May 10, 2023
After the unfortunate death in the New York subway of mentally ill homeless guy Jordan Neely, I pointed out that much of the stress imposed upon daily life in New York by violent, free-range lunatics like Neely, who had been arrested four times for punching people, wouldn’t be all that hard to solve:
In NYC, the loons who commit the most egregious random attacks (e.g., punching 5′ 4″ 67-year-old Rick Moranis) usually have a long paper trail of arrests and online warnings about them. Putting just the 500 scariest crazymen in asylums could do wonders.
But it turns out that I overestimated by an order of magnitude just how big the roundup would have to be to have included Neely. On Sunday, The New York Times reported:
[Neely] was well known for years to the social work teams that reach out to homeless people on the subways, and had hundreds of encounters with them…. Mr. Neely was on what outreach workers refer to as the “Top 50” list—a roster maintained by the city of the homeless people living on the street whom officials consider most urgently in need of assistance and treatment. He was taken to hospitals numerous times, both voluntarily and involuntarily….
Why have alarming nuts been allowed to colonize New York’s mission-critical subway system? Why do we no longer have what we once did: adequate facilities in the countryside for agitated urbanites to decompress far from the madding crowd?
The massive deinstitutionalization of the 1960s–1980s is now widely considered a blunder, but why did it seem like a good idea at the time? We need to consider why progressive reformers in the English-speaking world turned as fervently against lunatic asylums in the 1970s as their forebears had become enthusiastic for them in the middle of the 19th century.
The movement to construct massive stone or brick buildings in calm rural settings to shelter the mentally troubled began in Britain among Quaker humanitarians around 1800. New England Unitarian reformer Dorothea Dix brought it to the USA in the 1840s.
For example, the massive Trans-Allegheny Lunatic Asylum opened in Weston, W.Va., in 1864 at the height of the Civil War. Resting on a square mile of grounds, the sandstone structure comprises 242,000 square feet. By the low tax standards of the time, this typical Victorian state mental hospital represented an immense expenditure by the state government.
Like most of the state asylums of the second half of the 19th century, the Trans-Allegheny was designed according to psychiatrist Thomas Kirkbride’s cutting-edge batwing floor plan, with eight staggered wings en echelon to maximize ventilation and natural light to better heal the inmates. Dr. Kirkbride, like many other Victorian progressives, believed that mental illness could be cured by providing a serene, health-inducing setting in contrast to the deplorable old Bedlam-style madhouses.
Certainly, offering an attractive and orderly campus couldn’t hurt mental well-being. But, over time, the fact that these vast facilities did not prove a panacea for insanity as originally assumed they would led to disgruntlement among taxpayers called upon to fund the maintenance of these expensive buildings.
Moreover, the creative class, left and right, seized upon these vast structures as symbols of malignity.
The reactionary right saw the inmates as the embodiments of their worst fears of chaos. That Victorian sanatoriums were built with a batwing layout may have some vague connection to why Arkham Asylum is where Batman’s criminal rivals are constantly being sent to and escaping from. The Kirkbride-plan Danvers State Insane Asylum served as the inspiration for horror writer H.P. Lovecraft, who in turn has been referenced by Batman comics since 1974.
And the liberationist left viewed the patients’ keepers as the enemy. For instance, the Kirkbride-plan Oregon Hospital for the Insane was the setting for the hugely influential novel and movie One Flew Over the Cuckoo’s Nest, in which the chief villainess is the authoritarian Nurse Ratched.
These sentiments were already brewing by the early 1900s. Therefore, a half century after it opened, the Trans-Allegheny Lunatic Asylum rebranded itself as the Weston State Hospital.
That didn’t mean, however, that treatment much improved. In the first six decades or so of the 20th century, therapies included, largely for lack of anything better, such dubious expedients as lobotomies, electroconvulsive therapy (which, surprisingly, sometimes works—a relative of mine sixty years ago benefited from it—but often fails badly), and eugenic sterilizations.
Not surprisingly, with few cures available, the number of people confined to asylums continued to rise. Inmates at Weston peaked in the 1950s at 2,600, less than 100 square feet per patient (including staff areas and hallways).
