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ANNUAL REPORT – 2020
NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
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Annual Report 2020
National Institute of Mental Health Ministry of Health - Sri Lanka
ANNUAL REPORT – 2020
NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
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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 client care, capacity building, advocacy, community engagement, multi-sector collaboration and research delivered by competent and reliable staff
ANNUAL REPORT – 2020
NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
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ANNUAL REPORT – 2020
NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
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Table of Contents Director’s Message .............................................................................................................................................. 8 Services Offered at NIMH .................................................................................................................................. 10 NIMH response to Covid-19 ............................................................................................................................... 11 Outpatient Services............................................................................................................................................ 15 Outpatient Department & Psychiatric Intensive Care Unit ........................................................................... 15 Out-Patient Clinics ......................................................................................................................................... 15 Dental Unit ..................................................................................................................................................... 16 Navodaya (Day Treatment Centre) ................................................................................................................ 17 Day ECT Centre............................................................................................................................................... 18 Gender Based Violence Prevention Unit ....................................................................................................... 19 National Mental Health Helpline – 1926 ....................................................................................................... 21 Inpatient Services............................................................................................................................................... 23 Inward Acute Care ......................................................................................................................................... 23 Forensic Psychiatry Unit................................................................................................................................. 25 Psycho-Geriatric Unit ..................................................................................................................................... 26 Adolescent Psychiatry Unit ............................................................................................................................ 27 Perinatal Psychiatry Unit................................................................................................................................ 28 Learning Disability Unit .................................................................................................................................. 29 ECT Unit.......................................................................................................................................................... 30 Isolation Unit .................................................................................................................................................. 31 Medical Ward................................................................................................................................................. 32 Rehabilitative Services ....................................................................................................................................... 33 Day Rehabilitation Service ............................................................................................................................. 33 Rehabilitation Centre ..................................................................................................................................... 34 Ward Based Rehabilitation ............................................................................................................................ 35 Intermediate Ward(s) ................................................................................................................................ 35 Occupational Therapy Unit ............................................................................................................................ 36 Horticulture Therapy Unit .............................................................................................................................. 37 Long Term Ward(s)..................................................................................................................................... 39 Villa(s)......................................................................................................................................................... 39 Halfway Home Mulleriyawa ....................................................................................................................... 40 Psychiatric Social Work Unit .......................................................................................................................... 41 Community Psychiatry Unit ........................................................................................................................... 42
ANNUAL REPORT – 2020
NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
6 Ancillary Services ............................................................................................................................................... 43 Planning & Development Unit ....................................................................................................................... 43 Planning Section ......................................................................................................................................... 43 Quality Management Section .................................................................................................................... 43 Public Health Section & Public Health Inspector ....................................................................................... 44 Disaster Management Section ................................................................................................................... 45 Health Informatics Section......................................................................................................................... 45 Infection Control Unit ................................................................................................................................ 46 Health Promotion Unit ............................................................................................................................... 47 Computer Maintenance Unit ..................................................................................................................... 48 Media Unit ..................................................................................................................................................... 48 Training Unit & Research Unit ....................................................................................................................... 49 Nutrition Unit ................................................................................................................................................. 51 Kitchen ........................................................................................................................................................... 51 Special Grade Nursing Officer’s (SGNO) Office .............................................................................................. 52 School of Nursing Mulleriyawa ...................................................................................................................... 53 Medical Record Room .................................................................................................................................... 54 Diagnostic Services......................................................................................................................................... 55 Laboratory Department ............................................................................................................................. 55 Electroencephalography (EEG) Unit........................................................................................................... 56 Electrocardiography (ECG) Unit ................................................................................................................. 57 X-Ray Department...................................................................................................................................... 58 Physiotherapy Unit ........................................................................................................................................ 59 Pharmacy Department ................................................................................................................................... 60 Administration Department........................................................................................................................... 61 Inquiries & Transport Unit ......................................................................................................................... 61 Overseer’s Office........................................................................................................................................ 61 Diet Branch................................................................................................................................................. 61 Accounts Department .................................................................................................................................... 62 Shroff.......................................................................................................................................................... 62 Other .............................................................................................................................................................. 63 Telephone Exchange .................................................................................................................................. 63 Drivers ........................................................................................................................................................ 63 Maintenance Team .................................................................................................................................... 63 Special Activities ................................................................................................................................................ 64 Annexures I: Cadre Details of NIMH .................................................................................................................. 67 ANNUAL REPORT – 2020
NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
7 Annexures II: Research Submitted to Ethical Review Committee, 2020 ........................................................... 69 Annexures III: Annual Financial Report of NIMH. 2020 ..................................................................................... 71 Acknowledgements............................................................................................................................................ 74
Table of figures
Figure 1: Annual Summary of Dental Unit, 2020 ............................................................................................... 16 Figure 2: Annual Summary of GBVPU, 2020 ...................................................................................................... 20 Figure 3: Types of Referrals to GBVPU, 2020 ..................................................................................................... 20 Figure 4: Annual 1926 Calls, 2020 ...................................................................................................................... 21 Figure 5: Annual Acute Ward Admissions, 2020 ................................................................................................ 23 Figure 6: Distribution of Mental & Behavioral Disorders (Provisional), 2020 ................................................... 24 Figure 7: Visitor's Board & Open School Summary, 2020 .................................................................................. 25 Figure 8: Annual Forensic Clinic Visits, 2020...................................................................................................... 25 Figure 9: Annual Psycho-Geriatric Unit Admissions, 2020 ................................................................................. 26 Figure 10: Annual Admissions to the PPU, 2020................................................................................................ 28 Figure 11: Annual Admissions to LDU, 2020 ...................................................................................................... 29 Figure 12: Annual ECT Patients, 2020 ................................................................................................................ 30 Figure 15: Annual Summary of Day Rehabilitation Service, 2020 ..................................................................... 33 Figure 17: Annual Activities of Psychiatric Social Work Unit, 2020 ................................................................... 41 Figure 15: Annual Activities of Horticulture Therapy Unit, 2020 ....................................................................... 37 Figure 18: Annual Summary of Laboratory, 2020 .............................................................................................. 55 Figure 19: Annual Summary of EEG Unit, 2020 ................................................................................................. 56 Figure 20: Annual Summary of ECG Unit, 2020 ................................................................................................. 57 Figure 21: Annual Summary of X-Ray Department, 2020 .................................................................................. 58 Figure 22: Annual Physiotherapy Sessions, 2020............................................................................................... 59 Figure 23: Annual Summary of Pharmacy, 2020................................................................................................ 60
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NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
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Director’s Message It is with much delight that I ink my 2nd Director’s message for an annual report of National Institute of Mental Health (NIMH), the largest tertiary care hospital in Sri Lanka caring for clients with mental illness. Managing the services of NIMH amidst the COVID 19 pandemic was a challenging task. This year in particularly has been about investing time in improving the knowledge, skills and attitudes of my staff in infection control. The efforts in levied training, infrastructure development at NIMH will yield results in the years & decades to come. Due to COVID19, the year 2020 has been a watershed year and did not follow the usual dynamics of promotion, prevention, cure and rehabilitation of people and their families affected by mental impairments. Despite many setbacks, the team spirit in NIMH has been driving force towards our progress during these difficult times. Many diverse and unprecedented events occurred in 2020. At the outset myself and my team had to enhance the focus on infection control, isolation & quarantine management while maintaining essential services employing technology in innovative methods. Secondly, with the help of Tri-Forces, Ministry of Health & multiple donors we established many centers of care for clients who were being managed for COVID19 with the opening of multiple Isolation Units & Mental Health COVID Treatments Units. You may read more about their efforts in this report. We were pleasantly surprised to still receive outstanding community support for ward management and community related activities despite the circumstances. I invite you to read about our many activities and events in this report. None of these would have been possible without the dedication of 1045 full-time staff of NIMH working tirelessly around the clock including by Director, Deputy Director, Consultants, Administrative officer, Medical Officers, Special Grade Nursing officers, Other Sectionals Heads & other staff. An honorable mention should be made of Consultant Physician, Dr Shehan Silva who left us after successfully setting up the ground work for COVID19 clinical management during early waves of transmission. We look forward to another year of new normalcy with the ambition to overcome this difficult period.
