<P> The moral treatment movement was initially opposed by those in the mental health profession . By the mid-19th century, however, many psychologists had adopted the strategy . They became advocates of moral treatment, but argued that since the mentally ill often had separate physical / organic problems, medical approaches were also necessary . Making this argument stick has been described as an important step in the profession's eventual success at securing a monopoly on the treatment of "lunacy". </P> <P> The moral treatment movement had a huge influence on asylum construction and practice . Many countries were introducing legislation requiring local authorities to provide asylums for the local population, and they were increasingly designed and run along moral treatment lines . Additional "non-restraint movements" also developed . There was great belief in the curability of mental disorders, particularly in the US, and statistics were reported showing high recovery rates . They were later much criticized, particularly for not differentiating between new admissions and re-admissions (i.e. those who hadn't really achieved a sustained recovery). It has been noted, however, that the cure statistics showed a decline from the 1830s onwards, particularly sharply in the second half of the century, which has been linked to the dream of small, curative asylums giving way to large, centralized, overcrowded asylums . </P> <P> There was also criticism from some ex-patients and their allies . By the mid-19th century in England, the Alleged Lunatics' Friend Society was proclaiming that the new moral treatment was a form of social repression achieved "by mildness and coaxing, and by solitary confinement"; that its implication that the "alleged lunatics" needed re-educating meant it treated them as if they were children incapable of making their own decisions; and that it failed to properly inform people of their rights or involve them in discussion about their treatment . The Society was suspicious of the tranquility of the asylums, suggesting that patients were simply being crushed and then discharged to live a "milk sop" (meek) existence in society . </P> <P> In the context of industrialization, public asylums expanded in size and number . Bound up in this was the development of the profession of psychiatry, able to expand with large numbers of inmates collected together . By the end of the 19th century and into the 20th, these large out - of - town asylums had become overcrowded, misused, isolated and run - down . The therapeutic principles had often been neglected along with the patients . Moral management techniques had turned into mindless institutional routines within an authoritarian structure . Consideration of costs quickly overrode ideals . There was compromise over decoration--no longer a homey, family atmosphere but drab and minimalist . There was an emphasis on security, custody, high walls, closed doors, shutting people off from society, and physical restraint was often used . It is well documented that there was very little therapeutic activity, and medics were little more than administrators who seldom attended to patients and mainly then for other, somatic, problems . Any hope of moral treatment or a family atmosphere was "obliterated". In 1827 the average number of asylum inmates in Britain was 166; by 1930 it was 1221 . The relative proportion of the public officially diagnosed as insane grew . </P>

Who worked to reform conditions for the (moral) treatment of patients