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THE HARYANA MENTAL HEALTH PROGRAM

Introduction

The National Mental Health Program came into existence in 1982, but due to various reasons including lack of trained manpower, it could not take off properly. After the enactment of the Mental Health Act, 1987, the Govt. of India started to look at mental health problems in the community very seriously. The Mental Health Program in Haryana started in district Kurukshetra in the year 1999. In 2006, two more districts were added i.e. Hisar and Gurgaon.

It is a well known fact that mental health disorders are increasingly recognized as a major public health problem. According to National Institute of Mental Health & Neuro Sciences about 1 -2% of the population suffers from major mental problems and about 5% of the population from minor depressive disorders. About 25% of the population attending PHCs suffer from various psychological problems. Most of them do not require hospitalization but it is estimated that about 1% of them have severe mental disorders that may require hospitalization.

Structure

  • The Mental Health Program has the following components:-
  • The District Mental Health Program
  • State Institute of Mental Health
  • Centre of Excellence

·         State Mental Health Authority

 

District Mental Health Program

The District Mental Health Program is currently being implemented in Gurgaon, Hisar and Kurukshetra. In the meeting of the State Mental Health Authority on 12.08.2015 approval of worthy Additional Chief Secretary was granted to start DMHP in the 4th district i.e. Panchkula.

The objectives of DMHP are:-

  •    Prevention, promotion and long term continuing care at different levels.
  •   Augmentation of infrastructure, equipment and human resource
  •    Promoting community awareness and participation
  •    To broad base mental health into other related programs

The components of DMHP are:-

  • Service provision: Management of Mental Health Disorders and counseling
  • Capacity building: Training and development of manpower, early identification and management of mental disorders
  • Awareness generation: through IEC activities for early identification of mental disorders

Staff positioning:-

According to the latest guidelines from Govt. of India dated 24.06.2015, the staff positioning of District Mental Health Program is as under:-

Staff

Regular/Contract

Number

Psychiatrist

Regular

1

Clinical Psychologist

Contract

1

Psychiatric Nurse

Contract

1

Psychiatric Social Worker

Contract

1

Community Nurse/Case Manager

Contract

1

Monitoring & Evaluation Officer

Contract

1

Case Registry Assistant

Contract

1

Ward Assistant/Orderlies

Contract

1

 

Total

8

 

Problems, Gaps and Constraints:-

 Mental illness is considered a taboo in general public – patients are generally taken to temples and god-men

  • Lack of awareness about mental illness being treatable – sometimes even at medical and paramedical level
  • Rehabilitation measures inadequate. Haryana does not have a rehabilitation policy for mentally ill patients.
  • Psychiatry not given adequate weightage in medical colleges.

State Institute of Mental Health (SIMH)

The State Institute of Mental Health is a tertiary care mental health institute under the Directorate of Medical Education & Research,

  • State Institute of Mental Health was established in 2011 at PGIMS Rohtak.
  • It is a 40 bedded tertiary care hospital.
  • It is responsible for referral services.
  • Chief Executive Officer is Dr. Rajiv Gupta, MD (Psychiatry)
  • A Committee for the monitoring and supervision of SIMH was constituted vide notification order no. 48/11/1995-5HBII modified on 10.02.2015. The committee members include:

 

a)      Additional Chief Secretary to Govt. of Haryana, Health & Family Welfare

b)      Additional Chief Secretary to Medical Education & Research

c)       Vice Chancellor, Pt. B.D. Sharma, University of Health Sciences, Rohtak

d)      Director General Health Services

e)      Director, Pt. B.D. Sharma, PGIMS, Rohtak

f)       Senior Professor and Head of Psychiatry Department and Chief Executive Officer, SIMH, Rohtak

This committee is mandated to meet every six months.

Centre of Excellence (CoE)

The Centre of Excellence was made in the Department of Psychiatry, PGIMS, Rohtak in 2009-10. The purpose of the creation of this entity is the development of trained manpower in the State. Haryana does not have adequate numbers of psychiatrists, psychologists, psychiatric social workers and psychiatric nurses. The mandate of the Centre of Excellence is to address this problem.

