New rules classify mental health establishments into five categories and prescribe standards for infrastructure, staffing, admissions, physical restraints, rehabilitation and patient rights
Tamil Nadu has notified the Tamil Nadu State Mental Healthcare Regulations, 2026, introducing detailed standards for mental health establishments across the state. The regulations cover infrastructure, staffing, admission procedures, patient care, safety, rehabilitation and safeguards for the rights of people receiving mental healthcare.
The regulations have been notified by the State Mental Health Authority and classify mental health establishments into five categories based on the services they provide.
These include standalone mental health establishments, psychiatric departments of medical colleges, psychiatric wards in multispecialty hospitals, standalone de-addiction centres and establishments providing psychosocial rehabilitation.
Minimum Infrastructure Standards Prescribed
The regulations prescribe minimum infrastructure requirements for mental health establishments.
Wards and dormitories must provide at least 6 square metres of floor space per bed. Establishments must also 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 made mandatory for in-patients who do not wish to stay in either a male or female ward.
Stricter Admission Rules for De-addiction Centres
Specific safeguards have been prescribed for admissions to standalone de-addiction centres.
Before admission, every individual must undergo an assessment by a psychiatrist. The psychiatrist must certify whether the person is fit for admission to the facility.
People 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 such condition develops after admission, the patient must be transferred to an appropriate mental health establishment or medical facility capable of managing the condition.
The provisions are intended to ensure that psychiatric and medical emergencies requiring immediate intervention are not managed in facilities that may lack the necessary emergency support and continuous monitoring capabilities.
Conditions Prescribed for Physical Restraint
The regulations also establish specific conditions governing the use of physical restraints.
Restraint can 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 of restraint must be authorised by a psychiatrist, with the circumstances and duration documented in the patient’s case sheet.
The details must also be entered in a separate restraint register. The patient’s family or nominated representative must be informed within 24 hours of the use of restraint.
Patient Rights and Rehabilitation Provisions
The new framework provides for family visits, communication facilities and a grievance redressal mechanism for patients.
Discharge must be carried out in accordance with the Mental Healthcare Act. Patients who undertake work voluntarily and in accordance with applicable requirements are entitled to remuneration in line with minimum wage provisions.
The regulations also formally recognise sheltered and supported accommodation as part of the mental healthcare framework.
Such facilities must maintain rental agreements and resident registers, obtain the consent of residents and display their registration certificate and Patient Rights Charter.
Each unit can accommodate a maximum of five residents and must receive weekly visits from a professional social worker.
Serious incidents and deaths must be reported to the family or, where there is no family, to the police.
Comprehensive Framework for Mental Healthcare Establishments
The Tamil Nadu State Mental Healthcare Regulations, 2026, establish requirements covering infrastructure, staffing, professional qualifications, treatment practices, admissions, physical restraints, rehabilitation and patient rights across different categories of mental health establishments.
The regulations provide a state-level framework intended to standardise the functioning of mental healthcare facilities while incorporating safeguards for patients, particularly those requiring de-addiction, rehabilitation and supported accommodation services.
