Gracefully Insane: The Rise and Fall of America's Premier Mental Hospital

by Alex Beam

Its landscaped ground, chosen by Frederick Law Olmsted and dotted with Tudor mansions, could belong to a New England prep school. There are no fences, no guards, no locked gates. But McLean Hospital is a mental institution-one of the most famous, most elite, and once most luxurious in America. McLean "alumni" include Olmsted himself, Robert Lowell, Sylvia Plath, James Taylor and Ray Charles, as well as (more secretly) other notables from among the rich and famous. In its "golden age," McLean provided as genteel an environment for the treatment of mental illness as one could imagine. But the golden age is over, and a downsized, downscale McLean-despite its affiliation with Harvard University-is struggling to stay afloat. Gracefully Insane , by Boston Globe columnist Alex Beam, is a fascinating and emotional biography of McLean Hospital from its founding in 1817 through today. It is filled with stories about patients and the Ralph Waldo Emerson prot'g' whose brilliance disappeared along with his madness; Anne Sexton's poetry seminar, and many more. The story of McLean is also the story of the hopes and failures of psychology and psychotherapy; of the evolution of attitudes about mental illness, of approaches to treatment, and of the economic pressures that are making McLean-and other institutions like it-relics of a bygone age.

This is a compelling and often oddly poignant reading for fans of books like Plath's The Bell Jar and Susanna Kaysen's Girl, Interrupted (both inspired by their author's stays at McLean) and for anyone interested in the history of medicine or psychotherapy, or the social history of New England.

Genres: Nonfiction, History, Psychology, Mental Health, Mental Illness, Medical, Psychiatry

296 pages, Paperback

First published November 30, 2001

About the author

I'm [still] a [part-time] columnist for the Boston Globe. Before that I worked as a business reporter in Los Angeles and Moscow. I've lived in Boston since 1984, and written for the newspaper since 1987. I'm working on my next book, about the Mormon prophet Joseph Smith. I wish I still resembled that handsome photo, taken about a decade ago. UPDATE: Finished the Joseph Smith book (obviously) and have started turning over soil for my next project. UPDATE: Finished that project, a short, sharp book called "The Feud: Vladimir Nabokov, Edmund Wilson, and the End of a Beautiful Friendship." UPDATE The Nabokov-Wilson book got lovely reviews, and now I am days away from handing in the ms for my seventh book, my fifth work of nonfiction, the (true) story of Mies van der Rohe and his girlfriend/client/tormentor, Dr. Edith Farnsworth, for whom he built the Farnsworth House. (Please Google it - famous, beautiful house) ) UPDATE I ghost-wrote a book sometime in here, but alas under conditions of strictest secrecy. It was quite successful and I'd be happpy to do that kind of work again. I follow my Goodreads reviews, and would like to offer a collective Thank You to the men and women, who -- without exception, as far as I can see -- have offered literate, unbiased reactions to my writing. Thanks!

Reviews

[Videoclimber(AKA)MTsLilSis · Rating 2 out of 5]

I just couldn't get into this book. I was expecting more about what went on at the hospital. I wanted to know about how the patients were treated and what happened to them. This book was not about that. Most of the book was about the hospital building itself and its location and how it changed throughout time. There were a few small mentions of who stayed there, but not enough to hold my interest. I guess this could be of interest to those who want to know about hospital buildings, but don't look here for patient treatment, because you won't find it.

[Rachel · Rating 5 out of 5]

What I liked best about this book is that Alex Beam does not simply mock the wealthy, upper-class persons who were the patients at McLean Hospital in Massachusetts. Instead, he places these patients' and doctors' lives into a social and historical context. The result is a compassionate and generally respectful look at patients' suffering and struggle to overcome mental illness. He includes sections on Anne Sexton, Robert Lowell, and James Taylor (the pop singer).

