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Sd/-Dr.K. Ramesh Reddy Director of Medical Education

INWARD OFFICE OFTHE DIRECTOR OF MEDICAL EDUCATION, TELANGNA ADERABADRY

Rc.No.40811/Psy-P1/2018

Sub:

Ref:

ats MentaHealthae2

Supdt Asst.

Diredate o6.09,2023.2s CSRMO

DME, TS, Hyd.

Care Act 2017 – Govt Orders on Minimum Standadfo Establishments under MHA2017- Communicated – Reg.

G.0. Ms. No.148, HM&FW (D)Dept., dated 26.08.2023.

Planning (P1-Psy) – ImplementatipUPMent

Health

Kind attention of the Chief Executive Officer, State Mental Health Authority /Superintendent, Institute of Mental Health, Hyderabad, is invited to the G. 0. reference cited, , wherein the Government issued orders regarding Minimum Standard for Mental Health Establishments as per Mental Health Care Act, 2017.

In view of the above, Copy of the Government orders reference cited is enclosed herewith for taking further necessary action.

Director of Medical Education

heChiefExecutiveOfficer,StateMentalHealth Authority,Telangana/Superintendent, Institute of Mental Health, Hyderabad.

GOVERNMENT OF TELANGANA ABSTRACT

HM&FW Dept – Telangana State Mental Health Authority – Minimum Standards

for Mental Health Establishments as per Mental Health Care Act, 2017 Notification – Orders – issued.

MOdIcaJl DrGO.Ms.NO.148

ÖRDER:

HEALTH, MEDICAL AND FAMILY WELFARE(D) DEPARTMENT

From the

Lr.Rc.No.A1/IMH/HYD/2023, dated 09.05.2023.

Dated.26.08.2023 Read

Hyderabad,

Director

of Medical

Education,

In the circumstances reported by Director of Medical Education, Hyderabad read above, the Government of Telangana hereby specified the

minimum standards for different mental health establishments as per Mental Health Care Act, 2017 is as follows:

2 Mental Health Establishments as per Mental Health Care Act, 2017 will provide one of the following services

a. Admission and treatment of Persons with Mental IlIness

b. Admission and treatment of Persons with Mental Illness and co

existing Substance use disorder

c. Acute Detoxification in Persons with Substance use disorders

d. Non-Pharmacological Interventions for Persons with Mental Illness

e. Vocational Skills and Rehabilitation

f. Long Term Care/Rehabilitation.

3. Depending upon the spectrum of services provided and the size of such

mental health establishments providing such care, these establishments necessitate

to be categorized into the following subcategories for the purpose of prescribing the minimum standards:

a. Short Term Treatment including detoxification centre for drug abuse (<1

month): Facility, where patients of substance abuse shall be kept and treated

for symptoms of substance withdrawal and/or overdose. For this purpose, detoxification is a set of interventions aimed at managing acute intoxication and withdrawal.

b. Long Term Treatment Rehabilitation Centre (1 month or more) Here the substance use patients can be kept for more than 1 month with the focus on lifc skills and vocational training.

C. Treatment Centre for drug abuse and other mental disorders (1 month or more) for patients with co-existing psychiatric disorder (Dual Diagnosis facility): Dual Diagnosis here means Substance Use Disorders present along with Psychiatric Diagnoses (not to be confused with medical co morbidities.

d. Short Term Acute PsychiatricTreatment facility: Facility, where patients of psychiatric illness shall stay for short term treatment for around 3-6 months for the purpose of treatment and stabilization of psychiatric condition.

e. Long Term Psychiatric Rehabilitation Centre: Here the patients with psychiatric illness stay for more than 6 months with the focus on life skills and

vocational training for their social reintegration and rehabilitation back into the community.

Page 1 of 6

Type of Facility Requirement, >

(1)

Short Term Treatment

including detoxification centre

Long Term Treatment Rehabilitation Centre (1

Treatment Centre for

drug abuse and other

Short Term Treatment including acute hospitalization

Long Term Treatment Rehabilitation Centre/Halfw ay Home (>6 months)

Allthese facilities have been further sub categorized keeping in view the number of beds/capacity.

Up to 20 beds

21-50 beds

” More than 50 beds

4 The present standards have been formulated keeping in mind

5

a. Patient Safety

b. Human rights of Patients

C. Medical and psychosocial care standards

d. Ensuring quality care

e. Humane, friendly enabling environment

f. Other contextual local factors.

These facilities are expected to provide a friendly environment, rather than a restrictive atmosphere and are expected to provide facilities for recreation, indoor and outdoor games, outings, family visits, and other recreational tools.

These minimum standards will be reviewed periodically every two years.

The minimum standards for various sub-categories of facilities are depicted in Table. The standards have been devised to strike an appropriate balance between respectable quality medico-psycho-social care, safety and optimal

functioning of the centers.

