Document courtesy of NDoH, views do not necessarily reflect those of the IUSS working group
DRAFT MENTAL HEALTH INFRASTRCUTURE STANDARDS
FORENSIC UNITS
Description
General Requirements
-
The building/s shall comply with all conditions and
requirements prescribed by the applicable local authority,
provincial and/or national departments and shall be issued
with a Certificate of Compliance in terms of the National
Building Standards Act.
-
All the building and structural requirements prescribed in the
general health legislation applies in psychiatric hospitals.
-
The facility must have a maintenance plan.
-
The rooms must be well ventilated, with an adequate
temperature control system.
-
There must be fire detection systems in the facility.
-
Electrical fittings should be recessed / concealed and be
tamper-proof from within the rooms.
-
Light switches and heating systems must be centrally
controlled.
-
The materials, finishes and workmanship used for toilets
and hand basins must be as durable and unbreakable as is
reasonably possible.
-
Hot water supply should be thermostatically controlled to
prevent injury to users and staff. See Annexure
-
The temperature of hot water should be designed and
[Type text]
Yes/ No
Document courtesy of NDoH, views do not necessarily reflect those of the IUSS working group
maintained to deliver a maximum temperature of 45ºC at
any point of use.
Specific Infrastructure Requirements
-
The awaiting trial detainees referred for observations must
be kept separately from other state patients and mental
health care users at all times.
-
The facility must provide accommodation that does not
facilitate unwanted sexual and physical contact between
users.
-
The facility must provide for separate sections:
-
Males and females must not be mixed.
-
Children must not be mixed with adolescents.
-
Adults must not be mixed with either children or
adolescents.
-
When appropriate and possible, users must have the
opportunity to communicate privately with other users, their
families and friends unless contra-indicated on safety or
clinical grounds.
-
Provision must be made for privacy and respect with regard
to bathing, dressing and toilet needs, even in communal
spaces.
-
There must be a secure, private space to keep personal
possessions.
-
The awaiting trial detainees must be accommodated in
secured single rooms.
-
There must be sufficient and adequate sized rooms where
the observations are conducted by a team of professionals.
[Type text]
Document courtesy of NDoH, views do not necessarily reflect those of the IUSS working group
-
The seclusion room or maximum-security room must be
situated close to the nursing station to allow for constant
supervision by staff.
-
The seclusion room or maximum-security room must have a
toilet and basin.
-
Mental health care users in the rooms must not be able to
lock themselves inside or inside cupboards.
-
All cupboards and wardrobes, in rooms if any must be fixed
to the walls.
-
The beds in the rooms must be immovable. Concrete bed
should be used.
-
Fire-resistant mattresses should be used.
-
Floors must be slip-resistant when wet. Epoxy floors is
recommended with under floor heating.
o 2 types of under Floor heating.
-

Water . This type is highly recommended.

