Introduction:
In India, Section 84 of IPC describes the defences available to the person of an unsound mind. Persons of unsound minds are vulnerable in nature. There is a complete chance of their exploitation in a situation where they are not being sought protection. The law that protects an unsound minded person and provides defence from criminal liability to the unsound minded person is known as the Law of Insanity. Whenever an insane person commits a crime due to the effect of his insanity, he does not have a guilty mind to understand that what he is doing is something that is prohibited by law. The insanity law has proven to be of practical importance in understanding the situation and the mental position of an insane person and in certain reasonable circumstances granted them exemption from criminal liability.
Origin of the Rules on the Plea of Insanity:
According to the rule of the M’Naghten, it must be clearly demonstrated, in order to establish the defence of insanity, that the accused worked under a fault at the time of the act so much as to be unaware of the nature and quality of the act he was doing. This explanation cannot be taken as a full definition of proof, as it fails to explain various aspects of insanity.
It is therefore imperative to note that the term “insanity” has a particular meaning in criminal law. It is not necessarily used in its medical sense, but its legal significance must be understood. Therefore, insanity as a defence refers to legal insanity and not medical insanity. The concept of ‘legal insanity’ refers to certain requirements to be met by the accused according to the rules laid down in the law. Legal insanity is a narrower concept than medical insanity. Legal insanity is a concept narrower than medical insanity. For example, some mental illnesses such as schizophrenia, paranoia or lunacy may overlap with the legal and medical conceptions of insanity and may also be protected against insanity or insanity of mind when the other conditions are fulfilled in order to satisfy legal insanity criteria.
English Law on the Defence of Insanity:
English criminal law considers insanity a valid defence of crime. The fundamental definition of insanity is based on the M’Naghten Rules. These rules are not about insanity medical definitions. In M’Naghten’s case, the judges declared the following insanity principles:
All are presumed to be sane and to have enough reason, until proved contrary, to be responsible for their crimes.
It must be clearly demonstrated in order to establish the defence of insanity that at the time of the act, the accused was working under such a defect of reason, from mental illness, as
He didn’t know the nature and the qualities of the act he was doing or
He did not know what he was doing was wrong.
The accused must, therefore, prove on the basis of the facts that he was suffering from a defect of reason caused by mental illness in an effort to argue insanity, because either he was unaware of the nature and quality of the act, or he had not realized that his actions were wrong.
The Mental Health Care Act, 2017 has defined mental illnesses as 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. It also includes mental conditions associated with the abuse of alcohol and drugs. A study conducted by the National Institute of Mental Health and Neurosciences (Nimhans) concluded that 13.7% of Indians suffer from mental illnesses and 10.6% of this requires immediate intervention. Out of these, nearly 1.9% of the population suffers from a severe mental disorder which includes schizophrenia, bipolar mental disorders, etc.
According to a recent National Mental Health survey, approximately 150 million people in India need care for their mental health condition. Common mental disorders, including depression, anxiety disorders and substance use disorders affect nearly 10% of the Indian population. According to the Human Right Watch, only 0.06 per cent of India’s health budget is devoted to mental health and available data suggests that state spending in this regard is abysmal. In a survey of 3,556 respondents from eight cities across India, a staggering 47% could be categorized as being highly judgmental of people perceived as having a mental illness according to the live love laugh foundation, a non-profit organization. In the same survey, it was highlighted that 26% of the individuals were afraid of the mentally ill people. Mental health patients, according to the WHO, are receiving the worst care and support possible and live their lives in a state of utter disregard by their fellow countrymen. Only 14% of individuals receive long term care and actual benefits from treatments. For every 1000 patients, there are 0.3% of health professionals available in the country. Mental hospital expenditures are not available. Increased suicides rates among citizens, decreased life expectancy, and low economic growth all are the issues that have one answer to it, healthy mental lives of the citizens.
