Forensic psychiatry

FORENSIC
PSYCHIATRY
DR. HIMANSHI

PSYCHIATRY
It is branch of medicine which deals with the study, diagnosis and treatment of psychiatric
illness.

FORENSIC PSYCHIATRY
Forensic psychiatry deals with the application of knowledge of psychiatry in the administration
of law and justice.
Law Psychiatry
Forensic
Psychiatry

FATHER OF FORENSIC PSYCHIATRY
Paul Zacchias

Components of Crime
Components
Actus Rea
Criminal Act
Mens Rea
Criminal
Mind

SYMPTOMS IN INSANITY
SYMPTOMS
Hallucination Illusion Delusion Impulse

HALLUCINATION
A false sensory perception without external stimulus.
Not always a sign of psychosis.
Causes:
1. HALLUCINATIONS OCCUR IN FEVER, INTOXICATION OR INSANITY.
2. Person may commit suicide or homicide.

HALLUCINATION contd..
Types of Hallucination
1.Auditory
1.hearing imaginary voices.
It is most common type.
Visual
perceiving non existent
images.
Olfactory
perceiving non existent
odour.
Gustatory
perception of taste without
any apparent stimulus.
Tactile hallucination
person imagines that rats
and mice are crawling into
his body. Eg. Magnan
symptom or cocaine bugs or
formication.
VOFA: Visual (Organic Brain Disorder) (Functional Brain Disorder) Auditory
Gustatory and olfactory: Temporal lobe epilepsy
Auditory: Paranoid Schizophrenia

ILLUSION
Misinterpretation of a real external stimulus.
May misinterpret a dog as a lion or a rope to be a snake or a branch of a tree to be ghost or a
man as a wild animal.
A sane person may experience an illusion but is capable of correcting it.
An insane person continues his perception even when the real facts are clearly pointed out.

DELUSION
It is a false, firm, fixed belief in something which is not a fact and inconsistent with his social
background and persists even after its falsity is clearly demonstrated.
It is a disorder of thought/cognition.
It is medico-legally important because the person cannot be regarded as fully responsible for
anti-social acts as delusion may lead a person to commit suicide, murder or any other crime.

Delusion contd.
Types of
Delusion
1.Delusion
of grandeur
or
exaltation
Delusion of
persecution
Delusion of
influence
Delusion of
infidelity-
Also known
as OTHELLO
SYNDROME
.
Delusion of
nihilism- It
is seen in
major
depression.
Delusion of
hypochond
riac
Self
reproach-
the person
accuses
himself for
things that
happened
in past.
Erotomania
(deClemba
urat
Syndrome)
Fregoli
Syndrome
Capgras
Syndrome
(delusion of
misidentific
ation)

IMPULSE
A sudden and irresistible force compelling a person to the conscious performance of some
action without motive or forethought.
A sane person is capable of controlling the impulse but an insane person does things on impulse.
Suicidal and homicidal impulses are commonly encountered in acute mania.
May lose self control and commit crime eg out of anger.
Criminally responsible unless insanity is present.

Impulse contd.
Types of
Impulse
1.Kleptomania 1.Pyromania Mutilomania Dipsomania Trichotillomania

Phobias
Excessive and irrational fear of a particular object or situation
1. Agoraphobia – fear of open space.
2. Acrophobia – fear of height.
3. Claustrophobia- closed space fear.
4. Nyctophobia- fear of darkness.
5. Mysophobia – dirt.
6. Xenophobia- excessive fear of strangers.

SOMNAMBULISM
Walking during sleep.
Person is not asleep but in a state of dissociated consciousness, in a hallucinatory state,
unrelated to his immediate environment.
He may commit suicide or meet an accident.
Usually no recollection of the event but may be repeated in a subsequent fit.
The person is NOT criminally responsible for his acts.

Psychosis
Characterized by withdrawal from reality and living in a world of fantasy.
Disturbance in personality.
Loss of insight.
Presence of delusions and hallucinations.
Eg schizophrenia, mood disorders.

Delirium
Crime may be committed due to hallucination or delusion.
Person is not responsible.
DELIRIUM TREMENS- Delirium in an alcoholic who is deprived of his dose for a 72-96hours. He is
restless, irritable, aggressive, abusive etc.
NOT responsible for his criminal acts.

Neurosis
NO loss of touch with reality.
Presence of insight.
Contact with surrounding preserved.
Eg anxiety disorders, phobias, OCD.

