The recently formed Karnataka State Mental Health Authority (KSMHA) is developing a set of minimum standards for mental health facilities in the state, many of which lack adequate infrastructure and professionals.
The authority has the power to shut down detox centers and mental health clinics that do not meet standards, causing more harm than good to patients.
The standards are part of the state’s draft Mental Health Regulations, under the Mental Health Act of 2017. KSMHA has formed a three-member panel, which is currently drafting the regulations. Once complete, the draft will be reviewed by a 15-member committee headed by Nimhan’s director, Dr. Pratima Murthy.
Dr. Prashantha NR, KSMHA Additional Member Secretary, said he will send the final draft to the state legislature in a couple of months. After the approval of the legislature, the authority can enforce the regulations.
“Currently we are giving provisional registration to mental health establishments. They will get permanent record only after they send us in writing that they have met the new standards. We will also carry out routine inspections to check if they are working according to the rules,” says Dr. Prashantha.
Although similar standards existed as part of the ‘State Mental Health Rules, 2012’ under the Mental Health Act 1987, the state mental health authority did not have the power to act against failing institutions. The powers rested with the deputy commissioner of the district.
However, with their multiple responsibilities, deputy commissioners acted on complaints from the public and rarely proactively identified illegal institutions.
“Under the 1987 Act, the deputy commissioners were the licensing and enforcement authorities,” said Dr. H Chandrashekar, secretary member of the former state authority. “The State Mental Health Authority was just a policy-making body.”
He said only 250 institutions in Karnataka were licensed under the deputy commissioners at the time, while registration was zero in districts like Koppal.
Dr. Chandrashekar said the new KSMHA has to crack down on illegal mental health centers that have proliferated in large numbers. He gave the example of an addiction elimination center in Bangalore run by former addicts, which had been closed down by the deputy commissioner.
“The center did not have qualified personnel, not even a nurse. It was previously a poultry farm and only had three toilets for 130 residents,” she said. Although the demand for detox centers has been huge, people are hesitant to visit state institutions. “This has given way to illegal mental health institutions,” said Dr. Chandrashekar.
Nimhans Medical Superintendent Dr. Muralidharan K emphasized the need to regulate inpatient facilities, especially to ensure standards in care, sanitation, nutrition and expertise. The rules will not subject individual practitioners to regulation as the law does not prescribe standards, Dr. Prashantha said.
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