S.I. No. 202/1946 -- Department of Local Government and Public Health. Mental Treatment (Regulations) Order, 1946.

S.I. No. 202/1946 -- Department of Local Government and Public Health. Mental Treatment (Regulations) Order, 1946. 1946 202

No. 202/1946:

DEPARTMENT OF LOCAL GOVERNMENT AND PUBLIC HEALTH. MENTAL TREATMENT (REGULATIONS) ORDER, 1946.

ARRANGEMENT OF ARTICLES.

PART I.

PRELIMINARY.

Article		Page
1.	Short title and commencement	17
2.	Interpretation	17

PART II.

APPLICABLE TO EVERY MENTAL INSTITUTION.

Records.

3.	Form of records	17
4.	Records to be kept in institutions	19
5.	Register of receptions	19
6.	Register of discharges, removals and deaths	19
7.	Register of patients	19
8.	Case book	19

Forms relating to Reception of Patients.

9.	Reception of chargeable patients as persons of unsound mind	23
10.	Report by public assistance authority under Section 231 of the Act	23
11.	Application for reception of private patient as person of unsound mind	23
12.	Particulars to accompany application	23
13.	Order for reception of private patient as person of unsound mind	23
14.	Reception of temporary patients	23
15.	Reception of chargeable patient as voluntary patient	23
16.	Notice of reception of chargeable patient as voluntary patient	23
17.	Notice of reception of private patient as voluntary patient	23

Treatment of Patients.

18.	Classification of patients	25
19.	Examination of patient on reception	25

Treatment of Patients.

Article		Page
20.	Prohibited articles	25
21.	Accommodation of patients	25
22.	Bathing of patient on reception	25
23.	Rules in regard to baths	25
24.	Report of chief medical officer after reception of patient	25
25.	Sleeping hours of patients	25
26.	Dietary of patients	27
27.	Meal hours	27
28.	Treatment of patients	27
29.	Employment of patients	27
30.	Visitation of patients	27
31.	Correspondence of patients	27
32.	Notification of illness of patient	27

Restraint and Seclusion.

33.	Mechanical means of restraint and seclusion	27
34.	Additional means of restraint	29

Departure of Patients.

35.	Notice of escape, removal or discharge of patient	31
36.	Notice of return of patient who has escaped or is removed	33
37.	Notice of departure of voluntary patient	33
38.	Notice to relatives of death	33
39.	Notice to Minister of death	33
40.	Report of death to coroner	33

PART III.

APPLICABLE TO MENTAL HOSPITAL AUTHORITIES.

Acquisition of Land.

41.	Prescribed forms	33
42.	Prescribed map	35

Care of Institutions.

43.	Repair of defects	35
44.	Insurance of institutions	35

Records.

Article		Page
45.	Additional prescribed records	37

Visiting Committees.

46.

Rules for visiting committees

Religious services in Institutions.

47.

Religious services and chaplains

Patients in Mental Institutions.

48.	Clothes of patients	39
49.	Escort for patient being transferred	39
50.	Procedure on death of a patient	41

Boarding-out of Patients in Private Dwellings.

51.	Boarding-out requirements	41
52.	Prohibitions in regard to boarding-out	43
53.	Clothes of boarded-out patients	43
54.	Visiting committees for boarded-out patients	43

Accounts of Mental Hospital Authorities.

55.	Application of Public Bodies Order to mental hospital authorities	45
56.	Determination of net cost of maintenance of chargeable patients	45
57.	Calculation of cost of care, maintenance and treatment	47

PART IV.

APPLICABLE TO PRIVATE INSTITUTIONS.

58.	Form of application for registration	47
59.	Maps to accompany application for registration	49
60.	Form of application for renewal of registration	49
61.	Prescribed fees	49
62.	Certificate of registration	51
63.	Additions and alterations to institutions	51
64.	Change in medical staff	51
65.	Visitation of institution by medical practitioner	51
66.	Duties of visiting registered medical practitioner	51
67.	Medical visitation of single patients	53

PART V.

APPLICABLE TO PRIVATE CHARITABLE INSTITUTIONS.

Article		Page
68.	Form of application for registration	53
69.	Maps to accompany application for registration	55
70.	Form of application for renewal of registration	55
71.	Certificate of registration	57
72.	Additions and alterations to institutions	57
73.	Change in medical staff	57
74.	Visitation of institution by medical practitioner	57
75.	Duties of visiting registered medical practitioner	57

PART VI.

APPLICABLE TO APPROVED INSTITUTIONS.

76.	Form of application for approval of institution	59
77.	Change in medical staff	61
78.	Medical visitation of patients	61
79.	Duties of medical officer	61

SCHEDULE.

RELATING TO REGISTERS TO BE KEPT IN MENTAL INSTITUTIONS.

FORM
1.	Register of Receptions	65
2.	Register of discharges, removals and deaths	67
3.	Register of patients	69
4.	Register of mechanical restraint and seclusion	71

RELATING TO CHARGEABLE PATIENT RECEPTION ORDERS.

5.	Application for recommendation for reception of a person as a person of unsound mind and as a chargeable patient	73
6.	Application under Section 165 of the Act by member of Gárda Síochána for recommendation for reception	77
7.	Application under Section 166 of the Act by the appropriate assistance officer for recommendation for reception	79

Relating to Chargeable Patients Reception Orders.

Form		Page
8.	Statement of particulars to accompany application for reception as a person of unsound mind	81
9.	Recommendation for reception of a person as a person of unsound mind and as a chargeable patient	85
10.	Order for the reception of a person as a person of unsound mind and a chargeable patient	87
11.	Report by public assistance authority for the purposes of Section 231 of the Act	89

RELATING TO PRIVATE PATIENT RECEPTION ORDERS.

12.	Application for a private patient reception order	95
13.	Order for reception of a person as a person of unsound mind and a private patient	99

RELATING TO TEMPORARY PATIENT RECEPTION ORDERS.

14.	Application for reception of a person as a temporary patient and a chargeable patient	103
15.	Certificate of authorised medical officer to accompany application for reception as temporary patient and chargeable patient	107
16.	Order for reception of person as temporary patient and chargeable patient	109
17.	Application for reception of person as temporary patient and private patient	111
18.	Certificate of registered medical practitioners to accompany application for reception as temporary patient and private patient	113
19.	Order for reception of person as temporary patient and private patient	115

RELATING TO VOLUNTARY PATIENTS.

20.	Application for reception of person as voluntary patient and chargeable patient	117
21.	Notice of reception of person as a voluntary patient and a chargeable patient	119
22.	Notice of reception of person as a voluntary patient and a private patient	121

RELATING TO NOTICES AND REPORTS TO MINISTER.

Form		Page
23.	Report to Minister by chief medical officer of mental institution upon the expiration of twenty-one days after the reception of a person under a reception order	121
24.	Notice to Minister of escape, removal or discharge from mental institution of a person detained under a reception order	123
25.	Notice to Minister of return to a mental institution of a person detained under a reception order who has escaped or been removed	125
26.	Notice to Minister of departure from approved institution of a person who had been treated therein as a voluntary patient	125
27.	Notice to Minister of death in mental institution of a patient who had been detained therein under a reception order or who was being treated therein as a voluntary patient	127

RELATING TO ACQUISITION OF LAND BY MENTAL HOSPITAL AUTHORITIES.

28.	Compulsory acquisition order	129
29.	Advertisement of making of compulsory acquisition order	131
30.	Notice to owners or reputed owners, lessees or reputed lessees and occupiers of the making of a compulsory acquisition order	133
31.	Advertisement of notice of confirmation of compulsory acquisition order	135
32.	Notice to objector who appeared at local inquiry of confirmation of compulsory acquisition order	137

RELATING TO BOARDING-OUT OF PATIENTS.

33.	(i) Contract for a chargeable patient boarded-out	139
	(ii) Contract for a private patient boarded-out	141

RELATING TO PRIVATE INSTITUTIONS.

34.	Application for registration of a private institution	143
35.	Application for renewal of registration of a private institution	147
36.	Certificate of registration of a private institution	147
37.	Statement of registered medical practitioner as to health of a person of unsound mind in a private institution	149

RELATING TO PRIVATE CHARITABLE INSTITUTIONS.

Form		Page
38.	Application for registration of a private charitable institution	151
39.	Application for renewal of registration of a private charitable institution	155
40.	Certificate of registration of a private charitable institution	155

RELATING TO APPROVED INSTITUTIONS.

41.

Application for approval of an institution for the reception of temporary or voluntary patients

157

S.I. No. 202. 1946.

DEPARTMENT OF LOCAL GOVERNMENT AND PUBLIC HEALTH.

THE MENTAL TREATMENT ACT, 1945.

THE MENTAL TREATMENT (REGULATIONS) ORDER, 1946.

The Minister for Local Government and Public Health in exercise of the powers vested in him by the Mental Treatment Act, 1945 , and of all other powers in this behalf enabling him, by this his Order, makes the regulations hereinafter appearing and hereby orders and declares as follows, that is to say :—

PART I. PRELIMINARY.

Short title and commencement

1.—(1) This Order may be cited as the Mental Treatment (Regulations) Order, 1946.

(2) This Order shall come into operation on the commencement of the Mental Treatment Act, 1945 .

Interpretation.

2.—(1) In this Order unless the context otherwise requires

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

the expression " patient " means a person suffering from illness of a mental or kindred nature and receiving care and treatment in a mental institution and a person receiving advice or treatment at a consulting room or clinic in pursuance of the provisions of the Act ;

the expression " intern patient " means a patient residing in a mental institution and receiving care and treatment therein.

(2) A reference in this Order to an officer in relation to any function shall be construed to include a person authorised to discharge and discharging such function during the absence or inability to act of such officer.

PART II. APPLICABLE TO EVERY MENTAL INSTITUTION.

RECORDS.

Form of records.

3. Where in this Order any book, record, report or other document is directed to be kept or made in connection with a mental institution and the form thereof is not prescribed, such book, record, report or document shall be kept or made in such form as the person in charge shall determine.

Records to be kept in institutions.

4. In addition to any other records prescribed in this Order there shall be kept in each mental institution for the accommodation of intern patients the following records :—

(a) a register of receptions ;

(b) a register of discharges, removals and deaths ;

(d) case books ;

(e) a medical journal ;

(f) a diet book ;

(g) an epileptic record ;

(h) a casualty record ;

(i) a register of mechanical restraint and seclusion ;

(j) chaplains' books.

5.—(1) The register of receptions to be kept in a mental institution shall be in the Form No. 1 in the Schedule to this Order.

(2) A separate register of receptions shall be kept for persons of unsound mind, temporary patients and voluntary patients maintained in a mental institution.

6.—(1) The register of discharges, removals and deaths to be kept in a mental institution shall be in the Form No. 2 in the Schedule to this Order.

(2) A separate register of discharges, removals and deaths shall be kept for persons of unsound mind, temporary patients and voluntary patients maintained in a mental institution.

7. The register of patients to be kept in a mental institution shall be in the Form No. 3 in the Schedule to this Order and shall contain the following particulars in regard to every patient taken care of in the institution :—

(a) full name, address, profession or occupation, age and sex of the patient, with date of reception, and information as to whether patient is married, single or widowed, whether a person of unsound mind, a temporary patient or a voluntary patient, whether a chargeable patient or a private patient, with particulars as to mental illness and bodily condition of patient, particulars of previous treatment in an institution, and names of medical practitioners recommending or ordering reception,

(b) particulars of discharge, removal or death.

Case book

8.—(1) A case book to be kept in a mental institution may be either in book form or in loose-leaf form.

(2) An entry in the case book in relation to a patient shall be made at the following times :—

(a) immediately after the patient is examined on reception ;

(b) at the expiration of each week during the first four weeks after the patient's reception ;

(d) once in each quarter afterwards ; and also

(e) at any time when there is a change in the patient's condition or when anything unusual occurs in relation to the patient.

(3) Entries of the following particulars shall be made in the case book in regard to each patient :—

(a) the name, date of reception, age, sex, religion, occupation, whether married, single or widowed, nationality, whether subject to epilepsy, whether suicidal or dangerous to others, whether chargeable or private, whether a former member of Defence Forces, whether a prisoner, address of nearest relatives ;

(b) the family history of the patient, with special attention to the presence or absence of mental or nervous disorder in the relatives ;

(d) the history of the illness for which patient is being treated including the aetiological factors of the disease in so far as they are ascertainable ;

(e) a description of the phenomena of the mental illness ;

(f) a record of a complete physical examination of the patient ;

(g) a diagnosis of the case.

(4) A copy of the following document shall be made or attached to the case book :—

(a) in the case of a chargeable patient, the recommendation for reception ;

(b) in the case of a private patient, the reception order ;

(d) in the case of a voluntary patient, the medical recommendation.

(5) In the case of a temporary patient particulars of any extension of the period of detention shall, immediately on receipt of notification of extension by the Minister, be entered in the case book with the reasons therefor.

(6) In the event of any change in the classification of the patient or of the departure, discharge or transfer of the patient the fact shall be noted in the case book with the date thereof and particulars of the destination of the patient.

(7) In the event of the death of a patient particulars from the notice of death sent to the Minister shall be entered in the case book.

(8) In a mental institution in which temporary patients and voluntary patients are maintained as well as persons of unsound mind separate case books shall be kept in relation to each of these classes of patients.

