Behind the Walls of the World’s Psychiatric Hospitals
Behind the Walls of the World’s Psychiatric Hospitals
Ep. 47: History of the Provincial Lunatic Asylum, Part 1 (1850-1857)
In this week's episode, we discuss the socio-political events that led to the construction of the Provincial Lunatic Asylum in Toronto, Canada. Find out why it took so long for the asylum to be constructed and why it was only half-built by the time it opened in 1850. Learn about the very turbulent first decade of the asylum's history and why the medical superintendent sued a local newspaper for libel.
All sources will be listed at the end of the episode transcript.
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Hello, hello, hello, and welcome back to Behind the Walls of the World’s Psychiatric Hospitals! I’m your host, Dr. Sarah Gallup, and today we are starting a new series on a hospital in…drum roll…Canada!
I was so excited to start learning about this old hospital, but I kept getting stuck on some facts, and I realized…you guys, I really don’t know that much about Canada. Like, it’s a little shameful. So suffice it say that I took a crash course on the history of Canada in order to get a better understanding of the historical and societal contexts in which the asylum was built. Hopefully, you learn some new information, too, along the way.
And this is where I make the general disclaimer that I am not an expert on any of the hospitals I’ve discussed – not even the ones where I’ve worked and trained – but I will do my best to make sure the information I present is as accurate as I can find.
So, to that end, I used a lot of sources for this first episode. I gathered much of my information from the Centre for Addiction and Mental Health website at www.camh.ca, as well as an article written by Chris Raible on the Canada’s History website, and a fascinating 2019 dissertation written by Maximilian Smith. These and all other sources are listed at the end of the episode transcript.
Trigger warnings for this episode include some brief accusations of sexual assault and torture during pregnancy.
So come on in and make yourself comfortable as we go behind the walls of Toronto’s Provincial Lunatic Asylum…
The beginning of mental health care in Canada is going to sound familiar if you’ve been listening to the show for a while. Mental illness has always existed, but centuries ago, people had other ways of explaining and understanding it. For a long while, people with mental illness were described as demon-possessed. Later some were accused of witchcraft. There were all sorts of explanations. But we start to see a shift in thinking during the late 18th century about what to do with the undesirables of society. There were layers upon layers of change happening around this time – namely, around the world, colonization.
We’ve only discussed hospitals in a few countries thus far in the show – in the U.S., Wales, Australia, and now Canada. With the notable exception of Wales, the other former colonies were getting established around this period. And when a new government is formed, one of the first jobs is to establish laws. It’s easy enough to know what to do if someone breaks a law, but the question lingered about what to do if someone hasn’t broken a law but is still…different? Meaning that they don’t conform to usual societal rules and values or are otherwise seen as different.
This is where we find ourselves in Canada. In 1791, the Constitutional Act divided the former province of Quebec into Upper Canada and Lower Canada (“Timeline of Canadian History”). Upper Canada is modern-day Ontario, while Lower Canada is modern-day Quebec. This is where I got confused during my research, so forgive my ignorance. I kept scratching my head at the name Upper Canada because one thing I do know about Canada is that Toronto is right on the southern border across from Buffalo, NY. And that doesn’t exactly scream “upper” Canada to me, especially since that makes Lower Canada north of Upper Canada. But apparently it doesn’t really have to do with geographical location – it’s more about the location to the Great Lakes and the fact that Upper Canada lies mostly above the headwaters of the Saint Lawrence River, in comparison to Lower Canada (“Upper Canada”). I know you all knew that, but I’m just explaining where I got confused.
So anyway, Upper Canada was formed in 1791 and by the following year, the legislature of the new province was introducing laws and statutes. One of which was building a jail in every district. Funding for these jails came out of the same pot as other, more essential projects, so the jails were underfunded from the start (Smith 34).
