March 19, 2004

The Institutional Confinement of ‘Idiot’ Children in Twentieth-century Canada: the case of the Orillia Asylum, 1900-1950

The history of intellectual disability in the Anglo-American context has long remained in the shadow cast by the history of madness and psychiatry and, more recently, physical disability. As Anne Digby contends: “Historically, the social marginality of people with learning disabilities has been mirrored by their academic marginality.” While this academic marginality has recently been diminished by the emerging field of disability history in the United States, Britain and Canada, the portrayal of Canadian asylums for people with intellectual disabilities has continued to be understood by historians (and thus society) in a traditional paradigm -- as “dumping grounds” used by families, physicians and the state for unwanted and unproductive members of society.

This interpretation stands in contrast to recent developments in the history of the ‘lunatic’ asylum which have examined the short-term use of mental hospitals, the strategic role of families in the committal process, and the persistence of community care. The detailed investigation of institutional case files, as seen in the work of Cheryl Krasnick Warsh, Mary-Ellen Kelm, Geoffrey Reaume, James Moran and David Wright, has allowed for a patient- and family-centred perspective on rise of the lunatic asylum. All of these recent works have responded to the lack of investigation into the social, medical and behavioural characteristics of patients, factors influencing admittance to an institution, and the role that families played in the identification of lunacy, the decision to commit a family member, and how families negotiated treatment, leisure and care while their kin were institutionalized.

My dissertation hopes to take these new interpretative perspectives and apply them to the history of the idiot asylum. In Ontario, four principal institutions for ‘lunatics’ were established in the second half of the nineteenth century: in Toronto, Kingston, London and Hamilton. For ‘idiot’ children and adults, by contrast, the province constructed a separate institution - the Orillia Asylum for Idiots (now the Huronia Regional Centre). Between its opening in 1876 and 1950, Orillia accepted almost 10,000 people with intellectual disabilities for admission, many for life. In contrast to the dominant historical view of ‘idiot’ asylums in Canada, I will argue that Orillia was often used as only one option of many open to families, and was often used as a last resort after numerous years of familial and community care. The decision to apply for admission to the asylum was often triggered by increasingly difficult behavioural patterns, family (usually maternal) illness, poverty, or seeking educational or occupational training for children. Examining closely individual case files, I will reinterpret the relationships between confined children, family members and the formal medical (in this case, psychiatric) institution. I will also compare and contrast the modes of treatment and care that existed within and without the medical institution.

Therefore, following these historiographical developments, this research project proposes several hypotheses, all of which reinterpret the confinement and care of idiot children in twentieth-century Canada: (1) that family members played a central role in the identification of their kin’s developmental disability; (2) that family members petitioned for asylum committal, influenced diagnosis and even aspects of care, and decided when children would be discharged; and (3) that social class, race, gender, the severity of the child’s disability all affected the family’s ability to influence admission and medical treatment.

The archival research concentrates on a systematic 1 in 5 sampling of the approximately 8,025 patients admitted during 1900-1950 (n=1,605). These case files are a key focus for historical enquiry since they contain admission and discharge summaries, medical reports, clinical records, treatment reports and, more importantly, correspondence between family members and their confined child, and also with the superintendent of the asylum. It will demonstrate how family members, and sometimes the children themselves, negotiated aspects of institutional life. Furthermore, it will explore how class, race, gender and severity of disability affected the ability to carry out these negotiations. Finally, it will investigate how these factors influenced the relationship between family members with the institution’s superintendent, staff psychiatrists, and other medical and non-medical staff. It challenges the arguments by other historians about the ‘hegemonic’ control physicians had in the process of confinement and shows a much more equal relationship between the institutional personnel and family members. Through this type of examination, a new social history of care inside and outside of the asylum of people with intellectual disabilities will emerge.

By probing the relationships between confined patients, their families and the Orillia Asylum this dissertation will provide insight into how medical professionals and lay people characterized childhood disability and how they understood the origins, behaviours and treatment practices. It will illuminate the historical understanding of medical and lay attitudes towards the nature of intellectual disability, its aetiology, and the behaviours associated with it. Furthermore, it will construct an understanding of medical treatment given to these children relative to their characteristics and behaviours. In doing so, not only will information be gathered about treatment inside the asylum, but also through these files, information drawn will include treatment prior to confinement. A recent research paper presented at the Canadian Society for the History of Medicine (n=221 case files) confirms that family members often sent letters indicating prior treatment for their child, including, massage therapy, visits to specialists in the United States, and castration. My dissertation will explore these treatment modalities in detail.

Posted by Jessa at March 19, 2004 05:00 PM