In 1862 the ‘lunatic’ asylum on the Island was reformed by Dr William Edmunds with a ‘moral management system’. This attracted more middle-class patients all of whom were white. These patients were kept apart from the other patients even though this was not done explicitly on the basis of race.
During the 1860’s there were also more chronically sick white patients admitted to the hospital on the Island. This occurred at the time of the economic depression, tightening control of relief and the need for state care for destitute British Immigrants. After 1876, white patients were separated from black patients and by the 1880s the number of admissions of chronically sick white people outstripped admissions of black people. The hospital for chronically sick people was closed in 1892.