Taking forward the debate on the role and power of institutions for treating and incarcerating the insane, this volume challenges recent scholarship and focuses on a wide range of factors impacting on the care and confinement of the insane since 1850, including such things as the community, Poor Law authorities, local government and the voluntary sector.

Questioning the notion that institutions were generally 'benign' and responsive to the needs of households, this work also emphasizes the important role of the diversity of interests in shaping institutional facilities.