How Mental Illness Influences Criminal Responsibility - A Deep Dive Into Legal And Ethical Implications
Author: LawSphereX
Category: Criminal Law
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HOW MENTAL ILLNESS INFLUENCES CRIMINAL
RESPONSIBILITY: A DEEP DIVE INTO LEGAL AND
ETHICAL IMPLICATIONS
Ankita, LL.M (OYC), Rajiv Gandhi National University of Law
ABSTRACT
This study explores the intricate relationship between mental illness and criminal responsibility, highlighting the legal and ethical implications inherent in this dynamic. It explores how mental health disorders can influence in criminal actions, thereby challenging conventional ideas of guilt and accountability. By analyzing relevant case law and legislative frameworks, the research delineates the criteria used to assess criminal responsibility in individuals with mental illnesses, focusing on standards such as the McNaghten Rules and their application in various jurisdictions. Additionally, the paper addresses the ethical implications of involuntary commitment and treatment, highlighting the need for a balanced strategy while ensuring public safety.
By thoroughly exploring these topics, this study aims to enhance the ongoing discussion regarding mental health and for reforms that acknowledge the complexities of mental illness and foster more equitable treatment outcomes.
INTRODUCTION
The Indian legal system refers to the set of laws functioning within the country. In ancient times, India had a distinct legal tradition, along with its own school of legal thought and practice. Law has long been used as a means for intellectual discourse and the enforcement of religious principles. The concepts of tolerance and pluralism presented by Manu gained significant acceptance in Asia.1. Shariat law was introduced, though it primarily governed the Muslim community. A notable transformation took place when India came under British rule, resulting in the substitution of Islamic and Hindu laws with common law. Consequently, the contemporary legal framework in India is primarily influenced by the British legal system, showing minimal connection to its pre-colonial origins. A large portion of contemporary Indian law is built upon English Common Law, which is based
on documented legal precedents and influenced by European and American legal systems. Many of the laws that were established during British rule are still in force today. For instance, much of the legislation related to mental health issues has its origins in this colonial period. The idea of mental disease, how mentally ill people are treated, and the law are all intertwined. As stated by Rappeport, the court can be seen as "another house... with its different motives, goals, and rules of conduct" for psychiatrists2. While the court often focuses on evaluating factors such as competency, potential dangerousness, reduced responsibility, or the broader interests of society. Thus, these issues were covered by the majority of the previous PMI laws in India as well. Nonetheless, laws written since the 1980s frequently emphasise PMI rights as well.
Mental Illness and the Constitution of India Article 21 of the Indian Constitution asserts that “an individual cannot be deprived of life or personal liberty except through a procedure prescribed by law. ” According to certain rulings, "facilities for reading, writing, and expressing oneself in diverse forms, freely moving about and mixing and comingling with fellow human beings" are included under the article 21 of the Constitution3. Under Section 16 of the Representation of People Act, 1950, ‘individuals declared mentally unsound by a competent court are ineligible for inclusion on electoral rolls. As a result, such
1 HP GLENN, LEGAL TRADITIONS OF THE WORLD 255-76 (Oxford University Press 2000).
2 S.BLOCH, P.C ET AL., PSYCHIATRIC ETHICS (Oxford University Press 1981).
3 SINGH MP, VN SHUKLA’S CONSTITUTION OF INDIA 165 (9th ed., 1994).
individuals are constitutionally prohibited from holding any public office, including positions like President, Vice President, Minister, Member of Parliament, or member of a State Legislature.’
LEGISLATION IN INDIA REGULATING THE TREATMENT OF INDIVIDUALS
WITH MENTAL DISORDERS
The relationship between law and mental disorder is particularly important when it comes to the treatment of people with mental disorders. Often, the treatment of the persons with mental illnesses involves some degree of restriction on their personal liberties. Many countries have established regulations that govern the care and management of these conditions. In Indian asylums originated during the British era, even though numerous Ayurvedic texts provide comprehensive accounts of different mental disorders the actual treatment started with the British era. After the British monarch assumed control over India's administration in 1858, a series of laws were promptly established regarding the treatment and care of individuals with mental health issues4.
The legislation in question is comprised as: The Lunancy Acts gave instructions on how to set up mental asylums and how to accept individuals with mental illnesses. India's lunacy laws in the mid-1800s were influenced by the British legal context of the time. Unsurprisingly, the various Acts introduced in 1858 reflected the judicial framework for handling individuals with mental illnesses. In the early 1900s, Indian intellectuals, driven by a rising sense of political awareness and nationalism, began to emphasize the dreadful conditions in mental asylums. This increasing pressure resulted in the passage of the Indian Lunacy Act in 1912. This act significantly influenced the development of psychiatry in India5. After being renamed mental hospitals in 1922, lunatic asylums were now subject to central government regulation and oversight.
