therapeutic activity, and medics were little more than administrators who seldom attended to patients and mainly then for other, somatic, problems. any hope of moral treatment or a family atmosphere was "obliterated". in 1827 the average number of asylum inmates in britain was 166; by 1930 it was 1221. the relative proportion of the public officially diagnosed as insane grew. although the retreat had been based on a non-medical approach and environment, medically based reformers emulating it spoke of "patients" and "hospitals". asylum "nurses" and attendants, once valued as a core part of providing good holistic care, were often scapegoated for the failures of the system. towards the end of the 19th century, somatic theories, pessimism in prognosis, and custodialism had returned. theories of hereditary degeneracy and eugenics took over, and in the 20th century the concepts of mental hygiene and mental health developed. from the mid 20th century, however, a process of antipsychiatry and deinstitutionalization occurred in many countries in the west, and asylums in many areas were gradually replaced with more local community mental health services. in the 1960s, michel foucault renewed the argument that moral treatment had really been a new form of moral oppression, replacing physical oppression, and his arguments were widely adopted within the antipsychiatry movement. foucault was interested in ideas of "the other" and how society defines normalcy by defining the abnormal and its relationship to the normal. a patient in the asylum had to go through four moral syntheses: silence, recognition in the mirror, perpetual judgment, and the apotheosis of the medical personage. the mad were ignored and verbally isolated. they were made to see madness in others and then in themselves until they felt guilt and remorse. the doctor, despite his lack of medical knowledge about the underlying processes, had all powers of authority and defined insanity. thus foucault argues that the "moral" asylum is "not a free realm of observation, diagnosis, and therapeutics; it is a juridical space where one is accused, judged, and condemned." foucault's reassessment was succeeded by a more balanced view, recognizing that the manipulation and ambiguous "kindness" of tuke and pinel may have been preferable to the harsh coercion and physical "treatments" of previous generations, while aware of moral treatment's less benevolent aspects and its potential to deteriorate into repression. the moral treatment movement is widely seen as influencing psychiatric practice up to the present day, including specifically therapeutic communities (although they were intended to be less repressive); occupational therapy and soteria houses. the recovery model is said to have echoes of the concept of moral treatment.