1. A review of Mental Health Law in Pakistan
Presentation by
Rubeena Kidwai, Ph.D.
Consultant Clinical Psychologist
Hubert H. Humphrey Fellow

2. History of mental health law in Pakistan
Mental health law introduced in Indo-Pak subcontinent (then India) – Lunacy Act 1912
Referred to persons with mental illness as “Lunatics” or “idiots of unsound mind”
Main emphasis was on
removing persons with mental illness away from mainstream society and keeping them under custodial care or “asylums”
‘Protecting’ the society from persons with mental illness

3. Mental health law in Pakistan
2001 – Lunacy Act repealed and replaced by Mental Health Ordinance 2001 (MHO 2001)
Drew heavily on Indian Mental Health Act 1987
Used more humane and relatively updated terminology
e.g. “mental illness”, “psychiatric facility”, “care in the community”
Addressed human and civil rights of persons with mental illness
Informed consent
Right and privilege to confidentiality
Right to protection of property and assets
Punitive measures against abusive treatment

4. Mental health law in Pakistan
Federal Mental Health Authority (FMHA) formed whose task it was to:
Form rules and regulations to make the Ordinance enforceable
Advise government regarding matters of mental health – prevention and promotion
Advise on setting up on mental health services and on improving existing mental health services
Prescribe code of practice for mental health service providers

5. Mental health law in Pakistan
2001 MHO introduced and FMHA formed
2003 Member of FMHA reported they were working on creating forms and procedures in line with MHO
No additional news of any meetings or activities about FMHA
2001 onwards – PAMH, HRCP and other stakeholders involved in:
Awareness raising about the MHO
Consultations regarding suggested amendments
Advocacy for the implementation of MHO

6. Mental health law in Pakistan
2005 – Tenure of members of FMHA ended
FMHA lapsed
Board of Visitors (BoV) formed was in Sindh
Due to lapse of FMHA the BoV did not have a valid presence
PAMH contacted the Federal Ministry of Health numerous times to
Urge the FMHA to convene and begin its tasks
To reconstitute and activate the FMHA

7. Mental health law in Pakistan
2007 – PAMH filed a petition with Sindh High Court asking for reconstitution of the FMHA
2008 (Oct) – Sind High Court ordered Federal Ministry of Health to reconstitute FMHA
2009 (Dec) – FMHA reconstituted - but did not meet
2010 Jan- Jun - PAMH initiated a signature drive petitioning the FMHA and the Supreme Court to take steps to implement the MHO
2010 (Jun) – Chief Justice took note of the issue and directed the issue to Human Rights Cell which in turn issued a directive for the FMHA to convene
2010 (Dec) meeting of FMHA

8. However… 2010 April – 18th Amendment Bill was passed
Process of devolution of power and greater power to provinces
Federal legislative list vs. Concurrent legislative list
MHO becomes a casualty of 18th Amendment
FMHA dissolved
MHO does not have force

9. Problem or opportunity??
Current scenario
Sindh Government has drafted a Provincial Mental Health Bill
Currently in Provincial Assembly

10. Loopholes and lacunae Definition of mental illness
Exclusion of other mental health service providers and mental health facilities
Power to police
Absence of psychiatrists in many areas
Does not address civil or criminal liability of a person suffering from mental illness

11. The way forward…
Need for advocacy for the enforcement of mental health law
Advocacy for improving upon the clauses
Inclusion and active participation of all stakeholders

12. References
Mental Health Ordinance, full text, retrieved on November 28, 2011, at Ordinance.pdf
Gilani, A.I., Gilani, U. I., Kasi, P. M., & Khan, M. M. (2005) Psychiatric Health Laws in Pakistan:From Lunacy to Mental Health. PLoS Med 2(11): e317
doi: /journal.pmed

13. Thank you!!