ACTS OF GHANA

 MENTAL HEALTH DECREE, 1972 (NRCD 30)

ARRANGEMENT OF SECTIONS

Section

PART I—PSYCHIATRIC HOSPITALS

1. Establishment of psychiatric hospitals

2. Duties of chief administrator

3. Hospital visitors

4. Visiting committees

PART II—VOLUNTARY ADMISSION

5. Application for admission

6. Admission of patient

7. Discharge of patient

PART III—MENTAL HEALTH PROCEEDINGS

8. Court order for temporary treatment

9. Court order for prolonged treatment

10. Procedure in urgent cases

11. Hospital to have custody of patient

12. Discharge of patient

13. Fees for medical practitioner

14. Warrant for removal

PART IV—MENTAL HEALTH REVIEW TRIBUNAL

15. Establishment and proceedings of Tribunal

16. Applications to Tribunal

17. Powers of Tribunal

PART V—GENERAL

18. Property of patient

19. Treatment at other hospitals

20. State Psychiatric Hospitals

21. Removal of patients to country of origin

22. Warrant to search for and remove patients

23. Mentally ill persons found in public places

24. Notice of death of patient

25. Application in cases of mental disorder

26. Accommodation of certain classes of patients

27. Visits by friends and relatives

28. After-care service

29. Regulations

30. Interpretation

31. Repeal

IN pursuance of the National Redemption Council (Establishment) Proclamation, 1972 this Decree is hereby made:

PART I—PSYCHIATRIC HOSPITALS

Section 1—Establishment of Psychiatric Hospitals.

(1) The Commissioner may by executive instrument establish psychiatric hospitals and specify their boundaries.

(2) Hospitals established under this section shall be under the direction and control of the Commissioner.

(3) The Commissioner may establish psychiatric units in any hospital other than a psychiatric hospital, and each such unit shall for the purposes of this Decree be deemed to be a psychiatric hospital.

Section 2—Duties of Chief Administrator.

It shall be the duty of the chief administrator of every psychiatric hospital to ensure the good maintenance of the hospital and the welfare of the patients therein, and in particular it shall be his duty to ensure—

(a) that every part of the hospital, including wards, kitchens,  washing facilities and toilets, are at all times kept in a  clean and sanitary condition;

(b) that every patient is kept clean and adequately nourished and receives care and treatment adequate to his case;

(c) that every patient is kept adequately clothed;

(d) that every complaint is promptly investigated and appropriate action taken.

Section 3—Hospital Visitors.

(1) District Administrative Officers, Magistrates and such other persons as the Commissioner may nominate shall be visitors of any psychiatric hospital.

(2) A visitor shall be entitled to enter and inspect any part of a psychiatric hospital at any hour of the day or night, and may enquire into any complaint.

(3) A visitor may at any reasonable time interview any patient without an officer of the hospital being present:

Provided that no visitor shall be allowed to enter the room of any patient whom the chief administrator considers to be dangerous except—

(a) in the presence of and with the consent of the chief administrator or any other person nominated by  him in writing, or

(b) except where the person desiring to enter the room states in writing that although he has been warned that the patient is dangerous he still wants to enter his room.

(4) It shall be the duty of the chief administrator to provide facilities ensuring that the interviewing of any patient may be conducted with safety.

(5) The chief administrator shall keep a visitor's book in which every visitor who visits the hospital shall enter his name, the date and time of his visit, and any remarks he may wish to make concerning any complaint and any matter connected with the management of the hospital.

Section 4—Visiting Committees.

(1) The Commissioner shall appoint three or more visitors to be a visiting committee for each psychiatric hospital.

(2) The visiting committee of any psychiatric hospital shall meet at the hospital once a quarter, or often if necessary, and shall—

(a)  examine its books and accounts, if they think fit;

(b) inspect every part of the hospital, including wards, kitchens, stores and sanitary facilities;

(c) receive and enquire into any complaint preferred by or against  any officer, staff or patient.