Electrical .
Toilets, bathrooms and showers should provide for
individual privacy and safety.
-
A remote shut off valve should be installed in all ablution
facilities.
o Taps :
One rose mixer
o Shower Rose :
o Toilets :
See Annexure 1
See Annexure 1
o Basin :
o Flushing system:
[Type text]
See Annexure 1
See Annexure 1
Document courtesy of NDoH, views do not necessarily reflect those of the IUSS working group
-
All fittings or furniture must avoid sharp corners or edges,
which could pose a risk of injury to users.
-
All areas must be able to be kept clean and homely.
-
A rest room must be provided for staff on duty, which must
be located within the nursing unit.
-
Toilet facilities must be provided for staff on duty.
-
Facilities must take cognisance of infection control policies
applicable to health care.
DESIGN
-
The design must avoid any item or furniture that can be
used as a weapon.
o All tables and chairs should be bolted to the floor.
-
The layout and design must allow for easy supervision and
observation of users by staff at all times.
-
The layout and design must prevent areas of concealment
for purposes of hiding or launching surprise attacks on
others or staff.
-
The position of the nursing station should provide for secure
effective surveillance of all activities in the ward.
-
The layout and design should provide enough space to walk
freely inside the ward.
-
The layout, design and finishes must allow for easy
maintenance of the facility without hampering the orderly
management of the ward and its users.
-
The ceiling must be out of reach of mental health care
users. All ceilings should be concrete with all electrical
[Type text]
Document courtesy of NDoH, views do not necessarily reflect those of the IUSS working group
fittings inside the slab and maintenance is done in the roof.
Access is from outside.
SECURITY
-
The entrance to each room must be security controlled from
the nursing station.
-
Consistent with the users’ right to privacy, all rooms must be
monitored with CCTV.
-
Panic buttons should be installed in each room to summon
additional staff and help from elsewhere in the facility
-
The windows and doors to the single rooms must be burglar
proofed.
-
Doors of the single rooms must be solid core, reinforced
and must lock from outside.
-
The courtyard wall or fence must be high out of reach and
secured to avoid escape of the awaiting trial detainees.
-
Safe and secured treatment rooms must be available for
medical procedures and other neurological/or physical
assessments.
-
Main entrance to the facility must be security controlled
-
The door at the main entrance must be solid core,
reinforced and lock from outside.
-
The seclusion room or maximum-security room door must
allow for adequate observation by staff.
-
Windows should not be glazed with breakable glass and
must prevent escape of users.
-
Windows and open spaces must be so constructed as to
[Type text]
Document courtesy of NDoH, views do not necessarily reflect those of the IUSS working group
prevent suicide attempts.
Mirrors, if any, must be made of safety glass and be mounted to
the wall.
STRUCTURAL ENVELOPE
The following should be considered:
 A facility/building-management zone and security/alarm
system must be in place complete with security lighting
and infra-red movement sensors installed in strategic
places;
 Warning/signal-light system should also be employed in
strategic places;
 Intruder/panic alarm system with strategically placed fixed
buttons and mobile buttons corresponding to range
requirements lining up with planning layouts;
 Radio communication and access control, with permit
system complete with biometric capabilities, is required
through-out the facility;
 Standard door frames in secure areas should be 1.5 to
2.0 mm thick to accommodate heavy steel door leaves
and/or gates;
 Door frames should not be configured with top-light units;
 Door leaves should be constructed of steel as for
seclusion rooms with proper lock mechanisms;
 Doors should open outward from the secure area and not
obscure fire escape routes in terms of the NBR’s. Width of
escape routes (corridors) should comply with the NBR’s;
 Gates should be on a sliding mechanism sliding into a
cavity of two secure wall skins and maintenance to it
should be easily accessible;
 Gate locking mechanisms should both be electrical with
mechanical over-ride duplicates in an event of a power
failure;
 Doors and gates should have lockable access ports to
hand through items of need to observandi at times;
 All security doors/gates must be electrically controllable
from the observation station;
 Window frames/outward-opening-sections should be the
narrow, 75mm, kind populated with eight to twelve
millimeter glass or poly-carbonate silicone/installed from
the outside to prevent self harm or harm to others.
Handles to opening section should be accessible from the
outside only;
 Ventilation should conform with the NBR’s and ASHRAEstandards as stipulated;
[Type text]
Document courtesy of NDoH, views do not necessarily reflect those of the IUSS working group








Natural lighting should also conform with the NBR’s and
supplemented by acceptable levels during night time and
over cast days;
All materials used in secure areas for observandi should
be non-combustible (complete with a smoke detention
system), vandal-proof and un-useable as objects of self
harm or harm to others;
CCTV monitoring of all areas for observandi, vandal-proof
and out of their reach, is required with careful
consideration to placement/view with respect to human
rights and privacy;
All electronic/electrical equipment should be
supplemented by an uninterrupted power-supply and
backup generators for essential security and safety
features;
Bed-bunk and ablution facilities in observandi bedrooms
should be of vandal-proof material, concreted into walls
and floors, and un-useable to be dismantled and used as
objects of self harm or harm to others;
Ceiling in observandi areas should be constructed of
concrete no less than 4.5 meters high;
Perimeter walls and roof edges in areas for observandi
should be 4.5 meters high and of a smooth wall surface to
prevent grip for vertical climbing;
All electrical distribution boards, fire hydrants,
extinguishers and control panels should be carefully
placed out of reach of observandi and built-into walls
locked but accessible in case of an emergency for staff
only and conforming to NBR’s;
NATIONAL BUILDING REQUIREMENTS
The applications of the NBR’s can have an influence on the
security control and safety of the layout especially in terms of the
following:
 Long corridors and fire escape routes;
 Mandatory fire protection equipment required like firehose-reels and fire-extinguishers
 All internal observandi interface areas should be
monitored for smoke detection and treated for fire
protection such as fire-sprinkling-systems;
 Reticulation for fire-detection/protection equipment should
be tamper proof but functionally useable during an
emergency and carefully planned for location and access;
 Emergency rescue/protection equipment in case of a fire
emergency should be considered because of the security
[Type text]
Document courtesy of NDoH, views do not necessarily reflect those of the IUSS working group



