Annual Report 2018 by National Institute of Mental Health, Sri Lanka

Annual Report 2018

National Institute of Mental Health Ministry of Health - Sri Lanka

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Annual Report 2018 ÂŠ National Institute of Mental Health, Ministry of Health, Sri Lanka National Insitute of Mental Health Mulleriyawa New Town Tel: 0112 578 234 - 7, Fax: 0112 578 238 Email: info@nimh.health.gov.lk Web: http://nimh.health.gov.lk Facebook: https://www.facebook.com/pg/NIMH.Angoda/ Printed on 100% recycled paper by Printec Establishment (Pvt) Ltd - 0112 815 816 2

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Our Vision

To Lead the Nation in Mental Health Care

Our Mission

To provide comprehensive and evidence based Mental Health Services appropriate to the Local Context through state of the art approaches to patient care, capacity building, advocacy, community engagement, multi-sector collaboration and research delivered by competent and reliable staff

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Table of Contents Directorâ&#x20AC;&#x2122;s Message Introduction Services Offered at NIMH Outpatient Services Outpatient Department & Psychiatric Intensive Care Unit Out-Patient Clinics Dental Unit Colombo Outreach Ambulance Service Navodaya (Day Treatment Centre) Day ECT Centre Gender Based Violence Prevention Unit National Mental Health Helpline â&#x20AC;&#x201C; 1926 Inpatient Services Inward Acute Care Forensic Psychiatry Unit Adolescent Psychiatry Unit Pregnancy & Puerperal Care Unit Learning Disability Unit ECT Unit Isolation Unit Medical Ward Rehabilitative Services Day Rehabilitation Service Rehabilitation Centre Ward Based Rehabilitation Intermediate Ward(s) Long Term Ward(s) Villa(s) Halfway Home Mulleriyawa Occupational Therapy Unit Psychiatric Social Work Unit Community Psychiatry Nursing Programme Ancillary Services Planning & Development Unit Planning Section Quality Management Section Public Health Section Infection Control Unit Disaster Management Section Health Informatics Section

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

9 10 11 12 12 13 14 15 16 17 18 20 21 21 22 24 25 26 27 28 29 30 30 32 34 34 35 36 37 39 40 41 42 42 42 42 44 45 46 46

Media Unit Training Unit & Research Unit Nutrition Unit Kitchen Special Grade Nursing Officer’s (SGNO) Office School of Nursing Mulleriyawa Medical Record Room Diagnostic Services Laboratory Department Electroencephalography (EEG) Unit Electrocardiography (ECG) Unit X-Ray Department Physiotherapy Unit Pharmacy Department Administration Department Inquiries & Transport Unit Overseer’s Office Diet Branch Accounts Department Shroff Other Telephone Exchange Drivers Maintenance Team Special Activities World Mental Health Day International Mental Health Nursing Conference Special Projects & Staff Welfare Activities Annexures I: Cadre Details of NIMH Annexures II: Research Submitted to Ethical Review Committee, 2018 Annexures III: Annual Financial Report of NIMH. 2018 Acknowledgements

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

47 48 49 49 50 51 51 52 52 53 54 55 56 57 58 58 58 58 59 59 59 59 59 59 60 60 62 63 66 68 70 72

Table of Figures Figure 1: Annual OPD Sessions, 2018 Figure 2: Annual Clinic Sessions, 2018 Figure 3: Types of Treatment, 2018 Figure 4: Annual Dental Visits, 2018 Figure 5: Annual Summary of Navodaya, 2018 Figure 6: Annual Day ECT Sessions, 2018 Figure 7: Annual Summary of GBVPU, 2018 Figure 8: Annual Acute Ward Admissions, 2018 Figure 9: Visitor's Board & Open School Summary, 2018 Figure 10: Annual Forensic Clinic Visits, 2018 Figure 11: Annual Psycho-Geriatric Unit Admissions, 2018 Figure 12: Activities of Adolescent Psychiatry Unit, 2018 Figure 13: Annual Admissions to Adolescent Unit, 2018 Figure 14: Annual Admissions to the PPU, 2018 Figure 15: Annual Admissions to LDU, 2018 Figure 16: Annual ECT Patients, 2018 Figure 17: Annual Isolation Unit Cases, 2018 Figure 18: Annual Medical Clinic Visits, 2018 Figure 19: Annual Admission to Medical Ward, 2018 Figure 20: Annual Summary of Day Rehabilitation Service, 2018 Figure 21: Annual Rehabilitation Activities of Rehabilitation Centre, 2018 Figure 22: Annual Training Activities of Rehabilitation Centre, 2018 Figure 23: Activities of Rehabilitation Centre, 2018 Figure 24: Annual Admissions to Intermediate Wards, 2018 Figure 25: Activities of Halfway Home Mulleriyawa, 2018 Figure 26: Annual OT Sessions, 2018 Figure 27: Annual Activities of Psychiatric Social Work Unit, 2018 Figure 28: Activities of Quality Management Section, 2018 Figure 29: Activities of Nutrition Unit, 2018 Figure 30: Annual Summary of School of Nursing Mulleriyawa, 2018 Figure 31: Annual Summary of Laboratory, 2018 Figure 32: Annual Summary of EEG Unit, 2018 Figure 33: Annual Summary of ECG Unit, 2018 Figure 34: Annual Summary of X-Ray Department, 2018 Figure 35: Annual Physiotherapy Sessions, 2018 Figure 36: Annual Summary of Pharmacy, 2018 Figure 37: Activities of World Mental Health Day, 2018 Figure 38: Activities of International Mental Health Nursing Conference, 2018 Figure 39: Special Activity Highlights of NIMH, 2018

12 13 14 14 16 17 19 21 22 22 23 24 24 25 26 27 28 29 29 31 32 33 33 34 38 39 40 43 49 51 52 53 54 55 56 57 61 62 65

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Director’s Message It is with great happiness that I write my 4th Director’s message for the annual report of National Institute of Mental Health (NIMH), the largest tertiary care hospital in Sri Lanka caring for clients with mental illness. Carrying on the plans set in 2015 when I assumed duties, this year has been about investing time in pioneering activities which improves the knowledge, skills and attitudes of my staff as well building infrastructure for clients. I’m confident these pioneering efforts in training, infrastructure building, and research will give NIMH prominence in the coming years. The year 2018 has been busier than usual improving on the work of the previous years in promotion, prevention, cure and rehabilitation of people and their families affected by mental disorders. As always, the team culture that is now built in NIMH is a key secret to our progress. I can see that the regular in-service training programmes which covers all types of staff is catalyzing all strata of our team to help in better decision making and teamwork. Many significant events occurred in 2018. First, I and my team took the initiative, involving all stakeholders, to have the first ever research conference for the nursing profession in mental health. Titled ‘International Mental Health Nursing Conference’, this was a landmark event which attracted not only the support of nurses but also doctors and allied health professionals. The event had all the features of a research conference which you can read about below. Secondly, with the ever-growing burden of mental health in Sri Lanka, there is an urgent requirement for a client to be able to connect easily with mental health professionals. With the assistance of Consultant Psychiatrist Dr Pushpa Ranasinghe, we launched the National Mental Health Helpline (1926). I believe both these activities will bear fruit in the years to come. We are continually encouraged by the outstanding community support we receive every year for ward management and community related activities such as World Mental Health Day. I invite you to read about our many activities and events in this report. None of these can be achieved without the dedication of the 1,045 full-time staff working tirelessly around the clock guided by Director, Deputy Director, Consultants, Medical Officers, Matrons, Nurses & other Sectionals Heads. The dedication of our entire staff must be appreciated. A honorable mention should be made of Consultant Psychiatrists Dr Jayan Mendis who retired in this year after many years of transformative work in mental health as the previous Director and as a Consultant Psychiatrist. We also warmly welcome our new Consultant Psychiatrist Dr Pushpa De Silva. Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Introduction The National Institute of Mental Health (NIMH) was established in 1926 and it is one of the oldest hospitals in South Asia. At present, it is the largest tertiary care hospital in Sri Lanka caring for clients with mental illness. The former Mental Hospital was upgraded to a National Institute in 2008. The Halfway Home, Mulleriyawa (HWH) and the School of Nursing, Mulleriyawa are also under the administration of NIMH since 2008. The NIMH has a total of around 1500 beds and annually around 8000 clients are admitted seeking treatment for all types of mental illness. NIMH provides acute care, intermediate care and long-term care as well as specialized services. There are about 900 inward clients treated at NIMH on any given day. The NIMH is the main training center in Sri Lanka for undergraduate and post-graduate trainees in Psychiatry from Medical and allied fields and provide for basic and in-service training for health staff as well. All postgraduate trainees in MD Psychiatry undergo a compulsory training for a minimum period of 6 months at the NIMH. The NIMH has around 1045 full-time staff. The top administration of NIMH comprises of a Director and a Deputy Director who oversee affairs via the Planning & Development Unit, Administration Department & Finance Department. As at 31st December 2018, NIMH had 10 Consultant Psychiatrists, a Consultant Physician, a Consultant Haematologist, 72 Grade Medical Officers and 3 Dental Surgeons. There are 3 Special Grade Nursing Officers, 5 Ward Sisters, 434 other Grade Nursing Officers, 7 Pharmacists, 2 MLTs, 10 Psychiatric Social Workers, and 11 Occupational Therapists. (For the full cadre details please refer Annexures I: Cadre Details of NIMH).

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Services Offered at NIMH

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Outpatient Services Outpatient Department & Psychiatric Intensive Care Unit

Outpatient Services Date established: 1926

Outpatient Department & Psychiatric Intensive Care Unit Main Objective:

Date established: 1926

The Outpatient Department & Psychiatric Intensive Care Unit acts as the central hub for all

Main Objective: OPD and admission registrations including psychiatric emergencies.

The Outpatient Department & Psychiatric Intensive Care Unit acts as the central hub for all OPD and

Services Offered:

admission registrations including psychiatric emergencies.

• Management of clients at Outpatient Department via advice & referral who do not

Services Offered: require admission.        

• Admission of clients voluntarily. • Admission of clients on a non-voluntary relatives, non-relatives, or Management of clients at Outpatient Department viabasis advicevia & referral who do not requirePolice, admission. Admission of clients voluntarily. Prison. Admission of clientsofon a non-voluntary via relatives, non-relatives, Police, or Prison. • Admission clients who have basis no identifiable details on rotation basis. Admission of clients who have no identifiable details on rotation basis. • Management of psychiatric emergencies at admission. Management of psychiatric emergencies at admission. • Administration of injections, dressings. Administration of injections, dressings. • Administration of Hepatitis B injection for staff. Administration oftea Hepatitis B injection for staff. • Providing for clients and relatives. Providing tea for clients and relatives.

Figure 1: Annual OPD Sessions, 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Out-Patient Clinics Date established: 1939 Out-Patient Clinics Main Objective:

Date established: 1939

The general psychiatry clinics are held at National Hospital of Sri Lanka. The main aims are to give specialized psychiatry care in a clinic setting and to make travel for clients easier.

Main Objective:

The general psychiatry clinics are held at National Hospital of Sri Lanka. The main aims are to give specialized

Servicescare Offered: psychiatry in a clinic setting and to make travel for clients easier. Services Offered:

• General Psychiatry Clinics • Psycho-Geriatric  General Psychiatry ClinicsClinics • Substance Clinics Abuse Clinics  Psycho-Geriatric  Substance Abuse Clinics • Forensic Clinics 

Forensic Clinics

Figure 2: Annual Clinic Sessions, 2018 Figure 2: Annual Clinic Sessions, 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Dental Unit Date established: 1972 Dental Unit Main Objective:

Dental Unitaims to improve oral health of the inward clients and outpatients and alleviate TheDate Dental Unit established: 1972 stigma in society towards NIMH. Main Objective:

Date established: 1972

The Dental Unit aims to improve oral health of the inward clients and outpatients and alleviate stigma in Services MainOffered: Objective: society towards NIMH.

The Dental Unit aims to improve oral health of the inward clients and outpatients and alleviate stigma in

• Provide treatments for oral diseases for inward clients and outpatients. society towards NIMH. Services Offered: • Promotion of oral health for inward clients and outpatients. Services Offered:

 Provide treatments for oral diseases for inward clients and outpatients. Highlights of 2018: 

Promotion of oral health for inward clients and outpatients. environment

 Provide treatments for oral diseases for inward clients and outpatients.  Promotion Highlights of 2018:of oral health for inward clients and outpatients. environment

• An oral health training programme was conducted to commemorate World Oral Health Highlights 2018: supportive staff, focusing on improving oral hygiene of NIMH inward Day for ofNIMH  An oral health training programme was conducted to commemorate World Oral Health Day for NIMH clients. supportive on improving hygienetoofcommemorate NIMH inwardWorld clients.  An oral staff, healthfocusing training programme wasoral conducted Oral Health Day for NIMH • Thesupportive Dental Unit environment wasoral improved by color washing the unit and establishing focusing onwas improving hygiene NIMH inward clients.  The Dental Unitstaff, environment improved by color of washing the unit and establishing a new name a new name board.  The Dental Unit environment was improved by color washing the unit and establishing a new name board. board.

Figure of Treatment, Treatment,2018 2018 Figure3: 3: Types Types of Figure 3: Types of Treatment, 2018

Figure 4: Annual Dental Visits, 2018 Figure 4: Annual Dental Visits, 2018

Figure 4: Annual Dental Visits, 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Colombo Outreach Ambulance Service Date established: 2013 Main Objective: The Colombo Outreach Ambulance Service aims to provide prompt assessment and treatment of clients who are aggressive at home and difficult to be brought to the hospital using conventional transport within a 50km radius from NIMH. This is a paid service which includes an administrative fee, refundable deposit, and a distance fee. Services Offered: • The client is visited by a team comprising of a Medical Officer, a Nursing Officer/ Community Psychiatric Nurse, Psychiatric Social Worker and a supportive staff in an Ambulance. • The requirement of in-ward care is decided by the respective Consultant Psychiatrist based on the information provided by the Medical Officer, Community Psychiatric Nurse and the Psychiatric Social Worker. • The clients are brought back to NIMH if the team decides that the client needs admission to NIMH.

