ABSTRACT
This chapter presents a brief history of how the age-old problem of madness became the medical problem of mental illness. The analysis identifies two recurring issues: one, the identification of a heterogeneous troubling segment of the population, the mad 'who persistently create havoc, discord and disarray, creating extraordinary burdens for others'. The another one is the escalation over time of bureaucratic institutional government supported 'psychiatric' control and coercion under the cover of medicine. Views on madness in colonial America evolved from that of their European predecessors. By the early 1800s many of the mad were forcibly confined and treated in suburban asylums. The federal expansion of mental health funding and policy consequently reduced the role of the state-run mental hospital system. The successful nineteenth-century transition from lay to medical control of madness energised the mental health reform movement as it sought to convince the population and state governments to establish more and more asylums.