The Head of Department of Psychiatry is Senior Professor, Dr. Rajiv Gupta (MD Psychiatry)

Mandate is training of skilled manpower including

  • Psychiatrists,
  • Psychiatric Social Workers,
  • Clinical PsychologistS,
  •  Psychiatric Nurses

State Mental Health Authority (SMHA)

State Mental Health Authority was notified on 20.05.1994 and later reconstituted on 28.02.2014. The mandate of the State Mental Health Authority is to look after the implementation of the Mental Health Act, 1987 in the State of Haryana. The members of the authority are:-

 

Official Members

 

1.

PS/ACS to Govt. of Haryana (Health)

Chairperson

2.

Director General Health Services

Member

3.

Head of Department Psychiatry, PGIMS, Rohtak

Member

4.

Deputy Director (Health Education)

Convener

5.

Dr. Rajeev Trehan (Psychiatrist), General Hospital, Panchkula

Member Secretary

 

Non-Official Members

 

6.

Dr. Brahmdeep, Psychiatrist, General Hospital, Gurgaon

Member

7.

Dr. Krishna Soni, Psychologist, SIMH, Rohtak

Member

8.

Dr. Vikas Ranjan Sharma, Psychiatric Social Worker, SIMH, Rohtak

Member

 

The members of the SMHA are mandated to meet every six months. According to a resolution passed in the 13th All India Meet of the State Legal Services Authorities held at Ranchi, Jharkhand on 21-22 March, 2015, a resolution was passed that National Legal Services Authority shall make a request to the Central Govt. to amend the State Mental Health Rules, 1990 in order to include the Member Secretary of each State Legal Services Authority as a nominated and ex-officio member of SMHA. In the meanwhile, the Haryana State Legal Services Authority has requested that its Member Secretary be invited to the meetings of SMHA as a Special Invitee or Observer.

Salient Points:-

  • Regulatory Authority for Mental Health Act, 1987.
  • Grant of licenses to Psychiatric Hospitals & Nursing Homes.
  • Regular Monitoring of Psychiatric Nursing Homes.

How to apply for a licence to operate a Psychiatric Nursing Home.

 

Fill the following form and send it to:

The State Mental Health Authority Cum DGHS

Swasthya Bhawan, Sector 6,

Panchkula - 134109,

Haryana

FORM I

[Refer rule 15]

APPLICATION FOR MAINTAINING A PSYCHIATRICHOSPITAL/NURSING HOME

To

The State Mental Health Authority Cum DGHS

Haryana, Panchkula

 

 

Dear Sir/Madam,

I/We intend to establish/maintain a Psychiatric Hospital/Psychiatric Nursing Home in respect of which I am/we are holding a valid license for the establishment/maintenance of such hospital/nursing home. The details of the hospital/nursing home are given below:

 

1.  Name of Applicant

2.  Details of license with reference to the name of the Authority issuing the license and date.

3.  Age:

4.  Professional experience in Psychiatry.

5.  Permanent address of the applicant.

6.  Location of the proposed Hospital/Nursing Home.

7.  Address of the proposed Nursing Home/Hospital.

8.  Proposed accommodations:

a)  Number of rooms.

b)  Number of beds.

Facilities provided:

a)  Out-patient.

b)  Emergency services.

c)  (c)In-patient facilities.

d)  Occupational and recreational facilities.

e)  ECT facilities.

f)  X-ray facilities.

g)  Psychological testing facilities.

h)  Investigation and laboratory facilities.

i)  (i)Treatment facilities.

Staff Pattern:

a)  Number of Doctors.

b)  Number of Nurses.

c)  Number of Attendants.

d)  Others.

 

I am sending herewith a bank draft for Rs................... Drawn in favour of State Mental Health Authority Cum DGHS as licence fee.

 

I hereby undertake to abide by the rules and regulations of the Mental Health Authority.

I request you to consider my application and grant the licence for establishment/maintenance of Psychiatric Hospital/nursing home.

 

Yours

faithfully,

Signature………………………………………………………

Name………………………………………………………….

Email ………………………….

Mobile: ……………………………

Date………………………………………….

