Mental health care act 2017

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Government of Punjab (Department of Health and Family Welfare)

NOTIFICATION

Chandigarh, the…………… 2019

G.S.R……. In exercise of the powers conferred by the proviso to Sub Section (2) and (4) of Section 121 of the Mental Healthcare Act, 2017, the State Government hereby makes the following rules, as depicted in Part-I.

CHAPTER– I

Preliminary

1. Short title, extent and commencement:-
(1) TheseRulesmaybecalledthePunjabStateMentalHealthcare(StandardsofCare)

Rules, 2019.
(2) TheyshallcomeintoforceondateoftheirpublicationintheOfficialGazette. (3) TheyshallextendtothewholeStateofPunjab.

2. Definitions. – (1)In these rules, unless the context otherwise requires,-

a. “Act” means the Mental Healthcare Act, 2017 (10 of2017);

b. “Form” means a form appended to these rules;

c. “Hospital and community-based rehabilitation establishment” means an establishment providing hospital and community-based rehabilitation services;

d. “Hospital and community-based rehabilitation service” means rehabilitation
services provided to a person with mental illness using existing community resources with an aim to promote his reintegration in the community and to make such person independent in all aspects of life including financial, social relationship building and maintaining;

e. “Half-way Homes” means a transitional living facility for persons with mental illness who are discharged as inpatient from a mental health establishment, but are not fully ready to live independently on their own or with the family;

f. “Sheltered Accommodation” means a safe and secure accommodation option for persons with mental illness, who want to live and manage their affairs independently, but need occasional help and support;

g. “Supported Accommodation” means a living arrangement whereby a person, in need of support, who has a rented or ownership accommodation, but has no live-in caregiver, gets domiciliary care and a range of support services from a caregiver of an agency to help him live independently and safely in the privacy of his home;

h. “Non-official member” means a member of the State Authority nominated under clauses (g) to (n) of sub-section (1) of section 46 of the Act;

i. “Schedule” means the schedule annexed to these rules;

j. “Section” means section of the Act;

(2) The words and expressions used herein and not defined, but defined in the Act or, as the case may be, in the Indian Medical Council Act, 1956 or in the Indian Medicine Central Council Act, 1970, in so far as they are not inconsistent with the provisions of the Act, shall have the meanings as assigned to them in the Act or, as the case may be, in those enactments.

CHAPTER II

PERMANENT REGISTRATION OF MENTAL HEALTH ESTABLISHMENTS BY STATE AUTHORITY

3. Provision for Permanent Registration of Mental Health Establishments by State Authority

. 1)  Every mental health establishment in the State, except the mental health establishment under the Control of the Central Government, shall be registered with the State Mental Health Authority for which an application will be submitted in Form–B appended with these rules.

. 2)  Every mental health establishment registered previously under any act/rules shall also submit an application for permanent registration to the State Authority in Form-B within six months from the notification of the standards of Care rules by the State Government, containing details as specified therein, along with a fee as notified by the State Government by way of a demand draft in favor of the Chairperson, State Mental Health Authority payable at the place where the State Authority is situated.

. 3)  TheStateAuthorityshall,onbeingsatisfiedthatthementalhealthestablishmentfulfills all the requirements in terms of sections 65, 66and Schedule A, B & C appended with these rules, grant to such mental health establishment, a permanent registration certificate in Form-C.

4. Validity and Renewal of Certificate of Registration-The permanent registration certificate granted under sub-rule (3) of rule 3 shall be valid for a period of three years from the date of such grant and an application for renewal of such certificate shall be made in Form-B along with fee notified by State Government from time to time, ninety days before the date of expiry of the period of validity of such certificate and in case application is not made within the specified period, the mental health establishment concerned shall be liable to pay penalty in addition to renewal fee notified separately by the State Government by way of a demand draft. The renewal certificate shall be valid for a period of three years.

5. The manner of filing objections:- Every individual or a body may file an objection to the 2

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State Mental Health Authority against grant of permanent registration to a Mental Health Establishment within the stipulated period in Form –D appended with these rules.

6. Issue of Duplicate Certificate-Where a certificate of registration granted to a mental health establishment is destroyed or lost or mutilated or damaged, the State Authority may issue a duplicate certificate on an application made by such establishment along with an amount of fee notified by the State Government by way of a demand draft drawn in favor of the Chairperson, State Mental Health Authority payable at the place where the State Authority is situated.

7. Maintenance of Digital Register- A category-wise register in Form- A of all registered mental health establishments shall be maintained by the State Authority in digital format in accordance with the provisions of section71. It will be uploaded on the website of State Mental Health Authority.

8. Approval of local authority: Every Mental Health Establishment at the time of seeking registration / renewal must submit an approval certificate from the local authority for building plan of mental health establishment, along with completion certificate.

CHAPTER-III
CATEGORIES OF MENTAL HEALTH ESTABLISHMENTS

9. Classification of Mental Health Establishments – The State Government shall classify the Mental Health Establishments into following categories as defined in the section 65, sub section (5), clause(a)

. (1)  Institute of Mental Health

. (2)  Psychiatry wing of Medical Colleges

. (3)  Psychiatry wing of General Hospital/Multispecialty Hospital

. (4)  Substance use disorder treatment centers/Drug De-addiction Centers: providing treatment facility for Substance abuse.

. (5)  *Psychiatric Nursing Homes: providing Treatment facilities to persons with psychiatric disorders

. (6)  Substance use disorder Counseling and Rehabilitation center: Providing prolonged Counseling and rehabilitative services during and after the treatment for substance use disorder.

. (7)  Rehabilitation Centers for persons with mental illnesses other than substance use disorder.

. (8)  Shelter homes for mentally ill or persons with Substance Use Disorders (Pingalwaras, community homes, Ashrams or any other residential facility under any name maintained by any Govt./ Semi-Govt. department, Individual, trusts, NGOs, Deras etc.)

(9) Halfway homes

*Psychiatric Hospitals/Nursing Homes are free-standing facilities established to offer facilities, beds and services over a continuous period exceeding 24 hours to individuals requiring diagnosis and intensive and continued clinical therapy for mental illness. Distinct parts of General Hospital can also be designated as Psychiatric Unit. This unit is organized, staffed and equipped to render psychiatric services.

10.List of services which should be available in Mental Health Establishments.– (1) The following list of services are mandatory for all Mental Health Establishments, unless specified otherwise.

. (a)  Registration and Documentation; (for all Mental Health Establishments category 1 to 9)

. (b)  Outpatient Treatment(for Mental Health Establishments mentioned at Category 1 to 5)

. (c)  Inpatient Treatment ( for Mental Health Establishments mentioned at Category 1 to 5)

. (d)  Inpatient Service ( for all Mental Health Establishments category 1 to 9)

. (e)  Emergency Services ( for Mental Health Establishments mentioned at Category 1 to 5)

. (f)  Nursing Services ( for all Mental Health Establishments category 1 to 9)

(g)Dispensing of Medications (Pharmacotherapy) ( for Mental Health Establishments mentioned at Category 1 to 5)

. (h)  Psychosocial Interventions ( for all Mental Health Establishments category 1 to 9)

. (i)  Laboratory Services (for Mental Health Establishments mentioned at Category 1 to 5)

. (j)  Referral/Consultation/Linkages (for all Mental Health Establishments category 1 to 9)

. (k)  Record Maintenance ( for all Mental Health Establishments category 1 to 9)

. (l)  Periodic Training of Staff and/or other Persons ( for all Mental Health Establishments category 1 to 9);

(2) The State Government shall issue the Standard Operating Procedures (SOPs) regarding treatment guidelines from time to time.