(3) After each quarterly inspection the visiting committee shall submit a written report through the Director of Medical Services to the Commissioner —

(a) specifying the places inspected and the matters examined or enquired into;

(b) stating, with reasons, whether or not they find conditions in the hospital to be satisfactory;

(c) making such recommendations as they think fit for the improvement of conditions in the hospital or for any other  purpose.

(4) A visiting committee may exercise any power conferred on an individual visitor by section 3.

PART II—PSYCHIATRIC HOSPITALS

Section 5—Application for Admission.

(1) Any person in need of treatment for mental illness may, either personally or through any person whom the chief administrator is satisfied to be a responsible person, apply in writing for admission to a psychiatric hospital as a voluntary patient.

(2) An application under this section shall be directed to the chief administrator of the psychiatric hospital and shall where possible be accompanied by a recommendation from a duly qualified medical practitioner.

Section 6—Admission of Patient.

(1) A person applying for admission under this Part shall be admitted as a voluntary patient if the nature of his case so requires, and if adequate facilities for his treatment are available.

(2) A person may be treated under this Part either as an in-patient or an out-patient.

Section 7—Discharge of Patient.

(1) A voluntary patient admitted under this Part may discharge himself at any time upon giving written notice to the chief administrator of the hospital.

(2) The chief administrator of the hospital may discharge a voluntary patient admitted under this Part at any time, where he is satisfied that the patient has recovered from his mental illness sufficiently to justify such discharge.

(3) Where a voluntary patient is incapable of expressing his intentions, he shall be discharged by the chief administrator on the written application of a relative or other suitable person, where the chief administrator is satisfied that adequate arrangements will be made for the care and maintenance and, where necessary, the treatment of the patient.

(4) A written notice under subsection (1), and a written application under subsection (3), shall be made not less than seventy-two hours before the proposed time of discharge, unless the chief administrator in his discretion accepts a lesser period of notice.

PART III—MENTAL HEALTH PROCEEDINGS

Section 8—Court Order for Temporary Treatment.

(1) Any informant may give to a magistrate information on oath, supported by two medical recommendations, to the effect that it is expedient for the welfare of any person believed to be suffering   from mental illness, or for the public safety, that such person should be forthwith placed under care, observation and treatment in a psychiatric hospital.

(2) One of the medical recommendations referred to in sub-section (1) shall be from a practitioner experienced in psychiatry, and shall—

(a) specify in full detail the reasons why he considers that person to be a proper subject for care, observation and treatment;

(b) specify in full detail the facts upon which he founds his opinion, distinguishing facts which he has himself observed from facts communicated by others,

(c) state the results of his enquiries into the previous cast history of that person; and

(d) state all matters known to him which he considers likely to be of service with reference to mental treatment.

(3) Where information is laid in accordance with this section the magistrate shall in any place which he deems convenient examine the person believed to be suffering from mental illness, and in the same place or elsewhere shall hold an enquiry as to the state of mind of that person.

(4) For the purposes of an enquiry under subsection (3) the magistrate shall have the same power of summoning witness and administering oaths as in a summary trial.

(5) Where the magistrate is satisfied as a result of his enquiry under subsection (3) that there is good reason to believe the person in question to be suffering from mental illness, and that it is expedient for his welfare, or for the public safety, that he should forthwith be placed under care, observation and treatment in a psychiatric hospital, the magistrate may order that such person be placed under care, observation and treatment in a psychiatric   hospital for such period, not exceeding six months, as the magistrate thinks fit.

Section 9—Court Order for Prolonged Treatment.

(1) Where a person is under care, observation and treatment in a psychiatric hospital pursuant to an  order for temporary treatment made under section 8, and the chief administrator of the hospital is of the opinion that, by reason of the severity or nature of the mental illness it is necessary for the welfare of such person or for the public safety that he should forthwith be placed under prolonged treatment in a psychiatric hospital, the provisions of this section shall apply.

(2) In the circumstances referred to in subsection (1), the administrator shall, before the expiration of the order for temporary treatment made under section 8, give to a magistrate information on oath, supported by a medical recommendation, to the effect that it is necessary for the welfare of the person suffering from mental illness, or for the public safety, that such person should be forthwith placed under prolonged treatment in a psychiatric hospital.

