The definition of insanity is building the same structure over and over again hoping for different results. Carla Yanni’s Architecture of Madness is a history of how a few medical minds tried to cure the world of insanity through certain architectural principles. Many thought that with the right combination of airflow, room placement, and natural environment, the thoughts that plagued a troubled mind would be washed away. Yanni’s look at the timeline of asylum and hospital construction from the mid-1800’s through the mid-1900’s is as interesting as it is infuriating. Very little credence was paid by medical “professionals” on actually looking inward; only grandeur was considered. This led to ever-expanding buildings on ever-expanding tracts of land, but no real results. If you’re into niche architectural trends, this one is a good read; if not, there’s not much else for you here. ( )

The Architecture of Madness is a really interesting look at the link between building design and the treatment of the mentally ill in (mostly) the US. Way before Prozac, before even Thorazine, and between the profoundly inhumane treatment eras of the 18th and mid-20th centuries, psychiatrists reasoned that the best way to treat mental illness was to have patients live in relaxed, outdoorsy, open settings. Places where they could be with nature, be productive, and not simply be locked away in a dirty cell until the end of time. This is where influential figures such as Kirkbride came in, who designed probably the most famous psychiatric hospitals in US history.

Of course, eventually, overcrowding became a problem, turning the very buildings that were supposed to help treat mental illness back into a system of warehousing people in deplorable conditions. The introduction of psychiatric medications such as Thorazine and removal of funding away from state hospitals led to the ultimate demise of many of these psychiatric hospitals, although some are still around today.

This book was rather academic (which is to be expected) and at times hard to slog through, but I found the ultimate question to be very compelling: was the architecture of the buildings helpful, or were the odds stacked against them in a way that disallowed us from even answering that question?

The author argues that after deinstitutionalization, architecture no longer factored into the treatment of the mentally ill. I actually disagree somewhat: one need only take a trip to any major city in the US to see benches that are equipped with unnecessary handles every foot or so, spikes driven into the ground near places one could curl up to sleep at night, purposefully uncomfortable bus shelters, etc. An entire subset of urban design has arisen to make the homeless go elsewhere, and the sad fact is that kicking the mentally ill out of state hospitals left most of them no other option than to live on the streets. Of course, the issues of the homeless mentally ill, the hospital to jail/prison pipeline, and other horrific consequences of deinstitutionalization are best left to (and are) addressed in other books. ( )