Medicine, Health Care and Philosophy

, Volume 16, Issue 3, pp 605–613 | Cite as

Perspectives on Erving Goffman’s “Asylums” fifty years on

  • John Adlam
  • Irwin Gill
  • Shane N. Glackin
  • Brendan D. Kelly
  • Christopher Scanlon
  • Seamus Mac SuibhneEmail author
Short Communication


Erving Goffman’s “Asylums” is a key text in the development of contemporary, community-orientated mental health practice. It has survived as a trenchant critique of the asylum as total institution, and its publication in 1961 in book form marked a further stage in the discrediting of the asylum model of mental health care. In this paper, some responses from a range of disciplines to this text, 50 years on, are presented. A consultant psychiatrist with a special interest in cultural psychiatry and mental health legislation, two collaborating psychotherapists in adult and forensic mental health, a philosopher, and a recent medical graduate, present their varying responses to the text. The editors present these with the hope of encouraging further dialogue and debate from service users, carers, clinicians, and academics and researchers across a range of disciplines.


Institutionalisation Mental health Asylums Psychiatry Mental illness Hospitals 


  1. Adlam, J., Pelletier, C., and C. Scanlon. 2010. ‘A Citizen of the World’: Cosmopolitan responses to metropolitan models of social inclusion. Unpublished Conference paper presented at ‘Education and Citizenship in a Globalising World’, Institute of Education/Normal University of Beijing, London, November 2010.Google Scholar
  2. Adlam, J., and C. Scanlon. 2010. Consulting to the out-group. Forensische Psychiatrie und Psychotherapie 17(3): 66–81.Google Scholar
  3. Agamben, G. 1995 [1998]. Homo Sacer: Sovereign power and bare life. Stanford: Stanford University Press.Google Scholar
  4. Agamben, G. 2003 [2005]. State of exception. Chicago: University of Chicago.Google Scholar
  5. Arendt, H. 1963 [2006]. Eichmann in Jerusalem. London: Penguin.Google Scholar
  6. Bacik, I. 2001. A human rights culture for Ireland? In Towards a culture of human rights in Ireland, ed. I. Bacik and S. Livingstone, 1–45. Cork: Cork University Press in association with the Centre for Cross Border Studies (Armagh).Google Scholar
  7. Bauman, Z. 2000. Liquid modernity. Cambridge: Polity.Google Scholar
  8. Bell, V. 2010. On Fernando’s photograph: On the bio-politics of Aparición in contemporary Argentina. Theory, Culture and Society 27(4): 69–89.Google Scholar
  9. Bion, W.R. 1961. Experiences in groups. London: Routledge.CrossRefGoogle Scholar
  10. Brown, G., Kainth, K., Matheson, C., Osborne, J., Trenkle, A., and Adlam, J. 2011. An hospitable engagement? Open door psychotherapy with the socially excluded. Psychodynamic practice 17(3): 307–324.Google Scholar
  11. Brown, G., and Walker, J. 2010. Prison language as an organisational defence against anxiety. In Psychiatry in prisons: A comprehensive handbook, ed. S. Wilson and I. Cumming. London: Jessica Kingsley.Google Scholar
  12. Carel, H. 2008. Illness: The cry of the flesh. Stocksfield: Acumen.Google Scholar
  13. Chodoff, P. 1984. Involuntary hospitalisation of the mentally ill as a moral issue. American Journal of Psychiatry 141: 384–389.PubMedGoogle Scholar
  14. Cooper, A., and Lousada, J. 2005. Borderline welfare: Feeling and fear of feeling in modern welfare. London: Karnac.Google Scholar
  15. Dartington, T. 2010. Managing vulnerability: The underlying dynamics of systems of care. London: Karnac.Google Scholar
  16. Declerk, P. 2006. On the necessary suffering of the homeless. In Divided cities: The Oxford amnesty lectures 2003, ed. R. Scholar. Oxford: Oxford University Press.Google Scholar
  17. Department of Health. 1984. The psychiatric services—planning for the future. Dublin: The Stationery Office.Google Scholar
