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Editorial — Psychiatric Patient Built Environments: Liberating Our Past

By Geoffrey Reaume
Network, Summer 2008

A brick boundary wall. An oval playing field. A laundry and bakery now used as a museum. What do these places have in common? They were all part of the built environment of 19th century Ontario insane asylums, and they still exist today. Each was created through the unpaid labour of insane asylum inmates under the guise of "moral therapy." While in theory moral therapy was supposed to aid in the mental "restoration" of mad people, in practice it was also used to justify the exploitation of free labour of psychiatric patients in the running of mental institutions throughout the western world. Though administrators and architects have been given a great deal of credit in history books for the building of asylum structures, only in recent years have unpaid patient labourers started to be more widely recognized for the contributions they made to the world which they built, quite literally, with their own hands.

The built environment in psychiatric history has usually served to confine and restrict patients behind barriers of exclusion and surveillance. In Ontario, the oldest of these built environments still in existence are the brick boundary walls on the south side of the present day site of the Centre for Addiction and Mental Health, the former Asylum for the Insane, Toronto. The south boundary walls date to 1860 while the still existing east and west boundary walls on the site date from 1888-89. Bricks once used to confine are instead being used to liberate a past that has, for too long, been hidden away from most people. Now, this history of exploitation and exclusion, as represented by these walls, can liberate patients' past while also challenging prejudice today. The walls exclaim: "Look at these bricks! Think about who built them for no pay!" That such structures still exist well over a century after they were constructed speaks volumes about the abilities of the patients who built them. It also provides concrete evidence that people with a psychiatric history are very capable workers who deserve fair pay like anyone else.

As part of the effort to preserve these walls, last year CAMH clients were employed at union wages to help restore part of the west wall at Queen Street — physically taking ownership of their own history and preserving it for the future. A form of poetic justice, given this wall's past.

There are plenty of examples of psychiatric patient-built environments around Ontario. The oval playing field at present-day Humber College in Etobicoke, formerly Mimico Asylum, took male patient labourers two years to level in the 1890s to make it the smooth sporting ground it is today. And the museum of the present-day Fort Malden National Historic Site in Amherstburg, Ontario, was built as a laundry and bakery by Malden Asylum inmates in 1861. These are just two more locations among many where the creators of these built environments need to be memorialized for their work. In doing so, we remember with respect people who were ostracized and devalued during their own lifetimes, while also providing a positive example to challenge persistent discrimination about the abilities of psychiatric consumer/survivors today, prejudice which is older than the 19th century built environments at which asylum inmates toiled.

Geoffrey Reaume is associate professor at the School of Health Policy and Management, Faculty of Health, York University, where he teaches in the Critical Disability Studies Graduate Programme. He is author of Remembrance of Patients Past: Patient Life at the Toronto Hospital for the Insane, 1870-1940 (Toronto: Oxford University Press Canada, 2000) and Lyndhurst: Canada's First Rehabilitation Centre for People with Spinal Cord Injuries, 1945-1998 (Montreal: McGill-Queen's University Press, 2007).

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