RECEPTION OF PATIENTS.

Reception of chargeable patients as persons of unsound mind.

9. Forms Nos. 5 to 10 in the Schedule to this Order shall be the prescribed forms for the purpose of Chapter I of Part XIV of the Act and shall be used for the purpose for which they are respectively expressed to be applicable.

Report by public assistance authority under section 231 of the act.

10. The particulars to be furnished by a public assistance authority to a mental hospital authority in pursuance of section 231 of the act shall be sent in the Form No. 11 in the Schedule to this Order.

Application for reception of private patient as person of unsound mind.

11. An application for the reception of a person as a person of unsound mind and a private patient shall be in the Form No. 12 in the Schedule to this Order.

Particulars to accompany application.

12. The statement of particulars to accompany an application for the reception of a person as a person of unsound mind and a private patient shall be in the Form No. 8 in the Schedule to this Order.

Order for reception of private patient as person of unsound mind.

13. An Order for the reception of a person as a person of unsound mind and a private patient shall be in the Form No. 13 in the Schedule to this Order.

Reception of temporary patients.

14. Forms Nos. 14 to 19 in the Schedule to this Order shall be the prescribed forms for the purposes of Chapter III of Part XIV of the Act and shall be used for the purpose for which they are respectively expressed to be applicable.

Reception of chargeable patient as voluntary patient.

15. An application for the reception of a person in an approved institution as a voluntary patient and a chargeable patient shall be in the Form No. 20 in the Schedule to this Order.

Notice of reception of chargeable patient as voluntary patient.

16. The notice to the Minister of the reception of a person in an approved institution as a voluntary patient and a chargeable patient shall be in the Form No. 21 in the Schedule to this Order.

Notice of reception of private patient as voluntary patient.

17. The notice to the Minister of the reception of a person in an approved institution as a voluntary patient and a private patient shall be in the Form No. 22 in the Schedule to this Order.

TREATMENT OF PATIENTS.

Classification of Patients.

18. Patients in a mental institution shall be classified and suitable accommodation assigned to each class.

Examination of patient on reception.

19. Each patient shall, after reception for intern treatment in a mental institution, be examined by appropriate members of the staff and any contusions or injuries on the person of the patient shall be carefully noted and the attention of the person who conveyed the patient to the institution shall be called to any such contusions or injuries.

Prohibited articles.

20. A patient shall not be allowed to bring into a mental institution any intoxicating liquors or other articles the introduction of which to the institution is forbidden by the person in charge of the institution.

Accommodation of Patients.

21. Each patient on reception in a mental institution shall be assigned to the division of institution appropriate to him.

Bathing of patient on reception.

22. Unless the chief medical officer of the institution shall otherwise direct each patient on reception for intern treatment in a mental institution shall be bathed.

Rules in regard to baths.

23.—(1) Except on the order of a medical officer of the institution the temperature of a bath for a patient in a mental institution shall not be less than 88 nor more than 98 degrees, Fahrenheit.

(2) Except where a medical officer of the institution otherwise directs each intern patient in a mental institution shall be bathed at least once a week.

(3) Every bath given to a patient shall be a separate bath with clean water and clean towels.

(4) At least one nurse shall be present while a patient is being bathed.

(5) A nurse present at the bathing of a patient shall make a note of any contusions or marks on the body of the patient and make a report in regard to them to the person in charge of the institution.

(6) A copy of this regulation shall be posted up in each bathroom in a mental institution.

Report of Chief Medical Officer after reception of patient.

24. The report to the Minister by the chief medical officer of a mental institution upon the expiration of twenty-one days after the reception of a person in the institution under a reception order shall be in the Form No. 23 in the Schedule to this Order.

Sleeping hours of patients.

25. The hours during which patients in a mental institution shall be confined to bed for sleep each night shall be fixed by the person in charge who may vary the hours in any particular case.

Dietary of patients.

26.—(1) The dietary of intern patients in a mental institution shall be in accordance with such scale or scales as may be drawn up by the chief medical officer of the institution with the approval of the mental hospital authority in the case of an institution maintained by them or of the person in charge in any other case.

(2) A medical officer of a mental institution may in any particular case in which he may deem it necessary so to do prescribe articles of diet additional to or in substitution for those provided in the approved dietary scales.

Meal hours.

27. The hours at which meals shall be served to intern patients in a mental institution shall be those fixed by the person in charge.

Treatment of patients.

28. Patients in a mental institution shall be treated with all gentleness compatible with their condition ; and restraint, when necessary, shall be as moderate, both in extent and duration, as is consistent with the safety and advantage of the patients.

Employment of patients.

29. Patients in a mental institution shall in so far as suitable employment can be provided for them be kept employed according to their capacity and ability.

Visitation of patients.

30. The chief medical officer of a mental institution may, with the approval of the person in charge, fix certain days on which patients in the institution may be visited by relatives and friends and may prescribe hours during which such visits may take place, provided that the chief medical officer may prohibit a visit in any particular case.

Correspondence of patients.

31. All correspondence or letters to or from an intern patient in a mental institution shall pass through the person in charge of the institution but letters to which section 266 of the act refers shall not be opened.

Notification of illness of patient.

32. In case of dangerous illness or serious injury of an intern patient in a mental institution notification shall be sent forthwith to any relative or friend whom the patient may desire to see, or, if the patient does not express any desire in this respect, to the applicant for the reception order or the person who made the last payment in respect of the patient or to such relative as the person in charge of the institution thinks proper.

RESTRAINT AND SECLUSION.

Mechanical means of restraint and seclusion.

33.—(1) Mechanical means of bodily restraint of patients in mental institutions means and includes all instruments and appliances whereby the movements of the body or any part of the limbs of a patient are restrained or impeded.

(2) 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.

(3) Mechanical means of bodily restraint or seclusion shall not be used except on an order signed by a medical officer of the institution or by the registered medical practitioner who is attending the patient.

(4) In every case where mechanical means of bodily restraint or seclusion is applied particulars describing the means of restraint or seclusion used and the grounds therefor shall be entered in the Register of Mechanical Restraint and Seclusion in the Form No. 4 in the Schedule to this Order. The entry shall be made and signed by the medical officer or registered medical practitioner who ordered the restraint or seclusion each day throughout the whole period during which the restraint or seclusion is used.

(5) A copy of the entries, if any, in the Register of Mechanical Restraint and Seclusion shall be forwarded to the Minister at the end of each quarter.

(6) The following instruments and appliances only shall be made use of for the purpose of mechanical restraint :—

(a) a jacket or dress laced or buttoned down the back, made of strong linen, 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

(b) a jacket with blind sleeves forming part of the dress ;

(c) gloves without fingers, fastened at the wrists with buttons or locks, and made of strong linen or chamois leather, padded or otherwise ;

(d) sheets or towels, when tied or fastened to a bed or other object.

(7) During the use of any of the mechanical appliances specified in the preceding sub-article the patient shall be kept under special supervision continuously, and shall under no circumstances be left unattended and shall be visited frequently by the nurse in charge of the department in which the patient is accommodated and at regular intervals by the medical officer or registered medical practitioner who ordered the use of such appliances.

(8) A patient in seclusion shall be visited once in every fifteen minutes by the nurse in charge of the department in which the patient is accommodated and at regular intervals by the medical officer or registered medical practitioner who ordered the seclusion.

Additional means of restraint.

34. The following shall not be considered as mechanical means of bodily restraint for the purposes of the next preceding article, but they may be used only on the order of a medical officer or registered medical practitioner and a record shall be made of their use in the clinical records :—

(a) a continuous bath the cover of which shall not be used unless the aperture therein for the patient's head is large enough to allow his body to pass through ;

(b) dry and wet pack in which the patient shall be swathed in sheet and blankets only, the outer sheet being, if necessary, sewn or pinned ; straps or ligatures of any kind shall not be used and the patient shall be released for necessary purposes at intervals not exceeding two hours ;

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

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

(e) sheets and towels for the purposes of artificial feeding when held by nurses and not tied or fastened ;

(f) trays or rails fastened to the front of chairs to prevent young persons, cripples or aged infirm adults from falling out and thereby injuring themselves ; provided that in the case of an adult it is within the patient's power to undo the fastening ;

(g) any restraint which is necessary for the sole purpose of enabling electrical or other special treatment to be given to a patient.

DEPARTURE OF PATIENTS.

Notice of escape, removal of discharge of patient.

35. The notice to be given to the Minister of the escape, removal or discharge from a mental institution of a patient who had been detained therein under a reception order shall be in the Form No. 24 in the Schedule to this Order and shall contain the following particulars :—

(a) the name of the institution, the full name and address of the person who had been detained, whether he was a temporary patient or a person of unsound mind, a chargeable patient or a private patient ;

(b) the date of the escape, removal or discharge ;

(ii) if removal—place to which removed and purpose of removal,

(iii) if discharge—particulars of mental condition on discharge and circumstances of discharge if not improved.

Notice of return of patient who has escaped or is removed.

36. Where a patient who had been detained in a mental institution under a reception order escapes or is moved therefrom and is again admitted to or brought back to the institution the notice given to the Minister of the return of the patient to the institution shall be in the Form No. 25 in the Schedule to this Order and shall contain the following particulars :—

(a) the name of the institution, the full name and address of the patient, whether he is a temporary patient or a person of unsound mind, a chargeable patient or a private patient ;

(b) date of reception preceding escape or removal, date of escape or removal, date of return to the institution, and the circumstances under which the patient is brought back.

Notice of departure of voluntary patient.

37. The notice to the Minister of the departure of a voluntary patient from an approved institution shall be in the Form No. 26 in the Schedule to this Order.

Notice to relatives of death.

38. In the event of the death of a patient in a mental institution immediate notice of the death shall be given to the nearest relatives of the deceased who may be known to the person in charge.

Notice to Minister of death.

39. The notice to be given to the Minister of the death in a mental institution of a patient who has been detained therein under a reception order or who was being treated therein as a voluntary patient shall be in the Form No. 27 in the Schedule to this Order and shall contain the following particulars :—

(a) the name of the institution, the full name, address, sex, age and profession or occupation of patient, whether he was a voluntary patient, a temporary patient or a person of unsound mind, a chargeable patient or a private patient, and whether the patient was married, single or widowed,

(b) the time, cause and circumstances of the death, the duration of the illness leading up to death and the name or names of any persons present at the death.

Report of death to Coroner.

40. The report on the death of a patient to be given to the coroner shall contain the particulars prescribed in the next preceding article.

PART III. APPLICABLE TO MENTAL HOSPITAL AUTHORITIES.

ACQUISITION OF LAND.

Prescribed forms.

41. Forms Nos. 28 to 32 set forth in the Schedule to this Order shall be prescribed forms for the purposes of Part VII of the Act and shall be used for the purposes for which they are respectively expressed to be applicable.

Prescribed map.

42. The map by reference to which the lands to which a compulsory acquisition order relates are required to be described shall comply with the following conditions :—

(1) The map shall be upon a scale of not less than one inch to every 220 feet, and unless the whole of such map shall be upon a scale of not less than one inch to every 100 feet an enlarged map shall be added of any building, yard, or garden upon a scale of not less than one inch to every 100 feet.

(2) Each field, enclosure, road, passage, house, building, stream, well or spring, which is to be taken, wholly or in part, shall be clearly shown on the map and coloured pink thereon, with fences of the lands abutting thereon accurately indicated and with the areas to be taken marked in acres, roods and perches, statute measure, and clearly defined by boundaries.

(3) Each separate parcel of land or property of any kind shall be indicated and marked on the map by a distinctive number corresponding to a number assigned to such property in the schedule to the compulsory acquisition order.

(4) The map shall show all townland boundaries, so far as they intersect or closely adjoin the lands scheduled in the compulsory acquisition order, and either (a) in respect of each scheduled parcel of land in a rural area, the names of the townland, district electoral division, electoral area, and county ; or (b) in respect of each scheduled parcel of land in a municipal area, the electoral area, parish, street and number.

(5) The scale of the map shall be clearly marked thereon and the points of the compass and a portion of any closely adjoining street or road shown, with the name thereof, or with words indicating the towns or villages to or from which the street or road leads.

(6) The map shall be sealed with the seal of the mental hospital authority, duly authenticated, and shall be marked by endorsement thereon of the short title of the compulsory acquisition order to which it relates.

CARE OF INSTITUTIONS.

Repair of defects.

43. A mental hospital authority shall keep in good and substantial repair the premises and fixtures of their district mental hospital and of any other institution maintained by them, and shall from time to time remedy without delay any defect in the repair of such hospital or institution, its water supply, drainage, heating or ventilation, or in the furniture or fixtures thereof.

Insurance of Institutions.

44. A mental hospital authority shall insure and keep insured in such manner as they shall determine the premises of their district mental hospital and of any other institution maintained by them against any loss or damage by fire, for such sum as shall be reasonably sufficient to cover any probable loss.

RECORDS.

Additional prescribed records.

45. In addition to any other records prescribed in this Order there shall be kept in each institution maintained by a mental hospital authority for intern patients the following records :—

(a) a surgeon dentist's book ;

(b) a stimulant's book ;

(d) a postmortem book ;

(e) a morning statement book ;

(f) a matron's clothing, materials and conversion book ;

(g) a requirements book ;

(h) books for reports of the various officers required to make daily reports ;

(i) a visitors' book ;

(j) a gatekeeper's book.

