I am not the ﬁrst and will not be the last to refer to the help of many people in writing a book, but my acknowledgements and thanks are nonetheless heart-felt in regard to this one. I rapidly became absorbed in the history of 'madness', in its broadest and non-derogatory sense, and the changing concepts and boundaries of insanity and mental health care. For almost two centuries the Norfolk Lunatic Asylum/St Andrew's Hospital was a site for these. It opened as one of the very ﬁrst county asylums and its closure featured among the last of the older psychiatric hospitals. From its establishment in 1814 it provided forms of care, some harsh and custodial, some compassionate and therapeutic, offering what was then considered to be 'ﬁt provision' for its 'unfortunate patients'. The asylum/hospital was simultaneously a place for solace and relationships; a highly organised and controlled environment but also a living, working and therapeutic community. It embodied contrasting experiences, sometimes brutal but often kindly; it provides a case- example but also a place of many histories. This account cannot do justice to them all, particularly the hidden lives of literally thousands of patients, but this rationale informs what has been compiled here.
First and foremost, I thank the Norfolk Mental Health Care NHS Trust for its appreciation of the need for a researched history of St Andrew's Hospital and its willingness and generosity in making the necessary financial commitments. The Trust's staff at Drayton Old Lodge and Hellesdon Hospital have always been helpful and both Graham Shelton and Mark Taylor, respectively former and current chief executives, encouraged and allowed me considerable scope in accessing records, including confidential material falling within the '100-year rule'. Freda Wilkins-Jones, Jonathan Draper and other staff at the Norfolk County Record Ofﬁce, where most of the extensive documentation relating to St Andrew's is now held, greatly facilitated this research. I also wish to thank staff at the Norfolk Local Studies Library and Norwich Health Authority for their assistance.
The University of East Anglia allowed and supported my period of research leave and colleagues in the School of History and the Wellcome Unit for the History of Medicine have willingly shouldered any burdens resulting from my absence. In particular, Roy Church, Edward Acton and Roger Cooter ensured a positive response to the Norfolk Mental Health Care NHS Trust's initiative. Carole Rawcliffe, Rhodri Hayward, Roger Munting and Richard Wilson offered constructive and enlightening comments on various draft chapters. I thank them for valuable advice whilst apologising for the few instances where I have remained obdurate. I also wish to thank