Friday, 30 January 2015

MENTAL HEALTH ORDINANCE 2001

MENTAL HEALTH ORDINANCE 2001

( VIII OF  2001)

[20th February, 2001]
An
Ordinance

to consolidate and amend the law relating to the mentally disordered persons with respect to their care and treatment, the management of their property and other related matters

WHEREAS  it is expedient  to consolidate  and amend the law relating to the treatment  and care of mentally disordered persons, to make better provisions for their care, treatment, management of properties and affairs and to provide for matters connected therewith or  incidental thereto and to encourage  community  care  of  such mentally  disordered  persons  and  further  to  provide  for  the promotion of mental health and prevention of mental disorder;
AND WHEREAS the National Assembly and the Senate stand suspended  in pursuance of the Proclamation of Emergency of the fourteenth day of October, 1999, and the Provisional Constitution Order No. 1 of 1999 ;
AND WHEREAS the President is satisfied that circumstances exist which render it necessary to take immediate action;
NOW, THEREFORE, in pursuance of the Proclamation of Emergency of the fourteenth day of October, 1999, and the Provisional Constitution  Order  No. 1 of 1999, read with the Provisional Constitution (Amendment)  Order No. 9 of 1999, and in exercise of all powers enabling him in that behalf, the President  of the Republic of
Pakistan is pleased to make and  promulgate  the following Ordinance: -

CHAPTER I

PRELIMINARY

1.               Short title, extent and commencement.— (1) This Ordinance may be called the Mental Health Ordinance, 2001.
(2)             It extends to the whole of [1][the Punjab]
(3)             It shall come into force with effect from the 20th day of February, 2001.
2.               Definitions.—  (1) In this Ordinance, unless there is anything repugnant in the subject or context, –
(a)             “approved psychiatrist” means a medical practitioner possessing a recognized  postgraduate qualification and registered with the Pakistan Medical  and  Dental  Council  and  also approved by the Authority;
(b)             “Authority” means the 3 [Punjab Mental Health Authority] constituted under section 3 ;
(c)              “cost of maintenance”  in relation to a mentally disordered  person, includes the cost of lodging, maintenance,  clothing,  medicine and care of a mentally disordered person and any expenditure incurred in  removing   such mentally  disordered   person  to  and  from  a psychiatric facility together with any other charges specified in this behalf by the Government;
(d)             “Court of Protection ”means a  District  Court  having  jurisdiction under this Ordinance in matters specified herein and designated as such by the Government;
(e)             “Court” means a Court of Protection;
4[(f)      “Government” means Government of the Punjab;]
(g)             “health facility” means any basic health unit, rural health   centre, Tehsil hospital, district hospital, teaching hospital and  any private medical facility,
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supervised by a medical practitioner;
(h)             “hospital    management”    means   personnel    operating    and    or managing  any  psychiatric  facility  or  a  health  facility   that   has provision for indoor treatment for the mentally disordered;
(i)               “informed consent” means voluntary and continuing  permission  of the
patient  or  if  the  patient  is  a  minor  his  nearest  relative  or guardian,  as the  case  may  be,  for  assessment  or  to  receive  a particular  treatment based  on  an  adequate   knowledge  of  the purpose, nature, likely effects, and risks of that treatment including the likelihood of its success and any alternatives to it and the cost of treatment;
(j)               “Magistrate” means a Judicial Magistrate of the first class specially empowered by the Government to perform functions and exercise powers of a Magistrate under this Ordinance;
(k)             “medical officer” means a medical graduate serving in a Government health facility   and registered with the Pakistan Medical and Dental Council;
(l)               “medical  practitioner”  means  a  medical  graduate  registered  with the Pakistan Medical and Dental Council with good standing;
(m)           “mental disorder” means mental illness, including mental impairment, severe personality disorder, severe mental impairment and   any   other   disorder or   disability  of   mind and “mentally disordered”  shall   be  construed accordingly   and  as  explained hereunder:
(i)               “mental impairment” means a state of arrested or incomplete development  of  mind (not amounting to severe mental impairment) which includes significant impairment of intelligence  and  social functioning  and  is  associated  with abnormally  aggressive  or seriously irresponsible conduct on the  part  of  the  person concerned  and  “mentally  impaired” shall be construed accordingly;
(ii)             “severe  personality  disorder”  means  a  persistent  disorder  or disability   of   mind (whether or not including  significant impairment of intelligence) which results in    abnormally aggressive or seriously irresponsible conduct on the part of the person concerned;
(iii)           “severe mental impairment” means a state of arrested or incomplete development of mind which includes severe impairment of intelligence and social functioning   and is associated with abnormally aggressive or seriously irresponsible conduct on the part of the person concerned and “severely mentally impaired” shall be construed accordingly;
Explanation:- Nothing contained  in clause (m), sub-  clauses (i),  (ii)  and  (iii) above  shall  be  construed  as  implying  that  a person may  be dealt  with  under  this Ordinance  as suffering from mental  disorder  or from any  other  form of such  mental disorder defined in this section,  by reason only of promiscuity or other immoral conduct,  sexual deviancy or dependence on alcohol or drugs.
(n)             “mentally disordered prisoner’ means a person, who is a  prisoner for whose detention in or removal to a psychiatric  facility or other place of safety, an order has been made in  accordance  with the provisions of section 466 or section 471  of  the Code of Criminal Procedure, 1898 (Act V of 1898), section 30 of the Prisoners Act, 1900  (III  of  1900),  section 130  of  the  Pakistan  Army  Act,  1952 (XXXIX of 1952) section 143 of the Pakistan Air Force Act,  1953 (VI o f 1953) or section 123 of the Pakistan Navy Ordinance, 1961 (XXXV of 1961) ;
(o)             “minor” means a child or adolescent not having attained the age of eighteen years;
(p)             “patient” means a person who is under treatment and care;
(q)             “place  of  safety”  means  a  Government   run  health  facility,   a psychiatric  facility,  or  residence  of  any  suitable  relative  who  is willing to temporarily receive the patient;
(r)              “prescribed” means prescribed by rules or regulations as the case may be, made under this Ordinance;
(s)              “psychiatric facility” means a hospital, institute, ward, clinic, nursing home, day-care  institution,  half-way  house,  whether  in  public  or private sector involved in the care of mentally disordered persons;
(t)              “psychiatrist” means a medical practitioner possessing a recognized postgraduate  qualification in psychiatry and  registered with the Pakistan Medical and Dental Council;
(u)             “relative” means and  includes  any  person  related  by  blood  or marriage or  adoption  under  the  personal  law,  with  the  mentally disordered person;
(v)             “rules” means the rules made under this Ordinance;
(w)            “specialized psychiatric treatments” means electro-convulsive treatment, antipsychotic depot injection, psychosurgery, and such other form of treatment as may be  specified  for the purposes  of this Ordinance; and
(x)             treatment of mentally disordered person” means the  assessment and treatment  of a mentally  disordered  person  and  shall  include assessment, care,  training,  habilitation  as  well  as  rehabilitation techniques or measures, as the case may be.

