In The Last Asylum, Barbara Taylor, a Canadian historian living in England, offers a searing account of her own journey through mental illness – or “madness,” as she frequently calls it. The book combines history and memoir, but the latter parts are the most challenging to read. Taylor describes her experiences, including time in an institution and 21 years of psychoanalysis.

Taylor’s story is linked to the history of how mental health is considered and treated. From 1988 to 1992, the author spent time in Friern Hospital, once England’s largest psychiatric institution (it is now a luxury apartment complex). She is educated, white, and middle class, all of which, she recognizes, gives her a level of privilege the mentally ill often do not enjoy. She describes a fractured relationship with her parents, who – awful as they may have been – also provided her with extensive financial support.

Taylor recreates many psychoanalytic sessions, representing them on the page in italics. These sections of the book, with their naked self-revelation, proved uncomfortable and difficult for this reviewer. It’s also hard to imagine how Taylor could remember it all in such detail, though she is forthcoming about trying to access the truth of her experience out of her memory, which, as she points out, plays a huge role in how we interpret our present circumstances.

One interesting aspect of the book is Taylor’s short history of psychoanalysis in Britain, and evolving views of madness, which prove extremely complicated and highly individual. The closure of asylums has meant the loss of homes for people unable to cope on their own, and while the initial idea was to provide community care for such displaced individuals, the resources for that care never materialized. As a result, many mentally ill people live on the streets. Taylor explores complex issues of choice versus care, and locates the points at which ill people find themselves unable to make positive choices for themselves.

Perhaps the most valuable element is Taylor’s attempt to be honest about her own experience. She argues for the importance of history, both public and personal. The medical case-history, for example, is increasingly being abandoned in favour of a more “efficient” box-ticking report. People’s stories matter. This one certainly does.