 

Please forward this application along with the following annexures through the Civil Surgeon of your district to the office of the Director General Health Services Haryana, Sector 6, Panchkula. Annexures: 

·         Bank draft of Rs. 200.00 (rupees two hundred only) in favour of "*State Mental Health Licensing Authority Cum DGHS*". (Rs. 200.00 for new license and Rs. 100.00 for renewal)

·         The map of your premises (Nursing Home) duly attested by Officials of HUDA or Municipal Corporation or similar authority in your area.

·         A complete list of all the personnel who will be working in the nursing home including self attested photocopies of their Degrees/certificates/educational qualifications.

·         An undertaking from the psychiatrist in-charge that quarterly reports shall be sent to this office (performa for reports can be emailed from this office on request) failing which your licence can be revoked.

Once all these documents are received through the civil surgeon, a committee will be constituted to inspect the premises and submit a report on the basis of which the license shall be granted/ denied.

De-addiction Program

 

Drug de-addiction program is being run by department of Social Justice & Empowerment and Health Department is a technical collaborator for this program. All applications for the establishment of drug de – addiction centres have to be forwarded to the department of Social Justice & Empowerment at the address given below:

 

Department of Social Justice and Empowerment

SCO No. 68-70, Sector 17 A

Chandigarh

Website: socialjusticehry(dot)gov(dot)in

 

SHORT NOTE ON DRUG DE-ADDICTION CENTRES IN HARYANA

Drug de-addiction centres in Haryana are governed by the "Haryana De-Addiction Centres Rules, 2010" which were notified in HARYANA GOVT. GAZ. (EXTRA) Sept, 1, 2010 vide notification no. S.O.92/C.A.61/1985/S.71 & 78/2010. The rules were made for establishment, appointment, maintenance, management, superintendence of centres, for appointment, training, powers and duties of personnel employed in such centres and for identification, treatment, education, aftercare, rehabilitation, social re-integration of addicts and for supply for narcotic drugs and psychotropic substances to the addicts.

These rules were notified by the Department of Social Justice and Empowerment which has the primary responsibility for all the drug addiction centres in the State. The Health Department is involved in giving technical support to the Social Justice & Empowerment Department in this endeavour.

The drug de-addiction centres run by the Govt. (various departments) are given in the table below:

S. No.

Drug De-addiction Center

Department

1

DDC Ambala

Health Department

2

DDC Yamuna Nagar

Health Department

3

DDC Kurukshetra

Health Department

4

DDC Kaithal

Health Department

5

DDC Hisar

Health Department

6

DDC Gurgaon

Health Department

7

DDC Sirsa

Health Department

8

DDC Panchkula

Health Department

9

DDC Panipat

Health Department

10

DDC Fatehabad

Health Department

11

DDC Karnal (Kalpana Chawla)

DGMER

12

DDC Rohtak (PGIMS)

DGMER

13

DDC Sonepat (BPS Govt. Medical College for Women)

DGMER

 

The drug de-addiction centres being run by private hospitals/NGOs & the Red Cross as per data supplied by the Department of Social Justice and Empowerment are given in the table below:

Sr. No.

District

NGO/PVT.

Red Cross/ Other Govt.

HD/DGMER

1

Panchkula

-

-

1

2

Ambala

6

-

1

3

Yamuna Nagar

-

-

1

4

Kurukshetra

3

1

1

5

Kaithal

1

1

1

6

Karnal

1

-

1

7

Sirsa

1

1

1

8

Fatehabad

1

-

1

9

Jind

3

1

-

10

Panipat

-

-

1

11

Sonipat

5

-

1

12

Hisar

7

-

1

13

Bhiwani

-

-

-

14

Rohtak

1

1

1

15

Jhajjar

1

-

-

16

Mahindergarh (Narnaul)

-

1

-

17

Rewari

-

1

-

18

Gurgaon

3

-

1

19

Faridabad

2

1

-

20

Palwal

-

-

-

21

Mewat

-

-

-

 

Total

35

8

13

 

G. Total

56

The link to the complete list of the De-addiction centers as provided by the Department of Social Justice and Empowerment is given at the end of this document.

The ideal (minimal) manpower requirement for each drug de-addiction centre is as per the above mentioned notification is given in Table-3 below:

TABLE-3

S. No.

Name of Post

Number of posts

Regular/contract

1

Psychiatrist

1

Regular

2.

