The history of women's role in the care of mentally ill people is relatively unchartered territory. Women were involved in mental health care in a variety of ways and at the beginning of the 19th century they could operate in capacities equal in status to those of men. Social policies which gave legal backing to medical authority; the rise of medical professionalism, which until the last quarter of the century excluded women; the Victorian ideology which fixed women in a subservient role, all served to ensure that their contribution to the care of mentally ill people was subordinate to that of men. This was reflected in the duties they undertook and their rates of pay, which were always less than those of men.