This document discusses the Mental Health Ordinance of 2001 and procedures related to mentally ill patients. It outlines the objectives of the ordinance as consolidating laws around the treatment and care of mentally disordered persons. It describes the procedures for admission, discharge, and handling wandering patients. It also discusses testamentary capacity, requirements for a valid will, the role of doctors in taking wills, and the civil responsibilities of mentally ill patients.

1. MENTAL HEALTH ORDINANCE
2001, WILL & CIVIL
RESPONSIBILITY
Dr Faiza Nadeem
Assistant Professor Forensic Medicine

2. 1. What are the objectives of Mental Health Ordinance 2001.
2. Describe procedure of admission and discharge of mentally ill
patient based on Mental Health Ordinance.
3. Describe procedure of handling a wandering lunatic.
4. Define testamentary capacity.
5. Enlist conditions required for a valid Will.
6. Describe the role of a doctor in taking a Will from a sick person.
7. Explain the concept of civil responsibility of mentally ill patients.
LEARNING OBJECTIVES

3. MENTAL HEALTH ORDINANCE
2001
20th Feb 2001
OBJECTIVE OF THIS ORDINANCE
To consolidate and amend the law relating to the
TREATMENT and CARE of mentally disordered persons,
to make better provisions for their CARE, TREATMENT,
MANAGEMENT OF PROPERTIES AND AFFAIRS and to
provide for matters connected therewith or incidental
thereto and to encourage COMMUNITY CARE of such
MENTALLY DISORDERED PERSONS and further to
provide for the PROMOTION of mental health and
PREVENTION of mental disorder.

4. 1. Care in the community (Section 7)
2. Care and treatment on an informal or voluntary basis. (Section 8)
3. Admission for assessment (Section 10)
4. Admission for treatment (Section 11)
5. Admission for assessment in case of urgency. (Section 12)
6. Emergency holding (Section 13)
7. Mentally disordered persons found in public places (Section 19)
ASSESSMENT AND TREATMENT OF MENTALLY DISORDERED PERSONS

5. ● Provision of GUIDANCE, EDUCATION, REHABILITATION after
care and preventive measures in the community (Family,
home, workplace or educational institutions etc).
CARE IN THE COMMUNITY SECTION 7

6. ● Patient comes himself or is brought by relative or
referred by a medical practioner for Psychiatric
assessment.
● Ist Examined by Psychiatrist/Medical Officer.
● Treated on outpatient basis or otherwise.
● May be discharged on withdrawal of his consent.
CARE AND TREATMENT ON INFORMAL OR VOLUNTARY BASIS SECTION 8

7. a) Admission for assessment.
b) Admission for treatment
c) Urgent admission for assessment.
d) Emergency holding.
RESTRAINT /DETENTION FOR ASSESSMENT & TREATMENT

8. ● Grounds for detention:
Patient’s own interest or protection of other persons. Care and
treatment in community on an informal and voluntary basis is not
possible.
● Medical recommendation. (Two)
1. Psychiatrist, 2. Medical officer.
● Period of detention. 28 days
● Right of appeal (To the court of protection). only once within
14 days.
ADMISSION FOR ASSESSMENT SECTION 10

9. ● Grounds for detention:
Need of treatment in psychiatric facility in Patient’s own interest or
protection of other.
● Medical recommendation:
Two medical officers one of whom approved Psychiatrist.
● Period of detention: Six Months (Renewable for a further six
months then for period of one years as many times required).
● Right of appeal (To the court of protection): Right of one
appeal in each period of detention.
ADMISSION FOR TREATMENT SECTION 11

10. ● Grounds for detention:
Urgent necessity for detention and fact that procedure under Sec 11
will invite undesirable delay.
● Medical recommendation:
One approved psychiatrist or his nominated medical officer.
● Period of detention: 72 hours
● Right of appeal (To the court of protection): No.
URGENT ADMISSION FOR ASSESSMENT SECTION 12

11. ● Grounds for detention:
Necessity to hold an admitted patient for safety of his health and
protection of other and it is not practicable to furnish medical
recommendation to In charge of psychiatric facility or his nominated
M.O.
● Medical recommendation:
One by M.O. of the psychiatric facility.
● Period of detention: 24 hours
● Right of appeal (To the court of protection): No.
EMERGENCY HOLDING SECTION 13

12. Type of Detention
Medical
Recommendation
Period
Right of
Appeal
Admission for Assessment Two 28 Days Yes
Admission for Treatment Two
6 Month
Renewable
Yes
Urgent Admission for
Assessment
One 72 Hours No
Emergency Holding One 24 Hours No

13. ● Grounds for detention:
If an officer in charge of a police station finds in a place to which
the public have access, a person whom he has reason to believe, is
suffering from a mental disorder and to be in immediate need of
care or control the said officer.
● Medical recommendation:
Psychiatrist or his nominated Medical Officer.
● Period of detention: 72 hours.
MENTALLY DISORDERED PERSONS FOUND IN PUBLIC PLACES SECTION 19

