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Space, place and the asylum: an introduction
Health
Pergamon
(‘81997
& Plume. Vol. 3. No. 2. pp. 71~~72. 1997 Elsevier Science Ltd. All nghts reserved Printed in Great Britain 1353~8292:97 $17.00+0.00
PII: S1353-8292(97)00001-4
Space, Place and the Asylum: an introduction Deborah C. Park Independent Reseurcher, 210 Ledbury Street, Toronto, Ontario M.5M 4J5, Cunadu
John P. Radford 4700 Keele Street, North York, Ontario M5M 4J5, Depurtment of‘ Geography, York Unil~ersit~~, Cunada
The asylum has long been viewed as both a concrete realization of social attitudes and a signifier of the existing order, playing a role in its perpetuation. In 1962, at the beginning of the end of the asylum era, the British Health Minister Enoch Powell, pondering his government’s proposal to close half of the beds in mental hospitals in England and Wales over 15 years, commented on the systemic inertia embodied in these physical structures: “There they stand, isolated, majestic, imperious, brooded over by a gigantic water-tower and chimney combined, rising unmistakably and daunting out of the countryside-the asylums which our forefathers built with such solidity”. In the following decades, policy-makers frustrated with the slow pace with which plans for deinstitutionalization were being implemented frequently quoted these words. Renewed academic interest in the asylum has also recognized the asylum’s physical prominence as the embodiment of particular conceptions of order and therapy. Over the last two or three decades the numerous studies of asylum location choices and patterns of admission have been supplemented by attention to the institutional built environment. Such investigation has raised asylum scholarship from the “quiet backwaters” which it once occupied, and has established important links to broader themes in social history. More recent investigations, drawing inferences from the close investigation of primary sources, have taken on a pronounced trans-disciplinary tone. Among the results has been an intensified appreciation and partial reconceptualization of asylums both as constructed spaces and as distinctive places.
The papers in this special issue reflect these new research initiatives. They represent work anchored in a number of disciplines but displaying little interest in the niceties of academic ownership. Geographers, historians and sociologists form the nucleus of a pluralistic set of approaches to mental health in general, and some of them place the asylum at the centre of their attention. While the papers range over a number of topics, two themes permeate the collection as a whole. The first is exclusion-the asylum used as a means of spatially separating individuals from the community-motivated either by a desire to place people with particular diagnoses in a therapeutic environment or for the purpose of social control and custody. The papers detail the operation and manifestation of exclusion in a variety of contexts, subjecting it to a critical reevaluation. The other theme is class!fication-the recognition of the existence within contemporary asylum accounts of a preoccupation with diagnosis, sorting and labelling. Classification of existing and prospective institutional residents, typically seen during the asylum era as a precondition to successful therapy, was reflected in an ever more specialized allocation of space within and between institutions. Yet ambiguities were evident in policy directions and even more so at the level of actual experience. Even such supposedly fundamental distinctions as those between asylum, hospital, and prison were seldom clear, as illustrated by the frequent renaming which has characterized most individual institutions. Within these broad categories a blurring of boundaries defied repeated attempts to construct categorization schemes based on rigorously “scientific” principles. 71
In the first paper in the collection. Chris Philo presents a broad, interpretive survey of geographical contributions to the study of asylums. Geographers, he notes, have written widely on community opposition to specific facilities, and have paid some attention to decision-making criteria at the other end of the location process. He goes on to review research on facility utilization and admissions, and notes its preoccupation with “Jarvis’s Law” of distance decay. His critical attention is directed mainly to the work of Michael Dear and co-workers, who, he argues have overstated exclusion and viewed the past too much in terms of current attitudes, especially in their earlier work. Philo invites us to explore mental illness as a social construct, and to see beneath the surface of social policy a series of ontological transformations between abstract content and concrete form. Barry Edginton’s paper on “moral architecture” explores exactly this kind of transformation. His focus is the York Retreat, founded in 1796 and still in operation, continuing to occupy a central position in asylum studies. being associated both with the development of moral treatment and the adoption of distinctive architectural forms. Edginton integrates these, arguing that the constructed environment of buildings, gardens and scenery was a vital component in the Retreat’s treatment of mental illness. The design of buildings and grounds reflected the comforting surroundings of a large patriarchic family. Spaces were clearly demarcated for various members of the staff, and for different social rankings among patients. Therapy was lodged in the essence of the place itself, and the translation of moral treatment into concrete form at the Retreat, Edginton argues, was a major influence on nineteenth century asylum architecture. Claire Cornish’s paper re-directs our attention away from the rise of a two-centuries-old prototype towards the demise of one of its latter-day offspring. The context is deinstitutionalization, but the focus is the impact of recent policy directives on the physical and human environment of an asylum in Cornwall, as interpreted in terms of its own past. Cornish discovers a sense of loss among the staff, and a continued aura of stigma which continues to haunt the asylum site in the mind of the local community. Above all, she finds attributes of place, of a location to which persisting meanings have become attached.
