Regional mental hospitals in India are perceived as colonial artefacts in need of reformation. In the last two decades, there has been discussion around the maltreatment of patients, corruption and poor quality of mental health treatment in these institutions. This ethnography scrutinizes the management of madness in one of these asylum-like institutions in the context of national change and the global mental health movement. The author explores the assembling and impact of psychiatric, bureaucratic, gendered and queer narratives in and around the hospital. Finally, the author attempts to reconcile social anthropology and psychiatry by scrutinising their divergent approaches towards ‘mad narratives’.