Mental Health Laws in Pakistan: Understanding Rights, Reforms & Protections
Pakistan inherited the Lunacy Act of 1912 which was largely ceremonial in its impact upon Mental Health care in the country. The Orignal Lunacy Act 1912 had four major parts dealing with:
Definitions of significant terms,
Rules about the reception, care,
Treatment of individuals who are mentally ill,
Procedural rules for establishing whether or not an individual is mentally ill.
Towards the end of the Millennium, it became Obsolete for the needs of a modern state such as Pakistan. In 2001, the act was replaced by the Pakistan Mental Health Ordinance.
There was little progress on this front until 2001 when the first Pakistan Mental Health Act of 2001 was passed.
The 2001 ordinance has brought about significant changes in the law:
Especially in the domains of care and treatment and management of the property and other related matters. For the first time, legal rights and protection was given to the Mentally Ill.
The 2001 law has discarded such outdated and imprecise terms as:
Criminal lunatic (an oxymoron, given that lunatics cannot be held responsible for their acts),
The ordinance uses the term mental health as a part of its title and defines the converse mental disorder as mental illness, including mental impairment, severe personality disorder, severe mental impairment, and any other disorder or disabling of mind.
The term mentally disordered prisoner replaces criminal lunatic
instead of asylum, health facility and psychiatric facility are used wherever suitable.
A very practical step forward has been the introduction of a definition of informed consent for treatment.
In light of the new definition, consent would only be considered valid when it is informed, that is when the patient (or guardian or nearest relative, in case of a minor)
Adequately informed of the purpose, nature, likely effects, and risks of the treatment, including the likelihood of its success, any alternative, and the costs to be incurred.
By addressing this significant issue, an important gap in the law has been bridged.
CONSENT REGARDING DETENTION
Under the Lunacy Act of 1912, the detention of people alleged to be “lunatics” for a period of ten days, extendable by the magistrate's permission to a maximum of 30 days .
Given the rampant corruption and widespread abuse of power endemic in the Pakistani legal system, this provision was bound to be exploited.
In the new 2001 ordinance clearly limits the period of forced detention to a maximum of 72 hours.
During this time period, examination by a psychiatrist or the psychiatrist's nominated medical officer has to be ensured, and necessary arrangements must be made for starting care and treatment. It is hoped that this will prevent the widespread abuses of the law that often occurred before 2001.
CRIMINAL AND CIVIL LIABILITY
One of the most important legal issues that arise with regard to people who are mentally disordered is the issue of the extent of criminal and civil liability.
In British law, for instance, individuals who are mentally disordered qualify for the “defence of insanity and automatism”, which leads to a legally stipulated reduction in their liability for criminal offences.
Similarly, in Pakistani civil law, individuals who are mentally disordered do not have the capacity to enter into valid contracts and, hence, cannot be held liable for breach of contract.
The new ordinance, therefore, has had no bearing whatsoever on one of the most crucial questions of law pertinent to individuals who are mentally disordered: how will it be determined that someone is or is not mentally ill?
HUMAN RIGHTS
Besides stressing the requirement of informed consent, it grants patients the right to confidentiality, stipulating, “No patient shall be publicized nor his identity disclosed to the public through press or media unless such person chooses to publicize his own condition.”
Moreover, suicide, per se, is not to be considered a sign of mental illness, though persons attempting suicide must subsequently be assessed by an approved psychiatrist to ascertain their mental status.
LEGAL PROSECUTION
A list of four distinct offenses has been created by the ordinance. These crimes are
Willfully making false statements so as to discredit someone as mentally ill
Negligence of a manager of the estate of a person who is mentally disordered or such person's refusal to submit accounts
ill treatment of a patient by the staff of a psychiatric facility, and (4)
Ill treatment or exploitation, including the traditional practice of induced microcephaly of any person who is mentally ill by members of the public at large.
Punishments have been prescribed for these criminal offenses, which include fines and imprisonment ranging from six months to five years.
Induced Microcephaly: The Making of “Rat Children” Iron rings to induce microcephaly in otherwise healthy infants to exploit them as beggar was also made Punishable under the law!
Another important section of this Bill is that:
All blasphemy defendants arrested by the police are required to have a psychiatric assessment to determine whether they meet the criteria for involuntary admission under the Bill.
This clause has been inserted due to recent reports of mentally disordered defendants being excessively and disproportionately victimised under the blasphemy laws.
This clause serves to carve out some protections for the mentally disordered being prosecuted under the undiscussable Blasphemy Law of Pakistan.
Moreover,
In cases where there is clear medical evidence that some trivial criminal offending is due to an underlying mental disorder in a defendant, and that treatment of the mental disorder will mitigate future risk of offending, the Bill allows the court judge to impose a hospital order for the patient to be handed over to a psychiatrist for treatment, instead of being punished in prison.
This allows better rehabilitation for those offenders who could benefit with psychiatric treatment.
Our Commitment to Ethical Mental Health Care:
At SOCH clinics, we adhere strictly to the ethical and legal standards outlined in national and provincial mental health laws. We ensure that all treatments are administered with informed consent, confidentiality, and cultural sensitivity. We believe mental illness should never be a source of shame—and that every person deserves care grounded in dignity and science.