All of a sudden America sees these photos that look like concentration camp photos. You see people huddled naked along walls, strapped to benches — and it really is this descent into this shameful moment. And the country did say, we have to do something about this. – Robert Whitaker, writer

The photographs Whitaker mentions were taken by Jerry Cooke, who was then 26 years old, born Yuri Kutschuk on this date October 18 1921, in Odessa (†2005). He was well qualified to make them; his aunt, Celia Kutschuk, was responsible from November 1935, for the employment and promotion of a number of significant American and immigrant-American photographers through her PIX agency in New York at 250 Park Avenue. They included PIX‘s founding photojournalist Alfred Eisenstaedt (1898-1995) who left in 1957 to freelance, Hans Knopf (1907-1967), Ed Feingersh (1924-1961), Bob Schwalberg (1927-1996), Larry Fried (1926-1983), Bob Henriquez, Garry Winogrand (1928-1984), and George Zimbel (*1929). Robert (1913-1954) and Cornell Capa (1918-2008) were also briefly associated with PIX. Another, theatre photographer Eileen Darby (Lester) (1916-2004), later set up her own agency Graphic House in 1941. Jerry Cook received his training in photography at the agency, starting in the darkroom, then given a Rolleiflex by his aunt and sent out on assignment (he was with Eisenstaedt as he photographed the famous VJ-Day victory kiss)

By the mid-twentieth century, American publicly funded mental hospitals, like their British counterparts, had become the tattered undergarment of the otherwise well-dressed modern health care system. Financially poor in relation to the general hospital, the psychiatric hospital system in both these countries did not have funds to attract well trained personnel. Instead, during the Second World War several thousand conscientious objectors in the US and Great Britain were obliged to work in psychiatric institutions, and given their convictions, some began to publicly decry the conditions.
In April 1945, in Reader’s Digest, journalist Albert Q. Maisel had pleaded in his article The Veteran Betrayed; “How long will the Veterans’ Administration continue to give third-rate medical care to first-rate men?”… “Our disabled veterans are being betrayed by the incompetence, bureaucracy, and callousness of the Veterans’ Administration” he wrote, continuing that the “root of the cancer” was in the Central Office in Washington, and he called for the appointment of a new medical director who “could restore simple, common humanity to the Veterans’ Hospitals.”
Somehow Maisel persuaded staunchly patriotic LIFE magazine in the US (only nine months after the end of the war) to publish his article Bedlam 1946: Most U.S. Mental Hospitals are a Shame and a Disgrace, a photographic exposé of two state hospitals: Pennsylvania’s Byberry and Ohio’s Cleveland State.
The article’s sub-heading made it clear that this was not sensationalism:
The author of this article, through his previous writing and his testimony before a congressional committee, helped instigate important improvements in the Veterans Administration’s mental hospitals. The Ohio photographs were taken by Jerry Cooke with the permission of Frazier Reams, Ohio State Commissioner of Public Welfare, and the cooperation of the Ohio Mental Hygiene Association, an affiliate of The National Committee for Mental Hygiene.
To a country shaken by recent revelations of Nazi atrocities, the pictures were deeply affecting as they revealed the terrible abuse of psychiatric patients, and readers were distraught to read Maisel’s written accounts:
…beatings and murders are hardly the most significant of the indignities we have heaped upon most of the 400,000 guiltless patient-prisoners of over 180 state mental institutions. We feed thousands a starvation diet, often dragged further below the low-budget standard by the withdrawal of the best food for the staff dining rooms. We jam-pack men, women and sometimes even children into hundred-year-old firetraps in wards so crowded that the floors cannot be seen between the rickety cots, while thousands more sleep on ticks, on blankets or on the bare floors. We give them little and shoddy clothing at best. Hundreds—of my own knowledge and sight—spend 24 hours a day in stark and filthy nakedness. Those who are well enough to work slave away in many institutions for 12 hours a day…
Jerry Cooke’s photographs may horrify contemporary audiences with their apparent invasion of these patients’ privacy. But it is clear he has made efforts to conceal identity by obscuring faces in heavy shadow and shooting toward the light or through cropping as in image (top right above, unpublished). In at least one case (left, above) burning-in of the subjects face (selective additional exposure during printing) leaves us peering to see the disturbing expression on the tightly bound patient’s face, though bruises and swelling on her leg, which she seems to be raising from the floor for relief, are left evident.
We must balance against this the effect that the story had. An eyewitness account makes a convincing case, and photography implicates its viewers in seeing its subject; one million or more witnesses in the case of LIFE (the number of subscribers at the time). The magazine was careful to present the article as authoritative by including the writers credentials on this subject.
Cooke too had a track record with LIFE. When young men were leaving behind community, family and loved ones, LIFE commissioned Cooke to photograph the Grafton, West Virginia community for the December 1, 1943 issue. There, a woman Martha (apparently her real name – Cooke followed her up years later) had been corresponding with an Air Force soldier. Only 22 years old then, and a recent immigrant himself, Cooke reveals in tender pictures his sympathy for the couple’s plight.
Sadly, while awareness had been raised, the solutions to this distressing issue were mixed, in both motivation and degrees of success.
Following publication of LIFE’s article Mary Jane Ward released, also in 1946, her novel The Snake Pit (Random House) that became a national best seller (later turned into one of the most popular films of 1949), further raising social concerns about US mental hospitals. This crisis of attention motivated the now infamous Dr. Walter Freeman to devise a simple version of the lobotomy procedure; one that could be used on a mass scale. His transorbital lobotomy method didn’t require a neurosurgeon and could be performed outside of an operating room without anesthesia by using electroconvulsive therapy to induce seizure.

Even the liberal reformers, like Albert Deutsch who did so much to expose these horrendous conditions in his influential book of 1948, The shame of the States (Harcourt, Brace, New York) concluded by recommending more extensive use of the new physical treatments in psychiatry, namely insulin, metrazol, electric shock, and prefrontal lobotomy. Over and over again, the money that would be saved if inmates could be discharged to the care of their families was used as an argument to justify lobotomy. The Superintendent of the Delaware Mental Hospital, the first state hospital to adopt lobotomy, reported that even a small state like Delaware had already saved thousands of dollars, and John Fulton claimed that “if only 10 percent of the patients occupying neuropsychiatric beds could be sent home, it would mean a savings to the American taxpayer of nearly a million dollars a day.”
Many would argue that given the risks to public health and pharmacological regulation in the US through the current administration’s determination to ‘monetise’ it to save dollars, these are policies and issues that may return to affect millions.
[The journalist Albert Q. Maisel later wrote an exposé of Scientology Dianetics: Science or Hoax? for Look magazine December 5, 1950, amongst numerous articles and at least 11 books, mostly on medicine and mental health which had become his specialty. Read the 1946 LIFE article in its entirety]
Jean-Philippe Charbonnier (1921-2004) photographed a comparable essay in 1954 for Réalités magazine, where he was a staff reporter/photographer. He documented Hopital Pasteur, Poitiers, and other psychiatric hospitals (which appear here to be in better hands than those in the USA and Britain) taking a very different approach from Cooke’s to privacy; the interactions with patients are more direct, and the images more studied and, in the case of the opening shot, staged.
The spirit of Charbonnier’s imagery aligns with the Humanist Photography movement originating in France, to which he subscribed. A number of the most powerful amongst the following images were not published due to the sensitivities of the 1950s.