Posts Tagged ‘history of mental illness’

“Rockwood Has 693 Inmates,” Kingston Daily Standard. October 5, 1912. Page 2.

Dr. Ryan, Supt., Makes Annual Report.

Fifty-Six Deaths During Year, Being 8 Per Cent. of Total Population, an Increased Rate.

The annual report of Dr. Ryan, medical superintendent of Rockwood Hospital, has just been made, and gives Rockwood’s total population at the present time as 693, of whom 38 are women and 632 men.

During the past year there were 108 admissions to the hospital, 100 by ordinary process and 8 by warrant. Of these admissions, 48 were men and 60 were women. This admission rate is smaller than usual.

Fifty-two of these admissions were acute cases. The remaining forty-six were chronic cases.

During the year the discharge list captured 72 names, 29 men and 43 women. Of these discharged 58 were recovered, 11 showed marked improvement, and 3 were not benefited by their hospital treatment. The percentage of recoveries to admissions being about 54 per cent.

The death rate for the year just closed has been high, 34 men and 22 women, total 56, being slightly over 8 per cent. of the total number of patients under treatment. Tuberculosis was the cause of death in 14 cases. Other bronchial affections 9. Cardiac diseases 7. General Paresis 5. Debility of old age, 5. There was no death from suicide this year. One patient died while on probation.

Since the opening of the hospital there has been a total of 4,590 patients treated, of which the women held a slight majority. The daily average population has been 565. There has been one elopment in the past year.

Average conditions, business troubles, loss of friends, etc., are given as the cause of 18 cases admitted this year. Alcoholism comes second with 14 instances.

The Roman Catholic patients hold the record in population, 30 adherents of that religion having been admitted within the past year and 1,436 since the hospital’s opening, although Methodist made a strong second, the latter figures being 28 and 1,085 respectively. The other sects are represented as follows: Episcopalians, 18 and 883; Presbyterians, 13 and 719; Baptists, 3 and 84; other denominations, and 262; unascertained, 12 and 105. 

In regard to race nearly all are Canadian-born, although twelve English, 2 German, two Scotch, one Irish, and 1 Finlander have been admitted during the past year.

Those whose duties are along educational and higher domestic lines are numerous, 48 having been admitted last year. Farmers come next with 16, and mechanics with 9. The others are: Professional men, 1; commercial men, 7; domestic servants, 4; miners, engineer 5; seamen, 2; laborers, 8; no occupation 12.

The County of Frontenac is well represented, 31 residents of the county being in the Institution. Hastings and Renfrew come next with 22 and 19 respectively.

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“The idea of mental health took hold in the first three decades of the twentieth-century United States not so much because it was an idea whose time had come, but because of the threat presented by fulminating radical socialist thought.

At the turn of the twentieth century, US elites were drunk on wealth, even as they panicked at the specter of violent social revolution. Their paranoia was not entirely unfounded. The decades following the Civil War were a period of capitalist accumulation that by 1900 resulted in the top 1 percent of households owning 51 percent of the nation’s wealth; the bottom 44 percent owned only 1 percent.

Menaced by falling rates of profit, industrial capitalists and bankers after 1865 began a transition from laissez-faire competition to industrial monopolies, trusts, and mergers, in an attempt to artificially raise profits by controlling prices. This transition from industrial to finance capitalism subjected ordinary workers to the frenzied boom and bust cycles of speculative capital. It relied heavily on the expansion of consumer credit and debt, making ever-greater tranches of the population vulnerable to the convulsions of financial markets.

The nation roiled with class warfare. Class politics in the post–Civil War period were largely articulated via recurrent populist crusades. These movements were mostly comprised of farmers, tenants, and small proprietors, loosely if pugnaciously affiliated around resistance to the banking rackets’ entrenched interests in maintaining high interest rates and keeping the currency wed to gold backing.

By the turn of the twentieth century, one third of all small farmers were mortgaged at dizzying interest rates. 70 percent of the nation’s labor force had been transformed into landless wage earners with no delusions of achieving financial independence from the industrial and financial oligarchs.