What the new government hadn’t accounted for – probably because it wasn’t exactly a top priority – was what to do regarding the care of “lunatics” and the poor (Smith 32). People who had more mild symptoms of mental illness were called “docile lunatics,” and they were generally able to be treated at home by family members or sent to boarding homes (Smith 32). But the question remained about what to do with “furious lunatics,” people whose mental illness made them dangerous or disruptive to their community (Smith 31). It was clear that something had to be done about this group because they were often left wandering the streets and causing a raucous.
So in 1810, the legislature passed a new law that was just vague enough to provide a solution. It was called the Act to Declare the Common Gaols to be Houses of Correction. The jails around Upper Canada soon became filled with who the Act referred to as “idle and disorderly person[s] or rogues and vagabonds, and incorrigible rogues” (qtd. in Smith 32). This non-specific language – “disorderly persons” and “rogues” – doesn’t imply that someone has committed a crime. In fact, it sorta sounds like we’re talking about unhoused people and/or people with mental illness. It’s essentially criminalizing people for being different.
We’ve discussed this on other episodes of the show, but when we’re talking about differences here, there’s a broad spectrum of what we’re referring to. Anyone who had signs of severe mental illness (what we’d call schizophrenia or bipolar disorder today) would obviously be considered mad. But other differences were stigmatized, too. Developmental disorders, like Intellectual Disability or Autism, or chromosomal disorders, like Down Syndrome were considered taboo, and often children with those disorders would be sent away if their families could not or did not want to care for them. People with a disfigurement or physical disability also risked being sent away.
I feel a lot of empathy for those folks. They were separated from their family at an early age, or maybe they never even knew their parents, and if they became too unruly at the boarding home where they lived, they’d be expelled to the streets. Most probably couldn’t go back to live with their families. I’m sure it was difficult for many to get and keep a job. And so they’d wander around, alone, trying to find ways to get something to eat and find somewhere to stay warm. They probably knew they were different from everyone else, but what could they do about it?
But, as of 1810, these folks started to be jailed. And jail conditions were far from adequate. They were cold and damp (Smith 33), and “furious lunatics” were often chained to posts and walls.
The conditions were really abhorrent and cruel, even for the worst of offenders. Twenty years went by like this – lunatics getting picked up and dumped in local jails, then chained in cold, damp cells indefinitely. Fortunately, stories got out to the public about the barbaric conditions of the jails – not only from former inmates but from jail staff, magistrates, and concerned citizens (Smith 28). Petitions were formed to create better jail conditions and to separate lunatics from criminals.
In 1830, a law was passed that would provide some funds for a place to send lunatics other than jails. Many of these laws had absurdly long names, like this one. It was called – ahem – “The Act to Authorize the Quarter Session of the Home District to Provide for the Relief of Insane Destitute Persons in that District” (Smith 32). Or, as I will paraphrase, the “yeah, we really gotta build an asylum” Act. It was as if all of a sudden lawmakers realized that folks with mental illness needed humane treatment, not incarceration.
Unfortunately, these good intentions took a lot of time to actualize. It wouldn’t be for another nine years, in 1839, that the legislature of Upper Canada would authorize the building of an asylum (Raible). For the time being, they decided, lunatics could be housed at a temporary asylum. And so, starting in January 1841, lunatics were sent to the Old Toronto Jail on the NE corner of King and Toronto St (Dickson).
Part of the reason for the delay is because of political disagreements. During the early decades of the new province, there were huge rifts between the Tories and the Reformers and how they wanted to effect change. Add in waves of immigrants (mostly from Ireland) during the 1820s and 1830s, and this created a whole new class of wage laborers (Smith 19) – and, as generally happens, a new group of “different” people.
Another issue was where to construct the new asylum. It should be separate from central Toronto – somewhere in the countryside to promote a therapeutic environment. But also close to a university, so medical students could get training (Smith 7-8).
The province was making significant changes – they had plans for a major transportation infrastructure overhaul, establishment of a public school system, and, of course, plans for a hospital system, including an asylum (Smith 9).