Dr. Dhammika Wijesinghe Director (Actg), National Institute of Mental Health
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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 1409 beds and annually around 7000 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 1200 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 a strength of 1243 full-time staff. The top administration of NIMH comprises of a Director and a Deputy Director who oversee the affairs of NIMH via the Planning & Development Unit, Administration Department, Fi nance Department & Sectional Head Offices. As of 31st December, 2020, NIMH had 10 Consultant Psychiatrists, 2 Consultant Physicians, a Consultant Haematologist, 79 Grade Medical Officers and 3 Dental Surgeons. There are 6 Special Grade Nursing Officers, 5 Ward Sisters, 431 other Grade Nursing Officers, 8 Pharmacists, 6 MLTs, 9 Psychiatric Social Workers, and 11 Occupational Therapists. (For the full cadre details please refer Annexures I: Cadre Details of NIMH).
ANNUAL REPORT – 2020
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Services Offered at NIMH Preliminary Care • 24 hr Emergency admissions via Psychiatric Intensive Care Unit (PICU) • 24 hr outpatient department (OPD) • 24 hr 1926 National Mental Health Helpline &Chatline
Out-patient services •Day Treatment facility for minor mental illnesses at Navodaya Center •Day ECT facility •Day Rehabilitation facility •Alcohol Relapse Prevention Therapy •Gender Based Violence prevention and care •Colombo Outreach Ambulance Service •Community Mental Health Care •Continued care at NHSL and outreach clinics •Adolescent Mental Health Clinics •Gender Dysphoria Clinic
In-patient care •Treatment facilities for acutely ill clients •Medical Ward •Rehabilitation facilities - rehabiliation center, occupational therapy, horticulture therapy, ward-based activities •Vocational Training & Job Oriented Skills Training •Supported employments for rehabilitation clients •Psychiatric social services related to issues of clients •Physiotherapy, Laboratory, EEG, ECG and Radiography services •Isolation facility for communicable diseases •Oral health care
Specialized Care •Forensic Psychiatry care •Elderly mental health care •Adolescent Psychiatry Unit •Perinatal Psychiatriy Unit •Learning Disability Unit •Specialized Medical Ward •Dermatology Clinic •Wound Clinic •National Quarantine Center For Psychiatry Patients •Mental Health Covid Treatment Units
Other Services •Postgraduate and undergraduate trainings in Psychiatry •In-service training for the staff •Promotion of ethical research in mental health •Promotion of community mental-wellbeing via Health Promotion Unit •Mental Health Promotion ANNUAL REPORT – 2020
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NIMH response to Covid-19 The response of The National Institute of Mental Health was an organized and coordinated effort which started well before the 1st case was detected. Our response was focused on regular & transparent communication, coupled with an agile management strategy to respond to changing scenarios.
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All circulars sent by Government of Sri Lanka, especially Ministry of Health were adhered to. Action plans were sent to and approved by Ministry of Health. All basic Covid-19 prevention methods such as social distancing, hand washing, wearing of face masks were established before the 1st wave from the front gate until the client was admitted. This included the relocation of the OPD to a more open area and segregation of different risk levels. Wards were divided into categories below. All zones had dedicated staff, strict infection control protocols and recreational activities for clients. Most zones also had CCTV to facilitate distant observation o Red Zone 1: A dedicated team of doctors, nurses & health staff managed this zone which was reserved for Covid positive clients. The zone was equipped with CCTV and Audio Communication to reduce the contact incidents. A unique telephone calling facility for clients to call their relatives on a timed basis was introduced by Mobitel. Clients were given recreational activities. Managed by Consultant Physicians and Consultant Psychiatrists. The Mental Health Covid Treatment Units are MHCTU 1 (20 Beds) & MHCTU 2 (10 Beds) o Red Zone 2: This zone was to manage clients suspected of Covid-19 and quarantine patients as per the prevailing protocols. Managed by Consultant Physicians and Consultant Psychiatrists. The Isolation Units are ISO 1 (4 beds), ISO 2 (8 beds), LDU (6 beds), Ward 27 (6 beds). o Orange Zone: This was a unique requirement to NIMH to reduce the burden of Red Zones. o Yellow Zone: This zone was to manage low risk admissions and remaining patients who could not be discharged. o Green Zone: This was for the closed management of long term patients. Clinic services were functioning as follows: o Clinics at Navodaya, Prisons, and Community were active throughout via distant methods and returned to usual clinics with covid prevention measures. o NHSL Clinics were active with advice of NHSL Covid Cell. o Community Visits were continued with strict covid prevention measures. o Isolated areas were also given coverage in coordination with local MOH & PHI. A total of 41 internal circulars were published in multiple languages to manage the Covid-19 response. These were broadly covering the following areas. General Covid response - Management of outbreaks - Changes in ward layout Provision of outpatient drugs - Preparation of Covid Zones (Red 1, Red 2, Orange, Yellow, Green) Checklist for OPD - Checklist for Wards - Checklist for Isolation RAT Testing - PCR Testing Checklist for Covid positive - Staff risk assessment - Public gatherings clients Managing staff exposures - Internal cluster management - Conducting outpatient clinics Conducting Navodaya clinics - Admission algorithms - Managing transfers Allocation of MHCTU Staff - Conducting Community Clinic - Depot Medication Recreation for clients - Seclusion of clients - Cleaning ECT Management - Managing staff burnout - Client visitation
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Milestones o Establishment of Covid-19 Isolation Units (ISO) for Covid-19 suspected clients: The Covid-19 Isolation Units was the initial response to the pandemic. The initial ISO-1 was the already available Isolation Unit in NIMH. With ISO-2 NIMH was declared as the National Quarantine Center for Psychiatric Patients during the Covid 19 Pandemic (According to circular No.DDG/NCD/70/2020). The NIMH has 16 isolation rooms functioning since 06.04.2020 for this purpose and another 08 rooms were added by opening Isolation 2 Unit. This was declared opened by the Director-General of Health Services of Sri Lanka, Dr Anil Jasinghe. The repair and refurbishment of the old abandoned building was done by the Sri Lanka Army using their own funds. o
Establishment of Covid-19 Mental Health Treatment Units (MHCTU) for Covid-19 positive clients: The Mental Health Covid Treatment Unit of NIMH was declared (according to circular No.DDG/NCD/V/12/2020) open by the Director General of Health Services, Dr. Asela Gunawardene, in August with the presence of the Dr. Sunil De Alwis, Additional Secretary - Medical Services, Ministry of Health, Dr. Champika Wickramasinghe, Deputy Director General - Non Communicable Diseases, Dr. Jayasundara Bandara, Project Director, Sri Lanka Covid 19 Emergency Response and Health Systems Preparedness Project and the NIMH staff. This is a dedicated special treatment unit catering for Covid positive patients with acute psychiatric illnesses; renovation funded by World Bank grants.