11. Ancillary and Support Services. –(1)The following ancillary services shall be ensured by all the Mental Health Establishments either by itself or through outsourcing unless specified otherwise:

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. (a)  Ambulance services;

. (b)  Dietary services;

. (c)  Laundry services/Washing Facilities;

. (d)  Security services;

. (e)  Waste management including Biomedical Waste (wherever applicable);

. (f)  Electric Supply with power back up and stabilization

. (g)  24 X 7 Water supply

. (h)  Communication ( telephone and internet facility for emails)

. (i)  Sterilization and Disinfection (as per requirement);
CHAPTER IV

MINIMUM STANDARDS FOR MENTAL HEALTH EXTABLISHMENTS

12. All Mental Health Establishments, falling under any category mentioned in rule 8, shall be maintained in the manner and in the condition as laid down in the minimum standards prescribed in Schedule A , Schedule B and Schedule C of these rules. If a minimum standard is not specified in these rules, it shall not be lower than the prevalent standards for physically ill patients admitted in clinical establishments.

13. Grading of Mental Health Establishments: State Authority shall develop a system of rating/grading every registered Mental Health establishment to ensure quality assurance and the list will be uploaded on State mental Health authority website every year.

CHAPTER V CAPACITY TO CONSENT

14. Manner of proof of mental healthcare and treatment related to capacity to consent of person with mental illness. –

. (1)  As mentioned in the sub-section (1) of Section 81 of the Act, the Central Authority shall appoint an Expert Committee to prepare a guidance document for medical practitioners and mental health professionals, containing procedures for assessing, when necessary or the capacity of persons to make mental healthcare or treatment decisions.

. (2)  The State Authorityshall prepareits own guidelines till the central expert committeeprepares the guidance document for medical practioners .

. (3)  The State Authority shall prepareor follow necessary amendments in the document according to the State specific conditions.

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CHAPTER VI
RIGHTS OF PERSONS WITH MENTAL ILLNESS

15. Hospital and Community Based Rehabilitation Establishments and Services. –
(1) The State Government, as the case may be, shall establish such number of hospital and community based rehabilitation establishments, as it deems fit, for providing rehabilitation services required by persons with mental illness, having regard to the following, namely: –

. (a)  the expected or actual workload of the facility to be established;

. (b)  the number of mental health establishments existing in that State;

. (c)  the number of persons with mental illness in that State;

(2) The hospitaland community based rehabilitation establishments established by the State Authority, local authority, trust, whether private or public, corporation, co-operative society, organisation or any other entity or person shall follow the minimum standards specified in the Schedule A, B & C.

16. Right to access Basic Medical Records. –

(1) A person with mental illness shall be entitled to recieve documented medical information pertaining to his diagnosis, assessment and treatment as per the medical records.

. (2)  Apersonwithmentalillnessmayapplyforacopyofhisbasicinpatientmedicalrecordby making a request in writing, addressed to the medical officer or mental health professional in charge of the concerned mental health establishement.

. (3)  Within fifteen days from the date of receipt of the request under sub-rule (2), basic inpatient medical records shall be provided to the applicant in Form- E.

. (4)  Ifamentalhealthprofessionalormentalhealthestablishment,asthecasemaybe,isofthe opinion that the information deserves to be withheld in view of section 25(2) of the act, it may decline to provide the information to the patient while informing him of his right to appeal to the board in terms of section 25(3). Mental health Establishment or mental health professional may make an application tothe mental health review board stating the issues involved alongwith the reason of witholding the information .

. (5)  TheBoardsshall,afterhearingtheconcernedpersonwithmentalillness,byanorder,give such directions, as it deems fit, to the mental health professional or mental health establishment, as the case may be within thirty days from the date of receipt of the application.

17.Right to Legal Aid. – The person in charge of Mental Health Establishment ,custodial institution, including prison, police station, orphanages, women’s protection homes, old age homes and any other institution run by Government, local authority, trust, whether private or

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public, corporation, co-operative society, organisation or any other entity or person, where any individual resident is in the custody of such person, and such individual resident is not permitted to leave without the consent of such person, shall display signage board in a prominent place in English, Hindi and local language, for the information of such individual or any person with mental illness residing in such institution or his nominated representative informing that such person is entitled to free legal services under the Legal Services Authorities Act, 1987 or other relevant laws or under any order of the court if so ordered and shall also provide the contact details of the availability of services.

CHAPTER VII
AUDIT, INSPECTION AND ENQUIRY OF MENTAL HEALTH ESTABLISHMENTS

18.Audit of Mental Health Establishments. – (1) The State Authority shall, for the purpose of conducting audit of registered mental health establishments in the state, authorize a committee comprising of not less than three of the following persons to ensure that such mental health establishments comply with the minimum standards specified under the Rules, namely:-

(3)

. (a)  a representative of the Deputy Commissioner (not below the rank of SDM) of the district where the mental health establishment is situated;

. (b)  a representative of Director Health Services not below the rank of Deputy Director

. (c)  a respresentative of Social Security department not below the rank of Deputy Director or Joint Secretary

. (d)  a representative of the State Human Rights Commision of the State where the mental health establishment is situated;

. (e)  a Private psychiatrist who is not involved in bussiness related to any mental health establishment.

. (f)  a psychiatrist not in Govt service and is not running his own

. (g)  a mental health professional who is not a psychiatrist;

. (h)  a representative of a non-governmental organisation working in the area of
mental health;

. (i)  the representatives of the care-givers of persons with mental illness or
organisations representing care-givers; and

. (j)  representatives of the persons who have or have had mental illness.

For conducting audit of registered mental health establishment, the State Authority shall charge a fee notified by the State Government from time to time by way of a demand draft drawn in favour of the Chairperson, State Mental Health Authority payable at the place where the Authority is situated.

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19.Inspection and Inquiry of Mental Health Establishments. – (1) The State Authority / District Board, suo moto or on a complaint received from any person with respect to non- adherence of minimum standards specified by or under the Act or contravention of any provision thereof, may order an inspection and inquiry of any mental health establishment, to be made by a committee comprising not less than three of the following persons, namely:-

a Psychiatrist in Government service;
a representative of Director Health Services not below the rank of Deputy

a respresentative of Social Security department not below the rank of Deputy Director or Joint Secretary

(d) a mental health professional who is not a psychiatrist
(e) a Private psychiatrist who is not involved in bussiness related to any mental

health establishment.
(f) a representative of a non-governmental orgranisation working in the area of

mental health;
(g) a representative of the Deputy Commissioner (not below the rank of SDM) of the

district where the normal health establishment is situated.

. (2)  TheStateAuthority/DistrictBoardorthepersonsauthorisedbyitundersub-rule(1)may, if it has reasons to believe that a person is operating a Mental Health Establishment without registration or is not adhering tothe minimum standards specified by or under the Act or has been contravening any of the provisions of the Act or the rules and regulations made thereunder, enter and search any such Mental Health Establishment.

. (3)  During search, the State Authority/ District Board or the person authorised by it may require the mental health professional in charge of the mental health establishment to produce the original documents relating to its registration with the State Authority and it shall be obligatory on the part of the Mental Health Establishment to produce such documents.

. (4)  WithintwodaysofcompletingsearchoftheMentalHealthEstablishmentsundersub-rule (3), a written report of the findings of such search shall be submitted tothe Chiarperson of the Authority.

