The history of mental health law in Pakistan, including the mental health ordinance of 2001. https://psych.thinkific.com/courses/mental-health-act-pakistan-2001

1. A review of Mental Health Law in
Pakistan
• Presentation by
• Rubeena Kidwai, Ph.D.
• Consultant Clinical Psychologist
• Hubert H. Humphrey Fellow 2010-2011

2. History of mental
health law in Pakistan
• 1912 - Mental health law introduced in
Indo-Pak subcontinent (then India) – Lunacy
Act 1912
• Referred to persons with mental illness
as “Lunatics” or “idiots of unsound mind”
• Main emphasis was on
• removing persons with mental illness
away from mainstream society and
keeping them under custodial care or
“asylums”
• ‘Protecting’ the society from persons
with mental illness

3. Mental health
law in Pakistan
• 2001 – Lunacy Act repealed and replaced by Mental
Health Ordinance 2001 (MHO 2001)
• Drew heavily on Indian Mental Health Act 1987
• Used more humane and relatively updated
terminology
• e.g. “mental illness”, “psychiatric facility”, “care in
the community”
• Addressed human and civil rights of persons with
mental illness
• Informed consent
• Right and privilege to confidentiality
• Right to protection of property and assets
• Punitive measures against abusive treatment

4. Mental health law in Pakistan
• 2001 - Federal Mental Health Authority (FMHA) formed whose task it was to:
• Form rules and regulations to make the Ordinance enforceable
• Advise government regarding matters of mental health – prevention and promotion
• Advise on setting up on mental health services and on improving existing mental health
services
• Prescribe code of practice for mental health service providers

5. Mental health law in Pakistan
MHO introduced and FMHA formed
2001
Member of FMHA reported they were working on creating
forms and procedures in line with MHO
•No additional news of any meetings or activities about FMHA
2003
onwards – PAMH, HRCP and other stakeholders involved in:
•Awareness raising about the MHO
•Consultations regarding suggested amendments
•Advocacy for the implementation of MHO
2004

6. Mental health law in Pakistan
Tenure of members of FMHA ended
• FMHA lapsed
2005
Board of Visitors (BoV) formed was in Sindh
• Due to lapse of FMHA the BoV did not have a valid presence
2007
PAMH contacted the Federal Ministry of Health
numerous times to
• Urge the FMHA to convene and begin its tasks
• To reconstitute and activate the FMHA
2008

7. Mental health law in Pakistan
PAMH filed a petition with
Sindh High Court asking for
reconstitution of the FMHA
2007
(Oct) – Sind High Court ordered
Federal Ministry of Health to
reconstitute FMHA
2008
(Dec) – FMHA reconstituted -
but did not meet
2009
Jan- Jun - PAMH initiated a
signature drive petitioning the
FMHA and the Supreme Court
to take steps to implement the
MHO
2010
(Jun) – Chief Justice took note
of the issue and directed the
issue to Human Rights Cell
which in turn issued a directive
for the FMHA to convene
2010
(Dec) meeting of FMHA
2010

8. However…
• 2010 April – 18th Amendment Bill was passed
• Process of devolution of power and greater power to provinces
• Federal legislative list vs. Concurrent legislative list
• MHO becomes a casualty of 18th Amendment
• FMHA dissolved
• MHO does not have force

9. Problem or opportunity??
• Current scenario
• Sindh Government has drafted a Provincial Mental Health Bill
• Currently in Provincial Assembly

10. Loopholes
and lacunae
• Definition of mental illness
• Exclusion of other mental health service providers and
mental health facilities
• Power to police
• Absence of psychiatrists in many areas
• Does not address civil or criminal liability of a person
suffering from mental illness

11. The way forward…
• Need for advocacy for the enforcement of mental health law
• Advocacy for improving upon the clauses
• Inclusion and active participation of all stakeholders

12. References
Mental Health Ordinance, full text, retrieved on November 28, 2011, at
http://www.emro.who.int/MNH/WHD/Pakistan-Ordinance.pdf
• Gilani, A.I., Gilani, U. I., Kasi, P. M., & Khan, M. M. (2005) Psychiatric Health Laws in Pakistan:From Lunacy
to Mental Health. PLoS Med 2(11): e317
doi:10.1371/journal.pmed.0020317.

13. thankyou