How our teams adapted: o
Infection Control Unit
Making of PPE kits in-house.
Making of triple packs in-house; a total of 1000 from Infection Control Unit in 2020.
Supply polyethene aprons and face shields to all staff who brings patients to the out clinic.
Arranged awareness programmes to all staff category regarding Hand hygiene, Donning & Doffing of PPE, Proper mask usage, Taking PCR sample & handing over to the laboratory.
o
o
o
The unit has coordinated >2000 PCR collections from the infection control unit in 2020.
Navodaya
Medication was sent via post.
Prescriptions were sent via WhatsApp.
Follow up done via phone and Skype.
Community Psychiatry Unit
Peripheral clinics with safety precautions
Conducted clinics in isolated areas with full PPE
IM injections were continued with full safety precautions.
Monthly clinics medication were sent via post
Training Unit
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Continued lectures using Zoom Technology.
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Covid-19 Testing by Month 700 600 500 400 300 200 100 0
Covid19 Tests Sent number
Covid19 Tests +ve number
Admissions & Discharges by Month 120 100 80 60 40 20 0
Admissions number
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Discharges number
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ANNUAL REPORT – 2020
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Outpatient Services Outpatient Department & Psychiatric Intensive Care Unit Date established: 1926 Main Objective: The Outpatient Department & Psychiatric Intensive Care Unit acts as the central hub for all OPD and admission registrations including psychiatric emergencies. Services Offered:
Management of clients at Outpatient Department via advice & referral who do not require admission. Admission of clients voluntarily. Admission of clients on a non-voluntary basis via relatives, non-relatives, Police, or Prison. Admission of clients who have no identifiable details on rotation basis. Management of psychiatric emergencies at admission. Administration of injections, dressings. Administration of Hepatitis B injection for staff. Providing tea for clients and relatives.
Out-Patient Clinics Date established: 1939 Main Objective: 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. Services Offered:
General Psychiatry Clinics Psycho-Geriatric Clinics Substance Abuse Clinics at Navodaya Center Forensic Clinics at Prison Hospital Adolescent Clinics at Navodaya Center
Highlights of 2020:
In the year 2020 the service was disrupted multiple times due to Covid19. In summary the NHSL Clinic 26,392 sessions of care which includes either physical follow up with client or posting of medications.
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Dental Unit Date established: 1972 Main Objective: The Dental Unit aims to improve oral health of the inward clients and outpatients and alleviate stigma in society towards NIMH. Services Offered:
Provide treatments for oral diseases for inward clients and outpatients. Promotion of oral health for inward clients and outpatients.
Highlights of 2020:
Given a Lecture regarding oral diseases and oral health instructions to the NIMH staff on 26-02-2020.
Organized a lecture regarding impact of betel chewing toward Oral and General health from Maharagama Cancer Control Unit in March 2020.
Figure 1: Annual Summary of Dental Unit, 2020
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NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
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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. Conduct in-service and external training in mental health. Clinics for Gender Dysphoria Clients
Highlights of 2020:
During the Covid Pandemic several innovations were introduced o Medication was sent via post o Prescriptions were sent via WhatsApp. o Follow up done via phone and Skype. o Introduced safety methods to prevent corona and continue treatment without interruption. A Mental Health Awareness Program for World Womens’ Day at regarding Child Mental Health, PostPartum Psychosis and Alcohol and Substance Prevention was held at NIMH on 2020.03.06. A Community Mental Health Awareness Program for Care Givers of physically disabled was held at Divisional Secretariat, Central Colombo on 2020.03.13. The alcohol and substance prevention clinic was reorganized with effect from 2020.06.01. A new Gender Dysphoria clinic was started on 2020.06.01. A new clinic for senior citizens was started on 2020.12.01. For the year 2020 a total no of 9219 services provided of the year which includes new registrations, revisits, sessions held, medications issued, helpline calls received, awareness programs, referral of clients, family education & orientation visits.
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NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
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Day ECT Centre Date established: 2014 Main Objective: The main aim of Day ECT Centre is to minimize unnecessary admissions for ECT and keep the client with their family to enrich their mental health. Services Offered:
The Day ECT service is offered from Monday to Saturday including public holidays. The Day ECT service can be referred by Consultant Psychiatrist attached to NIMH or other Consultant Psychiatrists who can refer to a Consultant Psychiatrist at NIMH with a Pre-ECT assessment form.
Highlights of 2020:
Due to interruptions in service due to the Covid19 pandemic a total of 12 Day ECTs were done.
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NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
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Gender Based Violence Prevention Unit Date established: 2012, Prevention of Child Maltreatment Unit was added 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 victims of GBV. The GBVPU counsels’ perpetrators to reduce the incidence of GBV. The GBVPU arranges group counselling at family meetings. Coordination of "Committee regarding sexual harassments in the workplace" at NIMH
Highlights of 2020:
On 15th of January, the chairman of the TRCSL visited us and agreed to ensure security to prevent harassment to helpline staff over the phone.
Inter-staff net ball competition of NIMH, Halfway Home and Nursing college of Mulleriyawa was held on 5th of March in view of International Women’s Day. Ms. Tharjin Sivalingam of Sri Lanka National Netball attended as the Chief Guest.
Facilitated the “Open day” with educational and sales stalls for mental health staff professionals and community members, contributing the Women in need, Legal Aids, Women’s Bureau of Sri Lanka police and Human Rights commission on 6th of March in view of International Women’s Day.
The final programme in commemorating the International Women’s Day 2020 was successfully concluded on 11th of March 2020. The chief guest was Ms. Roshanie Dissanayake, Attorney at law and Municipal commissioner for CMC. Veteran Actor Mr. Roshan Ranawana attended as a Guest of Honor and a judge. As a main component in the events, a speech competition, a debate competition, poetry competition, among staff members and clients of NIMH was arranged in order to raise awareness in gender equality, sexual harassment in workplace and related legal issues.
Conducted the awareness raising video “Covid 19 with Gender Based Violence” with NIMH Media Team.
Conducted awareness raising programme on prevention of Gender based Violence for medical officers of Mental Health at NIMH.
During the Covid 19 pandemic period, counseled the clients through the helpline (1926) at about 100 and also posted medications for clients.
About 20 Medico legal and court cases have been handled and provided court reports, even during Covid 19 pandemic.
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NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
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Figure 2: Annual Summary of GBVPU, 2020
No of new clients
236
No of female clients
130
No of male clients
106
No of follow- up
504
Referrals
NIMH
102
Community
25
Police
04
Other hospital
67
Court
03
Clinics
04
1926
25
WIN
06 Figure 3: Types of Referrals to GBVPU, 2020
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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. Launched 1926 SMS chat line on 10/10/2020 and expanded our service in collaboration with Airtel Sri Lanka Pvt ltd.
