Sarah Lucinda Grunder on Joseph M. Galante, Images of America: Long Island State Hospitals (Charleston, S.C.: Arcadia Publishing, 2019), 128 pp. $21.99

By the 1950s, Long Island was at the center of mental health care in the United States, with more than 32,000 patients residing in three state institutions separated by only 11 miles. How these three residential state hospitals grew in the late 19^th and early 20^th centuries, treated their patients, and eventually, beginning with the introduction of Thorazine (and other anti-psychotic drugs) and President Kennedy’s signature on the Community Mental Health Act of 1963, declined is the subject of Joseph M. Galante’s Images of America: Long Island State Hospitals.

Author Joseph M. Galante, once a state hospital employee and now a graduate student in mental health studies at Hofstra University, cites his work with and in Long Island’s state hospitals as part of the inspiration for gathering the materials in this work.

Each chapter takes up a different aspect of the state hospital system on Long Island. A brief introduction outlines how the state hospitals – Kings Park State Hospital, the farm colony at Central Islip, and Pilgrim State Hospital – were developed in the region, the methods of therapy used in the facilities, and the eventual decline of the facilities as their moral and activity-based therapies fell out of favor and federal regulations led to declining patient populations. The state hospitals at Kings Park and Central Islip were eventually closed and programs were consolidated into the Pilgrim Psychiatric Center.

The first chapter examines how Kings Park and Central Islip grew from farmland to house more than 18,000 patients. Included are fascinating photographs of the land on which the hospitals and buildings were constructed, of buildings that housed patients and where medical staff labored, and of some of the facilities that kept the hospitals running, such as cafeterias and libraries (important for the then-isolated facilities).

Chapters two and three highlight the medical and fire, police, and wartime staff of the facilities. Particularly interesting are photographs of nurses and residential nursing students, and nurses engaged in applying various treatments to patients. As the author points out, nurses spent more time with patients than anyone and often became the family they no longer had (pp. 34-50).

Chapter four includes photographs of the farming and shops that were used to both sustain the large residential populations of the hospitals, but also as a form of activity-based therapy for patients. For example, of those patients who were employed at Central Islip, the largest number were assigned to be farm and garden workers. Other patients worked in cement shops, hospital laundry facilities, sewing rooms, furniture repair, and even typesetting. Central Islip had its own print shop where books, cards, and a facility newspaper were printed (p. 78).

The final chapter contains the most eclectic set of photographs, detailing the daily lives and activities on the grounds of the three hospitals. Photographs highlight the focus on moral therapy embraced by state hospitals, showing patients engaged not only in work, but also in music, dance, art, and other activities. Particularly interesting are photographs of patients enjoy outdoor space, doing calisthenics, performing in plays, and engaging in organized sports on the hospitals grounds.

Most of the images in the book come from a private collection and details of the holdings are not provided. This is unfortunate as the images would be useful to scholars of this history of medicine and the early 20^th century United States. Others, including the cover photograph, are drawn from the Kings Park Heritage Museum, which houses a collection of images in an online gallery. Additionally, the book offers a brief paragraph introducing the congestion, immigration, and strains on services and institutions wrought by late 19^th century industrialization and consolidation in New York City. Carrying these themes throughout the book, and situating them within the vast literature on reform movements of the 19^th and 20^th centuries, might prove helpful in better contextualizing the images.