. (5)  The State Authority, shall, on a receipt of the written report under sub-rule (4), may take such action as it deems fit, against the defaulting Mental Health Establishment in accordance with the provisions of the Act.

(a)

(b) Director (c)

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CHAPTER VIII
MENTAL HEALTH REVIEW BOARDS

20.Mental Health Review Boards. – (1) For the purpose of constituting Mental Health Review Boards under section 73, the State Authority shall, in consultation with the State Government, take decision on the number of such Boards to be constituted in the State, their location and jurisdiction, having regard tothe following, namely:-

. (a)  the expected or actual workload of the Board to be constituted;

. (b)  the number of mental health establishments existing in that State;

. (c)  the number of persons with mental illness in that State;

. (d)  the population of the place where such Board is to be constituted;

Provided that at least one Board shall be constituted for a district and where it is not feasible, one Board for a group of two or more districts, not exceeding three districts, in the State:

21.Appointment of Chairperson and Members of Board. –(1) For the purpose of appointment of the chairperson and membersof the Board under clause (a), and the members of the Board under clauses (c) and (d) of sub-section (1) of section 74, the State Authority shall call for applications by giving wide publicity thorugh open advertisement in at least two daily newspapers (one English and one local language) having wide circulation in the State and advertisement shall also be made available on the website of the State Authority;

Provided that the Deputy Commssioner of the district in which the Board is to be constituted shall nominate its representative not below the rank of SDM as the member of the Board under clause (b) thereof.

Provided further that the District judge/ Additional District Judge in service may be appointed as a chairperson of the Board after the approval from the Hon’ble High Court.

. (2)  The chief executive officer of the State Authority shall consider all applications received under sub-rule (1) and shortlist such applications which fulfill the basic eligibility requirements as provided in section 74 and place the same before the Chairperson of the State Auhority.

. (3)  The appointment of chairperson and members of the Board shall be made by the State Authority in accordance with merit.

. (4)  The State Authority shall, three months prior to occurance of vacancy in the office of chairpersons or member of the Board, or where such vacancy arises by reason of death or resignation or removal of such member, initiate the process for filing up such vacancy in

terms of law.

(5) The State Authority shall, from time to time, arrange for the chairpersons and members of the Board to undergo induction training in mental health law, mental healthcare and related areas of not less than two working days.

22.Other disqualifications for Chairperson or Member of the Board. –(1) In addition to the disqualifications specified in clauses (a) to (d) of sub-section (2) of section 74, a chairperson or a member of the Board appointed by the State Authority shall stand disqualified for the purposes of said sub-section (2), if he holds-

(a) any full-time or part-time assignment that prevents him from giving adequate time and attention to the work of the Board under the provisions of the Act and the rules made thereunder; or

(b) any office in any political party during his tenure of office in the Board.

. (2)  The State Authority may remove the chairperson or the member of the Board if a complaint is received against such person and on enquiry by a competent authority appointed forthat purpose by the State Authority, it is found that there is substance in such complaint and that the conduct of such person is unbecoming of the office he holds:
Provided that if such complaint is against the chairperson who had been a judifical officer, the complaint shall be forwaded to the Registrar of the concerned High Court for enquiry by the competent authority.

. (3)  The State Authority may suspend the chairperson or a member of the Board immediately if a criminal case is registered against such person and revoke such suspension if such person is acquitted of the charges framed against him in such case.

23.Honorarium, allowances and other terms and conditions of service of chairperson and members of Board. –(1)If a retired judge of the District Court is appointed as the chairperson of the Board, he shall be entitled to a consolidated monthly honorarium which together with the pension or pensionary value of the terminal benefits or both received by such person shall not exceed the last pay drawn by him.

. (1)  If a retired government servant is appointed as a member of the Board, he shall be entitled to a consoliated monthly honorarium which together with the pension of pensionary value of the terminal benefits, or both received by such person shall not exceed the last pay drawn by him.

. (2)  If Chairperson or any member of the Board is in service of the State Government or Central Government, his consolidated honorarium shall be in accordance with the rules applicable to Government servants of his cadre and he shall recieve travel allowance only

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for the day of sitting in the Board.

. (3)  Every member of the Board, who is not a servant of the Government, attending the meeting of the Board shall be entitled to sitting allowance, travel allowance, daily allowance and such other allowances as are applicable to non-official members of the Commissions and Committees of the State Government attending the meetings of such Commission or Committee.

. (4)  No additional pension and graduity shall be admissible to the chairperson or any other member of the Board for service rendered by him to the Board.

. (5)  The Chairperson or a member of the Board shall be entitled to such medical treatment and hospital facilities as he/she is entitled to in terms of service rendered earlier to a retired Government servant and at places where such scheme is not in operation, the chairperson and other members of the Board shall be entitled to such medical facilities as are provided in the Service rendered previously/ State government rules.

. (6)  The chairperson or a member of the Board shall be entitled to thirty days of earned leave for every year of service and the payment of consolidated honorarium during leave shall be governed by the State Civil Services Rules.
CHAPTER IX PRISONERS WITH MENTAL ILLNESS

24.Method, modalities and procedure for transfer of prisoners with mental illness. –

Transfer of a prisoner with mental illness to the psychiatric ward of the medical wing of the prison or to a mental health establishment set up under sub-section (6) of section 103 or to any other mental health establisments within or outside the State shall be in accordance with the instructions issued by the State Government, as the case may be.

25.Standards and procedures of mental health services in prison. – The mental health establishment referred to in sub-section (7) of section 103 shall conform tothe minimum standards and procedures as specified in Schedule A and B.

CHAPTER X FURNISHING OF INFORMATION

26.Furnishing of information. –The State Government may call for information concerning the activities of the State Authority of the Board periodically or as and when required by it and the State Authority or the Board, as the case may be, shall furnish such information in Form- F

27. Repeal : The Punjab Substance use disorder treatment and counseling and rehabilitation centers rules 2011 are hereby repealed.

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FORM A (As per Rule 7)

REGISTER OF MENTAL HEALTH ESTABLISHMENTS (in Digital Format ) *

Category …………….

Sr. No

Name and address of the applicant

Name of the establishment and address

Date of the application

Date and particulars of Registration

Category

No of beds

Date of renewal

Valid Up to

 

*Separate table for each category of Mental Health Establishment.

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Form B
(As per Rule 3 &4)

APPLICATION FOR PERMANENT /RENEWAL OF REGISTRATION BY A MENTAL HEALTH ESTABLISHMENT

To

Dear sir/ madam,
I/we intend to apply for grant of Permanent registration/ renewal of permanent

registration for the Mental Health Establishment namely …………………….. of which I am/ we are holding a valid license/ registration for the establishment/ maintenance of such hospital/ nursing home. Details of the hospital/ nursing home are given below:

1. Name of the establishment:

2. Past/Current Registration No………………………………… (Attach a copy of Registration Certificate)

3. Postal address of the establishment

4. Type of establishment: MHE Category

5. Category of establishment

6. Name, qualifications and experience of the in-charge of the establishment:

7. Number of beds:

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The Chairperson
State Mental Health Authority

8. Treatment Facility/Services provided ( write whatever is applicable)

Facility/Service

Requirement

(Fill As mentioned in Schedule A)

Status

Annexure if any

Out-patient

For Category 1 to 5

Yes/No/not applicable

In-patient

For Category 1 to 9

Yes/No

Number of rooms

Number of beds

 

 

Emergency

For Category 1 to 5

Yes/No/not applicable

 

Day Care

Yes/No/not applicable

ECT

For Category 1 to 5

 

