court were sent to forensic wards; and patients with medical/surgical co-morbidity were promptly referred to the respective departments of the Government Medical College Hospital. The OPD was functioning in a separate building from 8 AM to 1PM with an average daily outturn of 100 patients. The waiting area of OPD had adequate arrangement to accommodate 110 patients/family members and also had the facilities of drinking water and toilets. However, there was no arrangement for newspaper/periodical and television. There was also no canteen within the premises of GMHC. The Registration counter was manned by one staff nurse, 4 nursing assistants and 1 hospital attender/warder. In the absence of a data entry operator personal derails of patient relating to name, address, occupation and gist of illness were recorded manually. The services of Psychiatrists, Clinical Psychologists, Psychiatric Social Worker and one Staff nurse were available on regular basis in the OPD and one Asstt. Professor Psychiatry and 2 lecturers were coming twice a week on prescribed days from Deptt. of Psychiatry, Govt. Medical College, Kozhikode to attend OPD as well as IPD from 8 AM to 1 PM. Medical officer/specialist were recording details relating to case history, family history, personal history (to what extent mental illness is genetically loaded, and other relevant factors) and findings of the said examination were meticulously documented. The medical officers of the hospital were civil, courteous and considerate towards the patients and their relatives/family members. The decision about admitting a patient was taken by the concerned psychiatrist in a consultative manner. Medicines were given for a month. The drug compliance was poor because majority of the patients being from BPL families found it difficult to buy medicines or come again and again to collect medicine as they could not afford huge travel expenditure. The functioning of medical records library was not satisfactory. There were only 6 racks of uneven height. Some records had been kept in these racks and some in the cupboards and the records kept in the bare cupboards were vulnerable to white ant attacks. The case files of OPD patients (both old and new) were not maintained because of inadequate medical records system. An OP book was issued to all out patients wherein the details of their illness and treatment were recorded. In a scenario of poverty, congestion and overcrowding of human settlements, it may not be easy to comprehend that OP records would be maintained by the patients and presented for follow up (Schizophrenia patients in a fit of rage may tear and throw away these records). There was no full fledged pathological laboratory. A small clinical laboratory with one lab technician was providing basic investigation facilities. The biochemical tests conducted included Blood sugar (fasting and post prandial), Blood urea (renal function tests), Serum Creatinine, V.D.R.L. Serum Lithium Estimation. The computerized EEG machine was lying idle for want of an EEG technician. There was no arrangement for administering ECT in the Government Mental Health centre due to absence of anaesthetist. A proposal had been sent to the Govt. for Care and Treatment in Mental Health Institutions– Some Glimpses in the Recent Period 47