EARLIER this month, at a judicial conference on ‘Mental Health and Mens Rea’, Supreme Court Justice Umar Ata Bandial stated that it would be unfair to punish the mentally ill. That justice is not being served if the person being punished does not know why. Justice Mamoon Rashid Sheikh, from the Lahore High Court, echoed his sentiments, saying that judges, lawyers and mental health professional must collaborate to “find out the truth, and uphold what is just”.

Last year, the now Supreme Court Chief Justice Saqib Nisar rightly pointed out that mental health laws must be tightened to offer protection. “The courts will always support you,” he told a room full of psychiatrists, ready to lend their expertise in developing a proper system evaluation of offenders with mental illnesses.

These are encouraging indicators of a judicial system willing to listen, evolve and improve. There has never been a greater need to protect those who need it the most. A recent review has found that as much as 34 per cent of Pakistan’s population suffers from some form of mental illness. Worrying still is that this number is likely to be understated, as many still do not come forward because of the social stigma associated with mental disabilities. And even if mental illness is invisible, its symptoms can have very real consequences — as it did for Imdad Ali and his family.

Fifty and unwell, Imdad has been on death row for nearly 15 years for fatally shooting his spiritual teacher (for refusing to ‘return his heart’). Fifteen years of jail medical records and a family history of schizophrenia leaves little room for doubt that he is of unsound mind. Being in jail since 2001 has not helped. For the last four years, he has been in solitary confinement after fellow inmates complained of his manic episodes.

Imdad’s case has the potential to un-silence the law.

A patient of schizophrenia, such as Imdad, cannot think rationally and suffers from severely impaired judgement. His condition has progressively worsened despite the administration of anti-psychotic drugs, confirming he is treatment-resistant.

Schizophrenia is a progressive disease that causes structural changes in the brain, as confirmed by MRI and neuroimaging, that destroys the functions of the brain that cannot be ‘recovered’. It manifests itself through symptoms, which for Imdad has been disorderly and maladaptive behaviour, leading to his social and occupational dysfunction. Medication can only manage symptoms.

In short, a person of unsound mind is unable to form criminal intent and cannot subject to punishment under our law.

Unbeknownst to him, Imdad is also perhaps Pakistan’s most infamous death-row case in recent memory. He dominated news headlines last year after the Supreme Court dismissed his appeal, stating that “schizophrenia is not a mental disorder”.

Before this endangered the progress made by the medical community and human rights activists, the court exercised its wisdom and accepted an application to review the judgement, filed by the Punjab government itself. A special medical board was appointed to review Imdad’s mental state last December. His counsel and the medical community have waited for almost half a year, with bated breath.

Why? Because Imdad’s case has the potential to un-silence Pakistani law on whether mentally ill prisoners are fit to be executed. No explicit prohibition on hanging the mentally ill has led many a mentally ill prisoner, diagnosed and undiagnosed, to the gallows in the past. Many continue to languish in jails.

The Supreme Court has a unique opportunity to rectify this lacuna in the law, and champion some of the most vulnerable members of our society. By setting this precedent, the criminal justice system will bring Pakistan in line with its international legal commitments, signalling to the world that it takes its human rights obligations seriously.

The moment has arrived. Great adv­ances have been made in the field of mental health in recent years. Public perception about mental illness has started to shift, as more people come forward seeking help. With the passage of the Mental Health Ordinance, and Pakistan’s ratification of the ICCPR, our legislation is beginning to reflect a more appropriate understanding of this complex area of medicine.

The results of the medical evaluation must be brought forward. Keeping him in solitary confinement any longer is wrongful, not to mention cruel. He is a prisoner who deserves to be in a mental health facility, receiving the treatment he so badly needs and was too poor to afford before. He remains utterly unaware of his reality and does not remember why he is in jail.

But beneath the disease that overpowers his mind and will, he would be heartened to know that his case can help save the lives of many more who suffer like him.

And to a man who can do nothing, that means everything.

The writer is a Sitar-i-Imtiaz- and Hilal-i-Imtiaz-decorated emeritus professor of psychiatry.

Published in Dawn, May 18th, 2017