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

by Erika Dyck, Alex Deighton, Hugh Lafave (Primary Contributor)

The Saskatchewan Mental Hospital at Weyburn has played a significant role in the history of psychiatric services, mental health research, and providing care in the community. Its history provides a window to the changing nature of mental health services over the 20th century. Built in 1921, Saskatchewan Mental Hospital was considered the last asylum in North America and the largest facility of its kind in the British Commonwealth. A decade later the Canadian Committee for Mental Hygiene cited it as one of the worst facilities in the country, largely due to extreme overcrowding. In the 1950s the Saskatchewan Mental Hospital again attracted international attention for engaging in controversial therapeutic interventions, including treatments using LSD. In the 1960s, sweeping healthcare reforms took hold in the province and mental health institutions underwent dramatic changes as they began transferring patients into communities. As the patient and staff population shrunk, the once palatial building fell into disrepair, the asylum’s expansive farmland went out of cultivation, and mental health services folded into a complicated web of social and correctional services. Erika Dyck’s "Managing Madness" examines an institution that housed people we struggle to understand, help, or even try to change.

Genres: Mental Health, History

352 pages, Paperback

Published September 22, 2017

Reviews

[Rachelle · Rating 4 out of 5]

4 stars.

I have a neverending interest in this institution, since I grew up visiting my grandparents in Weyburn, SK. Though it was no longer a functioning asylum, we visited "The Mental" many times, where we'd walk around, revel at the massive size of it, and only wonder what horrific things went on inside the rooms.

The Weyburn Mental Hospital opened its doors in 1921, was known as the largest asylum built in North America, the last asylum built in the British Commonwealth - and one of the worst institutions in the country.

This book describes how the Weyburn Mental Hospital went from its treacherous reputation, to later receiving international recognition for making the most significant changes (progress) to mental health on the continent, and ultimately the volatile (patchwork) transformation to the mental health system in Canada.

The conditions at the Weyburn Mental Hospital ("The Mental") are described as subhuman. Patients experienced overcrowding, underfunding, abuse, forced confinement and restraint, labor (scrubbing floors, cooking, laundry, etc.) disguised as occupational therapy, controversial experimentation and procedures (eugenics for sterilization and population control), electroshock therapy, hydrotherapy (ranging from scalding hot to ice-cold water), psychiatric pharmaceuticals (LSD, antidepressants, tranquilizers) and as a last resort, lobotomy.
There were also significant structural defects. Ward sizes meant that patients couldn't be separated by their diagnoses, and so ended up being grouped together haphazardly; some windows in common areas and day rooms faced patient airing courts rather than the vast surrounding prairie view, and other windows opened onto closed verandas that provided no fresh air; weekly (yes, weekly) sewer backups that filled basement wards with raw sewage, where staff kept the "difficult" patients.

During these years, referred to as the asylum era, the terms used to describe the mentally ill included feeble-minded, moron, imbicile, lunatic, idiot, defective, mentally deficient.
When it came to reasons for being institutionalized, the hospital was known as a dumping ground, encompassing a vast range of diagnoses: mood disorders, personality disorders, trauma, tumor, manic depressive, melancholia, dementia, low IQ, senile, vascular (stroke), epilepsy, syphilis, schizophrenia. And there were those classified as "without psychosis," experiencing things like financial worry and destitution, family discord, learning difficulty, alcoholism, sexual orientation (homosexuality), poverty (as a means of shelter), and Veterans of WWI and then of WWII. There was also voluntary admission (for which these patients had to pay $2 a day to fund their stay).

As a whole, people feared mental illness, mainly due to a lack of understanding, tolerance, and empathy; mental illness was attributed to violence and criminal tendencies, thus prolonged stigma, and therefore justified institutionalization and segregation from the community as the solution.

Over time, certain aspects of civilization progressed, including changes to government parties, political views, laws, research, medical health reforms, and mental health policies, which eventually led to the shift away from institutionalized care. Rather, a focus on out-patient care that allowed people to remain part of the community, and therefore maintain their purpose, dignity, and sense of self.

Thoroughly researched and well written. I was hoping for more patient voices and experiences and/or possible interviews.

[Stephanie Pieck · Rating 3 out of 5]

This book gives a thorough history of mental health, mental hospitals, and the rise of socialized medicine in Canada using the Weyburn Mental Hospital in Saskatchewan as a lens. I learned a lot, especially about the unique culture and mindset of prairie communities and their quest to foster culture and economic vibrancy for residents despite bad weather, the uncertainties of agriculture, and other challenges facing them.
The book also illustrated the factors that led to the development of community-based psychiatric care.
Overall, a solid addition to the literature of mental health, government social policy, and the history of Canada.