The Mental Health Care Act: The Journey
Mental healthcare in India has had a fair share of legislation. Pre-independence existed the Indian lunatic asylum act, 1858, which was later modified to Indian lunacy act, 1912. The Act not only gave a separate term to the mentally ill but also did very little to help them, creation of asylums though was authorized was done in a minimalistic way. The lunatic word gave them social exclusion and worsened their condition. The act was drafted with the motive of protecting the people from lunatics and thus, resulted in total isolation of the lunatics leading to a grave violation of rights and cruelty. Therefore, to do away with the previous evils of the act, the mental health act was passed in the year 1987 which acted more liberally and softly towards the mentally ill.
It repealed the Indian lunacy act 1858. The act was divided into 10 chapters with 98 sections. Terms like mentally ill rather than lunatics were used. Psychiatric hospitals instead of asylums and mental hospitals were used. A more interactive and advanced system of approach was established by dividing powers between the centre and the state. Separate hospitals for juveniles were established. The procedure of admission was also modified and was made less stringent.
Some features of the Act:
Involuntary admission of the patient couldn’t exceed 90 days, the patient could come in voluntary if he is a major.
This act also recognized human rights and said that no physical or mental indignity would be given to patients.
He/she cannot be made a subject to research until and unless it benefitted him directly. Provided check on hospitals by appointing inspecting officers. Simple procedures existed for admission and discharge of mentally ill persons to hospitals.
Guardians were appointed for maintaining property and person of the mentally ill. The act gave Provision for bearing the expenses of treatment by relatives and government. Provided for a separate place for children, addicts and convicted persons.
Though the mental health act 1987, did alleviate the conditions to some level but didn’t make it the way it was supposed to be. Increased health care costs with little budget allocation, more pressure on hospitals and doctors than the government, post-discharge and rehabilitation care was not present.
Educating society was not taken as a measure, change of terminologies helped only theoretically and not practically.
The amendment of the act was critical because of two landmark developments. At the national level most exemplary amendments into the Protection of Human Rights Act of 1993 with advanced concerns of human rights and its protection, gave new dimensions and understanding to certain aspects of the society. At the International level, the most wanted ratification of the Convention on Rights of Persons with Disability in October 2007 further made it necessary to amend the laws.
In the year 2017, the mental health care act, 2017 was introduced, which repealed the earlier acts. it viewed the issue from a rights-based approach. The act was described as an act to provide mental health care and services to protect, promote and fulfil the rights of such persons during delivery of mental health care and services and for matters connected therewith or incidental thereto. The act defines “mental illness a substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgement, behaviour, capacity to recognize 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 characterized by subnormality of intelligence.”
Justice NV Ramana, Justice Mohan M. Shantanagoudar and Justice Indira Banerjee observed that Section 20 (1) of the Mental Health Care Act explicitly provides that ‘every person with mental illness shall have a right to live with dignity.’
Features:
It decriminalizes suicide and prohibits electroconvulsive therapy. It is, however, out of bounds for minors. Every person will have the right to access mental healthcare services. Such services should be of good quality, convenient, affordable, and accessible. This act further seeks to protect such persons from inhuman treatment, to gain access to free legal services and their medical records, and have the right to complain in the event of deficiencies in provisions. The act also recognizes the right to community living; right to live with dignity; protection from cruel, inhuman, or degrading treatment; treatment equal to persons with physical illness; right to relevant information concerning treatment, other rights and recourses; right to confidentiality; right to access their basic medical records; right to personal contacts and communication; right to legal aid; and recourse against deficiencies in provision of care, treatment, and services. However, the estimate of the expenditure required to meet the obligations under the law is not available. It is also not clear how the funds will be allocated between the central and the state governments. The concept of advance directive, which gives patients more power to decide certain aspects of their own treatment, has been picked up from the West. However, unlike developed countries, local factors such as existing mental health resources and lack of awareness about mental illness in India have not been taken into account. Mentally ill persons who suffer from serious psychological disorder often lack the ability to make sound decisions and do not always have a relative to speak on their behalf.
Legislations like the rights of disabilities act 2017 recognizes mental disability and provides various benefits to the mentally ill by putting tools of social inclusion in their hands.