Yes/No/not applicable

 

 

Psychological testing

For Category 1 to 5

Yes/No/not applicable

Investigation and laboratory

For Category 1 to 5

Yes/No/not applicable

Occupational and recreational facilities

For Category 1 to 9

Yes/No/not applicable

Any Other (Specify)

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9. Staff (Numbers):

Staff

Requirement

(Fill As mentioned in Schedule B)

Status

Education qualification and registration certificates annexed

Appointment and joining letters annexed

Psychiatrist

Yes/No

Yes/No

Medical officer

Yes/No

Yes/No

Project Director

Yes/No

Yes/No

Staff Nurse

Yes/No

Yes/No

Counselor/Psychiatric Social worker

Yes/No

Yes/No

Clinical Psychologist

Yes/No

Yes/No

Ward attendants

Yes/No

Yes/No

Security Guards

Yes/No

Yes/No

Cook –Cum Helper

Yes/No

Yes/No

Any Other

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10. Details of registration fee paid:

11. Copy of Certificate from Municipal Corporation/local Authority for approval of building plan along with Completion certificate : Attached/ Not attached

Declaration: We hereby undertake to abide fully by the provisions of the Mental Health Care Act, 2017 and rules and regulations laid down under it.

Compliance report regarding Standards of Care as per prescribed format/checklist is attached with the application form.

The information submitted by me as above is correct to best of my knowledge and no fact has been concealed and if any fact is found to be false at any stage, I understand that my registration shall be cancelled by The State Mental Health Authority.

Date
Place Signed by the Authorized Signatory

FORM C
( As per rule 3&4)

CERTIFICATE OF PERMENANT REGISTRATION/ RENEWAL OF PERMENANT REGISTRATION

The State Authority, after considering the application dated ………….. submitted by …………… under section 65 (2) or section 66 (12) of Mental Healthcare Act 2017 and Rule 3 of The Punjab State Mental Healthcare Rules 2019, hereby accords permanent registration/ renewal of permanent registration to the applicant mental health establishment in terms of Rule 3 (3) , as per the details given hereunder:

Name ……………………
Address ……………………..
No of beds …………………
Category allotted ……………… Validity__________________________________________ Previous Registration Number and duration of Renewal)___________________

validity:

(In Case of

The permanent registration certificate issued, is subject to the conditions laid down in the Mental Healthcare Act, 2017 and the rules and regulations made there under and shall be valid for a period of three years from the date of its issue and can be renewed.

Place Date

Registration Authority

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Seal of the Registration Authority

FORM-D (As per Rule 5)

FILING OBJECTIONS AGAINST GRANT OF PERMANENT REGISTRATION TO A STATE MENTAL HEALTH ESTABLISHMENT

The Chairperson,
State Mental Health Authority ……………………………..

It is in my knowledge that the Mental Health Establishment (name) ……………………………….situated at ………………………………does not fulfil the following requirements for registration under section 65 (4) of the Mental Health Care Act 2017 and the Rules and Regulations made thereunder.

1. _______________________________________________________

2. _______________________________________________________

3. _______________________________________________________

I enclose the following in support of what is stated above: 1.
2.
3.

Please take necessary action accordingly.

Address: Mobile Number: E-mail:

Date: Encls.

Signature Name

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Basic Medical Records:

Form-E
(As per Rule 16)

The mental health establishment shall maintain specific minimum records at their level for various types of patients they ‘are dealing with. The requirement of records to be maintained for in-patients, out patients and community outreach may vary and is accordingly specified below. A graded approach in minimum records to be maintained may be followed:

Community outreach register shall consist of information from (a) to (h) of the basic medical record of outpatient specified in paragraph 1 below.

The mental health establishments shall maintain and provide on demand the following basic medical record to the person with mental illness or his nominated representative.

1. Basic Medical. Record of all out-patients (at hospitals, nursing. homes, private clinics, camps, mobile clinics, primary health care centers and other community outreach programmes, and the like matters):

(In hard copy format)

(a) Name of the mental health establishment/doctor ________________________ (b) Date __________
(c) Hospital registration number__________________
(d) Advance Directive YES/NO _________________

(e) Patient’s Name ________________ (f) Age ____ Sex_____
(g) Father’s/Mother’s name
(h) Address . Mobile No.

(i) Chief complaints __________________
(j) Provisional diagnosis ________________
(k) Treatment advised and follow-up recommendations ___________________

2. Basic Medical Record of In-Patient .

(a) Name of the hospital/nursing home _________________ (b) Date _____________
(c) Patient’s name _______________
(d) Father’s/Mother’s name ____________________

(e) Age _______ Sex _________

(f) Address ______________

(g) Patient accompanied by (Name, age and nature of relationship) ________________ 18

. (h)  Hospital registration number _______________

. (i)  Identification marks _____________________

. (j)  Nominatedrepresentative·________________

. (k)  Advanced Directive – Yes or No; If yes salient features of the content

. (l)  Date of admission ____________ Date of discharge _______________

(m)Mode of admission (section under Mental Healthcare Act, 2017): Independent!

Supported

. (n)  Chief complaints

. (o)  Summary of Medical Examination Laboratory investigations

. (p)  Provisional/differential/ final diagnosis

. (q)  Course in the hospital (Treatment and Progress)

. (r)  Condition at discharge or discharge at request or leave against medical advice or
person with mental illness absconding or others

. (s)  Treatment advice at discharge

. (t)  Follow-uprecommendations

3. Basic Psychological Assessment Report (facilities where persons with mental illness undergoes psychological assessment):

Clinic Record no ___________________ (1) BASIC DETAILS:

  Name:

  Age:

  Gender:

  Education:

  Occupation:

  Date of testing:

  Referred by: 19

 Language tested in:

 Reason for referral:

. (2)  ASSESSMENT DETAILS:
IQ

  Specific Learning

  Neuropsychological

  Assessment

  Disability Assessment

  Personality Assessment

  Psychopathology Assessment

  Any other (Mention the specific domain such as interpersonal relations)

. (3)  Comments if any (may give brief detail of the referral purpose; e.g:, ‘the individual has mental illness and he has been referred for current psychopathology assessment as well as to ascertain the level of disability)

Brief background information (e.g., the nature of the problem, when it started, any previous assessments and like details):

Informant: Self.

Others Specify

. (4)  Salient behavioral observations (Comment on. alertness, attention, cooperativeness, affect, comprehension and any other relevant information)

. (5)  Tests/ Scales administered (Standardized tests! scales):

. (6)  Salient scores (if applicable such as Intelligence Quotient, scores obtained on cognitive function tests, severity rating on psychopathology scales, disability percentage and like details)

   

20

(7) Impression:

Recommendations: Further assessment

Therapy

Any Other

Assessed by .

Name:
Date: Qualification: Signature

Specify

4. Basic Minimum Standard Guidelines for Recording of Therapy Report (facilities where persons with mental illness are provided with therapy for any mental health problem)

Minimum Basic Standard Guidelines for Recording of Therapy (Name of the Institute/Hospital/Centre with address)

Clinic record no. ______________
THERAPIST SESSION NOTES

Verified/supervised by (if applicable)

Name
Date Qualification Signature

Patient Name: Age:
Gender :

Psychiatric diagnosis:

Session number and date:

Duration of session:

Session Participants:

 

Therapy method: Individual Couple/Family Group Other_____

Objectives of the Sessions:
1.
2.

3. 4.

