primitive at best. 1855-1935. In those days, people with mental illnesses were more often than not institutionalized and basically abandoned by their families. When they died, often there was no way to even contact families, which may have moved, or died, themselves. So, there were graveyards on the grounds of most such facilities. Patients, or inmates, if you prefer, were buried in those cemeteries, often without even a marker. Lots and lots of them.
The conditions at those places were horrible for those who were sent to them. Generally, they were funded, poorly, by the state and staffed, also poorly, with people who really knew little about the causes or proper treatment of those mental illnesses. Such institutions were also where people with learning disabilities were often sent, sometimes as children who would spend their entire lives there.
There were also private asylums, for those who could afford to send their relatives to them. Treatment was somewhat better at those facilities, but not that much better, since treatments were not any better understood than the causes of the illnesses or inborn conditions that sent people there.
In those days, too, people didn't really speak about mental illness much. For most families having a member who was mentally ill or intellectually challenged was considered to be shameful thing, so it simply wasn't discussed much, and families often sent members to these state-run asylums and rarely thought about them ever again.
It was a different time, with little understanding of the causes and treatment of such disorders. It's different today, sort of. We have learned to treat many mental illnesses fairly well. We understand more about intellectual disabilities, too. However, we also abandon our mentally ill to the streets these days. There are no more state institutions. They were shut down back in the 70s and later, due to their high cost of operation. People like Ronald Reagan in California said, "Let them be treated in their own communities," but forgot to fund such treatment.
Things are better for many people, now, than they were then. Medications are available, along with other treatments. If you can afford them, and have insurance to pay for the costs. If you do not, however, you might end up on the streets or in jails and prisons, which have become the de facto mental hospitals of today. We still forget about those people.
It is a shame on us, really. It was a shame in the days of asylums like that one, and it's a shame now.