From the Seward Asylum in Bram Stoker’s Dracula, to Pennhurst Hospital in Stranger Things 4, the psychiatric hospital and horror are inseparable. It was almost inevitable I would one day end up in similar territory. Below, I talk about some of the real life inspiration behind Between the Teeth of Charon, my own contribution to this enduring subgenre.

The image of a sprawling asylum dominating the landscape is a familiar trope to horror fans. Their vastness alone is threatening. Beyond those thick walls and barred windows the seemingly endless network of corridors and cells disorientates, the mandatory amenities – dining halls, theatres, chapels – become strange. Within these dark places lies a madness we hope never to know.

The stories of these places have changed with time. Where once the tales focused on the horror of the individual locked within, we now see more stories exploring the horror of the institution.

The accounts of abuse patients were subjected to is well documented and stretches from the dark ages into recent history. Moreover, some of this abuse was committed under the guise of treatment.

There is a preciseness to the horror of the lobotomy. Imagine the insertion of an orbitoclast – essentially an ice pick – into the eye socket just beneath the eyelid. The instrument would be pushed against the skull, then tapped with a hammer to pierce the bone and penetrate the brain, where the tip would slice into the prefrontal cortex. Lobotomies were carried out indiscriminately and reduced many to docile ghouls, a shadow of the person they once were.

Thankfully in the last few decades the understanding and treatment of mental health has developed significantly, and as a result these once ominous institutions have been left to rot.

Many horror fans will be familiar with the Danvers State Hospital in Massachusetts. Cult classic Session 9 was filmed on location at the notorious hospital. The film is filled with lingering interior shots of long corridors dissected by light and shadow, and much of the paraphernalia you see on screen was already there, discarded like the building itself. The reality bleeds into every frame.

Session 9, and subsequently Danvers, was a huge visual influence when writing Between the Teeth of Charon. However, the foundations of Hethpool Grange – the abandoned psychiatric hospital at the centre of Between the Teeth of Charon – lie much closer to home.

The internet is filled with videos and photographs of abandoned psychiatric hospitals, taken by urban explorers who have braved the sickly insides of these decaying beasts to capture their demise. This is how I discovered Cherry Knowle Hospital. Located in Ryhope, a village outside Sunderland, Cherry Knowle stood for over a century before its demolition in 2011. This one was close to home, less than twenty miles from where I grew up. The horror was almost tangible. The first brick of Between the Teeth of Charon was cemented in place with a handful of images of Cherry Knowle.

I first heard of Gartloch Hospital when I moved to Glasgow a few years ago. Fiona and I were driving along some backroads one afternoon, and I caught sight of a building – a tower – through the trees. I asked what it was, learnt it was an old asylum. I pulled off the road and drove up to the hospital. We didn’t leave the car, it was a gloomy afternoon and the hospital was surrounded by metal fencing and construction equipment, but a glimpse was all I needed. I was looking at the administration block, its two tall towers reaching up into the slate grey sky, and it too became a part of Hethpool Grange.

Between the Teeth of Charon was completed in early 2021. However, I recently went for a walk around the site of Lennox Castle Hospital with my camera. There was no reason for me to go. Still, I was compelled by curiosity.

The story of Lennox Castle is a familiar one. Neglect and abuse no one should have to suffer. I read the story of a 14 year old boy, sent to Lennox Castle Hospital because he skipped school. He didn’t leave for another four decades. The hospital finally closed in 2002 and the castle itself is all that remains. 

Imposing. Desolate. Forsaken. The abandoned psychiatric hospital is a liminal place with a sinister magnetism, a place where past horrors collide with present sensibilities, a place where we can glimpse darkness before returning safely to the light.

Between the Teeth of Charon is out Friday. Pre-order it here and add it on Goodreads.