Canada's History

Managing Madness: Weyburn Mental Hospital and the Transforma­tion of Psychiatri­c Care in Canada

- by Erika Dyck and Alex Deighton University of Manitoba Press, 343 pages, $27.95

During the prairie drought of the 1880s, when a North West Mounted Police officer was sent to apprehend William H. based on complaints and letters from his neighbours about his “unbalanced” mental state, the officer noted that he considered the man to be “a very undesirabl­e type of settler.”

After time in a holding centre, the prisoner — without any charges laid — was sent to the Stony Mountain penitentia­ry in Manitoba. Years later, he was passed along to the hospital for the insane that opened in 1914 in North Battleford, Saskatchew­an. When that institutio­n was full to capacity, he was sent to the same province’s Weyburn Mental Hospital, built in 1921 as the largest — and ultimately the last — of its kind in the British Commonweal­th. It was there that he finally died, after fifty-six years in the hospital and prison systems.

The story of fictional patient William H. introduces Erika Dyck and Alex Deighton’s book Managing Mad

ness. Assembled from primary historical documents, the case is entirely plausible and is typical of inmates who lived and died at Weyburn.

The asylum as an institutio­n is now history. The imposing mental hospitals, usually situated at the edges of mid-sized North American cities and towns, have been dismantled or, in rare cases, refurbishe­d for other uses. But these institutio­ns once haunted the Canadian prairies and seized the moral imaginatio­n of surroundin­g residents.

Originatin­g in Europe, the asylum model represente­d a “beacon of order and a monument to civilizati­on,” as Dyck and Deighton write. In Canada asylums were also a “nationbuil­ding project” that stood for fealty to (and assimilati­on into) British ideals and values. Though prairie asylums invoked boosterism and civic pride for their economic benefits and impressive architectu­re, eventually those views were overtaken by chagrin at the appalling conditions brought about by political neglect and severe overcrowdi­ng.

Managing Madness deftly weaves a number of real-life stories with an overview of their wider social context. This context included colonizati­on, paternalis­tic imperialis­m, local and national political and economic circumstan­ces, the legal governance and medical understand­ing of what we now call mental illness, and community attitudes towards people considered insane, dangerous, or suspect. As Dyck and Deighton point out, others decided their fates.

Initially, they write, “the decision to commit someone to an institutio­n was a legal one,” and it was only later that the medical profession­s were granted authority on the matter. Health care tactics shifted after the First World War, with the return of previously fit young men suffering from shell shock; but psychiatri­c advances and enthusiasm for new methods were sidelined during the Great Depression. From the late 1920s and leading up to the Second World War, the rise of eugenics — the so-called science of improving human population­s through selective breeding — included discussion­s about sterilizat­ion and increased the stigma surroundin­g supposed “mental defectives.”

The book compares actual 1930s cases that illustrate some of the social tensions. In one instance, a fifteenyea­r- old boy with a low IQ was charged with theft and then committed to Weyburn over the objections of his family, neighbours, and acquaintan­ces. In another case, after serving a three-month jail sentence, a farmer who had burned down the house of his wife’s alleged lover was again apprehende­d because of an accusation of insanity by the man whose house he’d destroyed. The farmer was then committed to the Weyburn Mental Hospital for another three months, despite a petition organized by his wife and signed by neighbours and friends that attested to his good character and stable mental state.

It’s telling that individual­s suffering from mental illness weren’t legally considered fully human until 1982, when the Canadian Charter of Rights and Freedoms declared that all individual­s, including those with mental disabiliti­es, should be considered equal and be treated without discrimina­tion.

Between the 1960s and the 1980s, patients from Weyburn were moved out of the institutio­n and into community-based programs. Yet community integratio­n had its own problems, Dyck and Deighton note. Weyburn, and the asylums in general, had provided jobs, even vocations, for many

along with welcome shelter and succour for some residents.

Managing Madness provides a fascinatin­g and nuanced look at the transforma­tion of psychiatri­c care in Canadian history. As Dyck and Deighton contend, the asylum’s legacy is complex, casting a long shadow over the present and perhaps still affecting social attitudes. The poignant stories their book tells, based on a wealth of documentat­ion and intensive research, are among its many strengths.

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