The Asylum in Context: An Essay Review

Lawrence Goodheart. Mad Yankees: The Hartford Retreat for the Insane and Nineteenth-Century Psychiatry. Amherst, Massachusetts, University of Amherst Press, 2003. 256 pp. $34.95.

David Wright. Mental Disability in Victorian England: The Earlswood Asylum, 1847–1901. Oxford, Clarendon Press, 2001. xii, 244 pp., illus. $100.

Pamela Michael. Care and Treatment of the Mentally Ill in North Wales, 1800–2000. Cardiff, University of Wales Press, 2003. 272 pp. $39.95 (paper).

Roy Porter &Amp; David Wright, eds. The Confinement of the Insane: International Perspectives, 1800–1965. Cambridge, Cambridge University Press, 2003. xvii, 390 pp., illus. $75.

The fervent critiques of the history of the asylum, beginning with Foucault's La Folie et la Déraison in 1961 and joined by others, such as Erving Goffman, David Rothman, and Andrew Scull, have been tempered over the past decades by an attempt to chart a host of complexities in asylum life. In the current literature, the asylum neither embodies a monolithic medical force controlling society's undesirables, nor can be neatly defined by a humanitarian impulse to cure. Instead, "negotiation" has become a key concept. A plethora of actors, with their own aims and intentions, are seen as providing a diverse set of influences on the operation of an asylum at a given historical moment. The result is a complicated and unique set of negotiations between state and local political organizations, family, police, and medical personnel, all of whom play an active role in the assessment and care of the insane. In short, the medical gaze no longer has exclusive authority; it is now refracted by many other "gazes."

These asylum histories also treat the institution as a porous structure; it is in constant dialogue and interaction with persons, agencies, and social forces outside its walls. So, while these monographs and essays are rooted in the story of a particular asylum's founding and administration, they are also firmly connected to larger social and cultural contexts. Concomitant with this trend is the expansion of the national and cultural scope of asylum histories, both private and public. Although there are still numerous publications on asylums within the English and American contexts (three of the books mentioned above fall into this category), these writings also include a monograph on a Welsh asylum, and Roy Porter and David Wright's volume takes the comparative approach to many new locales, including Japan, Argentina, Nigeria, India, Mexico, Australia, and South Africa.

Families of the insane are among the new actors playing a much larger role in this recent literature. They are viewed as authorities in their own right, who seek and coordinate asylum care, as well as make strategic decisions as to when to institutionalize their family members. The focus on family is central to David Wright's monograph, Mental Disability in Victorian England: The Earlswood Asylum, 1847–1901. This is one of the first published studies of an "idiot asylum" in England, which grapples with the history of the mentally disabled (or the developmentally disabled, in current parlance in the United States). Roy Porter may have been right when he remarked that unlike madness, "mindlessness has no mystique," which accounts for the sparse number of studies published on the history of mental disability in the United States and England (Wright, p. 3). More recent work, however, on the connections between feeble-mindedness and eugenics and in the relatively new field of disability studies, has begun to add significantly to the literature on the mentally disabled.¹

In his monograph, Wright contextualizes the process of institutionalization with practices and influences that took place outside the asylum walls. He sees the family as the primary identifier of mental disability and as a participant in all stages of institutionalization, including certifying patients, mediating treatment, and assisting in their release back to the community. To ascertain confinement practices, Wright compiled a database of over 2000 patients and examined Certificates of Insanity, which provided...