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8/7/2019 MENTAL UNSOUNDNESS seminar
http://slidepdf.com/reader/full/mental-unsoundness-seminar 1/23
8/7/2019 MENTAL UNSOUNDNESS seminar
http://slidepdf.com/reader/full/mental-unsoundness-seminar 2/23
SYNONYMS-Mental deficiency, mental
handicap, mental sub normality, mental
illness , amnetia ,insanity, madness,lunacy or disease of personality
8/7/2019 MENTAL UNSOUNDNESS seminar
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Disease of mind or the personality , in
which there is derangement of the
mental or emotional processes andimpairment of behavioral control
OR
State of mind in which person loses thepower to regulate his actions , reasoning
and conduct and is unable to adjust toordinary social requirements.
8/7/2019 MENTAL UNSOUNDNESS seminar
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1. HISTORY TAKING - To be done very
intimately and patiently only after taking the
patient into full confidence.a)Present complaints and difficulties
b)Family history-mental condition of parents,whether alive or dead.
c)Personal history
-date and place of birth
-normal/instrumental labour
-brought up by mother or any other person
8/7/2019 MENTAL UNSOUNDNESS seminar
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-infancy and childhood-schooling
-occupation and place of work
-menstrual history in females
-sexual life-marital history
-personal habits
-h/o physical illness and/or previousmental illness
-personality
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2.EXAMINATION OF THE PHYSICAL STATE:-
-examination of all body systems-
respiratory ,cardiovascular , nervous.
-sensory and motor functions-reflexes
,gait-condition of skin ,tongue , lips, body
temperature
8/7/2019 MENTAL UNSOUNDNESS seminar
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3.EXAMINATION OF MENTAL STATE:
-general apperance and behavior
-attitude and posture
-facial expressions
-speech, dress ,manner
-stupor,overactivity
-behavior
-personal habit-talk
-mood
8/7/2019 MENTAL UNSOUNDNESS seminar
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-mental content-disorder of perception
-state of conciousness
-judgement and insight-orientation
-compulsive phenomena
-memory, intelligence
-sleep
8/7/2019 MENTAL UNSOUNDNESS seminar
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4. LAB INVESTIGATIONS:
-Blood and urine analysis
-X-ray of the skull
-C.S.F. analysis
-E.E.G
-Scanning test
8/7/2019 MENTAL UNSOUNDNESS seminar
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5.OBSERVATION:
An alleged mental pt. to be kept under
observation by a psychiatrist for the
purpose of diagnosis and certification
Period of observation may extend to 10
days at a stretch or even upto30
days
8/7/2019 MENTAL UNSOUNDNESS seminar
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Certificate not to be issued after single
examination
Minimum of 3 examinations on differentdays and different hours recommended
Certificate should
¾
Contain clinical description of the patient¾ Indicate the reasons for diagnosis of the
specific disorder
8/7/2019 MENTAL UNSOUNDNESS seminar
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Insanity may be feigned or a person may
pose to be insane to
¾ Avoid punishment or death sentence in acriminal case
¾ Avoid court marshal or to leave job(bysoldiers)
¾ Avoid contracts (by businessmen)
8/7/2019 MENTAL UNSOUNDNESS seminar
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Feigned insanity should be differentiatedfrom real insanity on the basis of
-onset
-presence or absence of motive
-signs and symptoms
-insomnia
-exertion
-habits-frequent examinations
8/7/2019 MENTAL UNSOUNDNESS seminar
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May be-
¾ IMMEDIATE
¾ ADMISSION TO ASYLUM
8/7/2019 MENTAL UNSOUNDNESS seminar
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Done under personal care ofattendants.eg.by safely locking up in aroom
Done in case of
¾ An insane person who is dangerous tohimself or to others
¾ Person suffering from delirium due to disease
¾ Delirium tremens
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Procedures adopted are-1. Admission on voluntary basis ²person
considering himself mentally ill may requestMO in-charge of psychiatric hospital for
admission and treatment«in case of aminor, guardian may take such a request
2. Admission under special circumstances: for
pt.s who may not be able to express their willingness for admission as a voluntary pt.
8/7/2019 MENTAL UNSOUNDNESS seminar
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3. Reception order on application: officer in-charge can make an application to
the magistrate in case of a mentally ill
pt.who is undergoing temporary t/t if he
is satisfied that-t/t requires to be continued for more
than 6 months
-it is necessary in interest of the pt.or protection of others.
8/7/2019 MENTAL UNSOUNDNESS seminar
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4. Reception order on production of mentallyill before magistrate
a) an officer in charge is authorized to arrest a
wandering or dangerous mentally ill person and
produce him before a magistrate
b) an officer in charge of a police station or any
private person can report to a magistrate if he
believes that a mentally ill person is not kept
under proper control or is cruelly treated or
neglected
In both cases ,magistrate may pass an order for
admission for a mentally ill person
8/7/2019 MENTAL UNSOUNDNESS seminar
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5. Admission after judicial inquisition:
if a person possessing property is allegedto be mentally ill, the district court may order
an inquisition upon application made by
any relative in the court if it is satisfied ,it may
order to admit such person in psychiatrichospital.
6. Admission of mentally ill prisoner:
A mentally ill prisoner can be admitted to
any psychiatric hospital by an order passed byan appropriate authority under prisoners· act ,air force act, army act , navy act etc
8/7/2019 MENTAL UNSOUNDNESS seminar
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7. Admission of an escaped mentally ill
person:such a person can be retaken by any
police officer or any officer or servant of thepsychiatric hospital and readmitted into such
hospital.
8/7/2019 MENTAL UNSOUNDNESS seminar
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1. Voluntary pts. Should be discharged within24hrs of the receipt of request for discharge
made by the patient or the guardian
2. A mentally ill person who is admitted on an
application by a relative can himself or afriend or relative can apply to the magistratefor his discharge
3. An officer in-charge of a psychiatric hospital
can order in writing ,discharge, of anyinpatient on recommendation of two
medical practitioners ,one of whompreferably being a psychiatrist
8/7/2019 MENTAL UNSOUNDNESS seminar
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4. A mentally ill person detained under
Reception Order made on application shallbe discharged if the person on whose
application the admission order was made,
applies in writing to the officer in-charge
5. If a person detained on Reception Order issubsequently found by any judicial inquisition
to be of sound mind ,he is to be discharged.
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