In the past weeks I’ve noticed attention being paid in the media to the issue of mental illness in the prison system. In the New York Times, regular columnist Nicholas Kristof wrote this article arguing that prisons are the new mental hospitals. “Psychiatric disorders are the only kind of sickness that we as a society regularly respond to not with sympathy but with handcuffs and incarceration,” Kristof wrote. Apparently more than fifty percent of all inmates of American penal institutions have a mental health problem.
Closer to home, the Correctional Investigator of Canada, a rather fancy name for the prison ombudsman, was also reporting on the criminalization of mental illness.
What we used to call the lunatic asylum was created in large part to get the mentally ill out of prison. But now that we’ve done away with large mental institutions, apparently all we’ve done is turn the clock back 170 years so that once again we are putting the “mad” in jail.
I’ve been interested in the history of the mental hospital in Canada for many years, ever since I wrote a thesis on the subject back in 1975. The story begins early in 1836 when authorities in Saint John, New Brunswick, gathered up a group of lunatics – which is what the mentally ill were then called -- from the county gaol and moved them into the basement of a small, wooden building on Leinster Street. The person in charge of the transfer, George Peters, had inspected the gaol and discovered several mentally-ill inmates under heavy restraint, “some of them perfectly naked and in a state of filth.” It would be several years before a permanent asylum could be built but in the meantime Dr. Peters was allowed to move fourteen lunatics to the Leinster Street building. Inadequate as it was, this temporary asylum can be thought of as Canada’s first mental hospital.
It was followed by similar temporary facilities in Montreal (1839), where the third floor of the gaol was converted to a makeshift asylum, and in Toronto (1841), where a two-story red-brick gaol on King Street was emptied of criminals and left in the possession of a group of seventeen “insane persons” who had been chained up in the basement.
It is comforting to think that the birth of the asylum represented a change in public attitudes to the mentally ill, but it was often more a concern for the comfort of criminals than for lunatics that led to the creation of separate institutions. In Toronto, for example, government investigators agreed that “the unhappy beings in their paroxysms [i.e. mentally ill inmates] occasion a very considerable degree of annoyance and suffering to the other prisoners.”
Still, the new asylums (not yet hospitals for no medical treatment actually took place) represent a symbolic turning point in the treatment of the mentally ill in Canada. For the first time authorities recognized that the mentally ill should not be housed alongside the destitute or the criminal. Lunatics required a specific kind of care in a specific kind of institution. The chains came off, the cell doors opened, and the mad emerged blinking into the sunlight of humane care. It is a powerful image, at once atrocious and uplifting. How could we have confined people in such a manner, we wonder? Yet aren’t we admirable for setting them free?
Unhappily we now know that the story has an unhappy ending. The mental asylum deteriorated into a hell-hole that was in many ways no better than the prisons it replaced. So several decades ago we began to empty them, with appalling results. And now in many ways we are back where we started with our prisons once again filled with the untreated and the neglected.