Figure 4: Annual 1926 Calls, 2020
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Inpatient Services Inward Acute Care Date established: 1926 Main Objective: The aim of Inward Acute Care is the comprehensive management of acutely ill clients. Services Offered:
Comprehensive inward psychiatric care. Management of all psychiatric emergencies. Seclusion rooms for unstable clients. Coordination of referrals to other specialties. Coordination of care givers & stakeholder meetings. Transfer of clients to other hospitals for interventions and/or referrals. Provision of basic rehabilitation including indoor & outdoor games. Management of psycho-social factors via community centric programmes. Training of in-house staff, visiting medical, nursing, and allied health students on management of acutely ill clients.
Figure 5: Annual Acute Ward Admissions, 2020
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Figure 6: Distribution of Mental & Behavioral Disorders (Provisional), 2020
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Forensic Psychiatry Unit Date established: 1940s Main Objective: The aim of Forensic Psychiatry Unit is to provide comprehensive forensic mental healthcare. Services Offered:
Comprehensive inward care via male (Ward 21) and female (Ward 25) units. Coordination via Forensic Psychiatry Resources Centre (FRC). Outpatient services via Forensic Outpatient Clinic, NHSL. Clinic services at Welikada Prison, Colombo Remand Prison, Magazine Prison (+ Women’s Section), Prison Hospital (Colombo 9), & Institute of Forensic Medicine (Colombo 10). Holding of quarterly Visitor’s Board. Referrals to Magistrate’s Court & High Court. Gymnasium services for clients and staff. Rehabilitation of clients via Forensic Psychiatry Rehabilitation Unit (FRU). Rehabilitation of clients via Horticulture Area. Open school service conducted by National Institute of Education.
Highlights of 2020:
Clients participated in the New Year Festival in April. Clients actively took part in the religious programmes every Poya day. Clients actively took part in Christmas celebrations in December.
No. of Visitor’s Boards held
02
No. of open school sessions held
10
Figure 7: Visitor's Board & Open School Summary, 2020
Figure 8: Annual Forensic Clinic Visits, 2020
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Psycho-Geriatric Unit Date established: 1998 Main Objective: The aim of Psycho-Geriatric Unit is to provide comprehensive mental healthcare for the elderly client particularly those suffering from dementia. Services Offered:
Comprehensive inward psycho-geriatric care. Management of all psychiatric emergencies. Outpatient services via Psycho-Geriatric Clinic, NHSL. Community-based clinics in Modara. Comprehensive geriatric assessment per client in a multi-team approach. Coordination of referrals to other specialties. Transfer of clients to other hospitals for interventions and/or referrals. Rehabilitative activities such as occupational therapy and reminiscence therapy. Management of psycho-social factors via community centric programmes. Awareness programmes in public areas and via holistic care programme via Geriatric Association, Training of in-house staff, visiting medical, nursing, and allied health students in management of psychogeriatric clients. State of the art lecture hall facilities and library relevant to psycho-geriatric care.
Figure 9: Annual Psycho-Geriatric Unit Admissions, 2020
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Adolescent Psychiatry Unit Date established: 2015 Main Objective: The main aim of Adolescent Psychiatry Unit is to provide comprehensive psychiatric care in a safe environment for clients between 12-18 years. Services Offered:
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.
Highlights in 2020:
In the year 2020, the Adolescent Mental Health Unit saw a total of 120 admissions.
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Perinatal Psychiatry Unit Date established: 2007. The 1st ever in South-East Asia. Main Objective: The main aim of Perinatal Psychiatry Unit is to provide specialized care for women who develop psychiatric illness in and around the pregnancy or following childbirth. Services Offered:
Comprehensive inward psychiatric care for pregnant and post-partum clients. Management of all pregnancy and post-partum related psychiatric emergencies. Facilities for baby & bystander to stay with mother. Provision of 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 pregnant and post-partum clients.
Figure 10: Annual Admissions to the PPU, 2020
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Learning Disability Unit Date established: 2008 Main Objective: The main aim of Learning Disability Unit is to rehabilitate clients with learning disability and associated behavioral problems by training and educating their parents, guardians on rehabilitation skills to provide care for clients with special needs. Services Offered:
Comprehensive inward psychiatric care for clients with learning disabilities. Management of all psychiatric emergencies. Facilities for bystander to stay with the client. Rehabilitative activities such as activities of daily living, life skill programmes, cognitive development programmes. Management of psycho-social factors via community centric programmes. Programmes to improve life skills of parents and bystanders such as lectures on learning disability and discussions on how children with learning disability should looked after at home. Training of in-house staff and visiting medical, nursing, and allied health students in management of clients with learning disability.
Total Admissions by Gender
19 Male Female
35
Figure 11: Annual Admissions to LDU, 2020
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ECT Unit Date established: 1940s Main Objective: The main aim of ECT Unit is to provide quality electroconvulsive therapy for all outpatient and inpatient clients at NIMH. Services Offered:
Comprehensive ECT care for clients from managing Pre-ECT assessment to Post-ECT recovery. Management of emergencies relating to ECT. Dedicated card-based system for equitable distribution of ECT for all clients.
Figure 12: Annual ECT Patients, 2020
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Isolation Unit Date established: 2011 Main Objective: The main aim of Isolation Unit is to prevent the spread of communicable disease among clients by isolating diagnosed/suspected infected patients in a secure environment. Services Offered:
Comprehensive isolation care for infected clients. Protective isolation for severely immunocompromised patients. Source isolation to confine the infectious agent and prevent it’s spread. Training of in-house staff, visiting medical, nursing and allied health students in management of isolated clients.
Highlights in 2020:
In the year 2020, the Isolation Unit’s primary function was in the management of Covid-19. You may read about it ‘NIMH Covid Response.
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Medical Ward Date established: 2005 Main Objective: The main aim of Medical Ward is to provide specialized medical care to the inward psychiatric clients with co-morbidities. Services Offered:
Outpatient medical management of clients via Medical Clinic, NIMH. Comprehensive medical care for admitted clients. Coordination of medical referrals of psychiatric units. Coordination of transfers of clients to Tertiary Care Hospitals for specialized management. Management of medical problems of clients admitted to High Dependency Unit in Ward 20.
Highlights of 2020:
During the year 2020 a total of 203 clients were admitted to the ward. During the year 2020 a total of 3295 clients were seen in the clinic.
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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 Therapeutically engaging them in o Anger management training group shopping, banking, public transportation, o Activities of daily living training group meal preparation, and similar skills which o Stress management and relapse increase their independence. prevention training group Inculcation business promotion habits via business promotion unit o “Sith Mal Nimevum” sales outlet o Production of craft and sewing products o Lunch packets selling project for sale at Ministry of Health o Soft toy project (supported by Fashion o Cement flowerpot making project Bug) o Enhancement of vocational skills in o Work opportunities in Sashini Fashion, computer training via NIMH-NAITA Angoda computer training center in Navodaya. Outreach support for clients o Home visits via community centric o Placement of clients in regular jobs in the programmes private sector o Family meetings via community centric programmes Coordinating community access via Consumer Forum of the National Institute of Mental Health
Highlights of 2020:
The day rehabilitation service was restarted after second wave of covid-19 pandemic on 15th June 2020. It was opened only for the clients who could attend safely with their own transport.
The “sith mal” sales outlet was reopened on 18th June.
New agricultural site was developed at the Navodaya premises.