The chasm between the increasingly desperate position of deskilled labor — subject, with the introduction of Taylorism, to ever-more tyrannical control by management — and the gilded excesses of the speculative and industrial elite was obvious, most of all to the swelling ranks of the landless and precarious wage earners packed into the squalid flophouses coating the underside of the industrial cities.

The manifest antagonism of interests between Gilded Age capital and labor caused a proliferation of increasingly radical labor organizations, among them the Industrial Workers of the World (IWW), the Knights of Labor, and the American Federation of Labor (AFL). The period between 1870 and 1905 witnessed over thirty-seven thousand strikes.

Flailing to control working-class militancy, industrialists turned to armed scabs and police terror to break labor in bloody confrontations like the Haymarket Riot (1886), the Coeur d’Alene Silver Mine Strike (1892), the Pullman Strike (1894), and the Ludlow Massacre (1914).

Elites were alarmed by the spate of new social pathologies resulting from these social and demographic changes. By 1910, vagrancy, homelessness, and begging were rampant in urban centers. Chicago alone had up to seventy-five thousand homeless men in its streets and flophouses in 1923, and a 1915 government survey estimated the total number of “unemployables” nationally at five million, growing at a rate that eclipsed the general population increase. Divorce, or abandonment — the “poor man’s divorce” — rose to a rate of 20 percent of households in metropolitan areas by 1930, swelling the number of women and children requiring state or philanthropic support.

The dissolution of local or traditional kinship care networks was directly implicated in the seismic increase in the number of persons requiring care in asylums, whose inmates multiplied from 74,000 in 1890 to 150,000 in 1904, and over 267,000 by 1922. By 1920, the total cost of care for those labelled “insane” was estimated to exceed that of all agricultural production, with Americans diagnosed as “insane” growing at double the overall rate of population increase.

In short, by the first decade of the twentieth century, it was clear that the nation was in crisis. The question was a crisis of what? Faced with this question, the newly formed discipline of psychiatry would ally with Gilded Age elites and New Liberal political philosophy to argue that this turmoil could be solved by understanding the vast array of social ills as problems of mental health.

Emotions as Political Substance
If we want to understand the conditions under which “mental health” was proposed as the total cure for the United States’ ills, we need to grasp the dominant forms of political thought that emerged as part of the new liberal consensus. To the ills of a nation riven by class conflict and plagued by social ills, Progressive Era “New Liberals” offered a prescription of harmonious social integration. This vision of society as an integrated organism was to be guaranteed by the “emotional adjustment” and “mental health” of the individual. Its success would be secured through the benevolent rule of technocratic experts, trained and housed in the nation’s freshly minted university system.

Faced with the twin specters of social breakdown or a revolution of the strain developing in Russia, turn-of-the-century liberals embarked on a political project anchored in a redefinition of democracy. Here, the fundamental unit of politics was not the property owner, but the psyche. This political-philosophical outlook put aside the question of ownership (or not) of property, and instead prioritized the individual as a psychological entity, always conditioned by cultural habits and considered in relation to a cohesive social group unfractured by class conflict.

Thus, the New Liberals performed a kind of magic trick: by waving the wand of psychiatric technocracy over a scene of profound economic inequality, they transformed the subject of politics from the property-owning citizen into a freshly politicized psyche.

The New Liberals performed a kind of magic trick: by waving the wand of psychiatric technocracy over a scene of profound economic inequality, they transformed the subject of politics from the property-owning citizen into a freshly politicized psyche.

The political philosophy of the New Liberals differed from its predecessors in three key ways. First, in place of the free-willed individual posited by classical liberalism, New Liberalism regarded the individual as motivated by unconscious drives and habit formation that occurred below the surface of conscious thought or choice. The individual, they thought, was shaped through the accumulation of habit. As the influential pragmatist psychologist William James wrote in 1890:

Habit is thus the enormous fly-wheel of society, its most precious conservative agent. It alone is what keeps us all within the bounds of ordinance, and saves the children of fortune from the envious uprisings of the poor. It alone prevents the hardest and most repulsive walks of life from being deserted by those brought up to tread therein. It keeps the fisherman and the deck-hand at sea through the winter; it holds the miner in his darkness, and nails the countryman to his log cabin and his lonely farm through all the months of snow; it protects us from invasion by the natives of the desert and the frozen zone … It keeps different social strata from mixing.

