Regional mental hospital thane report by nhrc

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Ki ot

ANNEXURE-I
Regional Mental Hospital, Thane
Visit of Ravikumar Bhargava, LAS (Retd ) Special Repoteur

Central Zone ) National Human Rights Commission
9

August 2009

1.1 "Name of the Hospital”

12

APPENDIX -A

1) BACKROUND INFORMATION;-

"Address
State

Pin’ Code
Telephone number
“Fax number

Telex number
Email

Year of establishment

No. of years of
provision

Distance from city
centre

Detailed Histo
development ol
Hospital

of
the

Régional Mental Hospital, Tharie”
"Wägale Estate, L.B.S Marg, Thane
West S

laharastra
400607

© "28821810
~ 125820728

Ni
[email protected]
1901

Service “108 years

Anproximate 4 km,

“Aftachéa herewith
annexure

in Separate

/ ry 16 - paies history of development of the Hospital :-
atoi)

The hospital is located close to the Thane Railway Station.
Initially it was considered as an isolated area where people were
afraid to walk, However increasing Urban Expansion has resulted in
schools, colleges, residentiag! apartments and commercial
complexes coming up in the immediate neighbourhood.

The foundation Stone of Mental Hospital was laid on 11
February 1895 by HE Lord Harris, Governér of Bombay. This
Hospital is spread over 72 acres. The construction of this Hospital
was completed in 1901 at a cost of s. 3,98,790/-. Out of this an
amount of Rs. 88,250/- was donated’ by Sint. Bai Putalabai. The
land was donated by Seth Narottamdas Madhavdas. His son
Harkisandas Narottamdas donated an amounbt of Rs. 28,750/-
‘The major expenditure of this Hospital was borne by this family,
so this hospital was named as Narottamdas Madhavdas Mental

Hospital
Total area of Hospital : 72 acres
Builtup area 28.5 acres
Quarters : 5.5 acres
Open area : 38 acres

In the beginning the total bed strength of this Hospital
wes 200. Civil Surgeon was the Incharge of this Hospital.

In 1947 the bed strength was increased to 600, again in
1954 it was increased to 1191

In the year 1961 the bedstrength raised to 1765 and now
the present Medical Superintendent, Dr(Mrs) S.A.Malve is a senior
psychiatrist. The bed strength of the Hospital is 1850 with 800 beds
for female.

In the year 1989 the name of this Hospital was changed
to Mental Health Institute, tater in 1992 it was renamed as
Regional Mental Hospital, Thane.

Outdoor Patient Departmenbt started since 1983.

2

o Since 1949 Ganesh Utsav is celebrated every year. Golden
Zubilee was celebrated in 1999.

The intrest generated was to be used to improve the
quality of food, clothing and medical care. In addition it was felt
that providing activities of amusement and recreation would
alleviate,and even cure the suffering of the mentaliy il

All wards are closed ward. There are no oper or special
ward, There are separate wards for criminal and undertrial
patients, patients with epilepsy, Hansens disease and medically il.

3) MOU with State Government

K) MOU with other State

2. HOSPITAL INFRASTRUCTURE :

2:1 Architecture of the Hospital :

The Hospital is a complex of several tiled roof buildings
spread over 45 acres of land. It is surrounded by high Jal ike
‘wall with barbed wire on the top. Many of the old structures are
unfit for use, Some of the buildings still in use are in poor
condition with problems aggravated in the monsoon season. They
require frequent repairs, painting and maintenance work, One
feathure of this Hospital is the presence of a unit of the PWD in
the Hoswpital. This has resuled in their being responsive to the
needs of the Hospital. However a new building is urgently required
end the old structures can be demolished in a phased manner.

2. = 5

mer 7 Type of ward ~~ Available Total no. of Wards
| existing '
7 Bar TS ward CS

22 Open wards

3 | Paying wards No
7 |

; |

1 227 “amily we

2:35" | Children ward |
À 226 AlchonOT 8 Drug

227 Criminal ward

|
© 228 | Isolation we eur ES

2.29" Chronic ‘Ward

o

2310 Others ~~ Yes

2:3 : In the general category whast are the basic facilities
available :-

- Out patient department

- Services of barber are available

- The kitchen is housed in separate bui
And ventilated

- Laboratory investigations

- Drugs and modified ECT

9. It is well lit

- Recreational facility like television, music and indoor games-
There is a temple in the Hospiotal campus. Staff anf
patients together celebrate various National Religious
festivals.

There is a post of Yoga teacher and many patients learn
Yogas and Pranayam etc.

2.4 : In paying category what are the extra facilities available :

There is no paying category, But maintenance charges are
recovered according to Government orders.

25

Male ~~ Femalé ' Children ° Crimina! Total
1050 800. 1850

© 2.6 Describe the Administrative setup of the Organization

The Medical Superintendent is the overall in charge. She
is assisted by 6, at present 4 post of psychiatrist are vacent,,
9 psychiatric social workers and 24 trained psychiatric nurses,
at present 10 posts of psychiatric nurses are vacant... In
addition there are 18° Medical Officers, including
anesthetist and 90 nurses. There are 9 Occupational therapist
out of them 2 posts are vacant, 16 paramedical staff, 37
office staff, and 485 group D staff. There are at present’ no
clinical psychologist with 2 post lying vacant.

2.7 Are the buildings properly maintained

‘The buildings are not properly maintained. They should be
repaired, painted and the regular maintenance should be there.

2.8 If not reason for. the same :-
Inadequate grants.

2:9 Is it a private or Government building :
It is a Government building,

210. Persons responsible for maintenance :
P.W.D Department


211 Describe infrastructural inadequacy if any

Human Resources”

() Post of Psychiatrist, clinical psyctoloy,ist, and paycbiabic nurses
should be filled up,

{There should be placement of Post Graduate students of VLD
Psychiatry compulsorily for six month Le one cerns in Mental
Hospital as à part of carriculam of the course.

