Mental Health and the Law

Law Association for Asia and the Pacific) organised an interdisciplinary seminar at Madras on "The strategies for Professional Collaboration to Promote the Rights of the Mentally 111", which was attended by members of the legal and mental health profession. While an atmosphere of bonhomie prevailed, there were also undercurrents of mutual discomfort. This discomfort was generally due to fears of trespass by the other profession into the area perceived as one's own territory. Differences in viewpoint are, however, not entirely unfounded. "When a psychiatrist examines an individual at the request of court most of the principler that usually govern the doctor-patient relationship are altered" (Chiswick, 1985). As Rappeport (1981) has noted, for the psychiatrists the court is "another house.... with its different motives, goals and rules of conduct". While the psychiatrist is concerned primarily with the diagnosis of mental disorders and the welfare of the patient, the court is often mainly concerned with the determination of competency, dangerousness, or diminished responsbility and/or the welfare of other members of society. While the court is concerned with attribution of responsbility (or its lack), there is a distinct tendency among psychiatrists to be philosophical determinists based on the implicit assumption that, that which had a cause can not be freely willed, a philosophical error dating back to antiquity. Legal and mental health professionals often fail to understand each other's disciplines and problems. Several courts, both Indian and foreign, have criticized psychiatric testimony for the use of ununderstandable jargon. Psychiatrists, on the other hand, complain that the law has not kept pace with advances in psychiatry. The law is concerned with the determination of legal status and not about hypothetical explanations of behaviour. A court has noted that, "a person does not become a 'Lunatic' under the lunacy act on the debatable niceties of psychological and psychiatric theories.... it is not ultimate responsibility of the mental specialists and specialist doctors whose views are always entitled to great deference.... to find out and hold that a person is a 'Lunatic' " (Ranjeet Kumar Ghose V. Secretary, Indian Psychoanalytical Society, 1963, 1 Cri.LJ 579). However, the courts, often sharing the layman's concept of "insanity", have sometimes been skeptical of diagnoses like delusional disorder or even paranoid schizophrenia as a defence when the patient does not appear to be obviously mentally disordered. Psychiatrists must communicate with the legal profession in a language understandable and meaningful to it. …