This elevation of the unconscious conditioning of the individual over freedom of choice provided the basis for the second key difference that separated the New Liberals from earlier social philosophy. While older positivist social theory (like that of Emile Durkheim) held that something called “society” exerted an inexorable force on the individual, New Liberals thought it was possible to engineer society itself through scientific principles.

If the individual was shaped by the unconscious processes of habit formation, then the best tactic for social control was not in outright force (of the sort witnessed in bloody labor confrontations) but in changing individuals’ education and environment so as to inculcate social consensus. Accordingly, the political theater should be located in the psyche of the individual, one evolving dynamically in his or her environment, taking on habits that could be engineered by the elite, university-trained technicians of social order.

The idea of social consensus was the New Liberals’ third major innovation on older forms of political thought. Previous political economy recognized competing interests (either between classes or between property owners) as creating intrinsic, constitutive social factions whose necessarily clashing positions were mediated through politics.

The New Liberals rejected the notion that society was fundamentally fractured, instead understanding society as a harmonious whole comprised of a division of labor and social roles. As a result, the question of American democracy was not a matter of ensuring equality of property, but of ensuring psychic buy-in to the social system, in which every individual would find their “natural place” to which they were best suited by habit.

The New Liberals thus put the individual psyche and emotions at the center of their vision of democracy. In replacing the question of property with that of the “personality” or psyche, they pivoted from a positive definition of freedom (e.g. freedom to pursue equality of property) to a negative one: freedom from the “emotional disturbances” that result in the individual’s failure to buy into a social harmony based on varying personal roles.

In the words of the future architect of American psychiatry Adolf Meyer, the “very foundation of democracy” rested on the recognition that “men are not born equal” in their habits and natural endowments. Consequently, democratic freedom consisted in each person finding their “natural place” in the social order. The New Liberal vision of society and politics, then, hinged on the enshrinement of what Meyer termed an “emotional culture that will cause people to stand by the rules of the social game even when it is not in one’s own benefit.”

But how was this social consensus to be achieved? The New Liberals’ vision claimed to apply truly scientific principles to the management of social ills. This was American psychiatry’s promise to the US ruling class: a universal science of the individualized psyche that could guarantee the emotional adjustment of each person to their role in the social order.”

– Zola Carr, “Medicalizing Society.Jacobin, August 28, 2018.

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““Don’t be stupid, be a smarty, come and join the Nazi Party” is an intentionally obnoxious line from the hilarious “Springtime for Hitler” in Mel Brook’s The Producers. Not hilarious is the reality that doctors in Nazi Germany were “smarties” in Brook’s sardonic sense, as they joined the Nazi SS in a far higher proportion than the German general population. Also not funny is that U.S. doctors and healthcare professionals—from their “aiding torture” (description used in the CIA Inspector General’s Report) at Guantánamo Bay, Abu Ghraib, and elsewhere to the more recent drugging of detained child migrants—have served U.S. authoritarian policies.

In the Journal of Medical Ethics in 2012, Alessandra Colaianni reports “More than 7% of all German physicians became members of the Nazi SS during World War II, compared with less than 1% of the general population… . By 1945, half of all German physicians had joined the Nazi party, 6% before Adolf Hitler gained power.” Colaianni points out, “Physicians joined the Nazi party and the killing operations not at gunpoint, not by force, but of their own volition.”

Colaianni offers several explanations for doctors’ penchant for authoritarianism—reasons that continue to exist today. Two of her explanations are doctors’ socialization to hierarchy and their exceptional career ambitiousness. “Medical culture is,” she concludes “in many ways, a rigid hierarchy… . Those at the lower end of the hierarchy are used to doing what their superiors ask of them, often without understanding exactly why… . Questioning superiors is often uncomfortable, for fear both of negative consequences (retaliation, losing the superior’s respect) and of being wrong.” She also points out, “Becoming a doctor requires no small amount of ambition… .The stereotypical pre-medical student [is] ruthlessly competitive, willing to do anything to get ahead.”“

“Authoritarian” is defined by the American Heritage Dictionary as “characterized by or favoring absolute obedience to authority.” Authoritarians in power demand unquestioning obedience from those with lower rank, and authoritarian subordinates comply with all demands of authorities.