[Diana · Rating 3 out of 5]

Gracefully Insane‬: The Rise and Fall of America's Premier Mental Hospital [2001] - ★★★1/2

This non-fiction book is about McLean Hospital in New England, “one of America’s oldest and most prestigious mental hospitals” [Beam, 2001: 1], whose residents once included mathematician John Nash and authors Susanna Kaysen (Girl, Interrupted [1993]) and Sylvia Path (The Bell Jar [1963]). Comprised of beautiful Tudor mansions and set in a picturesque area, the institution became the first mental hospital in Boston and has been called a “cultural museum”. It also inspired Dennis Lehane's thriller Shutter Island [2003], and is an unusual mental hospital in many respects. McLean was known not only for its celebrity-patients and “moral treatment”, but also for its patient rooms furnished with every comfort, tennis courts, extensive gardens and free-standing cottages for its aristocratic clientele. From the hospital’s founding in 1811 to the late 1990s, Alex Beam traces the history of this institution, emphasising the contributions of different individuals on its development and how changes in the treatment of mental disorders throughout the two centuries impacted the running, structure and the organisation of McLean. We read both the doctors and the patients’ accounts.

Beam’s book may be chaotic and disjointed, but it is interesting, especially in its insights offered on the rise and decline of various popular treatments to treat mental disorders (and how McLean responded to various “medical treatment” trends), including lobotomy, electroshock therapy, hydrotherapies, psychoanalysis and drugs. The book ends with the overview of the 1970-90s, which “have been a time of trouble for full-service mental hospitals” [Beam, 2001: 233], since “the world has given up on long-term, residential mental health care”, in favour of “psychopharmacology...quick diagnoses [and] rapid drug prescriptions”.

[Andrea · Rating 4 out of 5]

It took me over three months to read this book! To be honest it may have to do with the fact that I was also reading several other books at the same time. Anyhow being from Boston made this book extra special for me since this is the location for that famous McLean Mental Hospital. The rich history of the facility and the treatment of mental health was fascinating. I also found some of the famous patients like Sylvia Plath and the Taylor (James, Livingston, and Kate) family to be very interesting, Having read Girl Interrupted and seen most of the movie gave me a very vivid image of what McLean Hospital looked like on the inside and out. Susanna Kaysen's troubled years at McLean Hospital were the basis for writing about her experiences while at McLeans. Maybe it is my curiosity for mental health disorders that made this book so fascinating for me but I think not everyone would feel the same. I have heard some reviews in which people called Beam's writing nothing more then name-dropping-gossip, I happen to disagree. Working in health care I have learned a lot about mental health and the stories contained in this book and others like it help to take away some of the stigmatisms related to mental health while exploring the difficulties of treating it.

[little · Rating 2 out of 5]

2.5/5 - this book is about a mental hospital in Boston called McLean, which is still operating today. It’s mostly the history of the hospital as well as a few chapter long anecdotes about the hospitals notable “alumni”. Although it was kinda interesting, I found the author’s tone to be a bit condescending as well as being generally hard to read. For example: “Almost half the patient population was over seventy-five; the hospital became dumping ground for wealthy families to warehouse gaga Uncle Milton.” Also, there is a huge focus on Boston elites. If you’re from Boston/Harvard you’ll probably love this book because it’s a tea spill on the wealthiest families of the area, but as a Texan I don’t give a shit and think the author needs a better editor

[Cameron · Rating 4 out of 5]

After watching a television show depicting ghost hunters in an "insane asylum" I found my curiosity increased about the history behind some of these institutions. By far, this is the book I enjoyed reading the most. The author focuses on the McLean hospital, part of the Harvard medical system and a temporary home to some of the rich and famous. A little teaser, the author of Girls Interrupted spent time at this hospital. The book focuses on the history of the hospital. Yet it is evident that the author spent additional years learning more about the patients who stayed there and he includes numerous additions from these sources. He is able to pull the story of the hospital together intertwined with stories of the patients and employees resulting in a book that I recently described as a "delightful read". A quote opening Chapter 2 states "Crazy people much more pleasant than I expected." At times I found myself cheering and other times devastated by the loss and I believe the author did a great job of depicting the plight of mental illness in a small segment of that population.