(3) The medical recommendation referred to in subsection (2) shall be from a practitioner experienced in psychiatry, and shall—

(a) specify in full detail the reasons why he considers that person to be a proper subject for prolonged treatment;

(b) specify the nature and severity of the mental illness diagnosed, the likelihood of complete or partial cure, and the period which in his opinion may reasonably be required to effect a complete or partial cure;

(c) specify in full detail the facts upon which he founds his opinion, distinguishing facts which he had himself observed from facts communicated by others;

(d) state the results of enquiries into the previous case history of that person and the results of the temporary observation and treatment of that person.

(4) The information given under subsection (2) shall also be accompanied by a copy of the order for temporary treatment made under section 8.

(5) Where information is laid in accordance with this section the magistrate shall in any place which he deems convenient (preferably the place of temporary treatment) examine the person believed to be suffering from mental illness, and in the same place or elsewhere shall hold an enquiry as to the state of mind of that person.

(6) For the purposes of an enquiry under subsection (5) the magistrate shall have the same power of summoning witnesses and administering oaths as in a summary trial.

(7) Where the magistrate is satisfied as a result of his enquiry under subsection (5) that the person in question is suffering from mental illness of such a nature and to such a degree as to make it necessary for his welfare, or for the public safety, that he should forthwith be placed under prolonged treatment in a psychiatric hospital, the magistrate may order that such person be placed under prolonged treatment in a psychiatric hospital for such period, not exceeding eighteen months as the magistrate thinks fit.

(8) An order for prolonged treatment made under this section may be renewed from time to time, in accordance with the provisions of this section, upon application made to a magistrate before the expiration of any current period of renewal, accompanied by copies of the original orders for temporary and prolonged treatment made under this Part.

Section 10—Procedure in Urgent Cases.

(1) Notwithstanding the provisions of section 8, in a case of  urgency where it is expedient either for the welfare of a person suspected by a medical officer to be suffering from mental illness, or for the public safety, that such person should be forthwith placed under care, observation or treatment, a registered medical practitioner may certify the case as one of urgency and thereafter such person may be received and detained in a psychiatric hospital in accordance with this section.

(2) Where a case has been certified as one of urgency under this section the person in question may be immediately received into a psychiatric hospital, but where such immediate admission is impracticable it shall be lawful for him to be received and detained in any other place of safe custody pending transfer to a psychiatric hospital.

(3) The authority receiving and detaining such person in another place of safe custody under subsection (2) shall ensure that he is transferred to a psychiatric hospital before the expiration of five days from the date of the certificate of urgency  referred to in subsection (1).

(4) Where a person is received into a psychiatric hospital either immediately in accordance with subsection (2) or within five days from the date of the certificate of urgency in accordance with subsection (3), he may be detained in that psychiatric hospital for any period not exceeding fourteen days.

(5) Unless the person detained is sooner discharged by the chief administrator of the hospital, information shall be given to a magistrate in accordance with section 8 within the period of fourteen days referred to in subsection (4); and where information is not so given, the person detained shall be released at the expiration of the period of fourteen days referred to in subsection (4).

Section 11—Hospital to have Custody of Patient.

(1) Where in accordance with the foregoing provisions of this Part a person is placed under care, observation or treatment in a psychiatric hospital, that person shall for all purposes be lawfully in the custody of the chief administrator of that hospital, and accordingly shall not be entitled to discharge himself or leave the hospital before the expiration of the period specified by the magistrate or by this Decree without the consent of the chief administrator.

(2) Where any such patient leaves the hospital without the consent of the chief administrator before the expiration of the period specified by the magistrate or by this Decree, he may, within the said specified period, be detained by any police officer in any place without warrant and returned to the hospital from which he came.

Section 12—Discharge of Patient.

