By analysing a collection of documents authored by Thomas Ritchie, founder of the Scottish Union of Mental Patients (SUMP), this study recounts the emergence of mental patient unionism at Hartwood Hospital, North Lanarkshire, Scotland. The discourse and action employed by Ritchie and SUMP are understood and situated in relation to intended audiences, social and material conditions of the asylum space, and transformations in cultures beyond the asylum, including nascent industrial strife, social liberalism, civil rights, the London ‘underground’ and counter-cultures.