Wade and roti making activity also was started as an income generation activity for the clients by selling them at the hospital canteen.
New admissions Functional assessments Individual sessions with social skills and assertiveness training Family meetings Rehabilitation training and orientation (For the OT at BH Homagama)
21 17 20 09 01
Figure 13: Annual Summary of Day Rehabilitation Service, 2020
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Rehabilitation Centre Date established: 15th March 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:
Rehabilitation process is carried out in 4 levels o Level 1 – to improve basic activities of daily living o Level 2 – to improve extended activities of daily living o Level 3 – for vocational training (in addition; NAITA training center is functioning for Computer application assistant, Handcraft, Tailoring, Pastry and Baker) o Level 4 - to facilitate social re integration and employment
Highlights of 2020:
There were four main occupation targeted NAITA courses which NIMH conducted in collaboration with National Apprenticeship and Industrial Training Authority (NAITA). This included a computer course (12 clients), bakery & pastry course (7 clients), tailoring course & a handcrafting course (5 clients).
All courses which were scheduled for four months were stopped in 2 months due to Covid-19
The rehabilitation canteen ‘NIMHewana Café’ trained 3 clients simultaneously during the first two months of the year 2020.
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Ward Based Rehabilitation Intermediate Ward(s) Date established: 2007 Main Objective: The aim of the Intermediate Ward(s) is to rehabilitate clients who are recovering from mental health problems by giving psycho-social support & promoting independence. Services Offered:
Rehabilitative activities via activities of daily living, vocational skills training, social skills training, communication skills training, housekeeping training, cookery training, and money management training focusing on income generation for those who are not eligible to send out for other rehabilitation units. Reintegration into society by placement of clients in jobs. 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 rehabilitation of clients.
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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 Cognitive assessment. o Functional assessment. o Skill assessment. Group therapy sessions on: o Activities of daily living o Anger management. o Reminiscence therapy. training o Drama therapy. o Creative writing. o Social skill training. o Art therapy. o Life skill training. o Music therapy. 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 Psychiatry Clinic (NHSL), & Psychiatry Clinic at Pannipitiya
Activities of Occupational Therapy Unit
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Horticulture Therapy Unit Date established: 2003 Main Objective: The aim of Horticulture Therapy Unit is to make a productive individual through rehabilitation by art and science of plants and nature. Services Offered:
Support of rehabilitation of clients referred via Horticulture Therapy, Therapeutic Horticulture, Social & Community Horticulture, & Vocational Horticulture. Rehabilitation of clients by recreational activities. Rehabilitation of clients by household activities. Support in social re-integration of clients through horticulture therapeutic measures, recreational activities, and activities of daily living. Support in improving social skills by money handling, shopping, going on picnics etc. Provide job-oriented skills training for clients referred. (Flowerpots, Plant nursery, Mushroom etc.)
Highlights of 2020:
Long term in-ward patients attended to horticulture and landscaping unit daily in 2020 including Public Holiday and Sundays.
Figure 14: Annual Activities of Horticulture Therapy Unit, 2020
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Activities of Horticulture Therapy Unit
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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:
Provide homely environment to long term clients Coordination of referrals to other specialties if necessary. 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 psycho-social rehabilitation of clients.
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:
Provide homely environment to clients. Coordination of referrals to other specialties if necessary. Rehabilitative activities via activities of daily living, spirituality, communication skills training, occupational therapy, music therapy, & art therapy.
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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:
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.
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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.
Figure 15: Annual Activities of Psychiatric Social Work Unit, 2020
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Community Psychiatry Unit 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. Follow up patients under Community files. 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. Facilitating discharge and leave procedure. 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 2020:
Continued conducting community clinics during the Covid-19 pandemic. During the 1st and 2nd waves the team managed 1058 community files, conducted 108 family meetings (under guidelines) and posted 2948 medication packs.
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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 2020:
Development of Hospital Master Plan Phase 1 (NIMH Main Hospital) is now in Ministry of Health approval stage. Phase 2 (Halfway Home) & Phase 3 (NTS) are in designing stage. The Citizen’s Charter is in the final stage of preparation. It will give a comprehensive idea of services in NIMH.
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. Establish and monitor the activities of 50 WITs (Work Improvement Team) Conduct key meetings in quality improvement
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o Quality & Safety Steering Committee o Clinical Governance Meeting o Quality Liaison Nurses Meeting Conduct Clinical Audits regarding safety issues (absconding; restrains, falls) for process improvements.
Highlights of 2020:
Held 11 Sectional Heads meetings. Held 12 Quality Liaison Nurses Meetings Held 02 Productivity Officer’s Meetings Held 05 WIT Presentation Meetings Held 03 WIT Leaders Meetings Held 01 Quality Steering Committee Meetings Held 04 Clinical Governance Meetings Held 01 Maintenance Meeting
Public Health Section & Public Health Inspector Date established: 2016 (Public Health & Public Health Inspector), 2020 (Health Promotion) Main Objective: The aim of the Public Health Section is to engage in disease prevention & control as well Services Offered:
Cantal coordination point for all the public health matters of hospital 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 & coordination of Infection control Nursing Officers and PHI activities. 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 2020:
The bulk of the work of Public Health Section & Public Health Inspector was centered around the Covid19 response. You may read about it above in ‘NIMH Response to Covid-19’. Conduct a programme for breast feeding awareness week on 26.08.2020 for pregnant and lactating mothers. Conducted a training on PPE handling and PCR taking for staff members on 11.12.2020. Conducted a training for staff members on handling covid positive patients on 16.12.2020.
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Disaster Management Section Date established: 2016 Main Objective: The aim of Disaster Management Section is to coordinate disaster preparedness and response of the institution at institutional level and national level. Services Offered:
Identification of hazards within the institution and assess the risk and update annually. Preparation of Hospital Disaster Preparedness and Response Plan for the institution according to the risk assessment and update accordingly and/or annually. Advocate and coordinate the necessities to reduce the risk for recognized hazards. Coordinate for the necessary steps needed for the disaster preparedness in the institution. Practically testing of the Hospital Disaster Preparedness and Response Plan and identify the gaps and lapses. Facilitate the disaster resilient environment within the institution. Coordinate the training for staff relevant to institutional disaster management. Coordinate and facilitate Hospital Disaster Management Committee. Support in National Disasters for relief activities mainly focusing the psychological first aid and mental health issues. Liaise with Disaster Preparedness and Response Division of Ministry of Health.
Highlights of 2020:
Disaster response to Covid 19 pandemic in order to prevent infection to spread among clients of NIMH. Supportive role to Public Health Section in strengthening and streamlining the infection control and prevention measures especially targeted to Covid 19 pandemic. Supportive role in response to Covid 19 among persons with Psychiatry illness in treatment and quarantine and or isolation. Supportive role in relation to prevention and management of Covid 19 among staff of NIMH by staff screening, follow up, quarantining, facilitating referral to treatment centers.
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.
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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.
Highlights of 2020
The Health Informatics Section was main technical focal point for Training & Research Unit for all remote learning using Zoom, Microsoft Teams, & Skype. The Health Informatics Section was the main technical focal point for Tele Judicial work for Forensic Psychiatry Unit, connecting the District & Magistrate Court(s).
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 2020:
Infection control committee meeting was held on 04.08.2020 New infection control unit construction was started.
