> Hospital

Institute of Mental Health, Chennai is involved in Mental Health care for the past 206 Years.? Founded in 1794 as an asylum to manage 20 patients, it has grown into an Institute with bed strength of 1800 patients.? It is no more an asylum for custodial care but a place for enhancing mental health and a training centre for mental health professionals.? Today Institute of Mental Health is the second largest Institute in India, offering mental health services to a massive population of Tamil Nadu and Pondicherry.??

The Institute is served by an army of trained professionals. Psychiatrists, Psychiatric Social Workers, Clinical Psychologists, Occupational Therapists, Recreational Therapists, Special Education Teacher, Skilled Training Staff, apart from Psychiatric Nurses are functioning, in co-ordination with each other contributing their own specific body of knowledge and skills to the benefit of mentally ill.

• Number of beds sanctioned :?? 1800
  

• Inpatients mean per day: 1651
  
• Out Patients mean per day: 360

In-patient Facility:

General Information:

The hospital has a bed strength of 1800 beds in 25 wards situated in 25 acres of land with rich vegetation. Many of the wards built during British period. The hospital is built on cottages type of architecture.

• Each ward will have admission block where newly admitted and acutely disturbed patients are lodged. Usually admission block is kept under lock and key to prevent patients from running away from the ward.
  

• Apart from admission there will be few improved blocks where the improved patients are housed. These blocks are generally kept open during the day time to facilitate the patients to attend recreational activities and occupational therapy
  
• An attendant will be posted to each block in the ward and he is expected to stay near the block all the time to attend to the needs of the patients

Following facilities are available in the in-patient services

• Wards for different category of patients:
  

• Wards for male patients
  
• Wards for female patients
  
• Wards for male and female children
  
• Special wards - A and B class
  
• Ward for critically ill male and female patients
  
• Rehabilitation ward
  
• Ward for male patients with Hansen disease
  
• De-addiction ward
  
• Male and female wards for mentally ill prisoners
  
• Ward for patients with Epilepsy

Rehabilitation services

• Industrial therapy center
  

• Occupational therapy center

• Each ward will be managed by Medical officer, Social welfare Officer, Staff Nurses, Attendants and Sanitary Workers. Duty hours of the medical officer and Social welfare officer are between 8.00 AM and 2.00 PM. Others work in shifts.

• Relatives who visit the patients at their wards are requested to meet the medical officer or Social welfare officer to know about the condition of the patient. If the medical officer not available in the ward due to other work like academic work, official meetings, etc the staff nurse of the ward will know his whereabouts.

• Based on the monthly income, the patients are classified into Paying and Non-paying category of patients. Patients are eligible for free treatment if their monthly income is less than Rs.1000/- Treatment and medication are same for both the paying and non-paying category of patients. Paying patients are entitled for special diet and special ward

Emergency Services:

• Round the clock emergency services are available in the hospital.?
  

• From 8 AM to 1PM the emergency services are provided at OP block. From 1PM to the next day 8 AM the emergency services are offered at the In patient campus
  
• Hospital does not have facility to pick up patient from their houses
  
• Hospital has not authorized any one to pick up patients from their houses or other places
  
• Hospital telephone numbers for emergency needs are 6421085, 6421086, 6421087 and 6421088

Services offered:

Outpatient services at the Institute of Mental Health, Chennai were first started on a small scale in the year 1947.? The year 1962 witnessed further expansion and improvement in these services.? For the first time, a day hospital facility was offered at the outpatient department.? A separate block for outpatient services started functioning from 1970, with wards to treat acute mental illness on a short-term basis.? A pioneering treatment centre for drug and Alcohol problems was established in response to the growing menace of drug abuse and Alcoholism, especially among the youth.? This Centre treats about 1000 patients every year and is engaged in research activities on drug and Alcohol abuse.

The Institute offers rehabilitation services for the chronic mentally ill.? The industrial therapy unit and occupational therapy unit facilitate in the rehabilitation by providing skills training on crafts like weaving, basket-making, soap manufacturing, binding, painting, soft toy making and quilting.? The bakery division produces quality bread for Institute of Mental Health and other hospital consumption.

