Admission and discharge procedure of psychiatric patients

This is the brief presentation on admission and discharge procedure of psychiatric patients in the psychiatric hospital.

1. MENTAL HEALTH NURSING ADMISSION AND DISCHARGE PROCEDURE Ms. Pooja dhimaan Tutor Lakshmi bai batra college of nursing

2. INTRODUCTION INDIAN MENTAL HEALTH ACT WAS DRAFTED BY PARLIAMENT IN 1987 CAME INTO EFFORT FROM APRIL 1993 REPLACES INDIAN LUNACY ACT OF 1912 DIVIDED INTO 10 CHAPTERS CONSISTING 98 SECTIONS

3. ADMISSION ADMISSION OF PSYCHIATRIC PATIENT COMES UNDER CHAPTER IV IT DEALS WITH THE PROCEDURES FOR ADMISSION AND DETENTION IN PSYCHIATRIC HOSPITAL / NURSING HOMES.

4. TYPES OF ADMISSION ADMISSION ON VOLUNTARY BASIS ADMISSION ON UNDER SPECIAL CIRCUMSTANCES ADMISSION BY THE POLICE OFFICER OR MAGISTRATE.

5. ADMISSION ON VOLUNTARY BASIS REQUEST BY MAJOR FOR ADMISSION AS VOLUNTARY PATIENT REQUEST BY GUARDIAN FOR ADMISSION TO A WARD(IN CASE OF MINOR) ON RECEIPT OF A REQUEST THE MEDICAL OFFICER- INCHARGE SHALL MAKE AN ENQUIRY WITHIN A PERIOD OF 24 HOURS AND IF SATISFIED HE MAY ADMIT SUCH APPLICATION AS A VOLUNTARY PATIENT. EVERY VOLUNTARY PATIENT ADMITTED SHALL BE BOUND TO ABIDE BY THE RULES MADE BY INSTITUTION .

6. ADMISSION ON UNDER SPECIAL CIRCUMSTANCES ANY MENTALLY ILL PERSON WHO DOES NOT, OR IS UNABLE TO, EXPRESS HIS WILLNGNESS FOR ADMISSION AS A VOLUNTARY PATIENT, MAY BE ADMITTED OR KEPT AS AN INPATIENT IN A PSYCHIATRIC HOSPITAL OR PSYCHIATRIC NURSING HOME ON AN APPLICATION MADE BY HIS /HER RELATIVE OR FRIENDS. IF MEDICAL OFFICER INCHARGE IS SATISFIED THEN THE PATIENT IS KEPT IN THE HOSPTAL AS A INPATIENT.

7. ADMISSION UNDER AUTHORITY /ORDER IT IS FURTHER DIVIDED INTO FOUR SUB SECTIONS. THEY ARE AS FOLLOW BELOW: RECEPTION ON APPLICATION SECTION 20 RECEPTION ON PRODUCTION BEFORE MEGISTRATE SECTION 23 RECEPTION AFTER INQUEST SECTION 26 ADMISSION AND DETENTION OF MENTALLY ILL PRISONER SECTION 27

8. RECEPTION ORDER APPLICATION FOR RECEPTION ORDER AN APPLICATION FOR RECEPTION ORDER MAY BE MAD E BY THE MEDICAL OFFICER INCHARGE THE SPOUSE OR THE RELATIVE OF THE MENTALLY ILL EVERY APPLICATION SHALL BE : SIGNED AND VERIFIED IN THE PRESCRIBED MANNER SHALL BE ACCOMPANIED BY TWO MEDICAL CERTIFICATE,ONE OF THEM ISSUED BY GAZATTED MEDICAL OFFICER. THE MEDICAL OFFICER CAN EXTEND INPATIENT TREATMENT TO MORE THAN 6 MONTH BY MAKING SUCH AN APPLICATION TO THE MAGISTRATE

9. MENTALLY ILL PATIENT EXHIBITING VIOLENT BEHAVIOUR ,CREATING OBSENSE AND DANGEROUS TO THE SOCIETY CAN BE DETAINED BY THE POLICE OFFICER AND PRODUCED IN COURT WITHIN 24 HOURS OF SUCH DETENTION , SUPPORT BY 2 MEDICAL CERTIFICATE ,SUBSEQUENT TO WHICH THE MAGISTRATE ISSUES A RECEPTION ORDER RECEPTION ON PRODUCTION BEFORE THE MAGISTRATE:-

