MORE THAN JUST A CELEBRITY PSYCH WARD

GRACEFULLY INSANE: THE RISE AND FALL OF AMERICA’S PREMIER MENTAL HOSPITAL

By Alex Beam, Public Affairs, $26, 255 pp.

Sitting on 250 lush acres in the tony suburb of Belmont, Mass., with its sprawling Tudor houses and handsome red-brick dorms amid apple and pear orchards, the McLean psychiatric hospital can be considered as much a Boston institution as Fenway Park or the Old North Church.

The hospital might not be as well known as either of those places; certainly, it doesn’t attract the number of visitors they do. But McLean has played an integral role in Boston’s social history. Like New York’s Bellevue Hospital, McLean represents, in just one word, some of the most uncomfortable, scandalous moments in its city’s past. And while McLean might not attract camera-toting tourists, it has hosted some of New England’s most prominent names.

“In the narrow landscape of Boston, the Boston intellectual milieu, McLean occupies a special place,” says Alex Beam, a Boston Globe columnist whose “Gracefully Insane: The Rise and Fall of America’s Premier Mental Hospital,” chronicles the hospital’s history. “I was surprised how many people’s biographies ran through McLean.”

Alumni include winners of the Nobel Prize (games theorist John Forbes Nash) and the Pulitzer (poets Anne Sexton and Robert Lowell). “Bell Jar” author Sylvia Plath spent her 21st birthday at McLean. Susanna Kaysen recounted her adolescent stay at McLean in “Girl, Interrupted.” Landscape architect Frederick Law Olmsted chose the grounds and was later a patient. Musicians are equally well-represented: James Taylor, his brother Livingston and sister Kate all logged time there, and Ray Charles was sent there by a forgiving judge after being caught with heroin at Logan Airport. (Apparently, it was hardly hard time; Charles later became, well, friendly with some McLean nurses.)

But McLean has been more than just a celebrity psych ward. The preeminent psychiatric hospital in the region, McLean was the hospital of choice for New England’s most prominent families, who packed off their unfortunate relations for stays of months, even years, at the well-appointed hospital. McLean was the facility of choice for what Lowell called “the thoroughbred mental cases,” for what Beam calls “the Mayflower Screwballs.”

A native of Washington, Beam moved to the Boston area 17 years ago. He quickly picked up hints of what McLean meant to his adopted hometown. With no gates and no barbed wire, and its lovely grounds and stately architecture, McLean looks more college campus than insane asylum. When Beam wrote a column for the Globe about the Autumn Gathering, an annual reunion of McLean alumni, he found the hospital’s administrators surprisingly receptive to his questions.

But for all its openness, McLean had a certain intrigue that drew Beam in for an even closer look. In part, he says, he was drawn by a personal curiosity about a place that has offered refuge to so many people at the most difficult periods of their lives; as he writes in “Gracefully Insane,” “[L]ife is impossible. … Who can’t understand the need for shelter? And who can’t sympathize with the people who seek that shelter? And who could fail to be interested in a place that offered that shelter?”

Based on interviews with former patients and staff and extensive research, Beam focuses on “the old McLean.” The hospital’s 19th-century founders subscribed to the theory that quiet rest in a pastoral setting was the way to cure the mentally ill. McLean, in its prime, was a self-contained, self-sufficient community, with its own farm, dairy and orchards.

For many Brahmin families, McLean was the perfect place to park senile grampas or nutty old aunties. But not every patient was benign. In the 1920s, blueblood Louis Shaw strangled his Irish maid but, thanks to his connections and family money, evaded prison and instead spent two decades at McLean.

For years after its founding, McLean was the only psychiatric hospital in the Boston area. Determined to keep it from becoming a pauper hospital, its early directors refused to admit charity cases for free, instead instituting a sliding fee scale. When public mental hospitals began popping up, poorer patients were diverted elsewhere, and McLean became increasingly upscale, with elegant furnishings, tennis courts, a golf course, a theater, even quarters for patients’ servants.

“The Old McLean I liken to the era of crossing the Atlantic by steamship,” Beam says. With its staff-intensive treatments and its lengthy stays (initial patient evaluations could take months), McLean set its patients on a slow-moving, and expensive, journey to wellness. By the 1980s, insurance companies began balking at the hefty bills. The trend in mental-health care was for shorter hospital stays, community outpatient programs and an increased focus on drug treatments.

McLean looked more and more like a dinosaur; “the hospital,” Beam writes, “was foundering like a luxury ocean liner competing in the age of jet travel.”

McLean began hemorrhaging millions of dollars a year. As its patient population dwindled, the administration began shuttering buildings it no longer needed. Today, McLean is in the midst of a restructuring plan that involves selling or giving away about 80 percent of its land to pay off its debts and minimize costs. While some patients still pay the $900-a-day fees, much of McLean’s programs are less expensive, HMO-friendly outpatient programs.

As Beam prepares to promote “Gracefully Insane,” he’s braced for some criticisms: namely, that his book — with its tales of celebrities, colorful eccentrics and sex scandals — “sugarcoats” the realities of life at a mental hospital.

“When you start talking about rich people and McLean, and Olmsted chose this beautiful site, and all these poets, there is a fair criticism someone is going to level at this book: ‘Mr. Beam sees what he wants to see, and disregards the rest,’ to paraphrase Paul Simon,” he acknowledges.

McLean’s pastoral, even plush setting aside, “horrible things happened there,” Beam says — not because it was a horrible place but because the people there were suffering horrible experiences. “Gracefully Insane” does not shy away from McLean’s darker moments, including two waves of suicides in the 1960s.

But there are other things — heartwrenching, appalling things — that Beam learned from former patients that he did not include in his book. One former patient wrote him a 40-page letter, in beautiful penmanship, about her experiences at McLean that, he says, he couldn’t bear to recount. “I chose not to print it because they scare me,” he says simply.

Beam recognizes that a place with a history as rich and tragic as McLean has a certain romantic quality. Even some patients saw the inherent fascination. “I quote Plath tellingly as saying, ‘I have to write something about [her time at] the mental institution, because people will read it,”‘ Beam says.

“There’s plenty of grim romantic stuff here. I get carried away by a character like [Louis] Shaw. He’s sort of a joke. Well, obviously, to the … woman who he murdered, he was a craven murderer,” Beam says.

“There’s nothing romantic about sitting across from a man or woman who spent two or three years at McLean and interviewing them for a couple of hours. Because they’re articulate; they remember a lot. It wasn’t romantic to them.”

M.A. Turner is a writer and editor in Massachusetts whose book reviews appear regularly in The Courant.