S.I. No. 261/1961 -- Mental Treatment Regulations, 1961

S.I. No. 261/1961 -- Mental Treatment Regulations, 1961 1961 261

S.I. No. 261/1961:

MENTAL TREATMENT REGULATIONS, 1961

The Minister for Health in exercise of the powers conferred on him by sections 8, 110, 129, 132, 151, 153, 161, subsection (7) of section 96 and subsection (7) of section 97 of the Mental Treatment Act, 1945 , (No. 19 of 1945), section 109A of the said Act (inserted by section 3 of the Mental Treatment Act, 1961 , (No. 7 of 1961)), and paragraph (c) of subsection (4) of section 65 of the said Act (as substituted by subsection (4) of section 41 of the Mental Treatment Act, 1961 ,) hereby makes the following Regulations:--

PART I PRELIMINARY

Citation and commencement.

1.--(1) These Regulations may be cited as the Mental Treatment Regulations, 1961.

(2) These Regulations shall come into operation on the 1st day of March, 1962.

Definitions.

2. In these Regulations, unless the context otherwise requires,--

" the Act " means the Mental Treatment Act, 1945 ;

" patient " means--

( a ) a person suffering from illness of a mental or kindred nature and receiving care and treatment in a mental institution, or

( b ) a person receiving advice or treatment at a consulting room or clinic in pursuance of the Act, or

( c ) a person receiving preventive care or after-care from a mental hospital authority;

" mental hospital authority " means--

( a ) a health authority within the meaning of the Health Act, 1947 , (No. 28 of 1947) in their capacity as an authority performing functions under the Mental Treatment Acts, 1945 to 1961, or

( b ) a joint board performing functions under those Acts;

" intern patient " means a patient maintained in a mental institution for the purpose of receiving care and treatment therein.

Revocations.

3. The Mental Treatment (Regulations) Order, 1946, (S.R. and O. 1946 No. 202) and the Mental Treatment (Examinations by Authorised Medical Officers) Order, 1946 (S.R. and O. 1946, No. 293) shall be revoked as from the commencement of these Regulations.

PART II APPLICABLE TO EVERY MENTAL INSTITUTION

4.--(1) There shall be kept, in each mental institution for intern patients, a register in the form prescribed in article 23 of these Regulations.

(2) The following provisions shall apply to the said register:--

( a ) There shall be entered in the register in regard to every patient taken care of in the institution the following particulars:--

(i) full name, address, age, sex, occupation, marital status and date of reception;

(ii) date of discharge, death or departure and reason for departure;

( b ) the said particulars in regard to voluntary patients, temporary patients and persons of unsound mind may be kept in one register or in two or three registers; where particulars of more than one class of patient are kept in a register there shall, in addition to the said particulars, be indicated opposite the name of each patient the class to which he belongs;

( c ) where a register contains the name of any temporary patient:--

(i) there shall be entered opposite such name particulars of any extension of the period of detention;

(ii) the register shall be examined at regular intervals, by a person authorised for that purpose by the authority carrying on the mental institution, to ensure that no patient is being detained without proper authority;

(iii) the dates of the examination of the register shall be recorded in the register and shall be signed by the person who carried out the examination;

( d ) the register may be either in book form, or in loose leaf form;

( e ) where any change occurs in the classification of a patient the change shall be recorded in the register;

( f ) there may be entered in a register such other particulars as may be considered necessary by the authority carrying on the mental institution.

Case record.

5. There shall be kept in respect of each patient in a mental institution a case record, in which the following particulars and such other particulars as may be considered necessary by the authority carrying on the mental institution shall be entered in regard to each patient:--

(i) the name, date of reception, age, sex, religion, occupation, marital status, address of nearest relatives;

(ii) the family history of the patient;

(iii) the personal history of the patient;

(iv) the history of the illness for which the patient is being treated;

(v) a diagnosis of the patient's illness;

(vi) the classification of the patient;

(vii) particulars of the medical examination on reception; any contusions or injuries on the person of the patient shall be recorded;

(viii) an entry giving particulars of the condition of the patient each week during the first four weeks after the patient's reception;

(ix) an entry giving particulars of the condition of the patient each month for the period of three months following the period referred to at (viii) above;

(x) an entry giving particulars of the condition of the patient each half year after the period referred to at (ix) above;

(xi) particulars of any material change in the mental condition of the patient;

(xii) particulars of any unusual occurrence in relation to the patient (including accidents);

(xiii) date of discharge, removal or death; in the case of death particulars of cause should be given.

Seclusion and bodily restraint.

6.--(1) For the purposes of this article--

( a ) seclusion of a patient in a mental institution means the placing of a patient (except during the hours fixed generally for the patients in the institution to retire for sleep) in any room alone and with the door of exit locked or fastened or held in such a way as to prevent the egress of the patient;

(b) bodily restraint of a patient in a mental institution means the application of clothing or other material whereby the movements of the body or any part of the limbs of a patient are restrained or impeded.

(2) Seclusion or bodily restraint shall not be used except where it is essential for the safety of the patient, or the safety of others, and is certified as so essential by a medical officer.

(3) Seclusion or bodily restraint shall be as moderate in duration and extent as is consistent with the safety of the patient and his benefit.

