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Overcrowded, illegal rehab centres mushroom across city
Of the more than 300 centres in Chennai, the Institute of Mental Health — the licencing authority — has sent showcause notices to 22 illegally facilities; doctors say such centres do more harm than good to patients.
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Chennai
While Chennai has more than 300 rehabilitation centres for people addicted to alcohol and drugs, the number by itself is not an assurance that a large number addicts in the city are willing to give up their habits.
Overcrowded and non-adherent to rules, these centres have the potential to cause more harm than good, claim doctors. As such, more than 22 centres have already been issued show cause notices for carrying out their activities illegally. Stating that many such rehabilitation centres have been mushrooming illegally, a doctor from the Institute of Mental Health (IMH) said that they receive complaints continually against such centres.
Dr Poorna Chandrika, the deputy medical superintendent at the IMH, said, “Every day we issue licenses to centres, but there are instances wherein some of them relocate and apply for a license again creating a double entry and making it hard to keep track of them.”
Besides that, she added that a number of such centres have been mushrooming in the state. “Whenever we receive a complaint about a centre running illegally, we issue a show cause notice and a response to it is mandatory. The matter is then handled legally,” Dr Chandrika said.
While it the government’s responsibility to issue licenses, Dr Anita Rao, the honorary consultant and former director of Medical Services, TT Ranganathan Clinical Research Foundation (TTK Hospital), said, “If the IMH is issuing licenses, it is their responsibility to look into the guidelines as per the minimum standards’ issued by the Ministry of Social Justice and Empowerment. They must conduct surprise inspections and ensure action is taken against centres that fail to follow the guidelines.”
Requirements to qualify for licence
While rehabilitation centres have been blooming, licences can be issued only based on certain guidelines, said Dr Rao. A centre must have a 15-bedded facility to cope with the clients at any given time. “Each centre should ensure that they have a gap of minimum 2.5 to 3 feet between the beds. They should have a psychologist, psychiatrist, general physician, nurses and staff available at the centre 24x7 and the centres should be equipped with CCTV cameras. Patients should not indulge in any form of violence or cruelty whatsoever,” said Dr Swathi N, a psychiatrist.
She also said that centres should be able to show family members and others what is happening within the centre at any time of the day through the CCTV cameras. Besides, the centres should also have a well-defined programme for the family members, especially for co-dependents and to ensure that he can be brought back into the society without stigma. Facilities should be made available for the addict to be able to involve himself in various activities such as yoga and meditation.
Also, for centres that have already received their licence from the IMH, it is essential that they hang it at the lobby or any other place accessible to the public, Dr Swathi said.
Surprise inspections
Following complaints received from people or any organisation, the IMH can conduct surprise visits at the centres. “Except for logistic reasons, we conduct surprise checks every now and then. We check for the requirements under the guidelines, and talk to patients there to know more about the functioning,” said Dr Chandrika.
Risks of rehabilitation in illegal centres
Dr Rao said that there are centres in the state that have employed ward boys and nurses who are not qualified for the job. “Some centres that we have received complaints against are run in extremely small rooms. In one such centre, we found that about50 patients were crowded in a single room with just one bathroom. It goes against the law,” she added.
“We have seen cases of patients being ill-treated within the centres leading to a lot of physical and verbal violence. The addicts tend to return home after three to six months far more irritated and take it out on the people who put them in there,” said Dr Rao.
She added that such illegal rehabilitation centres also keep family members in the dark about the patients’ recovery. “A few such centres in the state have also witnessed suicides by the addicts who were unable to bear the treatment meted out to them,” the doctor said.
It is therefore essential that family members or guardians or the addicts themselves, check out the rehabilitation centres properly before signing up for it, Dr Rao said.
Guidelines
- Rehabilitation centres are run at government medical colleges across the state and there are some private centres which are funded by the government
- The IMH grants licences to such centres after scrutiny on the basis of infrastructure, and psychiatrists and psychologists employed there
- The ones with an IMH licence are inspected periodically. But there are many private centres that are unregistered and run illegally Punishment for flouting the guidelines is closure
- It is important for those employed in such centres to be trained in capacity building and skill development
- They should have exposure to recent trends in terms of drugs abused, medical and psychiatric problems and new medicines that are available for treatment of an addiction
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