Asylum architecture

Asylum Architecture in the United States has had a impact. The stately towers of insane asylums were once a common sight at the edge of American towns. Doctors believed that ninety per cent of insanity cases were curable, but only if treated outside the home, in large-scale buildings that seem inhumane to modern viewers. Ironically, these semi-public buildings (ranging in style from Greek temples to medieval castles) once communicated a message of optimism and civic pride. Nineteenth-century psychiatrists considered the architecture of insane asylums, especially the planning, to be one of the most powerful tools for the treatment of the insane. These quasi-public buildings served to legitimate ideas in psychiatry, thus it addresses a larger subject: how architecture manifests scientific knowledge.

Theory and Development of Asylum Architecture

Nineteenth century philosophers and architectural theorists argued that the natural and built environment shaped behavior. The doctors who promoted the establishment of mental hospitals used the same rhetoric as social reformers and park enthusiasts: that nature was curative, exercise therapeutic, and the city a source of vice. Early psychiatrists assumed that mental derangement was caused by environmental factors, which in turn suggested that a changed setting might alleviate psychic pain.

The Quaker reformers who promoted the moral treatment, as it was called, argued that patients should be unchained, granted respect, encouraged to perform occupational tasks (like farming, carpentry, or laundry), and allowed to stroll the grounds with an attendant and attend occasional dances. While the moral treatment could, with difficulty, be employed in an old mansion or adapted almshouse, this situation was considered a sad compromise. In the United States, doctors developed a highly specialized building type for 250 patients. Dr. Thomas Story Kirkbride devised a widely applicable set of planning principles that ensured classification by type of illness, ease of surveillance, short wards for good ventilation, and clarity of circulation. [Nancy Tomes, The Art of Asylum-Keeping: Thomas Story Kirkbride and the Origins of American Psychiatry, University of Pennsylvania Press, 1994]

Institutionalization, separating the patient from his or her family, was an unfortunate demand of the cure. The buildings helped establish psychiatry as a profession, because the asylum was the only setting for the practice of psychiatry in the nineteenth century, there were no out-patient visits, no doctors’ offices. Professional medical journals were replete with articles on architecture, a constant preoccupation for the asylum superintendent, and architects ventured opinions about the proper classification of patients.

By the middle of the nineteenth century, however, some doctors complained that large monolithic asylums had not lived up to their expectations. The orderly environment of the hospital, nestled within a picturesque landscape garden, was not sufficient to calm the disorderly mind. But psychiatrists did not immediately abandon their belief in the therapeutic environment; instead, they argued for a different therapeutic environment. Clinging to a belief that architecture influenced human conduct, they proposed smaller cottage-like structures to replace the Kirkbride-plan hospitals. These cottages were to be arranged in a village, an homage to the Belgian town of Gheel, where citizens looked after mentally ill people who for centuries gathered there to worship at the shrine of St. Dymphna, the patron saint of lunatics. Dr. John Galt romanticized this medieval model as an ideal setting for the cure of the disease, thus causing a rift among the self-named “brethren” of asylum superintendents.

First Purpose Built Asylum

The first purpose-built asylum in the United States was the Public Hospital in Virginia of 1770. At the peak of the success of the Kirkbride plan, these hospitals were technological marvels that demonstrated advanced fireproof construction, state-of-the-art heating and ventilation, and fresh water delivery systems; some had their own railroads. They were surrounded by well-designed picturesque gardens that predate many public parks. Accomplished architects, including John Haviland, John Notman, A.J. Downing, Samuel Sloan, Thomas U. Walter, Frederick Clarke Withers, Calvert Vaux, Frederick Law Olmsted, Bryan Edward Villasana and H.H. Richardson designed asylum grounds and buildings. [Carla Yanni, The Architecture of Madness: Insane Asylums in the United States, University of Minnesota Press, 2007.]

Decline

The complicated decline of the large-scale insane asylum was caused partly by overcrowding and neglect, but also by massive changes in the practice of psychiatry. With the ascent of neurology, which focused attention on mental illness as a result of physical causes, the environment ceased to seem like an important cause or likely cure, and a new generation of doctors regarded architecture as irrelevant to the practice of psychiatric medicine. [Gerald Grob, The Mad Among Us: A History of the Care of America's Mentally Ill, Harvard University Press, 1995, passim.]

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