In this regard, the certification and admissions process was well-defined. The option for voluntary admission was introduced, with a primary focus on protecting society from the perceived risks associated with mental illness and ensuring that no mentally competent individuals were committed in asylums. The legislation included measures for judicial reviews concerning the condition of individuals with mental illnesses. After World War II, the UNGA adopted the UDHR. In 1950, the Indian
4 G.Banerjee, The Law and Mental Health: An Indian Perspective, 2001,
http://www.psyplexus.com/excl/lmhi.html (September 20, 2024). 5O. Somasundaram, The Indian lunacy act, 1912: The historic background, Indian J Psychiatry 3,14 (1987).
Psychiatric Society drafted a Mental Health Bill to update the outdated Indian Lunacy Act of
1912. Following an extensive legislative process, the Mental Health Act (MHA-87) was finally
enacted in 1987. The primary features of the Act are summarized as : • A thorough definition of mental illness and the implementation of a contemporary treatment approach that emphasizes care and rehabilitation instead of confinement. • Creation of the Central as well as State Mental Health Authorities, which are responsible for advising and supervising psychiatric facilities and nursing homes. • Provision for admission to psychiatric hospitals or nursing homes under specific circumstances, while also allowing for voluntary admissions and those made through receipt orders. • Designation of duties for the police and magistrates in addressing cases involving individuals with mental illnesses who are homeless or facing mistreatment. • Stipulations for penalties in the event of violations of the Act's provisions.
Although the Mental Health Act of 1987 (MHA-1987) includes several beneficial elements, it has faced criticism since its implementation. The Act is often seen as being primarily focused on the legal aspects of licensing, managing admissions, and addressing guardianship issues related to individuals with mental illnesses. The complexities, inconsistencies, and deficiencies present in the Act and its related regulations impede its proper implementation. Human rights activists have expressed concerns regarding the constitutionality of MHA-1987, contending that it restricts individual liberties without allowing for sufficient judicial oversight6. Currently, there are ongoing efforts to revise this act to ensure it is in accordance with UNCRPD.
The Persons with Disabilities (Equal Opportunities, Protection of Rights, and Full Participation) Act, 1995 The Persons with Disabilities (Equal Opportunities, Protection of Rights, and Full Participation) Act, 1995- (PDA-95) was implemented to eliminate disparities in access to developmental benefits between individuals with and without disabilities. Its goal is to safeguard persons with disabilities (PWD) from abuse. The Act requires the government to establish comprehensive initiatives for the empowerment and inclusion of PWD in society, 6 Choudhary L. Narayan & Deep Shikha, Indian Legal System and Mental Health, Indian J Psychiatry 177, 181 (2013).
ensuring accessible environments. It recognizes mental illness and mental retardation as disabilities, granting those to the benefits available to PWD. National trust Act‐1999 This Act, introduced in 1999, was designed to support and empower individuals with autism, cerebral palsy, mental retardation, and multiple disabilities etc. It encourages people with these disabilities to lead independent lives and remain integrated within their communities, while ensuring the protection of their rights and promoting equal opportunities. The Act provides a variety of support programs. Additionally, the Act is currently undergoing revisions to better align to the 2006 UNCRPD, broadening its scope. The revised version is expected to introduce provisions concerning the management of properties owned by individuals with mental health conditions (PMI).
UNCRPD 2006 and Indian Legislation In December 2006, the United Nations adopted UNCRPD, which was later ratified in May
2008 by India. As a result, India is making substantial changes to its legislation related to
disabilities. The convention represents a transformative approach, viewing disabilities through a human rights lens rather than merely as issues of social welfare. This shift emphasizes principles such as equality, dignity, and legal capacity. Article 4 stresses the need for safeguards against the misuse of mandatory assistance programs for persons with disabilities. Although the UNCRPD does not explicitly ban forced interventions, it refrains from endorsing involuntary mental health treatments7. In 2011, a draft Mental Health Care Bill (MHCB) introduced to initiate the revision of the Mental Health Act of 1987 (MHA-87). The MHCB aimed to replace the existing framework for licensing mental health facilities by creating a Mental Health Review Commission along with corresponding state panels.
A crucial aspect of the bill is the establishment of government responsibilities to give accessible services to all individuals suffering from mental illness. Additionally, the bill contains comprehensive provisions dedicated to safeguarding the basic rights of individuals with these health conditions, with an entire chapter devoted to the protections. United Nations, Convention on the Rights of Persons with Disabilities (2006), https://www. un. org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities. html ( Sept. 20, 2024).