(9 Material and Supplies

i) Linen:

Adequate supply should be there, as per norms (Norens chart io
ached herewith )

ii} Furniture

Fsmiture items for e.g cots for every patient, cupboar ts for
‘seeping, medicines and files of patient, racks and trollys etc

£) Buildings:-

alt wards (buildings } needs regar a vintenanee,
ins, autequate water supply
Coe system,

Reger repair arto ioteneree of

= Need adequate toivet as per norms, One doler, us
18) in each ward

Almost aii residential buildings 4

Nurses 1 Meadors,
ald de repaired, painted, regular m

x

nee SOE e prev

w) Electric Mai

Adequate and proper wiring, switch board, fans and tube lights
for every ward, office, road light etc. Post of electrician for full time for
hospital is needed for regular maintenance.

2) Mi

New psychiatric drugs are provided. Supply of Psychiatric and
Non psychiatric medicines should be adequate and regular.

3) Training:

The same in services training programme shoulde be
planned for training of all 4 Mental Hospitals for following category
of staff:

Mestical Officers
Nurses z
Psychiatric social worker

Occupational Therapist

Attendents

Already training is being taken for above category of staff
members of this hospital.

“Inadequate grants for (i) Material and Supplies (ii) Linen
ii) Maintenance of building and ity_and over all
maintenance for various systems (AMO

2.12 If inadequate, suggest remedial measures :

alo

40 -

3) STAFFING PATTERNS

3-1 Staffing pattern :

Sr.N” Designation i Sanctioned ! ~~ Post filled in Post
o [post vacant
1) Medicale ‘a 1 Be GS
‚Superintendent | __. — u lee
2) “| Deputy H T f 1 de

_!Superintendent _
3) “Psychiatrist
4) 7 Añesthetist ©

7 hologist ?
Psychologist
6) | Medical Officers | "18
(Out of which 3 |
are psychiatrist)
7). Matron
E) ‘As
9) 0
Officer chi
10) “Psy. Nurse “io
"Sister Inchärge To
“Nurse” Li
iatric Social 1
Worker pas _
) “Occupational” 9 | 7
‚Therapist_. |
15) "Office staff 31 Te
36) Other 16 -

paramedicals (eg! \
technicians, '
pharmacist’ etc)

che

© TD) TOME Group BT
staff (e.g |

| attendants,
} ¡barber, cook, and
_ipeons ) _

3.2 Non_ psychiatry. visiting consultants :

Information is Nil.

3-3 Staff members who stay in the campus of the Institution :

Information is submitted herewith in separate annexure,

3.4 Whether the staff is adequate :

The staff is adequate. Only the post of Psychia
psychologist and psychiatric Nurses should be filled

ist, clinical

“TOTAL
EMOLUM
A creo NES

ende pay 4300:-
grade pay 4200

y Adminstrative staff
Chief Admn Officer

800 = i de
rade 2 “4300.-

Ward attendants and peons 7, 4440 rade pay 1300 =>
a) Ward Attendent

AB“

3.6 Working hours of the doctors: 8-30 a.m to 3-00 p.m
3.7. Working hours of other staff: 10-00 a.m 10 5-45 p.m

3.8 Whether the service condition Yes
Is reasonable

9 Are the staff qualified and Yes
Suitable for the job

3.10Are the members of staff
Given any special trainin

Only departmental training is
given

3-11 Suggest remedial measures for
Improving pattern

4. ADMISSIONS AND DISCHARGE:

4-1 Describe the admission and discharge process

ns are governed by the Mental Health Act 1987
with the admitting authority being the psychiatrist, police, and
judiciary. However voluntary admissions are very low.

Decertification is done by the board of Visitors and patients
discharged with their relatives and with staff member of this
Hospital. In some circumstances Male and female both patients are
sent with Hospital escort. Discharge problems are mainly due 10
inadequate family support.. families living far away from the
Hospital without adequate emeregency care closed by and
readmission perceived as being difficult. Almost 40 % of the cases
are readmiued and this is largely due to drug default or inability 10
adjust to the home environment. Patients are informed of their rights

y

©
+2 Procedure of admission governed by: Mental Health Act 1987

4-3 Admitting authorities Psychiatrist, Police and

Judiciary
44 Are the rights of voluntary patients : Yes
made known to them at the time or
admission
Le) --- — si 7 wa * we
Number and type... 1952 1°1993°7 1097 : ioùs 1056 Total
310 365 30 2176 59 * 1120

Volant

1 A

mht by relatives | wel i 7
lavoluntary 1080 | 1022 - 1083" 1157" 1257 7 3499
Hrought by court sss as ae
Discha 1917 2242" 1841) 10330

52

- 16 168 17T
0 7 4
0
1.17 34

Dia
Suicide

IS-

Ag 47 Average Duration of stay:

4-8 Proportion of repeat
Admission during last
year

Reason for repeat
Admission
home

4-10 Decertification done by

4-11 Discharge procedures for

undertakin
Involuntary admission

4-12 Problems of discharge
support

13 Describe the police dept
Responsibility in discharge

3 months

40%

1) Drug default
2) inability to adjust to the

Environment

Board of Visitors

1) Sent with.relatives

2) Sent home with Hospital
escort

3) Sent home alone

1) Inadequate family

2) Families living far away from

Hospital without adequate

Emergency care closeby

Readmission perceived as
Being difficuit

If the address is not traceable than

the Police authority of that Particular
area requested to
trace and Confirm
the address
2) When patient is discharge
through Visitors Committee and
if inspite of repeated remind

-16-

Relatives do not come to take

charge 5
Of patient, than with the help of
Police, patient is handed over to
Relatives.

4-14 What are the action strategies :1) Repeated letters were sent to
10 discharge long stay patients relatives to take charge of pt

or if the address is not traced
than with the help of police
the address is traced and pt
sent to relatives with the help
of staff members and police
authorities.
2) Psychiatrie social worker
OF this Hospital gave frequent
Visits to patients relatives and
request them to visit this
hospital and took patient
home.

