I was pleasantly surprised and excited when asked to review this book. Initially apprehensive, I found the experience enriching, not only in expanding my limited knowledge about therapeutic communities but also in awakening a sense of intrigue and curiosity.

Asylum to Action provides a glimpse into history, of the rise and subsequent demise of the Paddington, a therapeutic community set in London in the late '60s/early '70s. The author, Helen Spandler, is a Research Fellow in social work and has published in other areas of mental health. Asylum to Action is a summary of her retrospective work on Paddington. She is clearly very knowledgeable and passionate about the research she carried out into the history of the hospital. This is conveyed within her narrative and she achieves a good balance between giving factual information and providing a forum in which to pose questions and allow productive debate.

The book is divided into thoughtful chapters. It begins by giving a history of the formation of therapeutic communities in an era of anti-psychiatry, social ideals and a rise in patients with mental health problems using their own voices to promote change.

The Paddington appears to have been an idealised experiment into health democracy and libertarianism, at a time of immense political struggle within the healthcare system. When faced with uncertainty in 1972, a tremendous effort by the Paddington's staff and patients prevented its closure. It provided a foundation from which patients gained more rights in treatment choices and allowed for an escape from traditional medicalisation and labelling. Unfortunately, it also portrays a very real situation where power struggles, a lack of boundaries and regulations and the extremes of political correctness can lead to corruption and destruction.

In contrast to other literature on the Paddington Day Hospital, Spandler challenges the negative accounts. Rather than purely lingering on its downfall, Spandler reinforces its achievements as a therapeutic microcosm that provided benefits to its patients. Its success also infiltrated the wider social context of the media and general public.

I believe that one of the rewarding aspects of this book is that aside from its core content it covers aspects of the ongoing struggles of the National Health service in today's political climate and the importance of solidarity.

Having spent some time in a therapeutic community in Massachussetts, USA as a medical student on my elective, I was drawn by the parallels of my own experiences. I became quite involved in the various dilemmas and debates that the book threw into question.

This book is a light and easy read. Although it may not be seen as a core text in terms of psychiatric training programmes, I would recommend it as an interesting and controversial read, for both mental health professionals and a wider audience.