mental unsoundness seminar

8/7/2019 MENTAL UNSOUNDNESS seminar

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SYNONYMS-Mental deficiency, mental

handicap, mental sub normality, mental

illness , amnetia ,insanity, madness,lunacy or disease of personality



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.



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



-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



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



3.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



4. LAB INVESTIGATIONS:

-Blood and urine analysis

-X-ray of the skull

-C.S.F. analysis

-E.E.G

-Scanning test



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



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



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)



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



May be-

¾ IMMEDIATE

¾ ADMISSION TO ASYLUM



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



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.



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.



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



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



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.



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



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.

mental unsoundness seminar

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