Tamil Nadu sets rules to keep critical patients out of ill-equipped de-addiction centres
Chennai: Nine years after the Mental Healthcare Act, 2017, Tamil Nadu has framed regulations for enforceable standards for psychiatric hospitals, de-addiction centres and rehabilitation homes, with safeguards to prevent critically ill patients from being admitted to facilities incapable of managing medical emergencies. The Tamil Nadu State Mental Healthcare Regulations, 2026, notified by the State Mental Health Authority under the central law, classify facilities into five categories — standalone mental health establishments, psychiatry departments in medical colleges, psychiatric wards in multi-speciality hospitals, standalone de-addiction centres, and centres for psychosocial rehabilitation. Wards must provide at least six square metres per bed, while facilities must have one toilet for every eight patients and one bathroom for every 10.
A key safeguard concerns admission to standalone de-addiction centres, IMH director Dr M Maalaiappan said. People with severe mental illness, violent behaviour, suicidal tendencies or serious medical illness cannot be admitted to standalone de-addiction or psychosocial rehabilitation centres, according to the regulations. Severe alcohol withdrawal, including delirium tremens, acute drug overdoses and extreme behavioural agitation are now medical as well as psychiatric emergencies,” he said.
They prescribe minimum norms for staffing, patient care, building safety, hygiene, records and protection of rights. Before admission, a psychiatrist must assess every person and decide whether the patient is fit for care at the centre or needs acute treatment elsewhere. “The provision addresses a potentially dangerous gap in addiction care. Acute stabilisation should happen at a general hospital or a multi-speciality medical facility with a psychiatry department, he added. Families, however, often approach the closest facility displaying a de-addiction sign without knowing whether it is equipped for emergency medical care. The regulations also mandate safe living conditions in all facilities, including adequate ventilation, lighting, bedding, drinking water, nutritious food, sanitation and fire-safety arrangements. They need facilities to display registration certificates, treatment tariffs and a charter of patients’ rights in Tamil and English. Facilities must also provide a gender-neutral ward or dormitory for inpatients who do not wish to be placed in either male or female wards.