4-15 Any strategy evoived to trace
the address of wandering,
junatics

-16 In case of grivences do patients
Have a right to appeal, if yes
Describe the procedure

1-17 Suggest any remedial measures
To improve admission &
Discharge procedure

ite

5) Finance

ES]

TESS 10103 IR Teta

Plan

Non plan

| Spesil Tange improve any

Mode of
expenditure,
Salaries for

199271993" 1994 T1595 996 Toul

"patients
Linen for
patient
“Equipments T i

el I —

Furniture

Maintenance

Maintenance of separate accounts for various funds : Yes

-18-

o

-37

Donations recived in
1992
1993
1994
1995
1996
Total

the budgetary allocation adequate

ll inadequate suggest remedial
Measures,

ya

No

— 11992 | 1993 1994
T + 2
i ll

Toial

Mode of ~~ T1585
expenditure |
lares For
EY

¿e

| pave |
! Equipments

A
¿Furniture ; H

‘Maintenance of separate accounts for various funds : Yes

- ge

Bor
1992
1993
1994
1995
1996
Total

Donations received in kind in the last 5 years, describe :-

intormation attached herewith.

56

IF the budgetary allocation adequate

iF inadequate suggest remedial

No

oe

6) CASULTY AND EMERGENCY SERVICES

‘The Hospital does not have a casualty and emergency
services. There is no short stay ward. There is one ambulance on
roadworthy condition. Excited patients are admitted directly by the
duty doctor. In patients with medical emergencies are transferred in
the ambulance to the General Hospital with a nurse or attendant.

7) OUTPATIENT DEPARTMENT,

7-1 Out patient services Present

Jf present frequently : Daily

3 Out patient service timin

8-30 a.m. to 1-00 p.m.

7-4 No. of cases seen inO.P.D : 10010150
Per day
7-5 No. of emergency cases seen : Nil

In OPD per day

7-6. Number of patients brought 12 inaday
Chained roped

7-7 Number of staff posted to OPD in last 5 years

Psychiatrie Social Worker,
rained psychiatrie

Fechnician _
Administrative sta
‘Aitendents and peons —

tervire rooms in OPD

There is one interview room in O.P.D
7-9 Average time spent on each patient : Approximaicly 15- 20
Minutes
7-10 Average time allotted to each pt : 1-1/2 hour
On his subsequent visit

7-11 Average waiting time for a patient : 13 to 20 minutes for

new
to be seen by a doctor patient and followup pt
510 10 minutes
3-12 Waiting hall for the patient in : There is waiting hall for
OPD patient in OPD

137

e -60-
7-13 Average no. of persons who 90 to 100 patients
Could be accommodated in
Waiting hall

7-14 Waiting room seating 2 Present
arrangement

7-15. Seating condition Averagé
7-16 Availability of free drugs: Only State
Government
In the OPD servant avai] this
facility
7-17 of deserving patients : 205%
Getting the benefit of free
medicines
7-18 List of free drugs provided NA
7-19 Duration of free drugs NA
provision
7-20 Ragistration fee if any Rs.5/-
7-21 Charges for other OP services Rs. 10/- upto 7 days
and
RS.307- for more than
7 days,
7-22 Are the facilities in out pt
adequate

7-23 Minadequate suggest remedial :
measures

= fue

ot

8. Inpatient servie
$-1 Description of typical dav_activies for the patients =

Recreational facilities are present in the form of televis ne
musie indoor and outdoor games and some magazines und
and ¡paper. For recovered patients Yoga therapy, Physical exercise
and indoor and outdoor games. occupational therapy’ is eared out
With activities such as screen printing, weaving, carpentoring and
{ailoting. The number of patients utilizing this facilities is very low
being largely limited to those who hav

Psychiatric condition. The lack
developing intervention modul

8-2 Cleaning of the inpatient ward :- Daily
8-3 Frequency of bath for in patient = D:
8-4 Frequency of dress change

5 Frequency in linen changing,
8-6 Plinth area per patient

In wards In stock

‘Available
Mattresses Available
Linen Available
Pillows Available
Warm clothes Available
Blankets Available
No. of pillow/pt | pillow
No. of blanketpt 1 blanket
Instead of sweater 1 bandi
Woolen bandi is provided
No. oftowels/pt 1 towel

“Is

o

6

8-8 Are patients allowed to wear: Yes
their own dress

8-9
8-10
811

$21

ifno any specific reason Nil

Specific uniform for males : Present

Type and colour of the uniform Kurta, Pañama is blue
and bandi is black

Specific Uniform for female : Present

Type and colour of uniform — Types are Salwar Kurta
& flocks and the colours
Matoon, blue and pink

No. of uniforms available/pt 4 uniforms for 1 patient

No. of washing platforms

Male ward : 1 platform

Basic facilities in the ward like
Ratio of toilevpt 1:13
Ratio of fans/pt
Ration of cots

Ratio of chairs

Privacy for the patient in ward: Present
provision of recreational
Facilities in the ward : Present

If yes provision available Television,radio,newspaper

Facilities for keeping pts Lockers are not adequate
Belonging in the ward in number
If present

-26-

- 03

8-22 Do the staff maintain the record Yes
Of manstruation

8-23 Do the staff maintain the record
Of each patients weight : Yes

8-24 Shaving of head for patients

Male Yes
Frequeney Once in a month
Female 2 Yes
Frequency Only when
delorising
Measure are
inadequate
8-25 Hair cut and face shaving for
Male patient
Frequency of hair cut Once ina month
Frequency of face shave weekly
8-26 Provision of inpatient Present
8-27 Anti lice/bug measures adopted Present
8-28 present. frequency Quarterly

8-29 Anti Mosquito measures Present

$-30 If present. Window attached mosquito

8-31. Percemtage of pay ing patients

8-32 Percentage of'non paying pis 30)

_ 23-

8-54 Order through count, Yellow
Declaration ration card, or certificate
from Tahasildar of that
Particular area.
8-34 Seclusion wards/Single rooms : Absent
8-35 Ifyes number of rooms NA

8-36 Usage of such rooms : NA

8-37 Presence of duty room in ward : Yes

8-38 _ If present facilities available : Chair is
their for

Patient
3-39

Visiting hours

8-40 Are the facilities in inpatient — : No
Adequate

8-4] Ifinadequate.suggest remedial
measures

“Human Resources ”

(mm) Post of Psychiatrist, clinical psychologist, and psychiatric nurses
should be filled up.