Issues and Challenges:
It overlooks the avoidance and advancement of mental prosperity rather makes it carefully a clinical issue. The Act does not give a reasonable method of setting up the Advance Directive. Further, specialists are of the sentiment that they are in the best position to make choices on parts of treatment since patients or their designated agents may have restricted information on emotional wellness and psychological maladjustment. The Act gives a thin and limited meaning of psychological well-being experts and does exclude psychotherapists, instructors and psychoanalysts. In contrast to the Act of 1987, the Bill does not accommodate the board of property of mentally ill people. This is a genuine aim of worry as mentally ill people could without much of a stretch be abused and their property detracted from them, leaving such people in a ceaseless condition of reliance. The monetary update of the Bill does not evaluate the use required for gathering the commitments under the Bill nor does it give subtleties of the sharing of costs between the focal and state governments. Without the allotment of satisfactory assets, the usage of the Bill could be influenced.
Several states face financial constraints, the central government might have to step in to ensure funds for the implementation of the law.
Erwadi Tragedy In 2001, 28 patients who were chained at a home for mentally-ill people died after a fire that engulfed the home in Erwadi village (Tamil Nadu). The incident highlighted the need for organized and human approach to mental health care. It highlighted the reformation of jail like mental hospitals. The grave human rights violations and the utter cruelty that the patients are subjected to cannot be ignored at any point.
In Section 84 of the Indian Penal Code, a person of an unsound mind shall act- Nothing is an offence committed by someone who is currently unable to know the nature of the act or does what is wrong or contrary to legislation due to a lack of a sound mind.
Nevertheless, it should be noted that the framers of the IPC preferred to use the expression “insanity of mind” instead of the term “insanity.” Insanity’s scope is very limited, while the mind’s insanity covers a large area.
For this defence, the following elements are to be established-
The accused was in a state of unsoundness of mind at the time of the act.
He was unable to know the nature of the act or do what was either wrong or contrary to the law. The term ‘wrong’ is different from the term ‘contrary to the law.’
If anything is ‘wrong’, it is not necessary that it would also be ‘contrary to the law.’ The legal conception of insanity differs significantly from medical conception. Not every form of insanity or madness is recognized as a sufficient excuse by law.
Distinction between Legal and Medical Insanity:
Section 84 of the Indian Penal Code sets out the legal responsibility test as distinguished from the medical test. It can be observed that the absence of will arises not only from the absence of understanding maturity but also from a morbid state of mind. This morbid mind condition, which provides an exemption from criminal responsibility, differs from the medical and legal point of view. According to the medical point of view, it is probably correct to say that every person, when committing a criminal act, is insane and therefore needs an exemption from criminal responsibility; while it is a legal point of view, a person must be held to be the same as long as he is able to distinguish between right and wrong; as long as he knows that the act carried out is contrary to the law.
It has been ruled by the Supreme Court that “mentally ill” people and psychopaths are unable to seek immunity from a criminal case, as it is their responsibility to demonstrate insanity at the time the crime was committed. So in practice, not every person who is mentally ill is exempt from criminal liability. There has to be a distinction between legal insanity and medical insanity. “Arijit Pasayat and the Bench of Justices, DK Jain, stated while upholding the life conviction of a man who cut off his wife’s head. The mere abnormality of mind, partial delusion, irresistible impulse or compulsive behavior of a psychopath does not provide protection from criminal prosecution as provided by the apex court held Section 84 of the Indian Penal Code (IPC). The Bench stated that Section 84 of the IPC, which provides immunity from criminal prosecution to persons of unsound mind, would not be available to an accused, as the burden of proving insanity would lie with them, as provided in Section 105 of the Indian Evidence.
In the case of Hari Singh Gond v. State of Madhya Pradesh[1], the Supreme Court observed that Section 84 sets out the legal test of responsibility in cases of alleged mental insanity. There is no definition of ‘mind soundness’ in IPC. However, the courts have mainly treated this expression as equivalent to insanity. But the term ‘insanity’ itself does not have a precise definition. It is a term used to describe various degrees of mental disorder. So, every mentally ill person is not ipso facto exempt from criminal responsibility. A distinction must be made between legal insanity and medical insanity. A court is concerned with legal insanity, not medical insanity.
