“Out of sight and out of mind” was certainly the approach taken to mental health before the end of the 20th century. There are six psychiatric hospitals in Northern Ireland: St. Luke's, Armagh (1825); Purdysburn/KHCP Belfast (1829); Gransha, Derry (1829); T&F, Omagh (1853); Downshire, Downpatrick (1869); and Holywell, Antrim (1898), all psychiatric hospitals still open and operational. Mental health policy has developed comprehensively since the 19th century and change is still ongoing, but it is still clear that mental health services in Northern Ireland lag significantly behind those in the United Kingdom. United. This essay will examine how and importantly why mental health policy developed in Northern Ireland throughout the 19th and 20th centuries. It will first illustrate life in the asylums, the policies that supported institutionalization and why change was necessary. Next, it will establish the progression of policy to support community and integrated care; it will examine this change and its effectiveness across society. Moving into the 21st century, it will focus on some of the key policies implemented throughout this period. Finally, a conclusion will be drawn, assessing current policy in Northern Ireland and how far we need to go to improve the quality of life for people with mental illness. First of all, it is important to understand the political and social situation in Northern Ireland. from 1898 to assess the changes that were made to the policy. Before 1921, the north and south of Ireland were under British rule. When the Government of Ireland Act 1920 divided the island of Ireland into two separate states, Northern Ireland and Southern Ireland, Northern Ireland remained under British rule while... .. middle of paper ......st accessed 03/17/2014.Samuel,M. (2009). Northern Ireland has a unified mental health law for the first time. Available: http://www.communitycare.co.uk/2009/09/10/northern-ireland-to-have-first-unified-mental-health-law/#.UyoQXqh_tR0. Last accessed 04/16/2014. Smith, S & McCulloch, Dr A. (2013). A brief history of specialist mental health services. Available: http://www.mentalhealth.org.uk/content/assets/PDF/publications/starting-today-background-paper-1.pdf. Last accessed 03/17/2014. Smith, SL, Action Mental Health. (2013). Talk Back: A look back at more than 65 years of mental health care. Available: http://www.mentalhealth.org.uk/content/assets/PDF/publications/talkback-september-2013.pdf?view=Standard. Last accessed 03/17/2014. Tonks, A. (1994). "Community care: the first year: community care in Northern Ireland: a promising start". British Medical Journal. 308 (1). Pages: 839.