(1) There should be placement of Post Graduate students of M.D
Psychiatry compulsorily for six months ie one term in Mental
Hospital as a part of carriculam of the course.

(0) Material and Supplies -

i)-Linen:

-28-

©

-65

Adequate supply should be there, as per norms ( Norms chart is
sttached herewith }

Furniture

Furniture items for e.g cols for every patient, cupboards for
keeping medicines and files of patient, racks and tro!lys etc.

(p) Buildings:-

= Almost all wards (buildings ) needs regular maintenance,
painting, adequate water supply . Regular repair and maintenance of
Hrainage system.

= Need adequate toilet as per norms. One toilet per six patients
(1:6) in each ward

for Nurses and Attendents

Almost all residential building
should be repaired, painted, regular maintenance should be provided.

Adequate and proper wiring, switch board, fans and tube lights
for every ward, office, road light etc. Post of electrician for full time for
hospital is needed for regular maintenance.

2) Me

New psychiatric drugs are provided. Supply of Psychiatrie and
Non psvehiatr

nedicines should be adequate and regular.

297

Already training is being, taken for the following category of staff
members of this hospital.

Nurses

Psychiatric social worker
Occupational Therapist
Attendents

9. Dietary and pantry facilities:-

9-1 What is the prescription regarding Quantity and
uality of food

The kitchen is houscned in the separate building. It
is well built and ventilated, Food is prepared hygicnically and
cooked on gas. Female patients help in the making of chapaties as a
part of Occupational therapy. Three meals + tea amounting to 2700
calories as per Civil Medical Code at the cost of Rs. 35/- per day are
served for each individual. A staff member checks the cooked food
every day before it is distributed. Patient carry the food in closed
steel container to the wards. The food is served on steel plates and
patients sit on the floor either in the verandah inside the ward or
weather permitting, on a cemented area outside the ward. Drinking
water is available in the wards. Seasonal fruits can be added to the
diet.

9-2 What is the budgetary allocation for food for the past 5

years

1992 Rs,
1993 Rs.
1994

+ Jo-

o

Seno mem
1 Morning
"030
3 Nom
sw
3 Alteran
N Miernoon
vum
Every
730

Vota!

NES

TO
in Brei

Son spot

Dan
240m tanith
fans ES
mx heat
Sem rive

on

Var te
lues
Feu Pom 2

Dimer 203

Pain

sa

a chicken y

Faved
60 104

ms

106$ 874.35

695 bet

Ios gis

haras

68
9-11 Supply of coffee, tea or milk Yes

9-12 Service timings of diet

Morning tea - 6-30 a.m.
Breakfast - 8-3 a.m
Lunch
Tea

Dinner

3 Provisions of drinking water to ts

Drinking water is available in the wards-
9-14 Provisions of water cooler Yes

9-15 Number od water cooler present

9-16 Food supply i, Containers carried
By patients
It Hand pulled trolly
9-17 Food supply provisions Closed container
9-18 Number of open container & NA
capacity
9-19 No. of closed container &
Capacity
9-20 Details of diet & diet schedule Attached
herewith
9-21 Mode of cooking Gas supply

9.22 Hygienic condition of the pantry Very Good

9-23 Mode of serving Plates and eups

-32-

a
7 u u 120

Si ZHIV screening cate

9 Hepa => 7

10-4 Charges for assessment

1) 1.Q/ Cognitive functions : Rs. No charges
ii) Personality assessment
iii) Diagnostic psychelogical te
1 v) Home visits

y) Collateral contacts

10-5 Timings for various investigation:

Inpatients,

Outpatients
¡0-6 Timing for issue of the results of investigations

Inpatient
Outpatient

#27 Treatment fac

Pharmachotheraps
No
Yes

\_. | Outpatic

e

10-8 Treatment facilities

Psychotherapy

counseling
[Behavioral therapy
ycho-education

habitation

10-10 Specific problem in investivatory and treatment facilities

10-11 Suggest remedic:
treatment facilities :-

11:- Medical records

1-1 Are there separate case file for Yes
Eack patient

{1-2 If No reason for the same NA

11-3 Average time taken to retrieve the

Case files
14-4 Total no, of case files maintained About 68500/-
{1-5 Total number of staff in Medical 2

Record department
11-6 Maintenance of case files Individual files

11-7 Filling of unit wise results of,

= 34-

Investigations, particulars of patients
patients correspondence

11-8 Retrival of files from Medical
Records

11-9 Percentage of papers files non
Retrievable

31-10 Assess pf patients record

15-11 Confidentiatity of case records

Explanation on the nature of iliness,
‘Treatment, Prognosis of the Patient
given to family

122 Are family members allow to see
the patients in wards

Are they encourage to take the
Patient out and take part in reer
activities

ation

= Deseribe any programme for family
Intervention

Do the patient write letters to their home

35"

Individual
patients file

To alt

Yes

No

Provided to all

All are allowed

All are encouraged

All are allowed

gi

13-3 Drainage facility of the Hospital Closed drainage

13-4 Water facility in the campus Adequate

13-5 Current water storage capacity

13-6 Availability of canteen facilities There is no canteen
In hospital premises

13-7 Telephone facility in the Hospital Adeugate

13-8 Library facilities for patient Present

13-9. If present details # available Daily news paper

lity for staff and trainces Absent

13-11 If present details # available
13-12 Recreational, Social and religious facilities available for
the patients :-

