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Policy and Program Notes: Photographing the (De)institutionalization of the Mentally Ill, Part 1

Photographers have long given their attention to lonesome, isolated cityscapes. Starting in 1899, for example, the French photographer Eugene Atget rose early each morning for 28 years to capture the empty streets, everyday storefronts, and old buildings of turn-of-the-century Paris. Paris was then in the midst of dramatic change. Neighborhoods were disappearing to make room for the Louvre and other large edifices.  Atget was aghast, preferring shadow-filled alleyways and upturned carts. In his photographs, images of people were rare, and often faded, more a memory than a lively presence. Atget did his best to preserve what soon would be lost, leaving artists, social historians and other observers to figure out what was left behind, and what was brought into being.

More recently, abandoned asylums and mental hospitals, and to a lesser extent prisons, have become the subject of photographers' interests. The Oregon State Hospital in Salem, Oregon is a good example of an institution that has been the subject of such attention, and therein rests an interesting story, the final draft of which journalists and historians will eventually tell.

Deinstitutionalization of the mentally ill occurred more or less at the same time, in the mid-1960s, that the general public was starting to learn about the plight of the institutionalized mentally ill. At about this time, Ken Kesey's novel One Flew Over the Cuckoo's Nest, published in 1962, gained widespread popularity, and eventually the book became a film. Both heightened the level of national dialogue about mental illness and (de)institutionalization.

In the film, which was released in 1975, Jack Nicholson starred as Randle Patrick McMurphy, a petty criminal sentenced to a work camp for statutory rape. McMurphy, always the con artist, played the system for a transfer for evaluation at a state mental hospital to avoid hard labor and to serve his sentence in what he expected would be a relatively relaxed environment. Louise Fletcher starred[AEP1]  as Mildred Ratched, a calm, tyrannical nurse who routinely humiliated her group therapy patients. McMurphy's stay at the mental hospital did not go as expected, as authoritarianism triumphed over anarchy.

Kesey wrote  One Flew Over the Cuckoo's Nest based on his experiences working in a veteran's hospital in Palo Alto, California while he was attending Stanford University. In the book itself, the mental ward, as much a metaphor as a place, was located in a nameless Oregon hospital, but in the film it took place at the Oregon State Hospital. As it's happened, two intriguing photo books have been published over the years about a particular mental ward at the Oregon State Hospital.

Ward 81

In 1975, photographer Mary Ellen Mark was sent on a magazine assignment about the making of One Flew Over the Cuckoo's Nest. While there, she met briefly with women on the hospital's women's ward, then the only such facility for "dangerous" women in Oregon. Some months later, in February 1976, Mary Ellen Mark, who was then less well known than she is today, and the psychologist Karen Folger Jacobs went back to the women's ward of the Oregon State Hospital, where they lived for 36 days. In a recent republication of their book, Ward 81 (Damiani, 2008), which was originally released in 1979, Mark recalls, "Karen Jacobs and I slept in an old deserted ward next to Ward 81. We would lock ourselves in our little cells every night. I am absolutely sure that this deserted ward was haunted. I would hear strange sounds all night in the empty hallway and above me, even though we were on the top floor. I was really happy that I could lock my cell and that Karen was in the cell next to mine - this was definitely very scary. In time, we settled into the routine at Ward 81. We ate our meals with the women (except for a few excursions to McDonald's for a special treat). We went to all of the activities - swimming; the weekly dance with the men's ward (which lasted 15 minutes) and of course joined the women in the endless hours in front of the TV."

The women on Ward 81 were living in unnatural quarters and not surprisingly they often look unnatural themselves, although the line between normalcy and deviancy is hard to decipher clearly. They are twisted in ball-like formation on the floor of the ward, where they are also seen frolicking in one fashion or another. They puff on cigarettes, they pray, and they prance about. They hold their legs close to them, they hold their heads tightly, and they hold themselves together as best they can. They peek into mirrors, through slots in doors, from under covers, and out of windows. They dance, sometimes alone, and other times with men from visiting wards. They play in the halls, in beds, and in baths. They express themselves sexually as well as madly.