Apart from its regular outpatient services, Institute of Mental Health also provides special clinical services for epilepsy, child guidance, problems of old age, neuropsychiatry, neurosis, sexual problems, crisis intervention, alcoholism and drug addiction on specified week days

During the year 1998, 4821 new cases were registered and 102801 old patients were reviewed at the out patients department.? Totally 5738 mentally ill patients were admitted into different wards of Institute of Mental Health.? Apart from the above-mentioned General Psychiatric patients, in the year 1998 around 18,000 patients were treated at the various special clinics in the out patients department.

Further details about services available are available in the Citizens Charter of Institute of Mental Health

Out-Patient Facility:

• Out Patient Department functions from 8.00 AM. to 1 PM.?
  

• Outpatient department functions on all the 365 days of the year.?
  
• Every patient seeking treatment in the hospital is registered in the out patient department
  
• Following is the procedure adopted for the registration of new cases:
  • Reception desk at the entrance of the OP block is managed by staff nurses
    
  • Patients or their relative are requested to register their name with the staff nurse at the reception
    
  • Particular number of patients can only be examined in a day hence an appointment system is being followed for registration. Surplus patients are requested to come for registration at prescribed dates
    
  • It is advisable to come to the hospital at 7.30 AM for early registration and examination
    
  • Later the patients will be assessed by the Medical Officer In-charge of OP and registered.
    
  • After registration the patient's history will be psychiatric social workers. Subsequently he will be examined by the junior doctors and later presented to the senior doctors and consultants for opinion regarding management
    
  • Admission are done liberally and the hospital practices revolving door policy where admissions and discharges are encouraged. Hence the patients and relatives are requested not to be apprehensive about and do not get mislead by intermediaries who promise to get them the admission
    
  • If the patients income is below Rs.1000/- per month he will be treated free of cost, which includes admission, medicines, laboratory investigations, etc.
    
  • Once the patient is registered by the medical officer in-charge of the OP, he will be given an OP number by the clerk in the OP block.
    
  • As the mentally ill patients need detailed evaluation, it will take more than an hour to complete the examination of the patient

Follow Up and Review of Old Cases:

• All the new cases registered and patients discharged from inpatient services are followed up at the Out patient department
  

• There are four consultation rooms located in the follow up wing of the OP block.
  
• A psychiatrist and an attendant to help him are posted to each room.?
  
• Seven units patients are given follow up treatment in the OP block
  
• Medicines are issued for one month at a time for the patients coming from far off places
  
• It is advisable to bring the patient for periodic follow up
  
• Admissions are done liberally hence there no need to approach any middleman for seeking admission. If you have any doubt kindly talk to the medical officer
  
• Review will be done only with the case file of the patients.
  
• Patients coming for follow up care are requested to present their OP ticket to the record room for tracing their case records. Any undue delay in tracing the case file may be brought to the notice of the Medical officer in-charge of OP

Special Clinics:

Hospital conducts special clinic for the certain category of patients. Following are the different special clinic conducted (Timing? 8 a.m? to? 1 p.m.)

Geriatric and Neuropsychiatry - Monday?
Child Guidance Clinic - Tuesday
De-addiction Clinic -? Wednesday
Epilepsy Clinic - Thursday
Adolescence Clinic - Friday
Neurosis Clinic -? Saturday

• Special clinic does not function on Sunday
  
• Patients below 12 years are registered in the child guidance clinic and patients between 13 to 18 years are treated at the Adolescence clinic. Hence patients belonging to these categories are requested to come on Tuesday or Friday for registration.
  
• Patients for all other special clinic will be registered in the main OP and later referred to special clinic
  
• An in-charge medical officer, psychiatric social workers and attendant are posted to the special clinic. Depending on the needs, one or more additional medical officers are posted to each clinic??

Admission Procedure for Old Patients:

• Depending on the need of the patient the medical officer of the particular unit will decide about the admission and admit the patient
  

• Once the patient is advised admission he should sign a declaration forms stating that he is willing for admission. This is an important formality in the admission of mentally ill patient in the hospital.
  
• Then the case is sent to the OP clerk for allotting the in patient number for the patient. If the patient's in come is more than Rs.1000 he becomes the paying patient and he has to pay a nominal charge for admission.
  