In the case of Surendra Mishra v. State of Jharkhand[2], It was pointed out that ‘every person suffering from mental illness is not ipso facto exempt from criminal liability.’ Furthermore, in the case of Shrikant Anandrao Bhosale v. State of Maharashtra[3], the Supreme Court, in determining the offense under Section 84 of the IPC, held that’ it is the totality of the circumstances seen in the light of the recorded evidence’ that would prove that the offense was committed.’ It was added: “The unsoundness of the mind before and after the incident is a relevant fact.”
Unsoundness of mind must be at the time of the commission of the Act.
The first thing a court to be considered when defending insanity is whether the accused has established that he was unsound at the time of committing the act. The word “insanity” is not used in Section 84 of the penal code.
In Rattan Lal v. State of M.P[4], it was well established by the court that the crucial point of time at which the unsound mind should be established is the time when the crime is actually committed and whether the accused was in such a state of mind as to be entitled to benefit from Section 84 can only be determined from the circumstances that preceded, attended and followed the crime. In other words, it is the behavior precedent, attendant and subsequent to the event that may be relevant in determining the mental condition of the accused at the time of the commission of the offense but not those remote in time.
In Kamala Bhuniya v. West Bengal State, the accused was tried for her husband’s murder with an axis. A suit was filed against the accused, she alleged to be insane at the time of the incident, the investigating officer recorded at the initial stage about the accused’s mental insanity. The prosecution’s duty was to arrange for the accused’s medical examination, it was held that there was no motive for murder. The accused made no attempt to flee, nor made any attempt to remove the incriminating weapon Failure on the part of the prosecution was to discharge his initial responsibility for the presence of mens-rea in the accused at the time of the commission of the offence. The accused was entitled to benefit from Section 84. And hence accused was proved insane at the time of the commission of the offence and was held guilty of Culpable Homicide and not of Murder.
Incapacity to know the nature of the act:
The word “incapacity to know the nature of the act” embodied in Section 84 of the Indian Penal Code refers to that state of mind when the accused was unable to appreciate the effects of his conduct. It would mean that the accused is insane in every possible sense of the word, and such insanity must sweep away his ability to appreciate the physical effects of his acts.
Incapacity to know right or wrong:
In order to use the defence of insanity under the latter part of Section 84, namely “or to do what is either wrong or contrary to the law,” it is not necessary that the accused should be completely insane, his reason should not be completely insane, his reason should not be completely extinguished. What is required, is to establish that although the accused knew the physical effects of his act, he was unable to know that he was doing what was either “wrong” or “contrary to the law.” This part of Section 84 has made a new contribution to criminal law by introducing the concept of partial insanity as a defence against criminal insanity. However, as a practical matter, there would probably be very few cases in which insanity is pleaded in defence of a crime in which the distinction between “moral” and “legal” error would be necessary. In any crime, insanity can undoubtedly be pleaded as a defence, yet it is rarely pleaded except in murder cases. Therefore, in a case, this fine distinction may not be very useful for the decision. The Indian penal code has advisably used either “wrong or contrary to the law” in Section 84, perhaps anticipating the controversy.
Rights under Mental Health Care Act, 2017:
The Mental Health Care Act, 2017 has been looked upon as a historical intervention in the field of medical healthcare. It has been termed as a ‘pro-right’ document for the PMI.
Right to make an advance directive:
The Act gives the right to persons with mental illnesses to make advance directive with respect to the way the person should and should not be treated in case of his mental illnesses. Further, in the advance directive, he also has the right to appoint a nominee who has the duty to act on his behalf in taking treatment decisions and all other purposes as given in the Act which has to be in the best interest of the PMI.
Right to access healthcare services:
The PMI has the right to access a mental health care or service provided or funded by the government. The Act provides that such mental health care services have to be acceptable to the PMI and their families, among other criteria.
The services provided should be affordable and of good quality so that financial status is not an impediment for persons suffering from mental disorder. Moreover, it is the right of the PMI that the quality of the services is not compromised.