VISITING COMMITTEES.

Rules for visiting committees.

46. The following rules shall apply to the visiting committee of a district mental hospital or other institution maintained by a mental hospital authority and to the visiting committee of an auxiliary mental hospital :—

(a) the visiting committee or any two or more members thereof shall inspect the hospital or institution at least once in each month ;

(b) on the occasion of each visit of inspection to a hospital or an institution the visiting members of a visiting committee shall be accompanied on their visit by the chief medical officer of the institution or by an assistant 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, that is to say :—

(i) inspect the premises including the buildings, out-offices, yards and farm buildings ;

(ii) inquire into the need for repairs to the buildings ;

(iii) inspect the different wards and apartments and see whether cleanliness is observed therein ;

(iv) inspect the furnishing of the different apartments in the buildings and inquire as to the state of repair of the furniture ;

(v) examine the heating, ventilation, lighting, sanitation and water supply of the buildings and see whether any repairs or improvements are required ;

(vi) inquire into the health and general condition of the patients ;

(vii) make inquiries as regards the dietary of the patients ;

(viii) make inquiries into and examine the occupations pursued by the patients and see whether any improvements can be suggested ;

(ix) afford patients an opportunity of seeing them and making complaints if they desire to do so ;

(x) inspect the work on the farms and in the gardens and ascertain whether any improvements can be effected ;

(xi) enter in the visitors' book any remarks which they think proper in regard to the condition and management of the hospital or institution and the patients therein ;

(d) within one week after a visit by the visiting members of a visiting committee to a hospital or institution the committee shall submit a report on the visit to the mental hospital authority.

RELIGIOUS SERVICES IN INSTITUTIONS.

Religious services and Chaplains.

47.—(1) In each district mental hospital, auxiliary mental hospital and other institution maintained by a mental hospital authority for intern patients provision shall be made for the holding of religious services on each Sunday and at other suitable times for patients and in particular for the celebration of Mass on each Sunday and each Holy-day of Obligation at such time or times as will permit of the attendance at Mass of all the Catholic patients whose condition of health does not prevent their attendance.

(2) A mental hospital authority shall appoint such number of persons to be Chaplains of the district mental hospital and any other institution maintained by them as shall in the opinion of the Minister be requisite for affording religious aid to the patients.

PATIENTS IN MENTAL INSTITUTIONS.

Clothes of patients.

48. A patient in a mental institution maintained by a mental hospital authority may, if the person in charge so approves, be permitted whilst in the institution to wear or use any clothing or other articles belonging to him.

Escort for patient being transferred.

49. Where it is proposed in the case of an intern patient in a mental institution maintained by a mental hospital authority to transfer the patient to another institution the person in charge of the institution from which the patient is being transferred shall provide such suitable escort for the patient as he considers necessary.

Procedure on death of patient.

50. On the death of a patient in an institution maintained by a mental hospital authority the following steps shall be taken :—

(a) a member of the medical staff of the institution shall inspect the body and carefully note any contusions, injuries, bedsores, or other marks, and enter particulars thereof in the post-mortem register ;

(b) particulars from the notice of the death sent to the Minister shall be entered in the case book within forty-eight hours of the death ;

(c) immediate notice of the death shall be sent to the nearest relatives of the patient who may be known to the person in charge of the institution ;

(d) if the relatives of the patient fail within thirty-six hours of the death to give notice of their intention to arrange for the burial of the remains, or give notice refusing to make any such arrangements, or fail to make or carry out within a reasonable time any such arrangements the remains shall be interred in an authorised place of burial in the presence of the Chaplain of the religious denomination to which the patient belonged and with the usual rites, if any, of that denomination ;

(e) on his next visit to the institution the Chaplain shall enter in the Chaplain's Book the date and place of the interment and the fact of his having performed or not the funeral service thereat ;

(f) if the patient belonged to a religious denomination in respect of which there is no chaplain for the institution at the time of the interment the person in charge of the institution shall, if possible, procure the services of a clergyman of that denomination, and such clergyman shall attend at the funeral in the same manner as a chaplain, and on receiving from him a certificate that he has attended the funeral and performed the funeral rites (if any), the mental hospital authority shall pay him suitable remuneration for his attendance.

BOARDING-OUT OF PATIENTS IN PRIVATE DWELLINGS.

Boarding-out requirements.

51. The following conditions shall be complied with in connection with the boarding-out of a patient in a private dwelling :—

(a) the person with whom the patient is boarded-out shall before receiving the patient enter into a contract with the mental hospital authority in the Form No. 33 (i) or 33 (ii) in the Schedule to this Order binding such person to observe all the conditions therein contained so long as the patient shall continue to be boarded-out with such person ;

(b) before signing the contract the mental hospital authority shall :—

(i) satisfy themselves by the report and personal inspection of one of their medical officers that the proposed dwelling is in a healthy situation and is otherwise suitable ; that the dwelling contains more than one room, and admits of the segregation of the sexes ; that a supply of pure and wholesome drinking water is at all times readily accessible to the inmates of the dwelling ; that good food and milk are easily obtainable and that the dwelling otherwise complies with this Order ;

(ii) arrange for a suitable escort to accompany the patient to the dwelling.

Prohibitions in regard to boarding-out.

52. A mental hospital authority shall not board-out any patient :—

(a) in any dwelling in which none of the adult inmates belongs to the sex of the patient ;

(b) with a person who does not belong to the same religion as the patient ;

(d) in any dwelling in which there is resident a person suffering from a disease likely to be prejudicial to the health of the patient.

Clothes of boarded-out patients.

53. The clothes to be provided for a patient boarded-out by a mental hospital authority shall not be of such shape, material or colour as to indicate connection with any institution, or to denote that the patient is a patient of the mental hospital authority.

Visiting committees for boarded-out patients.

54. The following provisions shall apply to any committee appointed by a mental hospital authority to visit patients boarded-out by the authority :—

(a) not less than two nor more than four members of the committee shall visit a patient at the same time ;

(b) where the patient to be visited is a woman at least one of the members of the committee visiting the patient shall be a woman ;

(i) make inquiries and satisfy themselves in regard to the quality and suitability of the food provided for the patient ;

(ii) make inquiries as to the supplies of milk and water to the dwelling ;

(iii) personally inspect the sanitation of the dwelling ;

(iv) personally inspect the bed and bedding provided for the patient ;

(v) inquire as to the religious aid given to the patient ;

(vi) make inquiries as regards the occupations provided for the patient and satisfy themselves that any work provided for the patient is suitable having regard to the condition and capacity of the patient ;

(vii) inquire as to the health of the patient since the previous visit and satisfy themselves as to whether the requisite medical aid was summoned, when needed ;

(d within one week of their visit the visiting members shall report in detail to the mental hospital authority on the condition of the patient and the dwelling at the time of the visit.

ACCOUNTS OF MENTAL HOSPITAL AUTHORITIES.

Application of Public Bodies Order to mental hospital authorites.

55. The relevant provisions of the Public Bodies Order, 1942, shall, with the necessary modifications, apply to mental hospital authorities and the accounts of mental hospital authorities.

Determination of net cost of maintenance of chargeable patients.

56.—(1) For the purposes of sub-sections (3) and (4) of section 43 of the act the net cost of the maintenance during any year by the mental hospital authority of a mental hospital district consisting of two or more counties or of a county borough and one or more counties of the chargeable patients from each such county borough and county shall be determined as follows, that is to say :—

(a) from the total expenditure of the mental hospital authority on revenue account during the year there shall be deducted the total of the sums received by the mental hospital during the year by way of revenue other than sums in respect of the maintenance of any patients ;

(b) the amount arrived at under paragraph (a) of this article shall be divided between the several contributory areas in proportion to the average daily number of all the patients from each such area maintained by the mental hospital authority during the year ;

(c) from the amount assigned to any contributory area on the division under paragraph (b) of this article there shall be deducted the total sum received by the mental hospital authority during the year in respect of the maintenance of all patients from that area ; and the remainder after the said deduction shall be taken to be the net cost of the maintenance of the chargeable patients from that area during the year.

(2) In this article the expression " contributory area " means a county borough, or county forming part of the relevant mental hospital district.

Calculation of the cost of care, maintenance and treatment.

57.—(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 taken as :—

(a) the average daily cost of each patient in such hospital or other institution determined in accordance with Article 91 of the Public Bodies Order, 1942, for the accounting period including such day, or where it is necessary to make the determination before the end of such accounting period, the preceding accounting period, together with

(b) the full cost of any specialist medical assistance employed solely in connection with the patient.

(2) For the purposes of section 212 of the act the average cost of the maintenance of a patient on any day in a district mental hospital shall be taken to be the average daily cost of each patient in such hospital determined in accordance with Article 91 of the Public Bodies Order, 1942, for the accounting period including such day, or where it is necessary to make the determination before the end of such accounting period, the preceding accounting period.

PART IV. APPLICABLE TO PRIVATE INSTITUTIONS.

Form of application for registration.

58. An application for registration of a private institution shall be made in the Form No. 34 in the Schedule to this Order, and shall be sent in an envelope addressed to the Minister and shall contain the following particulars :—

(1) the full name and address and the profession or occupation of the applicant ;

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

(3) the full name and profession or occupation of the person to be in charge of the institution and a statement whether such person proposes to reside in the institution ;

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

(5) details of the nursing staff to be employed in the institution and their qualifications ;

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

(7) 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.

Maps to accompany application for registration.

59. An application for registration of a private institution shall be accompanied by :—

(1) an ordnance sheet to the scale of four inches to one mile showing the premises of the institution, the buildings, the exercise grounds, gardens and roads of approach and indicating by colour the land and buildings to be included in the premises to be registered, and distinguishing the buildings to be occupied by patients ; and

(2) a sketch plan to a scale of not less than one-sixteenth of an inch to one foot of each floor of the buildings, having the sizes and floor areas of all the rooms and apartments clearly indicated thereon and a schedule thereon showing the purpose for which each room or apartment is to be used.

Form of application for renewal of registration.

60. An application for renewal of registration of a private institution shall be made in the Form No. 35 in the Schedule to this Order and shall contain the following particulars :—

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

(2) the situation of the institution ;

(3) the number of patients of either sex accommodated in the institution at time of application ;

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

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

Prescribed fees.

61.—(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, that is to say :—

(a) where the maximum number of patients proposed to be taken care of in the institution at any one time does not exceed ten, the fee shall be 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, the fee shall be 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 (if any) 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.

Certificate of registration.

62. A certificate of registration or renewal of registration issued by the Minister to the proprietor of a private institution shall be in the Form No. 36 of the Schedule to this Order, or in a form to the like effect.

Additions and alterations to institutions.

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

Change in medical staff.

64. The person in charge of a private institution shall inform the Minister of any change in the medical staff of the institution.

Visitation of institution by medical practitioner

65.—(1) A private institution which is registered in the register and in which two or more patients are taken care of shall be visited at least once in each day before twelve o'clock, noon, by the registered medical practitioner who is the medical officer of the institution.

(2) The institution shall also be visited by such registered medical practitioner 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 visiting registered medical practitioner.

66. The duties of a visiting registered medical practitioner of a private institution shall be :—

(a) to enter on the occasion of each attendance at the institution his name in a book to be provided for that purpose by the registered proprietor of the institution together with the time of his arrival and the time of his departure ;

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

(d) to examine the state of all patients in the institution as often as may be required by their mental or bodily state of health ;

(e) to give all necessary directions as to the dietary, classification, treatment, and nursing of patients in the institution ;

(f) to enter appropriate particulars of directions given by him in regard to the patients in the institution in a book to be provided for the purpose by the registered proprietor ;

(g) to see that a suitable clinical chart is provided in any case requiring one, that the required particulars are duly and properly entered thereon and that such charts when completed are bound together and preserved with the records of the institution ;

(h) to be responsible for the due observance of the regulations in relation to the restraint and seclusion of patients in the institution ;

(i) to report to the person in charge of the institution any case of infectious or suspected infectious disease in the institution and to take all such steps as may be necessary to prevent the spread of the disease ;

(j) to examine at least once in each week and also when requested by the person in charge the milk, meat and other provisions supplied for use in the institution and to report in writing any defect in the same to the person in charge ;

(k) to supervise the general hygienic and sanitary conditions of the institution ;

(l) to report in writing to the person in charge immediately as and when occasion arises :—

(i) any matter affecting the health of the patients in the institution,

(ii) any defect in the drainage, ventilation, heating or other arrangements of the institution and

(iii) any defect in the nursing and attendance of the patients in the institution or in the supply of medical or other requirements ;

(m) to make in writing to the person in charge such recommendations as he considers necessary for the introduction of improvements in the management of the institution.

Medical visitation of single patients.

67. When one patient only is taken care of in a private institution such person shall be visited by a registered medical practitioner at least twice in each week and at each such visit such practitioner shall sign a statement in the Form No. 37 in the Schedule to this Order as to the health of the person visited.

PART V. APPLICABLE TO PRIVATE CHARITABLE INSTITUTIONS.

Form of application for registration.

68. An application for registration of a private charitable institution shall be made in the Form No. 38 in the Schedule to this Order, and shall be sent in an envelope addressed to the Minister and shall contain the following particulars :—

(1) the full name and address and the profession or occupation of the applicant ;

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

(3) the full name and profession or occupation of the person to be in charge of the institution and a statement whether the person proposes to reside in the institution ;

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

(5) details of the nursing staff to be employed in the institution and their qualifications ;

(7) 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.

