Early colonists, arriving in North America, brought beliefs from the old country, some enlightened, some archaic. Unfortunately, insanity had fallen under the latter. People exhibiting aberrant behavior were popularly considered to be possessed by demons or witches and, on occasion, by the Devil himself. Most everyone has heard of the notorious Salem Witch Trials of 1692. In recent studies of the historical documents, describing the symptoms of the accused, modern psychologists have concluded that a majority of the executed "witches" were most likely insane. Witch hunting was not isolated to Puritan New England. It was common practice throughout the colonies.

Throughout the next century in Colonial America, the treatment of an insane person was almost invariably barbaric. Those without family or friends who took responsibility for them were mostly placed in prisons in the company of common criminals, often chained to walls, unclothed regardless of temperature, and mired in their own filth. Some families did take responsibility although they were more concerned with hiding their problematic relatives to avoid embarrassment than trying to help them. They stashed them away in attics, secreted sheds, and even holes in the ground. It wasn't until the 1770's that facilities began to be constructed specifically to house the insane. But again, these places were designed to extricate the individual from society, not to help him or her reassimilate through curative methods because insanity was universally regarded as incurable.

The 1800's brought much-needed change to the world of the insane. Through the efforts of some enlightened individuals, most prominently Dorothea Dix, the desperate plight of the insane was brought to the attention of the public, and lawmakers were forced to commit funds for more humane care. By mid-century, Thomas Kirkbride's theory of creating a curative environment took hold, and the age of the Asylum had arrived.