Mental health experts have lost touch with the benefits of old-fashioned insane asylums, where patients once enjoyed a sense of community and jobs like cleaning and farming, Oliver Sacks writes in the New York Review of Books. Touching on a new book of Christopher Payne photographs called Asylum—which offers "a mute and heartbreaking testimony" to "once-heroic structures"—Sacks argues that modern state hospitals, which rely on antipsychotic drugs, ignore "the benign aspects of asylums."
Drugs used in today's hospitals may stop delusions and hallucinations, but leave subtler symptoms like apathy untouched—and lead to patients being discharged and readmitted carousel-style. Meanwhile, "patients' rights" laws prevent them from working, so they sit like zombies "in front of the now-never-turned-off TV." For now, only a clubhouse in New York and a few residential communities for the mentally ill offer hope that "even the most deeply ill people… may be enabled to live satisfying and productive lives."
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