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Drunkard's Refuge: The Lessons of the New York State Inebriate Asylum (review)

Ireland and England (in the gendered nature of industrial development, and in the relative absence of a private mad-trade, respectively) could have led to an equally cogent analysis of how the persistence of traditional family forms of care intersected with the rise of the asylum. In other words, her findings have great potential for contributing to the current discussion about the “decentering” of the Victorian asylum. But once Michael starts the story of the Denbigh Asylum, she stops considering what is in her own view (in chapters 1 and 2) a major and enduring alternative to institutional care. To take another example, it is clear from Michael’s chapter “1874–1914” that infrastructure inefficiencies in the asylum—tremendous overcrowding, the heavy use of “soft” forms of mechanical restraint and of seclusion, and the resort to workhouses—did not make Denbigh an especially happy place for many patients (as well as staff). Although it is likely that most of the asylum’s workers were doing their best under very trying circumstances to “relieve the sufferings of its patients” (p. 2), this does not preclude the historian from a more critical assessment of the social, political, and economic relations that created this unfortunate state of affairs. This book is well researched and pioneering, and it opens up many avenues for reconsidering the history of mental health in Wales and elsewhere. It ought to stimulate Michael, and other researchers, to delve more deeply into the important issues that the book surveys.