The history of the mental health care system in Karnataka dates back to the colonial times. In the18th century, the legendary warrior Tipu Sultan was killed by the British and power was handed back to the Wodeyar clan. A British army regiment was stationed in Bangalore, which was then part of the princely state of Mysore. During the period, especially from 1831-1881, under the administration of British Commissioner Sir Mark Cubbon, the region witnessed a lot of developments in the healthcare system. Western medicine was introduced and hospitals/dispensaries were opened for the care of British infantry, Indian soldiers and civilians.

The Bangalore Lunatic Asylum was founded in 1847. Dr. Charles Irwing Smith, a British medical practitioner in Bangalore, played a pivotal role in the establishment of the asylum. The simple yet airy structured asylum with 50 beds was located at Pete or Pettah , Dharmambudi tank area (the present State Bank of Mysore head office building at the intersection of Kempegowda Road and Avenue Road, Bangalore).

At the asylum, the mentally-ill were allowed to move freely on the premises and were provided with opportunities to take part in activities like rope-making, gardening, cleaning, and other domestic works. In the ensuing years, doctors from Indian Medical Service were appointed and the number of patients at the asylum began to rise. By 1914, about 100 patients were admitted and discharged, on an average, every year.

In 1925, the asylum was rechristened Mental Hospital signifying a paradigm shift in management of mental problems. The old asylum / mental hospital on Avenue Road was closed in 1936-37, and the staff and patients moved to the new site Lakkasandra, the second highest hillock in Bangalore.

More than 100 acres of land was donated by the Maharaja of Mysore to establish the Mental Hospital. Dr. Frank Xavier Noronha became the first superintendent of the Mental Hospital. At this time (in 1936), Sir Mirza Ismail held the coveted position of the Dewan of Mysore. This period was billed as the golden age of Mysore. Both Sir Ismail and Dr. Noronha were keen gardeners and avid horticulturists. Their common passion for well-designed public spaces led to the formation of a new structure for the Mental Hospital encompassing vibrant gardens replete with lush landscapes and open spaces. The duo personally planted many of the exotic tree species that can still be seen on the campus.