In response to the 1845 Lunacy Act, initial, and what appeared to be perfunctory discussions took place in 1846 on the need for Newcastle to build its own asylum for pauper lunatics. It wasn’t until 1863 however, that proper consideration was given for the first time on whether the city should indeed build its own asylum or at least look into possible alternatives. When it eventually opened in 1869, the high ideals associated with such a venture were superseded almost from the outset by the need for enlargement to address the continual problems of overcrowding. This subsequently led to an almost constant programme of expansion that saw the asylum grow ever bigger in size over the next few decades.In the 1960’s – almost one hundred years later – proposals were put forward for a programme of closure that would herald the end of the asylum era. These proposals, in effect, were to be the precursor of care in the community initiatives which would eventually see the demise of mental hospitals such as St. Nicholas - although this would take many years to come to fruition. The physical manifestation of this process, for example, only began to have an impact from the early 1980’s onwards through the gradual contraction and displacement of hospital services as they became increasingly community-based. St Nicholas Hospital has had a long and varied history in its role as both lunatic asylum and psychiatric hospital. Nevertheless, despite various references to its presence in a number of local histories, its past has never been fully investigated in any great depth – until now. This book attempts to encapsulate the origins and history of Newcastle’s lunatic asylum in its entirety, from first opening in 1869 until what may be regarded as its eventual demise in 2001.