Descriptions of the general hospital psychiatric unit are often based upon facilities in large university centers and teaching hospitals. The psychiatric unit in a small community hospital faces very different problems. The authors review the steps they took in organizing and operating such a unit. Mistakes that might have been avoided are discussed, as well as those strong points that anyone planning a general hospital unit might wish to consider. Highly recommended is a "strong" director arrangement, allowing ample time for training, supervision, and administration.