(4) Where the seclusion or the bodily restraint of a patient in a mental institution is necessary the following provisions shall apply:--

(a) in every case where seclusion or bodily restraint is applied particulars describing the means of seclusion or restraint used and the grounds therefor shall be entered in the register prescribed in article 24 of these Regulations; an entry shall be made each day on which seclusion or restraint is applied and the entry shall be signed by the medical officer who ordered such seclusion or restraint;

(b) the following only shall be made use of for the purpose of bodily restraint:--

(i) a jacket or dress laced or buttoned down the back, made of strong linen or similar material, with long outside sleeves fastened to the dress only at the shoulders, and having closed ends to which tapes may be attached for tying behind the back when the arms have been folded across the chest, or

(ii) a jacket with blind sleeves;

(iii) gloves without fingers, fastened at the wrists and made of strong linen, chamois leather or similar material;

(iv) sheets or towels, when tied or fastened to a bed or other object;

(c) while under restraint, a patient shall be kept under special supervision and shall be visited at frequent intervals by the nurse in charge of the department in which the patient is accommodated and by a medical officer at such intervals as such officer considers necessary;

(d) while in seclusion, a patient shall be visited at least once in every fifteen minutes by the nurse in charge of the department in which the patient is accommodated and by a medical officer at such intervals as such officer considers necessary;

(e) the following shall not be considered as means of bodily restraint for the purposes of this article:--

(i) splints, bandages and other like appliances used in accordance with recognised surgical practice for operation or the treatment of fractures or other local injuries and so applied as not to interfere with the free movement of the body or limbs more than is necessarily incident to their use for such purpose;

(ii) gloves if fastened so as to be removable by the wearer;

(iii) trays or rails fastened to the front of chairs to prevent young persons, cripples or aged or infirm adults from falling, where in the case of an adult it is within the patient's power to undo the fastening;

(iv) any restraint which is necessary for the sole purpose of giving electrical or other special treatment to a patient, or for the purpose of feeding a patient.

Correspondence of patients.

7. Where the person in charge so thinks fit, correspondence to or from an intern patient may be examined by him but letters to which section 266 of the act applies shall not be opened.

PART III APPLICABLE TO MENTAL HOSPITAL AUTHORITIES

Rules for visiting committees.

8. In addition to the duties specified in section 96 of the Act in relation to the visiting committee of a district mental hospital and in section 97 of the Act in relation to the visiting committee of an auxiliary mental hospital which is not part of the district mental hospital, the following rules shall apply to visiting committees and visiting members of such committees:--

(a) at least once every two months the visiting committee acting collectively or by any two or more members nominated by them shall inspect the hospital and the other institutions and accommodation maintained by the mental hospital authority;

(b) on the occasion of each visit of inspection the visiting members of a visiting committee shall be accompanied on their visit by the chief medical officer of the institution or by a medical officer acting on his behalf;

(c) on the occasion of each visit of inspection the visiting members of a visiting committee shall do the following things:--

(i) see any patient whom they are requested by the patient or any other person to see;

(ii) examine at least one of the following:--

(I) the kitchens and dining rooms and the arrangements for the preparation and distribution of food;

(II) the day-rooms and the arrangements fox the occupation and recreation of patients;

(III) the washing, bathing and sanitary facilities;

(IV) the sleeping accommodation for patients;

(iii) report to the mental hospital authority on the visit and indicate any matters which require attention;

(d) the visiting committee shall so arrange its visits that all parts of the hospital and the other institutions and accommodation maintained by the mental hospital authority are visited and inspected at least once a year.

Prescribed conditions for entry in register under section 65 of the Act of names of certain officers and servants.

9. The following shall be the conditions to be fulfilled for entry in the register maintained under section 65 of the Act (as amended by section 41 (4) of the Mental Treatment Act, 1961 ) of the name of an officer or servant of a mental hospital authority part only of whose employment consists of the care or charge of patients:--

I--(a) the officer or servant shall be directly and personally responsible for the care or charge of patients and not merely working with or near patients who are not in his direct care or charge or not merely responsible for the direction or supervision of a person having direct responsibility for the care or charge of patients, and

(b) the officer or servant shall have the care or charge of patients in the normal course of his duties as an officer or servant and not merely as a duty occasionally assigned to or performed by him,

II-- the officer or servant shall be an officer or servant--

(i) whose name was, on the day on which section 41 of the Mental Treatment Act, 1961 , became operative, on the register maintained under section 65 of the Act, and

(ii) who continues to have the care or charge of patients to an extent not materially reduced thereafter.

Cost of care, maintenance and treatment for the purposes of sections 108 and 212 of the Act.

10.--(1) For the purposes of section 108 of the Act, the full cost of the care, maintenance and treatment of a patient on any day in a district mental hospital or other institution maintained by a mental hospital authority shall be determined by adding the full cost of any specialist medical assistance employed solely in connection with the patient to the average daily cost of maintenance of a patient in the hospital or institution determined in accordance with article 93 of the Public Bodies Order, 1946 (S.R. and O. 1946, No. 273).

(2) For the purposes of section 212 of the Act, the average cost of maintenance of a patient in a district mental hospital shall be calculated in the same manner as the average daily cost of maintenance of a patient in the hospital or institution is determined in accordance with Article 93 of the Public Bodies Order, 1946.

Payment of fee for medical examination under the Act.

11. The following shall be the prescribed provisions for the payment under section 274 of the Act (as amended by section 37 of the Mental Treatment Act, 1961 ) of a fee for an examination made pursuant to section 162, 165 or 166 of the act or for the purposes of section 184 or 190 thereof:--

(a) where a registered medical practitioner makes a medical examination of any person he shall, not later than one month after the date of such examination, or such extended period as the mental hospital authority shall in its discretion allow, submit to the mental hospital authority in the Form No. 10 in the Schedule hereto a claim in respect of the examination;

(b) where a recommendation for reception pursuant to section 162, 165 or 166 of the Act or a certificate for the purposes of section 184 thereof is not granted the relevant application in the Form No. 4 or 6 in the Schedule hereto shall be furnished to the mental hospital authority and the portion of the said Form indicating why the certificate or recommendation was not given shall be completed and on payment of the fee the said Form shall be returned to the said practitioner;

(c) where a registered medical practitioner makes an examination he shall not demand or receive any fee or other payment or consideration from any person other than the mental hospital authority in reward for his services;

(d) no fee shall be payable where a registered medical practitioner fails to complete properly any certificate or recommendation and it is necessary to have a further certificate or recommendation completed by another registered medical practitioner;

(e) not more than one fee of two guineas shall be payable in respect of any particular examination.

