Although it's flawed, this is an interesting and fact-filled book. Probably there's too much about the asylum's buildings--the book presents reasons and dates of construction, provides perhaps-too-detailed descriptions, describes repurposings of buildings as the hospital evolved, and mentions the final fate for virtually every building the institution ever built or used. Squeezed into that discussion, of course, are lots of details about the asylum's history and purpose.

There are also sections directly discussing treatment, and changing treatment practice. Much of this is surprisingly interesting. And there's a great chapter on the hospital's program to treat children and adolescents; part of the interest is the author's direct involvement in the development of the program.

What the book lacks is an explicit argument that the asylum's activities were worthwhile; Decker just assumes we agree that to be true, though he occasionally hints at the debating points which might be made to support the opinion (or to demonstrate its truth). There are occasional, slight, mentions of the hospital's negative image in the Kalamazoo community; since the author clearly thought that a problem, and seems to take some of the responsibility, it would be nice to have seen a chapter discussing those issues. It would be similarly useful to have a more explicit discussion of the state's political leadership's changing view of the state's mental hospital system.

Decker's not a great prose stylist, and there's a awful lot of unnecessary redundancy. I see no evidence of an editor; one could have helped. The last chapter, which argues that we've gone too far with our deinstitutionalization programs, badly needed a rewrite.

There are several appendices, all useful; I particularly liked the series of maps demonstrating the evolving layout of the hospital grounds.

All that said: Worth reading if you're interested in either the Kalamazoo asylum or the history of mental health treatment in America. There's lots of interesting material here, despite some issues in its presentation. I'm planning to read Decker's book about the Traverse City asylum, where he never worked; I expect to learn interesting things.

This review has also been published on a dabbler's journal. ( )