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Health Promotion Unit Date established: 2019 Main objective: The aim is to coordinate all the health promotion activities at NIMH. Services Offered:
Focal point for the health promotion activities of NIMH and visitors and clients. Coordinating health promotion programmes, commemorating internationally and nationally important days. Ex: Cancer prevention day, Breast feeding day etc. Cording health talks improving awareness on health hot topics daily via Public Address System. Assisting public health section, disaster management section, quality management section and infection control unit in their areas under health promotion preview.
Highlights of 2020:
Conducted a programme to commemorate national drug prevention day. Conducted a lecture on oral hygiene on 28.08.2020 by the Dental surgeon. Conducted a lecture on oral cancer prevention day 09.08.2020 to commemorate oral cancer prevention day. Conducted an awareness programme on psychiatric emergencies for liaison nurses on 09.08.2020. Conducted an Art exhibition and film display to commemorate suicide prevention day on 16.09.2020. Conducted an awareness programme on healthy nutritional habits for liaison nurses on 23.09.2020. A programme was conducted to Check blood pressure of staff on 29.09.2020 to commemorate world heart day.
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Computer Maintenance Unit Date established: 25th March 2020 Main Objective: The aim of Computer Maintenance Unit is to coordinate all the computer maintenance activities NIMH. Services Offered:
On-site inspection of all computer related issues. Servicing of computers at the unit. Repair of computers at the unit. Maintenance of anti-virus software of all computers.
Highlights of 2020:
In the year 2020 a total of 140 services and repairs were carried out. All computer service requested were standardized to a Job Card system so the stage of the process could be monitored. CCTV System was installed locally by ICTMU for ISO1, ISO2, Ward 27 & LDU saving the institute over Rs. 200,000. In the annual review of ICTMU it was estimated that the unit saved over Rs. 800,000 in servicing and installation charges related to ICT.
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 2020:
Media Unit continued to cover all events of NIMH during the pandemic.
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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 2020:
Post Graduate training classes via Zoom for Registrars and diploma trainees in Psychiatry PGIM exams for Registrars and Diploma trainees in Psychiatry. 50 case presentations and journal clubs conducted via ZOOM Relaxation program for all staff Art based activity sessions for all staff Cardiac Pulmonary resuscitation (CPR)training for all staff 04 In-Service training programmes (each programme consist of 2 days) conducted in each month of 2020 for the Medical Officers of NIMH. (Continuous Professional Development Programme) 1 day workshop on Psycho pharmacology for Registrars and diploma trainees in Psychiatry Nurses Journal club Art therapy sessions Drama therapy workshop Burnout training program for all staff Awareness training program for newly appointed nurses Medico – legal workshop 2 day mental health training program for ‘1990 suwa seriya’ staff – 2 work shop 2 day In-service training program on occupational therapy and Psychiatric rehabilitation 3 Mindfulness workshops MOCK session for PG trainee MOMH training via ZOOM technology 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
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05 In-Service training programmes (each programme consist of 3 days) conducted in each month of 2020 for the Nursing staff and Supportive staff. 06 In-Service training programmes conducted in each month of 2020 for the Supportive staff. 1 month clinical training for BSc nursing students of University of Ruhuna 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 Jayawardanapura 2 days training programme for the students of Paali & Buddhist University 4 Training programme on Skills development and violence prevention for the supportive staff of NIMH 5 weeks each clinical training for the student nurses of each 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) Covid 19 awareness program Conducted several program and events via Zoom Technology
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Nutrition Unit Date established: 2016 Main Objective: The aim of Nutrition Unit is to optimize the nutritional status of patients of NIMH. Services Offered:
Provides nutritional care for both in-patient and out-patient of the institute. Help to improve knowledge on nutrition among the hospital staff. Coordinate the Food Committee of NIMH. Supervise the food hygiene in kitchen and canteen.
Highlights of 2020:
New diet menus for the inward patients & staff were compiled and sent to the ministry for approval and it was started to give one portion of fruit for all the patients on every Friday.
Workshops of the Nutrition care circle were held with participation of nursing officers and clerical staff.
New diet menu was implemented for the Covid positive patients and the staff involved in those wards.
Kitchen Date established: 1926 Main Objective: The aim of the kitchen is to provide healthy meals for all in-ward clients and supportive staff members. Services Offered:
Prepare and distribute meals for all in-ward clients. Prepare and distribute meals for health assistants on duty. Provide space for donor food preparation. Provide special requirements of food for institutional activities as needed.
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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:
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. Coordination the Midnight Summary of the institution. Conduct weekly Nurse’s Journal Club.
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School of Nursing Mulleriyawa Date established: 1961 Main Objective: The aim of School of Nursing Mulleriyawa is to provide the knowledge and practice on mental health and psychiatric nursing for the nursing students nursing officers of Sri Lanka. Services Offered:
Provide training requirements of all-island student nurses for psychiatry component. Provide training requirements for Nursing Leaders for psychiatry component. Provide 6 month psychiatry nursing training programme Conduct school awareness programmes as part of training. Conduct community awareness programmes as part of training. Conduct community recreational programmes as part of training.
Highlights of 2020:
Organized Netball Tournament for halfway home clients Students participated to do activities with halfway home clients
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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.
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Diagnostic Services Laboratory Department Date established: 1949. Modern laboratory was established in 2007. Main Objective: The aim of Laboratory is to provide medical laboratory testing services in accordance with the applicable standards to satisfy the expectation of clinical staff and the administration. Services Offered:
Biochemistry related testing. UFR - SFR Urine Ketone Bodies - Serum Electrolytes Serum Glucose - Serum Urea Serum AST (SGOT) - Serum ALT (SGPT) Bilirubin (Total, Direct) - S. Protein (Total, Albumin) CRP - CSF – Protein Troponin I - Stool Occult Blood Sterile Fluid (Report, Glucose, Protein) Hematology related testing. FBC - ESR PT/INR - APTT Iron Stain Microbiology related testing. Urine Culture - Stool Culture Pus Culture - Sterile Fluid Report & Culture Rapid HIV Ag/Ab - RAT for Covid19 AFB (Sputum, Urine, Sterile Fluids) Coordinating specimens sent to MRI, RIA, & NHSL.
-
Dengue NS1 Antigen Serum Lithium Serum Creatinine Serum ALP CK-NAC Cholesterol (Total, HLD, TG) Urine hCG
-
INR Bone Marrow Films
-
CSF Report & Culture MRSA Screening PCR & Blood Culture
Figure 16: Annual Summary of Laboratory, 2020
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Electroencephalography (EEG) Unit Date established: 1994 Main Objective: The aim of EEG Unit is to be the cluster center for all EEG needs of NIMH and neighboring hospitals. Services Offered:
Routine EEG. Video EEG. EEG to confirm brain death of patients at ICU of National Institute of Infections Diseases (NIID), and Colombo East Base Hospital, Mulleriyawa. (CEBH) Pediatric EEG at NIID & Colombo East Base Hospital.
Figure 17: Annual Summary of EEG Unit, 2020
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Electrocardiography (ECG) Unit Date established: 2000s 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. Urgent ECGs are done at the client ward/unit.