10. RECEPTION AFTER INQUEST SEC 26 IF ANY DISTRICT COURT HOLDING ANY INQUESITION REGARDING ANY PERSON WHO IS FOUND TO BE MENTALLY ILL BY ORDER SUCH PERSON SHALL BE ADMITTED AND KEPT AS AN INPATIENT IN A PSYCHIATRIC HOSPITAL

11. ADMISSION AND DETENTION OF MENTALLY ILL PRISONER AND ORDER MADE UNDER SECTION 30 OF A PRISONER ACT DIRECTING A RECEPTION OF MENTALLY ILL SHALL BE SUFFICIENT AUTHORITY OF A PERSON INTO ANY PSYCHIATRIC HOSPITAL

12. ADMISSION IN EMERGENCIES THE MEDICAL OFFICER INCHARGE MAY ORDER THE ADMISSION OF A MENTALLY ILL PATIENT IF HE THINK HE IS DENGEROUS TO HIMSELF OR OTHERS PATIENT SHOULD BE PRODUCED BEFORE MAGISTRATE WITHIN 24 HOURS OR THE MAGISTRATE HIMSELF MAY VISIT PSYCHIATRIC HOSPITAL AND PASS RECEPTION ORDER

13. TEMPORARY TREATMENT ORDER ORDER ISSUED BY MAGISTRATE IN CASES WHERE THE RISK IN PRECEIVED TO THE PATIENTS LIFE THE MEDICAL OFFICER APPLY TO THE MAGISTRATE ALTERNATIVELY THE RELATIVES CAN GET THE MAGISTRATE TO ISSUE AN ORDER FOR TREATMENT IN SUCH CASES A SINGLE MEDICAL CERTIFICATE IS REQUIRED WHICH IS VALID FOR SIX MONTHS

14. ADMISSION OF MENTALLY ILL PRISONERS A MENTALLY ILL PRISONER MAY BE ADMITTED INTO A MENTAL HOSPITAL ON THE ORDER OF THE PRESIDING OFFICER OR A COURT.

15. MISCELLANEOUS ADMISSION A MENTALLY ILL PATIENT CAN BE ADMITTED EITHER ON HUMANITARIAN GROUNDS OR FOR OBSERVATION PURPOSE. SOCIAL WORKER CAN OBTAIN AN ORDER FROM THE MAGISTRATE.

16. DISCHARGE OF PSYCHIATRIC PATIENT IT COMES UNDER CHAPTER-V IT DEALS WITH MAINLY WITH THE PROCEDURE TO BE FOLLOWED FOR THE DISCHARGE OF MENTALLY ILL PERSON TYPES OF DISCHARGE: VOLUNTARY DISCHARGE UNDER SECTION-18 DISCHARGE UNDER SPECIAL ADMISSION UNDER SECTION-19 DISCHARGE IN RESPECT OF ADMISSON DUE TO AN ORDER OF AN AUTHORITY IN ALL FIVE TYPES

17. VOLUNTARY DISCHARGE UNDER SECTION-18 THE TRETMENT FO NOT MORE THAN 90 DAYSTHE MEDICAL OFFICER INCHARGE ON REQUEST BY ANY VOLUNTARY PATIENT BY THE GUARDIAN IF HE IS MINOR DISCHARGE THE PATIENT WITHIN 24 HOURS WITHIN 72 HOURS OF A REQUEST CONSTITUTE A BOARD CONSISTS OF two MEDICAL OFFICER IF BOARD CONCLUDE THAT THERE IS NEED OF FUTHER TREATMENT THE MEDICAL OFFICER SHOULD CONTINUE