CHAPTER II

ESTABLISHMENT OF [2][PUNJAB MENTAL HEALTH AUTHORITY]

3.               [3][Punjab Mental Health Authority].—  (1)  For  the  purposes  of  this  Ordinance, the Government shall constitute, by notification in the official Gazette, the [4][Punjab Mental Health Authority].
[5][(2)      The Authority shall consist of a Chairperson and not more than ten members to be appointed by the Government.]
9[(3)     The members of the Authority shall be as follows:-
(i)               Secretary to the Government, Health Department;
(ii)             Chief Consultant Psychiatrist, Punjab Institute of Medical Health, Lahore; and
(iii)           three eminent psychiatrists and two eminent psychologists of at least ten years’ standing.]
(4)             The  Chairperson  and  the  members  of  the  Authority,  other  than  exofficio members, shall be appointed on such terms and conditions  as may be determined  by  the Government.
(5)             The Chairperson and the members of the Authority shall be appointed for a tenure  of  fours  years. The  Chairperson  and  a  member  may  resign  from  his office  in  writing addressed to the 10[Government].
(6)             The Chairperson  or a member  of the Authority  may  be removed  from his office by the Government, for reasons of misconduct, or if he is unable to perform functions of his office, on account of mental or physical incapacity or for any other reason.
(7)             The Authority established under sub-section (1) shall carry out the
following functions .-
(a)             advise the Government  on all matters relating to promotion of  mental health and prevention of mental disorder;
(b)             develop and establish new national standards for care and treatment of
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patients;
(c)              recommend measures to improve existing mental health services  and setting up of child and adolescence,  psychogeriatric, forensic, learning disability and community based services;
(d)             prescribe procedures with respect to setting up and functioning of  the mental health services and facilities;
(e)             prescribe  a  code  of  practice  to  be  implemented  for  achieving  the purposes and objects of this Ordinance as well as to be followed by all the mental  health personnel  involved  with the care of  patients  under this Ordinance;
(f)              provide for regular review by the Board of Visitors to ensure that  the provisions of this Ordinance  for assessment  and treatment  are  being properly  carried  out,  whether  or  not  requested  by  any   individual, patient or his relative;
(g)             prescribe  for  care,  aftercare  or  rehabilitation,  under  supervision  or otherwise;
(h)             provide for and regulate the setting up of help lines and crisis  centres for the general public with regard to mental health;
(i)               provide  for,  organize  and  regulate  public  awareness  programs  and promote  research,  publish  journals,  bulletins,  magazines,  and  other educational material on mental health issues;
(j)               discharge  such  other  functions  with  respect  to  matters  relating  to mental health as the Government may require;
(k)             register psychiatrists  for  the  purposes  of  this  Ordinance,  in   such manner as may be prescribed; and
(l)               arrange and organize such courses and training programs as may  be necessary for carrying out the purposes and objects of this Ordinance.
(8) The Authority may, by notification in the official gazette, make regulations in respect of functions specified in subsection (7).
4.               Constitution of Board of Visitors .—  (1) The Authority shall, in consultation with the Government 1 1 [***] establish Boards of Visitors for carrying out the purposes of this Ordinance as hereinafter provided.
(2)             There shall be a Board of Visitors 12[***] which shall consist of
(a)             A  Chairperson  who  is  or  has  been  a  Judge  of  the  High Court;
(b)             two psychiatrists,  one having a minimum  experience  of  ten years in Government service;
(c)              one prominent citizen of good standing;
(d)             two medical practitioners of repute with a minimum standing of twelve years, one of whom shall be a nominee of Pakistan Medical and Dental Council; and
(e)             Director General Health Services  1 3 [***]  or  his nominee.
(3)             The Chairperson and members of the Board shall be appointed for a tenure of two years.
(4)             No member shall be deputed to perform any duty as a visitor to a psychiatric facility wherein he has a direct or indirect conflict of interest.
5.               Powers and functions of the Board.—  (1) The Board  may,  at any time,  enter and inspect any psychiatric facility within its area of responsibility and require the production of any records and documents for inspection to ensure that they are in proper order.
(2)             The Board shall periodically  inspect  every part of a psychiatric  facility
11   Omitted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)
12   Omitted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)
13   Omitted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)
and examine as far as possible every patient and mentally disordered prisoner. The Board  shall  inspect records and documents relating to the patients and mentally disordered prisoners since last visitation by the Board.
(3)             The Board may make recommendations to a psychiatric facility, the Authority and the Government, concerning improvement of conditions of such facility.
(4)             The Authority  may  order  the Board  to visit  any patient  in case  it appears necessary for the purpose of investigating any particular matter, or matters related to the capacity of the patient to manage his property and affairs, or otherwise, relating to the exercise of its functions. In compliance of this order, the Board may visit the facility or nominate a sub-committee of not less than two members:-
(a)             the Board or the sub-committee,  making a visit under this sub-section shall make such report on the visit as the Authority may order;
(b)             the Board or the sub-committee,  making a visit under this sub-section may interview and examine a patient in private and may require the production of and inspect any documents and/or medical records relating to the patient;
(c)              where the sub-committee  visits a facility it shall report to the Board and the Board shall make its final report to the Authority; and
(d)             where  the  Board  or  a  sub-committee   is  to  visit  a  mentally disordered prisoner,  it  shall  also  include  the  Inspector  General  of Prisons,  or  his nominee.
(5)             Where the Board is satisfied that any patient in a psychiatric facility is not receiving proper care or treatment, it may report the matter to the Authority which may  issue such directions as it may deem fit to the medical practitioner,  or psychiatrist in charge of  the psychiatric facility, as the case may be, who shall be bound to comply with such directions.
(6)             The Board shall enter remarks  in a register  to be kept for that  purpose in regard to the management and condition of a psychiatric facility and the inmates therein.
(7)             Any information obtained by any member of the Board in the course of his duties or which comes to the knowledge  otherwise, shall not be disclosed except to the  authorised person(s).
6. Establishment  of  psychiatric  facilities  by  the  Government.—  14[(1)  The Government may establish or maintain psychiatric facilities for the assessment, admission, treatment, rehabilitation, care and after care of mentally disordered patients at such places, as it deems fit.]
(2)             The psychiatric facilities established  under sub-section  (1) may organize or maintain separate units for –
(a)        persons who are above the age of eighteen years; (b)       child    and
adolescence psychiatric units;
(c)              psychogeriatric units for the elderly; and
(d)             persons who have been convicted of any offence and are  mentally disordered for whom special security measures shall be required.
(3)             Where drug dependence units need to be established, they shall be set up separately which may be within the premises of the psychiatric facility for people who are not mentally disordered but have drug dependence or patients with drug induced behavioural changes.

