Where Patients Once Sought Asylum

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Christopher Payne


To view images from Asylum: Inside the Closed World of State Mental Hospitals by Christopher Payne, click here for a slide show.

It sounds like the setup for a horror movie: a tour of abandoned state-run mental asylums throughout the United States. But Christopher Payne's new photography book, Asylum: Inside the Closed World of State Mental Hospitals, is an arrestingly beautiful look at facilities where generations of patients once lived, worked, and died. As Oliver Sacks points out in the introduction, "asylum, in its original usage, meant refuge, protection, sanctuary." In those days before psychotropic drugs and group homes, a patient's best hope for recovery was to spend years in a quiet, pastoral setting, away from the pressures of everyday life.

Some of Payne's photos have shades of creepiness: the barbed wire surrounding a turreted building or the cold grandeur of a crumbling marble staircase. But others are unexpectedly humanizing. As this book reveals, patients in asylums didn't just sit in padded rooms. They also ran their own farms and baked their own bread. Each of these facilities was a self-sufficient community, and Payne finds remnants of day-to-day operations: a metalworking shop, a beauty parlor, a collection of shoes outside a bowling alley. Payne is a trained architect, and his main objective is to document these massive structures before they collapse. But as he wanders from room to room, he also functions as an archeologist, unearthing fragments from long-forgotten civilizations.


Your book was about abandoned substations in New York City. What attracts you to crumbling buildings?

At first, there's a certain Indiana Jones aspect to the discovery. But after that initial awe wears off, what fascinates me most is that we as a society do not create buildings like this anymore, grand structures that are meant to last much longer than the architects. The hospitals in this book were created at a time when it was thought that architecture would help in the treatment of the mentally ill. The architects envisioned them as places of healing. It's kind of a romantic notion, but as an architect you want to think what you're creating is going to last forever and have a profound impact not only on the occupants but society as a whole.

In Oliver Sacks's introduction to your book, he points out that these facilities were called "asylums" because they were meant to be places of peace and refuge. Can you say more about how these buildings helped achieve that goal?

These places were created with noble intentions, and the architecture was certainly supposed to uplift people. The buildings were also sited in rural areas, which were supposed to encourage a healthier living style. But you can also look at the way the buildings were designed—they have these huge hallways where the patients were supposed to be social and hang out. It's also interesting to look at the arrangement of the buildings, the spaces in between them, because the idea was that the asylum was a whole community. The occupants would be on the grounds or on the farms keeping active. When you're strolling around the grounds, you can imagine what life was really like with thousands of people living and working there.

In the 1970s, there was a series of court cases that outlawed patient labor. How did those rulings affect the communal atmosphere you're describing?

The federal laws were passed for good reasons, but they also sucked a lot of the life out of these places. Obviously, the idea of work therapy borders on forced labor. But from what I learned, farming and building things did give the patients something to do in the absence of modern medical treatment. It took their minds off their troubles, and many of these people did get better. Part of it, too, was this notion of self-sufficiency. Since the hospitals were located in remote areas, the people needed to have farms and dairies where they could produce their own food, workshops where they could make everything onsite. There was a sort of utopian ideal behind these places, even if they later became something very different.

Some of your most striking photos show jumbled collections of toothbrushes and bowling shoes—everyday objects that were left behind. How did you happen to stumble upon these things?

I had to dig pretty deep to find some of those shots. In some cases, one of the workers would be showing me around and get a sense of what I wanted and lead me to rooms that still had artifacts of everyday life in them. By the time I got to most of the buildings, the rooms were empty or trashed or in such bad condition that they didn't yield a time-capsule-like photograph. So when I did find something like that, it was a goldmine. These things trigger emotions—they begin to describe not only a way of life in one of these institutions but the fact that there were thousands of people living there.

One of your photos shows an autopsy theater. What exactly was that?

Any institution that's far enough out in the country to produce its own food is also going to have a fully functioning hospital. Over time, you saw the introduction of operating rooms and dental offices. In some of the larger institutions, people would die every day, so they had to also have a morgue. And in a few cases, like St Elizabeth's in Washington, DC, the hospital itself was a research center. So these places weren't just warehouses for people. At their best, they were doing medical research.

Were some of the hospitals still operational when you visited?

A few of them had been renovated. But more often than not, I would arrive at a big hospital and find that most buildings were empty because the patient population was one tenth its original size. So the buildings were just left to fall in on themselves. A lot of the hospitals in the Northeast are completely abandoned. These states had the largest mental health systems, whereas some states in the Midwest didn't have as many hospitals so weren't as many facilities to close when the patient population shrunk down.

And why did the patient population shrink so much? Were all those people just given drugs and sent home?

The introduction of psychotropic drugs in the 50s did promise new hope. From what I've been told, the drugs were initially used to pacify and calm the patients. Over time, it became obvious that the drugs could help people return to normal life on the outside, and so it became harder to commit people. You had to have a reason—you had to show that these people were a threat to themselves or society. Then in the 60s, you had a shift toward community-based care. The idea of locking people up for decades on end went against the whole social movement that was transforming society.

But there wasn't a net ready to receive all these people when they were released. A lot of them are now in prisons or on the streets. Sending them out or giving them drugs didn't solve the problem. There's always the same number of people with mental illness. That's not going to change.

To view images from Asylum: Inside the Closed World of State Mental Hospitals by Christopher Payne, click here for a slide show.

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Jennie Rothenberg Gritz is The Atlantic's digital features editor. More

Jennie Rothenberg Gritz, an Atlantic senior editor, began her association with the magazine in 2002, shortly after graduating from the UC Berkeley Graduate School of Journalism. She joined the staff full time in January 2006. Before coming to The Atlantic, Jennie was senior editor at Moment, a national magazine founded by Elie Wiesel.

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