• Patients are requested to insist on official receipt for any payment made by them

Day hospital

• Some of the patients can be managed by keeping them in the hospital only during the daytime. For this purpose a day hospital is established at the OP block
  

• There are separate male and female day hospitals at the old patients wing of the OP Block
  
• Each ward can accommodate 10 patients
  
• Patients are kept in these wards from 8 AM to 4PM.?
  
• Staff nurses and attendants are posted for the day hospital

Rehabilitation Facilities:

Rehabilitation Services:

Institute has well established rehabilitation services for both in-patients and outpatients. The Industrial Therapy Centre (ITC) established in the 1972 runs Hospital canteen, Bakery, Cover making unit, Candle making unit, Chalk piece unit, Soft toy unit etc. Improved patients are employed in the above said units?

Occupational Therapy Centre is another unit, which caters to rehabilitation needs of the Institute. It has bookbinding, tailoring, weaving, blacksmith, painting, carpentry units, improved patients are imparted training.

Rehabilitation Council of India Bridge Course?

Rehabilitation Council of India (RCI) has identified Institute of Mental Health as one of the train centre for training the rehabilitation personnel. So far three training programs have been conducted and more than 75 persons from different NGOs had been trained.

Laboratory Facilities

• Hospital has a well equipped laboratory services which includes blood tests, X-ray, ECG and Electro Encephalogram
  

• Certain routine blood investigations are done for all the patients who are registered
  
• After registration and examination each patient is given a blood investigation form which they have to produce in the laboratory situated in the first floor of the OP block
  
• The results of the blood investigations will be entered in the respective patients case sheet
  
• Patient desires to know their laboratory results may get the information from the medical officer
  
• Electro Encephalogram (EEG) laboratory is situated in the inpatient campus. Patients should produce the EEG forms at the EEG lab to get appointment for doing EEG

Psychological Testing Facilities

• One clinical Psychologist is posted at the OP block and three others are in the in-patient services. They will be in-charge of conducting psychological tests like IQ assessment, Personality assessment, Etc
  

• All the patients do not require psychological testing. The medical officer examining the patient will decide about the need for psychological assessment and refer the patient to the clinical psychological by noting in the OP ticket or case file
  
• Patients are expected to produce the OP ticket to the Clinical psychologist for psychological testing
  
• Psychological testing will take two to more sessions depending on the nature of the tests. Hence patients will be given appointment for conducting the tests.
  
• Final psychological testing report will be filed in the case sheet. Patients can get information about the test result from the medical officers

Academic activities:

The Institute of Mental Health, attached to Madras Medical College, Chennai has a department of psychiatry at Government General Hospital.? Institute of Mental Health is an important teaching centre in Psychiatry and allied branches.? Postgraduate courses offered at Institute of Mental Health and Chennai Medical College is affiliated to Tamil Nadu Dr. M.G.R. Medical University and formerly its courses were affiliated to University of Chennai.? Teaching programs are conducted here for medical undergraduates, Postgraduates and for students of behavioural sciences.? Social workers with postgraduate training in Psychiatric Social work conduct the teaching programs of the Social work Department.? Nurses with training in Psychiatric Nursing are also on the teaching staff of the hospital.

• Psychiatric training programs for various categories of students
  

• Library? facility? is? available.? It? is established in1966
  
• Community Mental Health:
  
• Community Psychiatry Projects?
  
• Epidemiological study of psychiatric morbidity in an industrial population undertaken at Kalpakkam atomic energy center in the year 1994-95
  
• National Mental Health Program
  
• Training of trainers program 1996, a govt. of India sponsored program??
  
• District Mental Health Program?

Institute of Mental Health has been selected as a Nodal centre for this project by Government of India. The project is being implemented at Trichi. It is a five-year project commenced from 1997. The District Mental Health Program, Trichi implemented by Institute of Mental Health is emerging as a model community program for the country.

• Out Reach Services of Institute of Mental Health
  

• Counseling & Rehabilitation services at Seva Sadan and YWCA.
  
• Community services at?????????
  • District Mental Health Program at Trichi?
    
  • Psychiatric Health Centre, Poonamallee
    
  • Beggars Care Camp, Melapakkam?????
    
  • Half way Home for women YWCA