The entrance to the in-patients sections of the Institute of Mental Health (IMH) at Kilpauk is rather forbidding, being flanked by two rather high walls and guarded by a gate with spikes sticking out on the top. In contrast, the out-patient services wing seems to almost invite you inside. The gates are wide open, the walls are just about waist-high and there are no security guards or "Visiting Hours" boards up there.
The out-patient block is relatively new, having come up in 1971. But the IMH itself is over 200 years old, by the official reckoning. IMH's website traces its beginning to an asylum that was caring for 20 patients sometime in 1794. Situated in Purasawakkam, it was under the charge of the East India Company and the asylum was placed under the charge of Valentine Connolly, the company surgeon. As with many other such 'charges' handed over to officers of the East India Company, this was another way to make money. Connolly, when the time came for him to move to England, sold the practice, buildings and all (even though they were not his, but merely leased for 20 years) to Maurice Fitzgerald. Dr. Fitzgerald, in his turn, made money by selling the asylum to Dr. J. Dalton. Dr. Dalton went about enhancing the value of his purchase. He rebuilt some of the premises and expanded them to accommodate over 50 patients. But he probably got too greedy, for when he was looking to flog the place - which, by then, had come to be known as "Dalton's Mad Hospital" - the government medical board took it over. But it continued to be run more as private enterprise than as a state service, until 1860s.
In 1867, the Madras Presidency sanctioned construction of the Madras Lunatic Asylum. The site identified was Locock's Garden, in what is Kilpauk today. Construction took four years and on May 15, 1871, the Madras Lunatic Asylum started functioning in its new premises, with 145 patients. Since then, it has grown - and assumed various names, in keeping with the sensibilities of the periods - to its current position as a medical institute of significance. Attached to the Madras Medical College, the IMH offers Post-Graduate courses in Psychiatry, and cares for about 1800 patients, making it the second largest such facility in the country. There was a time, in the 1980s, when "Kilpauk case" referred to the target's feeble mind; I haven't heard the phrase for a long while!