I have a special interest in authoritarianism among psychiatrists and psychologists. In their schooling and training (and often beyond that), they live for many years in a world where one complies with the demands of all authorities, and so their patients who challenge authority and resist illegitimate authority appear to be “abnormal” and “mentally ill.”

In my training to become a psychologist, I discovered that students, trainees, and subordinate mental health professionals who challenged authorities routinely got labeled as having “authority issues,” which stigmatizes them in terms of career advancement. Both the selection and socialization of mental health professionals breed out most anti-authoritarians, and the handful of anti-authoritarians who manage to slither through the academic hoops to obtain their degrees have all, from my experience, paid a career price for challenging illegitimate authority. And that punishment has intimidated other mental health professionals from taking an anti-authoritarian path.

Corroborating my personal experience of the retribution heaped upon those rare anti-authoritarian psychiatrists, the journal Ethical Human Psychology and Psychiatry (in 2017) devoted an issue to dissident psychiatrists Thomas Szasz (1920-2012) and his protégé, psychiatrist Ron Leifer (1932-2017).

Perhaps the most famous anti-authoritarian psychiatrist in U.S. history is Thomas Szasz. His The Myth of Mental Illness (1961) brought the wrath of the entire psychiatric establishment against him. Szasz continues today to be widely misunderstood. “He did not deny that people suffer mentally and emotionally,” Leifer pointed out, “He was not even denying mental illnesses exist. He acknowledged that they exist, but … not as diseases in the same sense that diabetes or pneumonia are diseases.” Szasz argued that “mental illness” is a metaphor for emotional and behavioral problems in living. Szasz has been widely accused of being anti-psychiatry, but what he opposed was coercive psychiatry. Szasz was a fierce opponent of involuntary psychiatric treatment, believing psychiatry and psychotherapy should only be utilized when there is informed choice and consent.

What was establishment psychiatry’s reaction to Szasz? Psychologist Chuck Ruby reports, “Starting immediately on his open revolt, Szasz’s colleagues ridiculed him, and they considered him a traitor to the profession of psychiatry.” Ruby, the Executive Director of the International Society for Ethical Psychology and Psychiatry, notes, “There were unsuccessful attempts by New York state officials to remove him as a professor at SUNY Upstate Medical University at Syracuse, and his superiors at the university attempted to goad him into quitting.” Szasz was a full professor with tenure; but the chairman of the Department of Psychiatry, David Robinson, according to Leifer, “tried to drive Szasz into insubordination so he could fire him.” Szasz ultimately had to hire a lawyer to defend and protect his tenured appointment.

Ron Leifer, lacking tenure, was far more vulnerable to a career “hit.” Leifer reported that he was “excommunicated” from academic psychiatry in 1966, “fired [by Robinson] in retaliation for publishing a book that was interpreted to be criticism of psychiatry.” Leifer recounted, “I applied at other departments of psychiatry … but was rejected because of my association with Szasz. So much for the free expression of ideas in academic psychiatry!”

Then there is the case of Loren Mosher (1933–2004), the psychiatrist perhaps most respected by ex-patients who have become activists fighting for human rights. In 1968, Mosher became the National Institute of Mental Health’s Chief of the Center for Schizophrenia Research. In 1971, he launched an alternative approach for people diagnosed with schizophrenia, opening the first Soteria House in Santa Clara, California. Soteria House was an egalitarian and non-coercive psychosocial milieu employing nonprofessional caregivers. The results showed that people do far better with the Soteria approach than with standard psychiatric treatment, and that people can in fact recover with little or no use of antipsychotic drugs. Mosher’s success embarrassed establishment psychiatry and displeased the pharmaceutical industry. Not surprisingly, the National Institute of Mental Health choked off Soteria House funding, and Mosher was fired from NIMH in 1980.

Dissident psychiatrists are a rare breed, and those whom I have known tell me that the attempted hit on Szasz and the successful hits on Leifer and Mosher were as predictable as any hit by La Cosa Nostra (“our thing”)—as the psychiatry establishment is also not exactly tolerant of any challenges to “their thing.”

