Services for people requiring secure forms of care

[Extract] In the early 19th century, when institutional care for 'lunatics' started to become widespread across Europe, North America and the British colonies, almost all facilities were 'secure'. Wards or blocks were locked, patients were monitored and escorted at all times, the whole complex was surrounded by high walls, and entry and exit were through a single imposing 'main gate' controlled by the gatekeeper. The asylum therefore typically constituted an appropriate destination for people who had committed minor offences and were found to be insane. From the very beginning, most asylums had a number of 'criminal lunatics', and acquired special facilities to accommodate patients detained under criminal or lunacy legislation