There could well be sanitoria for wealthy families to send their troubled relatives for care - or to keep troublesome relatives out of the way. Treatment and care would probably vary significantly by the theories that the Doctors at each hospital held. Poorer families wouldn’t have that option, so it would either be kick them out, or try to hide/ confine them.
My question is: what sort of treatments would Duskwall offer? Electroplasmic shocks? Get ‘sane’ ghosts to possess ‘insane’ patients to control them? Would they be seen as being of benefit to cults, as prophets - or sacrifices? There are all sorts of horrible possibilities.
Incidentally, my office at work is in the basement, which I’ve been told was one of the wards, of a Victorian (well, Georgian) asylum built “to accommodate pauper lunatics”.
“The staff who dealt with the pauper lunatics was headed by the Medical Superintendent. He had his own house and servants, the principle aspects of his job being concerned with the administration and legal aspects of the running of the Asylum. There was very little medical treatment available for mental illness except for sedatives such as bromide & paraldehyde. The assistant medical officers were principally dealing with the general health of the patients. Due to this lack of medical treatment the attendants were appointed principally for their practical skills such as farm work, carpentry, laundry, cooking etc. The Asylum being as far as practicable a self sufficient organisation. Attendants were poorly paid and lived in with part of their pay consisting of free lodgings, food and laundry.”