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DIRECTORATE OF PUBLIC HEALTH

DIRECTORATE OF PUBLIC HEALTH, ODISHA

……………………………………………………………………………………………………………………………….

Letter No.             PH- DMHP-09/18                                                                                 Dt. …..….. /2019

From,

Director of Public Health,

Bhubaneswar, Odisha

To,

Commissioner -Cum-Secretary to Govt.,

H& FW Deptt., Odisha

Sub:  Submission of categories of Mental Health Establishments & Minimum Quality standards of mental health services under section (9) of Section (18) of NMH care Act 2017.

Sir,

With reference to the above cited subject, I am to submitting here with the categories of mental Health Establishment and revised Minimum quality standards of mental health services under sub section (9) of Section (18) of NMH care Act 2017 submitting by Joint DMET for your kind information and necessary action.

 

This is for your kind information & necessary action.

Yours Faithfully

Director of Public Health, Odisha

 

Memo No. ………………..                                                                                                  Date. …………………

Copy Forwarded to joint secretary to Govt., H& FW Deptt. I/C Scheme for kind information.

 

Director of Public Health, Odisha

 

 

 

Categories of different mental health establishment

Categories of different mental health establishment
1. Classification of Mental Health Establishments – The State Government classifies the Mental Health Establishments into following categories.
(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 Counselling and Rehabilitation center: Providing prolonged Counselling 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.
2. List of services which should be available in Mental Health Establishments.–
(1) The following lists 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 9)
d) Inpatient Service (for all Mental Health Establishments category 1 to 9)
e) Emergency Services (for Mental Health Establishments mentioned at Category 1 to 9)
tag category 6,7,8 to any of the category from serial for any psychiatry emergency.
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);category 6.7.8.9 to be facilitated by counsellor or care taker
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) and
other categories (6 to 8) to be tagged with 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);all the
records to be digitalized
l) Periodic Training of Staff and/or other Persons (for all Mental Health Establishments
category 1 to 9)
m) The State Government shall issue the Standard Operating Procedures (SOPs) regarding Treatment guidelines from time to time up-dation.
3. 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:
(a) Ambulance services
(b) Dietary services
(c) Laundry services/Washing Facilities
(d) Security services ( Male & Female)
(e) Waste management including Biomedical Waste (wherever applicable),electrical Audit;
(f) Electric Supply with power back up, stabilization & electric Audit
(g) 24 X 7 Water supply
(h) Communication ( telephone and internet facility for emails)
(i) Sterilization and Disinfection (as per requirement)
(j) House keeping
(k) Fire safety measures
A. Minimum for Standards for Mental Health Establishments
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.
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.
SCHEDULE – A
INFRASTRUCTURE CRITERIA FOR MENTAL HEALTH ESTABLISHMENTS.
Category1 (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 and
Rehabilitation Centers
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
vii) Dining and pantry Room
viii)Recreational facility
ix)Yoga and meditation
Rooms
1)Out Patient area i.Consultation chambers
ii. Counseling room
iii. Waiting area
iv. Staff Toilets &.patient toilet complex v).Pharmacy/Drug Dispensing room
vi) Dining and pantry room
vii) Recreational facility
viii)Yoga and meditation
Rooms
1)Out Patient area
i.Consultation chambers
ii. Counseling room
iii. Waiting area
iv. Staff Toilets
v. Patient toilet complex
vi.Pharmcy
vii.Drugs
viii) Dining and pantry Room
ix) Recreational facility
x)Yoga and meditation Dispensing room
Rooms
i) Reception area
ii) Consultation Chambers
iii) Counseling rooms
iv) 4.)Waiting area
v) Staff Toilets
vi) Records and Registration room
vii) Administrative area and stores
viii) Drug
ix) Dining and pantry Room
x) Recreational facility
xi) Yoga and meditation Dispensing room
Rooms
i)Reception area
ii)Consultation Chambers
iii)Counseling rooms
iv.)Waiting area
v).Staff Toilets
vi)Records and Registration room
vii)Administrative area and stores Drug
viii) Dining and pantry Room
ix) Recreational facility
x)Yoga and meditation Dispensing room
Rooms
i)Reception area
ii)Consultation Chambers
iii)Counseling rooms
iv.)Waiting area
v).Staff Toilets
vi)Records and Registration room
vii)Administrative area and stores Drug
viii) Dining and pantry Room
ix) Recreational facility
1) x)Yoga and meditation Dispensing room
Rooms
i)Reception area
ii)Consultation Chambers
iii)Counseling rooms
iv.)Wating area
v).Staff Toilets
vi)Records and Registration room
vii)Administrative area and stores Drug
viii) Dining and pantry Room
ix) Recreational facility
1) x)Yoga and meditation Dispensing room
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
room
vi. Wards store
vii. Patients relatives waiting area with Toilets
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
6.Meditation 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 Toilet
viii)Sluice room
Group D room
ix)Ward pantry with drinking water facility x)Staff Toilet
Patient Toilet complex xi)Recreation/ Rehabilitation/ Activity room
xii.Meditation 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
viii.Sluice room ix.Group D room
x. Ward pantry with drinking water facility
xi. Staff Toilet
xii. Patient Toilet complex
xii.Recreation/ Rehabilitation/ Activity room
xiii. Meditation Room
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
vii.Group D room
viii.Ward pantry
with drinking water facility with dining
ix. Staff Toilet
x)Recreation/ Rehabilitation/ Activity room
xi)Vocational Training room
xii)Meditation Room
Recreation/ Rehabilitation/ Activity
4) Wards
i..Beds
ii.Interview/counselingroo m
iii.Wards store iv.Patients relative waiting area with Toilets relatives waiting area with Toilets vi.Group D room vii.Ward pantry
with drinking water facility with dining
viii).Staff Toilet
ix)Recreation/ Rehabilitation/ Activity room
X)Vocational Training room
xi)Meditation Room
xii) Recreation/ Rehabilitation/ Activity
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
