This book is horrifying. Being poor in New York City in the late 1800's was a horror show. ( )

I actually hated this book but it was certainly well-researched and informative - which is why I went with two stars instead of one. There was so much of the same sort of abuse and misery described that, after a short while, it all ran together and the individual cases meant nothing to me - it was all the same horrible and disgusting treatment.

If the point of the book was to discuss on the atrocities inflicted upon those unfortunate enough to be sent to any of the work houses, alms houses, or asylums of the time, it did that ad nauseam. It felt like I was reading misery porn. It was honestly just too much of the same thing over and over and over and over.

If you're looking for something to give you a feel for what life in an asylum was like in a short, emotionally manageable dose, I highly recommend Ten Days in a Mad-House by Nellie Bly. I took a break from Damnation Island and listened to Bly's book and feel like I got a lot more out of the small book than I did from nearly 10 hours of this one. ( )

Stacy Horn has pieced together a history of the institutions on Blackwell’s Island (now Roosevelt Island) in New York City in the 19th century. The book is structured in sections that align with the buildings – an insane asylum, workhouse, almshouse, penitentiary, and hospital. These structures were almost instantly overcrowded and underfunded, leading to appalling conditions – limited ventilation, infestations of vermin, rampant diseases, starvation, violence, and prisoners serving as attendants. The author shows how good intentions went horribly awry.

Considering that records had largely been destroyed, it is apparent that Stacy Horn has done extensive research to find these detailed stories of people who lived, worked, and were confined on the island. She highlights the lives of abused, neglected, and murdered patients as well as those that tried to change the system or lessen the dreadful conditions.

This account is extremely detailed. Horn examines the flawed legal system and misguided social milieu that lumped together the poor, mad, sick, and criminal. She shows how these blurred lines have contributed to issues that persist today.

Memorable quotes:

“Although the insane were no longer thrown in prison (mostly), the criminal and the insane still formed one group in people’s minds, along with the poor, who were often thought of as defacto ‘guilty.’”

“Today around 28 percent of Americans suffer from some form of anxiety disorder, an affliction that would have been enough to get you committed in the nineteenth century.”

“In reality it was as easy to get an innocent person sent to the Workhouse as it was to get a sane person committed to an asylum.” ( )

I would have preferred this book to have more information about the day to day lives of the people incarcerated on Blackwell Island. It started out interesting but got so boring and repetitive that I began to skim most of the last half of the book. I would have like some actual historically correct and possibly verifiable stories. The ones the author relayed seemed to have been made up. ( )

In 1828, New York City purchased a small island. Located in the East River, Blackwell Island was the perfect location for a new asylum. At first, the plans were for a humane facility to help the mentally ill, indigent and criminal elements in the city. They estimated the number of mentally ill in the city to be less than .5% and planned an initial structure to house 200 people. The mentally ill and criminals would never be housed together and the facility might be able to help some of the chronically indigent in the city as well. They got a big surprise when the initial facility opened and had 199 patients (almost at max capacity) within days. The asylum was enlarged multiple times, and the plans for a humane facility was overpowered by cost cutting measures, bad planning and ignorance. In the 100 years Blackwell Island was used as an asylum the conditions, treatment of patients and medical services there were suspect and often cruel. Damnation Island tells the story of Blackwell Island and its inhabitants.

This book is very well researched and documented, which made it difficult to read. I had to read a chapter at a time...and go cool off....then return. What a grim picture of life in the 1800s. People could be committed for eccentricities or completely fraudulent reasons. Many women were committed because they were in the way or difficult, not because of any mental illness. Conditions in the institution were abysmal. Treatments were even worse. And this went on for 100 years!! Racism even played a part in the treatment of patients. The Irish were seen as incurable and intrinsically insane. Wow...really?? This book is a real eye opener about the use of institutions to pack away citizens seen as problems, without any real care about the quality of their life, health or care. At one point, the city was proud that they could run the institution at a cheap per-patient cost, completely oblivious to the fact that meant there was not enough food or medical supplies to go around. Patients were overcrowded, exposed to diseases and vermin, kept in unsanitary conditions and mistreated. Criminals housed on the island were hired as orderlies and workers and further mistreated patients. Just a sad tale all around.

I enjoyed this book, despite the grim subject manner. I am glad that there have been vast improvements in the mental health field, laws passed to protect people from fraudulent commitment, and health and safety regulations for institutions. I know that atrocities still occur, but I'm hopeful that they are nowhere near the level that happened on Blackwell Island.

Stacy Horn is the author of several non-fiction books including The Restless Sleep: Inside New York City's Cold Case Squad and Waiting For My Cats to Die: A Memoir. Damnation Island is well researched and interesting. I will definitely be reading more by this author.

**I voluntarily read a review copy of this book from Algonquin Books via NetGalley. All opinions expressed are entirely my own.**
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