Key issues/themes discussed: (Psychosocial· stressors/ lnter-personal problems/ lntra- 21

22

psychic conflicts/Crisis situations/Conduct difficulties-/Behavioral difficulties/Emotional difficulties/ Developmental difficulties/ Adjustment issues/Addictive behaviors/Others).

Therapy techniques used:

Therapist observations and reflections: Plan for next session:
Therapist
Name:

Date Qualification Signature

Date for next session: Supervised by (if applicable) Name
Date
Qualification
Signature

23

FORM F
(As per Rule 26)
INFORMATION ON THE ACTIVITIES OF THE STATE AUTHORITY/ BOARD

1. New Regulations notified:

2. Number of orders passed during the year:

3. Meetings held during the year:

4. Number and details of the mental health establishments under the control of the State
Government:

5. Number and details of the mental health establishments in the State:

6. Registration of mental health professionals by the State Authority:

7. Statement on references received from the Central Government and the State Government
and action taken thereon:

8. Quality and service provision norms for different types of mental health establishments under
the State Government:

9. Training imparted to persons including law enforcement officials, mental health professionals
and other health professionals about the provisions and implementation of the Mental
Healthcare Act, 2017:

10. Applications for registration of mental health establishments received, accepted and rejected
along with the reasons for such rejection:

11. Audit of Mental Health Establishments along with audit reports:

12. Complaints received regarding violation of rights of Mentally ill persons and action taken
thereon:

13. Details regarding guidance document for medical practitioners and mental health
professionals:

14. Number of cases registered regarding Sexual Harassment of Women at Workplace under
section 22 of the Sexual Harassment of Women at Workplace ( Prevention, Prohibition and
Redressal ) Act, 2013 and details thereof:

15. Details of inspection and inquiry of Mental Health Establishments:

16. Number of aspects to High Court against order of Authority and status thereof:

17. Complaints received regarding deficiencies in provision of services and action taken thereon:

18. Stakeholders consultations:

19. Inquiry initiated by the Authority/ Board:

20. Administration and establishment matters:

21. Budget and Accounts with details including balance sheet, income and expenditure account,
etc.:

22. Any other matter which may be relevant:

24

SCHEDULE –A PHYSICAL INFRASTRUCTURE CRITERIA FOR MENTAL HEALTH ESTABLISHMENTS.

Category 1 (Hospital based facility)

Category 2

Hospital based facility

Category 3

Hospital based facility

Category 4
Hospital based facility

Category 5
Hospital based facility

Category 6
Community based facility

Category 7

Community based facility

Category 8

Community based facility

Category 9

Community based facility

Institute of Mental Health

Psychiatry wing of medical colleges

Psychiatry wing of General Hospital/Multi- specialty Hospital

Substance use disorder treatment center

Psychiatric Nursing Homes

Substance use disorder

counseling Rehabilitation Centers

and

Rehabilitation Centers for Mentally ill

Shelter homes and other mentioned in category 8

Halfway homes

As per existing infrastructure and as upgraded by government from time to time

As per MCI guidelines

Rooms
(1) Out Patient area i.Consultation Chambers
ii. Counseling room iii.Waiting area iv.Staff Toilets
v. Patient toilet complex vi.Pharmacy/Drug Dispensing room

Rooms
1)Out Patient area i..Consultation Chambers ii. Counseling room
iii. Waiting area

iv.Staff Toilets v.Patient toilet complex vi.Pharmacy/Drug Dispensing room

Rooms
1)Out Patient area i.Consultation Chambers ii. Counseling room
iii. Waiting area

iv. Staff Toilets
v.Patient toilet complex (vi.Pharmacy
vii.Drug Dispensing room

Rooms
1) Reception area i.Waiting area ii.Staff Toilets

2) Records and Registration room
(3)Administrative area and stores

Rooms
1) Reception area i.Waiting area ii.Staff Toilets

2)Records and Registration room 3)Administrative area and stores

Rooms
1) Reception area i.Waiting area ii.Staff Toilets

2) Records and Registration room 3)Administrative area and stores

Rooms
1) Reception area i.Waiting area ii.Staff Toilets

2) Records and Registration room 3)Administrative area and stores

25

Category 1 Institute of Mental Health

Category 2 Psychiatry wing of medical colleges

Category 3 Psychiatry wing of General Hospital/Multi- specialty Hospital

Category 4
Substance use disorder treatment center

Category 5
Psychiatric Nursing Homes

Category 6
Substance use disorder counseling and Rehabilitation Centers

Category 7 Rehabilitation Centers for Mentally ill

Category 8
Shelter homes and other mentioned in category 8

Category 9 Halfway homes

2)Records and Registration room 3)Administrative area and stores

(Only if not shared with the hospital)
(4) Indoor Wards i.Beds

ii.Nursing station with Toilets iii.Interview/Treatme nt room

iv.Doctors duty room v.Nurses changing

2) Records and Registration room 3)Administrative area and stores

4)Wards
i. Beds
ii.Nursing station with Toilets iii.Interview/Treatment room
iv.Doctors duty room v.Nurses changing room vi.Wards store vii.Patients relatives waiting area with Toilet

viii.Sluice room

2)Records and Registration room 3)Administrative area and stores
4)Wards
i.Beds
ii.Nursing station with Toilets. iii.Interview/Treatment room
iv.Doctors duty room v.Nurses changing room vi.Wards store vii.Patients relatives waiting area with Toilets

4) Wards
i..Beds ii.Interview/counseling room iii. Wards store
iv.Patients relatives waiting area with Toilets
v.Patient toilet complex vi.Sluice room

vi.Group D room
vii.Ward pantry with drinking water facility viii.Staff Toilet

4)Wards
i. Beds
ii. Interview/counselingroo m

iii.Wards store iv.Patients relatives waiting area with Toilets v.Patient toilet complex vi.Sluice room

vi.Group D room vii.Ward pantry with drinking water facility viii.Staff Toilet

4) Wards
i. Beds
ii. Interview/counseling room
iii.Wards store
iv.Patients relatives waiting area with Toilets v.Patient toilet complex vi.Sluice room

vi.Group D room vii.Ward pantry with drinking water facility viii.Staff Toilet

4) Wards
i.Beds
ii. Interview/counseli ng room

iii.Wards store iv.Patients relatives waiting area with Toilets v.Patient toilet complex

vi.Sluice room

vi.Group D room( vii.Ward pantry with drinking water facility viii.Staff Toilet

26

Category 1 Institute of Mental Health

Category 2 Psychiatry wing of medical colleges

Category 3 Psychiatry wing of General Hospital/Multi- specialty Hospital

Category 4
Substance use disorder treatment center

Category 5
Psychiatric Nursing Homes

Category 6
Substance use disorder counseling and Rehabilitation Centers

Category 7 Rehabilitation Centers for Mentally ill

Category 8
Shelter homes and other mentioned in category 8

Category 9 Halfway homes

room
vi.Wards store vii.Patients relatives waiting
area with Toilets viii.Sluice room ix.Group D room x.Ward pantry with

drinking facility xi.Staff xii.Patient complex 5.Recreation/ Rehabilitation/ Activity room

water

Toilet Toilet

ix..Group D room
x.Ward pantry with drinking water facility xi.Staff Toilet
Patient Toilet complex 5.Recreation/ Rehabilitation/ Activity room

viii.Sluice room
ix.Group D room
x.Ward pantry with drinking water facility
xi. Staff Toilet

xii. Patient Toilet complex
5. Recreation/ Rehabilitation/ Activity room

5.Recreation/ Rehabilitation/ Activity room
6.Vocational Training room

7. Meditation Room

5.Recreation/ Rehabilitation/ Activity room
6.Vocational Training room

7. Meditation Room

5.Recreation/ Rehabilitation/ Activity room
6.Vocational Training room

7. Meditation Room

5.Recreation/ Rehabilitation/ Activity room 6.Vocational Training room

7. Meditation Room

In every room 15-20% area must be for ventilation and lighting.
Mental Health establishments under Category 6to 8 must have open space which shall not be less than 50% of the covered area. These infrastructure norms are for a facility of ten beds. For every ten beds, area for ward will be increased accordingly.