On the expiration of the period specified by the magistrate or by this Decree the patient shall be discharged:

Provided that the chief administrator of the hospital may, where he is satisfied that the progress of the patient is such as to justify his earlier discharge, certify to the magistrate and the magistrate may thereupon order that the patient be discharged.

Section 13—Fees for Medical Practitioner.

Every duly qualified practising physician or surgeon not employed by the Government who is appointed by a magistrate to make an examination of any person for the purposes of this Part shall be entitled for the examination and certificate to such sum as the Commissioner may prescribe.

Section 14—Warrant for Removal.

Where any person suffering or believed to be suffering from mental illness is sent from one district to another, a warrant under the hand of the magistrate of the district from which such person is sent shall be sufficient authority to any person to whom it is directed to receive and detain him and to carry and deliver him up to the person named in the warrant.

PART IV—MENTAL HEALTH REVIEW TRIBUNAL

Section 15—Establishment and Proceedings of Tribunals.

(1) There shall be a Mental Health Review Tribunal appointed by the Commissioner which shall consist of—

(a) a legal practitioner who shall be the Chairman;

(b) one member with qualifications in psychiatry;

(c) one other medical practitioner; and

(d) two other persons appointed by the Commissioner.

(2) The Commissioner may by legislative instrument regulate the proceedings of the Tribunal and the manner in which, and the times within which, applications may be made to the Tribunal under this Decree.

Section 16—Applications to Tribunal.

Subject to and in accordance with the provisions of regulations made under section 15 (2), an application may be made to the  Tribunal by or in respect of any person detained under this Decree  other than a person detained in a State Psychiatric Hospital, maintained under section 20,—

(a) requesting a review of the conditions under which he is  detained; or

(b) requesting his discharge; or

(c) requesting any other appropriate action to be taken with  respect to the circumstances of his case.

Section 17—Powers of Tribunal.

(1) Where application is made to the Tribunal by or in respect of a person detained under this Decree, the Tribunal may in any case direct that the patient be discharged, notwithstanding the previous order of any magistrate, and he shall be discharged accordingly; and the Tribunal shall so direct if they are  satisfied—

(a) that the patient is not then suffering from mental illness or any other mental disorder;

(b) that it is not necessary in the interest of the patient's health or safety or for the protection of other person that the patient should continue to be liable to be detained;

(c) that the patient, if released, would not be likely to act in a manner dangerous to himself or to others.

(2) Without prejudice to the powers of the Tribunal under subsection (1), the Tribunal may make appropriate recommendations to the Commissioner with regard to the circumstances of any case.

PART V—GENERAL

Section 18—Property of Patient.

(1) The chief administrator shall take charge of all personal property which a patient brings with him upon admission.

(2) Full particulars of the property shall be recorded in a register kept by the chief administrator.

(3) All such property shall be restored to the patient upon his discharge from a psychiatric hospital.

(4) All perishable property which a patient brings with him upon his admission shall be disposed of in such manner as the chief administrator may consider to be in the best interest of the patient.

Section 19—Treatment at Other Hospitals.

(1) Where it becomes necessary for a patient under this Decree to receive treatment at a hospital other than a psychiatric hospital, the chief administrator may transfer him to such other hospital for such period as may be necessary.

(2) During the period of such transfer the patient shall continue to be within the custody of the chief administrator for the purposes of this Decree.

Section 20—State Psychiatric Hospitals.

(1) The Commissioner may establish a State Psychiatric Hospital or Hospitals for the reception and custody of persons committed thereto in pursuance of criminal proceedings brought against them or admitted thereto from a prison.

(2) It shall be the function of any such State Psychiatric Hospital to assist the rehabilitation of any such person committed or admitted thereto.

Section 21—Removal of Patients to Country of Origin.

Where in the case of any patient admitted to a psychiatric hospital who is not a citizen of Ghana and who—

(a) is not a person committed to such hospital in pursuance of  criminal proceedings brought against him;

(b) is not a person admitted to such hospital from a prison and who is still liable to be confined to a prison,

the Commissioner is of the opinion, upon the advice of the Director of Medical Services, that for any good reason the removal of the patient from Ghana is desirable, the Commissioner may order the removal of the patient, in the care and custody of such person as he may specify, to the country of origin of the patient.