aspect
Central electrical lock/release mechanisms should be
considered for all single secure areas for doors in case of
a fire;
The facility should not be planned on more than one
building level;
Long corridors should be avoided for the purpose of
escaping a fire but to maintain the required security level
for observandi.
[Type text]
Document courtesy of NDoH, views do not necessarily reflect those of the IUSS working group
GENERAL MENTAL HEALTH FACILITIES
Description
GENERAL PRINCIPLES

Every mental health care User must receive care, treatment and
rehabilitation services according to standards equivalent to those
applicable to any other health care User.

Facilities providing care and treatment must at all times protect the
basic human rights of the mental health care User and the personnel;

The environment in which the mental health care User is kept must be
safe and secure;

The choice of materials, finishes and workmanship used in the facility
must take cognizance of the specific need of the User, and other Users
and personnel to exclude the possibility of self-harm, harm to others or
property.

An accommodation schedule is regarded as the final
interpretation of all requirements to fulfill a particular procedure
or set of procedures within or associated with a unit.
Management, administration and support services will underpin
clinical units of the facility. This schedule will form part of a Brief
for the facility endorsed by the stakeholders as defined by roles
and responsibilities delegated for the purpose.
-
The building/s shall comply with all conditions and requirements
prescribed by the applicable local authority, provincial and/or national
departments and shall be issued with a Certificate of Compliance in
terms of the National Building Standards Act.
-
All the building and structural requirements prescribed in the general
health legislation applies in health establishment that care treatment
and rehabilitation of mental health care user.
-
Adults, adolescent and children must be kept separately from each
[Type text]
Yes/ No
Document courtesy of NDoH, views do not necessarily reflect those of the IUSS working group
other including outpatient activities..
-
A ward in a general hospital be on the ground floor with an extended
area outside (fenced off with high fencing) for mobility of the patient.
The unit will have the following support areas (counseling room,
treatment room, consulting room, office, toilets, bathroom, shower,
group room, ward round room, nurse’s station, security office in front of
entrance to the unit, and a secure environment.
-
The design must avoid any item or furniture that can be used as a
weapon.
-
The layout and design must allow for easy supervision and observation
of Users by staff at all times.
-
The layout and design must prevent areas of concealment for purposes
of hiding or launching surprise attacks on others or staff.
-
The position of the nursing station should provide for secure effective
surveillance of all activities in the ward.
-
The layout and design should provide enough space to walk freely
inside the room.
-
The layout, design and finishes must allow for easy maintenance of the
facility without hampering the orderly management of the ward and its
users.
-
The observation room must provide accommodation that does not
facilitate unwanted sexual and physical contact between the patients.
-
The observation room must provide for separate sections:
-
Males and females must not be mixed.
-
Children must not be mixed with adolescents.
-
Adults must not be mixed with either children or adolescents.
-
When appropriate and possible, Users must have the opportunity to
communicate privately with other patients, their families and friends
unless contra-indicated on safety or clinical grounds.
-
Provision must be made for privacy and respect with regard to bathing,
dressing and toilet needs, even in communal spaces.
[Type text]
Document courtesy of NDoH, views do not necessarily reflect those of the IUSS working group
-
There must be a secure, private space to keep personal possessions.
-
The rooms must be well ventilated, with an adequate temperature
control system.
-
Panic buttons should be installed in each room to summon additional
staff and help from elsewhere in the facility
-
The windows and doors to the single rooms must be burglar proofed.
-
The courtyard wall or fence must be high out of reach and secured to
avoid escape.
-
There must be sufficient and adequate sized rooms where the
observations are conducted by a team of professionals.
-
Safe and secured treatment rooms must be available for medical
procedures and other neurological/or physical assessments
-
Main entrance to the facility must be security controlled
-
Mental health care users in the rooms must not be able to lock
themselves inside or inside cupboards.
-
Fire-resistant mattresses should be used.
-
Windows should not be glazed with breakable glass and must prevent
escape of users.
-
Windows should be slated and placed to such an extent to allow for
enough lighting.
-
Windows and open spaces must be so constructed as to prevent
suicide attempts.
-
Floors must be slip-resistant when wet.
-
Mirrors, if any, must be made of safety glass and be mounted to the
wall.
-
There must be fire detection systems in the facility and room.
-
Electrical fittings should be recessed / concealed and be tamper-proof
from within the rooms.
[Type text]
Document courtesy of NDoH, views do not necessarily reflect those of the IUSS working group
-
Light switches and heating systems must be centrally controlled.
-
The materials, finishes and workmanship used for toilets and hand
basins must be as durable and unbreakable as is reasonably possible.
-
Toilets, bathrooms and showers should provide for individual privacy
and safety,
-
The ceiling must be out of reach of mental health care Users.
-
Concrete ceilings are best practice principle.
-
Ceilings must be a minimum of 3m from the ground if concrete ceilings
are used.
-
Hot water supply should be thermostatically controlled to prevent injury
to users and staff.
-
The temperature of hot water should be designed and maintained to
deliver a maximum temperature of 45ºC at any point of use.
-
All fittings or furniture must avoid sharp corners or edges, which could
pose a risk of injury to users.
-
All areas must be able to be kept clean and homely.
-
A rest room must be provided for staff on duty, which must be located
within the nursing unit.
-
Toilet facilities must be provided for staff on duty.
-
Facilities must take cognisance of infection control policies applicable
to health care.
STRUCTURAL PRINCIPLES