LUCID INTERVAL
Period of sanity between phases of insanity.
It has to be diagnosed by a doctor.
Person is responsible for acts done during this period.
Can give evidence.
Can make a valid will.
NB- LUCID INTERVAL is also found in epidural hematoma (Period of consciousness between two
periods of unconsciousness)

LAWS OF INSANITY
Laws of Insanity
A American Law
Institute Test
Adequate Capacity to
Appreciate the criminality
of conduct is lost
B Browner Law
Substantial capacity to
appreciate the
wrongfulness of act is
lost.
C Currens Law
Capacity to Regulate the
conduct according to
requirement of the law.
D Durhams Law
Product Test. Criminal Act
is product of mental
disease or illness.
E (IR) Irresistible
Impulse Test (New
Hampshire Doctrine)
Free agency of will is
destroyed.
ABCDE

Mc NAUGHTENS RULE, 1843
Daniel McNaughtens was a
Scottish Wood Worker
Suffering from Paranoid
Schizophrenia
Mc Naughten thought that
catholic priests were
conspiring to kill him and the
PM was helping them.
Killed Edward Drummond;
the private secretary to the
prime minister Sir Robert
Peel, thinking him to be the
PM himself.

MC NAUGHTEN’S RULE CONTD.
Mc Naughtens Rule Section 84 IPC
An accused person is not legally responsible if it is
clearly proved that at the time of committing the
crime, he was suffering from such a defect of
reason from abnormality of mind that he didn’t
know the nature and quality of the act he was
doing (or) what he was doing, was wrong.
“Nothing is an offence which is done by a person
who at the time of doing it, by reason of
unsoundness of mind is incapable of knowing the
nature of the act, OR that he is doing what, is either
wrong or contrary to the law.”
In Mc Naughten, the person is not legally
responsible for the offence
According to section 84 IPC, the act is not even an
offence.
Disease of mind unsoundness of mind.

ASPECTS OF BRAIN FUNCTION
Aspects
of Brain
Function
Cognitive
Emotional
Motor

RESPONSIBILITIES OF A MENTALLY ILL
PERSON
Civil responsibility
Criminal responsibility

Civil responsibilities
1. Management of property
Chapter 6 of mental health act 1987.
If the person is incapable of managing his property, the honorable court (or) the collector
may appoint a person to look after his property or sale the same to fulfill his expenses or to
pay his debts.

Civil responsibilities contd.
2. Consent – invalid ( section 90, IPC)
3. BUSINESS CONTRACT (Indian contract act 1872)
invalid if one of the party is of unsound mind.
Valid if unsoundness started after formulation of contract.
Valid if made during lucid interval.

4. Evidence – not incompetent if he understands the questions and can give rational answer
(section 118 IEA)
Can give evidence in lucid interval.
5. Tort liabilities- respect to general rights of others.
person is liable for tort as long as his disease is not so great that he does not understand the
nature and consequences of the act.

6. Guardianship- cannot act as a legal guardian for a minor.
7. Marriage- according to Hindu MARRIAGE ACT 1955, THE MARRIAGE becomes null and void if at
the time of marriage
either party was unable to give valid consent
Due to unsoundness of mind, is unfit for marriage or procurement of children
Has been subject to recurrent attack of insanity.

Christian marriage is voidable if either party was a lunatic or idiot.
Parsi marriage act- unsoundness of mind is not ground of annulment.
Muslim law- marriage is void but if the guardian of the person thinks the marriage to be in his
interest or in the interest of society and willing to take the monetary obligations of the marriage,
then such a marriage can be performed.

Section 13, Hindu marriage act
divorce can be granted to the spouse on the basis that the other party has been incurably of
unsound mind and has been suffering continuously from such mental disorder that the
petitioner cannot reasonably be expected to live with the respondent.
Same is true also for parsi marriage act, special marriage act and divorce act.

A muslim woman can also seek divorce if her husband has been insane for two years.
Indian divorce act, 1869 amendment and 2001 amendment for christians- incurable insanity and
insanity for two years immediately before filing the petition are grounds for divorce.

8. Transfer of property – not competent.
9. Adoption- according to Hindu adoption and maintenance act 1956
A MAJOR HINDU MALE OF SOUND MIND CAN ADOPT A CHILD WITH CONSENT OF HIS SOUND
MINDED WIFE
A major and unmarried Hindu female of sound mind can adopt a child.
Adoption is not recognised among christians, parsi and muslims.