Recreational facilities are present in the form of
telcvision,music.indoor games and some news paper. There
temple in the campus. Staff and patients together celebrate various
National and religious festivals. The Hospital has been winning the
first prize for its stall during the Ganesh Pooja Festivities

14- Board of Visitors/ Management

14-1. Describe the decertification procedure adopted in your
Institution

Recertification is done by the Board of Visitors and patients
discharged with their relatives,

14-2 Presence of Board of Visitors Yes

-36-

o

|

133 If present detail the composition Fhe list of members is
OF board. as follows
1) Director of Health Services, Bo.bay

2) District and Sessions Judge, fhane

3) Aayukta Apanga Kalyan or their Representative
4) Dr. Dilip Joshi, Psychiatrist

5) Dr. V.R.Mahajan. Clinical Psychologist

6) Dr. Giceta Joshi. Clinical Psychologist

7) Smt. Mona Date, Psychiatrie Social Worker

8) Ad. Smt. Chaya Haldankar

9) Deputy Director of Health Services, Bombay Circle, l'hane
10) Civil Surgeon. Thane

11) Executive Engineer, PWD. Thane

12) Superintendent, Central Prison, Thane

13) Dr(Mrs) Malve, Superintendent, RMH, Thane

14-4 Byelaws regarding procedure As per Government
To be adopted in the board or Resolution number
Other sub committees

14-5 Frequency of the board of Once in month
visitors.

14-6 % of all admissions with 99% admissions are
Involvement of legal procedures with legat involvement

Only 1 % are on
Voluntary basis

14-7 % of all readmissions of legal 40%

Involving legal procedures

Implementation of Mental Health Fully complied

Act 1987

14-9 Reason for partial or non compliance NA

'ODetail the problem in implementing

Mental Health Act 1987

„37°

itation services

Present of separate section for rehabilitation and vocatiobal training
in the Mental Hospital: Yes

E present enumerate vocational sections: Occupational Therapy
department, Tailoring department, Weaving department,

Presence of sheltered workshop : Absent

If present enumerate sheltered workshop

Presence of Occupational Therapy _ Present

If present enumerate occupational therapy programme:
Tailoring, Weaving, Library, , Carpentering, Printing ete

Presence of scheduled activity programme : For all

Presence of day care facility Present
is their regular production No
IE present describe the production NA

Rehabilitiation ward in the hospital : 1 ward in 3 unit approximate
200 inmates provided with facilities

Describe the hald way homes facilities : No

Presence of long stay facility Yes

ımber of wards.number — : one ward in one unit,
Approximate 40 %

If present »

of

¡mates

um.
icchabilitation programme : — Combined for Male and female

Rehabilitation faciliti
Childres

for mentally ill
Nil

Rehabilitation programme for mentally and
Mentally: retarded Combined

15-19 16 13-23 Information is Nil
15-24 Are the patients used for routine Hospital work : Yes as a part
ol occupational therapy
‘Are the patients paid incentives No
lo describe the procedure adopted NA

therapeutic techniques followed : 1) Behavioural modiciation

in rehabilitation 2) Group
«pproaches

3) Therapeutic community
4) Family coun selling

Lypes of volunteers Voluntary agency personnel
Deseribe the family role Planning and training
Facilities for NGO Present

I present describe the programmes : Diwali. Independence day,
Raksha bandhn ete
Iype and number of

O involved : 1) Aniruddha trust
2) Sewadham
3) Rotary club
4) Lions club
5) Innerwheel

g-

40 Do you have any difficulty in the arca of rehabilitation

Inadequate staff, inadequate raw material, No sale of
production

15-41 Describe any specific inputs needed in the area

There should be rehabilitation centre

16:- Community Services

16-1 Describe the existing community mental Health activies and ,
services carried out by Hospital :

Psychiatrist from this Hospital visit Adahrwadi Jail, Beg

Home, Chembur, Childrens home, Ulhasnagar, and Bhiwandi
16-2 Describe the activies undertaken towards implementation of
National Mental Programme :

IPD.OPD,Disacharges, community services, Training of
Medical Officer, Day care centre, rehabilitation centre, Occupational
therapy ete
16-3 NA

16-4 Are there any teaching activies : Yes

16-5 If present describe For Psychpology students,
for Nurses for MBA students for architecture student

Report on the ongoinh District Mental Health Programme in the
State and the involovment of Insitutions

Yo -

so
© 16-6 Report on the ongoing districts Mental Health Programme in
the State and the involvement of the Institution

The programme is taken place in the District Jalgaon and
Alibag and _ itis proposed in the Districts Nasik, Dhule,
Nandurbar

16-7 Any other communityt out reach programmes carried out by
the Institution :

Exibition, Street play during Mental Health weak..Group
discussionsete

16-9 Are there any extension service programme outside the Mental
Hospital like consultation visit

Psychiatrist from this Hospital visits Adahrwa
Home Chembur, Orphanage of children at BI
a month,

i Jail, Beggars
andi and Uthasnagar

once

16-19 Provision of Mental Health Care at General Hospital,
Psychiatrie units and District Hospital : Present

161

16:12 What are the stumbling block in extension of Mental Health
Eure activities : Inadequate staff

16:13 Suggest remedial measures towards organization of
community mental health activies

DNB Course for psy
DPM for Doctors
DPN for Nurses and Psychiatric Social Workers
Clinical psychologist

chiatrist

-U-

17: Staff Training

17-1Do meeting of the following staf take palce

1) Medical staff Yes
2) Non Medical MH staff. Yes
3) Nurses Yes
4) Ward Attendent Yes
5) Class D Yes

Iso how frequently =

Once in a month

3 Are their in service training Present
programmes for the medical and
non medical staff

ifso describe For Medical staff psyehiatric train
For para medical as per their job chart
For Nurses psychiatric training and how to
Behave with mental patients
For Attendents, how to handle mental patients

172

Percentage of staff burn out
Among the total staff

17-6 What are the main reasons 50 % staff stays ln nearby arca
For a motivation among They get good salary
The staff of Mental Health.
Care activities.

care for the mentally.

ait.
Human Resources”

& Post of Psychiatrist, clinical psychologist, and psychiatric nurses
should be filled up.

