[2] However the Scottish Lunacy Commission inquiry which reported in 1857 found that the official oversight of mental health institutions "remained at best variable and at worst simply inadequate".

[3] It recommended the formation of a "Scottish Lunacy Board" who would address the shortfall in oversight.

[3][4] The legislation created a General Board of Commissioners in Lunacy for Scotland.

It also created district boards with the power to establish and operate publicly funded "district asylums" for patients who could not afford the fees charged by existing private and charitable "Royal Asylums".

[5] The aim of the legislation was to establish a network of "district asylums" with coverage throughout Scotland.