IMHH started community mental health services at Community Health Centre Farah, Community Health Centre Bah and Ram Krishna Mission Hospital, Vrindaban but due to shortage of trained psychiatrists the health centres at Farah and Bah had been discontinued. A team comprising of a psychiatrist, a DNB student, a clinical psychologist, a psychiatric social worker and staff nurse had been visiting the clinic once a month at Vrindaban to provide training to medical and para medical personnel at Community Health Centre and Primary Health Centre; diagnosis and treatment of psychiatric disorders; follow up visits; psychotherapy; community education; individual/family counselling; free distribution of medicines; participation in health fairs and exhibitions. The team made 12 visits at Varindaban in 2010 and provided community health services to 1906 patients. IMHH can alternatively adopt the pattern of IHBAS Delhi having two separate waiting halls for registration and OPD. A very large waiting hall duly covered by a canopy in IHBAS had a capacity to accommodate around 200 patients/ attenders prior to registration. There was an equally large waiting hall for paitens/ attenders to accommodate patients waiting after their registration for screening and medical advice. Suggestions · A separate post of a pathologist should be sanctioned for the laboratory. The biochemist in-charge of the laboratory may be deputed for a week to IHBAS, Delhi to study the working of their laboratories for introducing some of the innovations of IHBAS in IMHH Agra. Institute of Psychiatry (IOP), Kolkata (27th November, 2010) The daily average outturn of patients in OPD from 8 AM to 3PM was 115. Medical students had been attending OPD from 9 AM to 2 PM. The registration counter was managed by two clerks and all entries relating to name, age, sex, address, name of the informant/care giver etc. were made manually in the absence of a computer and data entry operator and were kept in the file of the patient. There were separate case files for each patient and these files were kept in the OPD office under the charge of a clerk. Retrieval of files was done on request. The confidentiality of files was fully maintained and only treating team had access to records. There was a good seating arrangement for the patients/family members in the waiting hall but facilities like drinking water, conservancy and recreation were quite inadequate. All the cases of the new patients were examined by Junior Resident. On an average Junior Resident spent 45 minutes to examine the new patients and record his/her personal history, family history and case history. The patient was then referred to the consultant who after discussion with the Junior Resident decided the line of treatment. The old cases were examined and disposed of by Junior Resident along with RMO within 20 minutes and the serious cases were Care and Treatment in Mental Health Institutions– Some Glimpses in the Recent Period 53