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Navodaya (Day Treatment Centre) Date established: 2012, Renamed to Navodaya in 2017 Main Objective: The main aim of Navodaya is to apply psycho-therapeutic techniques for minor mental health problems and support other mental health disorders. Services Offered: • • • • •

Treatment of minor mental health problems. Alcohol and Substance Abuse Clinic. Neurotic Clinic. Child and Adolescent Clinic. Conduct mental health awareness programmes and health camps in Navodaya and in public areas such as schools, banks etc. • Conduct in-service and external training in mental health. Highlights of 2018: • Established an Information Desk in January 2018. • Established an Alcohol and Substance Abuse Clinic in June 2018. • Established a Child and Adolescent Clinic in December 2018. Total no. of services provided New registrations Revisits Sessions Issued medication Information desk - helpline calls received Information desk – visits Awareness programmes & health camps conducted No. of participants for above programmes & camps Referred clients Clients who successfully ended their sessions No. of medical students who underwent orientation No. of nursing student who underwent orientation No. of psychology students who underwent orientation No. of school children who underwent orientation Figure 5: Annual Summary of Navodaya, 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

3516 388 831 1219 590 641 372 16 1284 59 17 162 172 05 365

Centre DayDay ECT ECT Centre

Date established: 2014

Objective: MainMain Objective: The The mainmain aim ofaim DayofECT Centre to minimize unnecessary admissions for ECT and keep Day ECT isCentre is to minimize unnecessary admissions for the ECTclient and with keeptheir

thetoclient family to enrich their mental health. family enrichwith theirtheir mental health. Services Offered: Services Offered:  

The ECTisservice offered fromtoMonday Saturday including public holidays. The • Day ECTDay service offeredisfrom Monday Saturdaytoincluding public holidays. • The Day ECT service can be referred by Consultant Psychiatrist attached to other the NIMH or The Day ECT service can be referred by Consultant Psychiatrist attached to the NIMH or Consultant other who Consultant who can referattoNIMH a Consultant Psychiatrist at NIMH Psychiatrists can referPsychiatrists to a Consultant Psychiatrist with a Pre-ECT assessment form.with a Pre-ECT assessment form.

Figure6:6:Annual Annual Day Day ECT Figure ECT Sessions, Sessions,2018 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Gender Based Violence Prevention Unit Date established: 2012, Prevention of Child Maltreatment Unit was established in 2015 Main Objective: The main aim of Gender Based Violence Prevention Unit (GBVPU) is to establish a friendly environment for survivors of gender-based violence & reduce incidence of gender-based violence. (GBV) Services Offered: • The GBVPU provides quality, culturally and age appropriate counseling, psychotherapy, medical, social and legal support to survivors of GBV. • The GBVPU counsels’ perpetrators to reduce the incidence of GBV. • The GBVPU arranges group counselling at family meetings. Highlights of 2018: • Enactment of sexual harassment prevention policy at NIMH since 1st of January. • Conducted a GBV awareness programme for nursing officers on 30th of January 2018. • Commemorated International Women’s Day 2018 with a programme on 9th of March 2018. As a main component in the event, a debate competition among staff members of NIMH was arranged in order to raise awareness in gender equality, sexual harassment in workplace and related legal issues. • Conducted a one-day workshop for community volunteers of Colombo Municipal Council on 22nd of June 2018. • Conducted awareness raising programme for group of 60 post-basic training nursing officers at Mulleriyawa Nursing School on 11th of July 2018. • Published a research on ‘Prevalence of gender base violence at the workplace among a selected group of female staff’ for International Mental Health Nursing Conference 2018. • Conducted three days in-service workshops for ~ 40 participants (each) to improve the knowledge regarding “telephone counselling, legal aspect of sexual harassment in workplace, Iegal aspects of domestic violence, social response & services and communication skills” on 6th to 8th September & on 19th,21st, & 23rd November 2018. • The National Mental Health Helpline 1926 was ceremonially opened on 15th October 2018. • Conducted a lecture on prevention of workplace sexual harassment on 19th of November 2018.

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

• Conducted a one-day workshop on 20th November for over 100 staff at NHSL to improve the knowledge regarding prevention of workplace sexual harassment in commemoration of the International day for Elimination of Violence against Women. • Medical officers and nursing officers participated in the national level awareness programme on gender base violence prevention programme at Family Health Bureau on 18th to 21st December 2018. Prevention of Child Maltreatment Unit The Prevention of Child Maltreatment Unit was established to have a friendly environment for survivors of child maltreatment & reduce its incidence. A total number of 25 clients were registered from adolescent admissions in 2018. The main problems were identified were conductive disorder, psychotic problems and poor school performance. No. of new clients No. of female clients No. of male clients No. of follow up Referrals to NIMH Referrals to community centers Referrals to clinics Referrals to National Mental Health Helpline – 1926 Type of incidents Rape Sexual harassment Physical assault Forced marriage Limited resources Psychological harassment Others

362 200 162 890 144 165 31 18 00 04 142 01 38 15 111

Figure 7: Annual Summary of GBVPU, 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

National Mental Health Helpline - 1926 Date established: 15th of October, 2018 Main Objective: The aim of National Mental Health Helpline is to help clients easily by connecting them with a mental health care provider to answer their queries and de-escalate emergency situations with clients. Services Offered: • • • • • •

Is a service which runs 24/7 Provides a portal for inquiries related to mental health Provides a connection to care during times of distress Provides support in emergencies such as risk of suicide Provides comprehensive and coordinated responses in short and long term Connects clients with an extensive psycho-social network around the country

Highlights of 2018: • The National Mental Health Helpline was inaugurated on October 2018 in a fully equipped room next to Gender Based Violence Prevention Unit via a special grant from Sri Lanka Telecom. • Even in its few months of operation in 2018 the helpline successfully managed over 500 calls including managing emergencies such as de-escalating suicidal episodes of clients and getting them required help.

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Inpatient Services Inpatient Services Inward Acute Care

Inward Acute Care

established: DateDate established: 1926 1926 Main Objective: Main Objective: The aim of Inward Acute Care is the comprehensive management of acutely ill clients.

The aim of Inward Acute Care is the comprehensive management of acutely ill clients.

Services Offered:

       

Comprehensive inward psychiatric care. • Comprehensive inwardemergencies. psychiatric care. Management of all psychiatric • Management of all psychiatric emergencies. Seclusion rooms for unstable clients. • Seclusion rooms for unstable clients. Coordination of referrals to other specialties. • Coordination of referrals to other specialties.and/or referrals. Transfer of clients to other hospitals for interventions • Transfer of clients to other hospitals for interventions and/or referrals. Provision of basic rehabilitation. • Provision of basic rehabilitation. Management of psycho-social factors via community centric programmes. • Management of psycho-social community programmes. Training of in-house staff, visiting medical,factors nursingvia and allied healthcentric students on management of acutely • Training of in-house staff, visiting medical, nursing and allied health students on ill clients.

management of acutely ill clients.

Figure AnnualAcute Acute Ward Ward Admissions, Figure 8:8:Annual Admissions,2018 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Forensic Psychiatry Unit

DateDate established: 1940s 1940s established: Main Objective:

Main Objective:

The aim of Forensic Psychiatry Unit is to provide comprehensive forensic mental healthcare.

Services Offered:        

Services Offered:

Outpatient services via Forensic Outpatient Clinic, NHSL. Comprehensive inward care via via male (Ward 21) and female (Ward 25) units. • Outpatient services Forensic Outpatient Clinic, NHSL. Clinic services at Welikada Prison, Colombo Remand Prison, Magazine Women’s • Comprehensive inward care via male (Ward 21) and femalePrison (Ward(+25) units. Section), Prison Hospital (Colombo 9), & Institute of Forensic Medicine (Colombo 10). • Clinic services at Welikada Prison, Colombo Remand Prison, Magazine Prison (+ Holding of quarterly Visitor’s Prison Board. Hospital (Colombo 9), & Institute of Forensic Medicine Women’s Section), Gymnasium services for clients and staff. (Colombo 10). Rehabilitation via Forensic • Holdingofofclients quarterly Visitor’sPsychiatry Board. Rehabilitation Unit. Rehabilitation of clients via Horticulture • Gymnasium services for clientsArea. and staff. Open service conducted National Institute of Education • school Rehabilitation of clientsbyvia Forensic Psychiatry Rehabilitation Unit.

• Rehabilitation of clients via Horticulture Area. Highlights of 2018:

• Open school service conducted by National Institute of Education.

  

A gymnasium service was opened for the use of clients and staff on 5th July 2018. Highlights of 2018:in the New Year Festival in January 2018. Clients participated Clients actively took part in Vesak, Poson, and Christmas celebrations.

• A gymnasium service was opened for the use of clients and staff on 5th July 2018. • Clients participated in the New Year Festival in January 2018. • Clients actively took part in Vesak, Poson, and Christmas celebrations. No. of Visitor’s Boards held

No. of open school No. of Visitor’s Boards held sessions held No. of open school sessions held

04 40

Figure 9: Visitor's Board & Open School Summary, 2018 Figure 9: Visitor’s Board & Open School Summary, 2018

Figure10: 10:Annual Annual Forensic Figure ForensicClinic ClinicVisits, Visits,2018 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

04 40

Psycho - Geriatric Unit Psycho-Geriatric Date established:Unit 1998

Main Objective:

Date established: 1998

The aim of Psycho-Geriatric Unit is to provide comprehensive mental healthcare for the Main Objective: elderly client particularly those suffering from dementia. The aim of Psycho-Geriatric Unit is to provide comprehensive mental healthcare for the elderly client

Services particularly Offered: those suffering from dementia. • Outpatient Services Offered: services via Psycho-Geriatric Clinic, NHSL.            

• Community-based clinics in Modara. • Comprehensive psycho-geriatric care. Outpatient services viainward Psycho-Geriatric Clinic, NHSL. Community-based clinics in Modara. • Comprehensive geriatric assessment per client in a multi-team approach. Comprehensive inward psycho-geriatric care. • Management of all psychiatric emergencies. Comprehensive geriatric assessment per in a multi-team approach. • Coordination of referrals to otherclient specialties. Management of all psychiatric emergencies. • Transfer of clients to other hospitals for interventions and/or referrals. Coordination of referrals to other specialties. • Rehabilitative activities such occupational therapy and reminiscence therapy. Transfer of clients to other hospitals for interventions and/or referrals. • Management of psycho-social factors via community centric programmes. Rehabilitative activities such occupational therapy and reminiscence therapy. • Awareness programmesfactors in public areas and via holistic care programme via Geriatric Management of psycho-social via community centric programmes. Association. Awareness programmes in public areas and via holistic care programme via Geriatric Association, • Training of in-house staff,medical, visiting medical, nursing and allied health students Training of in-house staff, visiting nursing and allied health students in management of psycho-in geriatric clients. management of psycho-geriatric clients. State of the art lecture hall facilities and library relevant to relevant psycho-geriatric care. • State of the art lecture hall facilities and library to psycho-geriatric care.

Highlights of 2018:

Highlights of 2018:   

Weekly nursing workshop on geriatric care. • Weekly nursing workshop on geriatric care.on December 2018. The High Dependency Unit was formally inaugurated • TheMeeting High Dependency was formally December 2018. Carers was held everyUnit 4 months to connectinaugurated the staff with on family members to improve the • Carers Meeting was held every 4 months to connect the staff with family members to responsibility for our clients.

improve the responsibility for our clients.

Figure Annual Psycho-Geriatric Psycho-Geriatric Unit UnitAdmissions, Admissions,2018 2018 Figure11: 11: Annual

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

dolescent Adolescent Psychiatry Psychiatry Unit Unit

Adolescent Psychiatry Unit

te established: Date established: 2015 2015

Date established: 2015

ain Objective: Main Objective:

Mainaim Objective: e main aim Theofmain Adolescent of Adolescent Psychiatry Unit Psychiatry is to provide Unit iscomprehensive to provide comprehensive psychiatric care psychiatric in a safe care in a safe

vironment environment for The clients between for clients 12-18 between years. 12-18 years. main aim of Adolescent Psychiatry Unit is to provide comprehensive psychiatric care in a safe environment for clients between 12-18 years.

rvices Offered: Services Offered: Outpatient  Outpatient management management of adolescents of adolescents viaofChild & Adolescent via Child & Adolescent Psychiatry Clinic, Psychiatry NIMHClinic, NIMH • Outpatient management adolescents via Child & Adolescent Psychiatry Clinic, NIMH Comprehensive  Comprehensive inward psychiatric inwardinward care psychiatric for adolescent care for clients. clients. • Comprehensive psychiatric careadolescent for adolescent clients. Adolescent Unit ofPsychiatry all adolescent related psychiatric emergencies. Management  Management of • allManagement adolescent of all adolescent related psychiatric related emergencies. psychiatric emergencies. Coordination of referrals to other specialties. Coordination  Coordination of • referrals of to referrals other specialties. to other specialties. Date established: 2015 • Transfer of clients to other hospitals forand/or interventions and/or referrals. Transfer of Transfer clients toofother clients hospitals to other forhospitals interventions for interventions referrals. and/or referrals. Main Objective: • Rehabilitative activities. Rehabilitative  Rehabilitative activities. activities. The main aim of Adolescent Psychiatry Unit is to provide comprehensive psychiatric care in a safe • Management of psycho-social factors via community centric programmes. environment for clientsvia between 12-18 years. Management  Management of • psycho-social of psycho-social factors community factors via community centric programmes. centric programmes. Training of in-house staff, visiting medical, nursing and allied health students in Training of in-house Trainingmanagement of staff, in-house visiting staff, visiting nursing medical, andnursing allied health and allied students health in students management in management of of Services Offered: ofmedical, adolescent ill clients. adolescent adolescent ill clients. ill clients.        

ghlights in Highlights 2018 in 2018

Outpatient management of adolescents via Child & Adolescent Psychiatry Clinic, NIMH Comprehensive inward psychiatric care for adolescent clients. Management of all adolescent related psychiatric emergencies. Coordination of referrals to other specialties. Transfer of clients to other hospitals for interventions and/or referrals. Rehabilitative activities. Management of psycho-social factors via community centric programmes. Training of in-house staff, visiting medical, nursing and allied health students in management of adolescent ill clients.

