Jaydip Sarkar than mental retardation”. (It also defines a “mentally ill prisoner” as a mentally ill person for whose detention in, or removal to, a psychiatric hospital, psychiatric nursing home, jail or any other place of safe custody, an order under a relevant section of the Act has been made). Merely being in need of treatment is what constitutes mental illness in the Indian MHA ’87. Clearly, there are grave problems with this definition because it casts the entry net far too wide and arguably almost anybody who displays slightly abnormal behaviour can be deemed to be detainable as long as two doctors certify that he is in need of treatment and a magistrate accepts their recommendations. By making a person detainable merely because it is felt that he may be susceptible to treatment is a legally unsound strategy because without a reasonable definition of what mental disorder is, the law would be open to abuse. The history of psychiatry reveals that mental health laws can be used to masquerade incarceration as treatment and show psychiatrists more as agents of social control than healers. The experience of Soviet psychiatry of the communist era demonstrated for posterity the risk of having definitions that are open to misuse, where thousands of political dissidents were admitted involuntarily to psychiatric hospitals in the name of ‘treating’ them. More recently the abuse of psychiatry continues in China (Human Rights Watch 2002, van Voren 2003). Substantial criticism and resistance to proposed changes to the existing MHA of a country has been mobilized, where the government is proposing a definition similar in its scope to the one within the Indian MHA ’87 (Royal College of Psychiatrists 2002). There are different types of disorders with different treatment outcomes to which a legal definition of mental disorder must apply. The principle of beneficence in medical ethics (Beauchamp and Childress 1989) emphasises that in the treatment of a disorder, a cure should be pursued ideally where attempts are made to remove the cause of an illness. Where this is not possible, control or remission of the condition is desirable, failing which mere prevention of deterioration of the condition can be a legitimate aim of treatment. Merely detaining someone in the hope that some improvement can be demonstrated by virtue of being in a secure environment in the absence of effective treatment is unethical and cannot be allowed by law. In view of a changeable notion of what constitutes appropriate and effective treatment of a condition, it then becomes necessary to incorporate different categories of mental disorder when a statutory definition is attempted. A close look at the international classificatory system of psychiatric disorders, ICD-10 (WHO 1993) reveals that 108 there are primarily four different classes of mental disorders. These are: 1. Disorders of adults that are generally characterized by periods of relative well being interspersed with manifest symptomatology. The commonest examples include the affective disorders and schizophrenia even though there is often a progressively deteriorating course. These are conditions that are largely treatable with medications, often alone or in conjunction with psychosocial treatments. 2. Organic brain disorders, either congenital or acquired, where the damage is irreversible. The prototypical disorders in this category are the dementias (acquired) and mental retardation (congenital). Treatment can either control certain undesirable symptoms of these disorders (e.g. mental retardation) or arrest the progression of the disorder (for a while) but not reverse the deterioration (dementia). 3. Disorders of adult personality and of lifestyle (including substance misuse, sexual preference, and some impulse control disorders) which are only inadequately managed with pharmacotherapy, often requiring specialized psychological input to bring about symptom control, harm minimization, or both. Patients with substance misuse problems that lead to frank Axis I disorders would fall into both categories of 1 and 3. 4. Childhood disorders where the nature and treatment strategies are different to those of adult disorders, where patients are most often dealt with outside of a legal framework unless their disorders have features of adult disorders and they are no longer minors. The English and Welsh MHA ‘83 has four categories of mental disorder, where a specific clinical diagnosis of mental disorder is not required for involuntarily detention in hospital. These categories are i) mental illness, ii) mental impairment, iii) severe mental impairment and iv) psychopathic disorder. The other three categories apart from mental illness have the common feature of being associated with “abnormally aggressive or seriously irresponsible conduct” and can also include “impairment of intelligence” (Jones 2003, p 12). Psychopathic disorder in this act is a legal definition and does not translate into clinical psychopathy (Hare1991). It is merely the legal terminology for clinically diagnosed personality disorder that has been associated with violence. Under the English and Welsh MHA ’83, patients with mental impairment and psychopathic disorder can only be detained involuntarily if it thought that medical treatment is likely to alleviate or prevent a deterioration of their condition, reflecting the limitations of effectively treating