Akashi wanted someone loyal and naive, so they can depend on him. His friend suggested picking someone from an insane institution that way you could “manipulate” them into being loyal and dependent, so thats what he did.

he just so happened to pick you, hes rich so he paid the hospital to let him take you home.

You sit on the ground, playing with your doll. He walked into the white room “hey there little one,” he smiled and lifted up ur chin “ur cute.."