Problem was, Upper Canada had lots of plans but, uhhh, not a lot of tax revenue. And not really a lot of people or resources, either. So, on the verge of bankruptcy, Upper Canada merged with Lower Canada on July 23, 1840, and formed the Province of Canada. Don’t get too excited, though – it lasts fewer than 30 years (“Province of Canada”).
In the midst of all this change, though, plans were forming for the construction of a new asylum. A well-known city architect, John George Howard, was commissioned for designing the massive structure (Raible). A large plot of land outside Toronto and near Lake Ontario was selected as the site of the asylum. Problem was – and this is common problem in the story of colonization – the selected site was part of the council grounds and a camping site of the First Nation, the Mississaugas of the New Credit (“History of Queen Street Site”). But, unfortunately, this was disregarded.
And on August 22, 1846, a silver plaque and cornerstone were laid on the site of what would be the NE corner of the building by the Honorable Chief Justice John Beverley Robinson (“The CAMH Cornerstone”).
Over the next several years, lunatics who were still being held in the temporary asylum at the old jail were involved in the construction of the asylum. Their labor was unpaid, of course, and was considered part of their treatment. Construction occurred in stages, due to ongoing financial and political issues (“History of Queen Street Site”).
A 12-foot brick wall surrounded the eventual asylum as a symbolic means of separating the people within from the community outside. The large wall included an entrance gate and ornate details, like an iron fence atop the wall facing Queen Street (“The CAMH Cornerstone”).
The asylum building that John George Howard designed was a Neoclassical structured with a centralized dome. It was modeled after the British National Gallery in London, which had been built less than a decade prior (Bissett). The building would become an imposing 5-storey stone structure with a classical portico atop massive columns, meant to resemble the Parthenon of Ancient Greece.
Far from the graceful, sloping arches of Kirkbride hospitals in the U.S., the Provincial Lunatic Asylum was constructed intentionally with rigid lines and sharp angles – the belief being that the physical structure of the building would facilitate orderly mental states (“Centre for Addition and Mental Health”). The entrance was oriented toward north (Bissett), almost like a guiding north star.
There were some similarities with the Kirkbride hospitals, however. One was the large central administration block under the dome, which was off-limits to patients. In it were the superintendent’s residence, administrative offices, and the chapel (Bissett). It also housed a 12,000 gallon tank, into which water from Lake Ontario would be pumped; this offered the asylum the luxurious amenity of running hot and cold water (“The Provincial Lunatic Asylum”).
Inside the patient areas, Howard followed other Kirkbride features, such as placing patients in single rooms, with the more violent patients farthest from the administrative block (Bissett). He wanted to promote interaction with others, as well as with the environment, so Howard designed long, wide hallways that ended to form part of the exterior walls with access to fresh air and views of the grounds and Lake Ontario. Similarly, he designed large common rooms and a semi-circular verandah at the end of each wing for patients to gather and relax – an idea he borrowed from Worcester State Hospital in Massachusetts (“The Provincial Lunatic Asylum”).
Now, interestingly, the upper level of the building contained expensive, luxury apartments with Victorian verandahs. These spaces were designed for wealthy patients. And to truly show their separate state from other patients, these rooms were separated from the rest of the building by stairways that went directly to the ground level, ensuring that the elite patients didn’t have to interact with commoners (Bissett).
Construction of the asylum halted in 1849 due to more political and financial obstacles. But, finished or not, there was a rush to open the asylum due to overcrowding in the Old Toronto Jail. And so, on January 26, 1850, the Provincial Lunatic Asylum officially opened. The first 211 patients were transferred from the Old Toronto Jail to the asylum.
Even in its incomplete state, the asylum became an unlikely symbol of civic pride and modern advancements in treating insanity (Bissett). It became known as “one of the wonders of the West,” as it held the third largest patient population in all of North America and was the only permanent facility for psychiatric treatment in the Province of Canada (Bissett).