vii.Group D room
viii.Ward pantry
with drinking water facility with dining
ix. Staff Toilet
x)Recreation/ Rehabilitation/ Activity room
xi)Vocational Training room
xii)Meditation Room
Recreation/ Rehabilitation/ Activity
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
vii.Group D room
viii.Ward pantry
with drinking water facility with dining
ix. Staff Toilet
x)Recreation/ Rehabilitation/ Activity room
xi)Vocational Training room
xii)Meditation Room
Recreation/ Rehabilitation/ Activity
In every room, minimum 15-20% area must be for ventilation and lighting.
Mental Health establishments under Category 6to 9 must have open space.
1. Infrastructure requirements for all Mental Health Establishments holding OPD and indoor facility.
(a) Well maintained Pucca structure:
(b) Lift / Ramp facilities for disabled persons. lift or ramp facility will be as per provisions of the persons with disabilities act 2016.
 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) Sufficient ventilation and natural light;
(d) Sufficient illumination after sunset, good enough for reading;
(e) Illuminated passages leading to toilets and emergency exits during the night.
(f) The premises shall be well maintained and kept in good livable condition;
(g) Inverters/Power back-up for emergency lights during power failures and load shedding;
(h) No mental health establishment is allowed to run in a basement, However basement can be used as store but patients will have no access to it.
(i) Adequate Security measures 24×7 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 category in the local language.
(m) At the entrance of the MHE, a map of MHE with directions to be displayed & adequate signage for different wards, IPD, Pharmacy, toilet, lift, ramp, emergency exist to be displayed in
(n) The doctors and paramedics on duty needs to be displayed with mobile nos.
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 Mental Health Review Boards, accordingly or whenever applicable. No Establishments shall be allowed to change the location without the permission of competent Authority. Building has to be approved by local authority for establishment of Mental Health Establishment.
* If there is any change of Proprietorship of any Mental Health Establishment, it will be with prior approval from mental health review board with information to SMHA State Mental Health Authority.
2. Other requirements. – ( for all Mental Health Establishments )
(a) Provision for a water cooler with filtration systems may be made;
(b) Separate toilets (wash basins) and bathrooms should be provided for male and female patients in OPD and IPD.
(c) Lockable personal storage facilities for clothing and possessions should be provided. The ward/unit entrance and key clinical areas are clearly signposted;
(d) Male and female patients must have separate Wards, rooms, toilets and washing facilities;
(e) Minimum distance between two parallel beds not less than 1meter.
(f) Door width minimum 1 meter and minimum corridor width 1.5meters;
(g) Bunk Beds are not allowed;
(h) Common room, having TV, newspapers, magazines and indoor games. The chairs provided
in 1:2 ratio;
(i) 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 toilets for males and females;
(j) Proper fire safety measures, fire safety plan, fire safety exit indicators must be in place;
(k) Separate cots for each patient with mattresses, pillows, bed sheets, drawer sheets and Blankets in winter;
(l) Provision of mosquito net or control measures in sleeping areas;
(m) Ratio of fans (where required)to beds, not less than1:3;
(n) Minimum two exits where the number of beds in a dormitory is more than 5 or the width of the door shall not be less than 2.5feet;
(o) No sleeping cots in passages, under staircase or anywhere else except dorms/rooms;
(p) Hot water for bath during winter months;
(q) Separate Ward for Female patients.
(r) All the above mentioned areas to be covered under 24X7 CCTV surveillance
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.
(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 counsellor-patient interactions. The interview room should have adequate lighting and ventilation, and sufficient furniture.
(i) All electrical connections in the wards should be planned such that the patients have 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.
(l) A space may be designated with a examination table & step
(m) The beds, toilets, electrical accessories shall be such that the pt will not have any chance of suicide or inflict any injury to self and others
4. Equipments & 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. Anaesthesia 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; washing machine ; pantry cart
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/cancer/Geriatric illness. Anaemia 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 CDMO&PHO office;
l. Nurses engaged for shift duty in conformity with the Indian Nursing CouncilNorms1985.
All Mental health establishments shall follow the provisions as well as guidelines issued under The Rights of Persons With Disabilities Act 2016. All the staffs database with ADHAR link shall be maintained at MHEs
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.
All the staffs employed in the institution should be provided with refresher training on Mental Health/De-addiction and rehabilitative services at COE & other nearby Medical College & hospitals.
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;
(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) Preferably daily 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) Waste generating bins in waste generating areas and daily disposal of waste as per norms & BMW Rules 2016.
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.
g. Local available seasonal vegetables and fruits to be supplied to inpatients.
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 crisis situations.
(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 to be trained to use de-escalation techniques to prevent patients from harming themselves and others.
Schedule- B Staff Requirement for Mental Health Establishments
Category 1
Category 2
Category 3
Category 4
Category 5
Category 6
Category 7
Category 8
Category 9
Institute of Mental
Psychiatry wing
Psychiatry wing of
Substance use
Psychiatric Nursing
Substance use disorder
Rehabilitation Centers
Shelter homes and other
Halfway home
Health
of Medical
General Hospital
disorder treatment
Homes
counseling and
for mentally ill
mentioned in category 8
Colleges
/Multi- specialty
center
rehabilitation centers
Hospital
1.Director-
1. Fully
1. Separate