CHAPTER III

ASSESSMENT AND TREATMENT

7.               Care in the Community.—  (1) Community based mental health services shall be set up for providing  mentally  disordered  persons,  their  families  and  others  involved in their  care  with guidance, education, rehabilitation, after care and preventive measures and other support services on an informal basis.
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Explanation:-  For  the  purposes  of  this  section,  community  shall  include, family,  home, workplace, educational institutions and other places where care and after care can be provided on an informal or voluntary basis.
8.               Care and Treatment on an informal or voluntary basis.—  Any person who himself seeks or is brought by a relative or is referred by a medical practitioner or is referred by any authority for  forensic  psychiatric  assessment,  shall  be  examined  by a  psychiatrist  or   a   medical  officer nominated by him who shall record his findings in writing and decide that the patient be treated on an out-patient basis or otherwise. Any such person on withdrawal of his consent may be discharged in accordance with the provisions of this Ordinance.
9.               Duration for periods of detention for assessment, treatment, urgent admission and emergency holding.—  For the purposes of this Ordinance, there are four types of detention of a patient, namely; (1) admission for assessment, (2) admission for treatment, (3) urgent admission, and (4) emergency holding. The duration for each type of detention shall be as follows :-
(a)             The period of detention  for the purposes  of assessment  shall be up to 28 days from the date of application made under section 10;
(b)             The  period  of  detention  for  the  purposes  of  treatment  shall  be  up  to six months from the date of application made under section 11, and is renewable under the provisions of the said section;
(c)              The period of detention for the purposes of urgent admission shall be up to 72 hours from the time of application made under section 12; and
(d)             The  period  of  detention  in  the  case  of  a  patient  for  the  purposes of emergency holding already in hospital, shall be up to 24 hours from the time of application made under section 13.
10.            Admission for assessment.—  (1) A patient may be admitted to a Psychiatric Facility and detained there for the period allowed by subsection (4) in pursuance of an application made in accordance with subsections (2) and (3).
(2)             An application for admission  for assessment  may be made in respect  of a patient on the grounds that –
(a)             he  is  suffering  from  mental  disorder  of  a  nature  or  degree  which warrants  the  detention  of  the  patient  in  a  psychiatric  facility  for assessment (or for assessment  followed  by initial  treatment)  for at least a limited period; and
(b)             he ought to be so detained in the interests of his own health or safety or with a view to the protection of other persons; and
(c)              specifying that care and treatment in the community and on an informal and voluntary basis is not possible.
(3)             An application for admission for assessment shall be founded on the written recommendations in the  prescribed  form  of  two  medical  practitioners,  one  of whom  should  be  a medical officer and one should be a psychiatrist, or where a psychiatrist is not  available, a medical practitioner with experience in psychiatry, including in each case a  statement that in the opinion of such medical practitioners the conditions set out in sub-section (2) above are complied with.
(4)             A patient admitted to a psychiatric facility in pursuance of an application for admission for assessment  may be detained for a period not exceeding 28 days beginning  with the day on which application was made under this section, but shall not be detained after the expiration of that  period  unless  before  it  has  expired  he  has become  liable  to  be  detained  by  virtue  of  a subsequent application, order or direction under the provisions of this Ordinance.
(5)             Where a psychiatrist deems it fit he may discharge the patient from detention and advise the patient to continue treatment on voluntary basis.
(6)             The patient, his relative  or guardian  shall  have  the right  of filing only one appeal against the order of detention under this section to a Court of Protection within a period of 14 days from the day on which the application was made. The decision of the Court of Protection shall be final for the period of detention under this