[Kirsten · Rating 5 out of 5]

The story of McLean hospital, one of the most famous mental hospitals in the US. Sometimes it seems as though anyone who's anyone spent time in McLean; throughout the 20th century it was famous for catering to the rich and famous with the utmost discretion. Among its "alumni" are poet Robert Lowell, Sylvia Plath (who based her novel The Bell Jar on her experiences there), James Taylor and his siblings, Susanna Kaysen (who wrote about her experiences in Girl, Interrupted), John Nash, and Ray Charles, just to name a few.

In many ways, the history of McLean is the history of the last century of mental health care, although McLean as whole has been a kinder, gentler place than most mental hospitals. There are still stories of brutal, though well-intentioned, treatments: insulin shock therapy, icy hydrotherapy, electroshock therapy (with much higher levels of electricy than today's electroconvulsive therapy). Only a handful of lobotomies were ever performed at McLean, however, and the main emphasis was on milieu therapy -- the theory that providing structure and a relaxed, comfortable environment would go farther to help patients than any invasive procedure.

Of course, the milieu therapy led to a lot of long-term residents at McLean. In the heydey of psychoanalysis, the intake period was 40 days -- the actual treatment usually didn't start for weeks. This kind of treatment has fallen by the wayside in recent years, as health insurance and rising healthcare costs make it impossible for patients to afford more than the usual five day stay, and in turn, McLean is now a ghost of what it once was. It's easy to feel sort of nostalgic for the "old days" of psychotherapy, particularly since insurance and an overloaded system mean that many patients are diagnosed, given drugs, and only receive a very limited amount of talk therapy, if any at all. On the other hand, there's little evidence that McLean's milieu therapy was any more effective than the current methods, particularly in the case of psychotic patients. Still, one wishes somewhat for a happy medium -- no six month hospital stays, but enough time to offer a little caring and patience. As this book makes clear, however, this luxury was only ever available to the very rich, even when it was considered the best treatment for what ails you.

[Brittany Lynn Miskell Grenier · Rating 3 out of 5]

3.5

Fascinating history on McClean hospital.

[Cookie M. · Rating 4 out of 5]

Most, maybe all of us who have suffered through mental illness have wished for a place to retire from the cares if the world for a while, to live slowly, to be gently cared for while we fight the demons back to the nether realms where they belong. Today, if we are lucky, and I have been, we receive the right combination of drugs, counselling, and loving support from our families to recover on our own.
For many years, McLean Hospital in Massachusetts, was the very best our country had to offer the emotionally fragile and neuropsychologically damaged. It did it very well. If you could afford it.
"Gracefully Insane" not only does a wonderful job describing the history of the hospital, but it shares stories of the people who worked there, the patients who passed through, and the ones who came to stay and never left.
It takes us through the elegant 19th century, when most other asylums were wretched prison-like establishments, through the 20th, when breakthroughs began to be made (not all of them for the best) in the treatment of the mentally ill.
One of the most unfortunate changes in the 20th century was the effect of managed care, and insurance company policies limiting treatment.
Hospitals such as McLean have struggled with severe financial restrictions and can no longer be asylums in the true sense of the word, retreats from the stresses and dangers of the outside.
I found myself wishing there had been a McLean for me when I needed it.
I recommend this book to anyone interested in American history, history of medical and mental health treatment, and just a look into the alternative to the Victorian practice of locking crazy Auntie Mildred in the attic.

[Cat · Rating 3 out of 5]

Beam's "Gracefully Insane" is rich in anecdotal history, but poor in other areas. Makes for a light, enjoyable read, but Beam rarely teases out the interesting insights that arise from his excellent access to the inner workings of America's "Premier" mental hospital.
This book will make you think about the (troubled) history of psychiatry/ treatment of mental illness, and Beam's portrait of this institution caused me to shed no tears for the fall of this fabled refuge for blue blooded loons.

Reading interviews with "graduates", its hard not to question the assumptions that underlied McLean's very reasons for existence. Few of the individuals profiled within seem like they were ever a "danger to self or others". Indeed, when a rash of suicides hit McLean a couple of decades ago, the staff were singularly unprepared to cope. Perhaps this is because the "inmates" were not as bad off as one might suppose?

