Landmark decision by the Supreme Court of Pakistan on sentencing mentally disordered offenders

Updated: Feb 24

In a landmark decision on 10 Feb 2021, the Supreme Court of Pakistan ruled that prisoners with serious mental health problems cannot be executed for their crimes. In its ruling, the court also directed the Pakistan Government to establish modern and scientific forensic mental health services that ensure prosecutors and trial judges are provided with training in how to assess mental health issues during trials. These far reaching recommendations represent a significant milestone in Pakistan's judicial history and will change the fate of the mentally ill in the years to come.


Like many other countries, the laws in Pakistan relating to insanity & punishment have been subject to significant academic & legal debate. In particular, there has been ample discussion around the complexity of decision-making when it comes to the question of whether to punish or treat a convicted offender with mental disorder.


In a recent case, this complexity of decision-making was raised before the supreme court. Its Larger Bench was called on to address questions relating to culpability, competence to face trial, and execution of sentence in cases where accused persons suffer from mental illness.


The Court observed that the mental health of a person is as important and significant as their physical health. It noted that certain misconceptions can see the implications of mental illness overlooked, and that the vulnerability or disability it causes are not often given the importance and seriousness they deserve.


As a result, the court commuted the death sentences of two defendants who have spent years on death row after being convicted of murder. Both had been diagnosed with schizophrenia after their convictions.

Supreme Court of Islamabad

In delivering its historic decision, the Court directed that:

  • All individuals who come under, or who are implicated in legal or criminal proceedings will have to compulsorily be evaluated by a board of psychiatrists and psychologists on the orders of the Court.

  • All mentally ill defendants who go on to be incarcerated will always be treated in high security units dedicated to their care in teaching hospitals and not in jail hospitals.

  • The Federal Government (for Islamabad Capital Territory) and all the Provincial Governments shall immediately launch training programs and short certificate courses on forensic mental health assessment for psychiatrists, clinical psychologists, social workers, police and prison personnel.

  • The Federal Judicial Academy, Islamabad and all the Provincial Judicial Academies shall also arrange courses for trial Court judges, prosecutors, lawyers and court staff on mental illness including forensic mental health assessment.

The significance of these rulings should not be understated - they have the potential to impact the approach taken to mentally-ill defendants the world over.


WPA President, Dr Afzal Javed, congratulates the Pakistan Psychiatric Society and especially Brig Prof Mowadat Rana for their roles in assisting the Court during the hearing. The WPA & the national & international fraternity of psychiatrists lauds this history shaping decision and hope it influences the approach taken by many other countries as well.

Author: Dr Afzal Javed, WPA President

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