The services have to be in sufficient quantity and geographical inaccessibility should not be a hindrance anymore for the PMI. Thus, the Act ensures that the PMI does not have to travel far to access treatment.
For this, the Act also casts a duty on the government to ensure that healthcare facilities should be available in each district which is run or funded by the government. Moreover, if the government fails to provide such facilities in the district of a PMI, then it is the duty of the government to ensure that the facility at any other health centre is accessible to him, the cost of which is to be borne by the appropriate government.
Discrimination on any grounds such as gender, sex, sexual orientation, class, religion, caste, etc. is prohibited in the rendering of mental health care services.
Right to free of cost healthcare services:
The persons living below the poverty line or persons who are homeless or destitute have the right to avail the mental health care services and facilities free of cost and no financial cost, whatsoever, in the government-run or government funded establishments. Moreover, the appropriate government can also designate other healthcare centres where this provision shall be made available. Further, all persons with mental illnesses have the right to avail all the medicines enlisted in the Essential Drug list, notified by the appropriate government, at free of cost. Such availability has to be made by the government at all the state-run and state-funded health establishments.
Right to live in a community:
The government is obligated under the Act to provide such healthcare facilities so as the person suffering from mental illnesses is able to live in a community, along with his family. Such persons cannot be secluded from society and if it is so impossible for them to live with the family or the person has been abandoned by the family, it is the duty of the government to provide aid. Moreover, the mother of a child who is below three years has the right not to be separated from her child for the reason for her being mentally ill. This right can be reasonably restricted if there is a risk of harm to the child and the child can be temporarily separated from the mother.
Right to protection from cruel, inhuman and degrading treatment:
The roots of the right to a dignified life lie in Article 21 of the Constitution. This has been incorporated in the Mental Healthcare Act too which lays down that every person suffering from mental illnesses has a right to live with dignity. Moreover, such persons also have the right to be protected against cruel, inhuman and degrading treatment in any health establishment. Also, there are various other rights provided to them such as the right to a safe and hygienic environment and other conditions such as the right to privacy.
Right not to be treated under prohibited treatment:
The Act completely prohibits electroconvulsive therapy for children. Even for adults, the therapy has been performed by taking certain precautions such as using muscle relaxants and anaesthesia.
Right to equality and non-discrimination:
The persons with mental illnesses have the right to be treated equally with the physically ill patients at the time of treatment, i.e. with respect to emergency services, ambulance services, etc. Moreover, no discrimination shall be made on any basis which shall include gender, sex, sexual orientation, religion, culture, caste, social or political beliefs, class or disability.
Right to information:
The Act assumes that every person, including persons with mental illnesses, have the capacity to make decisions. Thus, the Act provides that any decision made should be an informed one. Therefore, such a person has the right to know the provisions of the Act under which he has been admitted, along with the criteria for the same. The person has also the right to know all the facets of the treatment for which he has been admitted, which includes the information of the side-effects of such treatment. Such information has to be made in an understandable language to the person who has been admitted and his nominated representative.
Right to confidentiality:
It is the right of every person with mental illnesses has a right that the details with respect to his mental illnesses and treatment are protected under confidentiality. Such confidentiality is also extended to the information stored in digital or electronic form. Thus, duty has been casted upon the health professionals for not revealing any such information subject to certain exceptions such as to prevent harm, in the interest of public safety and security, etc. Moreover, such information can also be released to the nominated representative and other health professionals for the purpose of treatment.
Right to legal aid and complaint:
Article 39A of the Constitution lays down the directive of free legal aid. This has been incorporated under the Act for persons with mental illnesses who can seek legal aid to exercise the rights provided under the Act. He also has the right to be informed about this right by the appropriate authority. Further, the person is also entitled to the right to complain with respect to the deficiency in mental health care services or facilities provided to him.
Along with these rights, there are other rights too such as the right to access medical records and the right to personal contacts and communication. The latter includes the right to refuse any visitor and communication made to him.