Figure 18: Annual Summary of ECG Unit, 2020
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X-Ray Department Date established: 1971 Main Objective: The aim of X-Ray Department is to provide a diligent & quality radiographic service to the hospital. Services Offered:
Routine and urgent X-Rays. Provide radiographic service to not only NIMH but also perform a cover-up function for NIID and CEBH Mulleriyawa.
Figure 19: Annual Summary of X-Ray Department, 2020
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Physiotherapy Unit Date established: 2000s 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:
Routine physiotherapy. RoutinE physiotherapy at ward for non-ambulatory clients. Performing chest physiotherapy to obtain sputum samples for investigations. Infrared treatment. Ultrasound treatment. Short wave diathermy treatment. Muscle stimulation treatment
Figure 20: Annual Physiotherapy Sessions, 2020
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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:
Preparation of estimates for pharmaceutical, surgical consumable & surgical non-consumable items. Prepare procurement for non-surgical consumable equipment. Monitor quality of all pharmaceuticals. Coordinate the repairing of surgical equipment and instruments. Outpatient dispending of drugs for OPD clients, ward discharge, Community Clinics, Gender Based Violence Prevention Unit, Psychogeriatric Clinic Ward, Navodaya Clinic, Substance Abuse Clinic & staff. Drug information is given to all clients at the point of dispensing. 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. Extemporaneous 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. Registration of drugs, surgical items & medical gases via Chief Pharmacist.
Highlights of 2020:
During the Covid19 pandemic the team ensured zero drug shortages and provided all necessary items. Two Pharmacists were designated to drug stores. Created a WhatsApp group to communicate information regarding pharmaceutical and surgical items. Month
Local Purchase
Drugs
Surgical Consumable
Dressings
January
50571.90
9744735.47
1144828.15
February
206735.60
7753496.41
March
131466.22
April
88817.12
May
44339.10
June
Non Consumable
Lotion
Dental
Oxygen
505112.79
258244.09
75140.45
64765.58
973072.60
109675.86
83613.24
78246.64
44894.45
3802371.11
852130.01
221353.28
9641.98
70648.44
17884320.63
772149.74
89136.19
41177.30
24449.46
1238119.35
331138.91
56685.44
77840.00
60083.26
65516.68
4980493.79
1714957.16
244210.31
July
64645.84
3122860.93
3426.97
215431.20
August
159053.80
338955.23
142704.54
173214.78
September
68694.76
2446327.94
1310407.53
53017.58
October
84550.78
7030221.89
513731.86
November
188510.40
4718375.20
700816.67
December
61783.00
1290539.42
141692.21
Total
1214685.2
64350817.37
8601056.35
1193600.00
103810.00
15859.65
74365.00
9304.47
69568.27
61203.63
26719.56
5283.21
46791.07
35543.00
51852.18
33296.10
780753.46
46502.17
44816.50
63718.92
140029.14
46981.52
21840.00
20378.84
2588620.03
4308.73
21393.97
788000.00
6804.00
2007302.70
746181.33
18811.73 362606.90
583406.48
Figure 21: Annual Summary of Pharmacy, 2020
ANNUAL REPORT – 2020
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61
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.
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62
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.
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63
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.
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64
Special Activities
International Women’s Day Celebration
World Mental Health Day Celebration
ANNUAL REPORT – 2020
World Suicidal Prevention Day Programme
Music Programmes for Clients & Staff
NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
65
Vesak Programme
Opening National Quarantine Center for Psychiatric Patients of NIMH
National Mental Health Helpline (1926) expanded its services to the SMS platform ANNUAL REPORT – 2020
Sinhala & Hindu New Year Celebration
Opening the Mental Health Covid Treatment Unit of NIMH
1990 Suwa Seriya Staff training in dealing with patients with psychiatric issues NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
66
Christmas Celebration
ANNUAL REPORT – 2020
Awareness Programme of Suicide Prevention Day
NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
67
Annexures I: Cadre Details of NIMH
National Institute of Mental Health
Approved Cadre
In Position
Director
1
-
Deputy Director
1
1
Consultant
12
12
Medical Officer
76
72
Dental Surgeon
3
3
SGNO
6
5
Accountant
1
1
Administrative Officer
2
1
Ward Sister
25
5
Nurse
415
369
PSW
20
9
Occupational Therapist
16
10
Medical Laboratory Technologist
6
6
Physiotherapist
3
3
Radiographer
2
2
Pharmacist
10
8
Dispenser
3
1
Development Assistant
11
-
PHI
1
1
EEG recordist
2
2
Cardiographer
2
2
Development Officer
10
10
Information and Communication Technology Assistant
3
2
Health Management Assistant
44
29
Ward Clerk
12
4
Nutritionist
2
1
Diet Stewards
4
3
House Warden
5
4
Health Driver
11
11
Telephone Operator
4
2
Hospital Overseer
8
6
Cook
20
7
Lab Orderly
2
1
Seamstress
2
1
Plumber
1
1
ANNUAL REPORT – 2020
NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
68 Attendant
250
125
Supportive staff
444
374
Approved
Halfway Home, Mulleriyawa
cadre
In position
Medical Officer
6
5
SGNO
1
1
Nurses
82
62
Occupational Therapist
2
1
Nutritionist
1
1
Diet stewards
2
2
Hospital Overseer
2
2
Cook
4
2
Telephone Operator
2
1
Attendant
42
14
Supportive Staff
50
40
Approved
Nurses Training School
Cadre
In Position
Principal
1
1
Senior Nursing Tutor
6
3
Nursing Tutor
4
4
Librarian
1
-
HMA
1
1
House Warden
4
3
Health Driver
2
1
Cook
3
1
Supportive Staff
10
8
Clinical instructor
Totals Per Category Director
1
PSW
9
Nutritionist
2
Deputy Director
1
Occupational Therapist
11
Diet Stewards
5
Consultant
12
MLT
6
House Warden
3
Medical Officer
79
Physiotherapist
3
Health Driver
12
Dental Surgeon
3
Radiographer
2
Telephone Operator
3
Accountant
1
Pharmacist
8
Hospital Overseer
8
Administrative Officer
1
Development Assistant
Cooks
10
SGNO
5
PHI
1
Lab Orderly
1
Principal (NTS)
1
EEG recordist
2
Seamstress
1
Ward Sister
5
Cardiographer
2
Attendant
139
Senior Nursing Tutor
3
Development Officer
10
Supportive staff
422
ICT Assistant
2
Nurse
ANNUAL REPORT – 2020
431
NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
69 Nursing Tutor
4
Clinical Instructor
HMA
30
Ward Clerk
4
Annexures II: Research Submitted to Ethical Review Committee, 2020 146/01/2020
Experience of informal care givers of unmarried female patients with Schizophrenia
147/01/2020
Prevalence and factors related to falls among geriatric patients admitted to the psychogeriatric unit at the National Institute of Mental Health
148/01/2020
A study on characteristic of patients with gender Dysphoria presenting to a Psychiatric clinic in a Tertiary care hospital
149/01/2020
Study to determine the seasonal effects on relapse of Bipolar Affective Disorder in patients admitted to the National Institute of Mental Health.
150/01/2020
Study of doctor’s knowledge, attitude and practices of treating Lesbian, Gay, Bisexual and Transgender individuals
151/01/2020
Effects of Integrated Art Based Therapy in patients with moderate depression who are on stable dose of medication in a military setting
152/01/2020
A study on presence of insight in outpatients with Schizophrenia and Bipolar Affective Disorder
153/01/2020
A study to determine the client factors associated with dropout of psychological treatment at Navodaya rehabilitation and Psychological treatment center.