• Adolescent playing areas was declared open on August 2018 for the recreational benefit

Adolescent  Adolescent playingofareas was declared areas was open declared on August open on August for 2018 recreational for thebyrecreational benefit our benefit young ourplaying young patients. The project was 2018 done as athe CSR project People’sofLeasing & of our young patients. The patients. project The wasproject done was a CSR done project as aLeaf CSR by People's project by Leasing People's & Finance Leasing & through Green through Leaf Green Leaf Finance PLC as through Green Landscaping Company (Pvt)PLC LtdFinance as wellPLC as Italian LandscapingLandscaping Company (Pvt) Company Ltd (Pvt) well as LtdItalian as well Embassy as Italian in Embassy Sri Lanka.in Sri Lanka. Embassy in SriasLanka. Highlights in 2018 

Adolescent playing areas was declared open on August 2018 for the recreational benefit of our young patients. The project was done as a CSR project by People's Leasing & Finance PLC through Green Leaf Landscaping Company (Pvt) Ltd as well as Italian Embassy in Sri Lanka.

Figure Figure 12: Activities of ofAdolescent Psychiatry Unit, 2018 12: Activities Adolescent Psychiatry Unit, 2018

Figure 12: Activities Figureof 12:Adolescent Activities of Psychiatry Adolescent Unit, Psychiatry 2018 Unit, 2018

Figure 13: Annual Admissions Adolescent Unit, 2018 Figure 13: Annual Admissions totoAdolescent Unit, 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Pregnancy & Puerperal Care Unit

established: 2007. ever in South-East Asia. DateDate established: 2007. The 1st The ever 1st in South-East Asia. Main Objective:

Main Objective:

The main aim of Pregnancy & Puerperal Care Unit is to provide specialized care for women who develop

The main aim Pregnancy PuerperalorCare Unit childbirth. is to provide specialized care for women psychiatric illness in of and around the&pregnancy following who develop psychiatric illness in and around the pregnancy or following childbirth.

Services Offered:      

Comprehensive inward psychiatric care for pregnant and post-partum clients. • Comprehensive inward psychiatric care for pregnant and post-partum clients. Management of all pregnancy and post-partum related psychiatric emergencies. • Management of all pregnancy and post-partum related psychiatric emergencies. Facilities for baby & bystander to stay with mother. • Facilities for baby & bystander to stay with mother. Provision of rehabilitative activities. • Provision of rehabilitative activities. Management of psycho-social factors via community centric programmes. • Management of psycho-social factors via community centric programmes. Training of in-house staff, visiting medical, nursing and allied health students in management of • Training of in-house staff, visiting medical, nursing and allied health students in pregnant and post-partum clients.

management of pregnant and post-partum clients.

Figure 14: Annual Admissions to the PPU, 2018

* Includes 46 transfers DMH, to CSHW, LRH, & other draining centers * Includes 46 transfers DMH, CSHW, LRH, & other draining centers.

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Learning Disability Learning Disability Unit Unit Date established: 2008

Date established: 2008

Main Objective:

The The mainmain aim ofaim Learning Disability Disability Unit is to rehabilitate with learning and associated of Learning Unit is to clients rehabilitate clientsdisability with learning disability

and associated behavioral problems training andguardians educating their parents,skills guardians on behavioral problems by training and educatingbytheir parents, on rehabilitation to provide rehabilitation skills to provide care for clients with special needs.

care for clients with special needs.

Services Offered:

Services Offered:       

• Comprehensive inward psychiatric care for clients with learning disabilities. Comprehensive inwardofpsychiatric care for clients with learning disabilities. • Management all psychiatric emergencies. Management of all psychiatric emergencies. • Facilities for bystander to stay with the client. Facilities for bystanderactivities to stay with theas client. • Rehabilitative such activities of daily living, life skill programmes, cognitive Rehabilitative activities such as activities of daily living, life skill programmes, cognitive development development programmes. programmes. • Management of psycho-social factors via community centric programmes. Management of psycho-social factors via community programmes. • Programmes to improve life skills of parentscentric and bystanders such as lectures on learning Programmes to improve life skills of parents and bystanders such as lectures learning disability disability and discussions on how children with learning disabilityon should looked afterand at discussions on how children with learning disability should looked after at home. home. Training of in-house staff and visiting medical, nursing and allied health students in management • Training of in-house staff and visiting medical, nursing and allied health studentsofin clients management with learning disability. of clients with learning disability.

Figure 15: LDU,2018 2018 Figure 15:Annual Annual Admissions Admissions totoLDU,

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

ECTECT UnitUnit

Date established: 1940s

Main Objective:

The The mainmain aim of ECTofUnit to provide quality quality electroconvulsive therapy for all outpatient and inpatient aim ECTisUnit is to provide electroconvulsive therapy for all outpatient and

inpatient clients at NIMH. clients at NIMH. Services Offered: Services Offered:   

• Comprehensive ECT care for clients from managing Pre-ECT assessment to Post-ECT

Comprehensive ECT care for clients from managing Pre-ECT assessment to Post-ECT recovery. recovery. Management of emergencies relating to ECT. • Management emergencies relating to ECT.of ECT for all clients. Dedicated card-based of system for equitable distribution

• Dedicated card-based system for equitable distribution of ECT for all clients.

Figure 16: Patients,2018 2018 Figure 16:Annual Annual ECT ECT Patients,

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Isolation Unit Date established: 2011 Isolation Unit Main Objective:

established: 2011 Unit is to prevent the spread of communicable disease among The mainDate aim of Isolation Objective: clients byMain isolating them in a secure environment. The main aim of Isolation Unit is to prevent the spread of communicable disease among clients by isolating in a secure environment. Servicesthem Offered:

• • • •

Services Offered:

Comprehensive isolation care for infected clients. Protective isolation for severely immunocompromised patients.  Comprehensive isolation care for infected clients.  Protective isolation for severely immunocompromised patients. Source isolation to confine the infectious agent and prevent it’s spread.  Source isolation to confine the infectious agent and prevent it’s spread. Training of ofin-house staff, medical, andin management allied health students in  Training in-house staff, visitingvisiting medical, nursing and alliednursing health students of isolated clients. management of isolated clients.

Figure 17: Annual Isolation Unit Cases, 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Medical Ward Date established: 2005 MainMedical Objective: Ward

Medical Ward

The main aim of Medical Ward is to provide specialized medical care to the inward psychiatric Date established: 2005 clients with co-morbidities. Date established: 2005 Main Objective: Main Objective: The main aim of Medical Ward is to provide specialized medical care to the inward psychiatric clients with Services Offered: The main aim of Medical Ward is to provide specialized medical care to the inward psychiatric clients with co-morbidities. co-morbidities.

• Outpatient medical management of clients via Medical Clinic, NIMH. Offered: • Services Comprehensive medical care for admitted clients. Services Offered: • Coordination of medical referrals of psychiatric units. Outpatient medical management of clients via Medical Clinic, NIMH. •  Coordination of management transfers ofofclients clients to Clinic, Tertiary Outpatient medical via Medical NIMH.Care Hospitals for specialized  Comprehensive medical care for admitted clients.  Comprehensive medical care for admitted clients. management.  Coordination of medical referrals of psychiatric units. Coordination of of transfers medical referrals oftopsychiatric units. •  Management of medical problems clients to management. High Dependency Unit in Coordination of clients Tertiary of Care Hospitalsadmitted for specialized  Coordination of transfers of clients to Tertiary Care Hospitals specializedUnit management.  Ward Management to Highfor Dependency in Ward 20. 20. of medical problems of clients admitted 

Management of medical problems of clients admitted to High Dependency Unit in Ward 20.

Figure ClinicVisits, Visits,2018 2018 Figure18: 18:Annual Annual Medical Medical Clinic Figure 18: Annual Medical Clinic Visits, 2018

Figure 19: Annual Admission to Medical Ward, 2018

Figure toMedical MedicalWard, Ward,2018 2018 Figure19: 19:Annual AnnualAdmission Admission to

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Rehabilitative Services Day Rehabilitation Service Date established: 2015 Main Objective: The aim of Day Rehabilitation Service is to help outpatient clients who are recovering from mental health problems and need psycho-social support by promoting recovery and reducing the impact that may accompany with their illness. Services Offered: • Improvement of skills development o Social skills training group o Anger management training group o Activities of daily living training group o Stress management and relapse prevention training group o Therapeutically engaging them in shopping, banking, public transportation, meal preparation, and similar skills which increase their independence. • Inculcation business promotion habits via business promotion unit o “Sith Mal Nimevum” sales outlet o Lunch packets selling project o Soft toy project (supported by Fashion Bug) o Work opportunities in Sashini Fashion, Angoda o Production of craft and sewing products for sale at Ministry of Health o Cement flowerpot making project o Enhancement of vocational skills in computer training via NIMH-NAITA computer training center in Navodaya. • Outreach support for clients o Home visits via community centric programmes o Family meetings via community centric programmes o Placement of clients in regular jobs in the private sector • Coordinating community access via Consumer Forum of the National Institute of Mental Health

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Highlights of 2018: • New work opportunity for clients at Sashini Fashion, Angoda. • Opening of NIMH-NAITA computer training center in Navodaya on 10th October 2018. • Registration of Consumer Forum of the National Institute of Mental Health as a volunteer organization in the divisional secretary office, Kolonnawa. • Clients visited Colombo Museum. • Clients visited Polhena Beach, Matara. Social skills training groups held Anger management training groups held Activities of daily living groups held Stress mx. & relapse prevention tr. gp. held Clients who completed rehabilitation and placed in job opportunities Meetings of Consumer Forum of the National Institute of Mental Health held

01 02 03 04 05 06

Figure 20: Annual Summary of Day Rehabilitation Service, 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Rehabilitation Centre Date established: 2017 Main Objective: The aim of Rehabilitation Centre is to improve clients’ lost skills with special attention for vocational training targeting employment to produce a productive individual. Services Offered: • Improve basic activities of daily living (Level 1) • Improve extended activities of daily living (Level 2) Rehabilitation Centre • Involve clients in vocational training (Level 3) e.g. computer application, tailoring, & handicraft. • Facilitate social re2017 integration and employment (Level 4) Date established: Main Objective:

Highlights of The2018: aim of Rehabilitation Centre is to improve clients’ lost skills with special attention for vocational training • Inauguration Vocational Training Centerindividual. in “Situational Level Courses” with National Apprentice and targeting of employment to produce a productive Industrial Training Authority (NAITA) for courses in Computer Application, Tailoring, and Handicraft. Services Offered: • Clients visited SOS Village, Piliyandala and donated school items to children of SOS Village.  took Improve basicin activities of daily livingof(Level 1) • Clients part Annual Trip Rehabilitation Center with staff to Kelaniya Raja Maha  Improve extended activities of daily living (Level 2) Viharaya, Gampaha Botanical Gardens and Negombo Beach.  Involve clients in vocational training (Level 3) e.g. computer application, tailoring, & handicraft. • Clients in NewandYear Festival,  participated Facilitate social re integration employment (Level 4)Poson Bhakthi Geetha, and World Mental HealthHighlights Day celebrations. of 2018: • Clients won the 2nd place in Group Dance at Clients’ Talent show in celebration of Inauguration of Vocational Training Center in “Situational Level Courses” with National Apprentice and World Mental Health Day. Industrial Training Authority (NAITA) for courses in Computer Application, Tailoring, and Handicraft.  were Clients visited SOS Village, Piliyandala and donated school to children of SOS Village. • Clients hosted to entertainment event byitems Rotaract Club of University of Colombo  Clients took part in Annual Trip of Rehabilitation Center with staff to Kelaniya Raja Maha Viharaya, followedGampaha by refreshment for clients. Botanical Gardens and Negombo Beach.  took Clientspart participated New Yeartherapy Festival, Poson Bhakthi Geetha, and World • Clients in a inmusic session organized byMental OldHealth BoysDayAssociation Of D.S. celebrations. Senanayake College, Colombo 07.  Clients won the 2nd place in Group Dance at Clients’ Talent show in celebration of World Mental Health Day. • Clients worked with students of NSBM Green University for their project “Sihinayaka  Clients were hosted to entertainment event by Rotaract Club of University of Colombo followed by Piyapath” whichforconsisted of a trip to Panadura Beach which was followed by other refreshment clients.  Clients took & partrefreshment. in a music therapy session organized by Old Boys Association Of D.S. Senanayake entertainments College, Colombo 07. Centre received a donation of books for the libraryPiyapath” by a group • Rehabilitation  Clients worked with students of NSBM Green University for their project “Sihinayaka which of volunteers. consisted of a trip to Panadura Beach whichin wasafollowed by other entertainments & refreshment. • Rehabilitation Centre participated project named “Art for Humanity” which was  Rehabilitation Centre received a donation of books for the library by a group of volunteers. carried at NIMH byparticipated Department of named Fine “Art Arts, University  out Rehabilitation Centre in a project for Humanity” whichof wasKelaniya; carried out at who NIMH did artwork by Department Arts, University Kelaniya; who did benefit artwork in 10 different sites of NIMH which in 10 different sitesofofFineNIMH whichofwill visually the clients. will visually benefit the clients.

