The Saskatchewan Mental Hospital at Weyburn has played a significant role in the history of psychiatric services, mental health research, and providing care in the community. Its history provides a window to the changing nature of mental health services over the 20th century. Built in 1921, Saskatchewan Mental Hospital was considered the last asylum in North America and the largest facility of its kind in the British Commonwealth. A decade later the Canadian Committee for Mental Hygiene cited it as one of the worst facilities in the country, largely due to extreme overcrowding. In the 1950s the Saskatchewan Mental Hospital again attracted international attention for engaging in controversial therapeutic interventions, including treatments using LSD. In the 1960s, sweeping healthcare reforms took hold in the province and mental health institutions underwent dramatic changes as they began transferring patients into communities. As the patient and staff population shrunk, the once palatial building fell into disrepair, the asylum’s expansive farmland went out of cultivation, and mental health services folded into a complicated web of social and correctional services. Erika Dyck’s Managing Madness examines an institution that housed people we struggle to understand, help, or even try to change.