The origins of North Wales Hospital lay in a reform movement for care of insane people that began in the late 18th century and continued until a few years after its opening as the Denbigh Asylum in 1848.

Prior to this time the belief had been that the afflictions of insane people should be dealt with by such methods as bloodletting and flagellation to disperse their inner demons, together with seclusion and manacling as means of control if they posed some sort of threat.

There were privately operated care institutions of dubious merit but such civic responsibility as was felt to exist was deemed to be within the purview of the penal and Poor Law systems until the passing of the County Asylums Act in 1808, which provided for publicly administered specialist facilities.

Treatment remained degrading, loosely monitored and poor until the passing of the 1845 Lunacy Act but the intervening years saw an increased recognition, both in parliament and elsewhere, that something needed to be done to harmonise and improve standards of care.

However, a meeting of some of the great and the good of North Wales - nobility, gentry and clergy - at Denbighshire Infirmary in October 1842 had resolved that they should subscribe to action for improved care and that this should take the form of a hospital for the insane.

Historian M. Rolf Olsen summarised the resolutions of this meetings as clearly stating the founder's view of conditions in North Wales and their aspirations to reform an untenable situation.

[a] Designed by architect Thomas Fulljames and constructed on 20 acres (8.1 ha) of land donated by a local benefactor, Joseph Ablett of Llanbedr Hall, the hospital was initially intended to accommodate 200 patients.

The subscribers had hoped that the hospital would provide a sympathetic environment for restorative treatment rather than just being a costly unwelcome dumping ground away from general society, as the workhouses were deemed to be.

A change in national concerns from emphasis on conditions of care to that of protecting wider society, which ultimately led to the 1890 Lunacy Act, meant that the hospital assumed a character similar to that of the workhouse.

Clwyd Wynne, who has studied the history of the hospital, says Imagine being one of those admitted for no other reason than having a baby out of wedlock and being left with suicidal and disturbed patients and others having epileptic fits.

A large number of patients suffered from epilepsy which was regarded as a mental illness and having no effective treatment, imagine the fear they must have felt with the danger of suffocation during a fit and no one available to assist.

Other labouring tasks were assigned at various times, such as painting and decorating the structure, while those patients who might abscond were in the early years made continuously to pump water so that they could be more easily monitored.

[5] Aside from employment within the hospital and social activities, such as dances and concerts, which often were led by the staff but also involved visits from or to external organisations, treatment was initially limited to sedation using chloral hydrate and, from 1871, Victorian Turkish baths.

That doctor, Frank Jones, later became Medical Superintendent (1913-1940) and encouraged many other changes, including to treatment and training, which resulted in what Wynne describes as "a more liberal attitude towards mental illness".

[8] The Wellcome Foundation provided a grant of £130,000 in 2017 to assist with cataloguing and preservation of the hospital records, which form the largest single such collection held by Denbighshire Archives.

[20][21] From around 2012, Denbighshire Council were intending to compulsorily purchase the property and then transfer ownership to the North Wales Building Preservation Trust (NWBPT),[22] which had been established in 2012 specifically to enable conservation of the site.

NWBPT's non-profit status was claimed to provide a means of doing so in a situation where the costs were such that margins were too slim to make the project commercially viable; however, Freemont kept raising the asking price for transfer of ownership.

A counter-proposal emerged in April 2018, involving the construction of two hotels and some housing by Signature Living, who claimed that unlike the other proposals theirs would retain all of the extant original buildings.

Writing in 1974, Olsen noted that the location, whilst geographically central for the counties that it served, was remote from the point of view of many potential visitors and that this may have impeded social interaction, which is nowadays considered an important element of mental health care.

The play has been inspired by patient records and an accompanying exhibition of artworks is intended to be based on the individual and familial memories of people whose lives were affected by the hospital.