Figure 21: Annual Rehabilitation Rehabilitation Figure 21: Annual RehabilitationActivities Activities ofof Rehabilitation Centre,Centre, 2018 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Figure 22: Figure Annual22: Training AnnualActivities Trainingof Activities Rehabilitation of Rehabilitation Centre, 2018 Centre, 2018 Figure 22: Annual Figure 22: Training Annual Activities TrainingofActivities Rehabilitation of Rehabilitation Centre, 2018 Centre, 2018 22: Training Activities Rehabilitation Centre, 2018 Figure Figure Figure 22: Annual 22:Annual Annual Training Training Activities Activities ofofRehabilitation of Rehabilitation Centre, Centre, 2018 2018

1st Anniversary Event by byEvent Rotaract University of 22 1st Yearst Anniversary 1stst Year of Rehabilitation of Rehabilitation Centre Centre Event Rotaract by Rotaract Club University Club University ofColombo Colombo of Colombo 2 st 1 Anniversary Year Anniversary YearAnniversary Anniversary of Rehabilitation Rehabilitation Centre Centre Event Event by Rotaract by Club University Club University Colombo of of Colombo 2 2 1st Year 1 1Year of Rehabilitation ofofRehabilitation Centre Centre byEvent Rotaract Event byRotaract Club Rotaract University Club University ofofColombo Colombo 22

Library Library Book Book Donation Donation by Volunteers byVolunteers Volunteers Library Book Library Donation Book Donation by Volunteers by Library Book Library Donation Book Donation Donation by Volunteers by Library Book by Volunteers Volunteers

Poson Poson Bhakthi Bhakthi Gee2018 2018 Gee Poson Bhakthi Poson Gee Bhakthi Gee2018 2018 Poson PosonGee Bhakthi 2018 PosonBhakthi Bhakthi Gee 2018Gee 2018

Figure 23:23: Activities Rehabilitation Centre, 2018 Figure Figure 23: Activities Activities of of Rehabilitation of Centre, Centre, 2018 2018 Figure 23: Figure Activities 23:of Activities Rehabilitation of Rehabilitation Rehabilitation Centre, 2018 Centre, 2018 Figure 23: Activities Figure 23:ofActivities Rehabilitation of Rehabilitation Centre, 2018 Centre, 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Ward Based Rehabilitation Ward Based Rehabilitation Intermediate Ward(s) Intermediate Ward(s) Date established: 2007

Date established: 2007 Main Objective: Main Objective:

The aim of the Intermediate Ward(s) is to rehabilitate clients who are recovering from mental health

The aim of the Intermediate Ward(s) is to rehabilitate clients who are recovering from mental

problems giving psycho-social support & promoting independence. healthbyproblems by giving psycho-social support & promoting independence. Services Offered: Services Offered:       

Comprehensive inward psychiatric care. • Comprehensive inward psychiatric care. Coordination of referrals to other to specialties. • Coordination of referrals other specialties. Transfer of clients to other hospitals for interventions and/or referrals. • Transfer of clients to other hospitals for interventions and/or referrals. Rehabilitative activitiesactivities via activities daily living, skillsvocational training, social training, • Rehabilitative viaofactivities of vocational daily living, skillsskills training, social communication skills training, housekeeping training, cookery training, and money management training skills training, communication skills training, housekeeping training, cookery training, focusing on income generation. and money management training focusing on income generation. Reintegration into society placement of clients inofjobs. • Reintegration intoby society by placement clients in jobs. Management of psycho-social factors via community centric programmes. • Management of psycho-social factors via community centric programmes. Training of in-house staff and visiting medical, nursing and allied health students in psycho-social • Training of in-house staff and visiting medical, nursing and allied health students in rehabilitation of clients.

psycho-social rehabilitation of clients.

Figure 24:24: Annual Wards, 2018 Figure AnnualAdmissions Admissionsto to Intermediate Intermediate Wards, 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Long Term Ward(s) Date established: 2007 Main Objective: The aim of the Long-Term Ward(s) 22 and 27 is to engage in long term rehabilitation in those clients who are unable to be rehabilitated in an intermediate setting and those who have been successfully rehabilitated in the intermediate setting but have not found social placement yet. Services Offered: • • • •

• • • •

Comprehensive inward psychiatric care. Coordination of referrals to other specialties. Transfer of clients to other hospitals for interventions and/or referrals. Rehabilitative activities via activities of daily living, spirituality & meditation training, vocational skills training, social skills training, communication skills training, housekeeping training, cookery training, art therapy, music therapy and money management training focusing on income generation. Horticulture therapy. Reintegration into society by placement of clients in job opportunities. Management of psycho-social factors via community centric programmes. Training of in-house staff, visiting medical, nursing and allied health students in psychosocial rehabilitation of clients.

Highlights of 2018: • • • •

Clients participated in new year celebrations & avurudu celebrations. Clients celebrated Vesak Poya by making Vesak lanterns and observing sil. Clients sold the harvested fruits and vegetables in Mental Health Day stall. Ward 22 (Male Long Term) was awarded Grade A under Direct Patient Care category in Productivity Promotion competition, 2018 in NIMH.

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Villa(s) Date established: 1926 Main Objective: The aim of the Villas is to engage in paid long-term rehabilitation in those clients who are unable to be rehabilitated in an intermediate setting and have not yet found social placement. Services Offered: • • • •

Highlights of 2018: • Clients participated in new year celebrations & avurudu celebrations. • Clients celebrated Vesak Poya by making Vesak lanterns and observing sil. • Clients participated in “Annual Villa’s Day” ceremony which was organized by Villas Society.

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Halfway Home Mulleriyawa Date established: 2008 Main Objective: The aim of Halfway Home Mulleriyawa is to rehabilitate, empower and socially reintegrate female residents who have had long term institutionalized care due to mental illnesses complicated with poor family/relations support. Services Offered: • Comprehensive inward psychiatric care. • Improve quality of life and minimize their feeling of institutionalization by providing homely environment within the institution. • Developing or redeveloping life-skills need for successful social reintegration via: o Training and improving Activities of Daily Living (ADLs). o Training and improving Instrumental Activities of Daily Living (IADLs). o Increasing life experiencing of clients by gradual exposure to society & social events. o Financially empowering the possible residents by Incorporating them into income generating rehabilitation programmes (horticulture, handcraft, sewing) or providing job opportunities to suitable residents (cleaner, domestic helper). o Providing necessary support for suitable residents to live in the society independently via Community Home Project. • Reclaiming the lost civil rights of residents (provide National Identity Cards, Voting Rights) • Legal support to settle their legal issues such as marriage & properties. Highlights of 2018: • Under the programme of remodeling wards to make it more like a home structure, “Manel House” was re-opened on 2nd February 2018 by Ms Anusha Gallage, Chief Finance Officer, Hatton National Bank who sponsored this Corporate Social Responsibility project. • New Year festival for residents was held on 7th of April 2018. It was the 10th consecutive New Year festival of residents organized by Unesco Club of Royal Collage Colombo. The Principal of Royal College, Mr. B. A. Abeyrathna was the chief guest. • For the 1st time, a New Year Festival was arranged for the staff. This was held on 27th of April 2018. Staff members were divided in to 3 groups and contested in a view of improving their performance as a team.

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

AvuruduAvurudu Avurudu Celebrations Celebrations Celebrations AvuruduAvurudu Celebrations Celebrations

StaffAvurudu Avurudu Staff Avurudu Celebrations Celebrations Staff Celebrations Staff Avurudu Staff Avurudu Celebrations Celebrations

Re-opening Re-opening “Manel House” “Manel House” Re-opening Re-opening “Manel “Manel House” Re-opening “Manel House” House”

Client outing Clienttoouting Ampara to Ampara Clientouting outing Clientto to outing Ampara to Ampara Client Ampara

Figure 25:Figure Activities 25: of Activities HalfwayofHome Halfway Mulleriyawa, Home Mulleriyawa, 2018 2018 Figure 25: of Halfway Home Mulleriyawa, 2018 Figure 25:Figure Activities 25:Activities Activities of Halfway ofHome Halfway Mulleriyawa, Home Mulleriyawa, 2018 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Occupational Therapy Unit Date established: 1950s Main Objective: The aim of Occupational Therapy Unit is to provide occupational therapy service needs for inward and outpatients of NIMH. Services Offered:

• Provide relevant assessments regarding patients’ needs via: o Occupational Cognitive assessment. o Functional assessment. Therapy Unit o Skill assessment.

established: 1950s • GroupDate therapy sessions on: Main Objective: o Activities of daily living training o Social skill training. The aim of Occupational Therapy Unit is to provide occupational therapy service needs for inward and o Life skill training. o Anger management. outpatients of NIMH. o Drama therapy. o Art therapy. o Music therapy. o Reminiscence therapy. Services Offered: o Creative writing. 

Provide relevant assessments regarding patients’ needs via: o Cognitive assessment. • Engage oin Functional therapeutic activities. assessment. o Skill • Participate inassessment. home visits with multi-disciplinary team.  Group therapy sessions on: • Participate in outpatient Clinic (NHSL),therapy. Prison Clinics o Reminiscence o at AngerPsychogeriatric management. o Activities of daily living clinics o Creative writing. o Drama therapy. training (Welikada Prison), Forensic Psychiatry Clinic (NHSL), & Psychiatry Clinic at Pannipitiya o Art therapy. o Social skill training. o Music therapy. o Life skill training. Highlights of  2018: Engage in therapeutic activities.  Participate in home visits with multi-disciplinary team.  Participate in outpatient clinics at Psychogeriatric Clinic (NHSL), Prison Clinics (Welikada Prison), Forensic • Won thePsychiatry 1st place from the productivity award in 2018 (Special Units Category). Clinic (NHSL), & Psychiatry Clinic at Pannipitiya

• World Mental Health Day activities: Organizing short film competition, supporting Highlights of 2018: talent show programme, & conducting an open day at OT hall with drama therapy &  Won the 1st place the productivity award in 2018 (Special Units Category). cognitive games forfrom school children.  World Health Daycelebration, activities: Organizing short Programme film competition, supporting show & drama), • Participated Mental in new year Poson (bhakthitalent geetha programme, & conducting an open day at OT hall with drama therapy & cognitive games for school Christmas programme. children.  Participated in new programme year celebration, Poson (bhakthi geetha & drama), Christmas • Conducted a music withProgramme artist for clients. programme. • Clients visited religious institutions Kelaniya Temple, Manelwatta Temple & Kotikawatta Church. Conducted a music programme with artist for clients. • Clients for areligious day outing atKelaniya National and Viharamahadevi Park.  went Clients visited institutions Temple,Museum Manelwatta Temple & Kotikawatta Church. 

Clients went for a day outing at National Museum and Viharamahadevi Park.

Figure 26: Annual OT Sessions, 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Psychiatric Social Work Unit Date established: 1968 Main Objective: The aim of Psychiatric Social Work Unit is to enable people to manage the social factors in their lives like relationships, housing, and employment that allow them to get well and stay well by therapy, support, and advocacy. Services Offered: • Assess patients and develop client’s specific social plans of care. • Provide therapy/counseling for carers & family members to deal with client’s mental health problem. • Interviews with admitted patients, members of their families, agency staff and others, and through collateral investigations. • Help clients to get services and financial assistance from institutions and agencies like Police, Pension Department, Legal Aids and other NGO and/or government organizations. • Reviews resident and family social situations as necessary and modify social plan of care. • Provides direct crisis intervention services when required. • Maintain case records and prepare social reports. • Arrange the services from referral agencies to help patients send back to the community. • Work as a member of multidisciplinary team in community mental health programmes • Helps clients and their families to obtain financial, legal and medical services. • Provide placement of clients in jobs, rehabilitation homes, and halfway homes at low cost or free of charge. Highlights of 2018: • • • •

“SEVANA POLA” self-employment project was expanded up to the premises of ministry of health. Psychiatric Social Work Unit project organized a mobile eyepremises clinicoffor clients of NIMH.  “SEVANA POLA” self-employment was expanded up to the ministry of health.  Psychiatric Social Work Unit organized a mobile eye clinic for clients of NIMH. Coordinated the Juice Bar for World Mental Health Day  Coordinated the Juice Bar for World Mental Health Day Psychiatric Social Unithashas successfully raised over Rs. 200,000 for “Mano  Psychiatric Social Work Work Unit successfully raised over Rs. 200,000 for “Mano Mithuro” fund. Mithuro” fund.

Figure Annual Activitiesof ofPsychiatric Psychiatric Social Work Unit,Unit, 20182018 Figure 27: 27: Annual Activities Social Work

Community Psychiatry Nursing Programme

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Date established: 2010 Main Objective:

Community Psychiatry Nursing Programme Date established: 2010 Main Objective: The aim of Community Psychiatry Nursing Programme is to give psycho-social support to clients at the level of the community via psychotherapy & support. Services Offered: • Conduct Community Outreach Clinics at Gangodawila, Pannipitiya, Grandpass, Rajagiriya, Rajamalwatta, & Delgahawatta. • Conduct Prison Mental Health Service Clinics at Welikada Prison, Colombo Remand Prison, Magazine Prison, Female Prison, JMO Office, Prison Hospital, & NHSL. • Assess patients in the community and develop client’s specific plans of care. • Carry out community based day to day nursing focused on Activities of Daily Living. • Coordinate with mental health focal points in Provincial & Regional Health Service. • Provide therapy/counseling for carers & family members to deal with client mental health problem. • Maintains case records to trace defaulters, ensure follow up and detect new clients. • Arranging the services from referral agencies to help patients send back to the community. • Work as a member of multidisciplinary team in community mental health programmes. • Dispense medication at the client’s locality via depot programme across the Western Province. • Participate in clinical decision making in Ward Rounds of NIMH. Highlights of 2018: • • • • • •

Participated in National Committee Meeting, Mental Health Unit. Conducted School Programme. Played a key role in International Mental Health Nursing Conference 2018. Participated in Community Training Programme held in Thailand. Participated in counselling workshop at Foundation Institute. Conducted health camps in Pannipitya Dharmapala Vidayala, BOI World Trade Centre, Mahamathya Vidyalaya Athurugiriya, Sri Sudarshanaramaya Rajagiriya • Conducted World Mental Health Day programmes in CDs Delgahawatta, Kaduwela, & Rajagiriya. • Conducted ‘NIMH for Consumers’ workshop On World Mental Health Day.

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Ancillary Services Planning & Development Unit Planning Section Date established: 2016 Main Objective: The aim of Planning Section is to strengthen the Director in all the Hospital Planning and Development activities. Services Offered: • Focal Coordination for the Management, Development and Planning Unit of Ministry of Health. • Support in-service improvement of the institution. • Development of Annual Action Plan and other relevant plans. • Preparation of Performance reports and Progress reports. • Coordinate and Conduct Hospital Management Committee Meeting and other meetings related to Hospital Planning and Development • Management of Institutional Human resources • Preparation of Project Proposals for Hospital development. Highlights of 2018: • Development of Hospital Master Plan is ongoing from 2018 • Revision of existing Hospital Clinical Guidelines is ongoing from 2018 • Hospital Quarters were re-surveyed and redistributed to service categories according to the National Circular.

Quality Management Section Date established: 2011 Main Objective: The aim of Quality Management Section is to be the focal point of National Institute of Mental Health coordinates all Quality and Safety activities in NIMH. Services Offered: • Focal point for Directorate of Healthcare Quality & Safety, Ministry of Health. • Surveillance of clinical events and adverse events are monitored by the Quality Management Unit and send information periodically to Directorate of Healthcare Quality and Safety as per Ministry requirement.

