Life at the Texas State Lunatic Asylum, 1857-1997 (review)

Sarah C. Sitton.Life at the Texas State Lunatic Asylum, 1857-1997. College Station: Texas A & M University Press, 1999. 208 pp. $34.95 cloth.

The Texas State Lunatic Asylum, now known as the Austin State Hospital (ASH), served the state's residents for well over one hundred years. It opened in 1861, during the heyday of asylum building in the United States, and having come through the era of deinstitutionalization, ASH continues today, although in a much-diminished capacity. Using oral interviews, state reports, and newspaper accounts, Sarah C. Sitton narrates the experiences of the hospital folk (physician/superintendents, attendants, and patients) as she describes the internal workings of this one rather unextraordinary psychiatric institution. Sitton's slim volume is not the best book out there on the history of the asylum. Gerald Grob's studies of the mental institution, recently summarized in The Mad among Us; A History of the Care of America's Mentally Ill (1994), offer a broader context for both the rise of the asylum and the process of deinstitutionalization, and Joel Braslow's account of two California system hospitals, Mental Ills and Bodily Cures; Psychiatric Treatment in the First Half of the Twentieth Century (1997), asks more interesting questions about local hospital history. Nonetheless, Life at the Texas State Lunatic Asylum has something to offer historians of psychiatric institutions.

This book, as Sitton has titled it, is a story of life inside the asylum. In telling the experiences of the staff and patients, she approaches the mental hospital from the same perspective as did Erving Goffman in Asylums (1961); indeed, Goffman is Sitton's primary frame of reference for her description of the hospital's "underlife," the informal rules and networks that acculturated inmates and their keepers. Unlike Goffman's, however, Sitton's view of the asylum world is a rosy one--in her hands "asylum" becomes a self-sufficient "little town" where attendants, who lived on the grounds, liked their work with the patients, where "good" patients routinely earned privileges, and where both staff and patients enjoyed the recreational opportunities afforded by movies, dances, and the institution's parklike grounds. Yet, as Sitton makes clear, ASH should not be historicized as a "total institution;" rather, she points to the permeability of the institution's boundaries: the local community and the institution's government sponsor filtering in and out of the hospital, interacting with and sometimes directly influencing the life of the institution. Among the more provocative of Sitton's observations is the image of the mental hospital as a recreational site for the local community, an image best captured by the photograph of neighborhood couples courting in the 1890s on the grounds of the state lunatic asylum.

A most interesting section of this book is Sitton's discussion of the asylum superintendents. The author is at her best when she is describing the multifaceted roles of these individuals and other staff members. Responsible for everything from patient health to stocking the asylum's lakes with fish, the superintendents had an unenviable position, one that, at least in the nineteenth century, was tied to political patronage. And while they had the authority to run the institution according to the most up-to-date psychiatric practices, they often found that authority constrained by the "traditional routines" of the employees who worked the wards and the patients who lived on them (59). Of particular relevance is Sitton's identification of employee "clans," the many generations of local families who found work at the asylum and carried on its traditions. Everyday life at ASH was, it seems, a perpetual, and three-way tug of war.

The book certainly benefits from the oral interviews Sitton conducted with former employees of the institution. Although they provide much of the book's spice, these anecdotal accounts of everyday life in a Texas asylum, the oral...