In comparison to other natural and medical sciences, German psychiatry in the nineteenth century was characterized by its particularly close relationship to the state and society, its late establishment as an academic discipline, and its precarious relationship to the principles of scientific methods. In 1805 Prussia agreed to reform the system of caring for the mentally ill along the lines suggested by Johann Gottfried Langermann (1768-1832). With this decision, the largest and most important German state accepted responsibility for this group of people. In contrast to other medical disciplines, psychiatry had to respond to special pressures from interest groups as well: the attempt by doctors interested in psychiatry to establish a new discipline and to receive the full recognition of their medical colleagues; the state's demands to get the mentally ill off the streets, perhaps forcing them to work and thereby making them productive members of society; and last but not least, the interests of the patients and asylum inmates, interests that unfortunately counted little.

To trace and understand the development of psychiatry in Germany, the historian must inquire into the forces behind these interactions, as they played themselves out within this field of varied interests. The changing role of psychiatrists and the newly emerging tasks of psychiatry were, and are, related to the social construction of what is called “mental illness.” Mental illness can best be described as an interpretation of social behavior by means of pathological terms derived from medical concepts, in other words, as a transformation of social abnormality into pathological normalcy.