Background: Even though the older persons are culturally respected, their mental health is often neglected in this fast paced society. Mental health concerns are not evaluated or discusssed adequately even by physicians. Referrals to consultation-liason Psychiatry is one way to address the needs of Geriatric in-patients. We studied such referrals in a tertiary care hospital in South India. Methods: In this mixed methods study, we studied notes of referral and impression from the medical records of patients admitted in the department of Geriatric Medicine in Christian Medical College Vellore from September 1st 2022 to December 31st 2022. Thematic analysis was done, themes and subthemes were made. Sociodemographic, clinical and treatment data was extracted from medical records. Data was entered in MS Excel and was analysed in SPSS v23. Descriptive statistics were done. Results: There were a total of 72 referrals sent for 48 patients. Duplicates and wrong referrals were excluded. 66.7% patients were seen only once and only 8.4%% needed more than 3 consultations. The mean age of the study population was 71(9.42) years. 62% patients were male. 50% patients were from the South, 41.7% from rest of India, and 8.3% from Bangladesh. 4.2% patients had no comorbidities while 37.5% had mild, 39.6% had moderate and 18.8% had severe Charlson Comorbidity Index scores. The themes for referral were Behavioural problems-52.1%, Substance use-37.5%, Dementia-29.2%, Psychosis-27.1%, Delirium-20.4%, Mood disorders-10.4%, and adverse drug reactions-8.3%. Quetiapine (33.3%) and Mirtazepine (20.8%) were the most recommended drugs by psychiatrists, while Benzodiazepines were tapered in 31.3%. Conclusion: The study shows the areas of psychiatric inputs that are required for Geriatric in-patients. This has implications on training and service planning. [ABSTRACT FROM AUTHOR]