72
Derek Alderman’s focus is space rather than place. yet he is critical of any view of spatial relationships which view them as unproblematic. He suggests that nineteenth century asylum admissions procedures operated within a framework of the “politics of distance”. Specifically, he examines the idea that admissions reflected the degree of social distance between those diagnosed as mentally ill and their informal agents of control (family. church, community) more than simple distance decay. His quantitative analysis of admissions data from post Civil War Georgia is informed by the concept of competing notions of distance. The two remaining papers focus on the social power inherent in particular conceptions of the asylum. “Sentenced in Sorrow” by Steven Gelb provides an extraordinary illustration of the power intrinsic in notions of the asylum as place, presenting a graphic description of the outcome of a murder trial in which the defence successfully played upon the jury’s preconceptions of the asylum. The view of the asylum as a place of confinement and of punishment is symbolic of a single ontological transformation. In “She Thinks She is in the Queen’s Castle”, Lykke de la Cour examines perceptions of the “patients” asylum themselves. Her intensive investigation of the case files of female patients in a Canadian psychiatric hospital between 1920 and 1974 reveals a set of powerful “internal” perceptions of the asylum environment, and of coping mechanisms within a controlled space. The classification of patients and spaces in relation to these perceptions raises questions about resistance to imposed classifications and the role of human agency in institutional environments. It is our hope that this collection, in addition to exemplifying current research, will also stimulate further investigation. There is much scope for the study of other asylums, not only in the regions of Britain and North America represented here, but cross-culturally. We also hope to have laid the way for a future volume of Health & Place dealing with recent work on de-institutionalization. Thanks are due to Graham Moon and Chris Philo for their encouragement and cooperation. We are also grateful to the authors and reviewers whose prompt responses allowed the project to be completed according to the timelines projected at the outset.
Pergamon
(‘81997
& Plume. Vol. 3. No. 2. pp. 71~~72. 1997 Elsevier Science Ltd. All nghts reserved Printed in Great Britain 1353~8292:97 $17.00+0.00
PII: S1353-8292(97)00001-4
Space, Place and the Asylum: an introduction Deborah C. Park Independent Reseurcher, 210 Ledbury Street, Toronto, Ontario M.5M 4J5, Cunadu
John P. Radford 4700 Keele Street, North York, Ontario M5M 4J5, Depurtment of‘ Geography, York Unil~ersit~~, Cunada
The asylum has long been viewed as both a concrete realization of social attitudes and a signifier of the existing order, playing a role in its perpetuation. In 1962, at the beginning of the end of the asylum era, the British Health Minister Enoch Powell, pondering his government’s proposal to close half of the beds in mental hospitals in England and Wales over 15 years, commented on the systemic inertia embodied in these physical structures: “There they stand, isolated, majestic, imperious, brooded over by a gigantic water-tower and chimney combined, rising unmistakably and daunting out of the countryside-the asylums which our forefathers built with such solidity”. In the following decades, policy-makers frustrated with the slow pace with which plans for deinstitutionalization were being implemented frequently quoted these words. Renewed academic interest in the asylum has also recognized the asylum’s physical prominence as the embodiment of particular conceptions of order and therapy. Over the last two or three decades the numerous studies of asylum location choices and patterns of admission have been supplemented by attention to the institutional built environment. Such investigation has raised asylum scholarship from the “quiet backwaters” which it once occupied, and has established important links to broader themes in social history. More recent investigations, drawing inferences from the close investigation of primary sources, have taken on a pronounced trans-disciplinary tone. Among the results has been an intensified appreciation and partial reconceptualization of asylums both as constructed spaces and as distinctive places.