7 It is intended that these standards provide essential structure to the functioning of substance use treatment centers. In view of the large need of such services and the treatmernt gap, these standards have been kept to the minimum and only indicative of the basic requirement for these centers in terms of infrastructure and human resource requirements. These minimum standards will be applicable for allgovernment, private and NGO facilities working in the field of drug abuse and detoxification in the State of Telangana.

8 For the purpose of these standards the Counselor shall be defined as under: ACounselor is a person trained to give guidance on personal or psychological

6

problems,

with

minimnum qualification being graduate i n C l i n i c a l

Psychology/Psychology or Social Work and with 6month experience in De addiction services.

9 PsychiatricNursing Homes/Hospitals licensed under Mental Health Act

2017 providing detoxification faclities shall also maintain the prescribed minimum standards.

10. Standards of Ministry of Social Justice and Empowerment (MoSJE) 2009,

AIIMS De-Addiction Centre Guidelines and Draft of State Mental Health

Authority Minimum Standardswere consulted and deliberated for drafting the minimum standards keeping in view the local requirements.

Minimum Standards of various subcategories of Mental Health Establishments as per Mental Health Authority, 2017

for drug abuse (<1 month)

mental disorders

month or more )

(2) 3 (4 (5 (6)

Page 2 of 6

(<6months)

aat n

Livin) it

acces

w he

structure

A. Living and

Physical space (si’ted at an easily accessible

placeensuring safety and security of patients with

proper ventilation and sanitation facility)

Minimum patient /Ward area of 60 sa.

feet p e r bed

including adequate area for recreational

60 Sq. Feet per bed

Including adequate area for recreational

facilities,therapies, counseling etc.

Children and adolescents are to be segregated from Adult patients

Facility for safe keep of personal

belongings of patients

Full time and available on call

Minimum patient /Ward area of 60

Human Resources B1. Trained

Physician/ Medical care

*Minimum qualification –

Graduate degree (as per the system of allopathic/

AYUSH medicine) along with

registration with the concerned

Medical Council

B2. Psychiatrist

Minimum

Qualification -Diploma / MD / equivalent in

Psychiatry/ Psyc

hological

Medicine along

with registration with the Medical

council.

B3. Counselors

Minimum qualification –

graduate in Clinical

Psychology /

P’sychology / Social Work

Experience of working for 6 months in De

addiction services

adolescents are to be segregated from Adult patients

Facility for safe keep of personal

belongings of patients.

Full time and available on call

If patients with overdose are admitted, the doctor has to be available

round the clock.

Gynecologist on Call for facilities admitting

Females

Pediatrician on Call for facilities admitting Minors

Full time and available on call

Full time

1for every 20 beds or part thereof

facilities Pediatrician on admitting

facilities,

counseling, up/OPD etc.

Minimum

built up of 2000 Sq

Feet for 20 Children

patients

a n d

therapies,

follow

facility

Access to Psychiatrist on call

Full time

1 for every 20 beds or part thereof

Full time

P’sychiatrist with daily visits

Full time

1for every 20

beds or part thereof

Call for facilities

admitting Minors

Full Time

Part time

1for every 20

beds or part thereof

Females

Visiting Psychiatrist

Fulltime

1 for every 20 beds or part thereof

Page 3 of 6

sq. feet per bed

including adequate area for

recreational facilities,

therapies, counseling,

follow-up/ OPD etc.

Children and adolescents are to be segregated from Adult patients

Facility for safe keep of personal

belongings of patients

Fulltime and available on call

Minimum patient / Ward area of 60 sq. feet

including adequate a r e a for recreational

facilities,

therapies, counseling,

follow-up/OPD etc. Minimum

facility built up of 2000 Sq Feet

for 20patients

Children and adolescents are to be

segregated from Adult

patients

Facility for safe

keep of

personal

belongings of patients

Full time and available on call

Gynecologist on Call for facilities

admitting Females

Minimum patient

/Ward area of 60 sq. feet

per bed

including adequate

a r e a for

recreational

facilities,

therapies, counseling,

follow-up/ OPD etc.

Facility for safe keep of personal

belongings of patients

Part time and available on call

Gynecologist on Call for

per bed

B4. Social workers & Persons in

Recovery

B5. Nursingstaff

Nos.(Tobeasper NursingCouncil

norms)

Minimum qualification –

B6A. Vocational

trainers

B6B.

Yoga trainers

B7. Support Services/Staff

(Sanitation,

Security, attendants. Clerical and

managerial staff etc.)