Anti-authoritarian patients should be especially concerned with psychiatrists and psychologists—even more so than with other doctors. While an authoritarian cardiothoracic surgeon may be an abusive jerk for a nursing staff, that surgeon can still effectively perform a necessary artery bypass for an anti-authoritarian patient. However, authoritarian psychiatrists and psychologists will always do damage to their anti-authoritarian patients.

Psychiatrists and psychologists are often unaware of the magnitude of their obedience, and so the anti-authoritarianism of their patients can create enormous anxiety and even shame for them with regard to their own excessive compliance. This anxiety and shame can fuel their psycho-pathologizing of any noncompliance that creates significant tension. Such tension includes an anti-authoritarian patient’s incensed reaction to illegitimate authority.

Anti-authoritarian helpers—far more commonly found in peer support—understand angry reactions to illegitimate authority, empathize with the pain fueling those reactions, and genuinely care about that pain. Having one’s behavior understood and pain cared about opens one up to dialogue as to how best to deal with one’s pain. Because anti-authoritarian mental health professionals are rare, angry anti-authoritarian patients will likely be “treated” by an authority who creates even more pain, which results in more self-destructiveness and violence.

It is certainly no accident that anti-authoritarian psychiatrists and psychologists are rare. Mainstream psychiatry and psychology meet the needs of the ruling power structure by pathologizing anger and depoliticizing malaise so as to maintain the status quo. In contrast, anti-authoritarians model and validate resisting illegitimate authority, and so anti-authoritarian professionals—be they teachers, clergy, psychiatrists, or psychologists—are not viewed kindly by the ruling power structure.”

– Bruce C. Levine, ““Don’t Be Stupid, Be a Smarty”: Why Anti-Authoritarian Doctors Are So Rare.” Counterpunch, August 16, 2018. (via quoms)

Source: antoine-roquentin

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“Rockwood Patient Missing,” Kingston Daily Standard. July 30, 1912. Page 08.

The police have been requested to be on the watch for John Halter, alias Otto Webber, a patient who escaped from Rockwood Asylum, on the 18th inst. He is 5 ft., 4 in, weighs 190 or 200 lbs., bald headed and speaks with a German ascent. Being a criminal patient he is wanted very badly. The suggestion is made that he might be employed on a farm in this vicinity.

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“Have Experts See Patients,” Toronto Globe. February 20, 1919. Page 07.

And Decide What Institution Best for Them to Live In


Dr. C. P. Johns, physician at the Jail Farm, testifying before Mr. Justice Hodgins’ Commission inquiring into the extent of feeble-mindedness in Ontario, at the Parliament Buildings yesterday, suggested that there should be a clearing house in Toronto for mental defectives, where experts could examine patients and decide as to the institutions in which they should be placed. he advocated sending them to farm colonies for treatment, but not too many to one place. Dr. Johns said that from 35 to 40 per cent of the 289 inmates at the Jail Farm were subnormal mentality. The problem of disposing of these people was a difficult one. He complained of the difficulty in getting into Government institutions on account of delay, referring particularly to the Orillia Hospital.

Canon Tucker of London said he believed there were between 40,000 and 50,000 feeble-minded persons in Canada. The Church of England in Canada was organized for social service work, and it felt it owed a Duty to the State in respect to the health, morals and general welfare of the people. He promised the whole-hearted support of the Anglican Church to the Government in carrying out any well-developed scheme. ‘In the course of one or two generations feeble-mindedness could be eliminated altogether from our social life, if these people were segregated and treated in a kindly way and useful employment found for them,’ Canon Tucker said. ‘There should be a more thorough examination of immigrants before sailing for Canada.’

Dr. Lillan Langstaff, Superintendent of the Women’s Industrial Farm, said that 40 per cent of the inmates there were mentally defective. Classification she suggested as a solution, as moral degenerates taught vice to the ordinary feeble-minded person.

Mr. J. J. Kelso, Superintendent of Neglected Children and Inspector of Industrial School, recommended that local homes should be provided, the Government to undertake the capital expenditure and the municipalities and benevolent people to provide for the upkeep, with the assistance of women’s organizations.

The inquiry will be continued this morning, when Dr. Helen MacMurchy will testify.

