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Elaborately conceived, grandly constructed insane asylums—ranging in appearance from classical temples to Gothic castles—were once a common sight looming on the outskirts of American towns and cities. Many of these buildings were razed long ago, and those that remain stand as grim reminders of an often cruel system. For much of the nineteenth century, however, these asylums epitomized the widely held belief among doctors and social reformers that insanity was a curable disease and that environment—architecture in particular—was the most effective means of treatment.

In The Architecture of Madness, Carla Yanni tells a compelling story of therapeutic design, from America’s earliest purpose—built institutions for the insane to the asylum construction frenzy in the second half of the century. At the center of Yanni’s inquiry is Dr. Thomas Kirkbride, a Pennsylvania-born Quaker, who in the 1840s devised a novel way to house the mentally diseased that emphasized segregation by severity of illness, ease of treatment and surveillance, and ventilation. After the Civil War, American architects designed Kirkbride-plan hospitals across the country.

Before the end of the century, interest in the Kirkbride plan had begun to decline. Many of the asylums had deteriorated into human warehouses, strengthening arguments against the monolithic structures advocated by Kirkbride. At the same time, the medical profession began embracing a more neurological approach to mental disease that considered architecture as largely irrelevant to its treatment.

Generously illustrated, The Architecture of Madness is a fresh and original look at the American medical establishment’s century-long preoccupation with therapeutic architecture as a way to cure social ills.

Carla Yanni is associate professor of art history at Rutgers University and the author of Nature’s Museums: Victorian Science and the Architecture of Display.

            The story of Abraham Van Norstrand’s rise and fall is also the story of the clash between the great expectations and hard choices that have bedeviled public mental hospitals from the beginning. 

In the late 1970s, Barbara Taylor, then an acclaimed young historian, began to suffer from severe anxiety. In the years that followed, Taylor’s world contracted around her illness. Eventually, her struggles were severe enough to lead to her admission to what had once been England’s largest psychiatric institution, the infamous Friern Mental Hospital in North London.

The Last Asylum is Taylor’s breathtakingly blunt and brave account of those years. In it, Taylor draws not only on her experience as a historian, but also, more importantly, on her own lived history at Friern— once known as the Colney Hatch Lunatic Asylum and today the site of a luxury apartment complex. Taylor was admitted to Friern in July 1988, not long before England’s asylum system began to undergo dramatic change: in a development that was mirrored in America, the 1990s saw the old asylums shuttered, their patients left to plot courses through a perpetually overcrowded and underfunded system of community care. But Taylor contends that the emptying of the asylums also marked a bigger loss, a loss of community. She credits her own recovery to the help of a steadfast psychoanalyst and a loyal circle of friends— from Magda, Taylor’s manic-depressive roommate, to Fiona, who shares tips for navigating the system and stories of her boyfriend, the “Spaceman,” and his regular journeys to Saturn. The forging of that network of support and trust was crucial to Taylor’s recovery, offering a respite from the “stranded, homeless feelings” she and others found in the outside world.

A vivid picture of mental health treatment at a moment of epochal change, The Last Asylum is also a moving meditation on Taylor’s own experience, as well as that of millions of others who struggle with mental illness.