counselling was given by the examining MO. The Psychiatric Social Worker also played a very useful role in talking to the patients, ascertaining their difficulties and resolving them. All medical examination records of patients pertaining to checking of weight; notifying loss/gain of weight; blood pressure (recorded three times daily); blood counts and blood profiles were maintained properly after his/her admission in the ward by staff nurses under supervision of the resident doctors. A series of measures launched by IHBAS to bring quality assurance in inpatient services included post OPD/evening rounds by consultants; rounds on extended weekends or holidays; attendants keeping continuous vigilance/surveillance of high risk patients; compendium of clinical rating scales; standard operating procedures; and patient staff group meetings. An innovative measure taken by IHBAS was patient staff group meetings held on monthly basis for an hour to resolve issues related to day to day problems through coordinated efforts; to explain treatment related issues to the patients and their family members; and to discuss the opportunities in the making after discharge of the patient and follow up plan. The participants in the meeting were all patients of the wards who were fit to participate; family members/care takers of the patients admitted in the ward; members of the treating team, SR, JR, staff nurse, psychiatric social workers etc.; dietician, civil and electrical engineer; housekeeping supervisor; and security supervisor along with ward consultants. The minutes of the meeting were recorded in the PSGM register of the ward and a copy of the same was forwarded to the PSGM coordinator. IHBAS, Shahdara had total sanctioned bed strength of 500 and bed occupancy rate of 81 per cent with 326 beds occupied in 2009. It had Semi- open Wards (Male, Female) 20 beds each; Open wards (Male, Female) 20 beds each; Child and Adolescent Ward - 10 beds; Chronic (Rh) Ward (Male Female) 20 beds each; Private Ward (Paying Ward) 05 beds; De-addiction Ward - 20 beds; Psychiatric ICU - 5 beds; Forensic Ward - 20 beds. The hospital involved the families of the patients in treatment and rehabilitation of patients by pre-admission counselling and pre-discharge counselling, psycho educative sessions for the family/care givers. As a result, average duration of their stay had reduced 3 to 4 weeks. The wards were mopped every day to ensure tidiness. Patients bed sheets and linens were changed on every alternate day and clothes were changed every day. There was adequate supply of mattresses, linen and blankets etc. for all patients. Despite best of intentions and efforts the number of long stay patients was 25 in 2005 and 28 in 2009 and long stay of patients may be attributed to clinical and psychological factors. Clinical issues related to diagnosis, management or comorbid medical disorder and Psychosocial factors included lack of willingness on the part of family members to cooperate in the long term treatment plan and Care and Treatment in Mental Health Institutions– Some Glimpses in the Recent Period 59