Assignment of work to patients.

12.The assignment of work to a patient in a mental institution shall be in accordance with therapeutic principles and not in accordance with the considerations which would apply if he were employed as a servant, or under a contract of service.

Payments to patients for work done.

13.--(1) A mental hospital authority may make payments to patients in respect of work done where the authority, acting on the advice of the resident medical superintendent, consider that it is in the interests of the patients that such payments shall be made.

(2) The amount of any payment shall not exceed such sum as may, from time to time, be approved by the Minister.

(3) Payments shall be made only to such patients as, in the opinion of the resident medical superintendent, are likely to use the amount received for their benefit.

(4) Payments may be made in cash or by means of a voucher entitling the patient to purchase from the hospital goods to the value of the amount stated therein.

PART IV APPLICABLE TO PRIVATE, PRIVATE CHARITABLE AND APPROVED INSTITUTIONS

Application for registration or approval.

14.--(1) An application for registration of an institution as a private institution, or as a private charitable institution, or for an approval order under section 158 of the Act shall be made in the Form No. 3 in the Schedule hereto and shall be sent by post to the Minister or delivered at the offices of the Minister.

(2) An application for registration or approval shall contain the following particulars:--

(a) the full name and address and the occupation of the applicant;

(b) particulars of the applicant's estate or interest in the institution;

(c) the full name and occupation of the person to be in charge of the institution and who shall reside in the institution;

(d) particulars of the registered medical practitioner or practitioners to be in charge of the patients in the institution;

(e) particulars of the nursing staff to be employed in the institution;

(f) a full description of the institution, including its situation, acreage of lard included in the premises, particulars of buildings and their condition of repair, number and dimensions of wards and sleeping apartments in the institution, numbers of beds for patients to be provided in the institution and particulars of water supply, sanitation, heating and lighting and equipment;

(g) the number of patients of either sex proposed to be received into the institution and an indication of the method of segregation to be adopted both in the buildings and in the grounds.

Application for renewal of registration.

15.--(1) An application for renewal of registration of a private institution or a private charitable institution shall be made in the Form No. 3 in the Schedule hereto and shall be sent by post to the Minister or delivered at the offices of the Minister.

(2) An application for renewal of registration shall contain the following particulars:--

(a) the full name and address of the applicant;

(b) the situation of the institution;

(d) the number of patients of either sex proposed to be accommodated in the institution during the period for which the application is made;

(e) any variation in the particulars given in relation to the institution in the application for registration.

Fees for registration or renewal of registration.

16--(1) The prescribed fee to accompany an application to the Minister for registration or renewal of registration of a private institution shall be as follows:--

(a) where the maximum number of patients proposed to be taken care of in the institution at any one time does not exceed ten, five pounds ten shillings;

(b) where the maximum number of patients proposed to be taken care of in the institution at any one time exceeds ten, five pounds ten shillings, together with a sum of ten shillings for each patient in excess of ten proposed to be taken care of in the institution.

(2) The prescribed fee to accompany an application to the Minister by the person who carries on a private institution following the cesser by the registered proprietor to carry on the institution consequent upon any transfer, death or other event shall be one pound.

Additions and alterations to institutions.

17. Notice to the Minister of any addition to or structural alteration of the premises of a private institution or a private charitable institution shall be accompanied by sketch plans to the scale of not less than one-sixteenth of an inch to one foot of each floor of the building with the addition or alteration shown in a distinct colour and the sizes and floor areas of the different rooms clearly indicated.

Nomination of chief medical officer.

18. The registered proprietor of a private institution, a private charitable institution or an approved institution, other than an institution maintained by a mental hospital authority, shall nominate a person who is a registered medical practitioner to be the chief medical officer of such institution. Where the person in charge is a registered medical practitioner, such person may be nominated as the chief medical officer. The registered proprietor shall inform the Minister of the person nominated as chief medical officer and shall advise the Minister of any change in such nomination.

Visitation of institution daily by chief medical officer.

19. A private institution, a private charitable institution or an approved institution, other than an institution maintained by a mental hospital authority, and in which two or more patients are taken care of shall be visited at least once in each day by the chief medical officer.

Visitation of single patient twice weekly by chief medical officer.

20. Where one patient only is taken care of in a private institution such person shall be visited by the chief medical officer at least twice in each week and at each such visit the chief medical officer shall sign a statement in the Form No. 12 in the Schedule hereto as to the health of the person visited.

Visitation of institution at other necessary times by chief medical officer.

21. In addition to the visits required by Articles 19 and 20 of these Regulations, a private institution, a private charitable institution and an approved institution, other than an institution maintained by a mental hospital authority, shall also be visited by the chief medical officer when sent for by the person in charge or the head nurse or other responsible officer of the institution, in any case of sudden illness, accident or other emergency and at all such other times as the state of the patients in the institution may render necessary.

Duties of chief medical officer.