Maps to accompany application for registration.

69. An application for registration of a private charitable institution shall be accompanied by :—

(2) a sketch plan in a scale of not less than one-sixteenth of an inch to one foot of each floor of the buildings, having the sizes and floor areas of all the rooms and apartments clearly indicated thereon and a schedule thereon showing the purpose for which each room or apartment is to be used.

Form of application for renewal of registration.

70. An application for renewal of registration of a private charitable institution shall be made in the Form No. 39 in the schedule to this Order and shall contain the following particulars :

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

(2) the situation of the institution ;

(3) the number of patients of either sex accommodated in the institution at time of application;

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

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

Certificate of registration.

71. A certificate of registration or renewal of registration issued by the Minister to the proprietor of a private charitable institution shall be in the Form No. 40 in the Schedule to this Order, or in a form to the like effect.

Additions and alterations to institutions.

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

Change in medical staff.

73. The person in charge of a private charitable institution shall inform the Minister of any change in the medical staff of the institution.

Visitation of institution by medical practitioner.

74.—(1) A private charitable institution which is registered in the register shall be visited at least once in each day before twelve o'clock, noon, by the registered medical practitioner who is the medical officer of the institution.

(2) The institution shall also be visited by such registered medical practitioner 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 times as the state of the patients in the institution may render necessary.

Duties of visiting registered medical practitioner.

75. The duties of a visiting registered medical practitioner of a private charitable institution shall be :—

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

(d) to examine the state of all patients in the institution as often as may be required by their mental or bodily state of health ;

(e) to give all necessary directions as to diet, classification, treatment, and nursing of patients in the institution ;

(f) to enter appropriate particulars of directions given by him in regard to the patients in the institution in a book to be provided for the purpose by the registered proprietor ;

(g) to see that a suitable clinical chart is provided in any case requiring one and that the required particulars are duly and properly entered thereon and that such charts when completed are bound together and preserved with the records of the institution ;

(h) to be responsible for the due observance of the regulations in relation to the restraint and seclusion of patients in the institution ;

(k) to supervise the general hygienic and sanitary conditions of the institution ;

(l) to report in writing to the person in charge immediately as and when occasion arises :—

(i) any matter affecting the health of the patients in the institution ;

(ii) any defect in the drainage, ventilation, heating or other arrangements of the institution and

(iii) any defect in the nursing and attendance of the patients in the institution or in the supply of medical or other requirements ;

(m) to make in writing to the person in charge such recommendations as he considers necessary for the introduction of improvements in the management of the institution.

PART VI. APPLICABLE TO APPROVED INSTITUTIONS.

Form of application for approval of institution.

76. An application for approval of an institution for the reception of persons as temporary patients or for the reception of persons as voluntary patients or for the reception of persons as temporary patients and the reception of persons as voluntary patients shall be made in the Form No. 41 in the Schedule to this Order and shall be sent in an envelope addressed to the Minister and shall contain in every case the following particulars :—

(1) the full name and address and the profession or occupation of the applicant ;

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

(3) the full name and profession or occupation of the person to be in charge of the institution ;

and in the case of an institution which is not already a mental institution shall contain the following additional particulars :—

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

(5) details of the nursing staff to be employed in the institution and their qualifications ;

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

(7) a statement of the number of persons of either sex proposed to be received into the institution as temporary patients and the number of persons of either sex proposed to be received into the institution as voluntary patients and an indication of the method of segregation to be adopted ;

(8) a statement as to whether the whole of the institution is to be devoted to the care of temporary patients or the care of voluntary patients or to the care of both temporary patients and voluntary patients, or only part of the institution is to be so devoted and, if the latter, particulars of the part of the institution and the number of beds to be so devoted.

Change in medical staff.

77. The person in charge of an approved institution shall inform the Minister of any change in the medical staff of the institution.

Medical visitation of patients.

78. (1) Each patient in an approved institution shall be visited at least once in each day before twelve o'clock, noon, by a medical officer of the institution ;

(2) A patient in an approved institution shall be visited by a medical officer of the institution in case of sudden illness, accident, or other emergency and at all such other times as the state of the patient may render necessary.

Duties of medical officer.

79. The duties of a medical officer of an approved institution which is not an institution maintained by a mental hospital authority shall be :—

(a) to enter on the occasion of each attendance at the institution his name in a book to be provided for that purpose by the proprietor of the institution together with the time of his arrival and the time of his departure ;

(b) to be responsible for the medical treatment of the patients under his care in the institution;

(d) to examine the state of all patients in the institution as often as may be required by their mental or bodily state of health ;

(e) to give all necessary directions as to the diet, classification, treatment, and nursing of patients in the institution ;

(f) to enter appropriate particulars of directions given by him in regard to the patients in the institution in a book to be provided for the purpose by the proprietor ;

(h) to be responsible for the due observance of the regulations in relation to the restraint and seclusion of patients under is care in the institution ;

(j) to examine at least once in each week and also when requested by the person in charge, the milk, meat and other provisions supplied for use in the institution and to report in writing any defect in the same to the person in charge ;

(k) to supervise the general hygienic and sanitary conditions of the institution ;

(l) to report in writing to the person in charge immediately as and when occasion arises :—

(i) any matter affecting the health of the patients in the institution :—

(ii) any defect in the drainage, ventilation, heating or other arrangements of the institution, and

(iii) any defect in the nursing and attendance of patients in the institution or in the supply of medical or other requirements ;

(m) to make in writing to the person in charge such recommendations as he considers necessary for the introduction of improvements in the management of the institution.

SCHEDULE.

FORM NO. 1.

MENTAL TREATMENT ACT, 1945 .

Registered No.

Date of Reception

Full name of person received

Religion

Age on reception

Sex

Whether married single or widowed

Whether chargeable patient or private patient

Mental condition on reception

Bodily condition on reception

Observations

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

FORM NO. 2.

MENTAL TREATMENT ACT, 1945 .

Registered No.	Name of Patient	Religion	Date of Reception	Sex	Whether married single or Widowed	Whether chargeable patient or private patient	Age on discharge removal or death	Discharge			Removal				Death		Observations
Date of discharge	Reason for discharge	Mental condition on discharge	Date of removal	Reason for removal	Place to which removed	Mental condition on removal	Date of death	Cause of death
(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)	(9)	(10)	(11)	(12)	(13)	(14)	(15)	(16)	(17)	(18)

FORM NO. 3

MENTAL TREATMENT ACT, 1945 .

Registered No.	Full Christian name and surname of patient	Religion	Home address of patient	Rank, profession or occupation of patient	Age of patient on reception	Sex	Whether married, single or widowed	Whether person of unsound mind, a temporary patient or a voluntary patient	Whether a chargeable patient or a private patient	If a chargeable patient, name of medical practitioner who recommended reception	If a private patient names of medical practitioners who made reception order	Date of reception	Nature of mental illness on reception	Probable cause of mental illness	Bodily condition on reception	If previously in an institution, give name of institution, nature of illness and period of treatment	Discharge or Removal		Death		Observations of medical attendant.	Signature of medical attendant
Date	Mental and bodily condition	Date	Cause
(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)	(9)	(10)	(11)	(12)	(13)	(14)	(15)	(16)	(17)	(18)	(19)	(20)	(21)	(22)	(23)

FORM NO. 4.

MENTAL TREATMENT ACT, 1945 .

Registered No.	Date on which restraint or seclusion was used	Particulars of Patient			Particulars of Restraint			Particulars of Seclusion		Signature of medical officer who ordered restraint or seclusion
Name	Sex	Whether chargeable or private patient	Means of restraint employed	Duration of restraint	Purpose of restraint	Hours of seclusion	Reasons for seclusion
(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)	(9)	(10)	(11)

FORM NO. 5.

MENTAL TREATMENT ACT, 1945 .

Application under section 162 of the act for Recommendation for Reception of Person as a Person of Unsound Mind and as a Chargeable Patient.

1.	Full name of person in respect of whom the application is made	............................................................ .................................
2.	Address of person ............................................................ ............................................................ ........
3.	Full name of applicant ............................................................ ............................................................ ...
4.	Address of applicant ............................................................ ............................................................ .....
	............................................................ ............................................................ ......
5.	Relationship (if any) of applicant to person in respect of whom the application is made.	............................................................ ..................................
6.	Whether applicant is the appropriate assistance officer.	............................................................ ...................................

7. Declaration of Applicant :—

(1) I am at least twenty-one years of age.

(2) I last saw....................................(the person in respect of whom I make the application) on..................day of..............................19.........

(b) (3) I am

(a) the husband, wife, relative of the person in respect of whom the application is made,

(b) I am the appropriate assistance officer making the application at the request of the husband, wife, relative (a) of the person in respect of whom the application is made,

(c) I am not a relative of the person in respect of whom the application is made, and I am not the appropriate assistance officer, and the reasons why the application is not made by the husband or wife or relative (a) or at the request of the husband, wife, relative (a) by the appropriate assistance officer are :—

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

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

My connection with the person is—

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

The circumstances under which the application is made are—

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

(4) A statement of particulars regarding..........................................the person in respect of whom I make this application accompanies the application.

(5) I desire a recommendation for the reception............................................................ ...........................................................in the district mental hospital at............................................................ .................................as a person of unsound mind and as a chargeable patient.

Signature.............................................

Full Name.............................................

(in block letters)

Date...................................

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

Authorised Medical Officer.

.............................................Dispensary District.

(a) Strike out words inapplicable.

(b) and (c) Strike out paragraphs which are not applicable.

Attention is specially directed to the provisions of section 255 of the act as follows :—

" Where any person—

(a) makes a wilful misstatement in an application for a recommendation for reception, in an application for a reception order, or in a reception order, or

(b) makes a wilful misstatement in a medical or other certificate or in a statement or report under this Act of bodily or mental condition, or

(c) wilfully makes in a book, statement, or return a false entry as to a matter as to which he is required to make an entry by this Act or a regulation thereunder,

such person shall be guilty of an offence under this section and shall be liable on summary conviction thereof to a fine not exceeding one hundred pounds or, at the discretion of the Court, to imprisonment for a term not exceeding six months or to both such fine and such imprisonment."

FORM NO. 6.

MENTAL TREATMENT ACT, 1945 .

APPLICATION UNDER section 165 of the act BY MEMBER OF GÁRDA SÍOCHÁNA FOR RECOMMENDATION FOR RECEPTION.

Full name of person in respect of whom application is made

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

2. Address (if any) of person............................................................ ......

3. Declaration of Application :—

(1) I am a member of the Gárda Síochána.

(2) I am at least twenty-one years of age.

(3) I last saw (a).............................................on the ..................day of.............................................19.......

(4) I consider that for (b)	the public safety
	the safety of himself

(a).............................................should be placed forthwith under care and control.

(5) A statement of particulars respecting (a)............................................................ ...........

accompanies this application.

(6) I desire a recommendation for the reception of (a)...................................................in the district mental hospital at (c)..........................................as a person of unsound mind.

Signature .............................................

Full Name.............................................

(in block letters)

Date....................................

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

Authorised Medical Officer.

.............................................Dispensary District.

(a) Insert name of person in respect of whom application is made.

(b)Strike out words which are not applicable.

Attention is specially directed to the provisions of section 255 of the act as follows :—

" Where any person—

(a) makes a wilful misstatement in an application for a recommendation for reception, in an application for a reception order, or in a reception order, or

(b) makes a wilful misstatement in a medical or other certificate or in a statement or report under this Act of bodily or mental condition, or

(c) wilfully makes in a book, statement or return a false entry as to a matter as to which he is required to make an entry by this Act or a regulation thereunder,

FORM NO. 7.

MENTAL TREATMENT ACT, 1945 .

APPLICATION UNDER section 166 of the act BY THE APPROPRIATE ASSISTANCE OFFICER FOR A RECOMMENDATION FOR RECEPTION.

Full name of person in respect of whom application is made.

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

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

3. Declaration of Applicant :—

(1) I am the appropriate assistance officer for the assistance officer's district in which the person in respect of whom the application is made resides.

(2) I am at least twenty-one years of age.

(3) I last saw (a)............................................................ ..........on the ..................day of....................................19..........

(4) I know (or am informed) (b) that (a).......................................is not under proper care or control, neglected, cruelly treated by a relative (or other person) having the care or charge of him (b).

(5) A statement of particulars respecting (a)......................................accompanies this application.

(6) I desire a recommendation for the reception of (a)......................................................in the District Mental Hospital at (c)..........................................as a person of unsound mind.

Signature .............................................

Appropriate Assistance Officer.

Full Name ............................................

(in block letters)

Date ...................................

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

Authorised Medical Officer.

........................Dispensary District.

(a) Insert name of person in respect of whom application is made.

(b) Delete words which are not applicable.

Attention is specially directed to the provisions of section 255 of the act as follows :—

" Where any person—

(a) makes a wilful misstatement in an application for a recommendation for reception, in an application for a reception order, or in a reception order, or

(b) makes a wilful misstatement in a medical or other certificate or in a statement or report under this Act of bodily or mental condition, or

(c) wilfully makes in a book, statement, or return, a false entry as to a matter as to which he is required to make an entry by this Act or a regulation thereunder,

FORM NO. 8.

