In 1857 Lord Shaftesbury published his supplemental report on the state of workhouses in England and Wales. Figures showed the number of 'insane, idiotic and imbecile inmates' at the various workhouses in Staffordshire numbered 239, of which 89 were male. In the county town of Stafford 7 males and 12 females were considered insane, this out of a total of 7,555 in England and Wales.
It was stated these numbers were not spread evenly throughout England and Wales, remote rural locations would have a much higher percentage than those in more populous localities. Furthermore, this was particularly true in the hilly parts of the country.
It seems altitude was considered a factor in 19th century insanity.