The hospital was designed by Frederick Hyde Pownall,[1] and opened with accommodation for 1,700 patients in 1877.

[2] Two more blocks were added in 1881, and in 1889 it came under the auspices of London County Council.

[3] Spurs to two of the blocks, based on a design by George Thomas Hine,[4] were added in 1893.

[2] In 1967 it split into the Downview Hospital, a facility for adult mental disorders, and the Freedown Hospital, a facility for tuberculosis treatment.

[2] It closed in 1986 and was largely demolished in 1989;[2] the site is now occupied by HM Prison High Down.