NATIONAL INSTITUTE OF MENTAL HEALTH SRI LANKA: INSTITUTIONAL GUIDELINES
Mental Diseases Ordinance (Mental Health Act of Sri Lanka) NIMH admissions and patient care is governed under the Mental Diseases Ordinance (Last amended as Act 27 of 1956). The current Mental Diseases Ordinances is given as Annexure I in Section F . Voluntary Admissions Voluntary Admissions are possible under Section 23 of Mental Diseases Ordinance, An individual should be age sixteen or above to request for voluntary admission. This request is made on the H 68 Form. The Admitting Officer should be satisfied that the voluntary admissions is beneficial to the patient and that he/she has the mental capacity to request admission. For those below sixteen years of age if the guardian is requesting admission it needs recommendation of a Medical Officer. Involuntary (Temporary) Admissions Temporary Admissions which are involuntary can be made to NIMH based under Section 28 of the Mental Diseases Ordinance. As per the current practice the Admitting Officer should invoke the Section 28 by filling out the H82 form. This form can be filled by Any Medical Officer allocated for that duty by the Director who has a valid Sri Lanka Medical Council license under section 29 of the Medical Ordinance. As the Ordinance requires two independent signatures the second signature should be made by the Medical Officer of the Ward within 24 hours of admission after an independent assessment of the patient. . All Temporary admissions must be seen by the Consultant Psychiatrist or Unit Senior Registrar or the On Call Senior Registrar within 48 hours of admission. The temporary admission order once affirmed by the Senior Review remains valid for a period of 01 year. When a patient is admitted as a temporary order there should be an application made for admission by the spouse or close relative (next of kin). In the event the spouse or close relative is not available any acceptable person can make the application provided adequate reason is given in writing as to why the next of kin is not available. The Judgment for Involuntary Admission should be done so based on following criteria: 1. The Patient appears to be suffering from mental illness 2. The patient‘s mental illness requires IMMEDIATE TREATMENT 3. The patient's mental illness can be treated by admission to hospital and treatment is not available in a LESS RESTRICTIVE SETTING 4. Admission to hospital is required for: a. The patient‘s health and safety and b. To prevent deterioration of patient‘s mental or physical state and/or c. For the safety of members of the public 5. The patient has refused or is unable to consent to treatment The Protocol to follow in Involuntary Admission 1. Ensure the patient‘s medical and psychiatric needs are catered for (i.e. Complete the Psychiatric Case Sheet and initial treatment - H8 Form and if needed PICU Form 2. Ensure the request for admission of a person to an approved mental health unit is filled by next of kin/ other representative 3. Complete the recommendation for admission of a person involuntarily
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