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 bureaucracy 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. The author critically tackles the divergent approaches towards 'mad narratives' and attempts to reconcile the social anthropology and psychiatry of alienated individuals in urban India.