Section 22—Warrant to Search for and Remove Patients.

(1) If it appears to a magistrate, on information on oath   laid by any person, that there is reasonable cause to suspect that a person believed to be suffering from mental illness patients.

(a) has been, or is being, ill-treated, neglected or kept otherwise than under proper control, in any place within the jurisdiction of the magistrate; or

(b) being unable to care for himself, is living alone in any such place, the magistrate may issue a warrant authorising any police officer to enter, if need be by force, any premises specified in the warrant in which that person is believed to be, and, if thought fit, to remove him to a place of safety with a view to the making of an application in respect of him under section 8, or of other arrangements for his treatment or care.

(2) A person who is removed to a place of safety in the execution of a warrant issued under this section may be detained there for a period not exceeding seventy-two hours.

(3) In the execution of a warrant under this section the police officer shall wherever practicable be accompanied by a mental welfare officer and by a medical practitioner.

(4) It shall not be necessary in any information or warrant under this section to name the person concerned.

Section 23—Mentally Ill Persons Found in Public Places.

(1) If a police officer finds in a place to which the public have access any person who appears to him to be suffering from mental illness and to be in immediate need of care or control the  police officer may, if he thinks it necessary to do so in the interest of that person or for the protection of other persons, remove that person to a place of safety.

(2) A person removed to a place of safety under this section may be detained there for a period not exceeding seventy-two hours for the purpose of enabling him to be examined by a medical practitioner and for him to be interviewed by a mental welfare officer and of making any necessary arrangements for his treatment or care.

Section 24—Notice of Death of Patient.

(1) Notice of the death of any patient in a psychiatric hospital shall forthwith be given by the chief administrator of the hospital to the coroner of the district and to the nearest known relation of the deceased.

(2) Upon receiving notification of any such death the coroner shall forthwith carry out a full postmortem examination of the deceased to determine the causes of death.

Section 25—Application in Cases of Mental Disorder.

The provisions of this Decree shall apply to persons suffering or believed to be suffering from any degree of mental disorder, psychopathic disorder, arrested or incomplete development of mind, mental subnormality or any other disorder or disability of mind, howsoever called, as they apply to persons suffering or believed to be suffering from mental illness.

Section 26—Accommodation of Certain Classes of Patients.

(1) All female patients in a psychiatric hospital shall be accommodated separately from male patients.

(2) All children under the age of sixteen years in a psychiatric hospital shall be accommodated separately from older persons.

(3) Special provision shall be made for the accommodation of patients whose conduct may at any time be harmful to themselves or other patients

Section 27—Visits by Friends and Relatives.

Friends and relatives of a patient shall be permitted to visit that patient at all reasonable times, except where in the opinion of the chief administrator of the hospital such visits may be prejudicial to the recovery of the patient.

Section 28—After-Care Service.

The Commissioner may make such provision for after-care services (including supervision) and rehabilitation centres for discharged patients as he may consider necessary or expedient, and for this purpose may, where necessary, act in consultation with the Commissioner responsible for Social Welfare or with any recognised welfare organisation.

Section 29—Regulations.

The Commissioner may by legislative instrument make regulations—

(a) for the management and administration of psychiatric hospitals;

(b) for the welfare and treatment of patients;

(c) relating to admission, custody and discharge;

(d) prescribing forms for the purposes of this Decree;

(e) otherwise for carrying into effect the provisions of this Decree.

Section 30—Interpretation.

In this Decree—

"chief administrator" means a medical practitioner with training in psychiatry appointed by the Commissioner to control and administer a psychiatric hospital;

"Commissioner" means the Commissioner responsible for Health.

Section 31—Repeal.

The Lunatic Asylums Ordinance (Cap. 79) as subsequently amended is hereby repealed.

Made this 22nd day of February, 1972.

COLONEL I.  K. ACHEAMPONG

Chairman of the National Redemption Council

Date of Gazette Notification: 25th February, 1972.