27

1. Infrastructure requirements for all Mental Health Establishments holding OPD and indoor facility. –

. (a)  WellmaintainedPuccastructure:

. (b)  Lift / Ramp facilities for disabled persons. lift and ramp facility will be as per provisions of The persons with disabilities act 2016 and guidelines issued by The Department of Local Government.

  Stairs should not be the only means of moving between floors. They should be supplemented by lift and/or ramp.

  Where lifts are provided in a building, they shall be accessible to and usable by persons with disabilities at all levels used by the general public or staff.

. (c)  Sufficientventilationandnaturallight;

. (d)  Sufficientilluminationaftersunset,goodenoughforreading;

. (e)  Illuminatedpassagesleadingtotoiletsandemergencyexitsduringthenight.

. (f)  The premises shall be well maintained and kept in good livable condition;

. (g)  Inverters/Powerback-upforemergencylightsduringpowerfailuresandloadshedding;

. (h)  Nomentalhealthestablishmentisallowedtoruninabasement,Howeverbasementcanbeusedasstorebutpatientswillhavenoaccesstoit.

. (i)  Adequate Security measures shall be ensured.

. (j)  There shall be adequate arrangements for fire safety.

. (k)  There shall be no Aluminium partitions for rooms/ wards etc. Every specified room should be adequately constructed.

. (l)  The building shall have a prominent board displaying the name of the Mental Health Establishments along with the catagory in the local language.

28

NOTE:
*Each Mental Health Establishments shall have a building of its own or leased or rented with a rent agreement for at least three years, if the agreement is for less than three

years then the Establishments shall send the intimation to the State Mental Health Authority, accordingly or whenever applicable. No Establishments shall be allowed to change the location without the permission of State Mental Health Authority. Building has to be approved by local authority for establishment of Mental Health Establishment.
* If there is any change in the Management of any Mental Health Establishment, it will be with prior approval from State Mental Health Authority.

2. Other requirements. – ( for all Mental Health Establishments )

. (a)  Provisionforawatercoolerwithfiltrationsystemsmaybemade;

. (b)  Separate toilets (with WC and wash basins) and bathrooms should be provided for male and female patients; ie four set of toilets and washrooms, one each for male and female in OPD and one each for male and female for indoor.

. (c)  Lockablepersonalstoragefacilitiesforclothingandpossessionsshouldbeprovided.Theward/unitentranceandkeyclinicalareasareclearlysignposted;

. (d)  MaleandfemalepatientsmusthaveseparateWards,rooms,toiletsandwashingfacilities;

. (e)  Minimumdistancebetweentwoparallelbedsnotlessthan1meter.

. (f)  Door width minimum 1 meter and minimum corridor width 1.5meters;

. (g)  Wardbedandsurroundingspacenotlessthan6sqmeter/bed;

. (h)  BunkBedsarenotallowed;

. (i)  Common room, having TV, newspapers, magazines and indoor games. The chairs provided in 1:2 ratio;

. (j)  OPD and inpatient facilities to have sitting arrangements for patients and accompanying family members, registration, help and cash counter(s), drinking water facilities and separate

29

toilets for males and females;

. (k)  Properfiresafetymeasures,firesafetyplan,firesafetyexitindicatorsmustbeinplace;

. (l)  Separate cots for each patient with mattresses, pillows, bed sheets, drawer sheets and Blankets in winter;

. (m)  Provision of mosquito repellants or control measures in sleeping areas;

. (n)  Ratiooffans(whererequired)tobeds,notlessthan1:3;

. (o)  Minimumtwoexitswherethenumberofbedsinadormitoryismorethan5orthewidthofthedoorshallnotbelessthan2.5feet;

. (p)  Nosleepingcotsinpassages,understaircaseoranywhereelseexceptdorms/rooms;

. (q)  Hotwaterforbathduringwintermonths;

. (r)  Separate Ward for Female patients.

3. In wards/units where seclusion is used, there must be a designated room that meets the following requirements: ( for all Mental Health Establishments)

(a) It allows clear observation;

(b)It includes a means of two-way communication with the team.

(c) It is well lighted and ventilated.

(d)It has direct access to toilet/washing facilities.

(e) It is safe and secure – it does not contain anything that could be potentially harmful.

(f) It has a clock and calendar that patients can see. 30

4.

(g)A sluice room may be provided with janitor’s closet.

(h)The ward should have an interview room which provides privacy during doctor- patient or counselor-patient interactions. The interview room should have adequate lighting and ventilation, and sufficient furniture.

(i) Allelectricalconnectionsinthewardshouldbeplannedsuchthatthepatientshave minimal access to the electrical points. Electrical sockets should specially be avoided in secluded area like the toilets and bathrooms. The electrical connections for all such areas should be placed in a centrally decided location preferably near the nursing station.

(j) Likewise, the ward windows may be designed to minimize chances of illegal traffic of substances through the spaces or of patients escaping through windows. Use of glass partitions or windows should be minimized in the ward as such items are liable to be broken or damaged and may be injurious to the patients.

(k)Light music can be played in the ward during waking hours to provide a soothing environment to patients to hasten recovery.

Equipment & Other requirements. ( for Mental Health Establishments mentioned at Category 1 to 5 )

(1) Each Mental Health Establishments should have an Adequate medical equipments as mentioned below. –

(a)Medical equipment and instruments, commensurate with the scope of services and the number of beds; (b)Equipment and inventory kept in a good usable condition;

(c)Sufficient sets of basic equipment consisting of blood pressure apparatus, stethoscope, weighing machine, thermometer etc.; (d)Anesthesia equipment for ECT(Where ever used);

(e)Oxygen cylinders with flow meter;
(f) First aid box with standard contents; a daily check done for replenishments;( for all Mental Health Establishments ) (g)An examination table with footstep;

31

(h)Provision of wheelchairs and stretchers ( for all Mental Health Establishments )

(i) Psychological test materials should be available;

(j) Sufficient stock of drugs, medical devices and consumables. Documentation and record of medicine procured, in stock, dispensed, along with bills and registers must be maintainedandproducedatanytimeofinspectionbyStateMentalhealthAuthority;

(k)Ward/unit-based staff members have access to a dedicated staff room. Staff members receive training consistent with their role. Statutory and mandatory training, policies, procedures and guidelines should be available to all staff all the time. All new staff members are allocated a mentor to oversee their transition onto the ward/unit. System should be in place to enable staff members to quickly and effectively report incidents for treatment of physical health needs, including emergencies of admitted patients. Those patients who will be having Co-morbidities like diabetes, Hypertension, HIV/ TB /HBV/ HCV etc. or other conditions which require medical care should be provided with by engaging on-call Specialists or Tie ups with multispecialty Hospitals, for which a written & signed MOU with specified terms & conditions shall be in the records. Notifiable diseases have to be reported to Civil Surgeon’s office;

(l) Nurses engaged for shift duty in conformity with the Indian Nursing CouncilNorms1985.
(m) All Mental health establishments shall follow the provisions as well as guidelines issued under The Rights of Persons With Disabilities Act 2016.