B8. Laboratory services

Services

C1. Registration

C2. Inpatient Treatment

1nursing

Atleast1 nursingstaffto

beavailable

At least 1 nursing staff to be available

C3. Emergency services

Linkage/network Linkage/

NotMandatory

Regular 1for 20beds

staff Atleast 1nursing Atleast1 nursing staff for 20 Patients

At least stafffor20 Patients to be

round the for20 availableround clock

Patients to be availableroundthe

(1:20beds)

GNM

Preferable as per requirement

Mandatory

Asperrequirement,

In- house or

outsourcing arrangement

(1:10)

Not mandatory

Essential

Everypatients’ details to be recorded

and each patient to get a unique ID

round theclock (1:20 beds)

(1:20beds)

GNM Preferable as

p e r requirement

Mandatory

As per requirement,

In-house or outsourcing arrangement

(1:10 )

Not mandatory

Essential

Every patients

details to be recorded and

each patient to get a unique

ID

Every patient

to be seen by the doctor at

clock

(1:20 beds )

GNM

Not Mandatory for facility for Adults

Mandatoryfor

facilities for Minors

Not Marndatory

As per requirement,

In- house or

outsourcing

arrangement

Female attendants to

be available around the clock for facilities admitting Females and/or Minors

(1:10)

Essential – either in house/ outsourcing arrangement

Essential Everypatients’details to be recorded and

each patient to get a unique ID

the clock (1:20 beds)

GNM

Asper requirement

Asper requirement

Asper requirement, In

house or outsourcing arrangement

(1:10)

Essential – either

in

house/ outsourcing arrangement

Essential

Every patients’ details to be recorded and

each patient to get a unique ID

GNM Not Mandatory

for facility for

Adults Mandatory for facilities for Minors

Not Mandatory

Asper requirement,In

house or

outsourcing

arrangement

Female attendants to be

available around the clock for facilities

admitting Females and/or Minors

(1:5)

Essential – either

house/ outsourcing arrangement

Essential Every patients’ details toberecorded and each patient

toget a unique ID

Every patient to be Every patient to be Every patient to Every patient to seen by the doctor seen by the doctor at be seen by the be seen by the

every day of the stay least once per week doctor every day doctor every

at least once and on during the stay or on of the stay at least day of the stay least once per

SOS basis.

Availability of

isolation facility to reduce transmission of communicable

diseases/ infection

Linkage/network

with a hospital with 24 hour emergency medical facilities

SOS basis.

Linkage/network with a hospital with 24 hour emergency medical Facilities

once or basis.

on SOS

at least once and

on SOS basis.

Availability of

isolation facility to reduce

transmission of

communicable

diseases/ infection

week during thestay oron SOS basis.

Linkage/ network with

ahospital with 24 hour

emergency medical

facilities

Page 4 of 6

Not Mandatory Regu Regular 1forbea

with a hospital with 24 hour

emergency medical facilities

network with a

hospitalwith 24

hour emergency medical facilities

1f Regula

énsing of ations

¤rmacotherapy)

C5. Psychosocial interventions

Only on prescription by the doctor and by

the staff authorized to dispense

As per requirement, to be delivered by the qualified

personnel

Formal arrangements with concerned agencies/ organizations/ professionals

Patients should have access to wholesome food and daily dietary requirements

(If an in-house kitchen

is maintained,

Only on prescription by thedoctor and by

Only on prescription by

the doctor and by the staff authorized to

Only on prescription by the doctor and

by the staff authorized to

dispense

Asper requirement,to be delivered by

the qualified personnel

Formal

arrangements with concerned

agencies/ organizations/ professionals

Patients should

have access to wholesome food

Only on prescription by the doctor and by the staff

authorized to

dispense.

As per requirement, to be delivered by

qualified personnel

Formal

arrangements with

concerned

agencies/ organizations

/Professionals Patients

should have access to

wholesome food and daily

dietary requirements

(If an in-house kitchen is maintained,

appropriate regulatory norms must be followed

Manual or

digital

ensuring

confidentiality

as per provisions of

MHA2017 In place

C6. Referral / Consultation/ Liaison/Legal/

Ambulance Services

C7. Diet / food

be delivered by the qualified personnel

Formal arrangements with concerned agencies/ organizations/ professionals

Patients should have access to wholesome

food and daily dietary requirements (If an in-house kitchen is

C8. Record m a i n t e n a n c e

A. Mode of Records

B. Institutional Policy for

norms must be

followed)

Special Nutritional needs to be assessed by Pediatrician/ Dietician in case of Facilities admitting

Minors.

Manual or digital

ensuring confidentiality as per provisions of MHA

2017

In place

appropriate regulatory norms must be followed)

Special Nutritional needs to be assessed by Pediatrician/ Dietician in case of

Facilities admitting Minors.