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the 1890s and the 1920s, the Rome State Custodial Asylum for
Unteachable Idiots, superintendent Charles Bernstein extended the
civic obligation to be self-sufficient to even those whom previous
asylum superintendents deemed “unteachable.” During the
1870s and 1880s, Lowell and the superintendents of the Newark and
Syracuse asylums had steadily chipped away at the notion that the
“feebleminded” could claim membership in the deserving
poor. Charity officials’ fears of hereditary public dependency led
them to enforce the civic obligation to be self sufficient— or at
least to avoid dependency—on a permanently institutionalized, if
carefully selected, population. At Rome, inmates’ capacity for
self-sufficiency literally determined their social standing within
the institution. In part, however, Bernstein hoped that making
“unteachable” idiots self-sufficient would raise their
status in the eyes of charity officials—and, not incidentally,
increase his funding.
many ways, Bernstein seems to have been driven by his own less than
pleasant childhood. After
his parents died when he was nine, his abusive uncle, a local
schoolmaster, took in Bernstein and his three siblings. Later in
life, Bernstein reflected, “If ever I have the care of children
I shall be fair to them and let kindness rule my acts.”
Bernstein, even the least capable members of the deserving poor would
fulfill the civic obligation to be self sufficient.

the same time, starting in the 1910s and 1920s, Bernstein’s
environmentalist, anti-eugenic beliefs, along with his increasing
knowledge of inmates’ capabilities, led him to return to Wilbur’s
vision of reintegrating idiots into mainstream society. Bernstein
limited his efforts to “high-grade” inmates (although he
included some inmates with multiple disabilities). Nonetheless, his
extensive colony and parole program—which superintendents in other
states eventually imitated—foreshadowed the group homes that
emerged in the mid-twentieth century. Bernstein even managed to find
a means of resolving the problem that led Wilbur to establish a
custodial asylum in the first place: how to provide homeless inmates
with guidance during their transition to independent living.
Moreover, at the height of the eugenics movement, Bernstein
established colonies for women, thereby challenging the conviction of
charity officials and other asylum superintendents that feeble-minded
women could not safely live independently in mainstream society. In
contrast with standard historical accounts that emphasize the
oppressive nature of institutional life, inmates who left the asylum
maintained closed ties with staff and other inmates.

1894, the New York state legislature finally established an asylum
that could serve male “feeble-minded” adults and, in
particular, the “unteachable” idiots excluded at both
Newark and Syracuse: the Oneida State Custodial Asylum (renamed the
Rome State Custodial Asylum for Unteachable Idiots in 1896). The
New York state government bought the Rome site from Oneida County
after the State Care Act of 1890, which mandated the removal of all
insane people from county almshouses and transferred them into
regional state insane asylums. Oneida County had erected a designated
building for its insane population in 1876 near the rest of its
poorhouse complex. After the State Care Act passed, Oneida County
decided to move its almshouse to the city of Rome two miles away and
sold the entire complex of four residential buildings, several
outbuildings, and 350 acres to the state for a little over $200,000.
timing was likely not incidental. For more than a decade, the State
Charities Board and Carson had agitated for such an asylum with
little success. The severe economic depression that began in 1893,
however, had reignited the issue of public dependency.
Coxey’s Army of unemployed workers marched towards Washington,
charity officials and professional charity reformers once again
raised the specters of the beggar and the tramp and rejected workers’
arguments that they simply could not find employment. The depression,
however, proved to be a turning point in how professional charity
reformers and charity official understood dependency and
unemployment. In particular, the depression revealed that vagrancy
laws and scientific charity movement of
the 1870s and 1880s had done little to stem the tramp problem.
Gradually, reformers began to understand
that “most tramps were merely jobless migrants” rather than
“wily imposters” and move towards more complex views of
poverty and unemployment, although most reformers still supported
forced labor for paupers. Of course, the labor press and the Populist
press, along with Henry George, had long understood the connection
between depressions, unemployment, and tramping.

