Certificates required.—In the case of a parent or guardian who desires to place a mentally defective person under guardianship, two medical certificates are necessary, one of which must be from a medical man approved by the Local Authority or Board. If the person be not an idiot or imbecile, the certificates must be signed by a Judicial Authority, after such inquiry as he thinks fit. A defective to be dealt with otherwise than by parent or guardian, is so under an order by a Judicial Authority on a petition presented under the Act, an order of a Court if guilty of a criminal offence, or an order of the Secretary of State if detained in prison, a criminal lunatic asylum, or reformatory.
The order of a Judicial Authority may be obtained by petition of any relative or friend, or an officer of the Local Authority authorised under the Act for the purpose. Two medical certificates must accompany the petitions, one of which must be signed by a medical man approved by the Local Authority or Board; or, when a medical examination cannot be carried out, a certificate to that effect must be presented, and a statutory declaration made by the petitioner and one other person, who may be one of the medical certifiers, stating the class to which the defective belongs. Upon receiving the certificates the Judicial Authority interviews the defective. When the petition is presented by a parent or guardian, the Judicial Authority, if satisfied, may issue an order for the defective to be placed in an institution or appoint a guardian. If the petitioner be not parent or guardian, consent in writing of one or other must be obtained, without which the order must not be made, unless the parent or guardian withhold their consent unreasonably or are not to be found. If the Judicial Authority be not satisfied, he may postpone the order, or refuse it.
When the order is made by a Court, the Court must be satisfied, on medical evidence, that the person is a defective.
Two medical certificates are necessary when the Secretary of State makes an order.
The order remains in force for a year, may be renewed for a second year, and then for periods of five years.
GENERAL SYMPTOMS OF INSANITY
The onset of insanity may be gradual or sudden. More commonly the onset is gradual, and manifested by alterations of emotion and conduct, which may for a considerable period precede any impairment of intelligence. Periods of depression may alternate with periods of excitement. Irritability and instability of temper manifest themselves, and lead relatives and friends to become suspicious of the change that is the herald of serious mental impairment. Lack of interest in environment, business, or the usual pleasurable pursuits, also a tendency to personal seclusion manifest themselves, and changeability of the affections, more often to those nearly related, are not uncommon. Sooner or later the capacity to conduct business and allied pursuits becomes enfeebled, and the power of judgment lessened; depression begets apprehension and a dread of impending ruin in this world or in the world to come. Marked indecision and vacillation of action is quite common. Delusions follow, mostly of persecution, in the form of attempts to cause ruin or poisoning. Delusions associated with the special senses are common, particularly of hearing, supposed voices urging the committal of certain actions, or expressive of derision; of vision, by which objects are seen which are non-existent; of taste, imparting the idea of poisoning; of touch and pain, invoking peculiar sensations; of smell, conveying the idea that food, the body, &c., exhale disgusting odours.
Associated with the onset of insanity, and remaining permanently, are three special distortions of perceptions—viz. illusions, hallucinations, and delusions. So long as the first two can be reasoned upon and rejected, judgment remains. At one or other time the afflicted person becomes so affected by them that they become realities, and are accepted as true and existent; then the judgment is perverted, and the person is said to suffer from a delusion.
Illusions.—An illusion is a false perception, a perversion of the senses, a mockery, false show, counterfeit appearance. The false perception is, however, invoked by some external appearance.
Hallucinations.—Hallucinations are perverted sensations and perceptions, for the production of which no external impulse is present. The person may complain of seeing horrible reptiles around, which are not present. So long as the reasoning faculties are capable of dispelling the alleged reality of the hallucination and rejecting it, it remains but an hallucination.