Lee-Ann Monk has chosen an intriguing and little studied topic from the history of madness. The lay attendants, who worked directly with those admitted to nineteenth-century lunatic asylums, are the focus of her research, which centres on the archives of the insane institutions set up in the Australian colony of Victoria. Whereas the educated medical elite, who ran the asylums, and the patients themselves, have received extensive attention from contemporary historians, the attendants have remained largely in the shadows. In her book, Attending madness: at work in the Australian colonial asylum, Monk attempts to revise the “popular mythology of the lunatic asylum” which has “repressed the memory of asylum workers’ occupation and their sense of themselves as attendants” (p. 8). Her overarching thesis is that, prior to the return of these institutions to medical control at the end of the nineteenth century, by the late 1870s and early 1880s the attendants had acquired an “occupational authority … sufficiently strong to rival that of asylum doctors” (p. 221).

On the surface this seems a commendable historical project, but in practice her specific aims, which speak to a contemporary obsession with “identity”, leave the reader feeling unsatisfied and unconvinced. The sections on gender are a case in point. Monk explains that “establishing an occupational status consistent with gender identity was difficult for [the attendants] because the gender definition of asylum work … was uncertain” (p. 61). And with this contention in mind she discusses, in chapter 8, a series of wage protests by the attendants at the Ararat Asylum, who claimed that their income was insufficient to support themselves and their families in the local area. Affordable accommodation was scarce and the cost of living high. The men insisted that it was “utterly impossible to put anything whatever … by for a rainy day”, and that they could only support their dependents “respectably” with “much struggle and difficulty”.

The interpretative line that is taken up by Monk, in response to these archival records, utilizes a gender analysis approach: “[T]he reduction in the wages was potentially more than an economic challenge”, she insists. “It was also a ‘psychic’ challenge to their masculine independence and ‘manly pride’ because it threatened their ability to support their families” (p. 181). Whilst this reading of the sources is not inconsistent in any way, there is no evidence that actively supports it. More generally, Monk never stops to interrogate the strengths and weaknesses of her chosen approach. In this specific section, for example, she does not question whether this group of historical actors were concerned about their identity, occupational, gender or otherwise, in and of itself or only as a means to a pragmatic end. Indeed, did their aspirations to live a “respectable” life indicate a concern with anything like a twenty-first-century concept of “identity”? On this occasion it feels as if the author has put the theoretical cart before the empirical horse.

Other portions of the book, where the sources are better suited to Monk's chosen methodology, are stronger. In chapter 2, for example, she does make a persuasive case that the attendants at the Yarra Bend Asylum were concerned about separating themselves, as a certain “type” of person, from the patients. This section is built around the records pertaining to the employment of one particular co-worker who had originally been admitted to the institution as a patient before being taken onto the payroll. In this instance her decision to examine the notion of the attendants’ occupational identity is a potentially rewarding one. Only potentially, however, since the relentless narcissism, implied by her focus on the attendants’ own identity, is frustrating. Here she misses her chance to make a truly original contribution to the history of madness; she does not ask how this group of laypeople perceived the afflicted in their care. That they felt it necessary to work at distinguishing themselves from their patients is an insightful observation and begs the question as to how madness was defined within the community at this time. Its conceptualization, in the contemporary medical literature, has long been picked over by historians but here was the promise of a novel perspective on an important question. Instead we are offered a “fashionable” but ultimately disappointing study.