LEGAL DOCUMENTS OF ADMISSION OF MENTALLY ILL PATIENTS

BY
ARYEK-KWE JOSEPHINE
LIRA UNIVERSITY
CONTENT;
Admission procedures of mentally ill civil patients
Discharge procedures of mentally ill civil patients
Admission procedures of criminal/ forensic patients
Discharge procedures of criminal/ forensic patients
• The mental treatment Act of 1964 replaced the mental treatment
ordinance of 1938 and provides the following function for the
mentally ill;
• Provides and legalizes the admissions of the mentally ill patients into
authorized institutions
• Protects the mental patients
• Protects the hospital and staffs
• Protects the public
• Imposes punishment on wrong doers to the mentally ill
• Provides proper ways of discharging patients
A. LEGAL DOCUMENTS FOR ADMISSION OF
MENTALLY ILL CIVIL PATIENTS;
1. Urgency order; section 7 of the MTA
• It’s a simple and speedy procedure of getting patients to the hospital
or place of detention.

• It is signed by the following people;

• A qualified medical officer
• Police officer not below the rank of assistant inspector of police
• Gazzetted chiefs i.e LC III to LC V.

Remains in force for only ten (10) days. It is not renewed

Patient should be discharged after its expiry or should be admitted under the
usual temporary detention order.
2. Temporary detention order; section 3 of the MTA
• It’s the standard procedure of detaining a patient in the mental hospital.

• First thing needed to obtain this document is “information of lunacy”.

• Information of lunacy can be made by anyone but must be made by the patients attending
medical personnel who must swear it before a magistrate.

• Swearing should be done in presence of the patient and its best if the patient himself gives
his name.

• It’s a precaution taken by the magistrate to ensure that he has the right patient infront of
him.

• It remains in force for fourteen (14) days then it is renewed for another fourteen days before
it expires.
3. Reception order; section 5 of the MTA
• If the patient does not improve after the renewal of the temporary detention order,
the magistrates appoints two medical practitioners.

• These medical practitioners are not related to each other and the patient.
• They dig up the patients background information pertaining his behavior and illness.

• The magistrates examines the patient, certifies and the signs the reception order.

• Remains in force for one year, renewed for another one year then every after three
years until patient is discharged.

• Such patients are said to be certified. They are not supposed to sign a will, stand in
court as witnesses or even vote.
4. Voluntary order;
• Its not an order but its legally accepted. Its not under the mental treatment
act.

• The patient comes to the hospital by him/herself.

• He/she is presented to the psychiatrist who examines him and confirms that
he is mentally ill.

• The patient should be able to abide by the hospital rules and regulation

• Whenever he/she wants to leave he gives a 72 hours notice and the

psychiatrist arranges his discharge.
B. Discharge procedures for the mentally ill civil patients;
They are discharged in sections under the MTA and these include;

1. Section 18 of the MTA; discharge of mentally sane persons.

• The ward doctor recommends the physical fitness of a patient to the director
who then writes to the director of medical services urging him to discharge
the patient on treatment.
• If the patient is on temporary detention order or reception order, the director
writes to the magistrate who writes to discharge the patient.

2. Section 19 of the MTA; discharge under care of relatives.

If the relatives want to take their patient home; they make a ststement that
they will take care of their patient at home.
• If the patient proves unmanageable while at home, he/she can be readmitted.

• If 28 days expires from the time of discharge before readmission then a new
admission order is signed if being brought back for admission.

• No drug/ medication is provided on discharge.

3. Section 20 of the MTA; discharge of paying patients.

If the relatives or guardian feel that the expenses currently cannot be met by
him, he may request the doctor to discharge his patient.

If patient is not well enough but the relatives insists, he may be discharged on
condition that if anything happens to him, the hospital is not liable to any thing.
4. Section 21 of the MTA; discharging a patient on trial leave
• The director of medical services authorizes the director of the hospital to let a
patient on trial leave.

• Its for 28 days. If a patient fails to return after 28 days a fresh order is then
issued.

5. Section 22 of the MTA; discharge of an escapee patient.

If a patient escapes and has nit returned after 28 days from the day of
abscondment, he is discharged and shall not be taken back unless he comes on a
fresh order.

This section caters for the safety of the hospital and its authorities.
6. Section 23 of the MTA; discharge of a person with a sound mind.
This section provides for discharge of a person with a sound mind who might
have been detained against his will.

The magistrate examines the sane person and finds him sane.
he directs the medical officer to discharge him thereafter.

7. Section 36 of the MTA;

Concerns with the transfer of patients from one hospital to another.

