State Mental Health Authority Chhattisqarh
3’d Floor, Indrawati Bhavan, Atal Nagar, Raipur
Nawa Raipur, Atal Nagar, tra1g…?*;.]’ 202
No. F l-3612019/17-l – In exercise ofthe powers conferred by Section 65 and Section 123 ofthe Mentaf Healthcare Act, 20t7 ( l0 of 2017) C’MHCA), the State Mental Health Authority, chhattisgarh prescribes the following minimum standards relating to the administration of mental health establishments in Chhattisgarh, namely :-
I. Definitions
“Mental health establishments” are defined under Section 2 (t) (p) of the MHCA as any ,health
establishment’ including Ayurveda, yoga and Naturopathy, Unani, Siddha and Homeopathy
establishments by whatever name called, either wholly or partly, meant for the care of persons with
mental illness, established, owned, controlled or maintained by the appropriate Government, local
authority trust, whether private or public, corporation, co-operative sociity, organization or any other
entity or person, where persons with mental illness are admitted and reside a:t, or kept in, for care,
treatment, convalescence and rehabilitation, either temporarily or otherwise; and includes any general
hospital or general nursing home established or maintained by the appropriate covemment, local
authority, trust, whether private.or public, corporation, co-operative socie!, organisation or any other
entity or person; but does not include a family residential place where a person *iih mental illness resides with his relatives or friends.
“Half-way homes” are defined under_the- Mental Healthcare (Rights of Persons with Mental lllness)
Rules’ 201 8 as.transitional living facilities for persons with mental i-llness who are discharged as inpu,,”n,
from a mental health establishment, but are noi fully ready to live independently on their Jwn or with the family.
“Sheltered accommodotions” are defined under the Mental Healthcare (Rights of persons with Mental Illness) Rules, 2018 as safe and secure accommodation options for persons w-ith mental illness, who want to live and manage their affairs independently, but need occasionai help and support.
Mental health establishments in Chhattisgarh shall be classified under the following categories:
Crtegorv Category I Category 2 Category 3 Category 4
Category 5 Category 6 Category 7
The following common minimum standards establishments (Category I to 7):
itlental Health Esrablisbme a
Psyc}iatric Nursing Homes and Facilitiesffi (Child & Adolescent Clinics. De-Addiction Centres- erc ) Rehabilitation Homes
)netler Homes
natt-way Homes& Sheltered Accommodations
rr’ common Minimum standards (A[ categories of Menlar Hearth Estabrishmcnts)
are applicable to all categories of mental health
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1. All premises shall be well maintained and have proper living conditions:
l.l Each mental health establishment to 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 mental health establishment shall notiry the State Mental Health Authority ofthe same.
1.2 Mental health establishments shall not change their location without the permission of the State Mental Health Authority.
1.3 The building/s shall be approved by local authority for establishment of the mental health establishment.
1.4 Concrete structures are strong enough to withstand heavy rains and moderate natural calamities. 1.5 Structures are seepage free.
1.6 Functional windows and doors are present in all structures,
1.7 Buildings with more than two floors have a lift with a generator back-up.
1.8 Sufficient ventilation and natural light in the buildings.
1.9 Sufficient illumination after sunset that is appropriate for reading without causing strain to the eyes. I .10 Passages leading to toilets and emergency exits are illuminated during the night.
l.l I Inverters are functional for emergency lights during power failures and load shedding.
l.l2 Periodic painting of doors, windows and walls, intemal and external.
l.l3 Information board displaying the name and category of the mental health establishments in the
local language is prominently visible.
2. The living conditions shall be comfortable:
2.1 Separate cots with mattresses, pillows, bed sheets, drawer sheets and blankets in winter shall be provided.
2.2 Provision of mosquito repellents or control measures in sleeping areas.
2.3 Ratio offans to beds is not less than l:5 ratios.
2.4 Minimum two exits where the number of beds in a dormitory or ward is more than 12.
2.5 Sleeping cots shall not be placed in passages, verandas, under staircase or anywhere else except wardVdorms/rooms.
2.6 Hot water for bath is available during winter months.
2.7 Lockable personal storage facilities for clothing and possessions shall be provided. 2.8 Minimum distance between two parallel beds is not less than I meter apart.
3. The premises shall have adequate floor space available.
J.l Separate dormitories and wards for females, males and children who are inpatients.
A gender-neutral ward and dormitory for inpatients who don’t wish to be kept in either male or female ward.