1. Project Director /
1.Project Director /
1. Project Manager/ Dera
1. Project Manager/
1Psychiatrist (In the
functional
psychiatry ward in
Manager
Manager
Head etc.
Dera Head etc.
rank of Professor /
department of
hospital premises
Joint Director /
psychiatry
Psychiatrist with 15
years of experience.
2. Full time
Faculty as per
Full Time
Full time
Full time Psychiatrist
Visiting psychiatrist (at
Visiting Psychiatrist (at
Visiting psychiatrist
Visiting psychiatrist
Psychiatrists
MCI guidelines
Psychiatrist
Psychiatrist
Least twice a Week)
least once a week)
Clinical Psychologist
twice a week
Clinical Psychologist
twice a week
Clinical Psychologist
(no. as decided by the
Govt)
Category 1
Category 2
Category 3
Category 4
Category 5
Category 6
Category 7
Category 8
Category 9
Institute of Mental
Psychiatry wing
Psychiatry wing of
Substance use
Psychiatric Nursing
Substance use disorder
Rehabilitation Centers
Shelter homes and other
Halfway home
Health
of Medical
General Hospital
disorder treatment
Homes
counseling and
for mentally ill
mentioned in category 8
Colleges
/Multi- specialty
center
rehabilitation centers
Hospital
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
Faculty as per
Mental Health nurse
Mental Health nurse
Mental Health nurse
As per requirement.
Mental Health nurse
Mental Health nurse
Mental Health nurse
Nurse (Nurse-
MCI guidelines
Round the
Round the
Round the
Round the clock(Nurse-
Round the clock(Nurse-
Round the
Bed ratio (1:10)
clock(Nurse-Bed
clock(Nurse-Bed
clock(Nurse-Bed Ratio
Bed Ratio 1:10)
Bed Ratio 1:10)
clock(Nurse-Bed
Ratio 1:10)
Ratio 1:10)
1:10)
Ratio 1:10)
5. Full time
Faculty as per
Full time Psychiatric
Full time
Full time Psychiatric
Full time Psychiatric social workers / counselors- (1:10 ratio)
Full time Psychiatric
Full time Psychiatric
Full time Psychiatric
Psychiatric Social
MCI guidelines
social
Psychiatric social
social workers /
social workers /
social workers /
social workers /
Workers/ counselors-
worker/counsellors-
workers /
counselors (1:10 ratio)
counselors (1:10 ratio)
counselors- (1:10 ratio)
counselors- (1:10
1:10 ratio)
counselors (1:10 ratio)
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)
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 require
Any other supportive staff as required
Any other supportive staff as required
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


