Located within a short distance of each other, Holloway Sanatorium's, grandeur was in stark contrast to the relative plainness and functionality of Brookwood Asylum. The two Surrey asylums coped in distinctive ways with the pressures exerted by patients, families and central administrative authorities. Brookwood was accountable to ratepayers, and its treatment regime was subject to approval by the Commissioners in Lunacy, the Metropolitan Asylum Board (MAB), and the individual Poor Law unions. Holloway offered facilities that might have been enjoyed by the middle class at a country hotel or Continental health resort. Both institutions immediately proved to be more popular than had been expected, which brought the threat of overcrowding. The disruption and inconvenience of the ensuing building work, which went on for lengthy periods of time, militated against the development of stable treatment regimes. It was almost impossible for the superintendents to keep treatment at the forefront, while they oversaw the construction work (which entailed measures to keep patients safe from injury), and, for Brookwood at least, the ever-burgeoning paperwork that a centralized asylum system demanded.

More patients meant more staff, and considerable care was taken by both asylums to recruit reliable and efficient men and women with the right personal qualities. The point of treatment at these two contrasting institutions was broadly the same.