MENTAL TREATMENT ACT, 1945 .

Statement or Particulars to Accompany Application under Section 162, or Section 165 or section 166 of the act for a Recommendation for Reception and an Application under section 177 of the act for Reception as Person of Unsound Mind.

1.	Full name of person in respect of whom application is made	............................................................ .............................................
2.	Place of residence............................................................ ............................................................ .............
3.	Other residence, if any, during past three years.	............................................................ .............................................
4.	Age.......................................
5.	Sex.........................................
6.	Whether married, single or widowed............................................................ ..........................................
7.	Religion ............................................................ ............................................................ ..............................
8.	Profession or occupation ............................................................ ............................................................
9.	Whether this is the first attack of mental disorder............................................................ ...................
10.	Age on first attack of mental disorder............................................................ ........................................
11.	Whether previously under treatment as a voluntary or temporary patient, and if so, give particulars.	............................................................ ............................................
12.	Whether previously under care and treatment as a person of unsound mind and, if so, when.	............................................................ .............................................
13.	Duration of present attack............................................................ ...........................................................
14.	Probable cause of present attack............................................................ ................................................
15.	Whether person is subject to epilepsy............................................................ ......................................
16.	Whether person is suicidal............................................................ ..........................................................
17.	Whether person is dangerous to others, and, if so, in what way.	........................................................... .............................................
18.	Whether any near relative has been afflicted with mental defect or mental disease.	.................... ............................................................ .

19.	Particulars of income received by or property belonging to person.	............................................................ ............................................
		............................................................ ............................................
20.	Public Assistance district in which residence of person is situated.	............................................................ .............................................
21.	Christian names, surnames and addresses of one or more relatives of person.	............................................................ ..............................................
		............................................................ ..............................................
		............................................................ ..............................................
		............................................................ ...............................................
22.	Name and address of person to whom notice in respect of the person under treatment is to be sent.	............................................................ ...............................................

Signature of Applicant............................................................

Full Name ............................................................ ..............

(In block letters)

Profession or Occupation........................................................

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

How related to or connected with person....................................

Date.....................................................

Attention is specially directed to the provisions of section 255 of the act as follows :—

" Where a person—

(a) makes a wilful misstatement in an application for a recommendation for reception, in an application for a reception order, or in a reception order, or

(b) makes a wilful misstatement in a medical or other certificate or in a statement or report under this Act of bodily or mental condition, or

(c) wilfully makes in a book, statement or return a false entry as to a matter as to which he is required to make an entry by this Act or a regulation thereunder,

FORM NO. 9.

MENTAL TREATMENT ACT, 1945 .

RECOMMENDATION FOR RECEPTION OF PERSON AS PERSON OF UNSOUND MIND AND AS CHARGEABLE PATIENT.

1.	Full name of person in respect of whom recommendation is made.	............................................................ ....................................
2.	Address (if any) of person.	............................................................ ....................................
		............................................................ ....................................

3. Recommendation :—

(1) I have to-day examined ............................................................

(2) I am of opinion that he is a person of unsound mind, that he is a proper person to be taken charge of and detained under care and treatment and that he is unlikely to recover within six months from the date hereof.

(3) I have formed this opinion on the following facts

(a) facts observed by myself............................................................ ............................................................ .........

(b) facts communicated by others .......................................

(4) I recommend that................................................be received in the district mental hospital at................................................as a person of unsound mind.

(5) I am of opinion that if so received.............................................will be a chargeable patient.

Signed ..................................................

Authorised medical officer for

.............................. Dispensary District.

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

FORM NO. 10.

MENTAL TREATMENT ACT, 1945 .

ORDER FOR THE RECEPTION OF A PERSON AS A PERSON OF UNSOUND MIND AND A CHARGEABLE PATIENT.

1.	Full name of person in respect of whom the reception order is made.	............................................................ ............
2.	Address of person............................................................ .........................................................

3. Order.

A recommendation by Dr............................................................ . authorised medical officer of............................................................ dispensary district for the reception of ............................................................ .............................. in the district mental hospital at..........................................................as a person of unsound mind and a chargeable patient having been made, I have to-day examined the person and I am satisfied that he is a person of unsound mind and a proper person to be taken charge of and detained under care and treatment and I hereby order that........................................................be received and detained in the said district mental hospital as a person of unsound mind.

Signed ................................................

Resident Medical Superintendent.

(or medical officer of the hospital acting on his behalf).

Date ....................................

FORM NO. 11.

MENTAL TREATMENT ACT, 1945 .

FORM OF REPORT BY PUBLIC ASSISTANCE AUTHORITY FOR THE PURPOSE OF section 231 of the act.

I. Particulars to be filled in by mental hospital authority before document is sent to public assistance authority.

From 1. .........................................................Mental Hospital Authority.

To 2.......................................................... Public Assistance Authority.

3. Full name of patient in respect of whom inquiries are made	............................................................ .........................................
4. Address of patient before reception into mental hospital	............................................................ .........................................
5. Registered number of patient in records of Mental Hospital Authority	............................................................ .........................................
6. Age of patient	............................................................ .........................................
7. Sex of patient	............................................................ .........................................
8. Occupation of patient	............................................................ ..........................................
9. Whether patient is married, single or widowed	............................................................ ..........................................
10. Date of reception of patient	............................................................ ..........................................
11. Method of reception	............................................................ ..........................................
12. Names and addresses of relatives and friends of patient known to Mental Hospital Authority	............................................................ ..........................................
13. Rate of payment (if any) offered on behalf of the patient	............................................................ ............................................

II. Particulars to be filled in by Public Assistance Authority.

1. If patient is married, state Christian names and ages of husband, or wife, and of each child under the age of sixteen years

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

FORM No. 11.—continued.

2. If patient is widowed, state Christian name and age of each child under the age of sixteen years	............................................................ ..............................
3. Give full particulars of any other dependants of patient	............................................................ ..............................
4. Particulars of property belonging to the patient	............................................................ ..............................
5. Valuation of land or house property belonging to the patient	............................................................ ..............................
6. Acreage of farm belonging to or occupied by patient with acreage under tillage and stock carried	............................................................ ..............................
7. Particulars of income to which patient is entitled	............................................................ ..............................
8. Names and addresses of patient's relatives and friends	............................................................ ..............................
9. In the case of each person liable under section 230 of the act to maintain the patient give :
(a) full name and address	............................................................ ..............................
(b) number of children under sixteen years of age	............................................................ ..............................
(c) particulars of any other dependants	............................................................ ..............................
(d) particulars of any person or persons maintained in any institution by him	............................................................ ..............................
(e) particulars of property	............................................................ ..............................
(f) particulars of income	............................................................ ...............................

FORM No. 11.—continued.

10. If any other person is willing to contribute to the cost of the patient's maintenance in the mental hospital give particulars of such person and of relationship of the person to the patient	............................................................ ............................
11. Whether patient was insured under the National Health or Unemployment Inance Acts before reception. If not, state reasons	............................................................ ............................
12. Particulars of the weekly receipts by the patient before reception from Unemployment or Insurance Benefits or old age or other pension	............................................................ ............................
13. 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	............................................................ ............................
14. Amount of contribution which in your opinion should be made by or on behalf of the patient	............................................................ ............................

Signed............................................................ .............

Superintendent Assistance Officer.

Signed............................................................ ...........

Secretary to the............................................................ ..........

Public Assistance Authority.

Date ............................................................ ........

To the.............................................

Mental Hospital Authority.

FORM NO. 12.

MENTAL TREATMENT ACT, 1945 .

APPLICATION FOR PRIVATE PATIENT RECEPTION ORDER.

1. Full name of person in respect of whom application is made	............................................................ ..............................
2. Address of person	............................................................ ..............................
3. Full name of applicant	............................................................ ..............................
4. Address of applicant	............................................................ ..............................
5. Relationship (if any) of applicant to person in respect of whom the application is made	............................................................ ..............................

6. Declaration of applicant :

(1) I am at least twenty-one years of age.

(2) I last saw the person in respect of whom I make the application on the........................day of................................19

(3) I am (a) the.............................of the person (c)........................in respect of whom I make the application.

(b) I am not a relative of the person in respect of whom I make the application and the reasons why the application is not made by a relative are ............................................................ .. ............................................................ ............................................................ ....................

(c) My connection with the person is ............................................................ ...........................................................

The circumstances under which the application is made are ............................................................ ............................................................ ....................................

(4) A statement of particulars in regard to the person in respect of whom I make the application accompanies the application.

(5) I desire an order for the reception of (c)..............................into (d).......................................as a person of unsound mind and a private patient.

(6) I am not one of the persons prohibited under section 179 of the act.

Signature..................................................

Full name...............................................

(in block letters).

Date........................................

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

Registered Medical Practitioner.

(a) Give relationship to person in respect of whom application is made.

(b) Delete paragraph which does not apply.

(d) Insert name of mental institution into which reception of person is desired.

Section 179 of the Act 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) a person interested in the payments (if any) to be made on account of the taking care of the person proposed to be received ;

(iii) a 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 in sub-paragraphs (i), (ii) or (iii).

In sub-paragraph (i) the reference to a member of the governing body of an institution does not include a reference to a member of a mental hospital authority.

Attention is specially directed to the provisions of section 255 of the act as follows :—

" Where a person—

(a) makes a wilful misstatement in an application for a recommendation for reception, in an application for a reception order, or in a reception order, or

(b) makes a wilful misstatement in a medical or other certificate or in a statement or report under this Act of bodily or mental condition, or

(c) wilfully makes in a book, statement or return, a false entry as to a matter as to which he is required to make an entry by this Act or a regulation thereunder,

FORM NO. 13.

MENTAL TREATMENT ACT, 1945 .

ORDER FOR THE RECEPTION OF A PERSON AS A PERSON OF UNSOUND MIND AND A PRIVATE PATIENT.

1. Full name of person in respect of whom the reception order is made ............................................................ ...................................................

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

3. Declaration as to unsoundness of mind :

Declaration by one registered medical practitioner.

(1) I, the undersigned registered medical practitioner, have separately examined (a)............................................................ ......................... on the (b)..................day of .............................................19..........

In my opinion (a)............................................................ .....................is of unsound mind and is a proper person to be taken charge of and detained under care and treatment and is unlikely to recover within six months from the date hereof.

I have formed this opinion on the following facts :—

(i) facts observed personally ............................................................ ............................................................ ....................

(ii) facts communicated by others............................................................ ............................................................ ............................................................ ............................................................

I am separately satisfied that it is proper to make an order for the reception of (a) ............................................................ ........................................ in a mental institution as a person of unsound mind.

I am not one of the prohibited persons indicated by Section 178 or section 179 of the act.

Signed .............................................

Registered Medical Practitioner.

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

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

Date..............................................

Declaration by the other registered medical practitioner.

(2) I, the undersigned registered medical practitioner, have separately examined (a)............................................................ ..............................on the (b) .......... day of ............................................19.........

In my opinion (a) ............................................................ ............................ is a person of unsound mind and is a proper person to be taken charge of and detained under care and treatment and is unlikely to recover within six months from the date hereof.

I have formed this opinion on the following facts :—

(i) facts observed personally ............................................................ .................................

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

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

(ii) facts communicated by others............................................................ ...........................

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

I am separately satisfied that it is proper to make an order for the reception of (a) ............................................................ .....................................in a mental institution as a person of unsound mind.

I am not one of the prohibited persons indicated by Section 178 or section 179 of the act.

Signed ..................................................

Registered Medical Practitioner.

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

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

Date.............................................

4. Order.

We the signatories to the above declarations hereby order that (a)............................................................ be received and detained in (c)............................................................ a person of unsound mind.

Signed..................................................

and

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

Registered Medical Practitioners.

Date.............................................

(a) Insert name of person in respect of whom reception order is made.

(b) Insert date upon which examination was made.

NOTES.

(1) Section 178 of the Mental Treatment Act, 1945 , provides that a private patient reception order shall not be made after the seventh day after the day on which it is applied for.

(2) Section 178 of the Mental Treatment Act, 1945 , provides that a private patient reception order shall not be signed 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.

(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 in the foregoing paragraphs.

The reference to the governing body of a mental institution does not include a reference to a mental hospital authority.

FORM NO. 14.

MENTAL TREATMENT ACT, 1945 .

APPLICATION FOR RECEPTION OF A PERSON IN AN APPROVED INSTITUTION AS A TEMPORARY PATIENT AND A CHARGEABLE PATIENT.

1. Full name of person in respect of whom application is made ............................................................ ....................................

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

3. Full name of applicant............................................................ ..........

4. Address of applicant............................................................ ............

5. Statement of applicant

(1) (a) .............................................resides in the mental hospital district of the (b).........................................................Mental Hospital Authority.

(2) I hereby apply to have him/her received as a temporary patient and a chargeable patient for care and maintenance of whom the (b)............................................................ .................Mental Hospital Authority will be responsible in the (c)............................................................ ............................................................ (an approved institution maintained by that authority, or an approved institution in which temporary patients of the authority may be received).

(f) (3) am related to (a)............................................................ .....in the following manner (d)..................................................

(f) I am the appropriate assistance officer for the district in which (a)............................................................ resides, and I am acting at the request of (e).

I am not related to (a)............................................................ ...

(f) The reasons why the application is not made by a relative of (a)........................................are ............................................................ ............................................................ ...

