The first Mental Asylum can be traced back as early as the 5th century in the Middle East. Prior to that, families who had members suffering from mental health disorders just kept their ill relatives at home. Even after the advent of the mental asylum, it was not until the 18th and 19th centuries that urbanization allowed for greater access to these facilities. Blackwell's Island Lunatic Asylum, built in New York at the beginning of the 19th century, was the first municipal mental hospital in the United States, according to the American Journal of Psychiatry.
The rise of institutional psychiatry began with the emergence of the lunatic asylum, its gradual transformation and temporary replacement by modern psychiatric centers. Previously there existed institutions where the mentally ill or insane were kept, but the invention of the concept of institutionalization as an accurate solution to the problem of lunacy proved to be an event of the nineteenth century.
At the turn of the 18th century, the amount of special institutional care and other provisions for the mentally ill had been extremely limited. While lunacy was viewed majorly as a domestic issue, families and parish authorities were central to regimens of care taking. Parish authorities provided various forms of outdoor relief to such families, which included the provision of parish nurses and financial aid. In cases where family care was not possible, the family member was often “handed over” to other members of the local community or sent to private mental asylums. The parish authorities would also meet the expensive costs of confining such lunatics to charitable asylums such Bethlem, and other correction homes if they were judged to be specifically disturbing or violent.
Although the names and conditions of these Asylums were horrific, change was encroaching. The age of science and reason would soon lead to many more changes in treatment.