3.3 Minimum distance between two beds is not less than I meter apan and the space at head end is not less than 0.25 meter.
3.4 Door width is minimum L2 meters and minimum conidor width 2.5 meters.
3.5 Ward bed and surrounding space is not less than 6 sqm/ bed.
3.6 Kitchen/dining area and toilet/bath block are not in proximity.
3.7 Common room has television, newspapers, magazines and indoor games. The chairs provided are
in l:4 ratios.
3.8 Out-patient department (OPD) has sitting arrangements for patients and accompanying family
members; registration desk; help and cash counte(s); and drinking water facilities.
3.9 Provisions for accommodation of caregivers shall be made in case they are willing to provide
support to the inpatient.
3.10 If patients with mental illness are nursed in general wards, norms for adequate floor space and staffins shall be followed.
4. Hygiene, cleanliness and sanitation shall be maintained:
4.1 Daily sweeping, swabbing and dusting ofthe entire premises.
4.2 Sanitation maintained in all the areas including toilets and bathrooms using disinfectants.
4.3 Number of toilets is not less than in the ratio of I :4 and bathrooms not less than in the ratio of I : 10. 4.4 Separate toilets and bathrooms for males and females, gender neutral toilet and toilet for persons
with disabilities.
4.5 Number of wash basins not less than I : l2 outside the toilets/bathrooms and in the dining area. 4.6 Twenty-four-hour availability ofwater in wash basins, bathrooms and toilets.
4.7 Weekly change ofbed linen and colored bed linen shall be preferred.
4.8 Soiled linen are washed in a clean and hygienic environment.
4.9 Periodic pest control treatment to ensure premises and kitchenware free of cockroaches and
rodents.
4. l0 Dust bins are present in waste generating areas and daily disposal of waste is ensured.
4.1I Plates, dishes and cutlery used for eating, cooking vessels and other soiled vesselVcontainers are
washed and dried regularly.
4.12 Articles of personal hygiene like soap, toothbrush, toothpaste, oil, moisturizing cream and other
items based on request shall be made available to all the inpatients.
4.13 Female patients shall be provided with personal hygiene iiems during their menstruation ineluding
sanitary napkins, extra undergarments etc.
4.14 Toilets for female inpatients shall have disposal facilities for sanitary napkins.
4.15 The bathing and toilet facilities shall allow privacy.
4.16 The bath/toilet facilities shall be adjusted to the bathing and toilet needs of inpatients who are
bedridden or who have impaired mobility or other physical disabilities.
5. Wholesome, sumptuous and nutritive food and potable drinking water shall be provided in comfortable settings:
5.1
5.2 5.3 5.4 5.5 5.6
Well cooked, fresh, hot and hygienic food, appropriate to local food habits shall be provided without any restriction on quantities ofthe food served.
Food shall be served on dining tables with chairs.
No adulteration and contamination in food provisions.
Special meals shall be served as advised for patients having physical illness. Breakfast, aftemoon tea and two meals shall be served at proper timings.
Food menu changed daily and the same items other than cereals shall not be repeated on the same day or next day.
5.7 Filtered cold water shall be provided in summers and filtered room temperature water shall be provided rest ofthe year.
5.8 Food menu shall be displayed along with calorie count and timetables.
5.9 Food shall be served in a respectable and comfortable manner.
5.10 Safe drinking water along with provision ofa water dispenser shall be provided.
5.ll Food shall be prepared and served under satisfactory conditions in dining areas and shall be
6.1 o.z 6.3
culturally appropriate.
Facilities shall be provided for social, cultural, leisure and recreational activities:
Entertainment programme, socials and excursions shall be organized for inpatients.
Furnished visitors’ room for families coming to meet the inpatients.
Facilities shall be provided to inpatients for internal and extemal communications and freedom to receive visitors, use mobiles, send and receive mails and use anv other conventional mode to communicate.
6.4 A range ofregularly scheduled, organized activities which are shall be offered.
appropriate
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7. Privacy, dignity, safety and security of patients shall be protected:
7.1 Patients with suicidal ideation or at risk of attempting suicide shall be allotted a bed in a room designed to prevent self-injury.
7 .2 All windows shall have grills fixed.
