Tamil Nadu notifies new mental health establishment norms, strengthens patient safety

Chennai: Tamil Nadu has notified new regulations prescribing standards for mental health establishments, covering infrastructure, staffing, patient care, admission and safety. The regulations also set specific safeguards for de-addiction and rehabilitation centres and strengthen provisions aimed at protecting the rights of patients. 

The Tamil Nadu State Mental Healthcare Regulations, 2026, notified by the State Mental Health Authority, classify mental health establishments into five categories based on the nature of services provided. The categories include standalone mental health establishments, psychiatric departments of medical colleges, psychiatric wards in multispecialty hospitals, standalone de-addiction centres and centres providing psychosocial rehabilitation.

The regulations also prescribe minimum infrastructure requirements. Wards and dormitories must provide at least 6 square metres of floor space per bed, while establishments must maintain toilets at a ratio of one for every eight patients and bathrooms at one for every 10 patients.

A gender-neutral ward and dormitory has also been mandated for in-patients who do not wish to stay in either a male or female ward. 

Stricter Admission Rules for De-addiction Centres

The regulations prescribe specific safeguards for admissions to standalone de-addiction centres. Before admission, every person must undergo an assessment by a psychiatrist, who must certify whether the individual is fit for admission.

Patients who are severely mentally ill, violent, suicidal or suffering from serious medical conditions cannot be admitted to standalone de-addiction or psychosocial rehabilitation centres. If any of these conditions develop after admission, the patient must be shifted to an appropriate mental health establishment or medical facility equipped to manage the condition.

The provision addresses situations where psychiatric or medical emergencies may be mistaken for conditions that can be managed through routine rehabilitation. Severe alcohol withdrawal, acute drug overdose and extreme behavioural disturbances can require immediate medical intervention, including continuous monitoring and emergency support that may not be available at standalone rehabilitation facilities.

Rules Governing Physical Restraint

The regulations also lay down conditions for the use of physical restraints. Restraint may be used only when there is no other available means of preventing an immediate and imminent risk of harm to the patient or another person.

Any use must be authorised by a psychiatrist, with the circumstances and duration recorded in the patient's case sheet. The details must also be entered in a separate restraint register, while the patient's family or nominated representative must be informed within 24 hours.

Patient Rights and Rehabilitation

The framework provides for family visits, communication facilities and a grievance redressal mechanism for patients. Discharge is required to be carried out in accordance with the Mental Healthcare Act, while patients who undertake work with their consent and in compliance with the applicable requirements are entitled to remuneration in line with minimum wage provisions, as reported by The Hindu. 

The regulations have also formally recognised sheltered and supported accommodation as part of the mental healthcare framework. Such facilities must maintain a rental agreement and resident register, obtain resident consent and display their registration certificate and Patient Rights Charter.

Each unit can have a maximum of five residents and must receive weekly visits from a professional social worker. Serious incidents and deaths must also be reported to the family or, where there is no family, to the police.

The 2026 regulations therefore set out requirements covering the infrastructure, staffing, professional qualifications, treatment practices, admission, restraint, rehabilitation and rights of people receiving mental healthcare across different types of establishments in Tamil Nadu.