Makes an interesting companion piece for Goffman's "Asylums".

[Miriam · Rating 2 out of 5]

The history of McLean Hospital, one of the most famous mental institutions in the US. It's biggest problem is that it reads like a who's who of the mental hospital.

[emma · Rating 5 out of 5]

Well here I am back again at one of my most favorite niche fascinations: the pharmaceutical and mental health industry through the ages. If it mentions Walter Freeman, I have to read it. I’m making my way through the history one icepick at a time.

I loved this. What really stuck out to me was the “catch all” diagnosis of BPD for any young adult not fitting into their wealthy parents’ societal expectations. The discussion of ECT is just as relevant then as it is now, a practice debated upon and not understood fully when it “works” on patients. I’d love for someone to take a look at how modern SSRI’s, ECT, and lobotomies all have been used to numb patients more so than to address the deeper issues at play. This “bandaid” approach could have found its home in the book, but I also feel like it could be its own book entirely. If it exists please tell me.

I heard one modern psychiatrist who does brain scans on his patients before creating a treatment plan say that psychiatrists are the only doctors that don’t examine the organs they’re treating - over the phone or zoom people are prescribed medications. It was interesting to learn that, much to the dismay of patients, McLean spent months creating a profile on the individual before diagnosing them and creating a treatment plan.

The history of the building was fascinating as well as this whole concept of it acting as a sort of hotel for wealthy people with brain illnesses. The whole Stanley McCormick section was so interesting, and I enjoyed learning more about author Sylvia Plath’s complex relationship with her psychiatrist and ECT treatment beyond what I learned from The Bell Jar. James Taylor not wanting the staff to find out he probably wasn’t sick enough to be there could have been expanded on with greater commentary on why young people were so interested in mental health facilities as a camp-like experience.

I didn’t even realize the hospital was still functioning today and thought it was just a historically protected building. It’s amazing to me how many artists, musicians, poets, and other famous people have stayed at this hospital and that it continues to serve wealthy individuals today. I just saw Selena Gomez recently stayed here. Apparently stays can cost $900 a night, but this high payment seems to be what McLean has always catered to.

[Jo Besser · Rating 2 out of 5]

I'm not sure what I expected to get out of this book, to be completely honest. It was interesting to find out that James Taylor was a patient for a while. As well as Susanna Kaysen, who wrote Girl, Interrupted based on McClean.

I guess if anything, I was more irritated about the elitist mindset of this Hospital. That only the people who could afford the care could be able to stay at McClean. As well as the hospital to dump their "problem" children. I think that's changed since the 60s-70s since there is a need for Mental Health access.

[Joni Markowski · Rating 5 out of 5]

A compelling look into a prominent insane asylum in Massachusetts and the various treatments used throughout the decades.it also includes insurance issues including Medicare and Medicaid and how it altered the care of the insane. I believe it gives insight into the limited care available in mental health today. It makes you want to advocate for better resources in 2020and beyond.

[D]

I think this book tries to be three things at once: a chronological history of Mclean Hospital through the lens of its administrators (and its parent administrators at Harvard University; a gossipy account of McLeans more famous/infamous patients and practitioners, and a compare/contrast of McLean’s treatments and programs with the broader evolution of mental health therapies (and attitudes toward them) from Mclean’s 1811 inception to the turn of the millennium.

I’m probably the audience for at most two of those books, and the gossipy bits are less fun because many of them end grimly. (The material on Plath and Sexton was tough for me to read, even more than I expected). It also seems frankly bizarre to me that Reagan administration policies are not mentioned in the context of moving away from longterm hospitalization toward outpatient care.