154/02/2020 155/02/2020
Self-esteem and quality of life among the individuals who seek the transgender treatment in National Hospital Sri Lanka Care givers burden and associated factors among care givers of Dementia patients attending state hospital Psychiatry clinics in Colombo District
156/03/2020
Relationship between physical activity and level of Depression among middle aged patients who are under Psychotic treatments in National Hospital Sri Lanka and National Institute of Mental Health Sri Lanka.
157/03/2020
A comparative study on Resilience and Emotional Intelligence (EI) of postgraduate trainees in Psychiatry and Postgraduate trainees in other specialties in Sri Lanka.
158/08/2020
Medical comorbidities and associated factors among patients with a serious mental illness presenting to follow up psychiatric clinics at the National hospital of Sri Lanka (NHSL)
159/08/2020
Mental health literacy survey among general public with the socio-economic status.
160/08/2020
Factors affecting delay in presentation to the Psychiatric services after an acute episode of Psychiatric illness.
161/09/2020
The impact of preoperative education on preoperative anxiety among patients undergoing oral and maxillafacial surgeries at the National Dental (Teaching) Hospital, Sri Lanka.
ANNUAL REPORT – 2020
NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
70 162/09/2020 163/09/2020
A 6 month prospective study on Physical and mental health effects of mindfulness based work place yoga on health care staff at National Institute of Mental Health Use of “1926 Help line” and the outcomes during Covid pandemic in Sri Lanka
164/10/2020
Awareness of Postpartum Depression among husbands of primi mothers attending the Mulleriyawa antenatal clinic in Sri Lanka.
165/11/2020
Duration of untreated illness (DUI) and its associations in patients with mental illnesses presenting to three different psychiatric units in Sri Lanka: A descriptive study
166/12/2020
Sinhala translation and cultural adaptation of the Short Form of Multidimensional Jealousy Scale (SFMJS-S) and assessment of prevalence and phenomenology of Morbid Jealousy(MJ) among patients with Psychiatric illnesses admitted to the NIMH Sri Lanka using SFMJS-S
167/12/2020
The prevalence of Depression and its associated factors in patients admitted with deliberate self-harm to a Base Hospital in the North –Western Province, Sri lanka
168/12/2020
A study on stress, depression and anxiety level among health care workers in a dedicated hospital for COVID patients in Sri Lanka. A single unit experience.
169/12/2020
ANNUAL REPORT – 2020
To assess the stress level , anxiety and depression level among COVID tested positive pregnant women and how if differ from other pregnant women.
NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
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Annexures III: Annual Financial Report of NIMH. 2020 NIMH Object Code
Expenditure in year 2020
Allocation
Surcharge
Savings
Exp%
1001
454,561,044.61
460,911,747.82
292,327.90
(6,058,375.31)
101.40
1002
331,087,474.86
358,522,043.21
1,988.50
(27,432,579.85)
108.29
1003
207,723,480.59
210,286,157.26
152,868.92
(2,409,807.75)
101.23
1101
1,100,583.87
969,134.87
-
131,449.00
88.06
1201
3,826,328.67
3,597,918.44
-
228,410.23
94.03
1202
5,356,480.92
4,712,162.96
-
644,317.96
87.97
1203
81,156,841.71
80,507,607.31
654,814.40
99.20
1205
9,968,026.93
9,898,915.84
-
69,111.09
99.31
1301
4,500,000.02
4,412,805.50
-
87,194.52
98.06
1302
1,450,000.00
1,155,298.33
-
294,701.67
79.68
1303
10,243,453.63
9,359,113.35
-
884,340.28
91.37
1401
20,185.00
18,747.00
-
1,438.00
92.88
1402
6,489,946.53
6,325,439.52
-
164,507.01
97.47
1403
29,935,460.42
29,130,471.20
876,147.64
97.31
1404
-
-
5,580.00
71,158.42 -
-
-
1409
145,948,693.22
128,417,491.25
-
17,531,201.97
87.99
1506
3,826,943.02
3,807,616.47
-
19,326.55
99.49
1508
332,000.00
258,447.54
-
73,552.46
77.85
ANNUAL REPORT – 2020
NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
72
NTS Object Code
Expenditure in year 2020
Allocation
Surcharge
Savings
Exp%
1001
9,206,753.17
9,516,494.08
-
(309,740.91)
103.36
1002
2,747,010.80
3,219,762.40
-
(472,751.60)
117.21
1003
4,662,827.93
5,070,722.11
-
(407,894.18)
108.75
1101
-
-
-
-
-
1201
-
-
-
-
-
1202
80,960.00
137,465.00
-
(56,505.00)
169.79
1203
-
-
-
-
-
1205
-
-
-
-
-
1301
-
-
-
-
-
1302
-
-
-
-
-
1303
-
-
-
-
-
1401
-
-
-
-
-
1402
119,579.13
106,879.66
-
12,699.47
89.38
1403
861,397.19
816,939.98
-
44,457.21
94.84
1404
-
-
-
-
-
1409
1,121,079.00
621,079.00
-
500,000.00
55.40
1506
28,000.00
50,871.69
-
(22,871.69)
181.68
1508
ANNUAL REPORT – 2020
-
-
-
-
-
NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
73
UNIT II Object Code
Expenditure in year 2020
Allocation
Surcharge
Savings
Exp%
1001
64,062,159.25
61,915,029.39
-
2,147,129.86
96.65
1002
42,860,421.02
46,248,901.76
-
(3,388,480.74)
107.91
1003
27,886,447.86
28,251,810.23
-
(365,362.37)
101.31
1101 1201
250,000.00
67,250.00
-
182,750.00
26.90
1202
231,352.00
222,103.04
-
9,248.96
96.00
1203
28,487,404.88
23,872,796.77
-
4,614,608.11
83.80
1205
700,000.00
-
700,000.00
1301
141,027.47
41,027.47
-
100,000.00
1302
150,000.11
150,000.11
-
-
100.00
-
29.09
1303
-
-
-
-
-
1401
-
-
-
-
-
1402
568,703.72
502,097.44
-
66,606.28
88.29
1403
9,561,298.62
8,199,826.79
-
1,361,471.83
85.76
1404
-
-
-
-
-
1409
30,703,434.39
35,793,748.94
-
(5,090,314.55)
116.58
1506
525,230.44
454,576.37
-
70,654.07
86.55
1508
ANNUAL REPORT – 2020
-
-
-
-
-
NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
74
Acknowledgements Chief Editor(s) Dr. Dhammika Wijesinghe (Director) Dr. Arosha Wijewickrama (Deputy Director)
Data Collection Team (Planning & Development Unit) Dr. Mohamed Rikaz Sheriff (Health Informatics) Dr. Upeka Mettananda (Disaster Management) Dr. Sujani Perera (Public Health & Health Promotion) Dr. Ravi Mudalige (Public Health & Health Promotion) Ms. Nishani Chaturika (Medical Record Officer)
Publication Team (Media Unit) Dr. Kavinda de Silva Ms. Chamini Migunthanna Mr. Ashan Basnayake Mr. Lakmal Jayabuddhi
ANNUAL REPORT – 2020
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ANNUAL REPORT – 2020
NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA
