The chapter focuses on criminal patients and forensic psychiatry in Denmark and Finland in the early decades of the 20th century. The authors explore the crimes that were committed in these social contexts by examining patient records from a Danish high-security unit and Finnish mental hospital, paying special attention not only to the psychiatric assessments of the patients in these two institutions, but also their social class. The first conclusion they arrive at is that forensic psychiatry in both these Nordic countries was predominantly concerned with crimes committed by the lower classes; the second is that the socioeconomic and cultural context of crimes committed by the mentally unwell leave them open to different interpretations regarding guilt and responsibility. Contextualised knowledge about crimes can deepen our understanding of the ways in which desperation, deprivation, and lack of psychological and social support may lead to acts that are clearly reprehensible from the legal point of view, but perhaps less so from a moral perspective.