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Erving Goffman's Asylums (1961), a participant-observational study of St. Elizabeths Hospital in Washington, DC, was one of the first sociological examinations of the social situation of mental patients. In the mid-1950s Goffman sought to learn about the world of the patient, the subjective experience of hospitalization, and not the world of the staff. He posed as an employee of the hospital for a year, an assistant to the athletic director, and gathered ethnographic data on selected aspects of patient social life. Quantitative measurements, control groups, and statistical evidence were not utilized. Goffman claimed that in order to depict the patient's situation faithfully it was necessary for him to present a partisan view. He consciously biased himself in favor of patients on the grounds that previous professional literature on mental patients was almost always written from the point of view of the psychiatrist. Goffman admitted that, unlike some patients, he came to the hospital with no great respect for the discipline of psychiatry nor for the agencies involved with psychiatric practice.
In Asylums, Goffman created and delineated a total institution model of mental hospitals. He thought of mental hospitals in the same way as prisons, concentration camps, monasteries, orphanages, military organizations--places of residence and work where a large number of individuals are cut off from the wider society for a period of time. It was through this total institution model that Goffman painted a bleak picture of mental patients' circumstances. The hospital was depicted as an authoritarian system that forces patients to define themselves as mentally ill, change their thinking and behavior, suffer humiliations, accept restrictions, and adjust to institutional life. Asylums is only one of a number of books by sociologists appearing in the 1950s and 1960s that studied those characteristics of mental hospitals impinging upon patients and affecting the course of their illness (Belknap 1956; Caudill 1958; Dunham and Weinberg 1960; Scheff 1966; Stanton and Schwartz 1954; Strauss et al. 1964). These works are similar to Goffman's in that they all relied on qualitative data to describe the meaning of mental hospitalization for patients. Via observation and informal interviews, these social scientists all criticized the mental hospital and charged that it had a deleterious effect on patients. The Goffman book, the most widely known...