22. The duties of a chief medical officer of a private institution, a private charitable institution or an approved institution, other than an institution maintained by a mental hospital authority, shall include the following:--

(a) to be responsible for the medical treatment of patients in the institution;

(b) to complete a case record in regard to each patient in the institution;

PART V PRESCRIBED FORMS

23. Form No. 1 in the Schedule to these Regulations, or a form substantially to the like effect, shall be the prescribed form of the register of patients for the purpose of article 4 of these Regulations, or for the purpose of section 131, 152, 155 or 160 of the Act.

24. Form No. 2 in the Schedule to these Regulations, or a form substantially to the like effect, shall be the prescribed form of the register of seclusion and of bodily restraint for the purpose of section 264 of the Act.

Application for registration, renewal of registration or approval of institution.

25. Form No. 3 in the Schedule to these Regulations, or a form substantially to the like effect, shall be the prescribed form of application for registration or renewal of registration of a private institution or of a private charitable institution, or for an approval Order under section 158 of the Act.

Reception of chargeable patients as persons of unsound mind.

26. Parts I, II, III and IV of Form No. 4 in the Schedule to these Regulations, or forms substantially to the like effect, shall be the prescribed forms for the purposes of Chapter I of Part XIV of the Act and shall be used for the purposes for which they are respectively expressed to be applicable.

Other prescribed forms.

27. Forms No. 5 to 12, inclusive, in the Schedule to these Regulations, or forms substantially to the like effect, shall be the prescribed forms for the purposes for which they are respectively expressed to relate under the Act.

FORM No. 1

SCHEDULE

MENTAL TREATMENT ACT, 1945

NAME (in full)

Address

Age (Years)

Sex M=Male F=Female

Occupation

Marital status (whether single, married or widowed).

Date of reception

Date of discharge, departure or death

Reason for departure (if not due to discharge or death)

Particulars of extensions of period of detention of temporary patients

FORM No. 2

MENTAL TREATMENT ACT, 1945

Registered Number	Date on which seclusion or restraint was used	Particulars of patient		Particulars of seclusion		Particulars of restraint	Signature of medical officer who ordered seclusion or restraint
Name	Sex	Hours of seclusion	Reasons for seclusion	Means of restraint employed	Duration of restraint	Purpose of restraint

FORM No. 3

MENTAL TREATMENT ACT, 1945

Application for registration of an institution as a private institution or as a private charitable institution, or for an approval order under Section 158 of the Act, or for renewal of registration of an institution as a private institution or as a private charitable institution.

1. Name (if any) of institution and location............................................................ ................

............................................................ ............................................................ ..................................

2. Applicant:

( a ) Name in full............................................................ ........................................................

( b ) Address ............................................................ ............................................................ ..

( c ) Occupation............................................................ ..........................................................

( d ) Particulars of estate or interest in institution............................................................ .

............................................................ ............................................................ .................

3. Person in Charge:

( a ) Name in full............................................................ ........................................................

( b ) Address ............................................................ ............................................................ ....

( c ) Occupation ............................................................ ...........................................................

( d ) Whether person in charge undertakes to reside in the institution .................................

4. Description in institution:

( a ) Total acreage of land included in premises............................................................ .........

( b ) Particulars of buildings............................................................ .........................................

............................................................ ............................................................ .....................

5. Patients to be accommodated in institution:

Male

Female

Total

( a ) Number of temporary patients	............................................................ .......................
( b ) Number of voluntary patients	............................................................ .......................
( c ) Number of persons of unsound mind	............................................................ .......................
( d ) Methods of segregation	............................................................ .......................

6. Medical staff of institution:

( a ) Name of registered medical practitioner who is to be chief medical officer of institution............................................................ .................................................

( b ) Names of other medical staff............................................................ ....................

............................................................ ............................................................ ......

7. Particulars as to the number and qualifications of the nursing staff to be employed ............................................................ ............................................................ ...................

8. I hereby apply, in respect of the institution referred to in paragraph I, for--

Delete as appropriate		(i) registration as a private institution;
		(ii) registration as a private charitable institution;
		(iii) an approval order under section 158 of the Act;
		(iv) renewal of registration as a private institution;
(v) renewal of registration as a private charitable institution.

9. I certify that the particulars given above in regard to the said institution are correct.

Signature of applicant	............................................................ .......
Date........................................................

FORM No. 4

MENTAL TREATMENT ACT, 1945 .

PERSON OF UNSOUND MIND (CHARGEABLE)

Application, Recommendation and Order for Reception and Detention of a Person as a Person of Unsound Mind and as a Chargeable Patient.

PART I.--Statement of particulars, for the purposes of section 162, 165 or 166 of the Act, regarding Person: (to be completed by applicant).

1. Name of Person............................................................ ................................................

2. Address of Person............................................................ .............................................

3. Age.............................. (years).

Sex: ...............................

4. State whether married, single or widowed: ............................................................ ...........

5. Religion:..............................

Occupation.....................................

6. Person to whom notice in respect of the said person is to be sent:--

Name ............................................................ ............................................................ ...

Address ............................................................ ............................................................

7. If any previous application was refused, state--

( a ) Name of Doctor who refused application............................................................ .....

( b ) Date of refusal............................................................ ...........................................

_______________________________________________________________________

PART II.--Application in pursuance of section 162, 165 or 166 of the Act.

To Dr...........................................................

8. I desire a recommendation for the reception and detention of the person named in paragraph 1 in the district mental hospital at............................................................ ...............as a person of unsound mind and as a chargeable patient.

9. The said person--

*( a ) is not, in my opinion, capable of deciding whether to enter hospital voluntarily;		See Note
*( b ) is not willing to enter hospital voluntarily.	(1)

*Delete whichever does not apply.

