Legal matters

Admission, treatment, and discharge of a child

Shruti Ravi
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.
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 hospita, and All community-based alternatives have been exhausted, and have failed to meet the child’s needs
Two psychiatrists, or one psychiatrist and any other mental health professional, or one psychiatrist and one physician must independently make the assessment.
A child can be treated only after informed consent has been taken from their legal guardian.
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.
During the entire duration of their stay in a psychiatric hospital, the child will stay with their legal guardian or an attendant.
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 - Risk of death or irreversible harm to the child’s health, or serious harm done to themselves or to someone else, or damage done to property.
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.
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.
The following are completely disallowed: Sterilization surgery, Being chained, ECT without muscle relaxants and general anesthesia ,
When the child’s legal guardian does not support the admission or requests a discharge - the psychiatric hospital must discharge the child.
When a child — who has been admitted to a psychiatric hospital — turns 18 they will be treated as an independent patient.
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.
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.

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