1. CLINICAL TEACHING ON NURSES’
ROLE IN ADMISSION OF A
PSYCHIATRIC PATIENT
MRS. ANGELICA
NGAIZAMOY
DPMN 2023-2024
NIMHANS
2. INTRODUCTION
•It is important that we as a nurse should know the current law that
affects psychiatric nursing practice, so having good knowledge of legal
aspects in psychiatry and use it effectively to help the psychiatric
patients to receive respectful care.
3. CONTD.
•Lunacy Act 1912: custodial care of persons with mental illness.
•Mental health Act 1987: treatment of persons with mental illness.
•The Mental Health Care Act 2017 passed on 7th April 2017: protect
human rights during treatment.
4. •The mental health care Act clearly talks about the rights of person
with mental illness [PWMI] and lays down the ethical and legal
responsibilities of mental health professionals and the government.
The rights of the PWMI are par with the fundamental rights of human
beings.
•The mental health care Act for the first time, clearly articulates the
rights of persons with mental illness
5. Mental health care act 2017:
The law talks about the Act which safeguards the patients right to
access a range of mental healthcare facilities, such as inpatient,
outpatient, rehabilitation Services of PWMI (Persons with mental
illness) in the community, halfway homes, sheltered homes and
supported accommodation.
6. CHAPTER IV
•It deals with the procedures for admission and detention in psychiatric
hospitals/ nursing homes.
•Admission
Definition: allowing a individual who is diseased into a hospital with
Zeal, for preventive, curative, and rehabilitative care.
7.
8. ADMISSION ON VOLUNTARY BASIS
•Any person who considers himself to be mentally ill and wishes to be
admitted to a psychiatric hospital may apply to the medical officer-in-
charge,
•If he is a minor, the guardian can make this application on his behalf.
•The medical officer should make inquiry within 24hrs and should admit
the patient if he feels the admission/treatment is required.
•The voluntary patient, thus admitted has to abide by the rules made by
the institution
9. ADMISSION ON VOLUNTARY BASIS
Request by a major/guardian of the minor for admission to
medical officer.
Medical officer makes enquiries within 24hours.
If the medical officer is satisfied for admission.
Voluntary admission is made.
10. ADMISSION UNDER SPECIAL
CIRCUMSTANCES [INVOLUNTARY
ADMISSION]
•Any mentally ill patient who is unwilling for admission on a voluntary
basis may be admitted and kept as an inpatient in a psychiatric
hospital/nursing home.
•For such purpose an application should be made out on his/her behalf
by a relative or a friend of the mentally ill person, provided the medical
officer approval.
11. ADMISSION UNDER SPECIAL
CIRCUMSTANCE
Patient is unwilling or unable to make a request for admission, a
relative/ friend makes an application to the medical officer on behalf of
the patient.
Medical officer makes enquiries within 24 hours.
If the medical officer is satisfied for admission.
Involuntary admission is made.
12. ADMISSION UNDER AUTHORITY OR
ORDER
Any mentally ill person can be admitted and detained at a psychiatric
hospital or nursing homes in accordance with an order passed by the
court of law or an approved authority.
An authority can pass an order for reception and detention mainly
under four different categories, which include
1. Reception order on application.
2. Reception order on production of a mentally ill person before a
magistrate.
3. Reception order after inquest.
4. Admission and detention of a mentally ill prisoner.
14. 1. RECEPTION ORDER ON
APPLICATION
•The relative [husband, wife, guardian or a friend] can make out an application for the
admission of a mentally ill patient.
•An application is made out to the magistrate in writing supported by two medical
certificates, one of them issued by a gazette medical officer.
•No person being a minor or one who has not seen a mentally ill patient in the last
14days can make such an application
•The patient can be admitted after the magistrate obtains consent from the medical
officer in-charge of the mental hospital.
•Medical officer in-charge can extend inpatient treatment to more than 6month by
making such an application to the magistrate.
15. 1.RECEPTION ORDER ON
APPLICATION
Application is made by a relative/friend to the magistrate.
Application should be supported by two medical certificates.
Magistrate obtains consent from the medical officer-in-charge of
mental hospital/ nursing home.
Admission under reception order is made.
16. 2. RECEPTION ORDER ON
PRODUCTION BEFORE
MAGISTRATE:
Mentally ill patient exhibiting violent behavior detained by police
officer.
Produced in the court within 24hrs of detention.
Application is supported by two medical certificates.
Magistrate issues reception order.
17. 3. RECEPTION ORDER AFTER
INQUEST
Inquest of a mentally ill patient by district court.
In the interest of such person district court directs for admission
Admission is made.
18. 4. ADMISSION AND DETENTION OF A
MENTALLY ILL PRISONER:
•A mentally ill prisoner may be admitted into a mental hospital on the
order of the presiding officer or a court.
•Admission in emergency: the medical officer in-charge may order the
admission of a mentally ill patient if he thinks he is dangerous to
himself or others. However hospital needs to take magistrate order
within 24-72 hrs after admission, if not able to produce patient in the
court, Magistrate himself can visit the hospital to pass the reception
order on examination.
19. NURSES ROLE IN ADMISSION
PROCEDURE
Admission procedure involves lot of duties and responsibility for the
nurses,
Welcoming and Settling the patient in the ward.
Introducing self and other staff members.
Assigning a bed based on biological and emotional needs.
Complete the paper work during admission procedure.
Orienting to the geographical layout.
Explain the Safety of their belongings
20. CONTD.
Explaining rules, regulations and policies of the ward and institute.
Provide appropriate information to the patient with some of the ward
rules such as meal time, ward activities, visiting hour, how to make
appointment to see members, timings of the group meeting, unit
rounds.
Head to foot observation of the patient, enquire about any legal
issues that had prior to the admission.
Perform history collection and MSE. Document everything in the
Performa and admission details in the concern register.
Check for admission letters/ reception order .
21. OBSERVATION OF THE PATIENT
AT THE TIME OF ADMISSION
APPEARANCE:
Head, Eyes, Ears, Nose, Mouth, Limbs, any Physical injuries.
BEHAVIOUR:
Talk, Walk, Restlessness, Excitement, Depressed etc.
Thought and speech, mood and perception.
COGNITIVE FUNCTIONS:
Attention & concentration, memory, orientation, intelligence, judgment,
knowledge and insight.