  18. Dorling, D. 2010. Injustice: Why social inequality persists. Bristol: Policy.Google Scholar
  19. Expert Group on Mental Health Policy. 2006. A vision for change: Report of the expert group on mental health policy. Dublin: The Stationery Office.Google Scholar
  20. Fielding, H. 1743. A Dialogue between Alexander the Great, and Diogenes the Cynic. In The Works of Henry Fielding, Esq. With an Essay on his Life and Genius. ed. A. Murphy [A New Edition Edited by James P. Browne, M.D. (Edinb.) in Ten Volumes. Vol. VIII]. London. Bickers and Son. H. Sotheran and Co. [,_and_Diogenes_the_Cynic. Downloaded 1 June 2010].
  21. Finnane, P. 1981. Insanity and the insane in post-famine Ireland. London: Croon Helm.Google Scholar
  22. Foster, A., and V.Z. Roberts, ed. 1998. Managing mental health in the community: chaos and containment. London: Routledge.Google Scholar
  23. Foucault, M. 1961 [2001]. Madness and civilisation. London: Routledge Classics.Google Scholar
  24. Furnham, A. 1991. Watch and ward. BMJ 302: 667.CrossRefGoogle Scholar
  25. Gilligan, J. 1996. Violence: Reflections on our deadliest epidemic. London: Jessica Kingsley.Google Scholar
  26. Glouberman, S. 1991. Keepers: Inside stories from total institutions. London: King’s Fund.Google Scholar
  27. Goffman, E. 1961. Asylums: Essays on the situation of mental patients and other inmates. New York: Anchor Books, Doubleday and Company.Google Scholar
  28. Hansard. 2010. House of Commons Hansard Debates for 03 November 2010 (pt 0001). Downloaded from Accessed 27 June 2011.
  29. Healy, D. 1996. Irish psychiatry in the twentieth century. In 150 Years of British psychiatry. Volume II: The aftermath, ed. H. Freeman and G.E. Berrios, 268–291. London: Athlone Press.Google Scholar
  30. Hopper, E. 2003. Traumatic experience in the unconscious life of groups: The fourth basic assumption: Incohesion: Aggregation/Massification. London: Jessica Kingsley.Google Scholar
  31. Hopper, E. 2012. Trauma in organisations. London: Karnac.Google Scholar
  32. Inspectors of Lunatics. 1893. The forty-second report (with appendices) of the inspector of lunatics (Ireland). Dublin: Thom and Co. for Her Majesty’s Stationery Office.Google Scholar
  33. Jones, K. 1978. Society looks at the psychiatrist. British Journal of Psychiatry 132: 321–322.PubMedCrossRefGoogle Scholar
  34. Kelly, B.D. 2004. Mental health policy in Ireland, 1984–2004: Theory, overview and future directions. Irish Journal of Psychological Medicine 21: 61–68.Google Scholar
  35. Kelly, B.D. 2007. The Irish mental health act 2001. Psychiatric Bulletin 31: 21–24.CrossRefGoogle Scholar
  36. Kelly, B.D. 2008a. Mental health law in Ireland, 1821–1902: Dealing with the “increase of insanity in Ireland”. Medico-Legal Journal 76: 26–33.PubMedGoogle Scholar
  37. Kelly, B.D. 2008b. Mental health law in Ireland, 1945–2001: Reformation and renewal? Medico-Legal Journal 76: 65–72.PubMedGoogle Scholar
  38. Kelly, B.D. 2008c. The Mental Treatment Act 1945 in Ireland: An historical enquiry. History of Psychiatry 19: 47–67.PubMedCrossRefGoogle Scholar
  39. Kelly, B.D., and S. Guruswamy. 2006. A change of vision? Mental health policy in Ireland. Irish Medical Journal 99: 164–166.PubMedGoogle Scholar
  40. Levi-Strauss, C. 1955. Tristes tropique. Harmondsworth: Penguin.Google Scholar
  41. Lyons, F.S.L. 1985. Ireland since the famine. London: Fontana.Google Scholar
  42. MacSuibhne, S. 2009. Medical classics: Asylums: Essays on the social situation of mental patients and other inmates. BMJ 339: 867.Google Scholar
  43. Mays, N., and C. Pope. 1995. Qualitative research: Observational methods in health care settings. BMJ 311: 182–184.PubMedCrossRefGoogle Scholar
  44. Merriman, H. 2002. Erving Goffman revisited. BMJ 325: 817.CrossRefGoogle Scholar
