The legal guardian (or nominated representative) must apply for admission
The child’s legal guardian or the person who has been appointed to be the child’s nominated representative must apply to the doctor who is in charge of the hospital or the mental health professional in charge.
The assessment will check for four conditions
A child can be admitted only if:
The child has a mental illness of very high severity.
Getting admitted to a psychiatric hospital is in the best interests of the child.
The child’s mental healthcare needs can be met only if they are admitted to a psychiatric hospital
All community-based alternatives have been exhausted, and have failed to meet the child’s needs
Two mental health professionals must conduct the assessment
Two psychiatrists, or one psychiatrist and any other mental health professional, or one psychiatrist and one physician must independently make the assessment.
The rule of informed consent is followed
A child can be treated only after informed consent has been taken from their legal guardian.
The hospital must ensure a safe environment
The child must be accommodated separately from adults.
The place must be of an environment that takes into account the child’s age, developmental needs, and is of the same quality as the place where children receiving non-psychiatric treatment stay.
An adult must accompany the child during the stay
During the entire duration of their stay in a psychiatric hospital, the child will stay with their legal guardian or an attendant.
A woman attendant will be appointed
If the child’s legal guardian is a man, a woman attendant appointed by him will stay with the child.
A situation where there is a high risk of danger to a person or harm to property
A situation where there is
- Risk of death or irreversible harm to the child’s health.
- Serious harm done to themselves or to someone else.
- Damage done to property.
An exception is made in case of an emergency
In case of an emergency, if the legal guardian is available their informed consent will be taken. If not, the child will be treated without the legal guardian’s informed consent.
Only if the required permissions have been taken
ECT is not allowed in the case of a child. But, if the psychiatrist in charge is of the opinion that ECT is required, then informed consent needs to be taken from the child’s legal guardian, as well as prior permission of the district mental health review board (in case there is no district mental health review board, then the relevant district’s disability commission can be approached).
ECT is not a part of treatment that is permitted in case of an emergency, it can’t be given to a child in such a situation.
There are three procedures that are not permitted in any situation
The following are completely disallowed:
ECT without muscle relaxants and general anesthesia
The legal guardian will decide this
When the child’s legal guardian does not support the admission or requests a discharge - the psychiatric hospital must discharge the child.
There is a change of rules once a child turns 18
When a child — who has been admitted to a psychiatric hospital — turns 18 they will be treated as an independent patient.
The admission of a child has to be reported mandatorily
The medical officer or mental health professional in charge must inform the district mental health review board within 72 hours of the child having been admitted.
A stay beyond 30 days must be reported mandatorily, followed by a review
The district mental health review board must be immediately informed about a child’s admission continuing beyond 30 days.
Within a period of seven days of being informed, the board must conduct a mandatory review and do this every 30 days after.