Manual or digital

ensuring confidentiality

as per provisions of MHA 2017

In place

(i) Patient register confidentiality (ii) Patients

(i) (ü)

Patient register Patients assessment formats

i )

In place

Patient

and assessment

register Kii) Patients

assessment

formats

(üi)Signed Consent

forms Kiv) Doctors’

Patient

register Patients a s s e s s m e nt formats

recordkeeping

C. Mandatory records to be

maintained

formats

(ii) Signed Consent

forms (iv) Doctors’

prescription

(v) Medication related

records (vi) Records of

(ii) Signed Consent forms

(iv) Doctors’ prescription

(v) Medication related records

(vi) Records of psychosocial

intervention

Discharge slip/ summary (vi) Medication

related records as

per The Drugs and Cosmetics Act 1938 and Rules there Under

(ii)

(vi)

(vi)

appropriate regulatory maintained,

and daily

dietary requirements (If an in-house kitchen is

maintained,

appropriate

regulatory normsmust be

followed)

Special Nutritional

needs to be assessed by

pediatrician/ Die tician in case of

Facilities

admitting Minors.

Manual or

digital ensuring

confidentiality

as per provisions of MHA 2017

psychosocial intervention

Discharge

(vii)

related records

Records of psychosocial intervention

related

records (vi)Records of

psychosocial intervention

(vi) Discharge slip /

summary (vii) Medication

slip/ summary (vii) Medication

related records as per The Drugs and Cosmetics Act 1938 and Rules thereunder

(vi) Discharge slip/

summary (vii) Medication

the staff

to dispense.

authorized

Dispense As per requirement, to As per

Pane 5 of 6

requirement, to be delivered by the qualified personnel

Formal arrangements with concerned

agencies/ organizations /

professionals

Patients should have access to wholesome food

and daily dietary requirements

(If an in-house kitchen is maintained,

appropriate regulatory norms must be

followed)

Manual or digital

ensuring confidentiality as per provisions of MHA 2017

In place (i) Patient

register

(ii)Patients

a s s e s s m e n t

formats

(ii) Signed Consent

forms (iv) Doctors

prescription

(v) Medication Kv) Medication

prescription

(ii) Signed Consent

forms (iv) Doctors’

Prescripti

(v) Medicati on

related

records (vi) Records

of psycho social

interventi

Other Common minimum standards

D1. As per the

seeking registration.

To

S.A.M. RIZVI SECRETARY TO GOVERNMENT

(ix) Records to be

maintained as per other applicable Acts such as JJ Act/ POCSO etc. in case of Minors

(ix) Records to be maintained as

perother

applicable Acts such as J] Act/ POCSO etc. in case of Minors.

related related

(ix)

Smmary dication

related records as per The

Drugs and Cosmetics Act 1938

and Rules there under

organization

MHA2017,maintenance of minimum standards is the responsibility of the

D2. The critical issue of “informed written consent for admission will be as per the provisions of MHA, 2017 and the Rules thereof.

D3. Patients should be given adequate information about the patient rights, services, rules, charges, grievance redressal systems etc. at the time of admission and relevant information in this regard

should be prominently displayed at the location of registration/intake.

D4.Services should be addressed to the needs of the special /socially vulnerable population groups

(Children, Women, Senior Citizens, Transgender) incorporating gender and age sensitivities in addiction and related stress management.

D5. In case the facility provides services to children in need of care and protection,the services should

be in consonance with the facility illustrated in the Juvenile Justice Rules 2016 and guidelines issued by the Government from time to time.

D6. The facility shall submit periodical returns as may be prescribed from time to time by Government/SMHA.

D7. Provisions of all other applicable Acts/Rules for operating the facility shall be applicable.

(BY ORDER AND IN THE NAME OFTHE GOVERNOR OF TELANGANA)

The Commissioner, Printing Press, Telangana State, Hyderabad (With a request to publish in an extraordinary issue and furnish 200 copies to Government).

The Commissioner of Health and Family Welfare, Hyderabad

TheDirectorof PublicHealthandFamilyWelfare,Hyderabad

The Chief Executive Officer, State Mental Health Authority, Hyderabad. The Directorof Medical Education, Hyderabad.

The Commissioner, TVVP, Hyderabad. Copy to:

The Ministry of MoHFW,Gol, New Delh- 110011

Allthe Members of SMHA through Chief Executive Officer,

StateMentalHealth Authority,Hyderabad. The PS to Secretary to Hon’ble Chief Minister.

The PS to Hon’bleM(HM&FW).

The PA to Secretary to Government, HM&FW Dept. TheAccountant General,Telangana,Hyderabad.

The Law (C) Departrment. Sc/Sf

/ FORWARDED :: BY ORDER / /

records as per The Drugs and Cosmetics Act 1938 and Rules thereunder.

Records to be maintained as per other applicable Acts such as

JJAct/ POCSO etc.

in case of Minors

records as per The

Drugs and Cosmetics (viii) Act 1938

and Rules

there under

(ix) Records to be

maintained as per other

applicable Acts such as

JJAct/ POCSO etc. in case of Minors

SECTION ÓFFICER

(vi) tci esip/