This chapter provides some insights into how medicalized understandings led first to the persistence of large, stigmatized institutions and subsequently to their replacement by a philosophy of “community care.” It explains the largely ungrounded fears and stereotypes that fueled a perceived need to keep people with mental health problems separated from the rest of the community. “Cultivating a culture of vulnerability” is just one of the potential implications of the use of power, whether with good intentions or not. This is again an indication of the need for a holistic approach, one that aims to see the big picture. The notion of “asylum” has been a significant one in the history of mental health policy and practice. Its usage has strayed far from its original meaning of a safe haven to denote an institutionalized form of practice that was certainly not safe for the people trapped within it.