My connection with (a)..............................is............................................................ ............................................................

The circumstances under which I make the application are .................................................

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

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

(4) A certificate from the authorised medical officer accompanies this application.

(5) The said (a)..................................................receives or is entitled to the following income and property............................................................ ............................................................ ........

To the person in charge of (c). Signed...................................................

Date........................................

(a) Insert name of person in respect of whom application is made.

(b) Insert name of Mental Hospital Authority in whose district the person resides.

(c)Insert name of approved institution in which it is desired to have person received.

(d) Describe relationship with person.

(e) Give relative at whose request appropriate assistance officer is acting.

(f) Delete paragraphs not applicable.

Attention is specially directed to the provisions of section 255 of the act as follows :—

" Where any person—

(a) makes a wilful misstatement in an application for a recommendation for reception, in an application for a reception order, or in a reception order, or

(b) makes a wilful misstatement in a medical or other certificate or in a statement or report under this Act of bodily or mental condition, or

(c) wilfully makes in a book, statement, or return a false entry as to a matter as to which he is required to make an entry by this Act or a regulation thereunder,

such person shall be guilty of an offence under this section and shall be liable on summary conviction thereof to a fine not exceeding one hundred pounds, or, at the discretion of the Court, to imprisonment for a term not exceeding six months or to both such fine and such imprisonment."

FORM NO. 15.

MENTAL TREATMENT ACT, 1945 .

CERTIFICATE OF AUTHORISED MEDICAL OFFICER TO ACCOMPANY APPLICATION FOR RECEPTION AS TEMPORARY PATIENT AND CHARGEABLE PATIENT.

1. Full name of person in respect of whom certificate is given ............................................................ ............................................

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

3. Certificate

(1) I am the authorised medical officer in respect of (a)............................................................ ......................

(2) I examined (a)...................................on the...........................day of.............................................19 .

(3) The said (a)............................................................ ..............

(i) is suffering from mental illness, and

(ii) requires, for his recovery, not more than six months suitable treatment, and

(iii) is unfit on account of his mental state for treatment as a voluntary patient,

(b) or

The said (a).........................................................

(i) is an addict and

(ii) requires, for his recovery at least six months, preventive and curative treatment.

Signed................................................

Authorised Medical Officer.

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

Dispensary District.

Date...................................

(a) Insert name of person in respect of whom certificate is given.

(b) Strike out part not applicable.

FORM NO. 16.

MENTAL TREATMENT ACT, 1945 .

ORDER FOR RECEPTION OF PERSON AS TEMPORARY PATIENT AND CHARGEABLE PATIENT.

1. Full name of person in respect of whom order is made............................................................ ...........................................................

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

3. Order.

Having considered the application of (a).........................................of (b)..........................................................for the reception of (c)............................................................ as a temporary patient and a chargeable patient and the certificate of (d)................................authorised medical officer, which accompanied the application, I hereby order that (c)...........................................................be received and detained in (e)............................................................ as a temporary patient and a chargeable patient for whose care and maintenance the (f)............................................................ mental hospital authority shall be responsible.

Signed...................................................

The person in charge of (e).............................

Date.............................................

(a) Insert name of applicant for order.

(b) Insert address of applicant.

(d) Insert name of authorised medical officer who gives certificate.

(e) Insert name of approved institution in which person is to be received.

(f) Insert name of mental hospital authority responsible for patient.

FORM NO. 17.

MENTAL TREATMENT ACT, 1945 .

APPLICATION FOR RECEPTION OF PERSON IN AN APPROVED INSTITUTION AS A TEMPORARY PATIENT AND PRIVATE PATIENT.

1. Full name of person in respect of whom application is made............................................................ ........................................................

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

3. Full name of applicant............................................................ .......

4. Address of applicant............................................................ ..........

5. Statement of applicant :

(1) I hereby apply to have (a).............................................received as a temporary patient and a private patient in (b).......................

(a) (2) I am related to (a).......................................................in the following manner (c)........................................................

(d) I am not related to (a)...........................................................

The reasons why the application is not made by a relative of (a).......................................................are............................................................ ............................

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

My connection with (a).......................................................is............................................................ .........................

The circumstances under which I make the application are............................................................ ...........................

(3) A certificate signed by two registered medical practitioners accompanies this application.

(4) The said (a)........................................................receives or is entitled to the following income and property............................................................ .....................................................

Signed........................................................

Date...............................................

To the person in charge of (b).............................................

(a) Insert name of person in respect of whom application is made.

(b) Insert name of approved institution in which it is desired to have person received.

(d) Delete paragraph not applicable.

Attention is specially directed to the provisions of section 255 of the act as follows :—

" Where any person—

(a) makes a wilful misstatement in an application for a recommendation for reception, in an application for a reception order, or in a reception order, or

(b) makes a wilful misstatement in a medical or other certificate or in a statement or report under this Act of bodily or mental condition or

(c) wilfully makes in a book, statement, or return a false entry as to a matter as to which he is required to make an entry by this Act or a regulation thereunder,

FORM NO. 18.

MENTAL TREATMENT ACT, 1945 .

CERTIFICATE OF REGISTERED MEDICAL PRACTITIONERS TO ACCOMPANY APPLICATION FOR RECEPTION AS TEMPORARY PATIENT AND PRIVATE PATIENT.

1. Full name of person in respect of whom certificate is given ............................................................ ..................................

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

3. Certificate

(1) We the undersigned registered medical practitioners hereby declare that each of us has separately examined

(a)...................................on (b)...............day of.......................19.........., and each of us is of opinion that (a)............................................................ ...................................................

(ii) requires, for his recovery, not more than six months suitable treatment, and

(iii) is unfit on account of his mental state for treatment as a voluntary patient,

each of us is of opinion that (a)...............................................

(ii) requires, for his recovery, at least six months preventive and curative treatment.

(2) Each of us declares that he is not

(i) the person in charge of the approved institution in which (a).............................................is to be received, or

(ii) a person in the employment of the person in charge of that institution, or

(iii) a person having an interest in that institution.

Registered

Medical

Practitioners

{

Signed............................................................ ......

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

and

Signed............................................................ ......

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

Date............................................

(a) Insert name of person in respect of whom certificate is given.

(b) Insert date on which medical examination was made.

FORM NO. 19.

MENTAL TREATMENT ACT, 1945 .

ORDER FOR RECEPTION OF PERSON AS TEMPORARY PATIENT AND PRIVATE PATIENT.

1. Full name of person in respect of whom order is made ............................................................ ..................................

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

3. Order :—

Having considered the application of (a).........................................of (b)...................................................for the reception of (c)...........................................................as a temporary patient and a private patient and the certificate of (d)..........................and (d)............................................................ ....registered medical practitioners, which accompanied the application, I hereby order that (c)....................................................be received and detained in (e)............................................as a temporary patient and a private patient.

Signed...................................................

Person in charge of (e)

Date............................................ ..............................................

(a) Insert name of applicant for order.

(b) Insert address of applicant.

(d) Insert names of registered medical practitioners who gave certificate.

(e) Insert name of approved institution in which person is to be received.

FORM NO. 20.

MENTAL TREATMENT ACT, 1945 .

APPLICATION FOR RECEPTION OF PERSON AS VOLUNTARY PATIENT AND AS CHARGEABLE PATIENT IN AN APPROVED INSTITUTION.

1. Full name of person in respect of whom application is made............................................................ ....................

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

3. Application

(g) (1) I (a)......................................reside in the mental hospital district of the (b)...............................................mental hospital

I am at least sixteen years of age.

I hereby apply to be received as a voluntary patient and a chargeable patient for whose care and maintenance the (b)................................mental hospital authority will be responsible in (c)............................. (being an approved institution maintained by that mental hospital authority,

an approved institution in which voluntary patients of that authority may be received),

(g) I (d)......................................of (e)......................................am the parent or guardian of (a)...................................who resides in the mental hospital district of the (b).........................................mental hospital authority.

The said (a).......................................is less than sixteen years of age. I hereby apply to have him received as a voluntary patient and a chargeable patient for whose care and maintenance the (b)..............................mental hospital authority will be responsible in (c)................................................(being an approved institution maintained by that mental hospital authority,

an approved institution in which voluntary patients of that authority may be received).

4. A recommendation by the authorised medical officer stating that he examined (a).........................................on the (f)............day of.................19......, and is of opinion that he will benefit by the proposed reception accompanies this application.

Signature............................. ...............	}	Applicant (h)p1237h or parent (h) or guardian.
Date.......................................................

(a) Insert name of person in respect of whom application is made.

(b) Insert name of Mental Hospital Authority.

(d) Insert full name of parent or guardian making the application.

(e) Insert address of parent or guardian application.

(f) Insert date on which person was by authorised medical officer.

(g) Delete paragraph not applicable.

(h) Delete words not applicable.

FORM NO. 21.

MENTAL TREATMENT ACT, 1945 .

NOTICE OF RECEPTION OF PERSON IN APPROVED INSTITUTION AS A VOLUNTARY PATIENT AND A CHARGEABLE PATIENT.

1. Full name of person received............................................................ ..

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

3. Notice :

I beg to give notice that (a)...................................................who is by occupation a (b)...................................................and whose age is (c)...............was received on the (d)...............day of (d)............................................19......, as a voluntary patient and a chargeable patient for whose care and maintenance the (e)..................mental hospital authority will be responsible into (f)..........................(being an approved institution maintained by the (e)..........................mental hospital authority,

an approved institution in which voluntary patients of that authority may be received).

Signed.................................................

Person in Charge of Approved Institution.

Date...............................................

To The Minister for Local Government and Public Health.

(a) Insert name of person received.

(b) Insert occupation of person received.

(d) Insert date of reception.

(e) Insert name of mental hospital authority responsible for care and maintenance of person.

(f) Insert name of approved institution into which person has been received.

FORM NO. 22.

MENTAL TREATMENT ACT. 1945.

NOTICE OF RECEPTION OF PERSON IN APPROVED INSTITUTION AS A VOLUNTARY PATIENT AND A PRIVATE PATIENT.

1. Full name of person received............................................................ ..

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

3. Notice :

I beg to give notice that (a)........................................................whose profession or occupation is (b)...............................................and whose age is (c)..................was received on the (d)...............day of (d)............................................19........., as a voluntary patient and a private patient into (e)............................................which is an institution approved for the reception of voluntary patients.

Signed.....................................................

Person in Charge of Approved Institution

Date.......................................................

To The Minister for Local Government and Public Health.

(a) Insert name of person received.

(b) Insert profession or occupation of person received.

(d) Insert date of reception.

(e) Insert name of approved institution in which person has been received.

FORM NO. 23.

MENTAL TREATMENT ACT, 1945 .

REPORT TO MINISTER BY CHIEF MEDICAL OFFICER OF MENTAL INSTITUTION UPON THE EXPIRATION OF TWENTY-ONE DAYS AFTER THE RECEPTION OF A PERSON IN THE INSTITUTION UNDER A RECEPTION ORDER ON THE MENTAL AND BODILY CONDITION OF THE PERSON.

1. Name of Institution............................................................ ...........

2. Name of person received............................................................ .....

3. Address before reception............................................................ .....

4. Date of reception............................................................ ..............

5. Report.

I have this day examined (a).....................................................and I hereby certify that the mental condition of the said person is............................................................ ............................................................ .................and the bodily condition of the person is............................................................ ............................................................ ..........................

Signed.....................................................

Chief Medical Officer of the Mental Institution.

Date..................................................

To The Minister for Local Government and Public Health.

(a) Insert name of person.

FORM NO. 24.

MENTAL TREATMENT ACT, 1945 .

NOTICE TO MINISTER OF ESCAPE, REMOVAL OR DISCHARGE FROM MENTAL INSTITUTION OF PERSON WHO HAD BEEN DETAINED THEREIN UNDER A RECEPTION ORDER.

1. Name of institution............................................................ ...........

2. Full name of person............................................................ ...........

3. Address of person before reception.....................................................

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

4. Date of reception............................................................ ...............

5. Whether temporary patient or person of unsound mind ...........................................................

6. Whether chargeable patient or private patient ...........................................................

7. Date of escape, removal or discharge..................................................

8. If escape (a) State of mind on escape...............................................

(b) Full circumstances of escape.........................................

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

If removal (a) Place to which removed.........................................

(b) Purpose of removal...............................................

If discharge	(a) Whether recovered, improved or not improved
	(b) If not improved, circumstances of discharge	............................................................ ..............
		............................................................ ..............

To the Minister for Local Government and Public Health.

Signed............................................................ .............

Person in Charge of Institution.

FORM NO. 25.

MENTAL TREATMENT ACT, 1945 .

NOTICE TO MINISTER OF RETURN TO MENTAL INSTITUTION OF PATIENT WHO HAD BEEN DETAINED THEREIN UNDER A RECEPTION ORDER AND HAD ESCAPED OR BEEN REMOVED THEREFROM.

1. Name of institution............................................................ ............

2. Full name of person............................................................ ............

3. Home address of person............................................................ ......

4. Date of reception preceding escape or removal....................................

5. Whether temporary patient or person of unsound mind...........................

6. Whether chargeable patient or private patient....................................

7. Date of escape or removal............................................................ ....

8. Date of patient's return to institution................................................

9. Circumstances under which patient was brought back to the institution ............................................................ .................................... ............................................................ ....................................