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka



Surveillance  Surveillance of clinicalofevents clinical and events adverse andevents adverse are events monitored are monitored by the Quality by theManagement Quality Management Unit and Unit and send information send information periodically periodically to Directorate to Directorate of Healthcare of Healthcare Quality and Quality Safety and as Safety per Ministry as per Ministry requirement. requirement.  Establish  Establish and monitor andthe monitor activities the activities of 50 WITs of(Work 50 WITs Improvement (Work Improvement Team) Team) • meetings Establish monitor the activities of 50 WITs (Work Improvement Team)  Conduct  key Conduct key meetings inand quality inimprovement quality improvement • Conduct key meetings in quality improvement o Quality o &Quality Safety Steering & Safety Committee Steering Committee o Clinical o Governance Clinical Governance Meeting Meeting o Quality &Meeting Safety o Quality o Liaison Quality Nurses Liaison NursesSteering MeetingCommittee o Maintenance o Maintenance Meeting Meeting o Audits Quality Liaison Nurses Meeting  Conduct  Clinical Conduct Clinical regarding Audits regarding safety issues safety (absconding; issues (absconding; restrains,restrains, falls) for process falls) forimprovements. process improvements. o Clinical Governance Meeting Meeting HighlightsHighlights of 2018:o of Maintenance 2018: • Conduct Clinical Audits regarding safety issues (absconding; restrains, falls) for process improvements.  Conducted  Conducted EmployeeEmployee Satisfaction Satisfaction Surveys for Surveys internal forcustomers internal customers of NIMH (Doctors, of NIMH (Doctors, Nurses, Paramedical Nurses, Paramedical Staff, Psychiatric Staff, Psychiatric Social Workers, Social Workers, Health Management Health Management Assistants, Assistants, Health Drivers Health & Drivers Supportive & Supportive staff). staff). Highlights of 2018:  Conducted  Conducted Patient Satisfaction Patient Satisfaction Surveys for Surveys clientsfor ofclients Specialfor ofUnits Special andUnits Ward and discharge Ward discharge patients/relations patients/relations • Conducted Employee Satisfaction Surveys internal customers of NIMH (Doctors, to identifytobarriers identify to barriers care. to care.Staff, Psychiatric Social Workers, Health Management Assistants, Nurses, Paramedical  Conducted  Conducted 07 workshops workshops for & allSupportive categories for all categories in NIMH as in an NIMH In-Service as an In-Service programmes programmes Health07 Drivers staff).  Conducted  Conducted 07 WITs presentations 07 WITs presentations under the under theme the of theme “Awareness of “Awareness of Quality of and Quality Productivity” and discharge Productivity” for all for all • Conducted Patient Satisfaction Surveys for clients of Special Units and Ward staff. Around staff.480 Around staff 480 werestaff trained were intrained 2018. in 2018. patients/relations to identify barriers to care.  Conducted  Conducted a• Productivity a Productivity Promotion Promotion Award ceremony Award ceremony 2018. The2018. progress The progress was assessed was assessed in 3 sectors in 3assectors as Conducted 07 workshops for all categories in NIMH as an In-Service programmes • care, Conducted 07Supportive WITs under theThe theme of “Awareness Quality and Direct patient Direct patient Supportive care, care presentations & special care &units. special Theunits. assessment assessment done by qualified done byofqualified judge panel judge from panel from Productivity” for all staff. Around 480 staff were trained in 2018. National Productivity National Productivity Secretariat, Secretariat, Colombo Colombo East BaseEast Hospital, Base Hospital, Castle Street Castle Hospital Street for Hospital Women, for Women, • Conducted a Productivity Promotion Award ceremony 2018. The progress was assessed National Institute National of Institute Infectious of Infectious Diseases Diseases & NIMH. & Ward NIMH. 22 was Wardthe 22best was (“A” the best Grade) (“A”inGrade) Direct patient in Direct patient in 3 sectors as Direct patient care, Supportive care & special units. The assessment care and care Dental and Clinic Dental (“A” Clinic Grade) in (“A”among Grade) Special among Units. Special TheUnits. Record The room Record wasroom the best was (“B” the Grade) (“B”inGrade) in done byin qualified judge panel from National Productivity Secretariat, Colombo Eastbest Base Supportive Supportive Care Category. CareCastle Category. Hospital, Street Hospital for Women, National Institute of Infectious Diseases & NIMH. Ward 22 was the best (“A” Grade) in Direct patient care and Dental Clinic in (“A” Grade) among Special Units. The Record room was the best (“B” Grade) in Supportive Care Category.

Figure 28: Activities of Quality Management Section, 2018

Figure 28: Activities Figure 28:ofActivities Quality Management of Quality Management Section, 2018 Section, 2018 Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Public Health Section Date established: 2016 Main Objective: The aim of the Public Health Section is to engage in disease prevention & control as well as health promotion. Services Offered: • Supervision of the general cleanliness of the hospital • Supervision of the waste disposal system and the sewerage system & obtaining the scheduled waste license for the institution. • Monitor the cleanliness of the kitchen periodically and sanitation of the kitchen staff by screening them and liaising with the Public Health Inspector in performing tests to check the quality of food. • Assist in providing safe water to the institution by performing tests to check the quality of drinking water sources liaising with PHI. • Provide technical supervision and coordination of the activities of Infection control Nursing Officers and PHI. • Conduct infection control activities in the hospital liaising with Infection Control Nursing Officers under the supervision of Consultant Microbiologist. • Play advisory role in monthly Infection Control Liaison Nurses meetings. • Liaise with Public Health Inspector in preventive activities such as identification of dengue breeding sites, fogging activities, control flies, control bed bugs and other entomological issues. • Conduct vaccination and sterilization programme for cats and dogs in the hospital premises. Highlights of 2018: • Conducted awareness programmes for Infection Control Nursing • Conducted training programmes for cleaning service staff, liaising with Infection Control Nursing Officers. • Conducted an awareness programme on Tuberculosis to the staff. • Coordinated cat & dog vaccination and sterilization programme with Blue Paw Trust. • Coordinate the Mobile Eye Clinic by Association of Community Ophthalmologists of Sri Lanka & Rotary Club of Capital City.

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Infection Control Unit Date established: 2011 Main Objective: The aim of the Infection Control Unit is to ensure good sanitation to minimize the infections in the institution. Services Offered: • Carry out daily ward rounds by Infection Control Nursing Officer (ICNO) according the Infection Control Unit checklist. • Supervise the general hygiene, hand washing practice, and waste management. • Screen the emergence of infectious disease outbreaks other diseases like Dengue. • Conduct Wound Care Clinic with Consultant Microbiologist. • Carry out Hepatitis B Vaccination Programme which includes o Vaccinate all staff and test for HBsAb. o Vaccinate all long-term clients and other clients as much as possible. o Test HBsAb in clients whenever possible. • Carry out training programmes for Infection Control Liaison Nurses, Nursing Staff, Health Support Staff, * Cleaning Staff. • Hold monthly Infection Control Liaison Nurses meetings. • Coordinate and conduct Annual Infection Control Meeting. • Supervise sterility maintenance of equipment and sterile packs. Highlights of 2018: • Performed Hepatitis B Vaccination for 80 staff and 20 clients. • Attended to 104 clients in Wound Care Clinic. • Conducted 12 staff awareness programmes with participation by Nursing Officers and Supportive Staff.

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Disaster Management Section Date established: 2016 Main Objective: The aim of Disaster Management Section is to coordinate all the disaster management activities NIMH. Services Offered: • Ensure the disaster preparedness and safety of the institution, staff, & clients. • Preparation and implementation of the disaster preparedness and response plan for the institution. • Coordinate the Disaster Management Committee. • Coordinate with the Disaster Preparedness and Revision Division of the Ministry of Health in National Disaster Events. Highlights of 2018: • Establishment of Emergency Alert System for Halfway Home Mulleriyawa. • One day Awareness Programme on Gas Safety by Litro Gas Company was held on November 2018.

Health Informatics Section Date established: 2016 Main Objective: The aim of Health Informatics Section is to be the focal point for all data needs of NIMH. Services Offered: • Assist in preparation of Annual Action Plan, Annual Performance Report, Director’s Meeting, & various requests for data from Ministry of Health and other Ministries. • Coordinate with Consumables Division for all the hospital data forms. • Maintain digital datasets of Midnight Summary & Incident Summary. • Planning & Maintenance of Hospital Information System. • Coordinate data needs of health data systems such as eIMMR System, Admission Record Information System, Gender Based Violence Information System, HRMIS (Human Resource Management for Medical Officers), HRIS (Human Resource Information System for All Staff), MHMIS (Mental Health Management Information System) • Coordinate data needs of Clinical Governance meeting. • Assist Director to make information available for citizens as per Right to Information Act. • Compilation of Annual Report of NIMH. 46

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Highlights of 2018 • In December 2018, NIMH signed an agreement with a visiting team of psychiatrists from The Centre for Addiction & Mental Health, University of Toronto for a telemedicine/ e-learning model called ECHO (Extension for Community Healthcare Outcomes) to create a remote connection between mental health professionals in different regions.

Media Unit Date established: 2018 Main Objective: The aim of Media Unit is to coordinate all media needs of NIMH thereby reducing stigma by promotion of mental health events. Services Offered: • • • • • •

Manage all media needs of institutional events. Coordinate with external media agencies. Perform media surveillance function and address news which can affect mental health. Maintain social media presence. Coordinate website media work. Be the focal point for digital media work.

Highlights of 2018: • •

The Media Unit was formally opened on September 11th, 2018. The Media Unit has covered 27 institutional events.

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Training Unit & Research Unit Date established: 2006 (Training Unit), 2008 (Research Unit) Main Objective: The aim of Training Unit & Research Unit is to coordinate training and research activities in mental health for NIMH and National Level. Services Offered: • • • • • • • • •

Conduct monthly Ethical Review Committee (ERC) meetings. Coordinate all project proposals for training with Ministry of Health. Coordinate all logistical requirements for training that goes through the Training Unit. Conduct monthly Continuous Professional Development (CPD) programmes for Medical Officers. Conduct Journal Club for Postgraduate Trainees. Assist researchers in research submissions for ERC. Coordinate elective placements for trainees in mental health. Conduct orientation programmes on NIMH for visiting students and delegates. Facilitate & Coordinate In-Service Training Programmes

Highlights of 2018: • The Audio/Visual system was overhauled of 2 lecture halls. • The Audio/Visual system of the research auditorium was upgraded to being capable of remote learning. • Post Graduate training for Registrars and diploma trainees in Psychiatry. • 6 weeks training programme for Medical officers of Mental Health (MOMH). • Training programme on Psychiatric emergencies for the Preintern Medical Officers. • 1-day workshop on Psycho pharmacology for Registrars and diploma trainees in Psychiatry. • 2 weeks each clinical training for 3rd year medical students of University of Colombo. • 1 week each clinical training for the 3rd year medical students of University of Sri Jayawardanapura. • 2 days each training for the final year medical students of University of Kelaniya. • Professorial Psychiatric appointment for medical students of Kothalawala Defence University. • 12 In-Service training programmes (each programme consist of 3 days) conducted in each month of 2018 for the Nursing staff and Supportive staff. • 3-month training programme for the community psychiatric nurses. • 1-month clinical training for BSc nursing students of University of Ruhuna. • 1-month clinical training & theory and practical examination for BSc nursing students of University of Peradeniya. • 1-month clinical training & Viva Examination for BSc nursing students of Eastern University. • 1-month clinical training for BSc nursing students of Kothalawala Defence University followed with a clinical examination. • 6 weeks elective psychiatric training for the BSc nursing students of University of Sri Jayawardenapura • 2 days training programme for the students of Paali & Buddhist University. • Training programme on Skills development and violence prevention for the supportive staff of NIMH. • 5 weeks each clinical training for the student nurses of all the Nurses Training Schools (NTS) in Sri Lanka followed with a viva voce examination. • 2 weeks Psychiatry training programme for the student nurses of Lanka Hospital. • 2 weeks Psychiatry training programme for the student nurses of International Institute of Health Sciences (IIHS). 48

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Nutrition Nutrition Unit Unit

Date established: Date established: 2016 2016

Nutrition Unit

Main Objective: Main Objective:

aim of Nutrition is to optimize the nutritional of of patient Date established: 2016 The aim The of Nutrition Unit is toUnit optimize the nutritional status ofstatus patient NIMH.of NIMH. Main Offered: Objective: ServicesServices Offered: The aim of Nutrition Unit is to optimize the nutritional status of patient of NIMH.  Provides nutritional both in-patient and out-patient of the institute. Provides nutritional care for care bothfor in-patient and out-patient of the institute. Help to improve on nutrition among the hospital HelptoServices improve knowledge on nutrition among the hospital staff. staff. Offered:knowledge  Coordinate Food Committee NIMH. • the Provides nutritional care forof both in-patient and out-patient of the institute. Coordinate Foodthe Committee of NIMH. • Help to improve knowledge on nutrition among the hospital staff.  Supervise food hygiene in and kitchen and canteen. Supervise the foodthe hygiene in kitchen canteen. • Coordinate the Food Committee of NIMH. • Supervise Highlights of 2018: the food hygiene in kitchen and canteen. Highlights of 2018:

   

 

Highlights of 2018:  Workshops for Nutrition care circle were held with participation of officers nursing and officers and members of Workshops for Nutrition care circle were held with participation of nursing members of • Workshops for Nutrition care circle were held with participation of nursing officers and psychiatry social workers. psychiatry social workers. members of psychiatry social workers.  Workshop and patients on “බර අඩුකරන හරි මග” was held in with parallel with Nutrition Month Workshop for staff for andstaff patients “බර අඩුකරන held in parallel Nutrition Month • Workshop for staff on and patients onහරි —nrමග” wvqwas lrk yßu u`. was held in parallel with celebrations. celebrations. Nutrition Month celebrations.