10. *( a ) My connection with the said person is as follows:--

Delete whichever do not apply		Husband
		Wife
		Relative (my relationship is that of...........................................)
		(see Note(2) )
Appropriate assistance officer acting at the request of one of the following (delete whichever do not apply): Husband, Wife, Relative (state relationship) ...............................

*( b ) This application is not being made by any of the persons specified at (a) above because............................................................ ... ..........................My connection with the said person is............................................................ ..........................

and the circumstances in which I am making the application are.................................

............................................................ ............................................................ ......

*Only (a) or (b) should be completed

11. I certify that I am at least 21 years of age, that I last saw the said person within fourteen days of the date of this application and that all the particulars given in this document are correct to the best of my knowledge and belief.

Signature of applicant............................................................ ..........................

Name of applicant (block capitals)............................................................ .......

Address of applicant (block capitals)............................................................ ....

	............................................................ ......................................
	............................................................ .......................................
Date	............................................................ .......................................
District (if assistance officer)............................................................ ..................

_____________________________________________________________________

PART III.--Recommendation for Reception in pursuance of section 163 of the Act (to be completed by a registered medical practitioner).

12. I have considered the above application. I examined the said person on

(date)......................................................and

(1) I am of opinion that he/she is a person of unsound mind, is a proper person to be taken charge of and detained under care and treatment, is unlikely to recover within six months from the date hereof and is not suitable for admission as a temporary or as a voluntary patient. I have formed this opinion on the following facts:--

( a ) Facts observed by myself:............................................................ ..................

............................................................ .........................................................

( b ) Facts communicated by others:............................................................ .........

............................................................ .........................................................

Delete either (1) or (2), whichever does not apply.

I recommend that the said person be received and detained in the mental hospital named in Part II of this form.

I am of opinion that, if so received,: he said person will be a chargeable patient.

(2) I refuse to make the recommendation for the following reasons:

............................................................ ............................................................ ...........

............................................................ ............................................................ ............

	Signature............................................................ ......
	(Registered Medical practitioner)
	Address............................................................ .......
	Date............................................................ ......

PART IV.--Order for Reception and Detention in pursuance of section 171 of the Act.

13. I have examined the recommendation for the reception of the said person and I have to-day examined the said person. I am satisfied that he/she is a person of unsound mind and is a proper person to be taken charge of and detained under care and treatment.

14. I hereby order that the said person be received and detained in the mental hospital named in Part II of this form as a person of unsound mind.

	Signature:............................................................ ...............
	(Resident medical superintendent or medical officer of the hospital acting on behalf of the resident medical superintendent).
	Date:............................................................ ......................

NOTE (1).--If the person is capable of expressing his wishes and is willing to enter hospital voluntarily, it is undesirable that he should be admitted except as a voluntary patient.

NOTE (2).--The term " Relative " broadly covers any blood relation up to second cousin but does not include an " in-law ".

FORM No. 5

MENTAL TREATMENT ACT, 1945 .

PERSON OF UNSOUND MIND (PRIVATE)

Application in pursuance of Section 177 of the Act and Order for Reception and Detention in pursuance of Section 178 of the Act of a Person as a Person of Unsound Mind and as a Private Patient.

PART I.--Statement of particulars regarding Person: (to be completed by applicant).

1. Name of person............................................................ .........................................

2. Address of Person............................................................ .....................................

3. Age........................ (years). Sex: .........................................

4. State whether married, single or widowed:............................................................ .

5. Religion: ................................... Occupation: ...................................................

6. Person to whom notice in respect of the said person is to be sent:

Name:	............................................................ .....................................
Address:	............................................................ .....................................

7. If any previous application was refused, state--

( a ) Name of doctor who refused application.................................................

( b ) Date of refusal:............................................................ ..........................

PART II--Application.

To Dr............................................................ ........................................................

8. I desire an order for the reception and detention of the person named in paragraph 1 in the mental institution at............................................. as a person of unsound mind and as a private patient.

9. The said Person--

*( a ) is not, in my opinion, capable of deciding whether to enter hospital voluntarily.		See Note (1)
*( b ) is not willing to enter hospital voluntarily.

*Delete whichever does not apply.

10. *( a ) My connection with the said person is as follows--

Delete whichever do not apply
		Wife
		Relative (my relationship is that of.................................................)
(see Note (2) ).
Appropriate assistance officer acting at the request of one of the following (delete whichever do not apply): Husband, Wife, Relative (state relationship) .......................................

*( b ) This application is not being made by any of the persons specified at (a) above because............................................................ ............................

......................................................My connection with the said person is ............................................................ ...and the circumstances in which I am making the application are:............................................................ .

............................................................ .................................................

*Only (a) or (b) should be completed.

11. I certify that I am at least twenty-one years of age, that I am not one of the persons prohibited under section 179 of the Mental Treatment Act, 1945 , (see Note 3) that I last saw the said person within fourteen days of the date of this application and that all the particulars given in this document are correct to the best of my knowledge and belief.

Signature of applicant:	............................................................ ...........
Name ,, ,, (block capitals):	............................................................ ............
Address ,, ,, ( ,, ,, ):	............................................................ ............
............................................................ ............................................................ .........
Date:	............................................................ .............

PART III.--Private Patient Reception Order:

(i) Certificate by one registered medical practitioner:

12. I have separately examined the person named in paragraph 1 on the day of 19 I am of opinion that he/she is a person of unsound mind, is a proper person to be taken charge of and detained under care and treatment, is unlikely to recover within six months from the date hereof and is not suitable for admission as a temporary or as a voluntary patient. I have formed this opinion on the following facts:--

(a) Facts observed by myself:............................................................ .................

