In 1779, Susan Carnegie (1743–1821) persuaded the Town Council of Montrose, Scotland, to build a safe haven for those suffering from both poverty and mental illness. As a result, Montrose Lunatic Asylum became not only the first public asylum in Scotland, but among the first in the English-speaking world. Carnegie – born 175 years before women could vote – championed a humane and science-based response to mental illness. Montrose Asylum practised moral treatment a decade before Tuke and Pinel. As a champion of the new mental science, her enduring influence resulted in the hiring of the young W.A.F. Browne. Her story enriches the current wave of scholarship on Scottish psychiatry in particular, and on women in psychiatry in general.