(9) There should be placement of Post Graduate students of M.D
Psychiatry compulsorily for six months ie one term in Mental

Hospital as a part of carriculam of the course.

(6) Material and Supplies +
Ü-Linen:

Adequate supply should be there, as per norms (Norms chart is
attached herewith }

si, Furniture

Furniture items for e.g cots for every patient, cupboards for
nes and files of patient, racks and trollys ete,

Lecping medi

©) Buildings

Almost all wards (buildings ) needs regular maintenance,
painting, adequate water supply . Regular repair and maintenance of
drainage system,

Need adequate toilet as per norms. One toilet per six patients

vach war

= Almost al! residential buildings for Nurses and Attendents
wuld be repaired, painted, regular maintenance shoulk be provided.

(©) Electric Maintenance

us

Adequate and proper wiring, switch board, fans and tube lights
for every ward, office, road light etc. Post of electician for full time for
hospital is needed for regular maintenance. 2

New psychiatrie drugs are provided. Supply of Psychiatric und 1
Non psychiatrie medicines should be adequate and regular, AT

3) Training :- :

Already training is being taken for following, category of stat
members ofthis hospital

Medic:
Nurses

Psychiatrie social worker
Occupational Therapist
Attendents

flicers

hy

see

Certified that the particulars in respect of REGIONAL

MENTAL HOSPITAL, THANE given under serial numbers 1

420 of the above questionnaire are true to the best of my

knovledge and belief.

Date
yun

Medical Superintendent
Regional Mental Hospital, Thane

rica Surinam!
Mar Muse Hosp, Than,

us

e

OCCUPATIONAL THERAPY EVALUATION

Name,

Diagnosis

istory of t ent
Bith AChidhood History FIND [LI completed TIT

Educational History: Qualification,

Alitudo to sere! Boguar LT tg C

Perfomancein school Average ‘Above Av Boom iy =
Relstenshio wih iachers Good ee E>
SOI Drap out Yes ju [ =
Reasons ony Social À Parsnal IT Payerne

Occupational History: Age of stating job

Type-ctjob: Skted Unshiled Exscutve Cereal Farmer Houseuo Omer.

HO tecuontchangeinioe Nee TT] No}
Social History = Soda] social [TT
amity History:

Hobbies en i

Habits

Promorbid Personality
Past History: lo medical ness: =

Ho mental those —

‘Examination

Appearance unity

‘tase == Unccoperaive ==

Eye Content Maininos TT tet mottalnas

‘Thowght process oran ere

Detusors Preso ose

Halcnatons Yes te A j

Oñentaton n Time Pisce

Status Memory Good Far E

tre Present Para —|

Judgment Present Ipod C =

Behavior Restos tutor E } NoSpecile [= a}

Crying & Lung

Payenomator st Normal ) estes L I exces li 3
Asien of Dally Living

SollCare & Personal Degendent [7] Paray Dopendon( 7] imdependent( 7777]

one —

Communicason Verbal — vont 5 DJ]

Travel & Mebity Dependent À Patty Dependen | indopanden

orRen = =

or

ICCUPATIONAL TI PIST’S Ol RVATION

run | | ‚|
sens | Puma sum m 1 Mon? | mans

rada Poor! Fair 1 Good |

1 | mann
> rns
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Vom | worktteranee

12 | Soctaity win therapist,

¡19 | Socibiny wth patont

‘OCCUPATIONAL THERAPIST

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- 58-

office of The Executive Engineer, Thane Electra! Division, P-w.vaptı., My compound,
Station Road, Thane (M) Ph No 28335144 Fax No.25961827 Esnall No.

List of Proposed Electrical Works in Mental Hospital, Thane for the year 2009-40

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Fra Rename

[e ewtengeor n ve

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| CONSTRUCTION OF

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LH roïcoS 11900000 een 120 er
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“Stock Position Drugs

& Medicine Regional Me
Month : August 2009

sntal Hospital, Thane

be | Torenine A A Kost
Br lnipeotoraz/mediino Balance on loving [owing Balance On
pep: Inasos [eure lomo 17082009
i PSYCHIATRIC
E [ras Amitriptyline 25 me. 39300 © 3300 | 36000
3 fra Chororomanne SO 45000 © 37000 | s08000
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i fsb, Dispara 5 me 373200) o 3700 | sion |
Tab Hloperidol 5 mg o ET [eso fo
Fab HaloperidoL10 ma 300 a 00 | 25700
Fab Imipramine 25 m8 33050 5200 _| sense
Fak uth carbonate 3007 05800 O 200 31600
Tab Lorarepam 2 me o lo 9 ol
fab, nivezepam 5 mg o o © rs
Tab: Fimonde amg. o ° Hy Em
fst: Phenobn tone 30m o o 0 =
Tak Penobabtone 60 ME in 1800 Te |
Fab: menton Sodium 100 D 18800 jo E 16500,
Hab; Tividavine 25 má o lo ° >
Fay Tatugeranne Sm Tab
en 190000 o 10 | sm |
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ao, Sablon 12.5 mp 2300 > 5250 100
39 fr Folopendol 5m 505 ©. ms |
[ao li ssi Pentano OS am rc o 156
2 i Sele i rn E Ta
22 [inj Phenargan, o 20 | °__]
25 fink Dago EN o | os
24 in, Haloperidl Deconate ° > o o
25 fing Exton En o a a
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NEWER ANTIPSHIATRIC
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[Eras uetipine 50 me 5 9 o o
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ffs oxarbomarepine 180 mg 0 300 28 Da
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3 |rab, Olanzepine $ me. To 10 où on)

