One of my research interests is the development of psychology in the 19th century, and the treatment of mental health issues in the Victorian lunatic asylums which were built across the country as the methods of treatments for lunacy developed. The Victorian lunatic asylum has become a figure of fear, a place of many horrors which people are both fascinated and repelled by. However, many of them were developed to be welcoming places, akin to country houses where patients could rest and be well treated and feel themselves at home, yet also be managed kindly, well fed, with the opportunity for exercise and gentle and appropriate work, though of course this was not always the reality and then as now it was a system frequently abused. The picture we now have of the asylums is much more Gothic, and much more frightening.

Barbara Taylor’s book, The Last Asylum, looks at the asylum at Friern (also explored in Will Self’s novel Umbrella) in particular, and considers how these buildings were used towards the end of their working lives. Alongside her memoir of mental illness, Taylor discusses the treatments available for ‘madness’, and concludes with a reflection on the system now available, of care in the community combined with therapeutic methods. She also acknowledges and addresses the uncomfortable history of lunatic asylums, including their reputation as places of misery and ill treatment. Yet she also admits that Friern was somewhere where she was able to settle and to feel safe.

Taylor, a historian, underwent psychoanalysis for a long period of time and spend some time resident in the asylum at Friern just before its closure. As a result she has considerable insights into both the modern processes of psychoanalysis and the treatment available for those with serious mental illnesses. She is startlingly frank in this memoir; she admits her behaviour was troubling, and she explores how the treatments she underwent worked for her, including the difficult, angry stages which she went through with her psychoanalyst during the uncomfortable process of transference. The journey on which Taylor goes at her treatment progresses reflects their twisting corridors and monolithic old structure of the asylum in which she is staying. She discusses the building and its complex purposes and history sensitively, considering the history of mental health treatments and, more recently, of psychoanalysis, as well as the recent development of service user groups and the concept of care in the community. She reflects on whether these changes really improve the care that psychiatric patients receive, expressing a kind of relief that she could be taken in by the ‘stone mother’ of the asylum. The book concludes:

The story of the asylum age is not a happy one. But if the death of the asylum means the demise of effective and humane mental health care, then this will be more than a bad ending to the story: it will be a tragedy.

Not only is this book as well written informative and lively as you would expect a book by such a historian to be, it also raises some important questions about the treatment of mental health, both historically and in the present day. It is, of course, also an absorbing and enjoyable read which I thoroughly recommend.