Signed...................................................

Person in Charge of Mental Institution.

Date.............................................

To the Minister for Local Government and Public Health.

FORM NO. 26.

MENTAL TREATMENT ACT, 1945 .

NOTICE TO MINISTER OF DEPARTURE FROM APPROVED INSTITUTION OF PERSON WHO WAS BEING TREATED THEREIN AS A VOLUNTARY PATIENT.

1. Full name of person............................................................ ............

2. Address of person before reception...................................................

3. Notice :

I beg to give notice that (a)...................................................... who was received into (b)............................................................ on the (c)....................................day of (c)................................. 19 , as a voluntary patient and a (d).........................................patient (e) left the institution (or ceased to be a voluntary (f).................................day of ( f )..................19

Signed...................................................

Person in Charge of Approved Institution.

Date..........................................

To the Minister for Local Government and Public Health.

(a) Insert name of person.

(b) Insert name of approved institution in which person was being treated.

(d) Specify whether " chargeable " or " private."

(e) Strike out words which are not applicable.

(f) Insert date of departure.

FORM NO. 27.

MENTAL TREATMENT ACT, 1945 .

Notice to Minister of Death in Mental Institution of Patient who had been Detained therein under a Reception Order or who was being Treated therein as a Voluntary Patient.

1. Name of institution............................................................ ..............

2. Full name of person who has died............................................................

3. Home address of person............................................................ .........

4. The sex of person............................................................ .................

5. Age of person............................................................ .....................

6. Whether married, single or widowed...................................................

7. Profession or occupation............................................................ ......

8. Whether a voluntary patient, a temporary patient or a person of unsound mind............................................................ ...............................

9. Whether chargeable patient or private patient.......................................

10. Date and time of death............................................................ ..............

11. Cause of death............................................................ ......................

12. Whether cause of death was verified by post-mortem examination................ ............................................................ ......................................

13. Duration of disease from which person died.............................................

14. Name or names of person or persons present at the time of death............. ............................................................ .........................................

Signed...........................................................

Person in Charge of Mental Institution

Date.......................................................

To The Minister for Local Government and Public Health.

FORM NO. 28.

MENTAL TREATMENT ACT, 1945 .

FORM OF COMPULSORY ACQUISITION ORDER.

Whereas the (a)............................................................ ............................(hereinafter referred to as " the local authority ") in the exercise and performance of their powers and duties as a mental hospital authority require to take compulsorily the lands described in the Schedule hereto for the purpose (b)............................................................ ..........................................

Now therefore the local authority in pursuance of the Mental Treatment Act, 1945 , do hereby make the following order, that is to say :—

1. The local authority are hereby authorised to acquire compulsorily for the purpose aforesaid under the said Act and the Acts incorporated therewith, the lands described in the Schedule hereto which lands are coloured pink on the map marked (c)..............................................sealed with the common seal of the local authority and deposited at (d)..................................................

2. This Order may be cited as the........................................................ Compulsory Acquisition Order, 19..........

SCHEDULE ABOVE REFERRED TO.

Number of lands on map deposited at (d).........

Quantity, description and situation of the lands

Owners or reputed owners

Lessees or reputed lessees

Occupiers

Given under the Common Seal of the (a)...............................this...............day of.............................................in the presence of :—

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

Directions for filling up this form.

Insert : (a) Name of mental hospital authority.

(b) Purpose for which lands are proposed to be acquired.

(d) Place of deposit of map.

FORM NO. 29.

MENTAL TREATMENT ACT, 1945 .

FORM OF ADVERTISEMENT OF MAKING OF COMPULSORY ACQUISITION ORDER.

Notice is hereby given that the (a)......................................................in the exercise and performance of their powers and duties as a mental hospital authority made on the..................day of.................................., 19 , under the above-mentioned Act a compulsory Acquisition Order entitled (b)............................................................ ......................................... which will be submitted for confirmation by the Minister for Local Government and Public Health, authorising them to acquire compulsorily for the purpose (c)............................................................ ................................ the lands described in the Schedule hereto.

The said Order and the map referred to therein have been deposited at (d)............................................................ ....................................... and may be inspected thereat at all reasonable hours.

SCHEDULE.

(Here insert description of the lands comprised in the Order.)

Dated this...............day of.............................................19.........

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

Manager.

Directions for filling up this form :—

Insert—(a) Name of mental hospital authority.

(b) Short title of order.

(d) Place of deposit of order and map.

FORM NO. 30.

MENTAL TREATMENT ACT, 1945 .

FORM OF NOTICE TO OWNERS OR REPUTED OWNERS, LESSEES OR REPUTED LESSEES AND OCCUPIERS OF THE MAKING OF A COMPULSORY ACQUISITION ORDER.

To (a) ............................................................ ....................................

(Owner or reputed owner. Lessee or reputed lessee. Occupier).

of (b) ............................................................ ....................................

TAKE NOTICE that the (c)............................................................ ...in the exercise and performance of their powers and duties as a mental hospital authority on the...............day of............................................19........., made a compulsory acquisition order under the above-mentioned Act entitled (d)............................................................ ......................................... which is about to be submitted for confirmation by the Minister for Local Government and Public Health, authorising them to acquire compulsorily for the purpose of (e)............................................................ ........................... the lands described in the Schedule hereto.

The said Order and the map referred to therein have been deposited at (f)............................................................ ......................................... and may be inspected thereat at all reasonable hours.

Any person aggrieved by such Order may object thereto by sending an objection in writing stating the grounds thereof to the Minister for Local Government and Public Health, Dublin, before the (g)...............day of.............................19.........

the Act provides that if no such objection has been duly made or if every such objection has been withdrawn or if in the opinion of the Minister every such objection relates only to compensation the Minister may, as he shall think proper, refuse to confirm the order or confirm it with or without modification but if an objection (other than an objection which in the opinion of the Minister relates only to compensation) has been duly made and has not been withdrawn the Minister shall cause an inquiry to be held and after consideration of the report of the person who held the inquiry and of the objection or objections which occasioned the holding thereof, may, as he thinks proper, either refuse to confirm the Order or confirm it with or without modification.

SCHEDULE.

(Here insert description of the lands comprised in the Order).

Dated this...............day of.............................................19.........

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

Manager.

Directions for filling up this form.

Insert—(a) Name of person to whom notice is given.

(b) Address of person.

(d) Short title of Order.

(e) Purpose for which lands are proposed to be acquired.

(f) Place of deposit of order and map.

(g) Here insert a date not less than fourteen days from the service of the notice.

FORM NO. 31.

MENTAL TREATMENT ACT, 1945 .

FORM OF ADVERTISEMENT OF NOTICE OF CONFIRMATION OF COMPULSORY ACQUISITION ORDER.

(a).......................................... COMPULSORY ACQUISITION ORDER 19.........

NOTICE is hereby given that the Minister for Local Government and Public Health in pursuance of the powers vested in him by the above-mentioned Act, on the...............day of.............................................19......... confirmed (without modification) (with modification) an Order entitled as above-mentioned submitted to him by the (b)............................................................ .........authorising them to acquire compulsorily for the purpose of (c)....................... the lands described in the Schedule hereto.

A copy of the said Order as so confirmed by the Minister for Local Government and Public Health, and the map referred to therein have been deposited at (d)................................................and may be inspected thereat at all reasonable hours.

Any person who or whose property is affected by the Order may within three weeks after the first publication by advertisement of this notice apply to the High Court for the complete or partial annulment of the Order, and the Court if satisfied that the Order or any part thereof was made in excess of or was otherwise not authorised by the powers conferred by the Act or that such or any other person has been substantially prejudiced by any failure to comply in relation to the Order with the provisions of the Act, may as it shall think proper annul the Order either in whole or in part.

If no such application is made to the High Court, the Order will come into operation on the expiration of three weeks from the first publication by advertisement of this notice.

If any such application is made to the High Court the Order in so far as it is not annulled by the High Court will come into operation on the final determination of the application to the High Court.

SCHEDULE.

(Here insert description of the lands comprised in the Order).

Dated this................day of.............................................19.........

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

Manager.

Directions for filling up this Form :

Insert : (a) Short title of Order.

(b) Name of mental hospital authority.

(d) Place of deposit of order and map.

FORM NO. 32.

MENTAL TREATMENT ACT, 1945 .

FORM OF NOTICE TO OBJECTOR WHO APPEARED AT INQUIRY OF CONFIRMATION OF COMPULSORY ACQUISITION ORDER.

The (a)......................................... COMPULSORY ACQUISITION ORDER, 19.......................

To (b).................................................of.................................................

TAKE NOTICE that the Minister for Local Government and Public Health in pursuance of the powers vested in him by the above-mentioned Act on the...............day of.............................................19........., confirmed (without modification) (with modification) the above-mentioned Order submitted to him by the (c)............................................................ ........................... authorising them to acquire compulsorily for the purpose of (d)............................................................ ..................................the lands described in the Schedule to the said Order.

A copy of the said Order as so confirmed by the Minister for Local Government and Public Health, and the map referred to therein have been deposited at (e)............................................................ and may be inspected thereat at all reasonable hours.

Any person who or whose property is affected by the Order may within three weeks after the first publication by advertisement of the notice of the confirmation of the Order by the Minister, apply to the High Court for the complete or partial annulment of the Order, and the Court if satisfied that the Order or any part thereof was made in excess of or was otherwise not authorised by the powers conferred by the Act or that such or any other person has been substantially prejudiced by any failure to comply in relation to the Order with the provisions of the Act, may as it shall think proper annul the Order either in whole or in part.

If no such application is made to the High Court, the Order will come into operation on the expiration of three weeks from the first publication by advertisement of the notice of the confirmation of the Order by the Minister.

If any such application is made to the High Court, the Order, in so far as it is not annulled by the High Court, will come into operation on the final determination of the application to the High Court.

Dated this...............day 19.........

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

Manager.

Directions for filling up this Form :—

Insert : (a) Short title of Order.

(b) Name and address of objector.

(d) Purpose for which lands are proposed to be acquired.

(e) Place of deposit of order as confirmed and map.

FORM NO. 33 (i).

MENTAL TREATMENT ACT, 1945 .

FORM OF CONTRACT FOR CHARGEABLE PATIENT BOARDED-OUT.

THIS INDENTURE made this (a)...............day of........................... 19..., between the (b).............................................(hereinafter called the mental hospital authority) of the first part, and (c).........................................of the second part witnesseth that the said (c)...............................................doth hereby accept the charge of (d)................................................., now aged about (e)...............years, (and hereinafter called the patient) ; and in consideration of the sum of (f)...............per month, to be paid to (c).....................by the mental hospital authority as hereinafter mentioned, doth hereby covenant and agree to care and maintain the patient. And (c)....................................doth hereby bind himself (or herself) to observe and keep in respect of the patient the following conditions, that is to say :—

1. The said (c).........................................................shall properly and sufficiently board and suitably lodge the patient and see that the patient is properly dressed and kept clean in person and that the clothing provided for the patient is kept in repair.

2. If the patient shall at any time be suffering from illness or the effects of accident (c).........................................................will call in the services of the medical officer of the dispensary district in which (c).............................. resides, or if that officer is not available he will call in the services of another registered medical practitioner.

3. The patient shall be presented for inspection and examination at all reasonable times when required by the mental hospital authority or by the resident medical superintendent or other medical officer of the mental hospital authority or by the assistance officer for the district in which (c)........................resides or by the Inspector of Mental Hospitals or by a committee appointed by the mental hospital authority.

4. The patient shall be restored to the custody of the mental hospital authority and their officers at any time when (c).................................................shall be required by the Mental Hospital authority so to do.

5. The patient shall attend religious service at appropriate times at a place of worship of the religious denomination to which he belongs.

And the mental hospital authority doth hereby covenant and agree with (c).........................................................that so long as the patient shall continue in his (or her) charge, they (the mental hospital authority) will pay or cause to be paid to (c).........................................................the sum of (f)...............on the (g)...............day of each calendar month and a proportionate part of such monthly payment in the event of the patient being removed from the charge of (c).........................................................in the interval between any of the said days of payment.

And the mental hospital authority hereby further covenants and agrees that the patient shall from time to time be provided by them with suitable and sufficient clothing.

Given under our hands the day and year first herein mentioned.

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

Manager for the Mental Hospital Authority.

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

Person with whom the Patient is being Boarded-out.

(a) Insert date.

(b) Insert name of mental hospital authority.

(d) Insert name of patient.

(e) Insert age of patient.

(f) Insert amount.

(g) Insert " first," " second," or " third," etc., as may be agreed upon.

FORM NO. 33 (ii).

MENTAL TREATMENT ACT, 1945 .

FORM OF CONTRACT FOR PRIVATE PATIENT BOARDED-OUT.

THIS INDENTURE made this (a)................day of...........................19..., between the (b)..............................(hereinafter called the mental hospital authority) of the first part, and (c)............................................. of the second part, witnesseth that the said (c)...................................................doth hereby accept the charge of (d)...................................................., now aged (e)...............years, (and hereinafter called the patient), and in consideration of the sum of (f)...............per month, to be paid to (c).............................by the mental hospital authority as hereinafter mentioned, doth hereby covenant and agree to care and maintain the patient. And (c)....................................doth hereby bind himself (or herself) to observe and keep in respect of the patient the following conditions, that is to say :—

1. The said (c)........................................................shall properly and sufficiently board and suitably lodge the patient and see that the patient is properly dressed and kept clean in person and that the clothing provided for the patient is kept in repair.