  45. Munro, R. 2006. China’s psychiatric inquisition: Dissent, psychiatry and the law in post-1949 China. London: Wildy, Simmonds and Hill Publishing.Google Scholar
  46. O’Brien, F. 1939 [2000]. ‘The Workman’s Friend’, in At swim-two-birds. London: Penguin.Google Scholar
  47. O’Neill, A.-M. 2005. Irish mental health law. Dublin: First Law.Google Scholar
  48. Payne, C., and O. Sacks. 2009. Asylum: Inside the closed world of state mental hospitals. Cambridge, Massachusetts and London, England: The Massachusetts Institute of Technology Press.Google Scholar
  49. Penney, D., P. Stastny, and L. Rinzler. 2008. The lives they left behind: Suitcases from a state hospital attic. New York: Bellevue Literary Press.Google Scholar
  50. Persaud, R. 1993. Home street home. BMJ 306: 726.CrossRefGoogle Scholar
  51. Pope, C., and N. Mays. 2009. Critical reflections on the rise of qualitative research. BMJ 339: 737–739.Google Scholar
  52. Rapoport, R.N. 1960. Community as doctor: New perspectives on a therapeutic community. London: Tavistock.Google Scholar
  53. Reeves, S., M. Albert, A. Kuper, and D.B. Hodges. 2008. Why use theories in qualitative research? BMJ 337: 631–637.CrossRefGoogle Scholar
  54. Reynolds, J. 1992. Grangegorman: Psychiatric care in Dublin since 1815. Dublin: Institute of Public Administration in association with Eastern Health Board.Google Scholar
  55. Robins, J. 1986. Fools and mad: A history of the insane in Ireland. Dublin: Institute of Public Administration.Google Scholar
  56. Scanlon, C., and J. Adlam. 2008. Refusal, social exclusion and the cycle of rejection: A cynical analysis? Critical Social Policy 28(4): 529–549.CrossRefGoogle Scholar
  57. Scanlon, C., and J. Adlam. 2011. Cosmopolitan minds and Metropolitan societies: Refusal and social exclusion revisited. Psychodynamic Practice 17(3): 241–254.Google Scholar
  58. Scanlon, C., and J. Adlam. 2012. Disorganised responses to refusal and spoiling in traumatised organisations. In Trauma in organisations, ed. E. Hopper, 151–172. London: Karnac.Google Scholar
  59. Shorter, E. 1997. A history of psychiatry: From the era of the asylum to the age of Prozac. New York: Wiley.Google Scholar
  60. US Bureau of the Census. 1975. Historical statistics of the United States, Colonial Times to 1970, bicentennial edition, part 2. Washington DC: GPO.Google Scholar
  61. Viney, M. 1968. Mental illness: An enquiry. Irish Times, 23–30 October.Google Scholar
  62. Walsh, O. 2004. Gender and insanity in nineteenth-century Ireland. Clio Medica 73: 69–93.PubMedGoogle Scholar
  63. Walsh, D. 2006. Mental illness in Ireland and its management. In Health policy and practice in Ireland, ed. D. McCluskey, 29–43. Dublin: University College Dublin Press.Google Scholar
  64. Williamson, A. 1970. The beginnings of state care for the mentally ill in Ireland. Economic and Social Review 10: 280–291.Google Scholar
  65. Wilkinson, R., and K. Pickett. 2009. The spirit level: Why more equal societies almost always do better. London: Allen Lane.Google Scholar
  66. Zizek, S. 2008. Violence. London: Profile.Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • John Adlam
    • 1
  • Irwin Gill
    • 2
  • Shane N. Glackin
    • 3
  • Brendan D. Kelly
    • 4
    • 5
  • Christopher Scanlon
    • 6
  • Seamus Mac Suibhne
    • 7
    • 8
    Email author
  1. 1.Department of PsychotherapySt Thomas’ HospitalLondonUK
  2. 2.Department of PaediatricsChildren’s University HospitalDublinIreland
  3. 3.Department of PhilosophyTrinity College DublinDublinIreland
  4. 4.Department of Adult PsychiatryUniversity College DublinDublinIreland
  5. 5.Mater Misericordiae University HospitalDublinIreland
  6. 6.Maudsley Foundation NHS TrustLondonUK
  7. 7.Department of PsychiatrySt Luke’s HospitalKilkennyIreland
  8. 8.School of MedicineUniversity College CorkCorkIreland

Personalised recommendations