For the effective implementation of these rights, the Act also lays down the duties of the appropriate government along with the establishment of the Central Mental Health Authority. Further, to reach ground level implementation, the Act also provides for State Mental Health Authority, among other authorities.
Rights and disabilities of persons with mental illnesses under other laws:
The persons with mental illnesses have been given certain rights but along with that, the law has also taken away their certain rights.
Right to enter into a contract:
Such persons cannot give valid consent under the eyes of the law because of the incapability to understand the nature of the contract and to form a rational judgment. Therefore, they do not have the capacity to enter into a valid contract, except during lucid intervals under the Indian Contract Act, 1872. Lucid intervals mean the time when the person is not in the clutch of his mental illnesses.
Right to marry:
Marriage is governed by various personal laws. The Hindus are governed by the Hindu Marriage Act, 1955 which incapacitates a person suffering from mental illnesses to give a valid consent and hence, fulfil the requirement of a valid marriage. Similar provisions can be found in laws of other religions such as Muslims, Christians, etc. Even the Special Marriage Act, 1954 does not recognise the marriage as valid if consent is given by a person with mental illnesses. However, under all these personal laws, such marriage is not void but voidable.
Right to vote or hold public office:
The person with mental illnesses does not have the right to register in an electoral roll under the Representation of People Act 1950. Such mental incapacity has to be declared by a competent court. Thus, such person is disqualified from holding public office under the Constitution of India such the office of President, Vice-President, Members of Parliament, etc.
Right to make will:
A person suffering from mental illnesses cannot make a valid will, except during lucid intervals under the Indian Succession Act, 1925. This is because the person cannot understand the nature of the testamentary document because of such illnesses.
Right to not be held liable for a criminal offence:
The Indian Penal Code, 1860 exempts the persons with the unsound mind from criminal liability. This is because of the fact that one of the most important elements i.e. mens rea is missing from the offence. As there is no guilty mind, there can be no criminal liability
4 major shift in law for people with mental illnesses:
The law keeps on developing as per the needs of society and so has the law for mentally ill people. The development in the legal field with respect to such people can be traced through the following points.
After the invent of British in India, various laws were enacted to deal with mental illness and their care and treatment. Some of the laws which basically dealt with the establishment of mental asylums and the procedures to deal with mentally ill people are enlisted below.
The Lunacy (Supreme Courts) Act, 1858
The Lunacy (District Courts) Act, 1858
The Indian Lunatic Asylum Act, 1858 (with amendments passed in 1886 and 1889)
The Military Lunatic Acts, 1877.
During the first decade of the 20th century, public awareness about the pitiable conditions of mental hospitals accentuated as a part of the growing political awareness and nationalistic views spearheaded by the Indian intelligentsia. This led to the enactment of the Indian Lunacy Act, 1912. This resulted in a central legislation to deal with mental illness. However, the law dealt with the treatment and the procedural part and was not right-centric for the people suffering from mental illnesses.
The post-second world war saw the adoption of the Universal Declaration of Human Rights (UDHR) by the UN General Assembly. This demanded a further change in law for protecting the rights of mentally ill people. Thus, the Indian Lunacy Act, 1912 was replaced with the Mental Health Act, 1987. This Act dealt with the provisions such as human rights of such people and protection of their property, among other things.
The 4th major shift is the enactment of Mental Healthcare Act, 2017 which has provided for various rights of people with mental illnesses and has been enacted to remove the defects in the earlier law.
Conclusion:
In the wake of momentum rights arousing procedure inundating the world, the need of an increasingly sympathetic methodology towards our own one of a kind kinsmen .psychological wellness isn’t a malady or an issue to be looked down on, it’s something equivalent to having a cold or a viral fever which can be relieved. Given the correct sort of consideration. Dismissing it will just compound it. Enactments have constantly encompassed an issue, however just on the off chance that it could help reduce the continuous issues of the harmed. Teaching and sharpening the natives appears the best way to approach this issue. The absence of training at the piece of the natives in managing rationally sick is an unsettled issue. Disguise as opposed to systematization is the roadway to managing emotional well-being issues and accomplishing better monetary social and social worldwide guidelines.
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