at Newark, lawmakers and state charity officials intended for inmates
at the Rome asylum to reduce the cost of their public dependency as
much as possible, even though many had been deemed “unteachable”
by poorhouse superintendents or superintendents at other asylums.
Founding superintendent, John Fitzgerald and his second-in-command,
Charles Bernstein, agreed with these goals (Bernstein became acting
superintendent in 1903 and the permanent superintendent in 1904).
Indeed, Fitzgerald explicitly defined inmates’ labor as “compensation
for the state’s generous contributions for their support."81
1900, for instance, the 43 percent of inmates who were working—a
percentage far below either Syracuse or Newark—defrayed 15 percent
of the total cost of maintenance with the produce they raised on the
asylum’s farm (a value
of $6,563.63). Inmates also did all of the grading at one-third the
cost of contract labor, harvested most of the ice supply, sewed 5,863
new articles, and repaired 18,877 items.
pleaded with legislators to provide additional funds for
"industries.” He planned to use the industries—namely,
machine, carpentry, and blacksmith shops—to employ inmates who
could were not capable of doing farm labor. Fitzgerald argued that
without such employment, inmates “would become more depraved
than they are.” While he recognized that Rome was a custodial
institution, he suggested that the institution should also “benefit,
elevate and improve, as well as to care of, not demoralize, degrade
and render hopeless by inaction and lack of training.

Bernstein became superintendent in 1903, he expanded inmate labor
programs even further. By 1904, inmates manufactured all of the
clothing except "heavy knit underwear and ‘dress-up suits’ for
men, and this without employing any additional citizen labor in
connection” except occasional assistance from attendants.
Although the asylum’s population had increased by ten percent in just
one year, Bernstein had managed to reduce clothing costs by 15
percent by using inmate labor. Similarly, by having higher-grade
inmates care for lower-grade inmates, Bernstein had to increase total
wages by less than 1 percent, despite the substantial increase in
population between 1903 and 1904. In the same year, Bernstein
proposed canning string beans at the asylum, since inmates could do
the picking and stringing. Revealing his interest in maximizing the
economic and civic utility of inmate labor, he explained: “In
this way we are able to get two cents per pound inmate labor in this
item of string beans.. .this being no small item toward reducing our
direct per capita cost of maintenance to the State.”
the following years, inmates built an artificial lake so that the
institution could produce all of its
own ice, painted all of the buildings and roofs, excavated cellars
and foundations for new buildings and mixed the concrete, recaned
chairs, worked in the bake shop, laundry, farm, garden, dining rooms,
and on the wards, among other “remunerative labor…directly
profitable to the State.”
1905, Bernstein crowed: “The earnings of the 70 inmates employed
in these several industrial departments (farm, dairy, piggery,
hennery, garden, manufactured, clothing) show that these inmates have
actually supported themselves through their earnings for the asylum.”
as Rome’s population rose to Bernstein’s goal of 1,100 by October
1907, per capita maintenance dropped to $139.49 (Syracuse’s per
capita cost was $170.56 that year). Newark, with its stricter
admissions policies, had a lower annual cost of maintenance than Rome at $123.24.

moreover, sought to integrate the idea of self-sufficiency—namely,
useful labor and self-care—into every aspect of life at the asylum.
In 1903, he discarded Fitzgerald’s system of classifying newly
admitted inmates by medical categories such as “idiot,”
“idio-imbecile,” “imbecile,” and so on. Instead,
Bernstein recategorized his charges by their ability to care for
themselves and be productive as workers within the asylum (those not
yet capable of working attending vocational training classes). His
new scheme rose from no ability to work in class one, to “self-care’
in class two, "assist others” in class three, “usefulness
in industrial departments” in class four, and “good
workers” in class five.
clothing indicated which class they were in and, thereby, reflected
their status as producers.
on Carson’s experiments with teaching multiple-disabled and
severely-disabled pupils to work at the Syracuse asylum, Bernstein
required all “able-bodied inmates” and most “cripples”
to work. Bernstein likewise
sought to reduce inmates dependency by teaching as many self-care
skills as possible. To reinforce this mandate, in 1904 Bernstein
established a credit system whereby inmates could only obtain new
clothing by working or attending vocational training or self-care
classes—to which the school was nearly entirely devoted—and
showing good deportment.