8. Section 38 of the MTA;

This is concerned with the transfer of patients from one country to another i.e
foreigners from other countries to their own countries.
C. Legal procedures for admission and discharge
of criminal /forensic mentally ill patients;
• The penal code Act chapter 106 of the MTA is the order under which remand
patients are admitted
• The criminal procedure Act chapter 107 of the MTA is the order under which
classes A, B and C patients are admitted.
1. Remand patients;
• These are accused persons charged with an offense but suspected to be of
unsound mind while undergoing court proceedings.
• They are therefore admitted to a mental hospital for observations and
investigations.
• They are brought on a warrant of commitment on remand signed by a judge
or a magistrate for a fixed date or open date for appearing in court.
Fixed date remand;
• Its when the date of the next appearance in court is indicated.

• When the date is due, a patient is taken accompanied by a medical report

stating whether capable or incapable of pleading.

• If incapable of pleading he/she is brought back as a class B patient.

Open date remand;

Its when the date of the next hearing is not indicated on the warrant of
commitment.

The patient is collected on any date or time to appear in court on a

production warrant signed by a magistrate.
2. Class B patients;
• These are patients admitted from court having been found incapable of making
their own defense due to insanity.
• They are unable to follow the courts proceedings, appreciating the significance
of pleading guilty or not guilty, challenging the court and appreciating the
evidence given by witnesses.
• They are then admitted to Hospital for observation under the following orders;
• warrant of detention of accused person incapable of making his defense signed by a
judge or magistrate who tries the case pending ministers orders.
• Warrant of detention of accused person incapable of making his defense signed by
minister of justice or attorney general.

Discharge of class B patients;

When patient has recovered, the medical officer makes the certificate of fitness to plead
and takes it to the director of public prosecution who arranges with the court for hearing of
the accused.
• After pleading he is either found guilty and sentenced or found not guilty for
reasons of insanity and therefore brought back to the mental hospital as class
C patients.
3. Class C patients;
• These are criminal lunatics who have attended court and have not been found
guilty for reasons of insanity but are put in detention for unspecified period of
time.
• He is then admitted under the following orders;
• Ministers orders stating for the person not found guilty for reasons of insanity.
• Warrant of detention pending ministers orders signed by a judge or magistrate.

Discharge of class C patients;

• Patient is sent back to prisons pending ministers orders or arrangements are
made after the patient has improved and discharged right home on ministers
orders.
4. Class A patients;
• These are prisoners who develop a mental disorder while serving a sentence in prison.
• They are then transferred to a mental hospital while serving a sentence signed by a
magistrate.
These orders are;
• Temporary detention order or reception order.
• Warrant of commitment on the sentence of imprisonment
• Warrant slip indicating the date when the sentence expires.

Discharge of class A patients;

• When the patient recovers before his sentence expires, he is taken back to prison to
complete his sentence.
• When the sentence expires while patient is still in his hospital and patient has shown
good improvement, he is discharged home under section 18 of the MTA.
• If the sentence expires and patient still mentally sick, he is cancelled off from the
criminal register and transferred to a civil hospital on civil orders.
Mental Health Offences;
1. Section 28 of the MTA; signing of certificates by an unqualified persons
• If found guilty of signing such a document, the person should be detained for
a period of not less than a year.

2. Section 29 of the MTA; signing false medical certificate.

• If a medical professional fully and knowingly signs any certificate falsely
he/she is liable to imprisonment for a period not less than three years.

3. Section 30 of the MTA; assisting escaping of a mental patient from Hospital

• If a mental patient is assisted to escape or hidden, one is liable to pay a fine of
500 shs or imprisonment for a period not more than six months.
4. Section 31 of the MTA; staff permitting a patient to escape
Any hospital staff who willingly and knowing permits a patient to escape before
any proper discharge if found guilty, he/she is sentenced to six months
imprisonment.

5. Section 32 of the MTA; ill-treating of patients;

If any person employed in a mental hospital ill-treats a patient or neglects a
patient, he/she is liable to a fine of 500 shs or be imprisoned for six months.

6. Section 33 of the MTA; striking/ beating or ill-treating a person of unsound

mind while in the community.
If a person does this or obstructs an officer in a mental hospital while on duty, he
is liable to conviction of a fine of 500 shs or imprisonment for a period not less
than six months.
7. Section 34 of the MTA; engaging in any form of trade with a mentally ill
person
• Anybody who without the consent of a medical personnel gives, sells or barters
any commodity to a mental patient in or outside the hospital is liable to a fine
of 500 shs or imprisonment of one month.

8. Section 35 of the MTA; Trespassing on a mental hospital ground.

• Trespassing a mental hospital ground by any person is liable to a fine not
exceeding 200shs or imprisonment of 2 months.