Provided that the staff employed shall be provided refresher training at regular intervals on Mental health / De-addiction and rehabilitation services at the five model De-addiction centers and the MHE shall pay fee for this training, as per notified by Government from time to time.

5. Hygiene, cleanliness and sanitation. – (1) Each Mental Health Establishments shall have a clean environment inside and outside the campus. –

(a)Daily sweeping, swabbing and dusting of the entire premises;

(b)Sanitation maintained in all the areas including toilets and bathrooms using disinfectants; 32

(c)Number of toilets is not less than in the ratio of 1:5 and bathrooms not less than in the ratio of 1:5. There shall be separate toilets and bathrooms for male and female inpatients. Toilets for female in patients should have disposal facilities for sanitary napkins. Number of wash basins not less than 1:5 outside the toilets/bath rooms and in the dining area;

(d)All toilet complexes should have sanitary napkin dispensing units. (e)Twenty-four-hour availability of water in wash basins, bathrooms and toilets;

(f) Minimum Weekly change of bed linen for which colored linen is recommended; (g)Washing of soiled linen in a clean and hygienic environment;

(h)Periodic pest control treatment of premises. Kitchen should be free of cockroaches and rodents; (i) Rubbish bins in rubbish generating areas and daily disposal of rubbish.

6. Wholesome, sumptuous and nutritive food and potable drinking water. –

All Mental Health Establishments must prominently display the menu of meals along with calorie count and timetable. (a)Well cooked, hygienic and balanced food, appropriate to local food habits;
(b)Food shall be served in a respectable and comfortable manner;

(c)No adulteration and no contamination in provisions and food;
(d)Special meals served whenever clinically indicated (e.g. Patients having Diabetes etc.); (e)Breakfast, afternoon tea and two meals served at proper timings;
(f) Safe drinking water along with provision of a water dispenser.

33

34

7. Facilities for social, cultural, recreational activities. ( for Mental Health Establishments at Category 6 to 9 )

(a)Recreational programs, socials and excursions for inpatients;

(b)There should be a visiting policy which includes procedures to follow. There must be a designated space for patients to receive visitors and adequate visitors’ room for families coming to meet the inpatients;

(c)Facilities to inpatients for internal and external communications, send and receive mails (including e-mails) and use any other conventional mode to communicate with notified family members.

8. Alternate methods shall be used in place of seclusion and restraint to de- escalate crisessituations.

(a)Physical restraints in case of patients in Psychiatric nursing homes will be used only to prevent inpatients from hurting themselves or others, with the permission of the medical practitioner on duty or consultant psychiatrist and the circumstances recorded in a separate register kept for this purpose;

(b)Nursing Staff trained to use de-escalation techniques to prevent patients from harming themselves and others.

Schedule- B Staff Requirement for Mental Health Establishments

Category 1 Institute of Mental Health

Category 2 Psychiatry wing of Medical Colleges

Category 3 Psychiatry wing of General Hospital /Multi- specialty Hospital

Category 4 Substance use disorder treatment center

Category 5 Psychiatric Nursing Homes

Category 6 Substance use disorder counseling and rehabilitation centers

Category 7 Rehabilitation Centers for mentally ill

Category 8 Shelter homes and other mentioned in category 8

Category 9 Halfway home

1.Director- 1Psychiatrist (In the rank of Professor / Joint Director / Psychiatrist with 15 years of experience.

1. Fully functional department of psychiatry

1. Separate psychiatry ward in hospital premises

1. Project Director / Manager

1.Project Director / Manager

1. Project Manager/ Dera Head etc.

1. Project Manager/ Dera Head etc.

2. Full time Psychiatrists (no. as decided by the Govt)

Faculty as per MCI guidelines

Full Time Psychiatrist

Full time Psychiatrist

Full time Psychiatrist

Visiting psychiatrist(at Least twice a Week)

Visiting Psychiatrist (at least once a week)

Visiting psychiatrist twice a week

Visiting psychiatrist twice a week

35

Category 1 Institute of Mental Health

Category 2 Psychiatry wing of Medical Colleges

Category 3 Psychiatry wing of General Hospital /Multi- specialty Hospital

Category 4 Substance use disorder treatment center

Category 5 Psychiatric Nursing Homes

Category 6 Substance use disorder counseling and rehabilitation centers

Category 7 Rehabilitation Centers for mentally ill

Category 8 Shelter homes and other mentioned in category 8

Category 9 Halfway home

3. Clinical Psychologist – 2 (Full time)

Faculty as per MCI guidelines

Clinical psychologist -1(Full time)

Clinical psychologist (at least once a week)

Clinical psychologist – 1(Full time)

Clinical psychologist -1 (at least once a week)

4. Mental Health Nurse (Nurse- Bed ratio (1:10)

Faculty as per MCI guidelines

Mental Health nurse Round the clock(Nurse-Bed Ratio 1:10)

Mental Health nurse Round the clock(Nurse-Bed Ratio 1:10)

Mental Health nurse Round the clock(Nurse-Bed Ratio 1:10)

As per requirement.

Mental Health nurse Round the clock(Nurse- Bed Ratio 1:10)

Mental Health nurse Round the clock(Nurse- Bed Ratio 1:10)

Mental Health nurse Round the clock(Nurse-Bed Ratio 1:10)

Category 1

Category 2

Category 3

Category 4

Category 5

Category 6

Category 7

Category 8

Category 9

5. Full time

Psychiatric Social Workers/ counselors-

Faculty as per MCI guidelines

Full time Psychiatric social worker/counsellors- 1:10 ratio)

Full time Psychiatric social workers / counselors (1:10 ratio)

Full time Psychiatric social workers / counselors (1:10 ratio)

Full time Psychiatric social workers / counselors- (1:10 ratio)

Full time Psychiatric social workers / counselors (1:10 ratio)

Full time Psychiatric social workers / counselors- (1:10 ratio)

Full time Psychiatric social workers / counselors- (1:10 ratio)

6.Data entry operator-

(as per requirement)

As per requirement

As per requirement

As per requirement

As per requirement

As per requirement

As per requirement

As per requirement

As per requirement

7.Ward attendants

(1:10 beds)

Ward attendants (1:10 beds)

Ward attendants (1:10 beds)

Ward attendants (1 : 10 beds)

Ward attendants (1:10 beds)

Ward attendants (1 : 10 beds)

Ward attendants (1:10 beds)

Ward attendants (1 : 10 beds)

Ward attendants (1 : 10 beds)

36

Category 1 Institute of Mental Health

Category 2 Psychiatry wing of Medical Colleges

Category 3 Psychiatry wing of General Hospital /Multi- specialty Hospital

Category 4 Substance use disorder treatment center

Category 5 Psychiatric Nursing Homes

Category 6 Substance use disorder counseling and rehabilitation centers

Category 7 Rehabilitation Centers for mentally ill

Category 8 Shelter homes and other mentioned in category 8

Category 9 Halfway home

8.Sweepers

Sweepers(As per requirement)

Sweepers(As per requirement)

Sweeper (As per requirement)

Sweeper (As per requirement)

Sweeper (As per requirement)

Sweepers(As per requirement)

Sweeper (As per requirement)

Sweeper (As per requirement)

9.Cook cum Helper- (as per requirement)

As per requirement.