also tried hard to improve the poor living conditions in the asylum.
When Bernstein became superintendent in 1902, he inherited a decaying
asylum long known as “one of the most discreditable asylums for
the care of the insane and aged poor in the State.”
fact, Fitzgerald had already improved conditions somewhat during his
tenure. With the board’s help, Fitzgerald convinced lawmakers to
replace the old basement dining halls, whose stone and dirt floors
were “saturated with refuse water and grease” and where
inmates ate their meals with pipes and a first-floor water closet
dripping on them.
in 1900, most wards remained bare, lacking even enough furniture for
all of the inmates to sit down at once. The piggery, cow yard, and
slaughterhouse were all upwind of residential buildings and during
the summer, mosquitoes proliferated in marshy holes near the wards.
addition, attendants at the Rome asylum faced excruciatingly long
hours even when compared with their counterparts at Syracuse, Newark,
or other state asylums, working from 5:30 a.m. to 8:00 or 10:00 pm at

superintendent, Bernstein worked to improve conditions for employees
and inmates alike. In order to retain more attendants, he
significantly reduced their hours, giving them half of their evenings
off plus sick-time and two weeks of vacation, while increasing their
salaries by 40 percent. He also established dedicated recreation
rooms and separate rooms for married couples, bus service between the
asylum and the city of Rome, and in 1920, an employee governance
council to advise him on pension policies and social activities.
also unlocked nearly all of the wards and finally succeeded in
removing inmates from the old insane asylum cells—a long-time
concern of the board. In addition, Bernstein argued that inmates
deserved the basic dental care that could be provided by a resident
dentist, added pianos for entertaining and “calm[ing]”
Bernstein’s strong desire to improve conditions at the asylum for
both employees and inmates, the limited funding provided by the state
legislature hampered his efforts. In 1909, for instance, the asylum
board reported that that curtains, towels, and sheets
were so short that inmates had to undress in rooms without curtains,
in full view of the public traveling a nearby road, and that many
beds lacked sheets and pillowcases.

Wilbur, Bernstein recognized that teaching inmates to be
self-sufficient even whom local charity officials and other
superintendents deemed “unteachable—could help raise their
social standing. Moreover, lawmakers would more readily fund an
asylum that housed inmates capable of improving and being producers.”
Accordingly, just after he took charge at the Rome State Custodial
Asylum, Bernstein and the board of managers began trying to remove
“unteachable idiots” from the asylum’s name as an
“unwarranted stigma.” Reflecting his anti-hereditarian,
environmentalist beliefs, Bernstein argued in the 1903 annual report
that less than 1 percent of inmates were “truly unteachable.”
He pointed out that many could read and write, and “over 50 per
cent of them have been taught to be useful.” He complained that
“the interests of the asylum are jeopardized by the idea
existing among many people that only unteachables are cared for
here…. in the matter of supplies, the idea prevailing that the
smallest variety possible in diet and clothing is sufficient for
unteachables, who must necessarily live like animals.”
Bernstein argued that even the least capable inmates needed and
deserved more than food, clothing, and housing. Indeed, in 1903 he
lambasted a Syracuse officer, a Mr. Mason, who complained about the
large number of custodial cases at Syracuse. Mason made the fateful
mistake of claiming that custodial cases could never benefit from
training programs. An infuriated Bernstein replied: "Anyone who
has spent any time with the custodial class of feeble-minded and
observed them closely would soon be impressed with the fact that
housing, clothing, and feeding them, and that alone, was surely a
short-sighted policy, as, under such treatment, they are bound to
grow more dull, stupid, destructive, filthy or violent (this
depending on treatment) and require a constantly increasing amount of
personal attention from the attendants.”

spent most of his energy on his colony and parole system for “higher
grade” inmates, however. With this program, Bernstein returned
to Wilbur’s vision of using inmates’ self-sufficiency to reintegrate
them into mainstream society. Indeed, Bernstein created the first
large-scale, successful model of group homes and independent living
for people with cognitive disabilities.
did not originate the concept of farm colonies, which originally
developed as a treatment for insane people in Europe. Farm colonies
first became popular at American idiot asylums in the 1880s
(Wilbur’s Fairmount farm colony being one of the first). The American
farm colonies pioneered by Hervey
B. Wilbur in New York, