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Mental health bill

August 26, 2012


THIS refers to the excellent report, ‘Victimisation of mentally challenged girl’ (Aug 20). The story came on the heels of the Bahawalpur incident of burning alive of a mentally ill ‘blasphemer’ reported in Dawn (Aug 4). Apart from blasphemy as a law (which needs serious scrutiny), my problem as a psychiatrist is what do you do with a schizophrenic/psychotic who is not aware (responsible) of his/her actions due to reasons of an illness of which again he/she is not responsible?

The 11-year-old Christian girl in question suffers from Downs Syndrome. These patients can be easily identified even by a lay person due to their facial features.

The three factors in her life, i.e. minority, minor and a ‘special child’ (new name for intellectual subnormality) calls for protection rather than punishment.

Zia Awan’s observation that the Mental Health Ordinance 2001 (MHO 2001,) now defunct, would have given her a sensible way out is optimistic because there is no mention of compulsory psychiatric assessment for such unfortunate patients. Although for attempted suicides, section VII (49) states: "A person who attempts suicide shall be assessed by an approved psychiatrist..."

A new Sindh Mental Health Act 2012, prepared by the Pakistan Association for Mental Health, has been submitted to and lying with the Sindh health department, since January 20 this year.

It is a consensus document with the input from leading lawyers and other stakeholders. In this act a provision is included which calls for mandatory evaluation of such persons by an approved psychiatrist. Advocacy for early vetting by the law ministry and onward to Sindh Assembly is solicited by all concerned citizens.

However, in this case, besides sections 82 and 83 of the Pakistan Penal Code (dealing with minor), section 84 of PPS very clearly says: “Nothing is an offence which is done by a person who, at the time of doing it, by reason of unsound mind incapable of knowing the nature of the act or that he/she is doing what is either wrong or contrary to law”.

The legal community should also take note and act.

Besides legal protection, the bigger issue is the recently learnt behaviour by a section of the population to pronounce instant judgment and its execution (burning, beating to death of even small-time thieves).

Mental health awareness and the judicial system giving weight to the well-known concept of ‘Diminished Responsibility’ are but a small step forward.


A constrast

I UNDERSTAND it is a regular Islamic practice to delay the ritual sacrifice of the animal during Eidul Azha if it is found that the animal suffers from an illness. The illness must be treated first, before anything else happens.

Yet the mentally disordered minor from Mehrabadi village and the mentally disordered man from Bahawalpur (Dawn, Aug 4) were held responsible for their actions and, in the case of the latter, pitilessly punished for their alleged blasphemies by being burnt alive.

Does Islamic practice in Pakistan not extend compassion from the sacrificial beast to the human being?

Blasphemy law politics aside, there is a prima facie law of humanity which requires us to show compassion to the ill among us.

The Pakistan Association for Mental Health has recently circulated a remarkably progressive Sindh Mental Health Bill 2012 which enshrines robust protections and safeguards for all mentally disordered citizens in society, whilst ensuring that they receive the appropriate treatment for their mental disorder, and not punishment.

Perhaps time has arrived for the Sindh Assembly to enact this law and show the way to other provinces. I believe the bill is currently with the provincial law ministry.