Figure 29: 29: Activities of Nutrition Unit,2018 2018Unit, 2018 Figure Activities of Unit, Nutrition Figure 29: Activities of Nutrition

Kitchen Kitchen Kitchen Date established: 1926

Main Objective: Date established: Date established: 1926 1926 The aim of the kitchen is to provide healthy meals for all in-ward clients and supportive staff Main Objective: Main Objective: members. aimkitchen of the is kitchen is to provide healthyfor meals for all in-ward clients and supportive staff members. The aim The of the to provide healthy meals all in-ward clients and supportive staff members. Services Offered:

ServicesServices Offered:Offered: • Prepare and distribute meals for all in-ward clients. • Prepare and distribute meals for health assistants on duty.  Prepare and distribute meals for allpreparation. in-ward  Prepare and• distribute mealsfor for all in-ward clients. clients. Provide space donor food  Prepare and distribute meals forassistants health assistants on duty.activities as needed.  Prepare and• distribute meals for health on Provide special requirements of food forduty. institutional  Provide forfood donor food preparation.  Provide space forspace donor preparation.  Provide special requirements of food for institutional as needed.  Provide special requirements of food for institutional activitiesactivities as needed. Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Special Grade Nursing Officer’s (SGNO) Office Date established: 1926 Main Objective: The aim of Special Grade Nursing Officer’s (SGNO) Office is to be the focal point for all administrative and clinical requirements for nurses in NIMH. Services Offered: • • • •

• • • • •

Coordination of the Midnight Summary of the institution. Allocate the human resources of nurses in NIMH as per situational need. Coordinate in-service training programme for nurses. Coordinate resource persons for external training programmes NTS (Mulleriyawa), NTS of Private Hospitals, & Universities of Ruhuna, Peradeniya, Eastern, and Kotelawala Defense University. Clinical supervision of nursing at students, graduates & post-basic level. Mentor nursing activities such as in Productivity, Quality, Infection Control, & Health Education. Support in decision making on nursing matters. Played a key advisory role in International Mental Health Nursing Conference. Conduct weekly Nurse’s Journal Club.

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

School of Nursing Mulleriyawa Date established: 1961 Main Objective: The aim of School of Nursing Mulleriyawa is to provide the knowledge and practice of mental health and psychiatric nursing for the nursing officers of Sri Lanka. Services Offered: • • • • •

Coordinate training requirements of all-island student nurses for psychiatry component. Coordinate training requirements for Nursing Leaders for psychiatry component. Conduct school awareness programmes as part of training. Conduct community awareness programmes as part of training. Conduct community recreational programmes as part of training.

Category Student Nurses Nursing Officers

Male 152 49

Female 2939 28

Figure 30: Annual Summary of School of Nursing Mulleriyawa, 2018

Medical Record Room Date established: 1926 Main Objective: The aim of Medical Record Room is to preserve and manage all medical and non-medical records of NIMH. Services Offered: • Store all medical records including BHTs, investigations, forensic case reports, and clinical ledgers. • Store all non-medical records including admission records, administrative, & financial records. • Retrieve records for clinical purposes. • Retrieve medical records for legal purposes.

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Diagnostic Diagnostic Services

Services

Laboratory Department

established: 1949. Modern laboratory was established DateDate established: 1949. Modern laboratory was established in 2007. in 2007. Main Objective:

Main Objective:

The aim of Laboratory is to provide medical laboratory testing services in accordance with the applicable

The aim of Laboratory is to provide medical laboratory testing services in accordance with standards to satisfy the expectation of clinical staff and the administration. the applicable standards to satisfy the expectation of clinical staff and the administration.

Services Offered:

   

Biochemistry related testing. • Biochemistry related testing. Hematology related testing. • Hematology related testing. Microbiology related testing. • Microbiology related testing. Coordinating specimens sent to MRI, RIA, & NHSL.

• Coordinating specimens sent to MRI, RIA, & NHSL.

Figure 31: Annual Summary of Laboratory, 2018 Figure 31: Annual Summary of Laboratory, 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Electroencephalography (EEG) Unit Electroencephalography Date established: 1994(EEG) Unit Main Objective:

Date established: 1994

The aim of EEG Unit is to be the cluster centre for all EEG needs of NIMH and neighboring Main Objective: hospitals.

The aim of EEG Unit is to be the cluster centre for all EEG needs of NIMH and neighboring hospitals.

Services Offered:

Services Offered:    

• Routine EEG.

Routine EEG. EEG. • Video Video EEG. • EEG to confirm brain death of patients at ICU of NIID, and Colombo East Base Hospital, EEG to Mulleriyawa. confirm brain death of patients at ICU of NIID, and Colombo East Base Hospital, Mulleriyawa. Pediatric EEG at NIDDM Colombo East Base Hospital. • Pediatric EEG at&NIDDM & Colombo East Base Hospital.

Figure 32: ofEEG EEGUnit, Unit,2018 2018 Figure 32:Annual AnnualSummary Summary of

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Electrocardiography (ECG) Unit

Electrocardiography (ECG) Unit established: DateDate established: 2000s 2000s Main Objective:

Main Objective:

The aim of Electrocardiography (ECG) Unit is to provide all ECG needs of NIMH.

Services Offered:

 

Routine ECGs at the unit & for non-ambulatory clients are done at the client ward/unit. • Routine at the the client unit &ward/unit. for non-ambulatory clients are done at the client ward/unit. Urgent ECGs areECGs done at

• Urgent ECGs are done at the client ward/unit.

Figure 33:33:Annual ECG Unit, Unit,2018 2018 Figure AnnualSummary Summary of of ECG

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

X-Ray Department Date established: 1971 X-Ray Department Main Objective:

Date established: 1971

The aim of X-Ray Department is to provide a diligent & quality radiographic service to the

Main Objective: hospital.

The aim of X-Ray Department is to provide a diligent & quality radiographic service to the hospital.

Services Offered:

Services Offered:  

• Routine and urgent X-Rays. • Provide radiographic service to not only NIMH but also perform a cover-up function for Routine and urgent X-Rays. NIID and CEBH Mulleriyawa.

Provide radiographic service to not only NIMH but also perform a cover-up function for NIID and CEBH Mulleriyawa.

Figure 34:34:Annual of X-Ray X-RayDepartment, Department, 2018 Figure AnnualSummary Summary of 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Physiotherapy Unit

Date established: 2000s

DateMain established: 2000s Objective: Main Objective:

The aim of Physiotherapy Unit is to assist the clinical team in promoting the mobility and independence of clients at NIMH.

Services Offered:

Services Offered:       

• Routine physiotherapy. • Routing physiotherapy at ward for non-ambulatory clients. Routine physiotherapy. • Performing chest physiotherapy to obtainclients. sputum samples for investigations. Routing physiotherapy at ward for non-ambulatory • Infrared treatment. Performing chest physiotherapy to obtain sputum samples for investigations. • Ultrasound Infrared treatment.treatment. • Shorttreatment. wave diathermy treatment. Ultrasound • Muscle stimulation treatment Short wave diathermy treatment. Muscle stimulation treatment

Figure 35: Annual Physiotherapy Sessions, 2018 Figure 35: Annual Physiotherapy Sessions, 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Pharmacy Department Date established: 1926 Main Objective: The aim of Pharmacy Department is to maintain an effective supply chain of Pharmaceuticals, Surgical Consumables, Surgical Dressings, Surgical Non-Consumables, & Oxygen for the benefit of the client. Services Offered: • Outpatient dispending of drugs for OPD clients. • Indoor Pharmacy at NIMH & Halfway Home for all clients in wards and units at NIMH. • Consumable Store supplies consumable surgical items and dressings for all clients at wards and units at NIMH and Halfway Home. • Non-Consumable Surgical Section supplies & repairs non-consumable items to all wards and units. • Preparation Section supplies external preparation for all clients at wards and units. • The Local Purchase Section supplies medicines to in-ward clients on a name patient basis. • Dispense drugs in the community at outreach clinics at Pannipitiya, Kotahena, Modara, & Raiagiriya. • Coordinate Drug Therapeutic Committee meeting with Medical Supplies Division, Ministry of Health. Highlights of 2018: • In 2018, the Pharmacy Department was able to include some of non-formulary locally purchase items as formulary items making it easier to supply more costly drugs to clients. • A new Chief Pharmacist was appointed in 2018. Month

Local Purchase

Drugs

Surgical Consumable

Dressings

Non Consumable

Lotion

Dental

Oxygen

January

32127.43

661384.06

630850.32

0.00

12887.13

February

17776.78

3616261.24

146085.71

378589.21

0.00

52254.63

0.00

24634.99

March

31282.04

5662193.68

6088.08

0.00

240544.08

7245.00

0.00

9838.07

April

31833.30

1104969.84

1011870.92

378555.18

0.00

52563.66

47645.62

21199.42

May

45651.90

756741.46

26454.19

50619.90

0.00

40323.10

0.00

66572.35

June

46529.94

4327873.55

379478.85

0.00

9533.63

15790.05

138984.00

31662.87

July

10010.00

2176073.76

605821.95

125721.89

75802.68

22917.60

43991.99

104953.12

August

84295.03

2190609.02

283101.05

143639.88

446300.97

49379.40

0.00

64917.47

September

32603.43

4884423.53

1041837.47

0.00

37003.96

0.00

36523.14

October

149970.89

4228548.49

347837.46

389392.54

0.00

1817107.42

0.00

23593.03

November

38822.00

2001706.26

1286520.33

124759.97

1777775.50

6441.80

0.00

64189.40

December

24739.90

493781.54

191619.72

66849.91

333000.00

0.00

54504.15

Total

545642.64

32104566.43

5957566.05

1658128.48

2882956.86

2101026.62

230621.61

515475.14

Figure 36: Annual Summary of Pharmacy, 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Administration Department Date established: 1926 Main Objective: The aim of Administration Department is to assist the top management in human resources management, project management, and resource planning. Services Offered: • • • • • • • • • • • •

Assist Director in general administration. Administration of Overseer’s Office & Supportive Staff. Preparation of administrative returns for Ministry of Health. Manage documentation and coordinate projects as per approved Annual Action Plan. Manage documentation of utility payments for NIMH. Manage documentation of all staff needs (appointment, promotions, disciplinary, pension). Manage documentation of all dietary needs of clients warded in NIMH. Issue Internal Circulars. Manage Public Address System. Coordinate medical board. Coordinate court matters. Coordinate all transport needs of NIMH.

Inquiries & Transport Unit The Inquiries & Transport Unit plays the main administrative role for all legal and transport matters of NIMH. The office directly supports clients by managing their personal belongings when warded. In addition, the office manages telegrams received, handles police inquiries, and maintains the Admission Ledger of NIMH.

Overseer’s Office The overseer office plays the main coordinating role for all the supportive staff in the hospital managing the Health Assistant needs for wards, units, offices, mortuary, transport & maintenance units. The office plays a key role in the logistical arrangements of clients who have passed away.

Diet Branch The diet branch plays a facilitator’s role in organizing the diet orders from all the ward via receiving the diet, marking documents of patients. It also receives rail warrants of patients. In 2018, a delicious and nutritious diet was introduced to all the patients, protein control was introduced for high protein diet, & the diabetic diet was improved to help the clients with diabetes control their sugar level.

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Accounts Department Date established: 1926 Main Objective: The aim of Accounts Department is to assist the top management in financial & inventory management. Services Offered: • • • • • • • • •

Assist Director in general financial matters of NIMH. Assist Director in preparing budgetary allocations for NIMH. Preparation of financial returns for Ministry of Health. Financial management of all projects of NIMH. Financial management of all utility payments of NIMH. Financial management of staff salaries. Coordination of Technical Evaluation Committees. Coordination of Tender Boards. Coordination of Condemning Boards.

Shroff The Shroff plays the main role in physical cash management in NIMH. The Shroff is responsible for managing payment of vouchers prepared by Accounts Department, giving salaries to staff, accepting payments for paid services in NIMH, and allowing temporary deposits of monies relevant to NIMH.

Other

Telephone Exchange The telephone exchange is tasked with running the communication needs of the entire hospital. The exchange handles client inquiries, links clients with health staff and vice versa, and surveils the integrity of the internal telephone network.

Drivers The driver’s team form a vital cog of the NIMH wheel looking after every aspect of transport. They are responsible for shuttling the team for the NHSL and Community Clinics. They are also responsible for mobile client care and emergency transfers.

Maintenance Team The maintenance team looks after the day to day running repairs of NIMH under the purview of the Quality Management Unit. The team looks after general maintenance, masonry work, carpentry work, plumbing work, welding work, & electrical repairs. Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Special Activities World Mental Health Day The 2018 Annual World Mental Health Day was held under the theme of “Young People and Mental Health in a Changing World”. To commemorate this event NIMH held multiple events: • An Island Wide Inter School Debating Competition was held starting which was open to all 3 languages and all schools, government & private. This was held in NIMH as well as in Nalanda College. Parts of this event were streamed live on Facebook to promote mental health and reduce stigma. • A Short Films Competition was held on the above theme which was open to the public. 34 Short Films which were submitted to NIMH which was judged by an expert panel composed of clinical and non-clinical specialists. • An Art Competition was held which was open to clients & the paintings were exhibited. • A Care Givers Meeting and Educational Session “Suwa Sapayana Obata Diriya” was organized by the NIMH Community Psychiatric Nurses and Psychiatric Social Workers on 10.10.2018. • A Talent Show of Clients of NIMH was held on 10.10.2018. This was a very colorful and joyous event showcasing the talents of the clients of NIMH in singing and performing arts. • Vocational Training Center, a joint venture between National Apprentice and Industrial Training Authority of Sri Lanka (NAITA) and NIMH was opened by Hon. Minister of Health Dr. Rajitha Senarathne on 15.10.2018 in the presence of Chairman of NAITA, Dr. Saranga Alahapperuma, Director Mental Health, and other Health Ministry, NAITA, and NIMH officials. • The National Mental Health Helpline (1926) was officially launched by Hon. Minister of Health Dr. Rajitha Senarathne on 15.10.2018 in the presence of the Chairman of SLT, Director Mental Health, and other Health Ministry, and NIMH officials. The equipment and monthly costs for the 1926 line was generously borne by SLT in view of the national need. • Health Education Sessions were held for staff, school children and the visiting public. The session was inaugurated by a lecture by Professor Diyanath Samarasinghe on 15.10.2018. • The Open Day, Exhibition, & Closing Ceremony was held on 15.10.2018. The event included artwork done by clients, handwork exhibitions, ECT Demonstration, Nutrition Demonstrations, Sales Outlets, Free Nestomalt distribution, Street Drama, handing of awards to winners in arts, and display of short films in media center. The short film and inter-school debate awards were given at the closing ceremony held on the same day. This was a combined effort of staff from NIMH (Main Hospital), Halfway Home and School of Nursing (Mulleriyawa). 60

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Inter-School Debate Competition