[haunt · Rating 4 out of 5]

Incredibly thorough in its account of everything McLean, which is both a blessing and a curse. Beam’s writing is clear but anything but concise, and frequently segues into trivial, often unrelated side notes which may or may not be of interest. Each page is littered with names of individuals mentioned only once, random interjections that don’t connect to the point, and so on. However, some of these rabbit trails are in fact interesting and even useful to know, and you’ll definitely come away with a very broad, inclusive array of information on the subject. I do wish Beam had regularly included sources in footnotes in a more typical APA-type fashion, because some things I would have liked to look up later, but there is a section in the back of the book that details where his information originates (and I believe much of it was in oral form or otherwise unavailable to the public anyway). One thing to note is that this book is not a true account of patients’ experiences at McLean, as the title suggests, though snippets of patient accounts are incorporated throughout. Although a great many aspects of the patient experience are included, the use of only small excerpts of patient recollections tends to make the book read more like an account of the institution itself, albeit well-peppered with anecdotes of patient life, than of the advertised “life and death” inside. I went into the book thinking it would be a highly detailed account of the patients and procedures of McLean, focused heavily on patients’ own memories and accounts of their experience. In the end, it was not as patient-focused as expected, but proved an interesting and valuable, if occasionally tedious, read.

[Nicole · Rating 3 out of 5]

A work of non-fiction cataloging the history of the famous McLean Hospital, a psychiatric facility located in the Boston suburbs, this was a pleasure to read. Especially since I grew up a couple miles from the hospital (had even volunteered there as a young adult), I felt protective of this fine institution and all that it represented. It always seemed a staple of mental health treatment which was well known in the psychiatric circles but otherwise seemed to be a "secret" to others outside of the nearby community. Turns out Beam's novel revealed that this hospital was even more well known than I had suspected, just that this reputation existed a little above my pay grade. The novel catalogues the hospital's 200 year history from its humble beginings to its heyday in the 1900's as a facility providing excellent treatment for those who could afford it. The listing of the rich and famous who sought treatment within its walls is extensive and author Beam does a great job juxtapositing the historical background of the hospital with its evolving treatment modalities, as well as information on some of its more well-known residents. The hospital, much like many psychiatric hospitals across the country, has faced challenges in how it administers care in a changed health care environment and this stepwise progression is depicted nicely by Beam. For those with any training in psychology, medicine, or psychiatry this is a very well researched piece of medical history that is engrossing and factual. Readers without some of this background should not be intimidated by the subject matter or mental health terminology since Beam is able to provide good explanations for all without alienating. Highly recommended.

[Erin · Rating 4 out of 5]

This book was great. I sort of expected it to focus more on the various messed-up therapies common in the days when McLeans was started, but it kept that to a minimum. I found myself saddened that in the current age of "treat 'em and street 'em" therapies, a place like McLeans is having to change what made it essentially the best mental hospital in New England: a place where the mentally ill could take their own time to get better. I was also extremely entertained to learn how many famous people passed through its doors.

I've never been to McLeans, seen the grounds or anything, so I think I'll always picture it the way Olmstead imagined it: sprawling grounds, sparse living facilities (so residents of one ward didn't have to see residents of other wards necessarily), dairy farm, and all the other things that went into making it a universe unto itself.

[Marie · Rating 4 out of 5]

It's probably more of a 3.5...not the most organized book. It is all over the place and choppy (expect more a collection of short stories and it shouldn't bother so much), but it's an interesting glimpse into what used to be one of the most prestigious mental institutions for the wealthy and talented. It's the subject of many famous books/films and housed many famous individuals, Girl, Interrupted, Sylvia Plath/The Bell Jar, Ray Charles, James Taylor, many Harvard educated intellectuals...and a host of others. It also covers the evolution of psychiatric science from the days of lobotomies to the current drug-pushing, managed care marketplace. Quick read.

[Amanda · Rating 3 out of 5]

As a history of McLean Hospital, one of America's premier mental hospitals since it's opening in the 19th century, this book contains a great deal of interesting information. However, that information is tempered by the clunky and hard to follow writing. Although I really enjoyed the information that was presented, most of the writing was so hard to follow that I found myself having to go back and re-read regularly. This really made it hard to truly enjoy the book. In addition, the author did not present the information in an interesting or engaging manner. This book is worth a look because of the sheer amount of information found within, but be prepared for some frustration.