7.3 Adequate security measures to ensure physical safety of inpatients.
8. Record Maintenance and Dissemination:
8.1 Maintain personal and treatment record of all the patients and records shall kept at least for ten yeafs.
8.2 Pati€nts’ case histories and records shall be confidential and available only to the person/persons authorized by the State Mental Health Authority (SMHA) or by the Mental Health Review Board (MHRB) on request.
8.3 The following records shall be readily available. 8.3. I Anendance Register
8.3.2 Counseling Register
8.3.3 Records of Medicine Purchased and Consumed. 8.3.4 Stock Register
8.3.5 Fee Collection Receipts
8.3.6 Any other record as deemed n€cessary to be inspected
8.4 The following documents shall be maintained in the medical records: 8.4.1 Patient capacity assessment report
8.4.2 Signed informed consent
8.4.3 Doctor’sprescription
8.4.4 Medications related records 8.4.5 Treatment plan
8.4.6 Dischargeslip/summary/planning
9. Fire safety, pollution control and waste management:
9.1 Necessary procedures shall be provided to meet fire and non-fire emergencies and safe exit of inpatients and others.
9.2 Directional fire exit signage shall be appropriately displayed in minimum two languages one of which is local.
9.3 All fire safety measures shall be taken including fire prevention, detection, mitigation, evacuation, containment and mock drills.
9.4 All mental health establishments shall have a fire safety certificate and certification for biomedical waste management from local authorities.
I{L Specific Mlnimum Standards (Only Mental Health.Estsbtishments.of Category 1 to,4)
The following are specific minimum standards applicable to mental health establishments only of Category I to 4:
10. Adequate Healtb Professionals shall be employed to provide proper treatment:
10. I Inpatients shall be seen on a regular basis by a mental health professional. l0.2Amedical officer shall be available on call24 hourstomeet
ll.Other medical and Para-medical staffshall be requlrements:
I l.l Regular visits by a qualified medical practitioner, as per the norms fixed by the state govemment for medical check-up and treatment, no l€ss than twice weekly.
‘
I 1.2 Tie up with a local hospital shall be ensured for admitting patients ifrequired.
ll.3 Treatment for general health problems, including vaccinations, shall be made available to service
users at the facility or by referral.
I 1.4 Specialist doctors shall be available on call for emergency. (Gynecologist on call for women and
Pediatrician for minors)
12. Equipment and articles shall be procured and used for inpatients as per requirements:
l2.l Medical equipment and instruments shall be commensurate with the scope of services and the number of beds.
12.2 Equipment and inventory shall be kept in a good usable condition.
12.3 Sufficient sets of basic equipment consisting of blood pressure apparatus, stethoscope, weighing
machine. thermometer etc. are available.
12.4 Anesthesia equipment and muscles relaxants shall be provided in cases of electro-convulsive
therapy in the mental health establishment.
12.5 Oxygen cylinders with flow meter shall be available.
12.6 Sufficient stock of drugs, medical devices and consumables. Drugs in the Essential Drugs List and
psychotropic drugs shall be made available in sufficient quantity.
12.7 First aid box with standard contents and emergency life-saving equipment shall be made available
at all times.
13, High Dependency Unit:
l3.l High dependency unit shall be available for patients who require intensive care and support.
f4. OPD facilities shall be provided for the treatment ofpersons with mental illness rs out-patients:
l4.l Facilities for treating out-patients shall be available for no less than six days a week (excluding holidays).
14.2 OuFpatients shall be provided consultation by one or more mental health professionals.
14.3 Registration/help desks and billing counters shall be managed by local language speaking staff. 14.4 Prescriptions shall contain names of the patients, dates, names of medication, dosages, frequency,
duration, name, signature and registration number ofthe psychiatrist in legible writing.
14.5 Billingshall be done as perthe tarifffixed available to patients and their families to see.
14.6 Potable drinking water shall be made available.
14.7 Separate toilets and bathrooms for men, women, persons with disabilities and gender-neutral toilets
and bathrooms shall be available.
W. Stalfing Norms (Category-wise) Category of Mentsl Psychittrist Medical
Stalfing Norms in Ratio (Cadre-wise) Psychiatric Clinical
Psychiatric Attendsnts Social
Worker
Health Estsblishment
Category I :
State Mental Health l:20 Hospitals & lnstitutes of
Mental Health (tull tim€)
Officer
l:10
Nu rse (Der shift)
Cenerai Nurse: l:10
Psychiatric Nune: l:20
Psychologist
l:50
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I :50
l: l0
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deemag and chest clinic 