The papers in this special issue reflect these new research initiatives. They represent work anchored in a number of disciplines but displaying little interest in the niceties of academic ownership. Geographers, historians and sociologists form the nucleus of a pluralistic set of approaches to mental health in general, and some of them place the asylum at the centre of their attention. While the papers range over a number of topics, two themes permeate the collection as a whole. The first is exclusion-the asylum used as a means of spatially separating individuals from the community-motivated either by a desire to place people with particular diagnoses in a therapeutic environment or for the purpose of social control and custody. The papers detail the operation and manifestation of exclusion in a variety of contexts, subjecting it to a critical reevaluation. The other theme is class!fication-the recognition of the existence within contemporary asylum accounts of a preoccupation with diagnosis, sorting and labelling. Classification of existing and prospective institutional residents, typically seen during the asylum era as a precondition to successful therapy, was reflected in an ever more specialized allocation of space within and between institutions. Yet ambiguities were evident in policy directions and even more so at the level of actual experience. Even such supposedly fundamental distinctions as those between asylum, hospital, and prison were seldom clear, as illustrated by the frequent renaming which has characterized most individual institutions. Within these broad categories a blurring of boundaries defied repeated attempts to construct categorization schemes based on rigorously “scientific” principles. 71
In the first paper in the collection. Chris Philo presents a broad, interpretive survey of geographical contributions to the study of asylums. Geographers, he notes, have written widely on community opposition to specific facilities, and have paid some attention to decision-making criteria at the other end of the location process. He goes on to review research on facility utilization and admissions, and notes its preoccupation with “Jarvis’s Law” of distance decay. His critical attention is directed mainly to the work of Michael Dear and co-workers, who, he argues have overstated exclusion and viewed the past too much in terms of current attitudes, especially in their earlier work. Philo invites us to explore mental illness as a social construct, and to see beneath the surface of social policy a series of ontological transformations between abstract content and concrete form. Barry Edginton’s paper on “moral architecture” explores exactly this kind of transformation. His focus is the York Retreat, founded in 1796 and still in operation, continuing to occupy a central position in asylum studies. being associated both with the development of moral treatment and the adoption of distinctive architectural forms. Edginton integrates these, arguing that the constructed environment of buildings, gardens and scenery was a vital component in the Retreat’s treatment of mental illness. The design of buildings and grounds reflected the comforting surroundings of a large patriarchic family. Spaces were clearly demarcated for various members of the staff, and for different social rankings among patients. Therapy was lodged in the essence of the place itself, and the translation of moral treatment into concrete form at the Retreat, Edginton argues, was a major influence on nineteenth century asylum architecture. Claire Cornish’s paper re-directs our attention away from the rise of a two-centuries-old prototype towards the demise of one of its latter-day offspring. The context is deinstitutionalization, but the focus is the impact of recent policy directives on the physical and human environment of an asylum in Cornwall, as interpreted in terms of its own past. Cornish discovers a sense of loss among the staff, and a continued aura of stigma which continues to haunt the asylum site in the mind of the local community. Above all, she finds attributes of place, of a location to which persisting meanings have become attached.
72
Derek Alderman’s focus is space rather than place. yet he is critical of any view of spatial relationships which view them as unproblematic. He suggests that nineteenth century asylum admissions procedures operated within a framework of the “politics of distance”. Specifically, he examines the idea that admissions reflected the degree of social distance between those diagnosed as mentally ill and their informal agents of control (family. church, community) more than simple distance decay. His quantitative analysis of admissions data from post Civil War Georgia is informed by the concept of competing notions of distance. The two remaining papers focus on the social power inherent in particular conceptions of the asylum. “Sentenced in Sorrow” by Steven Gelb provides an extraordinary illustration of the power intrinsic in notions of the asylum as place, presenting a graphic description of the outcome of a murder trial in which the defence successfully played upon the jury’s preconceptions of the asylum. The view of the asylum as a place of confinement and of punishment is symbolic of a single ontological transformation. In “She Thinks She is in the Queen’s Castle”, Lykke de la Cour examines perceptions of the “patients” asylum themselves. Her intensive investigation of the case files of female patients in a Canadian psychiatric hospital between 1920 and 1974 reveals a set of powerful “internal” perceptions of the asylum environment, and of coping mechanisms within a controlled space. The classification of patients and spaces in relation to these perceptions raises questions about resistance to imposed classifications and the role of human agency in institutional environments. It is our hope that this collection, in addition to exemplifying current research, will also stimulate further investigation. There is much scope for the study of other asylums, not only in the regions of Britain and North America represented here, but cross-culturally. We also hope to have laid the way for a future volume of Health & Place dealing with recent work on de-institutionalization. Thanks are due to Graham Moon and Chris Philo for their encouragement and cooperation. We are also grateful to the authors and reviewers whose prompt responses allowed the project to be completed according to the timelines projected at the outset.