LAWS OF TUVALU
2008 Revised Edition

MENTAL HEALTH WING MANAGEMENT REGULATIONS

CAP. 28.16.1

MADE UNDER SECTION 22 OF THE MENTAL HEALTH ACT1

1. These Regulations may be cited as the Mental Health Wing Management Regulations. 

I. THE MEDICAL OFFICER IN CHARGE

2. The medical officer in charge shall visit the mental health wing once each day, and more often if necessary. If for any reason the medical officer in charge is at any time unable to visit the mental health wing, the Senior Medical Officer shall arrange for the daily visit in his stead of a medical officer or an assistant medical officer who shall while so visiting the mental health wing be regarded for the purposes of these Regulations as the medical officer in charge. 

3. He shall have the entire medical charge of and be responsible for the professional treatment of the patients. 

4. He shall see that the mental health wing is kept in proper sanitary condition. 

5. He shall cause a journal called the "Medical Journal" to be kept, in which shall be entered all prescriptions and directions and any variations of the dietary in regard to the treatment of the patients. 

6. He shall sign or initial all requisitions and vouchers before they are sent to the Senior Medical Officer for countersignature. 

II. THE ATTENDANTS

7. The attendants, under the supervision of the medical officer in charge, or such other medical officer not below the status of an assistant medical officer, as the medical officer in charge may delegate, shall: 

(i) reside in the quarters provided for them; 

(ii) be responsible for the safe custody of all stores, utensils, clothing and crockery and for their proper distribution and care; 

(iii) be responsible for the proper and adequate feeding and serving of all meals to patients; 

(iv) keep books to show the receipt and issue of all stores in their charge; 

(v) take proper care of all clothing and effects brought into the mental health wing by patients; 

(vi) inspect the wards or huts twice daily, and be responsible for their cleanliness, inspect all patients at least twice daily and, in addition, make a thorough search of all patients prior to their retiring for the night, and see that their rooms or huts are open for sufficient ventilation; 

(vii) see that the latrines are kept clean and in proper condition; 

(viii) immediately report to the medical officer in charge the death of, or serious accident to, or illness of any patient; 

(ix) without fail, report the names of patients who desire to see the medical officer in charge; 

(x) pay surprise visits to all the wards at night, and shall report to the medical officer in charge any irregularities; 

(xi) report daily to the medical officer in charge on his visit; 

(xii) see that all patients make proper use of the bath daily; 

(xiii) endeavour to find occupation for all the patients, such as reading, gardening, washing, scrubbing and other suitable occupation; 

(xiv) take patients for exercise beyond the grounds as instructed by the medical officer in charge; 

(xv) when in charge of working parties, see that the patients do not wander from sight or escape. Before taking out working parties from the wards report to the senior assistant medical officer and see that the working parties are safely returned to the wards or huts; 

(xvi) be given such time off, daily, as the medical officer in charge shall decide, and shall not be absent, except under special circumstances, which shall be reported to the medical officer in charge; 

(xvii) do all in their power to make the lives and surroundings of the patients happy and comfortable; 

(xviii) be medically examined previous to their engagement. 

III. GENERAL RULES

8. The various articles of uniform issued to the attendants shall be kept in complete and proper repair at all times by them and at their expense, except when the necessity for such repairs has arisen through the clothing being injured by a refractory patient in which case the repairs shall be done at the public expense. All uniforms shall remain the property of the Government. 

9. All attendants shall be liable to be suspended by the medical officer in charge for any serious breach of these Regulations pending the decision of the Minister. 

10. The hours of duty of day attendants shall be from 6 a.m. to 6 p.m. and the hours of duty of night attendants shall be from 6 p.m. to 6 a.m. All attendants shall do night duty in the order assigned to them by the medical officer in charge. 

11. Attendants shall be allowed half an hour for their meals after the patients' meals have been served, but one attendant, in weekly rotation, must always remain on duty while the others are at meals. 

12. Attendants on duty shall not visit their quarters during duty hours without permission from the medical officer in charge. 

13. Unless it is unavoidable, attendants shall not, when single-handed, approach a violent patient. 

14. All attendants shall be held strictly responsible that they report, at once, every occurrence requiring immediate attention. 

15. Wranglings or disputes about points of duty between attendants are strictly prohibited. Questions of this kind shall be referred to the medical officer in charge and complaints by one attendant against another shall be in writing. 

16. All patients shall be stripped on admission and examined with gentleness, a thorough search of their person and effects made, and all dangerous articles removed from their control. Male patients shall be examined in the presence of male attendants, and female patients in the presence of female attendants. They shall be carefully washed and clothed in the dress of the mental health wing: 

Provided that, in the event of any patient being too violent to allow of the carrying out of this Regulation, no force shall be used, but the patient shall remain under careful and constant supervision until the medical officer in charge - to whom such cases shall be communicated with the least possible delay - shall have seen and given directions for the treatment of such patients. 

17. Male and female patients shall be kept separate. Male attendants shall not enter the compound or the huts of the female patients of the mental health wing except on the express order of the medical officer in charge. 

18. Patients shall at all times be suitably clothed according to their requirements. 

19. Patients who are capable of working shall be employed daily in some occupation suited to their condition and ability under the sanction of the medical officer in charge. 

20. The wards shall be open from 6 a.m. to 6 p.m. 

21. Meals shall be served at the following hours - breakfast 8 a.m., dinner 12.30 p.m., tea 4.30 p.m. 

22. Excited and dangerous patients shall be kept apart as far as possible. 

23. Two patients shall not live together in one hut, or be locked in together, without the medical officer in charge's permission. 

24. Such utensils for the reception of excrementary matters shall be supplied as may be required and as the medical officer in charge may consider safe. 

25. Attendants shall not, on any account, punish patients, but shall, at all times endeavour to put a stop to and prevent quarrels and violence. They shall not use harsh, or intemperate language to the patients, whatever the language or the conduct of the patients may be. 

26. Whenever a patient cannot be soothed or controlled by gentle means, he or she shall be put, as quickly as possible, into a room provided for the purpose which shall be safely guarded. 

27. No patient shall be struck but those who are refractory shall be placed in seclusion. When their violence is likely to inflict injury to themselves or others, or to the buildings, mechanical restraint may be had recourse to, if approved by the medical officer in charge. 

28. The sickness of any patient shall be reported immediately to the medical officer in charge and the strictest attention shall be paid to the administering of any medicines, etc., ordered by him. 

29. Patients shall be allowed to receive visitors every Wednesday and Saturday afternoons, between the hours of 2 and 4.30 p.m., provided they are in a fit state to receive them, and on special occasions by order of the medical officer in charge. 

30. All ministers of religion shall have full access to the mental health wing for the purpose of visiting such inmates as are of their particular creed, with the permission of the medical officer in charge. 

31. No person shall bring into the mental health wing wards or compounds any matches, spirits, wines or fermented liquors, or knives or other dangerous weapons: 

Provided that attendants may keep a box of matches for the lighting of the patients' pipes or cigarettes. No patient, under any circumstances, shall be allowed to have matches in his or her possession. 

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ENDNOTES 
1 G.N. 93/54, L.N. 37/68, 3 of 1972