section.
11.            Admission for treatment.—  (1) A patient may be admitted to a psychiatric facility and detained there for the period allowed by the following provisions, in pursuance of an application made in accordance with this section.
(2)             An  application  for  admission  for  treatment  may  be  made  in  respect  of a patient on the grounds that –
(a)             he is suffering from mental illness, severe mental impairment, severe personality disorder or mental impairment and his mental disorder is of a nature or degree which makes it appropriate for  him to receive medical treatment in a psychiatric facility; and
(b)             it  is  necessary  for  the  health  or  safety  of  the  patient  or  for  the protection of other  persons  that  he should  receive  such  treatment and it cannot be provided unless he is admitted under this section.
(3)             An application  for admission  for treatment  shall be founded  on the written recommendations, on the prescribed form of two medical officers, one of whom shall be an approved psychiatrist,  including  in  each  case  a  statement  that  in  the opinion  of  such  medical  officers  the conditions set out in sub-section (2) above are complied with; and each such recommendation shall include –
(a)             such particulars as may be prescribed of the grounds for that opinion so far as it relates to the conditions set out in clause (a) of that sub- section; and
(b)             a statement of the reason for that opinion so far as it relates to  the conditions  set  out  in  clause  (b)  of  that  sub-section,   specifying, whether other methods of dealing with the patient are available and, if so, why they are not appropriate.
(4)             A  patient  admitted  to  a  psychiatric  facility  in  pursuance  of  an application under this section may be detained  in a psychiatric  facility, for a period not exceeding  six months allowed by clause (b) of section 9 but shall not be so detained or kept for any longer period unless the authority for his detention is renewed under this section –
(a)             the authority for detention  of a patient may, unless the patient  has previously been discharged,  be renewed  from the expiration  of the period of six months referred to in sub-section  above, for  a further period of six months;
(b)             from the expiration of any period of renewal under clause (a) above, for a further period of one year, if necessary and so on for periods of one year at a time.
(5)             The patient, his relative or guardian may file an appeal against the  order of detention under this section to a Court of Protection:
Provided  that  only  one  appeal  shall  lie  during  the  subsistence  of  each period  of detention.
12.            Admission for assessment in cases of urgency.— In any case of urgent necessity, an application for admission for assessment may be made in respect of a patient in accordance with the following provisions –
(i)               an  urgent  application  may  be  made  either  by  a  relative  of  the  patient or medical officer; and every such application shall include a statement that it is of urgent  necessity  for the patient  to be admitted  and  detained under  this section and that compliance with the provisions relating to an application for treatment, under section 11 would involve undesirable delay;
(ii)             an urgent application shall be sufficient in the first instance if founded on the medical  recommendation   of  an  approved   psychiatrist   or  his nominated medical officer and if practicable, the nominated medical  officer shall not be the same medical officer referred to in sub-clause (i) above;
(iii)           an urgent application shall cease to have effect after 72 hours from the time when  the  patient  is  admitted  under  this  section  to  the  psychiatric facility unless –
(a)             the second medical recommendation required by section 11 above is given and received by the psychiatrist in-charge of the facility within the said period of 72 hours; and
(b)             that  such  recommendation  and  the  recommendation  referred  to  in sub-clause (ii) above together  comply  with all the  requirements  as contained in  section 17.
13.            Emergency Holding.—  If in the case of a patient who is receiving treatment for mental disorder as an inpatient in a psychiatric facility who wishes or attempts to leave and it  appears to a medical officer –
(i)               that the patient is suffering from mental disorder to such a degree that  it is necessary for his health or safety or for the protection of others, for him to be prevented from leaving the facility, and
(ii)             that it is not practicable to secure   the  immediate   attendance   of   the psychiatrist in  charge  or  his  nominated  medical  officer  for  the  purpose of furnishing a medical recommendation, the medical officer shall record that fact in writing and in that event the patient may be detained in the hospital for a period of 24 hours from the time when the fact is so recorded or until the earlier arrival of the  psychiatrist in charge or his nominated medical officer.
14.            Emergency  Powers.—  Where  in  case  of  an  emergency  a  medical practitioner  is unable to obtain informed consent in writing,  he  may  administer treatment,  notwithstanding  the provisions of section 51, that in his professional opinion, is necessary for:-
(i)               saving the patient’s life; or
(ii)             preventing serious deterioration of his condition; or
(iii)           alleviating serious suffering by the patient; or
(iv)            preventing  the patient from behaving violently or being a danger  to himself or to others.
15.            Application by whom to be presented.—  (1) Subject to the provisions of subsection (3) the application on a prescribed form shall be presented by the husband or wife of the patient or, if there  is  no  husband  or  wife  or  the  husband  or  wife  is prevented  by  reason  of  mental  disorder, absence  from  Pakistan  or  otherwise  from making  the  presentation,  by  the  nearest  relative  of  the patient.
(2)             If the application is not presented by the husband or wife, or, where there is no husband or wife, by the nearest relative of the patient, the application shall contain a statement of the reasons  why  it  is  not  so  presented,  by  the  husband,  wife  or  the nearest  relative  and  of  the connection of the applicant  with  the patient,  and  the circumstances  under  which  he presents  the application.
(3)             No person  shall present  an application  unless he  has  attained  the  age of majority and has within fourteen days before the presentation of the application, personally seen the said patient.
(4)             The  application  shall  be  signed  and  verified  by  the  applicant,  and the statement of prescribed particulars by the person making such statement.
16.            Effect  of  application  for  admission.—  (1)  An  application  for  the  admission of  a patient to a psychiatric facility under this Ordinance, duly completed in accordance with  the section under  which  he  is  being  admitted,  shall  be  sufficient authority  for  the  applicant  or  any  person authorized by the applicant, to take the patient and convey him to a psychiatric  facility at any time within the following periods, that is to say –
(a)             in  the  case  of  an  application   made  other  than  an   emergency application within the period of 14 days beginning with the date from which the patient was last examined by an  approved Psychiatrist or medical officer,  as  the  case  may  be,   before  giving  a  medical recommendation for the purposes of the application;
(b)             in the case of an emergency application, under section 12, the period of 24
hours beginning at the time when the patient was examined by an approved psychiatrist or his nominated medical  officer giving the medical recommendation which is referred to in section 11 above, or at the time when the application is made, whichever is the earlier.
(2)             Where a patient is admitted within the said period to a psychiatric facility as mentioned in sub-section (1), on an application made under  sections10,  11 or 12, as the  case may be, the application shall be sufficient authority for the hospital management to detain the patient in the said facility in accordance with the provisions of this Ordinance.
(3)             Any application for the admission of a patient under sections 10, 11 or 12, as the case may be, and which appears  to be duly made and is founded  on the necessary  medical recommendations, may be acted upon without further proof of the signature  or  qualification  of the person by whom the application  or any such medical recommendation  is made or given or of  any matter of fact or opinion stated therein.
(4)             Once  a  patient  is  admitted  to  a  psychiatric  facility  in  pursuance  of an application for admission  for treatment,  any previous  application  under this Ordinance  by  virtue of which he was detained in a psychiatric facility shall cease to have effect.
17.            General provisions as to applications and medical recommendations.—  (1) General provisions as to applications :-
(a)             subject to provisions of this section, an application for admission for assessment  or  for  treatment  may  be  made  either  by  the  nearest relative  of  the  patient,  by  an  approved  psychiatrist  or  nominated medical   officer;   and   every   such   application   shall   specify   the qualification of the applicant to make such an application;
(b)             every  application  for  admission  shall  be addressed  to the  hospital management to which admission is sought;
(c)              before  or  within  a  reasonable  time  after  an  application  for   the admission  of  a  patient  for  assessment  is  made  by  an  approved psychiatrist or a nominated medical officer, as the case  may be, he shall take such steps as are practicable to inform the person (if any) appearing to   be   the   nearest   relative   of   the   patient,   that   the application is to be or has been made;
(d)             none of the applications mentioned in sub-section (1) above shall be made by any person in respect of a patient unless that  person  has personally seen the patient within the period of 14  days ending with the date of application;
(e)             any  recommendation  given  for  the  purposes  of  an  application  for admission for treatment, may describe the patient as  suffering  from more than  one  form  of  mental  disorder,  namely,  severe  mental impairment, severe personality  disorder,  mental impairment,  or any other disorder or disability of mind:
Provided that the application shall be of no effect unless the patient  is  described in  each  of  the  recommendations  as  suffering from the  same  form  of  mental  disorder whether  or  not  he  is also described  in  either  of  those  recommendations  as suffering  from another form.
(f)              each of the applications mentioned in subsection (1) above shall  be sufficient if the recommendations on which it is founded  are  given either as separate recommendations,  or as a joint  recommendation signed by the medical officer and a psychiatrist.
(2)             General provisions as to medical recommendations: -
(a)             where   recommendations   are   required   for   the   purposes   of   an application under this Ordinance,  they shall be signed on or  before the date of the application, and shall be given by a medical officer or an approved  psychiatrist  who  have  examined  the  patient   either together or separately,  but  where  they  have  examined  the  patient separately not
more than five days must have  elapsed  between the days on which those separate examinations took place;
(b)             Of  the  medical  recommendations  given  for  the  purposes  of  any application as referred under clause (a) above, one shall be given by an approved  psychiatrist  and unless  that psychiatrist  has previous acquaintance with the patient, the other such recommendation shall, if practicable,  be given by a medical  officer who has such previous acquaintance.
18.            Rectification of applications and recommendations.— (1) If within the period of 14 days beginning with the day on which application was made in respect of the patient to be admitted to a psychiatric facility for assessment or for treatment the application or any medical recommendation given  for  the  purposes  of  the  application, is  found  to  in  any  respect  incorrect  or  defective,  the recommendation or application may, within that period and with the  consent of the management  of the psychiatric facility, be amended by the person by whom it was signed; and upon such amendment being made the application or recommendation  shall have  effect and shall be deemed to have had effect as if it had been originally made as so amended.
(2)             Without prejudice to sub-section (1) above, if within the period mentioned in that sub-section it appears to the management of the psychiatric facility that one of the two medical recommendations on which  the application  for admission  of a patient is founded  is  insufficient  to warrant the detention of the patient in pursuance of the application, they may, within that period, give notice in writing to that effect to the applicant;  and where any such notice is  given in respect of a medical recommendation,  that recommendation  shall  be disregarded,  but  the application  shall be, deemed always to have been, sufficient if –
(a)             a  fresh  recommendation  complying  with  the  relevant  provisions  of this Ordinance  (other  than  the  provisions  relating  to  the  time  of signature and the interval between examinations) is furnished to the hospital management within that period; and
(b)             the  fresh  recommendation,  and  the  other  recommendation  given earlier on  which  the  application  is  founded,  together  comply  with those provisions.
(3)             Where   the   medical   recommendations   upon   which   an   application for admission  is  founded  are,  taken  together,  insufficient  to  warrant  the  detention  of the  patient  in pursuance of the application, notice under subsection (2) above may be given in respect of either of those recommendations;  but this subsection shall not apply in a case where the application is of no effect by virtue of clause (e) of sub-section (1) of section 17 above.
(4)             Nothing in this section shall be construed as authorizing the giving of notice in respect of an application made as an emergency application, or the detention of a patient admitted in pursuance of such an application after the period of 72 hours referred to in clause (iii) of section 12 above unless the conditions set out in clauses (a) and (b) of that section are complied with or would be complied with apart from any error or defect to which this applies.
19.            Mentally disordered persons found in public places.—  (1) If an officer in charge of a police station finds in a place to which the public have access, a person whom he has reason to believe, is suffering from a mental disorder and to be in immediate need of care  or control the said officer may, if he thinks it necessary to do so in the interest of that person or for the protection of other persons, remove that person to a place of safety, which means only a Government run health facility, a  government  run psychiatric  facility,  or  hand  him  over  to  any  suitable  relative  who  is  willing  to temporarily receive the patient.
(2)             A person removed to a place of safety under this section may be detained there for a period  not  exceeding  72 hours  for the purpose  of enabling  him to be  examined  by a psychiatrist or his nominated  medical  officer  and  for making any  necessary  arrangements  for his treatment or care.

