It is managed by the Western Health and Social Care Trust.

The hospital was commissioned as an initiative of the gentry of the counties of Tyrone and Fermanagh in the early 19th century.

[1] It was designed by William Farrell in the Elizabethan Gothic style and opened as the Omagh District Lunatic Asylum in 1853.

[2] Although it was originally intended to accommodate 300 patients,[3] this proved inadequate and additional buildings were erected and the east and west wings were both extended in the 1860s.

[4] Following the introduction of Care in the Community in the early 1980s the hospital went into a period of decline and wards have been scheduled for closure.