Social Worker/councilor

3

Regular

3.

Staff Nurse

4

Regular

4.

Pharmacist cum Record keeper

1

Regular

5.

Accountant cum data entry operator

1

Contract

6.

Ward Attendant

3

Contract

7.

Security Guard/ Chowkidar

3

Contract

8.

Safai Karamchari

2

Contract

9.

Cook cum Helper

1

Contract

 

Total Posts

19 (9 Regular, 10 Contract)

 

The infrastructure requirements for drug de-addiction centres as per the notification are given below:

A.     PHYSICAL STANDARDS:—

                     i.            The centre after obtaining license shall start operations within thirty days of the receipt of the license and inform the licensing authority about the commencement of its operation.

                   ii.            The licensing authority shall cause an inspection of such new centre to be conducted by the District Level Committee;

                  iii.            The, Centres shall have requisite number of beds (one for each patient). Adequate accommodation and proper spacing between the beds shall be provided.

                 iv.            The centre shall have sufficient ventilation and be free from any pollution which may be detrimental to the health of admitted patients.

                   v.            The centre shall have potable/drinking water and running water for washing, bathing and cleaning purposes.

                 vi.            The centre shall have proper sanitation facilities in terms of clean and adequate number of bathrooms, toilets and sinks.

                vii.            The centre shall provide clean bed linen, utensils and articles for personal hygiene of the patients.

              viii.            The centre shall provide fresh, nutritious and adequate meals to the admitted patients.

                 ix.            The centre shall have adequate recreational facilities for the patients.

                   x.            The following additional facilities shall be available in every centre; namely:—

a.       Reception enquiry/registration counter/waiting space with seating arrangements for a minimum of five persons.

b.      Cubicle/room for providing individual counseling, group therapy and family counseling.

c.       Space to store records of patients to ensure confidentiality and a system of easy retrieval.

d.      Related educational material such as posters to be prominently displayed at strategic points in the centres.

e.      Pamphlets, hand bills and other educational materials in vernacular shall be made freely available for the public. 

B.     MEDICAL STANDARDS:—

                     i.            No patient shall be coerced to undergo detoxification treatment without explaining the range of treatment options available to him including substitution/maintenance therapy and psychosocial interventions and his consent for undergoing treatment for de-addiction.

                   ii.            Treatment protocol of centres shall follow established and evidence based medical practice and guidelines published by the World Health Organization (WHO), Government of India, and Indian Psychiatric Society (IPS), including the harm minimization practices advocated from time to time.

                  iii.            Nursing and other staff employed in the centre shall be duly qualified as per their job requirement, be competent to handle the work assigned to them. The core staff (Doctors and nurses) shall have received training in de-addiction treatment from a recognized institution.

                 iv.            Officer in-charge of a centre shall be duly qualified psychiatrist or doctor with at least three months training in de-addiction treatment.

                   v.            When doctor manages a centre, it shall have a psychiatrist on its roll visiting the centre at least once a week.

                 vi.            Each centre shall furnish and prominently display an undertaking/arrangement from the management in charge of a Government/Private Centre for providing support and emergency services to the in-patients, if needed.

                vii.            Adequate transport/Ambulance for patients shall be ensured by the centre.

              viii.            Round the clock medical nursing care to the addict shall be ensured by the centre.

                 ix.            There shall be adequate and readily available stock of medicines required and related physical and psychiatric co-morbidities.

C.      RECORD MAINTENANCE AND DISSEMINATION:—

                     i.            It shall be mandatory for all the Centres to maintain personal and treatment record of all the patients.

                   ii.            These records shall be confidential and available only to the authorized persons on request with the discretion of Officer in charge of the centre.

                  iii.            All the data on activities of the centre shall be sent on Drug Abuse Monitoring System (DAMS) Performa developed by the Union Ministry of Health and Family Welfare, the Director General Health Services, Haryana and to the Director, Health and Family Welfare, Ministry of Health and Family Welfare, Government of India on the quarterly basis for the purpose of information and compilation of State and National data.

IMPORTANT LINKS

 




 
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