The Jehangir Institute of Psychiatry is a hospital located in Latifabad, a suburb of the city of Hyderabad in Sindh. Sir Cowasjee Jehangir (1812-1878), civil engineer and master constructor of Bombay, was asked in 1847 by the British government to execute certain irrigation projects in Sindh. He completed his work in 1850, and before he returned to Bombay, wishing to do well by the province of Sindh and recognising the needs of its people, he secured a large acreage of land at Giddu Bandar on which he constructed a hospital for the mentally ill patients. In acknowledgment of the great philanthropist’s gift, the grateful people of Sindh named it the Sir Cowasjee Jehangir Mental Hospital. It is the largest psychiatric hospital in Pakistan. It is locally known as the Giddu Bandar Mental Hospital. In a country with a huge occurrence of mental health issues, Sindh’s biggest mental asylum, in terms of size, the Sir Cowasjee Jehangir Institute of Psychiatry in Hyderabad is crumbling apart, brick by brick. The hospital was built in 1865, and has continuously been ignored, to the point that a few of its buildings have collapsed. Save for one recently renovated building, which houses a TV and a carom board for patients’ entertainment, the rest of the hospital also seems to be on the verge of collapse,. The history of the hospital is strewn with tales of extraordinary patients. There used to be a patient who memorised an entire psychology book by heart. You could ask him to recite any page of that book and he would do so. Another one had mastered all of Ghalib’s poetry. Unfortunately, those patients died a few years ago. Such extraordinary patients may now be part of legend, but there is still no shortage of creative and productive minds inside the wards. Some patients paint and sketch in their free time, and while most of these paintings are rudimentary, a few show advanced artistic skill and creativity. Others create decorative handicrafts, including miniature figurines. Patients stand proudly over their work as it is displayed, grinning and hopping from one foot to the other, too excited to stand still. In 1967, a psychiatrist, Dr Haider Ali Kazi was appointed by the government to head the hospital. In 1975, in keeping with the times, Dr Kazi arranged to have the hospital renamed as the Sir Cowasjee Jehangir Institute of Psychiatry. He served the hospital with the utmost devotion and capability, developing and improving its facilities until he retired in 1999. Thereafter, things began to deteriorate, and patients now suffer from the absenceof a top class psychiatrist. Dr Kazi, with great justification, now laments that neither the government nor the people of Sindh have bothered to do anything to ensure that the hospital is maintained and kept in an adequate condition to be able to treat the many mentally afflicted souls of this neglected province. In a country with a huge occurrence of mental health issues, Sindh’s biggest mental asylum, in terms of size, the Sir Cowasjee Jehangir Institute of Psychiatry in Hyderabad, is crumbling apart The meeting regarding the issues of the Sir Cowasjee Jahangir Institute of Psychiatry was recently held, presided by the chief secretary of Sindh. Senator Dr Karim Khuwaja, Chairman Sindh Mental Health Authority, highlighted the issues faced by the institute, and briefed about the MOU of handing over the OPD block to the Anti-Narcotic Force (ANF). The block has been built with the cost of 292 million; it is constructed for purpose of acute psychiatric emergency, and its handover would affect the functioning of the institute. The chairman informed the meeting that he would take up the matter with the chief minister of Sindh to revise the decision of MOU in the best interest of people suffering from mental health issues. He pointed out that the ANF has no mandate to treat a drug addict or to establish a hospital. The chief secretary also directed the secretary health to prepare a PC-I for the construction of a state-of-the-art building of the institute. He stated that the provincial government wished to make this institute a state-of-the-art, autonomous, international entity to keep it operational for the next 200 years, as it had already existed for over 150 years. He further stated that it was also a national heritage of Sindh. The Sir Cowasjee Jahangir Institute should be affiliated with LUMHS Jamshoro for educational purposes, but it must be autonomous and independent. The top priority must be given to patients who are suffering from mental illnesses. The medical superintendent of the institute informed the chief secretary that it was built in 1865 by the Parsi philanthropist, Sir Cowasjee Jahangir, and had been catering to mentally ill persons of not only Sindh but of all other provinces of the country. The number of OPD patients is increasing every year, and according to the institute’s record in 2009, a total of 33,568 patients attended the OPD. Last year, the number of patients was 77,264, and that is more than double within a period of nine years. The chief secretary, regarding illegal encroachments and allotments within the Sir Cowasjee Jahangir Institute assured that all encroachments would be removed and allotments will be cancelled. Earlier, the chief secretary had constituted a committee under Vice-Chancellor Liaquat University of Medical Sciences (LUMS) for preparation of draft legislation and a feasibility report for codal formalities for the autonomy of the institute and their affiliation with LUMS. The committee has completed the draft work and has submitted it to the Sindh government. It is hoped that in future this institute will be improved for the benefit of patients with mental health issues. Chief secretary Sindh and Chairman Mental Authority Senator Dr Karim Khuwaja are keenly interested to develop a standardised Sir Cowasjee Jahangir Institute. The writer is a retired doctor of the Sindh Health Department