My guess is that the large numbers of people warehoused at asylums in the 1950s led to an overreaction in which thought leaders then concluded that nobody needed to be locked up.
And keep in mind that these giant buildings that had been erected before the electric light bulb proved insufficient by 20th-century standards. Wikipedia notes:
A series of reports by ‘The Charleston Gazette’ in 1949 found poor sanitation and insufficient furniture, lighting, and heating in much of the complex, while one wing, which had been rebuilt using Works Progress Administration funds following a 1935 fire started by a patient, was comparatively luxurious.
Similarly, the serene Camarillo State Mental Hospital campus in Southern California opened in 1936 and soon hosted celebrities such as Charlie Parker and Oscar Levant. In 2002 it was converted into one of the finest campuses of the California State University system. (Meanwhile, the crazy and addicted relocated to camping out under L.A. freeway overpasses.)
Finally, in 1948, Australian John Cade discovered that lithium stabilized the mood of manic depressives. This set off a golden age of discoveries of psychiatric medicines.
By 1959 the Tory government in Britain was beginning to speculate that mental health drugs would obviate the need for expensive rural asylums. (On the other hand, progress in pharmaceutical research has since hit diminishing returns. And how can “community care” force patients to take them?)
The emerging view that society should shut its asylums was given memorable expression by the Tory health minister Enoch Powell in what might be his second most famous speech (behind only his 1968 anti-immigration “Rivers of Blood” oration). In his 1961 “Water Tower” speech, Powell declared that by 1975, community care would reduce the need for beds in rural asylums by half.
In case you are wondering why it’s called Powell’s “Water Tower” speech, that’s because Britain’s many government-funded rural mental refuges featured a huge water tower in case the gaslighting or the patients, who often smoked to self-medicate, set their buildings on fire.
Powell in 1961 seemed especially offended by the Victorian architecture of the rural asylums:
There they stand, isolated, majestic, imperious, brooded over by the gigantic water-tower and chimney combined, rising unmistakable and daunting out of the countryside—the asylums which our forefathers built with such immense solidity to express the notions of their day.
During an era when the most buildings erected since the war were concrete, steel, and glass excrescences, Powell got himself so worked up against the continued existence of these edifices that he even demanded they not be repurposed. Just how much people, especially Brits, in the era of postwar modernist architecture resented old stone structures can be inferred from this slightly unhinged part of his speech:
Do not for a moment underestimate their powers of resistance to our assault. Let me describe some of the defenses which we have to storm.
First there is the actual physical solidity of the buildings themselves: The very idea of these monuments derelict or demolished arouses an instinctive resistance in the mind. At least, we find ourselves thinking:
“Can’t we use them for something else if they cannot be retained for the mentally ill?”
“Why not at least put the subnormals into them?”
“Wouldn’t this one make a splendid geriatric unit, or that one a convalescent home?”
“What a pity to waste all this accommodation!”
These days, ironically, many British insane asylums erected on what then were the outskirts of London have been converted into luxury apartment complexes, often with new wings in the 19th-century style of the originals being added. In this century, Brits can’t get enough of what their 20th-century predecessors considered dark, satanic mills.
Powell went on:
Well, let me here declare that if we err, it is our duty to err on the side of ruthlessness. For the great majority of these establishments there is no appropriate future use….
Whether Powell sincerely loathed old buildings or whether he was cynically appealing to other people’s loathing in 1961, I can’t determine.
But do not underestimate how much people in the past were aesthetically offended by what people in the present adore. We idolize 19th-century stone architecture in part because it’s no longer filthy with coal soot. In one of the great conservative innovations of the 20th century, the De Gaulle government in the early 1960s began washing the great buildings of Paris. Over a few decades in the late 20th century, tastes then changed to recognize that 19th-century architecture was pretty awesome.
But in 1961, that was all in the future. Back then, many were convinced that Victorian architecture was inhumane.
The Weston State Hospital was finally shut in 1994. In 2007, an entrepreneur bought the ruin, changed the name back to the Trans-Allegheny Lunatic Asylum, and turned it into a tourist attraction. It offers daytime tours for those interested in social history and nighttime events for those interested in haunted houses.