Among the reported grievances of staff the workload and burnout, sexual harassment, and safety concerns inside the wards could be highlighted. Upon examination, the lack of staff was identified to be the root cause of such grievances. It was mentioned that the staff can relay the grievances to the hospital administration through the staff correspondence book, the nursing officer in charge of their ward, by documenting details in the incident detail report or by speaking to the Director. For effectively addressing the grievances the hospital has established a clinical governance unit. While the staff had mixed views about the said unit, it was stated that instead of the nursing officer in-charge of the ward relaying the details of the incidents during clinical governance meetings, the clinical governance committee should visit the place where the incident took place in order to get a better understanding of the root cause of such events to make an objective decision. Key Recommendations In the above context, the following key recommendations are made by the Commission. Detailed recommendations will be made to the relevant authorities along with the publication of the detailed report on the Fact Finding Mission on the Right to Health and Liberty of patients at NIMH. To the Ministry of Health 1. Immediate measures should be taken to enact a Mental Health Act, which is in line with the international medical standards and human rights obligations of the State. Given the urgency, measures should be taken to finalise the draft Act within the 1st Quarter of 2024. The Act must inter alia mandatorily provide for the establishment of a Mental Health Monitoring Board, with powers vested on the Board to ensure proper implementation of the duties, responsibilities and powers enumerated in the Act. 2. The administrative structure of the NIMH must be reformulated to facilitate the appointment of Psychiatrists as Administrators. In the absence, measures should be taken to at least appoint a Clinical Director with powers to oversee matters pertaining to clinical management. 3. Forensic Psychiatric Unit must be restructured, and infrastructure provided, to allow for the segregation of remand prisoners in the acute stage, remand prisoners in the intermediate stage, convicted prisoners in the acute stage and convicted prisoners in the intermediate stage. 4. Adequate funds should be allocated to upgrade the necessary infrastructure at the NIMH, especially the sanitary facilities, disability-friendly facilities, and ward facilities including bed monitors. 5. Resources should be allocated forthwith to address the staff shortage at the NIMH, in particular prioritising the recruitment of psychologists, an accountant, additional support staff and psychiatric social workers. Personnel recruited as support staff must be closely 8|Page

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