The Ministry of Social Justice and Empowerment (MSJE) was presented with a draft of "The Rights of Persons with Disabilities Bill, 2011 (RPWD Bill)," which seeks to revise the 1995 Persons with Disabilities Act (PDA-95). The proposed Section 18 of the bill ensures that individuals with disabilities are granted the same legal footing as everyone else across all arenas of life, invalidating any laws, regulations, or practices that would disqualify them from employment due to their disability. Furthermore, the bill provides PWDs to modify or discontinue any support system they have in place, while preserving their right to receive assistance when needed to exercise their legal rights. The concept of limited guardianship is introduced to replace full guardianship.
Additionally, out of the proposed 7% government job reservation for PWDs, 1% is specifically allocated to individuals with mental illnesses. The provisions of the RPWD Bill and the MHC Bill conflict with each other. The RPWD Bill's drafting team mainly consisted of human rights advocates. Some of these activists advocate for granting all persons with mental illnesses (PMI) full legal capacity, and they push for an outright ban on involuntary institutionalization, even proposing the complete closure of all mental health facilities. They argue that the MHCB falls short as it does not presume universal capacity and fails to provide a framework that enables individuals to make autonomous decisions about their lives. There have been calls for the full repeal of the MHA-87, with suggestions to address these issues through an integrated RPWD Bill under the MSJE's oversight.
Although the 2011 draft Mental Health Care Bill was introduced, it was never passed into law. However, the deliberations and recommendations from that time were instrumental in influencing later legislative developments. Over time, it became increasingly clear that comprehensive reforms were essential to effectively address the rights and needs of these individuals and mental health legislation in India aligned with evolving global standards. The Mental Healthcare Act, 2017 The Mental Healthcare Act of 2017 serves as the primary legislation governing mental health treatment in India. It defines the duties of mental health professionals and establishes clear processes for admission and treatment. The Act marks a significant transition towards a rightsbased approach. It supersedes the Mental Health Act of 1987 and reflects a shift in policy to ensure better care and treatment.
The Act characterizes mental illness to include disorders related to substance abuse, such as those associated with alcohol and drugs, as well as other mental health conditions and as "a
substantial disorder of thinking, mood, perception, orientation, or memory that grossly impairs judgement, behaviour, capacity to recognise reality, or ability to meet the ordinary demands of life. " Additionally, it guarantees patients' access to facilities such as sheltered and assisted housing, community centres, hospitals, and homes that offer rehabilitation treatments. It controls the use of neurosurgical therapies as well as research on PMIs (persons with mental illness). The MHA grants individuals the comprehensive right to establish an advance directive, enabling them to outline their treatment preferences in case of a mental health crisis. The Mental Healthcare Act, 2017, brought about several significant changes, including: • Informed Consent: Informed consent is a crucial element of mental health treatment.
According to the legislation, each individual must have the autonomy to decide how they want to be treated for their mental health, and no treatment may be started without the patient's informed permission. • Advance Directives: People can designate the treatment they want to get or not receive in the event that they become incapable of making decisions for themselves by creating advance directives. This covers choices for electroconvulsive therapy (ECT) and medication. • Ability to Make Decisions About Mental Health: Individuals' right to choose their own mental health treatment is recognised under the statute. A person is considered capable of making decisions about their mental health until evidence suggests otherwise. • Involuntary Admissions: Only under certain conditions are involuntary admissions permitted, and the legislation specifies the requirements that must be fulfilled.
The oversight of the involuntary admission process is a critical function of Mental Health Review Boards. • Prohibition of Electroconvulsive Therapy (ECT) and Psychosurgery for Minors:
With rare exceptions, the legislation prohibits the use of psychosurgery and electroconvulsive therapy (ECT) on minors, aiming to protect the young individuals dealing with mental illness issues. • Decriminalization of Suicide Attempts: By recognising that those who attempt suicide require care and assistance rather than punishment, the legislation decriminalises suicide attempts. This is a substantial change from previous legal provisions. • Central and State Authorities: The legislation establishes Centre-State Mental Health Authorities to oversee its implementation and offer policy recommendations to the government concerning mental health matters. • Training with Sensitization: To promote a compassionate approach and raise awareness regarding mental health conditions, the legislation requires training for healthcare providers, law enforcement personnel, and other pertinent parties.