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. Miscellaneous Standards.
(1) All the Mental Health Establishments shall display a board of 6’x4’ size with Name, address and Contact number of the Owner of the Private Mental Health Establishment, Registration/ Licensing status (including license number, validity of license), contact no. of the CDM&PHO (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;
(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) Names of all the Staff should also be displayed.
(4) Complaint box must be installed, and it should be at a clearly visible place.
(5) Prescription of medication by unauthorized person/employee/Mental health professional is strictly Prohibited.
3. 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.
(a) Attendance Register:
(b) Counseling Register:
(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) Records of Medicine Purchased and Consumed.
(e) Stock Register
(f) Fee Collection Receipts
(g) Any other record as deemed necessary to be inspected
4. Fire and other Safety Measures
(1) Necessary procedures exist to meet fire and non-fire emergencies and safe exit of inpatients and others.
(2) Appropriate display of directional fire exit signage, minimum in two languages, one of which is local.
(3) All fire safety measures taken including fire prevention, detection, mitigation, evacuation, containment and mock drills.
(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) Adequate transport facilities for patients for the purpose of linkage activities and Emergency Medical Care.
(6) All Mental Health Establishments must have Fire safety certificate from local authorities.
Schedule -C
Space calculation for Drug De-addiction center
Area
Proposed Norms (in Sq meter) For 10 beds
Outpatient area
Consultation chambers
14
Counseling rooms
9
Waiting area
30
Staff toilets
10
Patient toilet complex
20
Pharmacy
15
Drug dispensing room
Records and registration room
Outpatient registration
10
Admission office
Medical records office
10
Storage room
Administrative area and stores (only if not shared with the hospital)
Room for officers/sister in charge
20
Room for accounts personnel
Store room
Wards
Beds
60
Nursing station with Toilets
6
Interview/treatment/group
counseling room
20
Doctors duty room
8
Nurses changing room
4
Wards store
6
Patients relative waiting area with
toilets
12
Sluice room
10
Group D room
12
Ward pantry with drinking water
facility
10
Staff toilet
6
Patient toilet complex
30 ( 20 for male and 10 for female)
Recreation/Rehabilitation/Activity
room
20
Subtotal
332
Add 30% extra for circulation
space
99
Sub total
431
Add 10% for walls
43
Total Area
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
Proposed Norms(in Sq meter) For 10 beds
Outpatient area
Consultation chambers
14
Counseling rooms
9
Waiting area
40
Staff toilets
7
Patient toilet complex
30 ( 20 for male and 10 for female)
Pharmacy
22
Drug dispensing room
12
Records and registration room
Outpatient registration
15
Admission office
Medical records office
15
Storage room
Administrative area and stores (only if not shared with the hospital)
Room for officers/sister in charge
15
Room for accounts personnel
Store room
Wards
Beds
65
Nursing station with Toilets
7
Interview/treatment/group
counseling room
28
Doctors duty room
8
Nurses changing room
Wards store
6
Patients relative waiting area with
toilets
12
Sluice room
15
Group D room
12
Ward pantry with drinking water
facility
15
Staff toilet
7
Patient toilet complex
30 ( 20 for male and 10 for female)
Recreation/Rehabilitation/Activity
room
26
Subtotal
410
Add 30% extra for circulation
space
123
Sub total
533
Add 10% for walls
53
Subtotal
586
Add 50% for open space for
categories 6,7 and 8
293
Total Area
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 bedsfor females, one room with three beds and one with four beds for males.