18. DISCHARGE UNDER SPECIAL ADMISSION UNDER SECTION-19 A RELATIVE OR A FRIEND MAY MAKE AN APPLICATION TO MEDICAL OFFICER FOR CARE AND CUSTODY OF A PATIENT THE RELATIVE ARE REQUIRED TO FURNISH A BOND WITH OR WITHOUT SURETIES ALONG WITH AN UNDERTAKING THAT THE MENTALLY ILL PERSON SHALL BE PREVENTED FROM CAUSING HARM TO HIMSELF OR OTHERS

19. DISCHARGE OF A PATIENTADMITTED ON RECEPTION ORDER

20. DISCHARGE OF MENTALLY ILL PRISONER THE HOSPITAL AUTHORITIES HAVE TO REPORT EVERY 6 MONTHS ABOUT THE PERSON STATE OF MIND. IF THEY FIND THAT THE PERSON IS FIT THEY HAVE TO INFORM ABOUT THE SAME TO THE AUTHORITY. THE PERSON IS HANDED OVER TO THE PRISON OFFICER FOR FURTHER LEGAL ACTION.

21. LEAVE OF ABSENCE(SEC-45) ON APPLICATION BY A RELATIVE OR OTHERS TO THE MEDICAL OFFICER INCHARGE AND A BOND DULY SIGNED STATING THAT THE PATIENT WILL BE TAKEN PROPER CARE OF AND PREVENTED FROM INJURING SELF OR OTHERS LEAVE OF ABSENCE MAY BE GRANTED FOR A PERIOD OF MAXIMUM 60 DAYS

22. ROLE OF NURSE IN ADMISSION SETTING THE PATIENT IN THE WARD. INTRODUCING TO OTHER STAFF MEMBER AND PATIENT. CONSIDER BIOLOGICAL AND EMOTIONAL NEED BEFORE ASSIGNING A BED. PATIENT WITH SUICIDAL IDEATION OR PSYCHOTIC SHOULD BE PLACED WHERE HE CAN CLOSELY OBSERVED. INFORM PATIENT ABOUT WARD RULES, VISITING HOURS MEAL SCHEDULES. HEAD TO TOE OBSERVATION FOR ANY INJURY. PERFORM HISTORY COLLECTION AND MSE. WRITE NURSES NOTES, ENTERY IN ADMISSION REGISTER.

23. ROLE OF NURSE IN PAROLE PAROLE IS THE PERMISSION GIVEN TO PATIENT TO PERFORM CERTAIN RITUALS FOR ATTEND FAMILY FUNCTION. RELATIVES ARE CLEARLY INSTRUCTED ABOUT THE PURPOSE FOR WHICH THE PATIENT IS BEING SENT HOME AND WHEN HE SHOULD BE BROUGHT BACK. INSTRUCT THE RELATIVE AS TO HOW THEY SHOULD BEHAVE WITH MENTALLY ILL PERSON AS INSTRUCTED BY DOCTOR. THE RELATIVES BE ASKED TO OBSERVE COMMUNICATION PATTERN, SLEEPING PATTERN, DRUG REACTION, SOCIALIZATION, ABILITY TO PERFORM ROLE. IF THE PATIENT IS ON MEDICATION,INSIST ON REGULARITY & ABOUT DOSAGE AND SIDE EFFECTS.

24. ROLE OF NURSE IN DISCHARGE NURSE MUST ENSURE THAT THE PATIENT LEAVE THE UNIT WITH ALL BELONGINGS AND PERSONAL EFFECT. HAS APPROPRIATE MEDICATION WITH HIM. INSTRUCTION REGARDING MEDICATION REGIMEN,SIDE EFFECTS MUST BE CLEARLY GIVEN TO THE FAMILY. ANY PAPER WORK ,SIGNING OF DOCUMENT SHOULD BE DONE. MEDICAL RECORD FILE SHOULD BE SENT TO RECORD SECTION. THE NURSE SHOULD ASCERTAIN HIS TRAVEL PLAN AND OFFER ASSISTANCE IF NEEDED. NURSE MUST BEAR IN MIND THAT THE PATIENT MAY HAVE MIXED FEELING ABOUT LEAVING THE HOSPITAL. HELP HIM TO COPE UP WITH ANY DISTRESS ABOUT SEPARATING FROM NEW FOUND FRIENDS AND STAFF MEMBERS.

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