CHAPTER IV

LEAVE AND DISCHARGE

20.            Order of leave.— (1) An application in the prescribed form, for leave of absence in regard to any mentally disordered person (not being a mentally disordered prisoner) who is formally admitted in any psychiatric  facility  may be made  to the psychiatrist  in charge  of the  facility,  by a relative who is desirous of taking care and custody of such mentally disordered person for a specified period, requesting  that he may be allowed on his application  to take  care and custody  of such a patient and subject to the assessment by a psychiatrist, in charge of the said facility, who may allow or deny  the said application:
Provided that no application under this sub-section shall be made by a person who has not attained the age of majority.
(2)             Every application under sub-section (1) shall be accompanied by an undertaking-
(a)             to take proper care of the mentally ill patient;
(b)             to prevent the mentally ill patient from causing injury to himself  or to others; and
(c)              to bring back the mentally ill patient to the said facility on the expiry of the period of leave.
(3)             On receipt of the application under sub-section (1), the psychiatrist in charge may grant leave of absence to the mentally ill person for such period as he may deem necessary and subject to such conditions as may, in the interests of the personal safety of the mentally ill patient or for the protection of others, be specified in the order.
(4)             In case a patient is not returned  by the relative after a specified  period of leave, the said psychiatrist shall report to the magistrate, in whose jurisdiction the psychiatric facility is situated, and the referring authority and the Magistrate if satisfied, may direct the  police to recover and return the said patient to the psychiatric facility.
(5)             In any case where a patient is absent from a psychiatric facility in pursuance of order of leave granted under this section and it appears to the psychiatrist that is it necessary to do so in the interest of the patients’ safety or for the protection of other persons,  he may by notice in writing given to the patient or to the person for the time being in-charge  of  the patient, revoke the leave of absence and recall the patient to the psychiatric facility.
(6)             If after the passage of reasonable time after the notice as given under sub- section (5) above, the patient does not return or is not returned, then the psychiatrist may  report to the Magistrate and the referring authority of the reasons of revoking the leave of absence.
(7)             If  the  Magistrate  is  satisfied  with  the  report  of  the  psychiatrist  and the reasons as mentioned  in this section,  he may direct  the police  to locate  and produce  the  patient before him on a specified date and the Magistrate after hearing the patient, the person in charge and the concerned  psychiatrist  or their  representatives, may  make  an order  placing  the  patient  in the psychiatric facility or allow him to continue being in the care and custody of the person in charge or may make such other orders as he may deem fit.
(8)             Without prejudice to what has been stated above in this section, the period of detention under provisions  of section  10 or 11 shall continue  during the period for which  order of leave was granted:
Provided that a patient in whose  favour order of leave has been granted under this section shall not be recalled, after he has ceased to be liable to be detained for the periods specified under section 10 or 11, unless he is absent, at the expiration of period specified  under the above referred sections, without leave from the psychiatric facility.
21.            Discharge of a patient.—  (1)The psychiatrist in-charge of the treatment  of  a patient, may by order in writing, direct discharge of the patient at any time he deems it appropriate.
(2)             Where any order of discharge is made under sub-section (1), in respect of a person who has been admitted or is undergoing treatment as a patient in pursuance of an order of a referring authority,  a  copy  of  such  order  shall  be  immediately forwarded  to  that  authority by  the psychiatrist in charge.
(3)             Any  person   admitted   in  a  psychiatric   facility  under  an  order  made in pursuance of an application made under this Ordinance, may be discharged on an application made to the psychiatrist in charge:
Provided that no patient shall be discharged under this section if the psychiatrist in charge certifies in writing that the patient is unfit to be discharged for reasons of his own health and safety or the safety of others.
22.            Application  by  a  patient  for  discharge.—  (1)  Any  patient,  not  being  a mentally disordered  prisoner,  who  feels  that  he  has  recovered  from  his  mental disorder,  may  make  an application to the Magistrate for his discharge from the psychiatric facility.
(2)             The Magistrate may after making such inquiry as he may deem fit, pass an order discharging the person or dismiss the application.
Provided that no subsequent application for discharge shall be made by the patient during the said period of detention.
23.            Discharge  of  a  detained  person  found  not  to  be  mentally  disordered after assessment.— If any person admitted in a psychiatric facility is subsequently found not to be mentally disordered  and  is  capable  of  taking  care  of  himself  and managing  his  affairs,   an   approved psychiatrist, of the said facility shall forthwith, discharge such person from the psychiatric facility and notify the fact to the referring authority and the nearest relative.
24.            Duty  of hospital  management  to inform  relatives  of the discharge.— Where  a patient detained under this Ordinance in a psychiatric facility is to be discharged, the management of the psychiatric facility shall take such steps as are practicable to inform the  relative (if any), of the patient and  or  the  applicant  (if any),  and  or  any  suitable  person  who  is  willing  to  accept  the responsibility to take care and custody of the said patient; and that information shall, if practicable, be given at least seven days before the date of discharge.
25.            Application  for  discharge  to  Magistrate.—  Where  any  patient  is  admitted under section 10 or 11, his relatives may apply to the Magistrate within the local limits of whose jurisdiction the  psychiatric  facility  is  situated  for  his  discharge  and  the Magistrate  may,  in  consultation  with psychiatrist in charge of the treatment, after giving notice to the person at  whose instance he was admitted and after making such inquiry as he may deem fit, either allow or dismiss the application:
Provided that no subsequent application for discharge shall be made during the said period of detention.
26.            Notice about serious illness or death.—  If a patient becomes  seriously ill or dies, that fact shall be notified to his nearest relatives, if known or on whose application the  patient was admitted and also to the authority by whom the patient was referred to the psychiatric facility.
27.            Transfer  and  removal.—  Transfer  and  removal  of  patient  placed  in  a psychiatric facility to another such facility in 1 5 [any other Province or territory of Pakistan] shall  be  carried out in accordance with any general or special order of the 1 6 [Government with the consent of the Government of that Province or territory]  provided that a notice of such intended transfer or removal has  been given to the applicant.
28.            Foreign nationals.—  (1) When an arrangement has been made with any foreign state with respect to the placement of a patient, the Federal Government may issue a notification under this Ordinance directing the 17[Government for such placement of the patient].
(2)             On publication of a notification under sub-section (1), the agent of the foreign state in which the alleged mentally disordered person ordinarily resides may make an application for an order to the 18[Government].
15   Substituted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)
16   Substituted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)
17   Substituted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)
18   Substituted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)
(3)             The functions of the Magistrate shall  be performed  by such  officer  as the [6][***] Government may by general or special order appoint in this behalf, and such officer shall be deemed to be the Magistrate having jurisdiction over the alleged mentally  disordered person for the purposes of this section.
(4)             The [7][***] Government   may specify approved psychiatrists for the purposes of this section.

