T.N. government notifies Mental Healthcare Regulations

The Tamil Nadu State Mental Healthcare Regulations, 2026, have been officially notified.The regulations prescribe minimum standards including for infrastructure, staffing, professional qualifications, and patient care for mental health establishments, and also lay down provisions for patient safety and rights. It has classified mental health establishments (MHE) as standalone MHEs (category A), psychiatric department of medical colleges (category B), psychiatric wards of multispecialty hospitals (category C), standalone de-addiction centres (category D) and centres for psychosocial rehabilitation (category E).To ensure adequate floor space, an important specification is that the minimum area of wards/dormitories should be 6 sq.m per bed. It has also stated that there should be a gender-neutral ward and dormitory for in-patients who do not wish to be kept in either men or women wards. The number of toilets should be in a ratio of 1:8 and bathrooms should be at the ratio of 1:10.It has also stated that before admission to a standalone de-addiction centre, the person must be evaluated by a psychiatrist, who must certify fitness or otherwise for admission. Persons who are severely mentally ill, violent, suicidal, or severely medically ill should not be admitted to standalone de-addiction or psychosocial rehabilitation centres. If such a condition develops after admission, the person should be transferred to an appropriate category A/B/C MHE or medical establishment.The reason behind this was that conditions like severe alcohol withdrawal (manifesting as delirium tremens), acute drug overdoses, or profound behavioural agitation are medical and psychiatric emergencies. They carry high risks of cardiovascular collapse, seizures, severe electrolyte imbalances, and aspiration. Standalone de-addiction centres, particularly those focused primarily on psychosocial rehabilitation, counselling, and long-term recovery, often lack the 24/7 intensive care infrastructure, emergency crash carts, continuous multi-parameter monitoring, and immediate access to acute medical specialists required to manage life-threatening withdrawal states.While acute stabilisation should take place at a general hospital or multi-specialty medical facility with a psychiatric department, families in distress often fail to make this distinction and turn to the nearest facility bearing a “de-addiction” sign. This was considered while framing the regulations for the admission criteria to MHEs in categories D and E.Physical restraint, it said, was permitted only when it is the only means available to prevent imminent and immediate harm to the person or others. It must be approved by a psychiatrist, have circumstances and duration documented in the case sheet, be entered in a separate restraint register, and should be reported to the family/nominated representative within 24 hours.The regulations also provide for family visits, communication facilities, grievance redress mechanism, discharge in accordance with the Act, and remuneration for work undertaken by patients, with consent and compliance, under minimum wage requirements.The regulations also formally recognises sheltered and supported accommodation. The key requirements include weekly visits by a professional social worker, rental agreement, resident register and consent, maximum five residents per unit, display of registration certificate and Patient Rights Charter and reporting of serious incidents/deaths to family or police where there is no family. Published - September 15, 2026 09:37 pm IST