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Although the government
played a larger role in the care of the insane, often considered a threat to social order, than it did in relation to poverty, philanthropy was still important. The move to create specialized insane asylums spread across the western world in the mid-19th century. The model used in Quebec differed from that in many places, since the government paid per-patient fees to private institutions rather than open state-run asylums. As was the norm, the Montreal Catholic asylum was run by nuns.