The architecture and interior design of this mental ward for women are hard to discern. We see little of the whole, and patches of everything else. We see wire mesh barriers on windows and differently shaded tiles on the floor, with mutely colored walls. Little looks comfortable; much looks easily mopped. Everything is black-and-white.

In 1979, Karen Folger Jacobs, the psychologist, concluded, "We identified with the fragility and the strength of these women we came to love, these adopted sisters of ours. They are the women we might have been, the women we might one day become."

In c/o Ward 81

Women are no longer living on Ward 81, which has long since been emptied, swept, and left abandoned. Occasionally photographers ask entry, but most are denied permission. Undoubtedly this is because of liability concerns rather than being cautious about unwanted publicity. Indeed, Ward 81 has actually gotten a good share of publicity, so it's probably more correct to ask why the facility is so (comparatively) open.

One person given a window of opportunity to enter Ward 81 was Bill Diodato, a New York City photographer. A few years after 9/11, Diodato, who worked in the shadows of the Twin Towers, came across a newspaper story about the Oregon State Hospital. Like many New Yorkers, the aftermath of 9/11 occasionally left him feeling depressed. The mental health consequences of 9/11 on those living or working around the destruction of the Twin Towers is, as far as I know, a relatively untold story. But in seeing news photos of the hospital's dusty mental wards, something opened up within him. He decided to inquire about photographing them further.

"Entering Ward 81," Diodato reports of his 2005 trip to the Oregon State Hospital, "I found each room vibrated with pastel colors, some walls even adorned with curiously upbeat art from the patients. All this beauty was contrasted with a dense chalky air, earthy odor and constant crackling of debris beneath my feet."

Few signs of life actually remain in the 40 photographs that comprise In c/o Ward 81 (Golden Section Publishers, 2010), Diodato's austere, yet occasionally (surprisingly) festive exhibit book of his several day stay on the ward. Diodato had only a few days to work on taking photographs for this project, so the tour is quick. Opening Diodato's book you immediately confront the lightly-faded pink locked door to Ward 81. Then, you're inside. Diodato did not have much time to plan his approach, so he walked down one side of the ward's hallway, and then back up the other side. Ward 81 was small, although some rooms are clearly bigger than others. The smaller rooms have bright pastel colors, making the place seem lively, although this is clearly not the case. In the larger rooms, dayrooms perhaps, all that you might have seen on the walls has been stripped away, drawers built into the walls have been left hanging out, and closet doors in the pantry are left ajar. Floor tiles have warped upwards, wall paint has peeled, and ceiling plaster has fallen, chip by chip, to the floor.

Colors in some of the photographs are pallid, which was actually the case. At one point in time, these rooms were designed with a purpose: isolation, comfort, separation, safety. "The idea of enclosure and detachment serving as a safe haven to women in need was perplexing." Diodato writes in his brief introduction.  

"I wanted to know the stories of the women who lived in these rooms," he says. Yet the women are long gone. He speaks with Mark Ellen Mark, who writes an introduction to this volume, as she had met them some decades ago. But she does not know their stories either.

"My intention in publishing these images," writes Diodato, "is to present the physical crumbling and decaying cells, which represent the end of old, corrupt, poorly run asylums." The closing of Ward 81, Diodato suspects, brought "a sense of closure for the women."

Future Vision

Several years ago, a state legislator in Oregon commented on the fate of those who once lived at the Oregon State Hospital: "They lived there. And then often people forgot them. They just took them there and it was over." But the state mental hospital still holds its ground. Much of it is now in considerable decay and unusable. But recently a new building was built that facilitates current models of mental health treatment to make life inside much like life outside. Almost all the patients are committed involuntarily.

Photographer Bill Diodato can be reached by phone at (212) 563-1724, by e-mail at

Posted Fri, Mar 11 2011 4:19 PM by Tracey Vessels


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