CHAPTER V

JUDICIAL PROCEEDINGS FOR APPOINTMENT OF GUARDIAN OF PERSON AND

MANAGER OF THE PROPERTY OF THE MENTALLY DISORDERED

29.            Judicial  proceedings.—  Whenever  any  person  is  possessed  of  property and  is alleged to be mentally disordered, the Court of Protection, within whose jurisdiction  such  person is residing  may,  upon  application  by  any  of  his  relatives having  obtained  consent  in  writing  of  the [8][Advocate General Punjab]   by  order direct   an  inquiry  for  the  purpose  of ascertaining whether  such  person  is mentally disordered  and  incapable  of  managing  himself,  his property and his affairs.
30.            Regulation   of  proceedings   of  the  Court   of  Protection.—  (1)   The following provisions shall regulate the proceedings of the Court of Protection with regard to the matter to which they relate, namely:-
(a)             Notice shall be given to the mentally disordered person of the time and place at which it is proposed to hold the inquiry;
(b)             if it appears   that   personal   service   on   the   alleged   mentally disordered person would be ineffectual, the Court may direct such substituted service of notice as it thinks fit;
(c)              the Court may also direct copy of such notice to be served  upon any relative  of the alleged  mentally  disordered  person  and upon any other person to whom in the opinion of the Court notice of the application should be given;
(d)             the Court may require the alleged mentally  disordered  person  to attend, at such convenient time and place as it may appoint for the purpose  of being  personally  examined  by  the  Court,  or  to  any person from whom the Court may desire to have a  report of the mental capacity and condition of such mentally disordered person;
(e)             the Court may likewise make an order  authorising  any person  or persons therein  named  to  have  access  to  the  alleged  mentally disordered person for the purpose of personal examination; and
(f)              the attendance and examination of the alleged mentally disordered person under the provisions  of clause (d) and  clause (e) shall, if the   alleged mentally   disordered   person   be   a   woman   who, according to customs of the country, ought not to be compelled to appear  in  public,  be regulated  by  the  law  and  practice  for  the examination of such persons in other civil cases.
(2)             The  Court,  if  it  thinks  fit,  may  appoint  two  or  more  persons  to  act as assessors to the Court in the said proceedings.
(3)             Upon the completion  of the inquiry,  the Court shall determine  whether the alleged mentally disordered person is suffering from mental disorder and is incapable of  managing himself and  his  affairs,  or may  come  to a special  finding  that such  person  lacks  the  capacity  to manage his affairs, but is capable of managing himself and is not dangerous to himself or to others, or may make any such order it deems fit, in the circumstances  of the  case,  in the best interests of such person.
31.            Inquiry by subordinate Court on commission issued by the Court of Protection and proceedings thereon.—  (1) If the alleged mentally disordered  person resides  at  a distance of more than fifty miles from the place where the Court is held to which the application is made, the said Court may issue a Commission to any subordinate court to make the inquiry, and such subordinate court shall thereupon conduct the inquiry in the manner hereinbefore provided.
(2)             On the completion of inquiry the subordin ate court shall transmit the record of its proceedings with the opinion of the assessor, if any have been appointed, and its own opinion on the case; and the Court shall thereupon proceed to dispose the application in the manner provided in sub-section (3) of section 30:
Provided  that the Court  may direct  the subordinate  court  to make  such  further or other inquiry as it thinks fit before disposing of the application.
32.            Appointment  of  guardian.—  Where  a  mentally  disordered  person  is incapable  of taking care of himself, the Court may appoint any suitable person to be his guardian, or order him to be looked after in a psychiatric facility and order for his maintenance.
33.            Management of property of mentally disordered person.— (1) Where the
property of  the  mentally  disordered  person  who  is  incapable  of  managing  it,  the Court  shall  appoint  any suitable person to be the manager of such property.
(2)             No  person,  who  is a  legal  heir  of  a  mentally  disordered  person,  shall be appointed under section 32 to be the guardian of such a person or the manager of his  property, as the  case  may  be,  unless  the  Court  for  reasons  to  be  recorded  in writing  considers  that  such appointment is for the benefit of the mentally disordered person.
(3)             The  guardian  of  a  mentally  disordered  person  and  the  manager  of his property  appointed  under  this  Ordinance  shall  be  paid,  from  out  of  the  property of  the  mentally disordered person, such allowance as the Court may determine.
34.            Responsibility of manager.—  A person appointed as a manager of the property of a, under this Ordinance,  shall be responsible  for the care, cost of treatment  and maintenance  of the mentally disordered person and of such member(s) of his family as are dependent on him.
35.            Allowance payable to guardian.—  The manager of the property of the patient shall pay to the guardian of the patient such allowances  as may be fixed by the Court for the  care and maintenance of the patient and of such members of his family as are dependent on him.
36.            Powers  of  manager   of  property  of  mentally  disordered  person.—  (1) Every manager appointed under this Ordinance shall, subject to the provisions of this Ordinance, exercise the same power in regard to the management  of the property of the  mentally disordered person in respect  of  which  he  is  appointed  as  manager,  as the  mentally  disordered  person  would  have exercised as owner of the property, had he not been mentally disordered and shall realize all claims due to the estate of the mentally  disordered  person  and pay all debts and discharge  all liabilities legally due from that estate and in exercise of powers under this section regard shall be had first of all to the requirements of the mentally disordered person and the rights of the creditors, if any :-
Provided that no manager so appointed shall without the permission of the Court –
(a)             mortgage, create any charge on, or transfer by sale, gift,  exchange or otherwise,  any  movable  or  immovable  property  of  the  mentally disordered person; or
(b)             lease out or give on bailment any such property.
(2)             The permission under proviso to sub-section (1) may be granted  subject to such conditions or restrictions as the Court may think fit to impose.
(3)             The Court shall cause notice of every application for permission to be served on any relative or friend of the mentally disordered person and after considering  objections,  if any, received from the relatives  or friends  and after making such inquiries  as it  may deem necessary, grant or refuse permission having regards to the interest of the mentally disordered person.
37.            Furnishing   of  inventory   of  immovable   property,   etc.—  (1)   Every manager appointed  under  this  Ordinance  shall,  within  a  period  of  three  months from  the   date  of  his appointment, deliver to the Court an inventory of the immovable property  belonging  to the mentally disordered person and of all assets and other movable property  received on behalf of the mentally disordered person, together with a statement of all claims due on and all debts and liabilities due by such a person.
(2)             All transactions under this Ordinance shall be made through a bank authorized by the Court.
(3)             Every such manager shall also furnish to the Court within a period of three months of the closure of every financial year, an account of the property and assets in his charge, the sums  received  and  disbursed  on  account  of  the  mentally disordered  person  and  the  balance remaining with him.
(4)             If any relative of a mentally disordered person impugns, by a petition to the Court, the accuracy of the inventory or statement referred to in sub-section (1) or as the case may be, any  annual  account  referred  to  in  sub-section  (3),  the  Court  may summon  the  manager  and summarily inquire into the matter and make such order thereon as it thinks fit.
(5)             Any relative of a mentally disordered person may, with the leave of the Court, sue for an account from any manager appointed under this Ordinance or from any such person after his removal from office or trust, or from his legal representatives in the case of his death, in respect of any property  then or formerly  under  his management  or of any sums of  money  or other property received by him on account of such property.
38.            Inquiry  by Court  of Protection  in certain  cases.—  Where  a  mentally disordered person had, before the onset of his mental disorder, contracted to sell or otherwise  disposed of his property  or  any  portion  thereof,  the  Court  may,  after conducting  an  inquiry,  direct  the  manager appointed under this Ordinance to perform such contract and to do such other acts in fulfillment of the contract  as  the  Court considers  necessary  and  thereupon  the  manager  shall  be  bound  to  act accordingly.
39.            Disposal  of  business  premises  under  the  direction  of  Court  of Protection.—  Where a  mentally  disordered  person  had  been  engaged  in business before  he  became  mentally disordered the Court may, if it appears to be in the best interest of such a person, after proper hearing notices have been issued to dependants, relatives for hearing to  dispose of his business premises, direct the manager appointed under this Ordinance in relation to property of such person to sell and dispose of such premises and to apply the sale proceeds thereof in such manner as the Court may direct and thereupon the manager shall be bound to act accordingly.
40.            Investment  of  assets  of  mentally  disordered  person.—  All  sums  received by  a manager on account of any estate in excess of what may be required for the current  expenses of a mentally  disordered  person  or  for  the  management  of  his property,  shall  be  paid  into  the  public treasury on account  of the estate,  and shall be invested,  from time to  time,  through  state owned investment agencies, in the interest of the mentally disordered person.
41.            Appointment of a new manager or guardian.— (1) The manager of the property of a mentally disordered person may resign with the permission of the Court, or for sufficient  cause and for reasons to be recorded in writing, be removed by the Court and such Court may  appoint a new manager in his place.
(2)             Any manager  removed  under sub-section  (1) shall be bound to deliver the charge of all property of such a person to the new manager, and to account for all monies received or disbursed by him.
(3)             The guardian of the person of a mentally disordered person may resign with the permission  of the Court,  or for sufficient  cause  and for reasons  to be recorded  in  writing,  be removed by the Court and such Court may appoint a new guardian in his place.
42.            Dissolution of partnership.—  (1) Where a person, being a member of a partnership firm, is found to be mentally disordered, the Court may, on the application of any other partner, order for the dissolution of the partnership or on the application of any person who appears to that Court to be entitled to seek such dissolution dissolve the partnership in accordance with the provisions of the Partnership Act, 1932 (IX of 1932).
(2)             Upon  dissolution  a  partnership  firm  to  which  sub-section  (1)  applies, the manager appointed under this Ordinance may, in the name and on behalf of the mentally disordered person, join with the other partners in disposing of the partnership property upon  such terms, and shall do all such acts for carrying into effect the dissolution of the partnership as the Court may direct.
(3)             Notwithstanding  anything  detained  in  the  foregoing  provisions,  the Court may, instead of appointing a manager of the estate, order that in the case of cash, or in the case of any other property, the produce thereof, shall be realized and paid or delivered to  such person as may be appointed  by the Court  in this  behalf,  to be applied  for the  maintenance  of the mentally disordered person and of such members of his family as are dependent on him.
43.            Securities,   etc.,   of  mentally   disordered   person.— (1)   Where   any   stock or Government  securities  or  any  share  in  a  company  are  standing  in  the  name  of, or  vested  in,  a mentally  disordered  person  beneficially  entitled  thereto,  or  in  the manager  dies  in  the  estate  or himself becomes  mentally  disordered,  or  is  out  of the  jurisdiction  of  the  Court,  or  it  is  uncertain whether the manager  is living  or dead, or neglects  or refuses  to transfer  the  stock,  securities  or shares, or to receive and pay over thereof the dividends to a new manager  appointed in his place, within fourteen  days  after  being  required  by  the  Court  to  do  so,  then  the  Court  may direct  the company or 22[the Government] to make such transfer, or to transfer the same, and to receive an pay over the dividends in such manner as it may direct.
(2)             The  Court  may  direct  those  dividends,  the  profit  of  shares,  stock and Government securities shall be deposited in the mentally disordered person’s bank account.
(3)             Where any stock or Government securities or shares in a company is or are standing in the name of, or vested  in, any person  residing  out of Pakistan,  the Court  upon being satisfied that such person has been declared to be mentally disordered and that his personal estate has been vested in a person appointed for the management thereof, according to the law of the place where he is residing may direct the company  or 2 3 [the Government]  to  make transfer  of such stock, securities or shares or of any part thereof, to or into the name  of the person so appointed or otherwise, and also to receive and pay over the dividends and proceeds, as the Court thinks fit.
44.            Maintenance during temporary mental disorder.—  If it appears to the Court that the mental illness of a mentally disordered person is in its nature temporary and that it is  expedient to make provision for a temporary period, for his maintenance or for the maintenance of such members of his family as are dependent on him, the Court may direct his property or a sufficient part thereof to be applied for the purpose specified therein.
45.            Inquiry by Court of Protection into cessation of mental disorder.—  (1) Where the Court has reason to believe that any person who was found to be mentally disordered has ceased to be mentally disordered, it may direct any court subordinate to it to inquire whether such person has ceased to be mentally disordered.
(2)             An inquiry under sub-section (1) shall, so far as may be, conducted under this Ordinance.
(3)             If after an inquiry under this section, it is found that the mental disorder of a person has  ceased,  the  Court  shall  order  all  actions  taken  in respect  of  such person  under  this Ordinance to be set aside on such terms and conditions as that Court thinks fit to impose.
(4)             Without prejudice to the generality powers given above, the court shall have powers to make such orders and give such directions as the Court thinks fit, for the  betterment  of such a person.
46.            Appeal to High Court.—  An appeal shall lie to the High Court from an order made by a Court of Protection under this Chapter, within a period of sixty days from the date of  order  of the said Court.
22   Substituted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)
23   Substituted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)