The local newspapers were quick to herald the asylum as a success. George Brown, the editor of the Toronto Globe newspaper, described the asylum as “Exceedingly handsome, commodious, healthful and safe…a monument to the Christian liberality of the people. Where disturbing influences are absent – not a mere hospital or prison – where every good part of human nature is brought into play” (qtd. in Raible). That’s quite the endorsement.
Dr. John Scott was appointed as the first superintendent of the Provincial Lunatic Asylum, but from the time the asylum opened, there was talk of corruption and nepotism (Raible). There seemed to be a little too much favoritism going on during the hiring of employees. This, in part led to constant in-fighting between the chair of the asylum board and Superintendent Scott. And, perhaps distracted by all that drama, patients began to be neglected (Raible).
Rumors began about the poor conditions of the asylum and about patient abuse. They became so rampant that in 1853 a grand jury was called in to investigate (Raible). The grand jury toured the facility for three hours and left after making some minor suggestions regarding improving the ventilation and plumbing due to some unpleasant odors. Apparently dissatisfied with their report, a second grand jury was later invited. This group said the asylum was well-ventilated with no offensive smells. There were, they noted, some small repairs that could be done (Raible).
The increased in-fighting culminated in the legislature effecting another act into practice in July 1853. This one was not-so-discretely entitled, “the Act for the Better Management of the Provincial Lunatic Asylum at Toronto.” Understandably fed up with the constant bickering, Superintendent Scott resigned. Dr. Joseph Workman took over as medical superintendent in 1853 (Raible).
Now, Dr. Workman, to his credit, had been part of the Board and was familiar with the asylum and the problems it had. He intended to clean up not only the hospital itself but its reputation.
He began with the building’s structural issues. Dr. Workman had some special skills in this area. After earning his medical degree, Dr. Workman had taken over the family hardware business, where he worked for nearly 10 years (Raible). So his knowledge of hardware and plumbing came in handy while he fixed up the asylum. He found and fixed problems with the flues, vents, windows, water supply, and drains – especially the drains.
Dr. Workman also wanted to change the way that patients were treated. A proponent of moral therapy, he wanted all patients to be treated with compassion and decency. Dr. Workman believed that 50% of his lunacy cases were curable at home with appropriate treatment (Raible). And one thing about Dr. Workman: he had strong opinions, and he was not afraid to share those opinions. In fact, Dr. Workman strongly opposed mixing together patients who struggled with mental illness or other differences with the criminally insane. He called it:
An evil of inconceivable magnitude…in the working and present condition of this Institution has been the introduction into it, of criminal Lunatics from the Provincial Penitentiary, and the County Jails. It is an outrage against public benevolence, and an indignity to human affliction, to cast into the same house of refuge with the harmless, feeble, kind-hearted, and truthful victims of ordinary insanity, those moral monsters…or, yet worse, those villains who affect insanity by means of evading the just punishment of the most atrocious crimes. (Qtd. in Raible)
This is a powerful quote and, quite frankly, one I agree with. He’s basically saying here that his asylum was supposed to be a place for people with mental illness to get rest and treatment. Mixing those folks with the criminally insane – or people feigning insanity – did far more harm than good. And I agree, which is why today we have separate types of facilities for folks with developmental disorders and those who are forensically committed.
Dr. Workman also had very strong opinions on what constituted insanity. He believed that insanity was caused by prenatal problems, injuries to the skull, viral infections in the brain, and strokes – which we would still agree with today. He also attributed it to some other causes we no longer ascribe to, such as overlactation, masturbation, and epilepsy (Raible).
And this was all during the time that mental illness was being treated with methods that would be considered unnecessary and cruel today, such as blood-letting, purging, vomiting, blistering (whatever that meant at the time), low diet, and what was described as “the whole battery of medical destructives” (Raible).
We’ve mentioned in previous episodes the absurd reasons for hospitalization in the 19th century, which included everything from grief to relationship problems to menopause (Raible).
