From Asylum to Prison: Deinstitutionalization and the Rise of Mass Incarceration after 1945

Justice, Power, and Politics

by Anne E. Parsons

To many, asylums are a relic of a bygone era. State governments took steps between 1950 and 1990 to minimize the involuntary confinement of people in psychiatric hospitals, and many mental health facilities closed down. Yet, as Anne Parsons reveals, the asylum did not die during deinstitutionalization. Instead, it returned in the modern prison industrial complex as the government shifted to a more punitive, institutional approach to social deviance. Focusing on Pennsylvania, the state that ran one of the largest mental health systems in the country, Parsons tracks how the lack of community-based services, a fear-based politics around mental illness, and the economics of institutions meant that closing mental hospitals fed a cycle of incarceration that became an epidemic.

This groundbreaking book recasts the political narrative of the late twentieth century, as Parsons charts how the politics of mass incarceration shaped the deinstitutionalization of psychiatric hospitals and mental health policy making. In doing so, she offers critical insight into how the prison took the place of the asylum in crucial ways, shaping the rise of the prison industrial complex.

Genres: History, Nonfiction, Mental Health, Race, Politics, School, Sociology

240 pages, Hardcover

Published October 8, 2018

Reviews

[Darcia Helle · Rating 4 out of 5]

Asylums and prisons share a lot more common ground than most people realize. In this book, the author examines how politics, social upheavals, and fear politics combined over the years to alter prison and mental health policies. It seems we have always criminalized "abnormal" social behaviors, whether by committing people to asylums or locking them in prisons. These two systems fed off each other in a sort of see-saw pattern. And now, with asylums mostly gone, we have instead created mini asylums within prisons. Not much has really changed in 70 years, particularly for those living with severe mental illness.

The information is laid out well, taken decade by decade, and the content is easy to follow. The writing style is matter-of-fact, more textbook than narrative. The style is probably too dry for the casual reader, being more suited for research and those of us wanting to understand the complexities of this topic.

I was disappointed with the brevity. I pre-ordered this book months before the release, and I didn't pay attention to page count. Given the expanse of content, I was surprised to see how short this book is. Amazon lists the book as 240 pages. My hardcover is 211 pages. The epilogue ends on page 155, with the remaining pages being the appendix, acknowledgements, and notes. The first 19 pages are the introduction, which is essentially a summary of what you'll find in the book. So, really, the material is covered in only 136 pages.

What the description doesn't say is that the author focuses mostly on the state of Pennsylvania and the city and statewide changes there. Parsons does at times mention other asylums and prisons in other states, but for the most part she holds up Pennsylvania as an example of what was happening nationwide.

Despite my desire for broader and perhaps more detailed coverage, I still believe this is a book well worth reading. In our decades of flux from asylums to prisons, we have yet to stop criminalizing mental illness. Books like this force us to examine the truth of our system and our society.

*As an aside, I want to mention that the font size used in the hardcover edition is smaller than average. The book took me quite a while to read because the small font strained my eyes, particularly at night when my eyes were already tired. If you have healthy, young eyes, this probably won't bother you. Otherwise, you might want to opt for the Kindle version.*

[Durakov · Rating 5 out of 5]

So many books in the history of psychiatry rehash the same stories in new ways, but Anne E. Parsons has really found a new angle on deinstitutionalization and worked out an incredibly nuanced framework with which to think about the relationship between prisons and asylums.

Her writing is clear and flows well throughout, which makes the book more accessible than most on the topic and one I will be recommending to anyone interested in the era. The book is well-structured and maintains a pleasing balance between cultural observation, local narrative, and critique. I very much appreciated Parsons' care with language and the attention she pays to peer groups and alternative modes of treatment. She largely avoids the standard binaries on offer in psychiatric history and opens up new lines of inquiry I am eager to explore.

[Rachael · Rating 5 out of 5]

An excellent history (and pretty fast read) for anyone interested in deinstitutionalization or mass incarceration. Uses Pennsylvania as a case study, but the story played out in similar ways across the country.