Short Film Competition

Inter-School Debate Competition Inter-School Inter-SchoolDebate DebateCompetition Competition Inter-School Inter-School Debate Debate Competition Competition Debate Competition Inter-SchoolDebate DebateCompetition Competition Inter-School Inter-School Debate Competition

Short Film Competition Short ShortFilm FilmCompetition Competition Short Short Film Film Competition Competition Short Film Competition ShortFilm Competition Short Short FilmCompetition Competition

Art Competition Art Competition Art ArtCompetition Competition Competition Art Art Competition ArtCompetition Competition Art ArtCompetition Competition

Care Givers Meeting Care Givers Meeting Care CareGivers Givers Meeting Meeting Care Givers Meeting Care Meeting Care Givers Meeting CareGivers Givers Meeting Care CareGivers GiversMeeting Meeting

Talent Show Talent Show Talent TalentShow Show Talent Show Talent Show Talent Show Show Talent TalentShow Show

Opening of Vocational Training Centre Opening of Vocational Training Centre Opening Openingof ofVocational Vocational Training Training Centre Centre Opening Opening of Vocational Vocational Training Training Centre Centre Opening of Vocational Training Centre Openingof of Vocational Training Centre Opening OpeningofofVocational VocationalTraining TrainingCentre Centre

Opening of National Mental Health Helpline Opening of National Mental Health Helpline Opening Opening of ofofNational National Mental Health Health Helpline Helpline Opening NationalMental Mental Health Opening Opening of of National National Mental Mental Health Health Helpline Helpline Mental HealthHelpline Helpline Opening OpeningofofNational NationalMental MentalHealth HealthHelpline Helpline

Education EducationSessions Sessions Education Education Sessions Sessions Education Education Education Sessions Sessions EducationSessions Sessions Education EducationSessions Sessions

Street Drama Sales Outlets Street Drama Sales Street Drama SalesOutlets Outlets Street StreetDrama Drama Sales SalesOutlets Outlets Street Drama Drama Sales Outlets Outlets Street Drama Sales Outlets Figure 37: Activities of World Mental Health Day, 2018 Sales Figure Activities of World Mental Health Day, 2018 Figure 37:37: Activities of World Mental Health Day, 2018 Street StreetDrama Drama Sales SalesOutlets Outlets Figure Figure37: 37:Activities ActivitiesofofWorld WorldMental Mental Health Health Day, Day, 2018 2018 Figure Figure37: 37:Activities Activitiesof ofWorld WorldMental MentalHealth HealthDay, Day,2018 2018 Figure 37: Activities of World Mental Health Day, 2018 Figure Figure37: 37:Activities ActivitiesofofWorld WorldMental MentalHealth HealthDay, Day,2018 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

International Mental Mental Health Health Nursing Nursing Conference Conference International International Mental Health Nursing Conference

International Mental Health Nursing Conference

The The National National Institute Institute of of Mental Mental Health, Health, involving involving all all stakeholders stakeholders recorded recorded aa historic historic event event in in July July 19-21 19-21 The National Institute of Mental Health, involving all stakeholders recorded a historic event in July 19-21 2018 by the first for profession mental titled National Mental conference Health, involving all stakeholders recorded a historic 2018The by holding holding theInstitute first ever everofresearch research conference for the the nursing nursing profession in in mental health, health, titledevent 2018 by holding the first ever research conference for the nursing profession in mental health, titled in July 19-21 2018 by holding the first ever research conference for the nursing profession in ‘International ‘International Mental Mental Health Health Nursing Nursing Conference’. Conference’. This This was was aa landmark landmark event event which which attracted attracted not not only only the the ‘International Mental Health Nursing Conference’. This was a landmark event which attracted not only the mental health, titled ‘International Mental Health Nursing Conference’. This was a landmark support of also and health This was by Minster support of nurses nurses but also doctors doctors and allied allied health professionals. professionals. This also was officially officially opened by Hon. Hon. Minster event which but attracted not only the support of nurses but doctorsopened and allied health support of nurses but also doctors and allied health professionals. This was officially opened by Hon. Minster professionals. This was officially opened by Hon. Minster of Health. The event which was of Health. The event which was spread over 3 days had all the features of a research conference such of Health. The event which was spread over 3 days had all the features of a research conference such as as of Health. The event which wasallspread over 3 days had all the conference features of a such research conference such as spread over 3 days had the features of a research as Official Conference Official Conference Website, Abstract Book, Poster Keynote Sessions and Oral Presentations Official Conference Website, Abstract Book, Poster Presentations, Presentations, Sessions Presentations Website, Abstract Book, Poster Presentations, KeynoteKeynote Sessions and and OralOral Presentations Official Conference Website, Abstract Book, Poster Presentations, Keynote Sessions and Oral Presentations by local as well as foreign dignitaries. Over 50 submissions were received in this inaugural conference with by local asaswell as foreign dignitaries. Over 50 submissions were received in conference this inaugural by local as well foreign dignitaries. Over 50 submissions were received in this inaugural with by local as well as foreign dignitaries. Over 50 submissions were received in this inaugural conference with conference with future conferences being planned biennially. future future conferences conferences being being planned planned biennially. biennially. future conferences being planned biennially.

Registration Registration Registration Registration

Opening Ceremony Opening Ceremony Opening Ceremony Opening Ceremony

Lecture Lecture in Progress Lecture in in Progress Progress Lecture in Progress

Crowd Conference Crowd at IMHN Conference Crowdat at IMHN IMHN Conference Crowd at IMHN Conference

Poster Presentation Presentation Poster PosterPresentation Presentation Poster

Awarding of of Certificates Certificates Awarding Awarding of Awarding of Certificates Certificates

Figure 38: of International Mental Health Nursing Conference, 2018 Figure 38: Activities Activities of of International HealthNursing Nursing Conference, Figure 38: Activities International Mental Mental Health Conference, 20182018 Figure 38: Activities of International Mental Health Nursing Conference, 2018

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Special Projects&& &Staff StaffWelfare Welfare Activities Special SpecialProjects Projects Staff Welfare Activities Activities Special Projects & Staff Welfare Activities Special SpecialProjects Projects&&Staff StaffWelfare WelfareActivities Activities

Special Projects & Staff Welfare Activities

Pirith Pirith Ceremony PirithCeremony Ceremony Pirith Ceremony Pirith Pirith Ceremony Ceremony Pirith Ceremony Pirith PirithCeremony Ceremony

Volunteer Volunteer Music Music Programme Programme Volunteer Music Programme Volunteer Music Programme Volunteer Volunteer Music Music Programme Programme Volunteer Music Programme Volunteer VolunteerMusic MusicProgramme Programme

International International Women’s Day Day Debate Debate International International Women’s Women’s Day Day Debate Debate InternationalWomen’s Women’s Day Debate International Women’s Day Debate International Women’s Day Debate International InternationalWomen’s Women’sDay DayDebate Debate

Volunteers Volunteers from from Rotaract Rotaract Club Club Volunteers Volunteers from from Rotaract Rotaract Club Club Volunteers from Rotaract Club Volunteers from Rotaract Club Volunteers from Rotaract Club Volunteers Volunteersfrom fromRotaract RotaractClub Club

st st 1 Anniversary ofRehabilitation Rehabilitation Centre 11stst1 1ststAnniversary Anniversary Anniversaryof of Rehabilitation RehabilitationCentre Centre Centre Anniversary ofof Centre st st 1st Anniversary ofRehabilitation Rehabilitation Centre Anniversary of Rehabilitation Centre 11 Anniversary Anniversary ofof Rehabilitation Rehabilitation Centre Centre

Retirement Retirement of Dr. Jayan Mendis Retirement Retirementof of ofDr. Dr. Dr.Jayan Jayan JayanMendis Mendis Mendis Retirement of Dr. Jayan Mendis Retirement ofofDr. Jayan Mendis Retirement of Dr. Jayan Mendis Retirement Retirement of Dr. Dr. Jayan Jayan Mendis Mendis

World World TB Day Lecture WorldTB Lecture World World TB TBDay Day DayLecture Lecture Lecture World TB Day Lecture World World TB TB Day Day Lecture World TB DayLecture Lecture

Opening Opening Adolscent Play Play Area Area Opening ofof Adolscent Play Area Opening Openingof of ofAdolscent Adolscent Adolscent Play Play Area Area Opening of Adolscent Play Area Opening Opening of of Adolscent Adolscent Play Play Area Area Opening of Adolscent Play Area Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Wesak WesakProgramme Programme Wesak Wesak Programme Programme Wesak Programme Wesak Wesak Programme Programme Wesak WesakProgramme Programme

Dharma Dharma Desanava Desanava for for clients clients andand staffstaff Dharma Dharma Desanava Desanava for forclients clientsand and andstaff staff staff Dharma Desanava for clients Dharma Dharma Desanava Desanava for for clients clients and and staff staff Dharma DharmaDesanava Desanavafor forclients clientsand andstaff staff

Opening Opening of ofTransport TransportRoom RoomininHalfway HalfwayHome Home Opening OpeningofofTransport TransportRoom RoomininHalfway HalfwayHome Home Opening Opening of of Transport Transport Room Room in Halfway Halfway Home Home Opening TransportRoom Room inin Halfway Opening Opening of ofof Transport Transport Roomin inHalfway HalfwayHome Home Home

Cleaning Cleaning Service Service Training Training Cleaning CleaningService ServiceTraining Training Cleaning Cleaning Service Service Training Training Cleaning Service Training Cleaning CleaningService ServiceTraining Training

Animal AnimalSterilsation Sterilsationfor forPublic PublicHealth Health Animal AnimalSterilsation Sterilsationfor forPublic PublicHealth Health Animal Animal Sterilsation Sterilsation for for Public Public Health Health Animal AnimalSterilsation Sterilsationfor forPublic PublicHealth Health Animal Sterilsation for Public Health

Poson Poson Dansala Dansala Poson PosonDansala Dansala Poson Poson Dansala Dansala Poson PosonDansala Dansala

Opening Opening of ofForensic ForensicGym Gymfor forclients clientsand andstaff staff Opening ForensicGym Gymfor for clients Opening Opening ofofofForensic Forensic Gym forclients clientsand and andstaff staff staff Opening Opening of of Forensic Forensic Gym Gym for for clients clients and and staff staff Opening OpeningofofForensic ForensicGym Gymfor forclients clientsand andstaff staff

Nutrition Nutrition Awareness Awareness Programme Programme Nutrition Awareness Awareness Programme Nutrition Nutrition Awareness Programme Programme Nutrition Nutrition Awareness Awareness Programme Programme Nutrition NutritionAwareness AwarenessProgramme Programme

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Poson Dansala

Avurudu Celebrations Avurudu Celebrations

Avurudu Avurudu Celebrations Celebrations

Avurudu Avurudu Celebrations AvuruduCelebrations Celebrations Avurudu Avurudu Celebrations AvuruduCelebrations Celebrations Avurudu Celebrations

Avurudu AvuruduCelebrations Celebrations Avurudu Celebrations Avurudu Avurudu Celebrations AvuruduCelebrations Celebrations Avurudu Celebrations

Productivity Awards Productivity Awards

Book Diviyata’ BookLaunch Launch ‘Suwa Diviyata’

Productivity ProductivityAwards Awards Productivity Productivity Awards ProductivityAwards Awards Productivity Awards Productivity Awards

Book BookLaunch Launch‘Suwa ‘SuwaDiviyata’ Diviyata’ Book Book Launch ‘Suwa Diviyata’ Book Launch ‘Suwa Diviyata’ BookLaunch Launch‘Suwa ‘SuwaDiviyata’ Diviyata’ Book Launch ‘Suwa Diviyata’

Opening of New Mortuary Building Opening of New Mortuary Building Opening OpeningofofNew NewMortuary MortuaryBuilding Building Opening Opening ofof New New Mortuary Mortuary Building Building Opening of New Mortuary Building Opening of New Mortuary Building Opening of New Mortuary Building

Productivity Productivity Workshop Workshop Productivity ProductivityWorkshop Workshop Productivity Productivity Workshop Workshop Productivity Workshop Productivity Workshop Productivity Workshop

Mobile Eye Clinc LaunchLaunch ECHO eLearning/Telemedicine Programme Mobile Eye Clinc Launch ofofECHO eLearning/Telemedicine Programme Mobile Eye Clinc ofeLearning/Telemedicine ECHO eLearning/Telemedicine Mobile Mobile Eye EyeClinc Clinc Launch LaunchofofECHO ECHO eLearning/Telemedicine Programme Programme Mobile Mobile Eye Clinc Launch Launch ofECHO ECHO eLearning/Telemedicine Programme MobileEye EyeClinc Clinc Launchof ECHOeLearning/Telemedicine eLearning/TelemedicineProgramme Programme Mobile Eye Clinc Launch ofofECHO eLearning/Telemedicine Programme Figure 39: Special Activity Highlights of NIMH, 2018 Figure 39: 39: Special Activity ofNIMH, NIMH, 2018 Figure Special ActivityHighlights Highlights of 2018 Figure Figure 39: 39:Special Special Activity Activity Highlights Highlightsof ofNIMH, NIMH, 2018 2018 Figure Figure39: 39:Special SpecialActivity ActivityHighlights HighlightsofofNIMH, NIMH,2018 2018 Figure39: 39:Special SpecialActivity ActivityHighlights HighlightsofofNIMH, NIMH,2018 2018 Figure

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Annexures I: Cadre Details of NIMH National Institute of Mental Health Director Deputy Director Consultant Medical Officer Dental Surgeon SGNO Accountant Administrative Officer Ward Sister Nurse PSW Occupational Therapist Medical Laboratory Technologist Physiotherapist Radiographer Pharmacist Dispenser Development Assistant PHI EEG recordist Cardiographer Development Officer Information and Communication Technology Assistant Public Management Assistant Ward Clerk Nutritionist Diet Stewards House Warden Health Driver Telephone Operator Hospital Overseer Cook Lab Orderly Seamstress Plumber Attendant Supportive staff 66

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Approved Cadre 01 01 10 66 03 06 01 02 04 383 09 09 06 02 02 06 03 07 01 02 02 10 01 44 12 01 03 04 11 03 08 20 02 02 01 250 444

In Position 01 01 68 03 00 03 01 00 05 373 10 11 06 02 02 07 02 00 01 02 02 11 02 29 07 02 02 03 12 02 07 09 02 02 01 150 305