But Dr. Workman believed these more commonly-accepted reasons for insanity were absurd and overpathologizing normal issues. I can almost see him rolling his eyes at this as he said:
If anyone of these may be regarded as adequate to the overthrow of reason, how many lunatics should this Province contain? Intemperance alone would people fifty Asylums as large as our present one. Jealous wives and husbands would probably fill thirty…Political excitement would tenant a mad-house in every county, and one of superior class and size in the metropolis…Religious controversy would send in half the clergy of this Province, and large detachments of their congregations…If tobacco and slander caused insanity, there would be few in Canada left at large. (Qtd. in Raible).
I really like this guy. He’s not wrong – there were absolutely absurd reasons to hospitalize people at this time. And he experienced that when the asylum quickly became a dumping ground for the province’s “undesirables” – those deemed unmanageable, troublemakers, poor, congenitally defect, and old people (Raible).
So there was an interesting problem happening all at once: on the one hand, the admissions kept coming and coming until they overcrowded the facility; on the other hand, construction of the asylum still wasn’t complete. And Dr. Workman was understandably peeved. There was literally nowhere else for new patients to go until construction was complete, but local authorities seemed to shrug their shoulders and say, “Eh, make it work. By the way, here’s a grieving mom whose child just died. Take her, too.”
Absolutely fed up, Dr. Workman went before the legislature to let them know that they were preventing him from doing his job. In confidence (or so he thought), he told a member of Parliament the following:
If we had a single man in the Legislature who had ever studied the subject of insanity and insane hospitals, before today this house would have been completed. What sort of an account can any of you give at the bar of Heaven, for your willful ignorance, and woeful negligence? “Depart from me, ye cursed.” (Qtd. in Raible)
The fact that we have a record of this quote tells that that member of Parliament shared it with others. Dr. Workman was known for his opinions, which tended to go against the popular thinking of the time in regard to the causes and treatment of mental illness.
He was also known for writing his opinions in the Toronto Mirror, a newspaper that was the fiercest competitor of The Globe. You may remember a few minutes ago that the editor of the Globe, George Brown, had praised the asylum when it first opened. But Brown and Dr. Workman had had beef with one another for years, and their writings in competing newspapers didn’t help the situation.
In February 1857, George Brown published a scathing attack in the Globe of Dr. Workman’s moral character and medical competence (Raible). Brown accused Dr. Workman of “villainy, deceit, and tyranny” (qtd. in Raible). Together with a disgruntled former hospital porter, Brown accused Dr. Workman of sexual misconduct, inadequate security, physical harassment, and administrative mismanagement. His attack ended with this angry sentiment: “[Workman] has been sustained by the present corrupt government from graver charges, and until the moral pestilence of his superintendence stinks in the community, he is likely to continue his villainy and outrage” (qtd. in Raible). Ouch. Now, Dr. Workman was understandably outraged. Not only was this a vilification of his hospital, but it was a vilification of the care and moral treatment he had brought to the hospital. He immediately sued Brown for libel and sought 5,000 pounds in damages (Raible).
The Workman v. Brown libel case quickly became a public sensation. It was held in the York County Courthouse on April 22 and 23, 1857. Almost every local newspaper was there to cover the event (Raible).
The former asylum porter, James Magar, testified to the accusations he had made in The Globe. He stated that women at the asylum were victims of, at minimum, being watched by a male patient and at most sexually abused by him in the women’s bathroom. He also stated that that same male patient, Thomas Pearce, had been given special privileges, like being allowed to take one of the horses and go for whiskey (Raible).
Even Thomas Pearce himself was allowed to testify. He laughed while explaining that he hadn’t been with any of the women in the bathroom. He was there to fix the pipes. In the dark. At 11 PM. And, in any case, no one ever found a woman in there with him (Raible).
But the third testimony James Magar made was the most disturbing. He said:
A female in one of the wards was in the family way, and when she took labour and her pains increased her madness, the nurses did not know, and put on her a straight jacket, and confined her in the common place of punishment, when it was discovered by the cries of an infant, without Dr. Workman ever having told the attendants of her having been pregnant; the sight of the mother was awful, her face was all covered with blood in endeavoring to extricate herself (qtd. in Raible).