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13 |Tab, Escitalopram 10 mg 11800 Fo 5400 CTN

15 lin, Olentepine 10708 = 0 0 ol

NON PSYCHIATRIC DRUGS

= 63-

FA
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2 ra Gibenclamie Sm 220
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37 {rad uv. 52 "400,
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39 Trap! Metronidazole 200/400 mE, 3000.
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16 ra Piment D
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33 rab septan OS ROD
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20 Jin). Lasix 15 o o 15
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24 |inj. Iron & Dextran 880 To 25 855

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=65-

8172008257 PM MAUESH

ANNEXURE-IL

Regional Mental Hospital, Thane

(Central Zone ) National Human Ri

tof Ravikumar Bhargava, AS (Retd ) Special Repoteur

‚his Commission

On 6 August 2009

y

e

Appendix :

[Name of the Hospital” Regional Mental Hospital, Thane

[rares 7 [Wagale Estate, LES Marg, Thane (West)
Sas” Mahärashtra =—

|
[rene number | 25821810

"Fax number 5820728 ds

| Bu
"Email FR [email protected] 1

HOSPITAL INFRASTRUCTURE:

Have there been any new changes in the out patient and inpatient
department after 1996 (Mention in details )

Out Patient Department :

Al facilities are exist in Out Patient Department of this
Hospital before 1996. Only the EEG machine is introduced after
1996 and all indoor as well as out door patients can avail of the
EEG facilities in the hospital, as well as separate counters were

Started ie for case paper, medicine etc. in Out Patient
Department.

In patient Department:

~ 67+

|
|
|
|
|

Designation Sanctioned Post filled in | Post

post | vacant

Médical “a T u nor

| Superintendent | —

2) | Deputy 1 1 -

__ Superintendent

5 Psychiatrist 2

2) TAnesthetist,CLT 1

5) — Clinical 2 |
(Psychologist Lo —

8) + Medical Office icers 18

(Out of which 3 |

__Lare psychiatrist) _
7 Tatton T

|8) | Assistant Matron’ 2 T _ 170
“9) | Medical T T I 7. 0
‘Officer ese u
10) | Psy. Nurse 124 1 Fo
fai) "Sister Incharge |; 1 CIN EL 0
12) ‘Staff Nurse E Ea
113) | Psychiatric Social | — Y a

Worker _
14) Occupational EN 2

¡erapist =

35)" Office staff 37 31 + 6
116) [Other ie | 16 >
1 paramedicals (e.g |

*technicians, |
L.__¡pharmacist etc) _ A
17) | Other Group D 485 477 ms
| staff (e.g

attendants, |

barber, cook, and

!peons ‘). o a

_(%-

-30-

Availability of non-paychiatry Consultants :

Non psychiatric consultants are available for e.g
Gynaecologist, E.N.T specialist etc.

Staff who stay in the Hospital campus
Separate list submitted herewith

Adequacy_of staff strength

Staff is adequate, only the posts of clinical psychologist
and psychiatric nurses post are to be filled
Suggest remedial measures in staffing pattern

Any changes in

the following areas after 1996
Medical record

Medical record section is available. Medical Statistical
Officer, clerk needs training in Medial Statistics.

Rehabilitation

Day care Centre for recovered patients is started.Inadequate
' staff and no transport facilities.

Medication_available:
Newer antipsychotic drugs are provided( List attached )

Supply of psychiatric and Non psychiatric medicine should be
adequate and regular.

- 69-

2 a

© Diet :

The_diet is given to the patient as per Civil Medical Code
1976. (Zerox copy attached herewith ) Non vegetarian and
Vegeterian diet is given to the patient(Chart attached ). Total
calories for vegetarian patients are 2400 and for non vegetarian
patients are 2700

Power supply

Power supply is regular.Seperate sub station power unit is
available.

Canteen :-

There is no canteen facility for staff members.
Library :-

Medical library and Library is there for patients
Telephone :-

Telephone and intercom facility is available in
Hospital

Finance :
For 2007-2008

Stats san Tbepeaitre |
+ 1459500 |] 7 1408500 _
6236 6184

TL AA

Special funds if available:

Central Government funds of Rs. 2,94,50,000/-
released in. List attached.
Quality of care for the mentally ill :

INFRASTRUCTURE +

“Human Resources

(e) Post clinical psychologist, should be filled up.

(©) There should be placement of Post Graduate students of M.D
Psychiatry compulsorily for six months i.e one term in Mental
Hospital as a part of carriculam of the course.

(g) Material and Supplies -

Adequate supply should be there, as per norms (Norms chart is
attached herewith )

ii) Furniture

Fuimiture items for e.g cots for every patient, cupboards for
keeping medicines and files of patient, racks and trollys etc.

(b) Buildings"

= Almost all wards (buildings ) needs regular maintenance,
painting, adequate water supply . Regular repair and maintenance of
drainage system

= "Need adequate toilet as per norms. One toilet per six patients
(1:6) in each ward.

-A-

|
|

33.

= Almost all residential buildings for Nurses and Attendents
should be repaired, painted, regular maintenance should be provided.

(e) Electric Maintenane:

Adequate Regular repair and maintenance of proper wiring,
switch board, fans and tube lights for every ward, office, road light etc
Post of electrician for full time for hospital is needed for regular
maintenance.

2) Medicine :-

Newer antipsychotic drugs are provided. Supply of Psychiatric
and Non psychiatric medicine is adequate and regular.

