Rural vs urban sites

Different models of care in different countries ultimately led to different designs and locations for public asylums.
Geographic differences were seen in the location of the hospitals, whether they were set in an urban or rural site. A central urban location was essential for the way in which Dutch asylums functioned (1), and in Britain they were initially sited in urban locations usually next to general infirmaries (2) . It was only after about 1820 that the location of asylums shifted to the outskirts of cities and then later to rural locations.
Particularly in Britain, city living was seen as the cause of some madness. Ebenezer Howard's Garden City designs showed hospitals and asylums sited in the outer layers of the garden city near farms and pastures.
In Germany and Austria, the large monolithic asylum building set on a hilltop in an empty countryside gave way to the late nineteenth century smaller scale buildings scattered over the site. This was the 'villa system' of design which reflected the thought that the normalising image of the home should be built into the design. Small scale buildings embodying the architectural features of the home were designed. These also split the large patient population into more manageable groups according to diagnosis.
However, even where they were built specifically to be on the outskirts of cities or in rural locations, the fast pace of urbanisation subverted this intention, particularly in countries like India (3).
Furthermore, a rural location did not necessarily mean being cut off from other human contact, nor did an urban location ensure better integration into society.
Patients do commonly refer to extensive hospital grounds as places of relative freedom and autonomy but also such grounds reinforce the impression of the hospital as a separate place away from the surrounding city (4)

 
(1) Kromm, Jane. "Site and Vantage: Sculptural Decoration and Spatial Experience in Early Modern Dutch Asylums." In Madness, Architecture and the Built Environment. Psychiatric Spaces in Historical Context, edited by Leslie Topp, James E Moran and Jonathan Andrews, 19-40. New York: Routledge, 2007.
(2) Smith, Leonard. "The Architecture of Confinement: Urban Public Asylums in England, 1750-1820." In Madness, Architecture and the Built Environment. Psychiatric Spaces in Historical Context, edited by Leslie Topp, James E Moran and Jonathan Andrews, 41-62. New York: Routledge, 2007.
(3) Ernst, Waltraud. "Madness and Colonial Spaces - British India, c. 180-1947." In Madness, Architecture and the Built Environment. Psychiatric Spaces in Historical Context, edited by Leslie Topp, James E Moran and Jonathan Andrews, 215-238. New York: Routledge, 2007.
(4) Davies, Kerry. "'A Small Corner that's for Myself': Space, Place and Patients' experiences of Mental Healthcare, 1948-98." In Madness, Architecture and the Built Environment. Psychiatric Spaces in Historical Context, edited by Leslie Topp, James E Moran and Jonathan Andrews, 305-320. New York: Routledge, 2007.