Sprawling over 300 acres, the asylum was intended to be self-sufficient - as were the inmates, who were expected to pay their way through work. The grounds contained a butchers, dairy, market garden and the inmates largely worked on the estate's farm. So large was the site that it had its own station, served by a short, half-mile branch line that connected it to the main Otley and Ilkley Joint Railway (today: the Wharfedale line).
Those who died within the walls of the asylum were buried in unmarked graves in the hospital's own cemetry, located behind a present-day ambulance station on nearby Buckle Lane.
By the 1920s, the hospital had been renamed Menston Mental Hospital and as such it was known throughout Yorkshire to the delight of small boys, who would goad each other with phrases such as: "are you from Menston?"