Psychiatric hospitals used to be called lunatic asylums. Earlier asylums like the old Bethlem Royal Hospital in London (nicknamed "Bedlam") were like prisons. Patients received no treatment and were often imprisoned and chained. In the 19th century, new asylums were built. These were designed to be pleasant places with gardens and airy rooms, and later became known as psychiatric hospitals. Although they no longer looked like prisons, patients still had little freedom or hope of leaving. The term institutionalisation means when someone has lived in a hospital (or some other place like a prison) for so long that they cannot cope with living outside of it.