(1) These regulations will be called Minimum Standards of Care for Centres Providing Substance use Disorder Treatment and Rehabilitation, 2018

(2) They will come into force on the date of the publication in Official Gazette.

(1) In these regulations unless the context otherwise requires,

(a) Act means Mental Healthcare Act, 2017 .

(b) Forms as prescribed in The Mental Healthcare Act, 2017

(c) Section means section of The Mental Healthcare Act, 2017

(d) Counselor is a person trained to give guidance on personal or psychological problems, with minimum qualification being graduate in Clinical Psychology/Psychology or Social Work and with 6 month experience in De-addiction services.

(2) The words and expression used herein and not defined, but defined in the Act or as the case may be, in the Mental Healthcare Act, 2017, in so far as they are not inconsistent with the provisions of the Act, shall have the meanings as assigned to them in the Act or, as a case may be in those enactments.

INTRODUCTION AND BACKGROUND

3. Centres providing substance use disorder treatment and rehabilitation, commonly known as Deaddiction Centres , range from Acute Detoxification centres to long term care/Rehabilitation centres, and as per MHA, 2017 are Mental Health Establishment's (MHE's) mandatorily requiring registration. These MHE's offering deaddiction services need to maintain the minimum standards prescribed by the State Mental Health Authority (SMHA).

4. Section 65(3) of the Mental Health Care Act, 2017 empowers existing State Mental Health Authority for provisionally registering all Mental Health Establishments and specify the minimum standards for different mental health establishments.

5. Section 65(5) of the said Act, provides for classifying various mental health establishments by State Mental Health Authority and specify different standards for different categories.

(1) The substance use disorders treatment and rehabilitation centres provide one or more of the following services:

a. Acute Detoxification

b. Treatment of existing mental disorders and other co-morbidities

c. Counselling and Motivational Enhancement

d. Awareness and Patient Education

e. Vocational Skills and Rehabilitation

f. Long Term Care/Rehabilitation

(2) Depending upon the spectrum of services provided and the size of such mental health establishments providing such care, these establishment necessitate to be categorised into the following sub-categories for the purpose of prescribing the minimum standards:

a) Short Term Treatment including detoxification centre for drug abuse (< 1 month): Facility, where patients of substance abuse shall be kept and treated for symptoms of substance withdrawal and/or overdose. For this purpose, detoxification is a set of interventions aimed at managing acute intoxication and withdrawal.

b) Long Term Treatment Rehabilitation Centre (1 month or more) Here the substance use patients can be kept for more than 1 month with the focus on life skills and vocational training.

c) Treatment Centre for drug abuse and other mental disorders for patients with co-existing psychiatric disorder (Dual Diagnosis facility): Dual Diagnosis here means Substance Use Disorders present along with Psychiatric Diagnoses (not to be confused with medical co morbidities)

(3) All these facilities have been further subcategorised keeping in view the number of beds/capacity:

- Upto 20 beds

- 21-50 beds

- More than 50 beds

(4) The present standards have been formulated keeping in mind:

a. Patient Safety

b. Human rights of Patients

c. Medical and psychosocial care standards

d. Ensuring quality care

e. Humane, friendly enabling environment

f. Other contextual local factors.

(5) These facilities are expected to provide a friendly environment, rather than a restrictive atmosphere and are expected to provide facilities for recreation, indoor and outdoor games, outings, family visits, and other recreational tools.

(6) These minimum standards will be reviewed periodically every two years.

(1) The minimum standards for various sub-categories of facilities are depicted in Annexure 1. The standards have been devised to strike an appropriate balance between respectable quality medico-psycho-social care, safety and optimal functioning of the centres.

(2) It is intended that these standards shall provide essential structure to the functioning of substance use treatment centres. In view of the large need of such services and the treatment gap, these standards have been kept to the minimum and only indicative of the basic requirement for these centres in terms of infrastructure and human resource requirements. These minimum standards will be applicable for all government, private and Non Governmental Organization (NGO) facilities working in the field of drug abuse and detoxification in the State of Delhi.

(3) Psychiatric Nursing Homes/Hospitals licensed under Mental Health Act, 2017 providing detoxification facilities shall also maintain the prescribed minimum standards.

(4) Standards of Ministry of Social Justice and Empowerment 2009, AIIMS Deaddiction Centre Guidelines and Draft of SMHA Minimum Standards were consulted and deliberated for drafting the minimum standards keeping in view the local requirements.

Minimum Standards of various subcategories of Substance use disorder Treatment and Rehabilitation Facilities

1. Deptt. of Health and Family Welfare, Noti. No. F. No. 10/51/SMHA/IHBAS/2018/255, dated September 18, 2018, and published in the Delhi Gazette, Extra., Part IV, dated 19th September, 2018, pp. 7-12, No. 188.