The definition of madness and how it has been dealt with in different historical periods establish the social, cultural and institutional foundations for the emergence of psychiatry as a separate scientific discipline and the development and establishment of the schools of social and community psychiatry. This chapter examines the historical background of psychiatry and mental health from the viewpoint of the change in the social and scientific handling of madness and the interplay of wider cultural and social processes. This historical development begins in antiquity, continues with the emergence of asylums and the examination of "nervous disorders" in the Victorian age through the development of measures to promote mental health taken between WWI and WWII and the wider mental health movements which emerged in both Europe and the USA and came to fruition in the modern age and concludes with us highlighting contemporary issues, conflicts and concerns.