............................................................ .........................................................

(b) Facts communicated by others:............................................................ .........

............................................................ .........................................................

13. I am separately satisfied that it is proper to make an order for the reception and detention of the said person as a person of unsound mind.

14. I am not one of the prohibited persons specified in section 178 or section 179 of the Mental Treatment Act, 1945 , (see Note 4).

Signature:	............................................................ ...................
	(Registered medical practitioner).
Address:	............................................................ ...................
	Date:............................................................ ...........

(ii) Certificate by the other registered medical practitioner:

15. I have separately examined the person named in paragraph 1 on the day of 19 I am of opinion that he /she is a person of unsound mind, is a proper person to be taken charge of and detained under care and treatment, is unlikely to recover within six months from the date hereof and is not suitable for admission as a temporary or as a voluntary patient. I have formed this opinion on the following facts:--

( a ) Facts observed by myself:............................................................ ................

............................................................ ........................................................

( b ) Facts communicated by others:............................................................ .......

............................................................ .......................................................

16. I am separately satisfied that it is proper to make an order for the reception and detention of the said person as a person of unsound mind.

17. I am not one of the prohibited persons specified in section 178 or section 179 of the Mental Treatment Act, 1945 (see Note 4).

Signature	...........................................................
	(Registered medical practitioners).
Address
	Date:........................................................
(iii) Order:	.

18. We, the signatories to the above certificates, hereby order that the said person be received and detained in the mental institution named in Part II of this form as a person of unsound mind.

Signatures:	(i)...........................................................
	(ii)...........................................................
	(Registered medical practitioners).
	Date:.......................................................

NOTE (1).--If the person is capable of expressing his wishes and is willing to enter hospital voluntarily, it is undesirable that he should be admitted except as a voluntary patient.

NOTE (2).--The term " Relative " broadly covers any blood relation up to second cousin but does not include an " in-law ".

NOTE (3).-- Section 179 of the Mental Treatment Act, 1945 , provides that no person shall be received under a private patient reception order as a person of unsound mind in a mental institution if the Order has been made by or on the application of any of the following persons:--

(i) A member of the governing body of, or the person carrying on, or in charge of, the institution;

(ii) Any person interested in the payments (if any) to be made on account of the taking care of the person proposed to be received;

(iii) Any registered medical practitioner who is a regular medical attendant at the institution;

(iv) The husband or wife, father, step-father, or father-in-law, mother, step-mother or mother-in-law, son, step-son or son-in-law, daughter, step-daughter or daughter-in-law, brother, step-brother or brother-in-law, sister, step-sister or sister-in-law, guardian or trustee, or partner or assistant of any of the persons mentioned at (i) to (iii) above.

NOTE (4).-- Section 179 of the Mental Treatment Act, 1945 , prohibits the making of an Order by any of the persons mentioned in Note (3) above. Section 178 of that Act prohibits furthermore the making of an Order by " the applicant for the order or by the husband or wife, father, step-father or father-in-law, mother, step-mother or mother-in-law, son, step-son or son-in-law, daughter, step-daughter or daughter-in-law, brother, step-brother or brother-in-law, sister, step-sister or sister-in-law, guardian or trustee or partner or assistant of the applicant for the Order, or of the person to whom the Order relates." The registered medical practitioners making the order may not be related to or connected with each other in any of the ways listed in the preceding sentence.

FORM No. 6

MENTAL TREATMENT ACT, 1945 .

TEMPORARY PATIENT (CHARGEABLE)

Application, Certificate and Order for Reception and Detention of a Person as a Temporary Patient and as a Chargeable Patient in an approved institution in pursuance of Section 184 of the Act.

PART I.--Application.

To the person in charge of............................................................ ............Hospital.

1. Name of Person............................................................ .......................................

2. Address of Person............................................................ .....................................

............................................................ .........................................

3. Age:...................... (years). Sex: ............................................................

4. State whether married, single or widowed:............................................................ ..

5. Religion: ................................. Occupation: ................................. .........

6. I hereby apply to have the person named in paragraph 1 received as a temporary patient and as a chargeable patient. The person

*( a ) is not, in my opinion, capable of deciding whether to enter hospital voluntarily.		See Note (1)
*( b )is not willing to enter hospital voluntarily.

*Delete whichever does not apply.

7. *( a ) My connection with the said person is:--

Delete whichever do not apply
		Wife
		Relative (My relationship is that of........................ ) (see Note (2) )
Appropriate Assistance Officer acting at the request of oneof the following (delete whichever do not apply):

Husband, Wife, Relative (State relationship.............)

............................................................ ...........................................................

..............................................My connection with the said person is.............and the circumstances in which I am making the application are:................................................

............................................................ ............................................................ ............

*Only (a) or (b) should be completed.

8. I certify that I am at least twenty-one years of age and that all the particulars given in this application are correct to the best of my knowledge and belief.

Signature of applicant:	............................................................ ...
(See Note (3) below before signing).
Name of applicant (block capitals)	............................................................ ....

Address:............................................................ ...................................
Date:............................................................ .........................................
District (if assistance officer):............................................................ .......

PART II.--CERTIFICATE OF REGISTERED MEDICAL PRACTITIONER.

9. I examined the person named in paragraph 1 above on the..................... day of...........................19.........

10. *( a ) I am of opinion that he/she is suffering from mental illness, requires for his/her recovery not more than six months' suitable treatment and is unfit on account of his/her mental state for treatment as a voluntary patient.

*( b ) I am of opinion that he/she is an addict and requires for his/her recovery at least six months' preventive and curative treatment.