A facility/building-management zone and security/alarm system must
be in place complete with security lighting and infra-red movement
sensors installed in strategic places;
Warning/signal-light system should also be employed in strategic
places;
Intruder/panic alarm system with strategically placed fixed buttons
and mobile buttons corresponding to range requirements lining up
with planning layouts;
Radio communication and access control, with permit system
[Type text]
Document courtesy of NDoH, views do not necessarily reflect those of the IUSS working group
complete with biometric capabilities, is required through-out the
facility;
 Standard door frames in secure areas should be 1.5 to 2.0 mm thick
to accommodate heavy steel door leaves and/or gates;
 Door frames should not be configured with top-light units;
 Doors should open outward from the secure area and not obscure
fire escape routes in terms of the NBR’s. Width of escape routes
(corridors) should comply with the NBR’s;
 Gates should be on a sliding mechanism sliding into a cavity of two
secure wall skins and maintenance to it should be easily accessible;
 Gate locking mechanisms should both be electrical with mechanical
over-ride duplicates in an event of a power failure;
 Doors and gates should have lockable access ports to hand through
items of need to patients at times;
 All security doors/gates must be electrically controllable from the
observation station;
 Window frames/outward-opening-sections should be the narrow,
75mm, kind populated with eight to twelve millimeter glass or polycarbonate silicone/installed from the outside to prevent self harm or
harm to others. Handles to opening section should be accessible
from the outside only;
 Ventilation should conform with the NBR’s and ASHRAE-standards
as stipulated;
 Natural lighting should also conform with the NBR’s and
supplemented by acceptable levels during night time and over cast
days;
 All materials used in secure areas for patients should be noncombustible (complete with a smoke detention system), vandal-proof
and un-useable as objects of self harm or harm to others;
 CCTV monitoring of all areas for patients vandal-proof and out of
their reach, is required with careful consideration to placement/view
with respect to human rights and privacy;
 All electronic/electrical equipment should be supplemented by an
uninterrupted power-supply and backup generators for essential
security and safety features;
 Ceiling in observation room areas should be constructed of concrete
no less than 4 meters high;
All electrical distribution boards, fire hydrants, extinguishers and control
panels should be carefully placed out of reach of all patients and built-into
walls locked but accessible in case of an emergency for staff only and
conforming to NBR’s
[Type text]