m SYNONYMS-Mental deficiency, mental

handicap, mental sub normality, mental

illness , amnetia ,insanity, madness
,lunacy or disease of personality
Oisease of mind or the personality , in
which there is derangement of the
mental or emotional processes and
impairment of behavioral control
OR
State of mind in which person loses the
power to regulate his actions , reasoning
and conduct and is unable to adjust to
ordinary social requirements.
!. HISTORY TAKING - To be done very
intimately and patiently only after taking the
patient into full confidence.
a)ï


and difficulties
b) 
 -mental condition of parents,
whether alive or dead.
c)ï

 
-date and place of birth
-normal/instrumental labour
-brought up by mother or any other person
-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 previous
mental illness
-personality
¢.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
_.EXAMINATION OF MENTAL STATE:
-general apperance and behavior
-attitude and posture
-facial expressions
-speech, dress ,manner
-stupor,overactivity
-behavior
-personal habit
-talk
-mood
 -mental content
-disorder of perception
-state of conciousness
-judgement and insight
-orientation
-compulsive phenomena
-memory, intelligence
-sleep
v. LAB INVESTIGATIONS:

-Blood and urine analysis

-X-ray of the skull
-C.S.F. analysis
-E.E.G
-Scanning test
V.OBSERVATION:

An alleged mental pt. to be kept under

observation by a psychiatrist for the
purpose of diagnosis and certification

m Period of observation may extend to !

days at a stretch or even upto _ days
m Certificate not to be issued after single
examination
m Minimum of _ examinations on different
days and different hours recommended
m Certificate should
è Contain clinical description of the patient
è Indicate the reasons for diagnosis of the
specific disorder
m Insanity may be feigned or a person may
pose to be insane to
è Avoid punishment or death sentence in a
criminal case
è Avoid court marshal or to leave job(by
soldiers)
è Avoid contracts (by businessmen)
m Feigned insanity should be differentiated
from real insanity on the basis of
-onset
-presence or absence of motive
-signs and symptoms
-insomnia
-exertion
-habits
-frequent examinations
m May be-

è IMMEOIATE

è AOMISSION TO ASYLUM
m Oone under personal care of
attendants.eg.by safely locking up in a
room
m Oone in case of
è An insane person who is dangerous to
himself or to others
è Person suffering from delirium due to disease
è Oelirium tremens
m Procedures adopted are-
!. Admission on voluntary basis ²person
considering himself mentally ill may request
MO in-charge of psychiatric hospital for
admission and treatment«in case of a
minor, guardian may take such a request

¢. Admission under special circumstances: for

pt.s who may not be able to express their
willingness for admission as a voluntary pt.
_. 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.
v. Reception order on production of mentally
ill 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
V. Admission after judicial inquisition:
if a person possessing property is alleged
to 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 psychiatric
hospital.
6. Admission of mentally ill prisoner:
A mentally ill prisoner can be admitted to
any psychiatric hospital by an order passed by
an appropriate authority under prisoners· act ,
air force act, army act , navy act etc
r. Admission of an escaped mentally ill
person:
such a person can be retaken by any
police officer or any officer or servant of the
psychiatric hospital and readmitted into such
hospital.
!. Voluntary pts. Should be discharged within
¢vhrs of the receipt of request for discharge
made by the patient or the guardian
¢. A mentally ill person who is admitted on an
application by a relative can himself or a
friend or relative can apply to the magistrate
for his discharge
_. An officer in-charge of a psychiatric hospital
can order in writing ,discharge, of any
inpatient on recommendation of two
medical practitioners ,one of whom
preferably being a psychiatrist
v. A mentally ill person detained under
Reception Order made on application shall
be discharged if the person on whose
application the admission order was made,
applies in writing to the officer in-charge

V. If a person detained on Reception Order is

subsequently found by any judicial inquisition
to be of sound mind ,he is to be discharged.