KARACHI: Experts see flaws in law on mental health
By Our Staff Reporter
KARACHI, Oct 21: Participants of a workshop on Mental Health Ordinance 2001 expressed satisfaction over the repeal of the Lunacy Act 1912 and said that the present law appears to be very difficult to implement because of serious lacunas in it.
The workshop, organized by Pakistan Association for Mental Health, was of the view that the new law had made tall promises, which were not in conformity with the ground realities. The participants undertook to propose to the government the steps which should be taken to make the law workable in the best interest of the patients and the scientific practice of psychiatry.
Prof Haroon Ahmad, president, Pakistan Association for Mental Health, said that the mental health policy should be financially feasible and culturally relevant.
Suggesting abolition of mental hospitals, he called for the setting up of hostel-type accommodations in each district for the purpose.
The ordinance was promulgated in February and the rules of law were yet to be framed, he said, adding that if the required rules were not worked out at the earliest it was feared that the law would be put in a cold storage.
He underscored the need to strengthen psychiatry education at all levels, given the fact that there were at present only 200 qualified psychiatrists in the country. He also called for specialized training of nurses and paramedical staff for the care of the mentally ill.
Dr Waris Qidwai of the Aga Khan University Hospital said that the ordinance was very comprehensive and the role of family physicians was clear.
He said the family physicians could play very important role in the promotion of mental health and prevention of mental illness.
Since the family physicians still provided care to a bulk of mentally disordered patients, their representation in the federal mental health authority must be ensured, he added.
Zia Awan of the Lawyers for Human Rights and Legal Aid said that the promulgation of the ordinance to replace the anachronistic Lunacy Act 1912 represented a watershed in changing public perceptions on mental illness.
He said that there were several laudable clauses, showing significant reforms of the old ways of the Lunacy Act. However, there was room for improvement.
While discussing sub-section 7, which states that “after obtaining temporary leave if the patient does not return, and the magistrate is satisfied with the report and its reasons, he may direct the police to locate and produce him,” Mr Awan said that the services of the police must be kept to a bare minimum given their record and reputation.
“There is a need to sensitise police personnel, including those with a maximum public dealing, rather than the officer class,” he said.
Also a provision may be included specifying that in the case of female patients, female staff should be deployed as a mandatory measure to minimise chances of abuse, he said.
IA Rahman from the Human Rights Commission of Pakistan, while giving a human rights perspective on the law, said that some utterly vulgar expressions, such as lunatic, criminal lunatic and idiot, had been taken out of the law.
He said the use of the derogatory words was clearly in violation of the affected people’s basic human rights related to personal dignity.
He said there was also room for satisfaction that the new law considered it expedient to provide for the promotion of mental health and prevention of mental disorder and that the law makers have condescended to include a chapter under the title “protection of human rights of mentally disordered persons.”
However, he said, both these gestures lacked adequate comprehension of the right to mental health. “It may be said in mitigation of the law makers’ lapse that the international community too has been slow in explicitly recognising this right.”
According to him, demands for respect for human rights could not be fulfilled by only adding a chapter to any law. “Human rights today constitute the supreme set of civilizational values that must inspire our state, our politics, our economic managements, the content of education, and our entire social code,” he added.
He said respect for human rights must inspire the whole text of a law on mental health. Once this concept is accepted it would be possible to revise the composition of the federal mental health authority and the visiting board to include human rights authorities.
“What can be said at the moment is that all of us have to struggle for quite some time to change the thinking and behaviour of the lawmakers and administrators before we can say that we have done our duty to our fellow beings who are only more disadvantaged than those of us who boast of freedom from mental disorder,” he said.
The participants of the workshop also highlighted the lack of interest shown by the medical students in the study of psychiatry, saying since most of the students were “exam oriented” they show very little interest in the subject.
It was stated that there was a need for setting up mental health courts.
The role of Edhi Centre for the mentally disordered people came under severe criticism by some of the participants, who called for monitoring of the methods employed at the centre.
The participants decided that, while massive public awareness on mental health diseases would be carried out, the Association for Mental Health would take the initiative of sensitizing the caretakers of tombs/shrines about the actuality of the ailment.
The workshop was held in two sessions, each presided over by Sindh Ombudsman Justice Haziqul Khairi and Justice Nasir Aslam Zahid.
The others who spoke included Dr Abul Faizi, Justice Rahim Kazi, Dr Aziz Tank, Dr Muzaffar Hussain, Zia Awan, Jabbar Khattak, Dr Khalid Mirza, Dr Uzma Ambareen, Zubeida Mustafa, Sheen Farrukh, Hamid Maker, Dr Amanat Mohsin, Dr Muneer Junejo, Anis Haroon, Dr Anwar Mangi, and Arif Ishaq.