*( c ) I refuse to give a certificate as at (a) or (b) for the following reasons:

............................................................ .........................................................

Signature: ............................................................ ....................
(Registered Medical practitioner).
Address:............................................................ .......................
Date: ............................................................ ....................

*Delete whichever does not apply.

PART III.--ORDER FOR RECEPTION AND DETENTION.

11. I have considered the above application and certificate and I hereby order that the said person be received and detained in the mental hospital named in Part I of this form as a temporary patient and as a chargeable patient.

Signature:	............................................................ .
	Person in charge of the hospital or an officer of the hospital authorised to make a temporary chargeable patient reception order.
Date:	............................................................ ...

NOTE (1).--If the person is capable of expressing his wishes and is willing to enter hospital voluntarily, it is undesirable that he should be admitted except as a voluntary patient.

NOTE (2).--The term " Relative " broadly covers any blood relation up to second cousin but does not include an " in-law."

NOTE (3).--When the application has been completed and the medical certificate obtained, two courses of action are open to the applicant:--

( a ) He may present the application and the certificate to a doctor at the hospital. If the doctor, having considered the application and the certificate, makes a temporary chargeable patient reception order, the applicant may convey the person to the hospital within seven days (in exceptional circumstances this time may be extended by not more than a further seven days).

( b ) He may convey the person to the hospital without waiting for the making of the reception order but, if he adopts this course, the applicant is obliged to inform the person of his intention to do so, of the nature of the medical certificate at Part II above and of the fact that he may request a second medical examination. If the person requests a second medical examination, he may not be removed to hospital until the second examination has been made and unless the registered medical practitioner making it has agreed with the medical certificate.

FORM No. 7

MENTAL TREATMENT ACT, 1945 .

TEMPORARY PATIENT (PRIVATE)

Application, Certificate and Order for the Reception and Detention of a Person as a Temporary Patient and as a Private Patient in an approved institution in pursuance of Section 185 of the Act.

PART I.--APPLICATION.

To the person in charge of.................................................mental institution.

1. Name of person............................................................ ........................................

2. Address of person............................................................ .....................................

3. Age.............................. (years). Sex:...................................................

4. State whether married, single or widowed............................................................ ....

5. Religion.................................... Occupation..................................................

6. I hereby apply to have the person named in paragraph 1 received as a temporary patient and as a private patient.

The person--

*( a )is not, in my opinion, capable of deciding whether to enter hospital voluntarily;

See Note (1)

*( b ) is not willing to enter hospital voluntarily.

*Delete whichever does not apply.

7. *( a ) my connection with the said person is:--

Delete whichever do not apply.		Husband
		Wife
		Relative (my relationship is that of.................................
		............................................................ ................................. ).
(See Note (2)).

*( b ) this application is not being made by any of the persons specified at (a) above because............................................................ ........................................ ............................. .......................................My connection with the person is ............................................................ .........................................................

............................................................ .........................................................

and the circumstances in which I am making the application are ............................................................ ........................................................

............................................................ ...........................................................

*Only (a) or (b) should be completed.

8. I certify that I am at least twenty-one years of age and that all the particulars given in this application are correct to the best of my knowledge and belief.

Signature of applicant	............................................................ .
Name of applicant (block capitals)	............................................................ .
Address of applicant (block capitals)	............................................................ .
	............................................................ ..
Date:	............................................................ .

PART II.--CERTIFICATE OF REGISTERED MEDICAL PRACTITIONERS.

9. We hereby declare that each of us has separately examined the person named in paragraph 1 and each of us is of the opinion that

*(a) the said person is suffering from mental illness, requires for his/her recovery not more than six months' suitable treatment and is unfit on account of his/her mental state for treatment as a voluntary patient,

*(b) the said person is an addict and requires for his/her recovery at least six months' preventive and curative treatment.

Delete whichever does not apply.

Registered Medical Practitioners		Date of examination of person
	Signature ........................................
	Address .........................................
	Date ..............................................
	Signature ........................................
	Address .........................................
Date ..............................................

PART III.--ORDER FOR RECEPTION AND DETENTION.

10. I have considered the above application and certificate and I hereby order that the said person be received and detained in the mental institution named in Part I of this form as a temporary patient and as a private patient.

	Signature ............................................................ .....................
	Chief Medical Officer of the Mental Institution or Medical Officer of the Institution authorised to make a temporary private patient reception order.
	Date:

NOTE (1).--If the person is capable of expressing his wishes and is willing to enter hospital voluntarily it is undesirable that he should be admitted except as a voluntary patient.

NOTE (2).--The term " Relative " broadly covers any blood relation up to second cousin but does not include an " in-law."

FORM No. 8

MENTAL TREATMENT ACT, 1945 .

VOLUNTARY PATIENT (CHARGEABLE).

Application for Reception of a Person as a Voluntary Patient and as a Chargeable Patient in an Approved Institution in pursuance of Section 190 of the Act.

To the person in charge of:

1. *I hereby apply to be received as a voluntary patient and as a chargeable patient. or		*To be completed by the person but only where the person is at least 16 years of age.
2. *I hereby apply to have (name of person)..........................		*To be completed by the parent or guardian but only where the person is less than 16 years of age.
of............................................................ ..(address) received as a voluntary patient and a chargeable patient.
I am the ^parent\_guardian of the person referred to above. I enclose a recommendation by a registered medical practitioner stating that he examined the said person on the............day of....................................19......and that he is of opinion that the said person will benefit by the proposed reception.

Signature of applicant	............................................................ ........
Name of applicant (block capitals)	............................................................ ........
Address (block capitals)	............................................................ ........
Date:	............................................................ .......