2. If the patient shall at any time be suffering from illness or the effects of accident (c)........................................................shall call in a registered medical practitioner to attend him.

3. The patient shall be presented for inspection and examination at all reasonable times when required by the mental hospital authority or by the resident medical superintendent or other medical officer of the mental hospital authority or by the Inspector of Mental Hospitals or by a committee appointed by the mental hospital authority.

4. The patient shall be restored to the custody of the mental hospital authority and their officers at any time when (c)........................................................shall be required by the mental hospital authority so to do.

5. The patient shall attend religious services at the appropriate times in a place of worship of the denomination to which he belongs.

And the mental hospital authority doth hereby covenant and agree with (c)........................................................, that so long as the patient shall continue in his (or her) charge, they (the mental hospital authority) will pay or cause to be paid to (c)........................................................the sum of (f)............... on the (g)...............day of each calendar month, and a proportionate part of such monthly payment in the event of the patient being removed from the charge of (c)........................................................in the interval between any of the said days of payment.

And the mental hospital authority hereby further covenants and agrees that the patient shall from time to time be provided by them with suitable and sufficient clothing.

Given under our hands the day and year first herein mentioned.

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

Manager for the Mental Hospital Authority,

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

Person with whom the Patient is being Boarded-out.

(a) Insert date.

(b) Insert name of mental hospital authority.

(d) Insert name of patient.

(e) Insert age of patient.

(f) Insert amount.

(g) Insert " first," " second," or " third," etc., as may be agreed upon.

FORM NO. 34.

MENTAL TREATMENT ACT, 1945 .

FORM OF APPLICATION FOR REGISTRATION OF PRIVATE INSTITUTION.

1. Applicant :

(a) Name and Surname in full........................................................

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

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

2. Person in Charge :

(a) Name and surname in full........................................................

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

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

3. Description of Institution :

(a) Situation............................................................ .....................

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

(d) Condition of repair of buildings...................................................

(e) Number and dimensions of wards and sleeping apartments in institution............................................................ ........................

(f) Number of beds in institution for the accommodation of patients............................................................ .......................................................

(g) Particulars of water supply........................................................

(h) Particulars of system of sanitation...............................................

(i) System of heating ............................................................ .......

(j) System of lighting ............................................................ ........

(k) Particulars of general equipment...............................................

(l) Any observations on ordnance sheet which accompanies the application for registration............................................................ .............

(m) Any observations on Plan which accompanies the application for registration ............................................................ .................

4. Patients to be Accommodated in Institution :

	Male	Female	Total
(a) Number	..........................	.......................	.............................

(b) Methods of segregation :

(i) in buildings ............................................................ ......

(ii) in grounds............................................................ ....

5. Medical Staff of Institution :

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

(b) Date of registration............................................................ ......

(d) Names, dates of registration and special qualifications (if any) of assistant medical officers.......................................................

6. Particulars of Nursing Staff to be Employed :

(a) Matron :

(i) Name............................................................ ...............

(ii) Age...........................

(iii) Qualifications............................................................ ....

(b) Assistant Matron :

(i) Name............................................................ ...............

(ii) Age...........................

(iii) Qualifications............................................................ ....

(i) Name............................................................ ...............

(ii) Age...........................

(iii) Qualifications............................................................ ....

(d) Head Nurse (Female) :

(i) Name............................................................ ...............

(ii) Age...........................

(iii) Qualifications............................................................ ....

(e) Number of other nurses (Male)...................................................

(f) Name and qualifications of each............................................................ ............................................................ .....................

(g) Number of other nurses (Female).................................................

(h) Name and qualifications of each............................................................ ............................................................ .....................

Signature of Applicant..............................................

Date.................................

N.B.—The application must be accompanied by

(a) an ordnance sheet to the scale of four inches to one mile showing :

(i) the premises of the institution ;

(ii) the buildings ;

(iii) the exercise grounds ;

(iv) the garden ;

(v) the roads of approach ;

(vi) in a separate colour, the lands and buildings to be included in the premises to be registered ;

and

(vii) the buildings to be occupied by patients ;

and

(b) a plan to a scale of not less than one-sixteenth of an inch to one foot of the buildings, having the sizes and floor areas of all rooms and apartments clearly indicated thereon and a schedule thereon showing the purpose for which each room, or apartment is to be used.

FORM NO. 35.

MENTAL TREATMENT ACT, 1945 .

FORM OF APPLICATION FOR RENEWAL OF REGISTRATION OF PRIVATE INSTITUTION.

1. Name and address of applicant........................................................

2. Situation of Institution............................................................ .........

3. Number of patients accommodated in the institution at time of application	Males	Females	Total
..............	..............	..............
4. Number of persons (if any) lodged as boarders in the part of the institution used for the accommodation of patients	Males	Females	Total
..............	..............	..............
5. Number of patients proposed to be accommodated in the institution during the period for which application is made	Males	Females	Total
...............	..............	..............

6. Variations (if any) in the particulars given in relation to the institution in the application for registration in regard to—

(a) Person in charge ;

(b) Condition of institution and accommodation therein ;

(d) Medical staff of institution ;

(e) Nursing staff of institution.

Signature................................................

Date.............................................

FORM NO. 36.

MENTAL TREATMENT ACT, 1945 .

REGISTRATION OF PRIVATE INSTITUTION.

Certificate of Registration.

The Minister for Local Government and Public Health hereby certifies that..................................................

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

of............................................................ ............................................................ ....................................................

has been duly registered to keep an institution situated at..............................in the County............................................................ ...........as a private 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 Local Government and Public Health this...............day of..................19...

FORM NO. 37.

MENTAL TREATMENT ACT, 1945 .

Statement of Registered Medical Practitioner in Pursuance of 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

Whether under restraint or seclusion

Reasons therefor

General observations

Signature

FORM NO. 38.

MENTAL TREATMENT ACT, 1945 .

FORM OF APPLICATION FOR REGISTRATION OF PRIVATE CHARITABLE INSTITUTION.

1. Applicant :

(a) Name and surname in full......................................................

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

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

2. Person in Charge :

(a) Name and surname in full........................................................

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

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

3. Description of Institution :

(a) Situation............................................................ ....................

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

(d) Condition of repair of buildings..................................................

(e) Number and dimensions of wards and sleeping apartments in institution............................................................ ........................

(f) Number of beds in institution for the accommodation of patients............................................................ ..............................

(g) Particulars of water supply........................................................

(h) Particulars of system of sanitation...............................................

(i) System of heating............................................................ ........

(j) System of lighting............................................................ .....

(k) Particulars of general equipment...............................................

(l) Any observations on ordnance sheet which accompanies the application for registration............................................................ .........

(m) Any observations on Plan which accompanies the application for registration............................................................ ..............

4. Patients to be Accommodated in Institution :

	Male.	Female.	Total.
(a) Number	......................	........................	......................

(b) Methods of segregation :

(i) in buildings............................................................ .......

(ii) in grounds............................................................ ........

5. Medical Staff of Institution :

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

(b) Date of registration............................................................ .....

(d) Names, dates of registration and special qualifications (if any) of assistant medical officers........................................................

6. Particulars of Nursing Staff to be Employed :

(a) Matron :

(i) Name............................................................ ..............

(ii) Age..........................

(iii) Qualifications............................................................ ....

(b) Assistant Matron :

(i) Name............................................................ ..............

(ii) Age..........................

(iii) Qualifications............................................................ ....

(i) Name............................................................ ..............

(ii) Age..........................

(iii) Qualifications............................................................ ....

(d) Head Nurse (Female) :

(i) Name............................................................ ..............

(ii) Age..........................

(iii) Qualifications............................................................ ....

(e) Number of other nurses (Male)..................................................

(f) Name and qualifications of each..............................................

(g) Number of other nurses (Female)...............................................

(h) Name and qualifications of each..................................................

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

Signature of Applicant.

Date.............................................

N.B.—The application must be accompanied by :

(a) an ordnance sheet to the scale of four inches to one mile showing

(i) the premises of the institution ;

(ii) the buildings ;

(iii) the exercise grounds ;

(iv) the gardens ;

(v) the roads of approach ;

(vi) in a separate colour, the lands and buildings to be included in the premises to be registered, and

(vii) the buildings to be occupied by patients, and

(b) a sketch plan to a scale of not less than one-sixteenth of an inch to one foot of each floor of the buildings, having the sizes and floor areas of all rooms and apartments clearly indicated thereon and a schedule thereon showing the purpose for which each room or apartment is to be used.

FORM NO. 39.

MENTAL TREATMENT ACT, 1945 .

FORM OF APPLICATION FOR RENEWAL OF REGISTRATION OF PRIVATE CHARITABLE INSTITUTION.

1. Name and address of applicant.........................................................

2. Situation of Institution............................................................ .........

3. Number of patients accommodated in the institution at time of application	Males.	Females.	Total.
..................	..................	..................
4. Number of persons (if any) lodged as boarders in the part of the institution used for the accommodation of patients	..................	..................	..................
5. Number of patients proposed to be accommodated in the institution during the period for which application is made	..................	..................	..................
6. Variations (if any) in the particulars given in relation to the institution in the application for registration in regard to—
(a) Person in charge ;
(b) Condition of institution and accommodation therein ;
(c) Extent of accommodation in institution for patients ;
(d) Medical Staff of Institution ;
(e) Nursing Staff of Institution.

Signature................................................

Date.............................................

FORM NO. 40.

MENTAL TREATMENT ACT, 1945 .

REGISTRATION OF PRIVATE CHARITABLE INSTITUTION.

CERTIFICATE OF REGISTRATION.

The Minister for Local Government and Public Health hereby certifies that ............................................................ .......................................of ............................................................ ..........................................has been duly registered to keep an institution situated at..............................in the County of........................................as a 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 Local Government and Public Health this...............day of.........................19.........

FORM NO. 41.

MENTAL TREATMENT ACT, 1945 .

FORM OF APPLICATION FOR APPROVAL OF INSTITUTION FOR RECEPTION OF TEMPORARY OR VOLUNTARY PATIENTS.

1. Applicant :

(a) Name and Surname in full......................................................

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

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

2. Person in charge :

(a) Name and Surname in full......................................................

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

The following additional particulars shall be furnished in the case of an institution which is not already a mental institution :

3. Description of Institution :

(a) Situation............................................................ ....................

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

(d) Condition of repair of buildings..................................................

(e) Number and dimensions of wards and sleeping apartments in institution............................................................ ........................

(f) Number of beds in institution for the accommodation of patients............................................................ ..............................

(g) Particulars of water supply........................................................

(h) Particulars of system of sanitation...............................................

(i) System of heating............................................................ .....

(j) System of lighting............................................................ .....

(k) Particulars of general equipment...............................................

4. Patients to be accommodated in institution :

	Male.	Female.	Total.
(a) Number of temporary patients	..................	..................	..................
(b) Number of voluntary patients	..................	..................	..................
(c) Number of other patients	..................	..................	..................
(d) Methods of segregation	..................	..................	..................

5. Por ion of premises to be used for purposes for which it is approved :

(a) Whether whole of premises is to be so used............................................................ .......................
(b) If only part of premises is to be so used give full particulars of such part and the number of beds therein	............................................................ ..........................

6. Medical Staff of Institution :

(a) Name of registered medical practitioner who is to be chief medical officer of institution	............................................................ ............................
(b) Date of registration............................................................ ............................................................ ..........
(c) Special qualifications............................................................ ............................................................ .......
(d) Names, dates of registration and special qualifications of assistant medical officers (if any)	............................................................ .............................

7. Particulars of Nursing Staff to be employed :

(a) Matron

(i) Name............................................................ ..............

(ii) Age..........................

(iii) Qualifications............................................................ ....

(b) Assistant Matron

(i) Name............................................................ ..............

(ii) Age..........................

(iii) Qualifications............................................................ ....

(i) Name............................................................ ..............

(ii) Age..........................

(iii) Qualifications............................................................ ....

(d) Head Nurse (Female)

(i) Name............................................................ ..............

(ii) Age..........................

(iii) Qualifications............................................................ ....

(e) Number of other nurses (male)..................................................

(f) Name and qualifications of each..............................................

(g) Number of other nurses (female)...............................................

(h) Name and qualifications of each..................................................

Signature of Applicant............................................................

Date.............................................

GIVEN under the Official Seal of the Minister for Local Government and Public Health, this third day of April, One Thousand Nine Hundred and Forty-six.

(Signed) F. C. WARD,

Parliamentary Secretary to the Minister for Local Government and Public Health.

The Minister for Finance hereby consents to the provisions of Article 61 of this Order.

(Signed) PROINNSÍAS MAC AODHAGÁIN,

GIVEN under the Official Seal of the Minister for Finance, this sixteenth day of April, One Thousand Nine Hundred and Forty-six.

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	Irish Statutory Instruments
You are here: BAILII >> Databases >> Irish Statutory Instruments >> Department of Local Government and Public Health. Mental Treatment (Regulations) Order, S.I. No. 202/1946 URL: http://www.bailii.org/ie/legis/num_reg/1946/0202.html

Irish Statutory Instruments

S.I. No. 202/1946 -- Department of Local Government and Public Health. Mental Treatment (Regulations) Order, 1946.