In the past three decades there has been a wave of reforms in mental health treatment across the world. This has usually involved the closure of major institutions built during the nineteenth and twentieth centuries to accommodate those who were diagnosed as suffering from various degrees of insanity. The place of residential care in the treatment of people with psychiatric illnesses continues to figure in public debates about the protection of society as well as the management of mental health. Many of these concerns echo discussions about containment of the insane which surrounded the radical new reforms which laid the foundation for a new generation of institutions in the early Victorian years.

This study of the English lunatic asylum before 1914 is based on a careful examination of private as well as publicly-funded institutions in the Victorian and Edwardian decades. The political concerns which gave rise to the new asylums and which guided their development during the nineteenth and early twentieth centuries are explored in regard to the networks of relationships which influenced the passage of thousands of people to and from these places. In discussing the impact of class, migration, gender, households and aging on committal to the asylum, Melling and Forsythe challenge many earlier claims in regard to contemporary perceptions of insanity and reiterates the importance of distinctive institutions as well as a wide range of historical actors in control of these seen as mad.