[Stefanie Robinson · Rating 3 out of 5]

This book is about McClean Hospital. I had never really heard much about McClean Hospital, other than it was supposed to be an elite hospital. I learned that Frederick Law Olmstead chose the land that the hospital and surrounding buildings were placed on. I also learned that this hospital provided treatment for some of the most famous and the wealthiest people in the United States. Some people even came from abroad to be treated at this facility. Aside from the hospital and it's fate, we learned about some of the patients and methods of treatment employed at this facility. It was a very educational and interesting read, though I found it a bit boring at times.

[AB · Rating 3 out of 5]

It's interesting material, of course, but the author engages with it in what feels like a very shallow, surface way, and with a bit too much levity. I appreciate some of the humour -- "Crazy people much more pleasant than I expected" is still funny to me now the way it was sixteen years ago -- but I can't help but feel that when you're writing about a place that's essentially a repository of human suffering, a little more gravitas is called for, you know?

[Samantha Penrose · Rating 3 out of 5]

3 1/2 stars.
Instead of sharing excerpts that capture the overall mood, theme, and writing style of the book, I have chosen one line to share. It has little to do with the book as a whole, but it made me smile. It comes from a chapter near the end of the book, titled, 'Physician, Heal Thyself.'
Page 219
"Many admit that they enter the profession to wrestle with their own demons-"to find out what was wrong with me," is a phrase I heard over and over again."

[Tomi · Rating 2 out of 5]

There was some interesting information in this book - who knew Ray Charles was in a mental hospital for awhile? Overall, however, the book just gave a very superficial treatment to what could have been a very interesting story.

[Steven H · Rating 5 out of 5]

MORE THAN JUST THE STORY OF A SINGLE HOSPITAL

Alex Beam (born 1954) is an American writer and journalist, who is a columnist for The Boston Globe; he has written other books such as 'A Great Idea at the Time: The Rise, Fall, and Curious Afterlife of the Great Books,' 'American Crucifixion: The Murder of Joseph Smith and the Fate of the Mormon Church,' 'Fellow travelers,' etc.

He wrote in the first chapter of this 2001 book, "Mental health is the question for which we have yet to learn the answer. This book is, in part, a history of that question, and the many suggested answers. But it is also a book about people... this is a book about the men and women who needed shelter more than most of us, or who, in some cases, were more honest about their need for protection than we are. And about an institution that provided the shelter, imperfectly, in our imperfect world." (Pg. 14-15)

He notes, "Starting in the 1980s, neither private insurers nor government programs like Medicare and Medicaid were willing to finance the lengthy stays and staff-intensive therapy that had been McLean's specialty for almost two centuries. Whereas once well-heeled patients had checked in for months' if not years' worth of expensive, residential therapy, the standard admission was now the 'five-day': time enough for a quick psychiatric diagnosis, stabilization on drugs, and release 'into the community,' meaning to a halfway house or... back to one's family. By the early 1990s, McLean was losing millions of dollars a year." (Pg. 2)

He observes, "The teenagers who invaded McLean in the late 1960s and early 1970s changed the character of the hospital forever. They blasted their music in the halls, they took dope, and they engineered frequent escapes, which almost always resulted in a slump-shouldered taxicab ride back to the hospital from either Waverly or Harvard Square." (Pg. 211-212)

He asks, "Why do psychiatrists kill themselves? Many admit that they entered the profession to wrestle with their own demons---'to find out what was wrong with me,' is the phrase I heard over and over again... [two researchers] hypothesized that one in every three psychiatrists suffered from a mood disorder like mania or depression. This, they wrote, is three times the incidence in the general population... Mental illness can be infectious. Nurses, psychiatric aides and therapists are hardly indifferent to their surroundings in the mental hospital, and many of them break down themselves." (Pg. 219)

This book will be of great interest to anyone interested in mental hospitals, or the treatment of those with mental problems.

[William Nist · Rating 4 out of 5]

This year I have read two books chronicling the history of two major American Mental Hospitals--Bellevue and McLean. This book is about McLean Hospital outside of Boston. The two hospitals could not be more different. Bellevue is a public hospital taking all cases while McLean was a hospital for the affluent affiliated with Harvard.

