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In the 19th and 20th centuries, reformers in the United States and Europe built asylums in response to a range of social issues including disability - mental health, and alcoholism. These documents and images from the NLM Digital Collections bring to life the day to day experiences of people at these sites: the conditions of the asylums and the limits on liberty that many people in them experienced.

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The Insane in Foreign Countries, William Pryor Letchworth, 1889

Courtesy National Library of Medicine

Social reformers in the United States studied the practices of asylums in Europe and brought their ideas back to America. William Letchworth’s book The Insane in Foreign Countries became a reference text that documented the treatment of people diagnosed with mental health conditions in Europe in the 19th century.