Fans pick 100 books like The Last Asylum

Although Madhouse reads like a Stephen King novel, everything it recounts is actually true. At the turn of the twentieth century, Henry Cotton, a psychiatrist and the medical director of the New Jersey State Hospital at Trenton, thought he had found the solution to mental illness. His unconventional approach to treatment, however, left more people dead and disfigured than effectively cured. Andrew Scull’s deeply-researched narrative of Cotton’s medical interventions is a horrifying, yet entirely gripping, account of the lengths people have gone in the name of psychiatric treatment.

This classic account by a renowned sociologist is critical reading for those interested in the anti-psychiatry movement, a crusade that viewed psychiatry as more coercive than therapeutic and, in some cases, questioned the reality of mental illness itself. For one year, Goffman embedded himself in St. Elizabeth’s mental hospital in Washington, DC, where he ultimately concluded that the defining features of the asylum – similar to those of prisons and other “total institutions” – did more to shape the patient’s behavior than the supposed illness for which the patient had been admitted in the first place. Goffman’s observations left a significant impact on popular ideas about asylum care and helped contribute to widespread deinstitutionalization several decades later.

I love this book first and foremost because it is essentially the OG of madwomen narratives. Written in 1892, it is a super-creepy, sensory, trippy exploration of one woman’s sanity slowly being shredded by male medical “expertise”—in this case, a doctor’s prescription for postpartum depression: utter isolation in a bedroom with no intellectual stimulation... in order to alleviate postpartum depression (?!). Unsurprisingly, rather than “recovering,” the heroine drags readers down a terrifying rabbit hole of hallucination, self-destruction, and—ultimately—murder.

It’s a masterful, Hitchcockian deep dive into psychosis written over a half-century before Psycho. But it’s also an extremely satisfying example of feminist revenge-writing; Perkins not only drew on her own experience after suffering this “treatment” but sent a copy directly to her practitioner after its publication. Pow!

I found it fascinating to read Ethan Watters’ analysis of how American concepts of mental illness are exported and globalized, usually with disastrous consequences.

During a cultural moment when social justice, cultural relativism, and imperialism have entered the public consciousness, this book is more relevant than ever. With its focus on mental health labels and diagnoses, specifically, this book helped me understand how our notions of illness, psychological distress, and mental health don’t necessarily translate into other societies.

I loved thinking about familiar diagnoses here in the US, such as anorexia, depression, and PTSD, and reading about well-meaning initiatives that bring these labels into foreign contexts. By attempting to superimpose our conception of mental illness onto people in other countries, we inadvertently diminish the social networks and resilience of the societies we aim to help.

As a therapist who is sometimes weary of our cultural stories about psychological suffering, this… show more.

I read this book during my school days, which we are often told are the best of our lives. I enjoyed school, overall, but did encounter more than my fair share of bullies and vindictive teachers. Reading in the school library became my favourite escape, and I devoured this book in one lengthy sitting. I was fascinated and appalled in equal measure by secret society The Vandals, who made the kids at my school look like rank amateurs! After reading this book, the reader is left shell-shocked and wondering if it’s better to comply or to ‘disturb the universe’ as Cormier provocatively puts it.

This book stayed with me long after I made it my Summer read that year during a blisteringly hot July. It details a darkly destructive love affair between Stella, the wife of a man running an asylum, and Edgar, a murderer who is incarcerated there. McGrath’s vivid descriptions of the asylum and its grounds reframe the gothic tradition through an unflinching, contemporary lens. The doomed obsession of the novel’s star cross’d lovers reminds us that our own hearts can become institutionalised if we do not balance passion with compromise.

A man called “Pepper,” who may or may not suffer from mental illness, ends up in a locked mental ward in Queens, New York, where the entire novel takes place.

A beast, who the patients believe is the devil, comes out at night, assaulting and sometimes killing patients. Patient deaths are chalked up to suicide. The engaging, quirky characters—drugged to the gills while warehoused and essentially untreated in a public hospital—share the defining feature of being low-income and unprotected from both the supernatural and human forces that would destroy them. They must take matters into their own hands to protect themselves.

I appreciated the theme of how marginalization and isolation presented as much terror here as the supernatural. Yet, the hope and humor of the characters also kept me engaged and frequently smiling.

A deeply unsettling book, The Hospital occupies those liminal spaces that lie somewhere between illness and health, memory and madness. The narrator is admitted to the hospital to receive treatment for an unspecified disease and finds that the labyrinthine corridors and wards match those of his mind. Casablanca-born author Ahmed Bouanani was confined to a hospital bed for six months after contracting tuberculosis. Part hallucinatory fever dream and part half-remembered memoir, the book is a unique blend of Moroccan history and surrealist horror.

I like to write about public Victorian asylums – where the bulk of English people with mental illnesses were admitted.  But the counterpoint is the private system, where the poor, rich mad spent their time in nice surroundings with wacky treatments. Sarah Wise captures this perfectly through a real-life investigation of the people in the attic – think Jane Eyre, or The Woman in White – and how the law sought to protect them.

Long before the Victorian asylums, there was Bethlem – London’s ancient hospital for lunatics. Like Broadmoor, Bethlem also looked after high-profile criminals, but within a private and charitable institution that was mostly for the capital’s waifs and strays. Bedlam gives you a sense of how mental health developed as a concept from the medieval period to the present day.