The stigma of mental illness 

Book Review

From Under the Cloud at Seven Steeples 1878-1885: The Peculiarly Saddened Life of Anna Agnew at the Indiana Hospital for the Insane
Lucy Jane King, M.D.
Guild Press; $24.95

If you're curious about daily life in an insane asylum circa late 19th century, my prescription for you is to pick up a jewel of a book called From Under the Cloud at Seven Steeples by Lucy Jane King, M.D.

King, by near serendipity, was handed a manuscript called From Under the Cloud written in 1886 by Anna Agnew. Anna was a late 19th century mother and homemaker from Vincennes, Ind., who wrote about her struggle with the mental illness that prompted her institutionalization at the Indiana Hospital for the Insane in the fall of 1878. The hospital was later named Central State Hospital.

Intelligently and compassionately written, the book's focus is on Anna's seven-year hospitalization, from 1878-1885. King lets Anna retell her story more than 100 years later, adding contemporary viewpoints on mental illness, the history of psychiatry and reform.

There are also several interesting tidbits on Indiana history, which add an additional layer of interest for the Indy reader. "Seven Steeples" refers to the seven of eight prominent steeples that were visible from the road, crowning the building where Indiana residents went when, by law, they were deemed insane.

But like the children's hand game of "steeples and peoples," excitement builds when we get to see who is inside the architectural structure, and more specifically, what happens to them while they stay there.

King includes Anna's reflections on incidents of mental and physical abuse. At times she was referred to as "the devil," and "a fine subject for the dissecting table."

One incident describes how Anna was pulled and dragged around by one arm to the dining hall while she lay helpless on the floor. Then a supervisor ordered patients to spit on her. When she attempted to spit back at the supervisor, she was brutally attacked.

Yet not all of Anna's attendants were cruel. There are vivid scenes with her more compassionate caregivers. Nearing the end of her stay at the hospital, one doctor even took her and a group of patients to the circus. These are the type of mental health professionals King believes we need to help care for and support the mentally ill.

King's purpose for writing the book is the same as Anna's: to tell a story that addresses the stigma of mental illness. More than 100 years have passed since Anna wrote her story, From Under the Cloud, which she also had published and circulated. With the help of King, who is a clinical professor of psychiatry, emeritus, at Indiana University School of Medicine, Anna's work has been reborn.

In her introduction, King writes of Anna, "She courageously spoke out against the stigmatization of "insanity." Her message is even more pertinent now that treatment is available but underutilized."

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