14. A relative can apply for grant of leave from psychiatric facility
of an admitted patient to psychiatrist in charge on submission
of undertaking:-
i. To take care of mentally ill
ii. To prevent the patient to cause injury to himself or to
other.
iii. To bring back patient after expiring of leave.
LEAVE AND DISCHARGE (CHAPTER IV)
DISCHARGE-LEAVE

15. Section – 21.
The psychiatrist In charge of the treatment may order
discharge of the patient at any time be deem it appropriate.
Section-22
i. Any patient who feels that he has recovered, apply to
magistrate.
ii. Magistrate after making necessary inquiry, order for
discharge.
DISCHARGE OF PATIENT

16. Section - 23
If person admitted for assessment is found not mentally
disordered & is capable of taking care of himself & managing
his affairs. He will be discharged by psychiatrist of the faculty.
Section - 25
Application by relative for discharge of patient admitted under
section 10 & 11, his relative will apply to magistrate for his
discharge & magistrate in consultation with psychiatrist in
charge of treatment will allow or dismiss the application.
DISCHARGE OF PATIENT

17. Cases of attempted suicide-
Such persons should be assessed by approved psychiatrist & if
found to be suffering from mental disorder should be treated.
Confidentiality-
No patient shall be publicized not his identity disclosed to the public
through press or media unless such person chooses to publicize his
own condition.
Informed Consent-
Before commencing any investigation (s) and or treatment has been
given to patient or if the patient is a minor, his nearest relative or a
guardian, as the case may be.
PROTECTION OF HUMAN RIGHTS OF MENTALLY DISORDERED PERSONS
CHAPTER- VII

18. ● Where the consent of a patient of any form of investigation (s)
and or treatment (s) has been given by the patient or if the patient
is a minor , his nearest relative or a guardian, as the case may be,
may withdraw his consent in writing at any time before the
completion of the treatment.
● Without prejudice to the application of sub-section (s) above to
any treatment given under the plan of treatment to which a patient
or if the patient is a minor, his nearest relative or a guardian, as
the case may be, who has consented, to such a plan may, anytime
withdraw his consent in writing to further treatment, or to further
treatment of any description under the plan of treatment.
INFORMED CONSENT EXPLAINED

19. Section 29:
Whenever any person is possessed of property and is alleged to be
mentally disordered, the Court of Protection, within whose jurisdiction
such person is residing may, upon application by any of his relatives
having obtained consent in writing of the [24][Advocate General], by
order direct an inquiry for the purpose of ascertaining whether such
person is mentally disordered and incapable of managing himself,
his property and his affairs.
JUDICIAL PROCEEDINGS SECTION 29

20. ● Testamentary capacity refers to the ability of a person to make a
valid will.
● The word “WILL” denotes testamentary document Every person of
sound mind, not minor may dispose off his property by will An
insane may make a valid will during “lucid interval”.
● To invalidate a will on the grounds of insanity, it must be proved
that the testator was mentally incapacitated to the extent that he
did not know the nature of his act, was not aware of the
consequences, had not disposed off the property, if he had a
competent use of his mind (sound mind).
TESTAMENTARY CAPACITY SUCCESSION ACT SEC 59, PPC SEC 31

21. 1. The testator must be a major.
2. The testator must have a sound mind at time of making the
will.
3. The person must understand the nature and consequence of
the act.
4. The person must know what he/she has, to whom it is
being given, and reason behind it.
5. The person is executing it voluntarily without any influence.
6. The person must sign it in the presence of two witnesses.
7. None of the witnesses should be beneficiaries from the will.
CONDITIONS REQUIRED FOR A VALID WILL

22. ● Competency as a witness
● Mental disorders and marriage
● Mental disorders and contract
● Management of property.
CIVIL RESPONSIBILITIES OF INSANE CPC SEC 464-475

23. Possession of sound mind depends upon:
Normal perception of ideas and surroundings i.e. state, intact memory,
rational thinking and judgment, intelligence, behavior orientation,,
comprehension, mood.
Doctor’s duty:
To check the testator being “compos mentis” by asking simple questions
regarding mental faculties’ i.e.
● how old is he?
● where he reside?
● how and why he plans to dispose off his property?
● what is his estate?
● who are his legal heirs?
SANITY TESTIFICATION

24. Clinical testing of mental capacity: (by Psychiatrist)
Full personal / family history along with their mental state. opinion / views
about family, friends, business associates, religion, politics, hobbies, subject
to which he strongly feel must be asked. family doctor (relative / heir)
should not certify / testify
SANITY TESTIFICATION

25. MENTAL HEALTH MATTERS
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