Beautiful and informative (although I admit that I wanted even more history) ( )

This book showcases Christopher Payne's evocative photographs of the ruins of state mental hospitals. Most of these sprawling compounds have been abandoned for years. The exteriors still resemble solid brick fortresses, but their interiors have been destroyed by mold, plant growth, vandalism and neglect.

In his forward Oliver Sacks tries to rescue state mental hospitals from their horrifying "snake-pit" image. He waxes nostalgic for the days when indigent people with mental illness were sent to live, often permanently, in these state-run institutions. In accordance with 19th century ideals of "moral treatment", state hospitals were self-sustaining communities where patients grew their own vegetables, raised their own livestock, and even made their own clothes and shoes. Sacks points out that that the hospitals were havens for the mentally ill in the era before effective treatments were available. The imposing brick edifices protected the most vulnerable members of society, and, more importantly, allowed them to be themselves. Sacks writes of "spacious dayrooms" that contained "patients quietly reading or sleeping on sofas or (as was perfectly permissible) just staring into space...[state hospitals] were places where one could be both mad and safe, places where one's madness could be assured of finding, if not a cure, at least recognition and respect, and a vital sense of companionship and community" (p. 5).

Interestingly, as Payne writes in his discussion of the buildings' architecture, state hospitals were designed to be beautiful, and were a source of great civic pride to their host cities. The buildings' "outward similarity to the great resort hotels of the [Victorian] era is striking," he writes (pp. 9-10). Amenities included auditoriums and bowling alleys for the patients as well as elegant offices for doctors and administrators.

The book also includes photographs of old electroconvulsive therapy (ECT) devices and deep bathtubs for hydrotherapy.

Traditional state mental hospitals started closing in the 1960s and by the 1990s had almost ceased to exist, due to the widespread use of psychiatric drugs and the cost-cutting emphasis of the "de- institutionalization" movement. Most observers agree that the de-institutionalization of the mentally ill has been a failure. But would we really want to return to the days of the state-run mental institution? Looking at the photographs in this book, or even at just the picture of a straitjacket on the cover, I can't imagine that life at even the best-run state hospitals was ever as idyllic as Oliver Sacks claims it was. ( )

Eerie, haunting, and sad, Payne's photographs tell a fascinating story of some of America's almost-forgotten places. In a word: beautiful. ( )

A haunting, painful book to read. The extraordinary photographs complementary to the text offer a contextual glimpse into mental hospitals, which honorably began as "asylums." The deplorable decline that transformed such havens into virtual prisons utilized to experiment with and medicate its patients into submission is very different from its dignified beginnings. For those who found daily life overwhelming, it was an accessible, inviolable refuge and a peaceful shelter. A safe sanctuary, which brought to mind a line in Yeats' poem (The Stolen Child), "...for the world's more full of weeping than you can understand..." ( )

I came to Asylum: Inside the Closed World of State Mental Hospitals having interpreted “closed” figuratively (i.e. private; inaccessible to the general public). But Christopher Payne intends the word literally here, in this photographic tour of state psychiatric hospitals that have ceased operation and fallen into ruin.

In an introductory essay, neurologist Oliver Sacks discusses asylums as the castle-like sanctuaries they began as in the late 1800s, rather than the wretched places of confinement most grew to be by the mid-1900s. Photographer Christopher Payne laments similarly in his essay: “Sadly, few Americans realize that these institutions were once monuments to civic pride, built with noble intentions by leading architects and physicians who envisioned the asylums as places of refuge, therapy, and healing.”

Those essays are followed by nearly 200 full-page photographs (black and white, color) showing the decayed remains of numerous hospitals in dozens of states -- their architecture, grounds, interiors, equipment, and patients’ personal effects. Payne returns in an Afterword to describe how this book came to be, and how it felt, over weeks, to watch the demolition of one state hospital that held ties to his childhood.

My only quibbles were that I was confused by odd, blank pages (as though photographs had been removed at the last minute), and I longed for an index. Otherwise, this is a lovely, albeit melancholy, book, and a moving homage to state hospitals. ( )