*Pritha Chatterjee*
*
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*18 Feb 2011*
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*New Delhi: *For the first time in the country, quality control guidelines
for mental health institutions across the country are being compiled by the
Institute of Human Behaviour and Allied Sciences (IHBAS), under the aegis of
the Quality Council of India (QCI).
Being the first hospital to seek the prestigious QCI accreditation under the
National Accreditation Board of Hospitals (NABH), the hospital is
identifying quality assurance factors that are unique to a specialised
mental health facility.

Dr Nimesh Desai, Director of the autonomous institute under the Delhi
government, said: “The current QCI guidelines are meant for general
hospitals. Since we are the first such hospital to apply for their stamp, we
are involved in developing a framework for specific quality requirements of
mental health patients.”

*First in line*

The hospital has been working for the last three months to finalise these
guidelines, and hopes to complete its own accreditation process by this
year. QCI Secretary Dr Girdhar Gyani said, “IHBAS is doing an excellent job,
and may obtain the certification much before other hospitals that applied
long ago.”

The latest among a host of new facilities introduced at the IHBAS is a
six-bedded mother-and-child care ward, the first such at a mental health
institution in the country. Dr Rupali Shivalkar, Associate Professor of
Psychiatry at the hospital, said: “About 25-30 per cent women suffer from a
condition known as post-partum depression, which is chronic depression
post-delivery, during which they feel a sense of aversion towards the
infant. The treatment protocol for such problems usually involves separation
of the mother and the child. At IHBAS, we are now trying to treat these
conditions by keeping the mother with the infant in our new ward.”

Special paediatric beds have been procured for the ward, and two attendants
have been put on duty for every mother-child pair. The unit has also been
equipped to handle deliveries for pregnant patients as well. Till now, as
many such mothers were sent to the hospital by court orders for medical
care, the newborns were sent to NGOs or orphanages for the duration of the
treatment.

*Tweaking of guidelines*

This is one of the many aspects the institute is including in its
guidelines, which is being compiled by a team of six nodal officers,
comprising faculty members from different disciplines. Dr Shivalkar said:
“NABH guidelines gives a patient the right to refuse treatment and sign the
consent forms for treatment modalities. In cases of mental health patients,
hospitalisation and treatment are often involuntary as they are not in the
state to make the right decision.” Existing guidelines also state that
patients and their immediate relatives have the right to access treatment
records. “Often what patients reveal in the course of treatment is
confidential, and it would be a breach of trust to reveal such details to
the family,” said Dr Shivalkar.

Other important points of difference lie in critical and emergency care at
psychiatric hospitals. “While ICUs at general hospitals strictly require
infection control and equipment for monitoring a patient’s vitals, we do not
have any ventilators in our ICUs,” she added. Meant for suicidal and
homicidal patients, the ICU’s focus is on providing intensive personal care
to stabilise patients.

Security guidelines also need to be more strict in psychiatric hospitals.
“Symptomatic patients need to be kept away from sharp objects and electric
wires lest they harm themselves,” Dr Shivalkar said.

http://www.indianexpress.com/news/in-line-for-quality-stamp-ihbas-forms-rules-for-psychiatric-setups/751574/0

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