29th January 2010 and 24th to 26th February 2011) The percentage of voluntary admissions in the hospital had gone up from 91% in 2001-02 to 96% in 2010- 11. The total number of patients admitted and discharged was more or less evenly matched. During the period between 200102 and 2010-11 around 14 to 22 per cent of admissions of patients were readmissions due to poor drug compliance resulting in relapse of mental illness. The average length of stay of indoor patients in RINPAS declined from 79 days in 2005-06 to 61 days in 2010-2011. The patients admitted in RINPAS had been coming from Jharkhand and other states like Bihar, West Bengal, Orissa, Chattisgarh, U.P, Arunachal Pradesh, Madhya Pradesh and Maharashtra but majority of the patients came from Jharkhand and Bihar. All cases of female patients weighing less than 40 kgs need special investigation to find out the reasons for their low weight and they should also be provided special diet. The regular medical examination of inmates was conducted and medical examination results were entered in the registers. However, the major area of concern was that the weight of several female patients was less than 40 Kgs. The total sanctioned bed strength of RINPAS was 500 and bed occupancy remained below the sanctioned bed strength except two years when it was 506.06 in 2001-02 and 527.66 in 2010-2011. All wards were open/family wards except prison ward which a closed ward. Patients are provided with cots, linen, pillows and blankets. Patients clothing were changed every day and linens were changed on alternate day. Majority of female patients were wearing hospital uniform of salwar kameej. RINPAS had 92 long stay patients and the long stay of patients had been attributed to wrong addresses furnished by family members while admitting their patients, inability of wandering mentally ill persons picked up by the police from the streets and brought to RINPAS with the reception order from a judicial magistrate to furnish their address, and patients not responding to treatment due to chronic nature of ailment. The escape of patients from the RINPAS had come down from 15 in 2001-02 to 1 each in 2008-09 and 2009-10 and 2 in 2010- 2011 mainly due to dramatic change in the atmosphere of the hospital brought by policy of openness along with care and attention. The number of deaths of patients between 2001-02 and 2010-2011 varied from 2 to 10 each year. The death audit revealed that utmost care was taken and every effort was made to save the lives of the patients and not a single death took place on account of negligence. Government Mental Health Centre (GMHC), Thrissur (14th April, 2009) The hospital strictly followed the procedure for admission and discharge as laid down in Mental Health Act, 1987. The decision relating to admission and Care and Treatment in Mental Health Institutions– Some Glimpses in the Recent Period 63