New norms on cards for mental health establishments in Karnataka

Karnataka has hundreds of de-addiction centres and mental health facilities. But many of them operate without sufficient facilities or professionals, often harming patients. The recently-constituted Karnataka State Mental Health Authority (KSMHA) is now developing a set of minimum standards for these centres.

The authority has the power to shut down establishments that do not comply with the standards.

KSMHA is developing the standards as part of the state’s draft Mental Healthcare Regulations, under the Mental Healthcare Act, 2017.

A three-member committee, formed by the KSMHA, is drafting the Regulations now. The draft will then be examined by a 15-member committee headed by NIMHANS Director Dr Pratima Murthy.

KSMHA will send the final draft to the state legislature in a couple of months, says KSMHA Additional Member Secretary Dr Prashantha N R. Once the legislature approves the regulations, the authority can enforce them.

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Dr Prashantha said, “Currently, we are giving provisional registration to mental health establishments. They will get permanent registration only after submitting to us in writing that they have complied with the new standards. We will also conduct routine inspections to see if they are complying with the rules.”

Such standards existed previously too, as part of the State Mental Health Rules, 2012. This was under the previous Mental Health Act, 1987. As per that Act, the State Mental Health Authority did not have the power to take action against non-compliant establishments. Only the Deputy Commissioner (DC) of each district could. But the DCs, with their multiple responsibilities, usually took action only on getting complaints from the public, and rarely identified illegal establishments proactively.

Dr H Chandrashekar, a member secretary of the previous State Authority said, “Under the 1987 Act, DCs were the licencing and enforcing authorities. The State Mental Health Authority was only a policymaking body”.

Only around 250 establishments in Karnataka had received licences under the DCs then and there was zero registration from some districts, like Koppal, said Dr Chandrashekar.

He said there is a dire need for the current KSMHA to take proactive action, given a large number of illegal facilities.

He gave the example of a de-addiction centre in Bengaluru that was run by ex-addicts themselves, which the DC shut down. “The centre had no qualified personnel or even a nurse. It was a poultry farm previously and had only three toilets for 130 residents,” he added.

“There’s a huge demand for de-addiction facilities, but people are hesitant to go to government facilities. So there’s a huge racket running illegal facilities,” he said.

Nimhans Medical Superintendent Dr Muralidharan K said regulations are very important for in-patient facilities, especially in terms of care, sanitation, nutrition and expertise.

However, no standards will be set for individual mental health professionals as the Act doesn’t prescribe this, Dr Prashantha said.