CHAPTER VI

LIABILITY TO MEET COST OF MAINTENANCE OF MENTALLY DISORDERED

PERSON ADMITTED IN A PSYCHIATRIC FACILITY

47.            Liability  to  meet  cost  of  maintenance  of  a  patient  admitted  in  a psychiatric facility.—  (1) The cost of maintenance of a patient admitted in a Government owned psychiatric facility shall be borne by the Government:
Provided that –
(a)             the authority   which   made   the  order   has  not  taken   an undertaking from any person to bear the cost of maintenance of such a person;
and
(b)             there is no provision for bearing the cost of maintenance  of such person by the Court of Protection under this Ordinance.
(2)             Person   holding   public  office  or  a  public  servant   who   is  paid   by the Government and is mentally disordered shall continue to receive benefit as per entitlement even after he  retires  voluntarily  or  on  attainment  of  the  age  of superannuation  or  on  the  basis  of  medical invalidation.
(3)             In case of  defence  personnel,  the  paymaster  of  the  military  circle within which any psychiatric facility is situated shall pay to the officer in charge of such facility  the cost of maintenance  of  such  a  mentally  disordered  person  received  and detained   therein  under  this Ordinance.
(4)             Where  any such person  admitted  in a psychiatric  facility  has an estate or where any person legally bound to maintain such person has the means to maintain such person, the Government or local authority liable to bear the cost of maintenance of such a person under any law, for the time being in force, may make an application to the Court within whose jurisdiction the estate of such a person is situated or the person legally bound to maintain the said person and having the means  therefore  resides,  for an  order  authorizing  it  to  apply   his   estate  towards  the  cost  of maintenance or directing the legally bound person to bear the cost of maintenance.
(5)             Nothing contained in the foregoing provisions shall be deemed to  absolve a person legally bound to maintain a mentally disordered person from maintaining such a person.
48.            Maintenance out of pay, pension, etc.—  (1) Where any sum is payable in respect of pay, pension, gratuity or any allowance to any person by the Government and the  person to whom the sum is payable  if certified  by a Magistrate  under  this Ordinance  to be a  mentally  disordered person, the officer under whose authority such sum would be payable, may pay to the person having charge of the mentally disordered person so much of the said sum, as he thinks fit, having regard to the cost of maintenance of such person and may pay to such members of the family of the mentally disordered person as are dependent on him for maintenance, the surplus, if any, or such part thereof, as he thinks fit, having regard to the expenses of maintenance of such member.
(2) Where  there  is  any  further  surplus  amount  available  out  of  the funds specified sub-section  (1) after  making  payments  as provided  in that subsection,  the  Government shall hold the same to be dealt with as follows, namely:-
(a)             where  a  mentally  disordered  person  is  certified  to  have ceased   to   be mentally disordered by the Court of Protection within the local limits of whose jurisdiction such person  resides  or  is  admitted,  the  whole  of  the surplus amount shall be paid back to that person;
(b)             where a mentally disordered person dies before payment, the  whole  of the  surplus  amount  shall  be  paid  over  to those of his heirs  who are legally  entitled  to receive  the same; and
(c)              where a mentally disordered  person dies during his  mental disorder
without   leaving   any   person   legally   entitled   to succeed to his estate, the whole of the surplus amount shall be paid into the State Treasury.

CHAPTER VII

PROTECTION OF HUMAN RIGHTS OF MENTALLY DISORDERED PERSONS

49.            Cases of attempted suicide.—  A person who attempts suicide shall be
assessed by an  approved  psychiatrist  and  if  found  to  be  suffering  from  a  mental disorder  shall  be  treated appropriately under the provisions of this Ordinance.
50.            Confidentiality.—  No patient shall be publicized nor his identity disclosed to the public through press or media unless such person chooses to publicise his own condition.
51.            Informed consent.— (1)  Before  commencing  any  investigation  or  treatment a psychiatrist or nominated medical officer shall obtain written informed consent, on a prescribed form, from the patient or if the patient is a minor, his nearest relative or a guardian, as the case may be.
(2)             Where the  consent  of  a  patient  to  any  form  of  investigation(s)  and  or treatment(s) has been given the patient or if the patient is a minor, his nearest relative or a guardian, as the case may be, may withdraw his consent in writing at any time before the  completion of the treatment.
(3)             Without prejudice to the application of sub-section (2) above to any treatment given under the plan of treatment to which a patient or if the patient is a minor, his nearest relative or a guardian, as the case may be, who has consented, to such a plan may, at  any time withdraw his consent in writing to further treatment,  or to further treatment  of any  description  under the plan of treatment.

