The Vanishing Act of Esme Lennox

The word “asylum” typically means a place of refuge, however, in the Victorian era, institutional “asylums” (or psychiatric hospitals) became veritable prisons where people deemed “unfit” to live in society were sent indefinitely. The facilities were intended to house individuals diagnosed with mental illness, but since the science of psychiatry was relatively new in the 19th century, people were often misdiagnosed and in time, any individual who exhibited socially undesirable behavior was in danger of being sent to a psychiatric hospital. Aside from the ubiquity of misdiagnosis, patients were also subjected to torturous treatments which have since been deemed ineffective in treating mental illness. Ironically, these facilities’ inhumane conditions, coupled with isolation and malpractice, led many patients to develop mental illnesses while incarcerated. Moreover, patients in these facilities, having become social pariahs, harbored no hope of release as their relatives had few other options for treatment, or refused to accept and support their loved ones.

During the late-20th century, advancements in neuroscience and psychology paved the way for more compassionate, comprehensive care for individuals with mental illness. With interventions like talk therapy, cognitive behavioral therapy, and more effective pharmaceutical treatments, committing individuals to psychiatric hospitals fell out of favor. In 1990, the Community Care Act forced the closure of several psychiatric facilities. The Mental Health Act of 1983 was a landmark advancement in neurodivergent treatment, as it required doctors to inform patients of their rights regarding assessment and care. The law aimed to prevent abuse of patients by caregivers and prevent patients from being held against their will. Though the Community Care Act released many individuals from forced incarcerations, it did not come without drawbacks. After the law was enacted and facilities were systematically shut down, over 100,000 individuals were released, some of whom had been incarcerated their entire lives. Without proper support systems or therapeutic interventions, some individuals struggled to adapt to life outside of psychiatric hospitals; some individuals developed mental illnesses while incarcerated, and could be potentially dangerous to themselves and others. Patients unable to adapt to their new lives or who resorted to violence found themselves re-committed in other facilities or placed in jail (Turner, Trevor, “The History of Deinstitutionalization and Reinstitutionalization.” Psychiatry, 1 September 2004, p. 1-4).

In preparation for writing The Vanishing Act of Esme Lennox, O’Farrell studied forced incarcerations, specifically focusing on women who were wrongfully confined. In the novel, Iris combs through Cauldstone’s records—and all the accounts she reads are directly taken from O’Farrell’s research. Through Esme Lennox, O’Farrell gives a voice to all the women who vanished into psychiatric hospitals, some of whom never left. As Esme’s facility closes and she leaves her prison of 60 years, she is faced with assimilation into the modern world and working through her repressed trauma with tragic results.