By working together, these laws aim to guarantee that people with mental illnesses in India receive treatment that is compassionate, dignified, and respectful of their autonomy and rights. The legislation also establishes procedures for monitoring and evaluation, including the function of Mental Health Review Boards at different levels. This marks a significant advancement in combating the stigma associated with mental illness and fostering a more inclusive approach. Criticism of The Mental Healthcare Act, 2017 • Lack of MHRBs: Numerous states have yet to implement necessary guidelines to guarantee the quality of Mental Health Institutions (MHIs), and many have not established State Mental Health Authorities or Mental Health Review Boards (MHRBs). Without MHRBs in place, individuals face challenges in asserting their rights or seeking redress when those rights are violated.
Insufficient Budgetary Allocation: Insufficient budget allocation and financial management lead to circumstances where shelter facilities remain understaffed, poorly equipped, and lacking adequate training for professionals and service providers tasked with delivering mental healthcare. • Stigma: Individuals are often placed in these facilities by families, law enforcement, or the legal system. Families often hesitate to reintegrate individuals who have been incarcerated due to the stigma associated with imprisonment and the belief that these individuals may no longer contribute value to society. • Gender discrimination plays a role here: In this case, gender discrimination is at play since women are more likely to be abandoned as a result of "violence in intimate relationships, marital discord, and family disruption.
" • Lack of Services in the Community: Although Section 19 recognizes the right of individuals to "live in, be part of, and not be segregated from society," no significant actions have been undertaken to actualize this right.
CRIMINAL RESPONSIBILITY AND HUMAN CAPACITY: THE REALTIONSHIP
BETWEEN MORAL CULPABILITY AND MENTAL ILLNESS
Criminal responsibility is essential to determine whether an accused individual should be held accountable for their actions during a criminal investigation, prosecution, and trial. Perhaps surprisingly, system professionals such as judges, practitioners, and expert witnesses almost never conceptually analyse this fundamental idea. The argument posits that a more profound comprehension of the philosophical, particularly the moral, foundations of attributing criminal responsibility would equip those of us in the criminal justice system to fulfill our respective duties more effectively. Comprehending the ethical aspect is especially crucial for the sentencing process, since determining moral culpability is a critical aspect. • "Criminal responsibility" for the purposes of this definition refers to criminal culpability, or the legal responsibility for committing the applicable offence.
“Moral culpability” denotes the moral blame that is justifiably associated with the offending behavior. Taking a moral stance is necessary in order to assign criminal responsibility. After deciding to forbid specific types of behaviour under penalty, we have morally concluded that only those with enough mental capacity need to face criminal charges for breaking such restrictions. In cases where an individual acknowledges to engage in unlawful activity or it is proven that they did, mental impairment serves as a defence against criminal responsibility. That's the domain where the mental disability defence functions. In R v. Verdins8, the Court expanded on its prior ruling in R v. Tsiaras9 that: “Impaired mental functioning at the time of the offending may reduce the offender’s moral culpability if it had the effect of: a.
Impairing the offender’s ability to exercise appropriate judgment; b. Impairing the offender’s ability to make calm and rational choices, or to think clearly; c. Making the offender disinhibited; d. Impairing the offender’s ability to appreciate the wrongfulness of the conduct; e. Obscuring the intent to commit the offence; or f. Contributing (causally) to the commission of the offence.
10” In the case of Brown v The Queen11, “the disorder: • Had a ‘very significant’ impact on her ability to exercise appropriate judgment, both in the sense that the offending behaviour was engaged to facilitate her return to custody, which itself was motivated by her lack of ability to integrate into society due to her disorder; and secondly, that she could not understand the impact of her fire-lighting behaviour ‘to the extent that a person without personality disorder would’; • Contributed to her making irrational choices, although there was no evidence that her thinking was disorganised or that she was not calm, consistent with an organised, delusional belief system;
8 R v. Verdins, (2007) 16 VR 269.
9 R v. Tsiaras, [1996] 1 VR 398.
10 Verdins, supra note 9.
11 Brown v. The Queen, [2020] VSCA 212.
Caused her to fail to experience the inhibitory mechanisms that most people would experience; • Prevented her from having any emotional awareness that the conduct was wrong on a ‘deeper moral level’, despite her understanding that her conduct was legally wrong (given her motivation for the behaviour was said to be for the purpose of being returned to custody); and • Contributed causally to the commission of these offences, as any causal explanation for her offending without reference to personality disorder would be ‘fatuous and empty’. ” The Court opined that ‘fundamentally impaired her ability to act rationally, regulate her conduct and fully understand the consequences’12. The fields of forensic psychology and psychiatry have taught courts new insights that have shaped the laws pertaining to mental illness and sentence.
