This paper explores the origins of insane asylums in 19th century England by comparing the official ‘received’ medically dominated perspective with an alternative sociological perspective The major structural changes in provision are addressed as the focus for analysing the differing histories A brief review is presented of the responses to insane people prior to the national asylum programme following the 1845 Lunacy Act, and of the reform logic that underpinned asylum care The alternative sociological perspective presents the origins of psychiatric asylums as part of the social and economic changes occuring generally at that time As such the origins of insane asylums are presented as part of a state-guided ‘sanitary’movement which included poor, criminal and insane people within its remit The effect of state-guided correction was the segregation of insane people from both the general population and other deviants who were formerly classed together Insane people are thus presented as a group of deviants who departed most radically from the ‘rational individualist’ qualities of self-control, predictability and responsibility required in the industrialized world of capital social relations that emerged during the last century