And, if true, this story is awful. A woman in labor placed into restraints, ostensibly left alone, and trying to free herself from the restraints until the baby was born. Medical professionals at the hospital affirmed that yes, a child had been born there, but the mother had not been restrained during the birth process. They did confirm how constantly dirty and distraught the patient had been. Sadly, the child only lived a few days (Raible).
Fortunately or not, these allegations had already been thoroughly investigated over a month prior to the trial. No evidence of the allegations had been found, leading investigators to conclude that the charges were “utterly without foundation and completely void of truth” (qtd. in Raible). Even though writers from the Globe had received a copy of the investigation’s findings, they conveniently forgot to publish them (Raible).
The trial ended with the jury unable to reach a decision. According to later reports by the Globe – so take those with a grain of salt – only two of the 12 jurors had sided with Dr. Workman, while nine sided with Brown. Apparently, they believed that at least some of the accusations against the asylum were true (Raible).
And so, Dr. Workman was allowed to continue working at the Provincial Lunatic Asylum for over 20 more years until 1875 when he retired “for reasons understood by myself” (qtd. in Raible).
And that’s where I’m going to pause the story of the Provincial Lunatic Asylum for this week. There’s still more to say about the time during Dr. Workman’s tenure, but I’ll pick that up next week.
Thank you for allowing me a couple extra days to compile information. Who knew I had so much to learn about Canada? Anyway, I hope you learned some new information, too.
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Most of all, thank you for listening! Please come back next week for more information about the Provincial Lunatic Asylum of Toronto.
And, as always, remember the words of Maya Angelou: “Do the best you can until you know better. Then, when you know better, do better.” Until next time…
Bissett, Tara. “The Provincial Lunatic Asylum (Centre for Addiction and Mental Health), Toronto (1850).”CanadARThistories. https://ecampusontario.pressbooks.pub/canadarthistories/chapter/the-provincial-lunatic-asylum-centre-for-addiction-and-mental-health/
“Centre for Addiction and Mental Health.” Wikipedia. https://en.m.wikipedia.org/wiki/Centre_for_Addiction_and_Mental_Health
Dickson, Lee. “The Archives of Ontario contain records of those admitted to Toronto’s Lunatic Asylum.” Toronto.com, 14 Feb. 2015. https://www.toronto.com/news/the-archives-of-ontario-contain-records-of-those-admitted-to-toronto-s-lunatic-asylum/article_44a442bb-acaf-5b14-8d3e-5a16cce7ebd3.html?
“History of Queen Street Site.” Centre for Addiction and Mental Health. https://www.camh.ca/en/driving-change/building-the-mental-health-facility-of-the-future/history-of-queen-street-site
“Province of Canada.” Wikipedia. https://en.m.wikipedia.org/wiki/Province_of_Canada
Raible, Chris. “999 Queen Street West: The Toronto Asylum Scandal.” Canada’s History, 24 Jan. 2016. https://www.canadashistory.ca/explore/science-technology/999-queen-street-west-the-toronto-asylum-scandal
Smith, Maximilian. “The world outside these walls”: Toronto’s Provincial Lunatic Asylum in Context, 1830-1882. Dissertation. September 2019. https://yorkspace.library.yorku.ca/server/api/core/bitstreams/8517fb3d-b50b-44cf-849a-25171ccfcbd4/content
“The CAMH cornerstone: A reminder and a legacy.” YouTube. https://www.youtube.com/watch?v=98VFIaeGxwc
“The Provincial Lunatic Asylum.” City of Toronto. https://www.toronto.ca/explore-enjoy/history-art-culture/museums/virtual-exhibits/john-howards-watercolours/the-provincial-lunatic-asylum/
“Timeline of Canadian History.” Wikipedia. https://en.m.wikipedia.org/wiki/Timeline_of_Canadian_history
“Upper Canada.” Wikipedia. https://en.m.wikipedia.org/wiki/Upper_Canada