McLean offered the rich and famous a genteel, gracious milieu for healing and restoration. The grounds were filled with mansions and gardens (even a golf course), housing the residents in comfortable suites instead of wards. McLean did offer all the innovations in psychiatry that rolled out over the decades (gruesomely detailed), but the tone was always one of elite professionalism. Many famous residents included Sylvia Plath (who committed suicide), James Taylor and Ray Charles.

Of course, about 40 years ago, the mental health field turned away from this type of mental institution, when the era of psychopharmacology began. These residential hospital are now rare, and Mclean also had to adjust. It has sold off most of its 250 acre campus, and now visits are for a week or so instead of lifetime!

The history if fascinating because it is both a social history and the history of a medical specialty. The book offers a condensed biography of all the major characters administrating this institution.

Read both books together for a comprehensive look at the American Psychiatric establishment since the early 19th century.

Bellevue: Three Centuries of Medicine and Mayhem at America's Most Storied Hospital

[Anna Engel · Rating 3 out of 5]

[3.5 stars]
Having done my undergrad thesis on the social and medical aspects of mental illness among women in the 19th century, I was excited to read this book. Overall, though, I have mixed feelings. On the negative side, a lot of the text is a who's-who of McLean residents over the years. On the positive side, Beam sometimes added information on the social drivers of mental illness (e.g., the 1960s) and also the development of treatments.

It's like you're walking around the campus and your guide is pointing out all the famous, infamous, and notoriously noisy residents. It's vaguely chronological and broadly thematic. So the narrative moves through broad eras to the modern day and each chapter has a focus—poets of the day, female writers, singers, the slackers of the 1960s. McLean catered to the upper classes and sheltered them (or hid them away) from the real world. McLean's purpose in the world of mental health seems to have been primarily concerned with preserving its image as a depository for the insanely rich insane.

[Ronald Koltnow · Rating 4 out of 5]

Gracefully Insane was Boston Globe journo Alex Beam's first non-fiction book (few know that he had written a c0uple 0f novels before this). It may be his best. Using the country club setting of McLean Psychiatric Hospital as a springboard, Beam traces the history of the treatment of mental patients. In olden times, lunatics were chained to walls, frightened to near death, and dunked in water until they lost consciousness. Then came insulin and electro-shock therapy. McLean was a center for millieu therapy, a way of making the filthy, yet insane, rich feel at home. The Mayflower Madcaps played golf, socialized, and went on their loony way. Beam gives us case histories and portraits of the patients and the doctors; Can you tell which was the most in need of psychiatric care? As the years progress and the Back Bay eccentrics are replaced by drug-addled brats, the book loses some steam. Yet, this is a fascinating look at how little we understand mental illness and why we will never know what works effectively on those who suffer from it.

[Ryan Johnson · Rating 4 out of 5]

This book proved to be very profound. Working in the field since graduating High School, working at 4 different State Hospitals in Mass, reading about Mcleans was like reading about the rich and famous though very different from the places I've worked, their were also many similarities mostly notably the architecture and quality of building materials, which in time all turn back to dust and either melt into the ground, get bulldozed over or simply get re-used in a manner no befitting its history. As with many books I read, this book has certainly given me many dog eared pages to go back and get the names of Authors and Books on the subjects pertinent to this book. I also need to catch up on the works of the Famous Mclean Graduates, its almost sick just how many poets and talented individuals thought admission to Mcleans was a "Must Have" in their resumes, but whatever.

Great Book.

[Marianne · Rating 5 out of 5]

A great book outlining the history of mental health treatment in the United States. Of course, it is also the history of the luxurious institution for the rich (still open today if you can pay for it yourself). It's filled with engrossing stories and is a great beginning for someone interested in finding out where we're going wrong in treating mental health issues today. Interestingly or ironically, the last chapter discusses insurance companies and insurance coverage and health care coverage is on the Sunday morning talk shows this very day. Once again, I read a book with a historical perspective only to find that we haven't really changed for the better.