During the past ten years much attention has been paid to the question of chronicity in mental hospital patients. At the same time there has been a trend towards establishing units (often attached to general hospitals) for short-stay in-patient and possibly day-patient care. In these units, where the emphasis is on outpatient treatment, it is soon apparent to the psychiatrists staffing them that they, too, have to cope with a population of chronic patients. They tend, however, to be outpatients rather than in-patients, and are probably better described as “long-term”. Heasman (1962) gave a graphic description of this problem in the non-psychiatric outpatient department and compared it to that of the “institutional neurosis” as described by Barton (1959). The purpose of this paper is to describe the situation in a Teaching Hospital Department of Psychiatry attached to a general hospital.