Offenders who are also mentally disordered have always posed problems for legal and penal systems. Historically the central issue was a legal one, that of determining the responsibility of such offenders for their crimes, but in modern times this has become less important in the face of deciding whether offenders should be dealt with penally or psychiatrically .1 It was in the mid-Victorian era that the rise of psychiatry and a system of public asylum care provided the initial impetus for this separation of the question of disposal from that of responsibility. Although by mid-century some provisions existed for the recognition and special detention of insane offenders, the superintendents of the new asylums and a growing number of prison medical officers began to realise that many of their ordinary charges might easily have found their way into either institution.2 Yet change in the treatment of mentally disordered offenders came only slowly. It was not until 1889 that the Home Secretary issued specific instructions to magistrates that such offenders need no longer be sent to prison but direct to an asylum, while no recognition of the problem was made by the legislature until 1913, when the Mental Deficiency Act included provisions to end the sending to prison of mental defectives who came before the courts.3