Halfway Home, Mulleriyawa Medical Officer SGNO Nurses Occupational Therapist Nutritionist Diet stewards Hospital Overseer Cook Telephone Operator Attendant Supportive Staff Nurses Training School

Principal Senior Nursing Tutor Nursing Tutor Clinical instructor Librarian PMA House Warden Health Driver Cook Supportive Staff

Approved Cadre 04 01 64 02 01 01 02 04 00 42 29

In position 04 00 61 00 01 01 02 02 01 23 09

Approved Cadre 01 06 03 00 01 01 04 01 03 09

In Position 00 01 03 00 00 01 01 01 01 10

Totals Per Category Director 1 PSW Deputy Director 1 Occupational Therapist Consultant 12 MLT Medical Officer 72 Physiotherapist Dental Surgeon 3 Radiographer SGNO 3 Pharmacist Principal (NTS) 1 Development Assistant Accountant 1 PHI Administrative Officer 0 EEG recordist Ward Sister 5 Cardiographer Senior Nursing Tutor 1 Development Officer Nurse 434 ICT Assistant Nursing Tutor 03 PMA Clinical Instructor 00 Ward Clerk

10 11 2 2 2 7 0 1 2 2 11 2 30 7

Nutritionist Diet Stewards House Warden Health Driver Telephone Operator Hospital Overseer Cooks Lab Orderly Seamstress Attendant Supportive staff

3 2 4 13 3 9 12 02 2 173 324

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Annexures II: Research Submitted to Ethical Review Committee, 2018 88/01/18 89/01/18 90/01/18 91/01/18 92/01/18 93/02/18 94/02/18 95/02/18 96/02/18 97/03/18 98/03/18 99/03/18 100/03/18 101/03/18 102/03/18

103/03/18 104/04/18 105/04/18

Antidepressant effects of Ketamine infusion in treatment Resistant Depressive Disorder – A Randomized Placebo Controlled Add-on Trial. Compliance and its associated factors among patients in Psychiatric unit at Teaching Hospital Anuradhapura. Frailty in Dementia patients presenting to National Institute of Mental Health (NIMH) and memory clinic at the National Hospital Sri Lanka (NHSL) Evaluation of factors associated with burnout among nurses working in National Institute of Mental Health, Sri Lanka. Prevalence and the degree of burnout in doctors of five major specialties and associated factors in teaching hospitals associated with Faculty of Medicine, University of Colombo. Patient experience on the delivery of health care at the National Institute of Mental Health, Sri Lanka Families’ perception of community mental health services for their relatives in a selected group of patients followed up in the community by the National Institute of Mental Health, Sri Lanka. Identify perceived challenges of nurses working in National Institute of Mental Health, Sri Lanka. Knowledge and attitudes regarding mental illness among caregivers of patients attending Pannipitiya outreach mental clinic in Sri Lanka. Student nurses attitudes and perception towards the people with mental illnesses Prevalence of Gender based violence at the workplace among selected groups of female staff at the National Institute of Mental Health, Sri Lanka. Knowledge and attitudes among health support staff about caring for patients with mental illness at the National Institute of Mental Health, Sri Lanka. Inter-professional collaboration between multi-disciplinary team members at the National Institute of Mental Health – Sri Lanka. Employee satisfaction of selected staff at half-way home, Mulleriyawa, Sri Lanka. The Implementation of the Modified Disbursement Linked Indicators of the Health Care Quality and Safety Directorate of the Ministry of Health (DLI 7) at the National Institute of Mental Health, Sri Lanka and Half Way Home, Mulleriyawa. Employee satisfaction of selected staff at the National Institute of Mental Health, Sri Lanka. Community psychiatric Nursing in Sri Lanka. A Description To assess the knowledge skills and attitudes on Psychological counseling of nursing officers in Psychiatric units and hospital in Sri Lanka.

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

106/04/18 Assess the problems of care givers of persons with mental illnesses who are currently admitted in National Institute of Mental Health, Sri Lanka. 107/05/18 An evaluation of the effects of a psycho education program on personal wellbeing of forensic psychiatry patients with psychosis. 108/05/18 Prevalence of malnutrition among long term Psychiatric patients at the National Institute of Mental Health, Sri Lanka. 109/05/18 Prevalence of malnutrition among patients admitted to the National Institute of Mental Health, Sri Lanka. 110/05/18 Trends and associated factors for readmission patient with mental illness in National Institute of Mental Health, Sri Lanka. 111/05/18 Nurses attitudes towards mentally ill people in National Institute of Mental Health, Sri Lanka. 112/06/18 Prevalence of burnout its associations and coping strategies of health care assistants of National Institute of Mental Health, Sri Lanka. 113/07/18 Knowledge, attitude and associated factors on healthy ageing among nurses aged 40-60 years in teaching hospitals of Colombo district 114/09/18 Surveillance of MRSA colonization on environmental surfaces and patient care equipment in selected wards of National Institute of Mental Health Sri Lanka 115/09/18 Pathways to Psychiatric care, factors determining different pathways taken and social and economic costs of associated with alternate pathways in patients presenting for the first time to the clinics and out-patient department of National In statute of Mental Health Sri Lanka 116/11/18 Evaluation of the Psychiatric Nursing curriculum of Nursing students (Diploma), using SIPP MODEL 117/11/18 Survey of prevalence of Depression and Anxiety among transgender people, attending gender dysphoria clinic at National Hospital of Sri Lanka 118/12/18 An empirical investigation of factors influencing retention of medical officers in the preventive health sector 119/12/18 Prevalence and risk factors of non-communicable diseases among health care workers in National Institute of Mental Health Sri Lanka

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Annexures III: Annual Financial Report of NIMH. 2018 National Institute of Mental Health, Unit II Mulleriyawa, NTS Mulleriyawa Financial Expenditure (Recurrent) - 2018 Object Code

Allocation

Expenditure in Year 2018

Surcharge

Savings

Exp %

Recurrent Expenditure

1,242,843,366.00

1,200,660,678.54

9,693,326.02

51,876,013.48

95.86

Total

Personal Emoluments

908,597,866.00

905,002,968.61

8,995,703.02

12,590,600.41

98.63

1001

Salaries and Wages

403,013,550.00

401,665,756.44

5,395,518.29

6,743,311.85

98.35

1002

Overtime and Holiday Payments

261,720,282.00

260,831,457.99

366,296.06

1,255,120.07

99.52

1003

Other Allowances

243,864,034.00

242,505,754.18

3,233,888.67

4,592,168.49

98.14

Total

Travelling Expenses

800,000.00

742,198.74

300.00

58,101.26

92.74

1101

Domestic

800,000.00

742,198.74

300.00

58,101.26

92.74

Total

Supplies

139,443,000.00

118,135,423.19

70,186.24

21,377,763.05

84.68

Grand Total

Description

1201

Stationery and Office Requisites

3,027,000.00

2,950,808.27

76,191.73

97.48

1202

Fuel

3,660,000.00

3,208,888.93

936.00

452,047.07

87.65

1203

Diets and Uniforms

110,100,000.00

97,741,895.82

58,450.00

12,416,554.18

88.73

Diets

110,000,000.00

109,518,881.81

58,450.00

539,568.19

99.51

Uniforms

1204

Medical Supplies

100,000.00

15,000,000.00

7,655,681.81

7,344,318.19

51.04

1205

Other

7,656,000.00

6,578,148.36

10,800.24

1,088,651.88

85.80

Total

Maintenance and Expenditure

19,166,000.00

18,300,928.50

22,600.00

887,671.50

95.37

1301

Vehicles

7,149,000.00

7,144,319.94

15,390.00

20,070.06

99.72

1302

Plant and Machinery

947,000.00

743,392.02

7,210.00

210,817.98

77.91

1303

Buildings and Structures

11,070,000.00

10,413,216.54

656,783.46

94.07

Total

Services

169,174,500.00

154,749,310.27

597,444.47

15,022,634.20

91.15

1401

Transport

652,500.00

468,500.00

184,000.00

71.80

1402

Postal and Communication

6,581,000.00

6,582,923.17

4,154.37

2,231.20

99.97

1403

Electricity and Water

51,841,000.00

47,527,449.60

468,493.10

4,782,043.50

90.86

Electricity

16,800,000.00

15,087,359.85

1,712,640.15

89.81

Water

30,041,000.00

28,204,359.75

468,493.10

2,305,133.35

92.44

Gas

5,000,000.00

4,235,730.00

764,270.00

84.71

1404

Rents and Local Taxes

1409

Other

100,000.00

46,000.00

54,000.00

46.00

110,000,000.00

100,124,437.50

124,797.00

10,000,359.50

90.92

Security

10,970,000.00

7,874,854.78

3,095,145.22

71.79

Cleaning Services

89,850,000.00

83,955,346.42

124,797.00

6,019,450.58

93.31

Others

9,180,000.00

8,294,236.30

885,763.70

90.35

Total

Transfers

5,662,000.00

5,405,822.82

7,092.29

263,269.47

95.36

1506

Property Loan Interest to Public Servants

4,467,000.00

4,267,174.91

6,092.29

205,917.38

95.40

1508

Other

1,195,000.00

1,138,647.91

1,000.00

57,352.09

95.20

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

National Institute of Mental Health, Unit II Mulleriyawa, NTS Mulleriyawa Financial Expenditure (Capital) – 2018 Description

Allocation Received

Expenditure in year 2018

Surcharge

Savings/ (Excess)

Capital Expenditure

121,286,094.1

81,532,184.41

327,857.45

40,081,767.14

Object code 111-01-05-2001(11)

Rehabilitation and Improvement of Buildings

72,204,665.47

49,229,820.76

22,974,844.71

111-02-11-1-2001(11)

Rehabilitation and Improvement of Buildings in NTS

5,000,000.00

2,947,793.57

2,052,206.43

Purchasing of Office Equipment’s and Household Items - NIMH

10,996,166.00

9,854,306.56

2,141,859.44

Purchasing of Office Equipment’s and Household Items - Unit II Mulleriyawa

1,000,000.00

Purchasing of Hospital Equipment’s - NIMH

5,691,400.00

6,630,438.75

60,961.25

Purchasing of Hospital Equipment’s - Unit II Mulleriywa

1,000,000.00

111-02-13-02-2401(12)

Capacity building of institutional staff on healthcare quality & Safety

303,000.00

305,062.00

4,260.00

2,198.00

111-02-11-1-2401(11)

In-service training programmes

4,290,240.00

2,622,075.00

323,597.45

1,991,762.45

Master of Public Management Course

280,000.00

111-02-14-20-2509(11)

Purchasing of Emergency Alert System

1,000,000.00

111-02-13-02-2509(12)

World Mental Health Day

1,200,000.00

1,162,753.00

37,247.00

International MH conference

300,000.00

272,201.00

27,799.00

Purchasing items for NTS Mulleriyawa

823,975.00

811,825.00

111-02-13-13-210311(04)

Purchasing Laboratory Equipment’s

510,000.00

111-01-05-0-2103(11)

Purchasing of AC

6,647,645.00

1,044,545.00

5,603,100.00

111-02-13-142-2103(11)

Re engineering of information System

3,084,921.50

1,085,429.00

1,999,492.50

111-01-05-0-2002(11)

Repairing Medical Equipment’s

500,000.00

427,110.00

72,890.00

Establish Internal Telephone Lines

4,891,281.15

3,147,654.78

1,743,626.37

Medical Supplies - Capital

569,250.00

495,000.00

74,250.00

Purchasing items for Forensic Rehabilitation Unit

400,000.00

241,050.00

158,950.00

111-02-13-11-2103(11)

Purchasing medical equipment’s

333,000.00

111-02-11-1-2102(11)

Mulleriyawa Nurses hostel opening ceremony/ Purchasing NTS items

260,549.98

132,119.99

128,429.99

111-01-05-0-2102 (11)

111-02-13-13-2103 (11)

111-02-13-02-2102(12)

111-02-13-13-2103(01) 228-01-01-2102

12,150.00

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Acknowledgements Chief Editor Dr Kapila Wickramanayake (Director) Co-Editors Dr Dhammika Wijesekara (Deputy Director) Dr Mohamed Rikaz Sheriff Dr Upeka Mettananda Dr Sujani Perera Data Collection Mrs. Nishani Chaturika Special Thanks Organizing Committee, World Mental Health Day, 2018 Dr Kapila Wickramanayake, Director Dr. Jayananda Horadugoda Dr. Mahesan Ganeshan Dr. Renuka Jayasinghe Dr. Saman Weerawardana Dr. Pushpa Ranasinghe Dr. Kapila Ranasinghe Dr. Sajeewana Amarasinghe Dr. Lushan Hettiarachchi Dr. Ganesha Liyanarachchi Dr. Dinuka De Silva Dr. Malka Dassanayake Dr. Upeka Mettananda Dr. Asangika Morathanna Dr. Thanuja Gunasekara Dr. Janaka Weeragalle Matron Sandhya Padmarani Mrs. WM KamanI Mr. Tissa Gamini

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka

Central Organizing Committee, International Mental Health Nursing Conference, 2018 CNO Mrs. Pathmarani SGNO Mrs. Ruwangani SGNO Mrs. Dhammika Secretary, Mrs. Piumi Ekanayake Vice-President. Mrs. Samanthi Treasurer, Mrs. Uditha Psychiatric Nurses Association: Mr. Samanpriya, Mrs. Sakunthala, & Mr. Sumal Training of Trainers: Mrs. Ranitha, Mrs. Lalani, & Mr. Wickramasinghe CPN, Ms. Migunthenna Nursing Master, Mr. Ananda Nursing Sister, Mrs. Jeewika NIC QMU, Ms. Erandi Media: NIC Navodaya, Mr. Bandara Organizing Committee, NIMH Productivity Awards, 2018 Dr. Kapila Wickramanayake Dr. Athula Krishanth Maddage Dr. Thanuja Siriwardene NIC QMU, Ms. Erandi Sincere thanks to all categories of staff who gave us the content without which an Annual Report is not possible. A special mention must be made of Dr Arosha Wijewickrama for his invaluable assistance at International Mental Health Nursing Conference & NIMH Productivity Awards. Our thanks to NIC Training, Mr Samanpriya & NIC Navodaya, Mr. Bandara for their historical knowledge of NIMH.

Annual Report - 2018 National Institute of Mental Health Ministry of Health - Sri Lanka