CHAPTER VIII

OFFENCES AND INDEMNITY

52.            Penalty for making false statement,  etc.—  (1)  Any  person  who  willfully makes  a false  entry  or  statement  in  any  application,  recommendation,  report, record  or  other  document required or authorized to be made for any of the purposes of this Ordinance,  with an intent to get someone to be detained  for assessment  or for treatment  of mentally  disordered;  or with intent  to deceive, makes use of any such entry or statement which he knows to be false, shall be guilty of an offence under this Ordinance.
(2)             Any person employed in a psychiatric facility, who strikes, ill-treats, maltreat or willfully neglects any patient confined in such psychiatric facility or willfully violates or neglects any of the provisions of this Ordinance shall be guilty of an offence.
(3)             Any manager of estate of a patient who willfully neglects or refuses to deliver his accounts or any property in his possession within the time fixed by the Court shall be guilty of an offence.
(4)             Without  prejudice  to criminal  prosecution  under any other law for the time being in force, whoever is guilty of an offence under sub-section (1), (2) or (3), shall be  punishable with imprisonment for a term which may extend to one year or with fine which may extend to twenty thousand rupees, or with both.
(5)             Any person who carries out any form of inhumane treatment, on a mentally disordered person which includes: trepanning, branding, scalding, beating, exorcising,  chaining to a tree etc. of any such person or subjecting a child to the cultural practice of  rendering him mentally retarded, by inducing  microcephaly,  or subjecting any such person to  physical, emotional or sexual abuse, shall be guilty of an offence, punishable with rigorous imprisonment which may extend to five years or with fine extending up to Rs50,000 or with  both.
(6)             Any person who contravenes  any of the provisions  of this Ordinance  or of any  rule  or  regulation  made  thereunder,  for  the  contravention  of  which  no penalty  is  expressly provided in this Ordinance, shall be punishable with imprisonment for a term which may extend to six months, or with fine which may extend to ten thousand rupees, or with both.
53.            Indemnity.—  (1) No suit, prosecution or other legal proceedings shall lie against any person for anything which is in good faith done or intended to be done in pursuance of this Ordinance or the rules made thereunder.
(2)             No suit or other legal proceedings shall lie against the  Government for any damage caused or likely to be caused for anything which is in good faith done or intended to be done in pursuance of this Ordinance or the rules or orders made thereunder.

CHAPTER IX

INSPECTION OF MENTALLY DISORDERED PRISONERS

54. Inspection of mentally disordered prisoners.—  (1) Where any person is detained under the provisions of section 466 or section 471 of the Code of Criminal
Procedure 1898 (Act V of 1898), section 130 of the Pakistan Army Act, 1952 (XXXIX of 1952), section 143 of the Pakistan Air Force Act, 1953 (VI of 1953, or section 123 of the Pakistan Navy Ordinance, 1961 (XXXV of  1961), the Inspector-General of Prisons, if the accused person is detained in a jail, and the Board of Visitors or any two members of such Board, if the accused person is detained in a  psychiatric facility, may visit him in order to ascertain his state of mind and such a detainee shall be visited once at least in every six months by the Inspector-General of Prisons or, as the   case may be, the Board or any two members of such Board, shall make a report as to the state of mind of such person to the authority under whose order the accused person is detained and the Inspector-General  of Prisons or, as the case may be, the Board of Visitors or any two members of such Board, shall make a report as to the state of mind of such person to the authority under whose order the accused person is detained.
(2) The Government may empower the officer in charge of the jail in which such accused  person  is  detained  to  discharge  all  or  any  of  the  functions  of  the Inspector  General  of Prisons under sub-section (1).

CHAPTER X

FORENSIC PSYCHIATRIC SERVICES

55. Forensic psychiatric services.—  (1) Special security forensic psychiatric facilities shall be developed by the Government to house mentally disordered prisoners,  mentally disordered offenders, as may be prescribed.
(2)             Admission,   transfer   or   removal   of   patients   concerned   with criminal proceedings in such facilities  shall be under the administrative  control  of the Inspector  General  of Prisons.
(3)             The  Board  of  Visitors  shall  have  an  access  to  such  persons  admitted in forensic psychiatric facility in accordance with the provisions of this Ordinance.

CHAPTER XI

MISCELLANEOUS

56.            Specialized Psychiatric Treatments.—  (1) Specialized psychiatric treatment may be carried out with the informed consent of the patient, on the orders in writing by the  psychiatrist  in charge of the treatment of the patient or his relative or guardian, if the patient is a minor.
(2)             All electro-convulsive  treatments shall preferably be administered  under general anesthesia.
(3)             All electro-convulsive treatments shall be advised by a psychiatrist, in charge  of the patient, recording the reasons for such advice and stating the reasons as to why  the alternative available methods of treatment are not appropriate.
(4)             Administration of long acting anti-psychotic depot injections shall only be carried out upon the advice of a psychiatrist for a period as specified in the prescription and such cases shall be reviewed periodically.
(5)             No person  shall  advise  and carry  out psychosurgery  or make  any decision  to carry out psychosurgery,  except in cases where it is decided to be necessary and  appropriate in a meeting in this regard, attended by a neurosurgeon,  a neurophysician,  a  physician,  two  approved psychiatrists and a clinical psychologist.
57.            Provisions for public and private sector psychiatric facilities.— The provisions  of this Ordinance shall apply to all psychiatric facilities whether in public and or private sector.
58.            Removal  of  difficulties.—  If  any  difficulty  arises  in  giving  effect  to  any  of the provisions of this Ordinance, the [9][Government] may make such order, not inconsistent with the provision of this Ordinance, as may appear to [10][it] to be necessary for the purpose of removing the difficulty:
Provided that no such power shall be exercised after the expiry of two years from the coming into force of this Ordinance.
59.            Power to make rules.—  [11][(1) The Government may, by notification in the official Gazette, make rules for carrying out the purposes of this Ordinance.]
(2)             Without  prejudice  to the  generality  of  the  foregoing  power,  the  rules may provide for all or any of the following matters, namely :-
(a)             to prescribe forms for any proceedings under this Ordinance;
(b)             to  prescribe   places  of  admission,   places  of  safety   and regulation of treatment of mentally disordered persons;
(c)              to regulate the admission,  care and treatment of under  trial persons or convicted prisoners;
(d)             to regulate the management of a mental health facility; and
(e)             to prescribe conditions subject to which a psychiatric facility may be licensed.
60.            Ordinance   to override.—  The   provisions   of   this   Ordinance   shall   have effect notwithstanding anything inconsistent therewith contained in any other law for the time being in force.
61.            Repeal and saving.—  (1) The Lunacy Act, 1912 (IV of 1912), is hereby repealed.
(2)             Notwithstanding  the  repeal  of  Lunacy  Act,  1912  (IV  of  1912), hereinafter referred to as the repealed Act,-
(a)             all orders made, acts done and powers exercised under the repealed Act shall be deemed to have been validly made, done and exercised and deemed always to have had effect accordingly; and
(b)             nothing  contained  in  this  Ordinance  shall  be  deemed  to  apply  to proceedings,  suits  or  appeals  and  applications  pending  under  the repealed Act before  any court immediately before the commencement of this Ordinance and such proceedings,   suits, appeals and applications shall continue to be heard and disposed of in accordance with the provisions of the repealed Act.




[1] Substituted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014) 3 Substituted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)
[2] Substituted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)
[3] Substituted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)
[4] Substituted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)
[5] Substituted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014) 9 Substituted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)
[6] Omitted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)
[7] Omitted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)
[8] Substituted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)
[9] Substituted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)
[10] Substituted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014)
[11] Substituted by the Punjab Mental Health (Amendment) Act 2014 (XI of 2014) 

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