10. TESTAMENTARY CAPACITY Sec 31 IPC
CAPACITY OF A PERSON TO MAKE A VALID WILL
The person should be of sound mind.
Should understand the nature of the will.
Has knowledge of his property to be disposed.
Recognizes the persons having moral claims to heir his property.
Not under the influence of any person.
Can make will in lucid interval.

Holographic will- will written by the testator in his own handwriting.

CRIMINAL RESPONSIBILITY
CRIME- A behavior which violates the law and is punishable.
PUNISHMENT- PENALTY GIVEN TO A PERSON FOR VIOLATING THE LAW.
AN INSANE PERSON-
1. Can’t be convicted if at the time of committing the crime, he was insane,
2. Can’t undergo trial,
3. Can’t be given capital punishment.

SECTIONS RELATED TO FORENSIC
PSYCHIATRY
SECTION 82- criminal responsibility of a child below 7 years of age. NOT responsible.
Section 83- responsibility of a child between 7 to 12 years. Maturity should be determined.
Section 84- criminal responsibility of insane.
Section 85- criminal responsibility of an intoxicated person.
Section 86- criminal responsibility of a voluntarily drunken person. Person is responsible.

MENTAL HEALTH CARE ACT, 2017
Indian Lunacy
Act, 1917
Mental Health
Act, 1987
Mental Health
Care Act, 2017

Mental Illness
“mental illness” means a substantial disorder of thinking, mood, perception, orientation or
memory that grossly impairs judgment, behaviour, capacity to recognise reality or ability to
meet the ordinary demands of life, mental conditions associated with the abuse of alcohol and
drugs, but does not include mental retardation which is a condition of arrested or incomplete
development of mind of a person, specially characterised by subnormality of intelligence;

SALIENT FEATURES MHCA, 2017
Mental asylums now called as Mental Health establishments.
MHRB Mental Health Review Board
CHAPTER 3: ADVANCE DIRECTIVE
Sec 5(a) how to be cared for;
Sec 5(b) how not to be cared for;
Sec 5 (c) Nominated Representative

RIGHTS OF PWMI
RIGHTS OF PERSONS WITH MENTAL ILLNESS
Right to live with
Dignity
Right to access mental
health diagnosis and
treatment
Right to information
Right to
confidentiality
Right to access their
basic medical records
Right to free legal aid
CHAPTER 5

PROHIBITIONS AND RESTRICTIONS
PROHIBITED PROCEDURES Section 95
1. Unmodified ECT
2. ECT in case of minors
3. Sterilization
4. Chaining

PROHIBITIONS AND RESTRICTIONS
Restriction on Psychosurgery Section 96
Restraints and seclusion Section 97
Decriminalization of Suicide Section 115

ADMISSIONS IN MHE
Admission
Voluntary
Requests his/her own
admission Sec 86
Admission of Minor
Section 87
Involuntary/
Supported
When nominated
representative
requests Section 88
and 89

PENALITIES
Penalties
For establishing or maintaining mental
health establishment in contravention of
provisions of this Act
First Contravention: Rs. 20000
Second Contravention: Rs. 2lakh
Subsequent Contravention: Rs.
5lakh
Punishment for contravention of
provisions of the Act or rules or
regulations made thereunder
First Contravention: Rs. 50000 or
6months or both.
Subsequent Contravention: Rs. 5
Lakh or 2 years or both

TRUE INSANITY VS. FEIGNED INSANITY
Features True Insanity Feigned Insanity
Onset Gradual Sudden
Motive Absent Always motive is present
Predisposing Factor Usually present, such as mental shock, frustration,
monetary loss, mental illness in parents
Absent
Signs and symptoms All uniform all the time, even when observed or
not, they point to particular type of insanity
Are irregular or even exaggerated specially if he thinks
that he is being observed
Facial expression Vacant look or peculiar look of excitement or
depression
Voluntary exaggerated of facial
Appetite and food Can resist drink for a day or two and food for
several days.
Tries to pose so but fails always, can not stay without
food for days.
Sleep May suffer from insomnia for nights together May with difficulties pass sleepiness nights for 1-
2days but not thereafter.
Habits Ordinarily dirty and filthy Clean and not dirty in habits

Forensic psychiatry

More Related Content

What's hot

Similar to Forensic psychiatry

Recently uploaded

In this document

Forensic psychiatry