provision in MHA 1987 for immediate
restraint. It is done U/s 81, IPC [act done to prevent other
harm]
Prerequisites – informed consent of guardian must be obtained.
If consent not obtainable for any reason, person can be restrained
without consent, but only as long as danger exists.
Method – by safely locking up in a room under immediate
personal care of attendants.

61. [B] Admission in a Psychiatric Hospital
 Procedures for admission in a psychiatric hospital have been
made so no person may exploit the law.
 If a person is aggrieved over an unfavorable will made by a
relative, he may try to prove him mentally ill by getting him
admitted to a psychiatric hospital.
 A criminal may himself get admitted in order to claim benefit
of S.84, IPC

62. [1] Admission on a voluntary basis
 Any person >18 y who considers himself a mentally ill person
and desires to be admitted to any psychiatric nursing home for
treatment, may request the doctor in charge for being admitted as
a voluntary patient [S.15].
 In case of persons <18 y, request is made by guardian [S.16].

63. Procedure
The doctor in-charge shall make such inquiry [examination etc]as
he may deem fit within 24 h and if satisfied that the applicant or
minor requires treatment he may admit him [S.17]
Comments
A straightforward procedure. The possibility of patient
malingering illness is prevented by doctor himself examining
such person.
Very few patients are admitted under this law.

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 Govt doctor
(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
Reception order [RO]– means a magisterial order for MIP to be
“received”, admitted and kept in hospital.
Application by doctor in charge
If doctor thinks that treatment is needed for >6 m or detention is
needed for patient’s own safety and that of others, he would make
an application to magistrate for a reception order [S.20(2)].

66. Application by husband, wife or relative
 Husband or wife of patient can make an application to
magistrate.
 If there is no husband or wife or if they are ill or absent or can
not make an application for whatever reason, any relative of
patient can make an application [S.20(3)].
 He must state why the husband or wife is not making the
application. He should also indicate his relationship with the
patient, and the circumstances under which the application is
being made [S.20(4)].

67.  All persons making application under this provision [husband,
wife, relative] must be >18 y and must have seen the patient
within 14 days of making application [S.20(5)].
 The application must be in prescribed form and must be
accompanied by certificates from 2 medical practitioners, one
of whom must be a Govt doctor [S.20(6)].

68.  Each medical practitioner should examine the patient
independently [S.21(a)]
 The certificate should state that the MIP is suffering from
mental disorder of such a nature and degree that his treatment in
the psychiatric hospital is required and that such detention is
necessary in the interests of the health and personal safety of
patient or for the protection of others [S.21(b) ].

69. [4] Reception order on production of mentally ill
person before Magistrate
[a] Wandering or dangerous mentally ill person
 A police officer in charge of a police station may detain any
wandering mentally ill person (WMIP) [who is wandering
aimlessly] or dangerous mentally ill person (DMIP) [who is
dangerous to himself or others due to his violent
behavior][S.23(1)].

70.  The Police officer would immediately inform him why he is
being detained. If WMIP or DMIP is incapable of
understanding, their relatives or friends must be informed
[S.23(2)].
 Such WMIP or DMIP must be produced before a magistrate
within 24 h of detention. The period of journey is not included
[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.
 If he 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.  If diagnosis cannot be made during that period, two more such
orders can be passed
 The doctor must make a diagnosis within 30 days [S.28(2)]
 If after medical certificate from doctor the magistrate is
satisfied of the need of his treatment or for protection of
himself or others (a) he may make a RO.

73.  If any relative or friend wants him to be admitted to a
particular licensed psychiatric hospital and agrees to bear cost,
and doctor in-charge of that hospital consents, an RO for that
particular hospital is made.
 If relative or friends furnishes a bond ensuring that WMIP or
DMIP would neither injure himself nor others, and agrees to
keep him, the magistrate, instead of making an RO, would
hand over such person to the relative or friend [S.24(2)].

74. Features True /real Feigned insanity
Onset Gradual Sudden
Motive Nil Presence of crime
Predisposing factors Present 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 examination Does not mind Resists for fear of
detection
Difference between real & feigned insanity

75. [b] Cruelly treated mentally ill person
 Police officer – may inform magistrate if a MIP is in the
custody of relative or guardian, and is being cruelly treated by
him [cruelly treated mentally ill person, CTMIP] [S.25(1)].
 Any private person – can similarly inform magistrate
[S.25(2)].

76.  The magistrate would call CTMIP, relative who is cruelly
treating him and person who is legally bound to maintain such
CTMIP [S.25(3)].
 Magistrate would order the person who is legally bound to
maintain such CTMIP to take his proper care. If he willfully
neglects to comply with the order, he can be fined up to `2,000
[S.25(4)].
 If it appears to magistrate that despite fine etc, the CTMIP
would not be properly looked after, he would make an RO,
under same procedural guidelines as with WMIP and DMIP
above [S.25(5)].

77. [5] Discharge of a mental ill person in asylum
1. A voluntary patient must be discharged within 24 hrs
of receipt of request for discharge made by the patient
himself or by the guardian
2. Admission by application can be discharged by
request but it must first be made certain that the
patient is fit to be discharged.
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 inquisition regarding 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
 If at the time when he makes the contract, he is capable of
understanding it and of forming a rational judgment as to its
effect upon his interests
 If other party can show it did not know the mental condition of
the other party, and the contract was fair " Contract may be
held valid

84. If mental illness develops after contract is signed
 Contract is valid, until and unless mental illness makes the
other party unable to perform service relevant to contract.
 Contract can be made during lucid interval
 A sane man, who is delirious from fever or who is so drunk
that he cannot understand the terms of a contract or form a
rational judgment as to its effect on his interests, cannot
contract whilst such delirium or drunkenness lasts

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 govt service.
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. An accused person is not legally responsible, if it is clearly
proved that at the time of committing the crime he was suffering
from such a defect of reason from abnormality in mind, that he
did not know the nature & quality of the act he was doing or that
what he was doing was wrong.
Section 84 IPC
Nothing is an offence which is done by a person who at the
time of doing it, by the reason of unsoundness of mind is
incapable of knowing the nature of the act or that he is doing
what is either wrong or contrary to law.

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)
“an accused person is not criminally responsible, even if he
knows the nature and quality of his act and knows that he is
wrong, if he is incapable of restraining himself from
committing the act, because of free agency of his will has
been destroyed by mental disease.”
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
In Civil cases
 If any intoxicated person involves in any civil responsibility,
then the case will be considered according to the nature of the
work and merit of the consequences.
In Criminal cases
 An intoxicated person may not be held responsible for his act,
if at the time of commission, due to the effect of intoxication,
he did not understand the nature and quality of the act and its
consequences and legal position
 If the person has taken the intoxicating agent on his own and
with a mind to perform the criminal act easily, he will be held
responsible for its commission.

98. THE END