__________________________________________________________________

FORM No. 9

MENTAL TREATMENT ACT, 1945 .

FORM OF REPORT FOR THE PURPOSES OF SECTION 231 OF THE ACT

I.--Particulars to be filled in by mental hospital authority before document is sent to county council.

1. Full name of patient in respect of whom inquiries are made	......................................................
2. Address before reception into mental hospital	......................................................
3. Age	......................................................
4. Occupation	......................................................
5. Whether married, single or widowed	......................................................
6. Date of reception	......................................................
7. Names and address of relatives and friends known to mental hospital authority	......................................................
8. Rate of payment (if any) offered	......................................................

	Signed............................................................ .........
	.......................................(Mental Hospital Authority

II.--Particulars to be filled in by County Council.

1. Is the patient the holder of a medical card or a dependant of the holder of a medical card ? (If the answer is " yes," the remainder of this form need not be completed).	............................................................ .............
2. If patient is married, christian name and age of husband or wife.	............................................................ ..............
3. Number and ages of children under the age of sixteen years.	............................................................ .............
4. If patient is widowed, number and ages of children under the age of sixteen years.	............................................................ ..............
5. Particulars of any other dependants of patient.	............................................................ .............
6. Particulars of property belonging to the patient.	............................................................ .............
7. Valuation of land or house property belonging to the patient.	............................................................ .............
8. Acreage of farm belonging to or occupied by patient with acreage under tillage and stock carried.	............................................................ ..............
9. Particulars of income to which patient is entitled.	............................................................ ..............
10. If any other person is willing to contribute to the cost of the patient's maintenance in the mental hospital, give particulars.	............................................................ ............
11. Whether patient was insured under the Social Welfare Acts before reception. If not, state reasons.	............................................................ ............
12. Any other facts which would indicate that the cost of maintenance should be defrayed either wholly or in part by or on behalf of the patient.	............................................................ .............
13. Amount of contribution which in your opinion should be made by or on behalf of the patient.	............................................................ .............

	Signed
	.....................................(County Council).
	Date:....................................................

FORM No. 10

MENTAL TREATMENT ACT, 1945 .

Claim for fees in respect of chargeable patients examined by a registered medical practitioner pursuant to section 162, 165 or 166 of the Act or for the purposes of section 184 or 190 thereof.

To............................................................ .........

Name of Person Examined

Address of Person Examined

Date of Examination

Whether a recommendation was made or a certificate given following examination.

If recommendation was made or a certificate was given state:

Institution in which the person was to be received

Whether as a person of unsound mind, a temporary patient or a voluntary patient

I hereby claim payment of fees in respect of the examination of the patients specified above. I declare that the particulars given in this return are correct and that I have not sought or received any fee or other payment or consideration in reward for my services from any other source in respect of the examination of the person(s) concerned.

	(Signed)............................................................ ....................
	Registered medical practitioner.
	Address ............................................................ ....................
	Date: ............................................................ .....................

N.B.--If an application for a recommendation or a certificate was not granted in the case of a temporary patient or a person of unsound mind, the relative application form should be submitted with this claim.

FORM No. 11

MENTAL TREATMENT ACT, 1945 .

Registration of private institution in pursuance of section 117 of the Act or of a private charitable institution in pursuance of Section 139 thereof

CERTIFICATE OF REGISTRATION.

The Minister for Health hereby certifies that...........................................................

............................................................ ............................................................ ............

of ............................................................ ............................................................ ........ has been duly registered to keep an institution situated at.................................................

............................................................ ..in the County of............................................ as a private institution/private charitable institution for the reception of......... .. ..........male patients and.............................................female patients.

The registration is to remain in force for a period of twelve months from ..............................day of.............................................19.......

GIVEN under the Official Seal of the Minister for Health this

...............day of............................................. 19.... .

FORM No. 12

MENTAL TREATMENT ACT, 1946.

Statement of registered medical practitioner pursuant to section 130 of the Act as to health of person of unsound mind in private institution visited by him.

Name of person of unsound mind............................................................

Sex ........................................

Date of visit

Mental condition

Condition of general health

General observations

Signature

GIVEN under the Official Seal of the Minister for Health this twenty-third

day of November, 1961.

SEÁN MAC ENTEE,

Minister for Health.

The Minister for Finance hereby consents to the provisions of Article 16 of these Regulations.

Dated the twenty-third day of November, 1961.

SÉAMAS Ó RIAIN,

Minister for Finance.

EXPLANATORY NOTE

These Regulations prescribe, in relation to the authorities responsible for the care and treatment of mentally ill patients under the provisions of the Mental Treatment Acts:--

(a) the records to be kept in respect of patients;

(b) the conditions governing the necessary use of seclusion and bodily restraint;

(d) rules for the guidance of visiting committees appointed under the Acts;

(e) the conditions to be fulfilled for the entry in the register maintained under section 65 of the Mental Treatment Act, 1945 , of the name of an officer or servant of a mental hospital authority part only of whose employment consists of the care or charge of patients;

(f) the provisions for the payment of fees for the medical examination of persons whose reception as chargeable patients is sought;

(g) the principles governing the assignment of work to patients and the making of payments to patients in respect of work done;

(h) the conditions governing the registration of private institutions and private charitable institutions and the approval of institutions for the reception of temporary patients and voluntary patients;

(i) the duties of chief medical officers of private, etc., institutions and

(j) the forms to be used in connection with the reception of patients and the administration of the Acts generally.

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	Irish Statutory Instruments
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Irish Statutory Instruments

S.I. No. 261/1961 -- Mental Treatment Regulations, 1961