The hospital authorities should pay special attention including special diet to patients having low body weight as they may be more vulnerable to secondary infections on account of having less resistance to fight infections. GMA with total sanctioned bed strength of 212 had bed occupancy rate of 99.3 in 2008 and 91 per cent in 2010. It had 2 closed and 2 open wards (one each for male and female patients). There was no congestion in the wards. In conformity with the recommendations of Prof. Channabasavanna Committee not more than 20 beds were put in each block and the gap between two beds was approximately of one metre. The improved patients had been provided with small cupboards to keep their personal belongings in both male and female wards. There was ideal bed patient ratio of 1:1, fan patient ratio is 0.75:l and toilet patient ratio of 1:3.75. To meet the requirements of elderly persons, physically and orthopaedically challenged persons, persons who are victims of rheumatoid arthritis, austeo-arthritis and austeo porosis with low density of bones and damaged connective tissues 3 WCs had been installed in the male and 4 WCs in the female wards. There were 2 separate halfway homes for male and female patients. The male halfway home had been shifted to the male closed ward due to on going construction work. The relatives and family members staying with the patients in the open wards had to put up with lot of discomfort and inconvenience. They had to sleep in extremely limited space on bare and damp floors in winters and had to walk a considerable distance to reach some restaurant to take their meals outside the hospital. The Commissioner Gwalior Municipal Corporation informed the Management Committee about Ramroti Yojana/Night Shelter under which accommodation could be made available to relatives of the patients along with others in 2 halls of Dharamsala having 22 beds, 3 latrines and 2 bathrooms on payment of nominal rent of Rs. 2 per bed and Rs. 5 per meal. In view of the low rent and concessional meals under the new scheme of Ramroti Yojana introduced by the Government, the accommodation available in the 2 halls may not remain vacant. It may be desirable to keep the said accommodation or at least 15 out of 22 beds reserved for the relatives of the patients. There were 41 long stay patients in the closed wards in 2010 and their stay varied between 2 to more than 15 years. The long stay of patients had been attributed to unknown whereabouts of patients brought by police with reception orders from the CJM; patients not showing any sign of recovery due to chronic ailments; reluctance on part of family members to shoulder responsibility of rehabilitation of fully recovered patients. There were 23 deaths in closed wards and 5 deaths in open wards from 2005 to 2010 and the number of escapes was 7 in closed wards and 386 in open wards during the same period. GMA had been auditing each and every death to establish whether death was natural or unnatural; whether death was avoidable or unavoidable; whether all possible efforts were made to save human life. The Care and Treatment in Mental Health Institutions– Some Glimpses in the Recent Period 67