As per requirement

As per requirement

As per requirement

As per requirement

As per requirement

As per requirement

As per requirement

10.Security guards

(as per requirement)

Security guards (as per requirement)

Security guards (minimum 3)

Security guards (minimum 3)

Security guards (minimum 3)

Security guards (minimum 3)

Security guards (minimum 3)

Security guards (minimum 3)

Security guards (minimum 3)

11.Any other supportive staff as required

Any other supportive staff as required

Any other supportive staff as required

Any other supportive staff as required

Any other supportive staff as required

Any other supportive staff as required

Liaison with laboratory, medical and surgical services and Any other

supportive staff as required

Any other supportive staff as required

Any other supportive staff as required

Category 1

Category 2

Category 3

Category 4

Category 5

Category 6

Category 7

Category 8

Category 9

12.Medical officer (MBBS) As per guidelines

As per MCI guidelines

As per requirement

Visiting MBBS doctor on daily basis

Visiting MBBS doctor on daily basis

37

  The above requirement of manpower is prescribed, keeping in view the bed strength of a Mental Health establishment. Requirement of staff nurse, data entry operators, counselors and attendants will increase depending upon OPD footfall of Mental Health establishment Categories 1 to 5 . For every 100 patients reporting in OPD there should be one Staff Nurse, One Data entry operator, one attendant and one counselor.

  Clinical Psychologists, Mental Health Nurses and Psychiatric Social workers will be required to be registered with the State Mental Health Authority.

1. Human Resource requirements (for all Mental Health Establishments )- (1)Adequate Health Professionals (Qualified) shall be employed to provide proper treatment as mentioned in the Schedule B. Staffing shall be sufficient to deliver optimal treatment and care, manage demand, and be responsive to any emergency 24 hours a day, 7 days a week;

(a) The Mental health professionals engaged by a mental health establishment shall have the same qualifications as laid down in the Act for the purpose of implementation of the Act.
(b) For the ministerial and subordinate staff and any other personnel engaged for whom the minimum qualifications are not laid down in the Act, the minimum qualifications shall be the

same as for the Government employees of an equivalent cadre.

Note: Only Female Staff (Nurse, Counselor, Therapist etc) will be allowed to take care of Female patients having Substance Use Disorders. 2. MiscellaneousStandards.

(1) AlltheMentalHealthEstablishmentsshalldisplayaboardof6’x4’sizewithName,addressandContactnumberoftheOwnerofthePrivateMentalHealthEstablishment,Registration/ Licensing status (including license number, validity of license), contact no. of the Civil Surgeon (or any other authorized person to whom any complaint can be made) must be displayed at a place which should be clearly visible with following color coding of the base with written in white letters over it. –

(a) Navy Blue base for categories 1, 2, 3,4 mentioned at Schedule A;

(b) Green base for categories 5, 7,8 mentioned at Schedule A; 38

3.

(c) Red base for category6 mentioned at Schedule A.

(2) Fee Charged from patients should be prominently displayed at the reception area and record of fee with bills must be maintained. (3) NamesofalltheStaffshouldalsobedisplayed.

(4) Complaintboxmustbeinstalled,anditshouldbeataclearlyvisibleplace.
(5) Prescriptionofmedicationbyunauthorizedperson/employee/MentalhealthprofessionalisstrictlyProhibited.

Record Maintenance and Dissemination

(1) It shall be mandatory for all the Mental health establishments to maintain personal and treatment record of all the patients. All records must be kept at least for ten Years. These records shall be confidential and available only to the person/persons authorized by the State Mental Health Authority (SMHA) or by the District Mental Health Review Board (DMHRB) on request. Some records shall be readily available, even on the surprise visits e.g.

39

(a) AttendanceRegister:

(b) CounselingRegister:

(c) CR files: a uniform format of CR files will be provided to all the centers and these files shall be made available to the inspecting team. The CR files will include the Standardized Consent form, DAMS performa and Feedback Performa (feedback from patients as well as families)also.

(d) RecordsofMedicinePurchasedandConsumed.

(e) StockRegister
(f) Fee Collection Receipts
(g) Anyotherrecordasdeemednecessarytobeinspected

4. Fire and other Safety Measures

. (1)  Necessaryproceduresexisttomeetfireandnon-fireemergenciesandsafeexitofinpatientsandothers.

. (2)  Appropriatedisplayofdirectionalfireexitsignage,minimumintwolanguages,oneofwhichislocal.

. (3)  Allfiresafetymeasurestakenincludingfireprevention,detection,mitigation,evacuation,containmentandmockdrills.

. (4)  Firefighting equipment periodically inspected, chemicals replenished and kept in usable condition. Biomedical waste management (as per norms of Punjab Pollution Control Board)
must be ensured and relevant documents must be submitted at the time of applying for registration

. (5)  AdequatetransportfacilitiesforpatientsforthepurposeoflinkageactivitiesandEmergencyMedicalCare.

. (6)  AllMentalHealthEstablishmentsmusthaveFiresafetycertificatefromlocalauthorities.

40

41

Schedule -C
Space calculation for Drug De-addiction center

     

Area

Consultation chambers Counseling rooms Waiting area Staff toilets Patient toilet complex Pharmacy
Drug dispensing room

Outpatient registration Admission office Medical records office Storage room

Proposed Norms (in Sq meter) For 10 beds

  

Outpatient area

Records and registration room

14 9 30 10 20 15

10 10

                                                         

Administrative area and stores (only if not shared with the hospital)

   

Room for officers/sister in charge Room for accounts personnel Store room

20

                

Wards

    

Beds 60

   

Nursing station with Toilets Interview/treatment/group counseling room
Doctors duty room
Nurses changing room Wards store
Patients relative waiting area with toilets
Sluice room
Group D room
Ward pantry with drinking water facility
Staff toilet
Patient toilet complex Recreation/Rehabilitation/Activity room
Subtotal
Add 30% extra for circulation space
Sub total
Add 10% for walls

Total Area

6 20

8 4 6 12

10 12 10

6
30 ( 20 for male and 10 for female) 20

332

99

431

43

474

                                                                                   

*Minimum 10 beds of which at least 3 will be earmarked for women.

*Rooms will be separated with pucca wall, no aluminium partition is allowed. Three beds for females, one room with three beds and one with four beds for males.

Space calculation for Rehabilitation center

     

Area

Consultation chambers Counseling rooms Waiting area Staff toilets Patient toilet complex Pharmacy
Drug dispensing room

Outpatient registration Admission office Medical records office Storage room

Proposed Norms (in Sq meter) For 10 beds

  

Outpatient area

   

14
9
40
7
30 ( 20 for male and 10 for female) 22
12

Records and registration room

                                

15 15

                  

Administrative area and stores (only if not shared with the hospital)

     

Room for officers/sister in charge Room for accounts personnel Store room

15

          

Wards

  

Beds 65

    

Nursing station with Toilets Interview/treatment/group counseling room
Doctors duty room
Nurses changing room Wards store
Patients relative waiting area with toilets
Sluice room
Group D room
Ward pantry with drinking water facility
Staff toilet
Patient toilet complex Recreation/Rehabilitation/Activity room

7 28

8

6 12

15 12 15

7
30 ( 20 for male and 10 for female) 26

                                                      

Subtotal 410

    

Add 30% extra for circulation space
Sub total
Add 10% for walls

123

533

        

53 Subtotal 586

        

Add 50% for open space for categories 6,7 and 8 Total Area

293

879

            

Minimum 10 beds of which at least 3 will be earmarked for women.

*Rooms will be separated with pucca wall, no aluminium partition is allowed. Three beds for females, one room with three beds and one with four beds for males.

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