Medieval terminology for mental health was a complex matrix of identifiers from legal, medical, and social sources and included terms for many mental, emotional, neurotic and psychotic conditions recognized today. Intellectual disability was one of those categories, especially in the legal realm, with the most-often used term being idiota. Governmental officials that became aware of properties in distress (unplanted, squatters ruining a site, etc) relieved individuals identified as idiota of their responsibilities and placed them into wardship with guardians, who not only cared for the wards but also their properties. The process of examination and civil ‘diagnosis’ of ability encompassed an individual’s intelligence, memory, cognitive ability, discretion, and, at times, appearance. The medieval terms, while not ‘intellectual disability’, certainly described differences in intellectual ability and used vocabulary appropriate for separate conditions, identifying a faulty memory, weak intelligence, difficult time managing property or goods, issue with coping day-to-day, or inability to have discretion. Medieval legal and administrative arms of the crown and local towns each used their own standards to judge competency and intelligence, yet all of them recognized the same wide variety of intellectual conditions and categories of symptoms for intellectual disabilities and other mental health conditions.