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Walking through History: Case Study of a Former Psychiatric Hospital Site

This past year we initiated a new pre-tour in-class activity that built on a similar project by Lizette Royer, archivist at the Cummings Center for the History of Psychology in Akron, Ohio. We provide each student with a copy of an annual report from the former hospital.
By Jennifer L. Bazar

An abandoned building with a previously isolationist history that connects to a marginalized population breeds intrigue. Our lack of historical engagement on the sites of former mental health institutions has not dampened interest. If anything, it has contributed to an increased wonder and desire to step through the walls. Keeping people from entering the closed facilities has perpetuated misinformation, assumptions and allowed community lore to grow unabated.

The story of the Mimico Branch Asylum/Lakeshore Psychiatric Hospital, opened 1890, just outside Toronto, Canada, is no different. Following the closure of the institution in 1979, portions of the property were used for independent mental health programming, although film crews were the most regular users. As the property became increasingly run-down, the future of the buildings became the center of a passionate debate. As has been the case in other areas, the community rallied to protect the site. Unlike typical arguments, which focus on architectural history, much of the preservation drive at the Lakeshore site came from the view that the former hospital property “belonged” to the community. Specifically, it had become their park, their valued green space, which needed to be saved against the encroachments from the urban density and sprawl of Canada’s largest city.

The community was successful in their arguments, with heritage designation assigned in 1989. That same year, the government entered into a 99-year lease with the neighboring Humber College. Although there was no formal recognition of the hospital on campus, the history of the site was never ignored. It was immediately following the first wave of renovations that our story begins to align with the all-too-common trope of the haunted asylum with ghost tours and haunted houses being offered on the grounds. Growing criticism in the second decade of the 2000s brought about the end to these events with concerns raised by community members and mental health activists as to the risk of perpetuating stigma.

Birth of the Interpretive Centre

The termination of the ghost tours coincided with a key development on the part of the college, that is, the establishment of a department through which the unique history of the grounds could be shared. As part of the negotiations between the college and the city for the construction of a new student center, the college agreed to establish, staff and fund what would become known as the Lakeshore Grounds Interpretive Centre, the institution where I currently serve as curator. With this, the tours were reborn as “historic tunnel tours.” Initiated by my predecessor, the tours provide a summary of the major trends and changes over the 89-years of the institution’s history. My aim is to normalize the discussion of the institution’s history: rather than focusing on the unique or unusual, the tragic stories of “them.”

Up until the opening of the Interpretive Centre, the new history-based tours were offered to a handful of classes within the college and twice a year to the public. Once we opened in 2017, we began to expand these offerings, and 3,500 people attended the 91 tours we hosted through the first year. We are on-track to meet that number in our second year. With these more regular offerings and dedicated department to provide the tours, we began to look at the challenge of engaging students at a deeper level.

Annual Report Activity

This past year, we initiated a new pre-tour in-class activity that built on a similar project by Lizette Royer, archivist at the Cummings Center for the History of Psychology in Akron, Ohio. We provide each student with a copy of an annual report from the former hospital along with a series of questions. I tend to select a few reports from different years so that comparisons can be drawn across time. After students explore the reports, we review their responses as a group. It makes almost no difference as to which report years they have, as the overlap across the other questions is sufficient for group discussion. We begin with the population, a concept that tends to be greeted with a fair amount of disbelief. Once shared, I explain that the institution was designed to house 500 patients, a number surpassed on all of the reports in the room and that the institution would reach its peak population of 1,500 in the 1930s. With this question we introduce the challenge of overcrowding and the fact that the institution was the central location of mental health treatment.

Next, we establish that there was a roughly equal split in terms of the number of male and female patients within a given year. This opens up discussion of both the design of the institution as well as ideas related to gender and illness.

It is at this point that we move into the list of the most common causes listed as responsible for the onset of insanity. These tend to garner some laughter from the class, with causes ranging from mental strain, worry and overwork, to religious excitement or masturbation. We spend time defining the many terms associated with the female reproductive cycle and stages of childbirth before also addressing the presumed heredity assumption. Although the students tend to be dismissive of the list at the outset because it is so all-encompassing, the tone changes as we discuss how it was derived from the admission records on which families would record what they thought to be the cause of the onset of symptoms. We take the comment one step further by highlighting the fact that the list does not include anything that we don’t also struggle with today. Difficulties in school, in work, strain at home, loss of loved ones, financial challenges or other major life changes remain influential factors in our own mental health.

It is from here that we transition to the very closely related table of diagnoses. This is where the students are challenged to look beyond the report and to use their phones to Google the terms. Although historians are careful to establish that there is not a direct continuum between terminology of the nineteenth or early twentieth centuries and those today, the point here is to establish that a quick “translation” of terms makes it clear that “dementia praecox,” for instance, is not as distant sounding when its connections to “schizophrenia” are revealed. It also becomes evident that some terms have remained unchanged, such as “dementia,” but that their associated descriptors have flipped. Whereas today a diagnosis of dementia would be presumed from the outset to be associated with advanced age, unless “early onset” were added, the reports we share specify “senile dementia” to indicate that advanced age is believed to be a factor in the development of the dementia. For mental health specific classes, this comparison of terms is particularly key so that students can draw direct connections to the concepts they have covered in their lectures, but even in non-health related programs our base knowledge of the current mental health taxonomy helps students to connect more directly with the patients listed only as statistical numbers in the reports.

Finally, we move to the general question of the wider focus of the reports. Regardless of year, the trend is similar. The focus is on the maintenance and repair of the physical structure. This is where the association between early asylum physicians as administrative caretakers first developed. With responsibility for the care of hundreds if not thousands of individuals placed in the hands of physicians, focus inevitably fell to the basic upkeep of the institutions. Here we can step back and explore the reasons for the opening of asylums, the challenges faced by their operations and their slow decline towards deinstitutionalization – the perfect introduction to launch into the tour.

Although the overall purpose of this activity is to encourage students to keep an open mind while on tour, it has been successful specifically in closing the gap between “then” and “now.” My measure for this has come through the changes in the types of questions I receive both during the pre-tour activity and the tour itself. There has been a marked decline in questions related to the “horrible things that they did to people” to direct questions about experiences, treatments and outcomes. There is no move away from the more challenging or controversial aspects of institutional history, but there is an opening provided for deeper discussion.

I contend that there is a very different experience between learning about our institutional history from books or lectures and actually stepping onto those grounds and exploring primary documents. Our mental health institutions may be considered particularly unique in this sense. With their initial designs to keep people out and separate their populations from the community around them and the later temptations provided by boarded-up abandonment following deinstitutionalization, we have set up a key environment in the mental health system that is taboo, off-limits or secretive. Preventing access only encourages people to make up their own history.

I hope that I have piqued your curiosity to consider engaging with the sites and records of our former institutional era as tools to move the multi-century battle against stigmatization forward. If I might leave you with one final anecdote, I would cite a statement that I hear regularly from students – the observation that if “I” had been alive during the asylum era, then “I” likely would have been institutionalized. This realization, above all others, is what encourages me to continue engaging with asylum history in this way. If a person can move from a view of “them” to “us” after a 90-minute tour, imagine what else can be accomplished.

About the Author

Jennifer L. Bazar is a curator at the Lakeshore Grounds Interpretive Centre, Humber College, Toronto, Ontario, Canada.