Forensic psychiatry, the link between psychology and law, has undergone a transformation within the Pakistani justice system. Building on the foundations laid by the Pakistan Penal Code, 1860 and the Code of Criminal Procedure, 1898 to address mental health, the Qanun-i-Shahadat Ordinance of 1984 further emphasized the role of expert witnesses in such cases. case. While Pakistan once relied on the Indian Lunacy Act of 1912, the landscape changed with the Mental Health Ordinance of 2001. But the game changer came with the 18th Amendment of 2010, prompting provinces to develop their own mental health policies reflecting the growth of the country. commitment to mental health in the legal field.
Several cases highlight the growing intertwining of mental health trials and criminal trials. The Safia Bano affair constitutes an important turning point. This case transformed the fate of three people, replacing their death sentences with life sentences. It also highlighted the increasingly essential nature of mental health assessments in the legal process. The legal knowledge of Justice Manzoor Malik, combined with the expertise of Professor Mowadat Hussain Rana, is testimony to the growing convergence of law and psychiatry.
The Safia Bano case marked a pivotal moment in the history of Pakistan’s forensic psychiatry, laying the foundation for the future of the country’s forensic mental health services. Subsequently, the landmark Imdad Ali case reinforced the Supreme Court’s unwavering recognition of the equal importance of mental and physical health in the legal realm. The court relied on a set of definitions and guidelines from established sources, such as ICD (International Classification of Diseases, DSM (Diagnostic and Statistical Manual of Mental Disorders), Indian Mental Health Act, 2007 , the Mental Health Act 2001 and the Provincial Mental Health Laws. He called for amendments to existing mental health laws, in line with the latest editions of the WHO ICD. In addition, the court ordered the removal of archaic and potentially stigmatizing terms such as insanity from legal texts, thus favoring the use of more modern and empathetic terminology.
The disturbing case of Zainab Ansari, coupled with Javed Iqbal Mughal’s horrific confession, and the horrific Noor Muqadam case of 2022 collectively highlight the urgent need for in-depth forensic psychiatric evaluations within Pakistan’s justice system. The brutal rape and murder of Zainab by Imran Ali revealed deep-rooted psychopathological issues in the perpetrator, highlighting the imperative to combat mental disorders in such contexts.
Qualified forensic psychiatrists are absent.
Similarly, the grisly crimes of the Mughals, involving the calculated murders of 100 boys, highlighted the urgent need for robust forensic psychiatric practices to navigate the intricacies of such brutalities. Furthermore, the tragic and brutal murder of Noor by Zahir Jaffer, which shockingly involved captivity and beheading, has amplified calls for a complex understanding and assessment of the mental state of the perpetrators before the execution of their crimes , thus further reinforcing the demand for comprehensive psychiatric assessment mechanisms within the legal framework.
In light of these grave realities and in response to the Supreme Court’s directives, the demand for specialized medical boards, staffed by psychiatrists and psychologists with expertise in forensic mental health, has reached an unprecedented peak. Current efforts remain limited due to a palpable deficit in capacity building: notably, Pakistan has not yet recognized forensic psychiatry as a specialty nor does it host a qualified forensic psychiatrist on its territory. This stark contrast causes apprehension, even though many qualified forensic psychiatrists of Pakistani origin practice successfully in countries such as Canada, the United States, the United Kingdom and Australia.
However, a breakthrough came in 2022. Canadian psychiatrists from Queens University Canada, in collaboration with the Psychiatric Society of Pakistan, Department of Psychiatry (MH Rana) at Sheikh Zayed Medical College Rahim Yar Khan Hospital, l Islamia University (Rahim Yar Khan campus) and Justice Project Pakistan. introduced a three-month online certification course in forensic mental health. This ambitious initiative aims to transform participants into professionals versed in evidence-based assessments and forensic testimony.
Pakistan has the potential to harmonize its legal heritage with modern advances in forensic mental health.
Dr. Ali Burhan Mustafa is Secretary, Psychiatric Society of Pakistan, Punjab Chapter and Associate Professor, Department of Psychiatry and Behavioral Sciences, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan.
Dr. Urooj Zafar is an Assistant Professor at the Department of Psychiatry and Behavioral Sciences, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan.
Published in Dawn, November 4, 2023
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