Forensic psychiatrists and psychologists provided guidance to judges and criminal law practitioners during a collaborative effort that led to the creation of the 2017 "Expert Reports on Mental Functioning of Offenders. "
A deeper understanding of the nature of judgments related to criminal responsibility and
culpability will improve the functioning of the criminal justice system for judges and practitioners. Achieving this goal necessitates a sustained willingness to learn from others.
CRIMINAL LIABILITY AND MENTAL ILLNESS UNDER INDIAN LAW
IPC specifies that “Nothing is an offence, which is done by a person who, at the time of doing it, by reason of unsoundness of mind, is incapable of knowing the nature of the act, or that he is doing what is either wrong or contrary to law.” The criminal responsibility of people with mental illness articulated through the McNaghten Rules, which are now integrated into Section 84 of IPC. The Supreme Court has determined that the assertion of insanity must be proven, as the law operates under the presumption that all individuals of voting age are sane. Section 89 of IPC provides “protection for actions taken in good faith by a guardian or someone with legal authority for the benefit of a person deemed mentally incapacitated.”
12 Id., at pg 12.
Under Section 471(i) of (Cr. P. C. ), individuals diagnosed with mental illness are admitted to psychiatric hospitals if their defense claims insanity. In certain instances, sentences have been commuted due to mental considerations. Regardless of whether a person having mental illness has engaged in criminal behavior, they deserve care and understanding. These cases highlight how the Indian criminal justice system addresses mental issues and disabilities. • In the case of Mahendra K. C. v. The State of Karnataka and Others13 The defendant, an officer in the State of Karnataka, had employed the brother of the appellant as his driver. The deceased had left a note detailing the reasons for their suicide, which they had shared on social media. After posting on Facebook, the individual took their own life.
The note alleged that the defendant was involved in various illegal activities to generate income. It further indicated that he funneled his illicit earnings into the deceased's bank account, effectively laundering the money. He then used to credit his relatives' accounts with all the money he had deposited to the deceased bank account. The appellant claims that the deceased suffered a tremendous deal of anguish and stress as a result of the accused's threats to murder him. The driver ended his life by poisoning himself as a result of this. The Karnataka High Court dismissed the case after a single judge bench found that it was a waste of time and that hearing it would have been a gross injustice. The Hon' Apex Court held that the High Court's decision to suspend the probe was erroneous and shouldn't have been taken for the same reason.
At this point, the High Court had no business acting as a Trial Court and verifying the accuracy of the facts. Additionally, the High Court had gone beyond what is permitted under Code of Criminal Procedure section 482. Moreover, the High Court did not examine the accuracy of facts either. It just went on to state its own perception of the case. The Supreme Court held that because this was such a delicate topic, it could not be approached in a "one size fits all" manner. The deceased was referred to as a "weakling" by the Karnataka High Court's single-judge bench, which was also censured by the Supreme Court.
13 Mahendra K.C. v. The State of Karnataka and Others, Criminal Appeal No. 1238 of 2021 (India).
Ultimately, the appellant's appeal was accepted by the division bench of Hon. Justices Dr. D. Y. Chandrachud and B.V. Nagarathna, which overturned the High Court's decision.
There has been discussion of significant legal provisions in the Indian law system pertaining to the PMI. The laws pertaining to PMI are now in a state of transition, with the majority undergoing revisions (like MHA, 2017) to align with the UNCRPD-2006. It is crucial to prioritize the well-being of both PMI and society as a whole in any legislative measures.
CONCLUSION
In conclusion, there are many facets to the difficult question of how mental illness affects criminal responsibility, which calls for a careful balancing act between justice and compassion. Legal systems worldwide struggle to determine whether individuals with mental illness can be held culpable. The way that mental illness is acknowledged in criminal proceedings has changed throughout time, and some jurisdictions have included defences like insanity and diminished capacity. Developments in psychology and neuroscience add to our growing awareness of the complex relationship between criminal responsibility and mental illness. There is a growing recognition of the need to ensure equitable treatment, rehabilitation, and the protection of rights for individuals with mental health conditions as legal systems strive to tackle the distinct challenges associated with mental illness.
Initiatives such as specialized assessments, mental health courts, and revised sentencing guidelines illustrate humane and rehabilitative justice framework. This reflects society's commitment to fostering understanding and support for those affected by mental health issues. In the end, striking the correct balance between responsibility and compassion is still difficult. This emphasises the need for ongoing discussion, investigation, and policy creation to guarantee that legal responses are not only reasonable but also take into account the variety of factors influencing behaviour in those who are impacted by mental illness.