Asylum: Inside the Closed World of State Mental Hospitals
Introduction by Oliver Sacks
MIT Press, 2009

209 pages, 10.4" x 12"

We tend to think of mental hospitals as “snake pits”—places of nightmarish squalor and abuse—and this is how they have been portrayed in books and film. Few Americans, however, realize these institutions were once monuments of civic pride, built with noble intentions by leading architects and physicians, who envisioned the asylums as places of refuge, therapy, and healing.For more than half the nation's history, vast mental hospitals were a prominent feature of the American landscape. From the mid-nineteenth century to the early twentieth, more than 250 institutions for the insane were built throughout the United States; by 1948 they housed over half a million patients. But over the next thirty years, with the introduction of psychotropic drugs and policy shifts toward community-based care, patient populations declined dramatically, leaving many of these massive buildings neglected and abandoned.

From 2002 to 2008, I visited seventy institutions in thirty states, photographing palatial exteriors designed by famous architects and crumbling interiors that appeared as if the occupants had just left. I also documented how the hospitals functioned as self-contained cities, where almost everything of necessity was produced on site: food, water, power, and even clothing and shoes. Since many of these places have been demolished, the photographs serves as their final, official record.

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