The nineteenth century brought an increased awareness of mental disorder, epitomized in the Asylum Acts of 1808 and 1845. The desire to contain or cure the afflicted led to an unprecedented growth of asylums across England and Wales. Shepherd compares and contrasts two very different institutions to provide a nuanced account of the nineteenth-century mental health system. In doing so she explores issues including the patient population, staff, treatments and therapeutic outcomes, incorporating an interrogation of the accepted roles of class and gender.

"'its value to future research is to be lauded providing, as it does, so much empirical and anecdotal evidence on the subject.'"