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

4. 1. ADMISSION ON VOLUNTARY BASIS
2. ADMISSION ON UNDER SPECIAL CIRCUMSTANCES
3. 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:
1. RECEPTION ON APPLICATION SECTION 20
2. RECEPTION ON PRODUCTION BEFORE MEGISTRATE SECTION 23
3. RECEPTION AFTER INQUEST SECTION 26
4. ADMISSION AND DETENTION OF MENTALLY ILL PRISONER SECTION 27

8. RECEPTION ORDER
 AN APPLICATION FOR RECEPTION ORDER MAY BE MADE 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
2. RECEPTION ON PRODUCTION BEFORE THE MAGISTRATE:-

10. 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. 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.  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.  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.  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

1. VOLUNTARY DISCHARGE UNDER SECTION-18
2. DISCHARGE UNDER SPECIAL ADMISSION UNDER SECTION-19
3. DISCHARGE IN RESPECT OF ADMISSON DUE TO AN ORDER OF AN AUTHORITY IN ALL FIVE
TYPES

17.  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.  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. ADMISSION
A CERTIFICATE FROM MEDICAL OFFICER
INCHARGE OF PSYCHIATRIC HOSPITAL
A MAGISTRATE ISSUES AN ORDER IF
PATIENT IS FIT FOR DISCHARGE

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.  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.  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.  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.

25. THANK YOU