3) Training
Already training is being taken for following category of staff members
of this hospital

Medical Officers
Nurses

Psychiatric social worker
Occupational Therapist
Attendents

“ Inadequate _grants for (i) Material and Supplies (ii) Linen
(iii)Maintenance of building and electricity_and over all
maintenance for various systems (AMC)

hts
Sugnature of the Signature of the
Mental Health Authority Medical Superintendent

Medical Superintandent
Regions: Kanal Hospital, Thane,

Supplementary proforma- Information pertaining to
current structure and functioning_of psychiatric f

lities ;

Name of the Hospital: Regional Mental Hospital, Thane

Funding |

Please
provide
detals

| seperately

[Plan (Amount In rupees
Non plan ( amount in

[Yearwise list attached
seperately

| —

rupees)
‘Other sources of funding

Information 15 Nil

TT Te

Yes I mn
Infrastructure | Separate outpatient black | Yes
Out patient | constructed | _
Dedicated emergency service No
For 24 hours = _ — i —
‘Facilities for relatives to Stay Tio
“— Waiting Fail for patients Yes ~
[TT elles for patients /relatives | Yes à
[Drinking water Yes :
"~~ [Tanteen service — E H No
=> OPD Tab service [ves | i
u Tist of free medicines List | rl
_|available for O.P dispencing attached |
[OPD rehabilitation facilities
available _ _|
specialized children services
pecial geriatric service
Specialised Torensic Service CHE
pectalised Deaddiction Yes
services _ _ —
‘Separate medical record Yes 4
ON section Ml |
Educational material for Yes
patients
~ "Total number of O.P new | ~

registration between 1%

- 7

ES
Mach 2007 to 31” March " 7
_. 12008 + _i
fotal number of OP 28831
followup registration between
1% March 2007 to 31% March
2008 —+--

A ale

* Overall number of allotted | 1050
beds =
lo. of Beds occupied as on. 7

1.4.2008 i i
Ror oF beds occupied as on 63T 1619 °
11.4.2009 |

Any cells Stil existing

No. of closed wards
“INO. of closed ward beds

TNo. of admissions to closed
i wards between 1.3.2007 to H
‚31.3.2008 |
No. of admissions to closed’ n
wards between 1.3.2008 to i
¡31.3.2009 :

No of open wards (patient [NT |
{staying with family |
| Members) in an unrestricted

In
Stal ho oF open ward bias TI
‘No. oF admission to open Nil
ward wards between 1% |

| March 2007 to 31.March
2008 _ : :
No. EN aid ward beds Nir 1
ni wards ) |

- hr

36

| Total number oF discharges

between 1% March 2007" to 1149 | 588 11737
31% March 2008 |

“Total number of discharges “| 1027 [516 1158 —
| Between 1% March 2008 to

131% March 2009

Total no. of inpatients with T

stay duration more than |

one year |

[2007-2008 —

¡2008-2009 504

No. of Tecovered patients — | “i
who are destitute No |

families who will accept
them

2007-2008 |
: 15 300 a34
2008-2009
— No of deaths
|
7 2007-2008 53 aT ‘oF
35 15 48
2008-2009

__ [Patient toilet r

No. of suicides

2007-2008

2008-2009

Yes — No j

24 Hours running Water |

TFans/coolers available

Yes

[Budget allocation for
oder patient/day in

RS. 357- per day

Tf leuten as per

caloric requirement,

Tr vegeterial patient |
2400 calorie per day

-75-

37
© —pléase miention caforie | provided and for non
provided per patient per | vegeterial patient
| day 2700 calorie per
patient is provided as |
| per Civil Medical Ñ
Code.

es “Ne

‘Separate dining facilities | No
available I | 4

: ‘Compulsary uniforms for Yes
Lou... [dosed ward patient | o \
"Disposable Syringes used Yes Yes 7
o throughout the hospital | |

vaving blades reused |” No
in any part of the i '
=== lospital Re 4
ring Tast year any | Ro;

¡Outbreak of infectious
disease, provide details |
Budget allocation for Rs. 35/-
food/per patient/day in per patient |

_ | rupees _
TSE oF investi

ns T Attached

! ‚available within the herewith
ae Hospital Lo. :
List of free medicines | Attached
ter _‚herewith__ ii
Sami available [Yes

=

© "No of patients receiving ~ 7 1697
ECT between 1* March |
12007 to 31° March 2008 ; 1

[Nox oF patients. receiving —

[ECT between 1% March” |
2008 to 31.3.2009 |

1745

~~ > > Sr Rnesthetist availability AM the Eme

| for all ECTS Lo |

‘Any patients received “| No

| unmodified ECTS during

the last year
[Separate children ward

-76-

28.
| yes no. of beds Ni

‘Separate gerlatrie ward

Nil

If yes no. of beds [NI

‘Seperate forensic service

Yes

IF yes no. of beds

‘Separate deaddiction
services

iF yes no of beds

| Ir patient rehabilitation
services available

To. of inpatients
referred to, rehabilitation
between 1* April 2007
to 31% March 2008 &
April 2008 to March
2009

‘outreach

services present

Whether outreach [ves

Lt

|
| Lez

| | Community
|

Number of community
outreach activity per
month _ u
No. of patient covered |
through outreach

i

‘Approximate 40 per —
month ”

Superintendent of

Any post graduale No

training provided _
Whether ine Medical”

¡Yes

—|
|

À

Hospital. is a psychiatrist |
Now oF wists By NHRC
and SHRC during the
last 10 years

TNO

ny Nigaten again
hospital with regard to
human rights

No

|

___|infringement ____,
(Display of humans M
the Hospital

No

~—TFunctiong Board oF
Visitors

yes

No. of visits Made
between 1.3.2007 to
31.3.2008

12

No. of visits made
between 1.3.2008 to

-39-

‘Board for disability No

certificate |

i No, of certificates Tssued | No

between 1-3-2007 to

| 31-3-2008 and 1.4.2008 |
to 31-3-2009 |

= | :
"Action taken on | hi =]
4 NHRC Ñ

| recvommendation _! J

1 Certified that the particulars provided in proforma 1 and 2 are true
and to the best of my knowledge and belief-

pa

Date Signature of eömpetent authority and

Ea Medical Superintendent
a heno hop Tare

- 787

NATIONAL
HUMAN RIGHTS COMMISSION

MAHARASHTRA STATE
RIGIONAL MENTAL HOSPITAL
THANE
2009

+9-
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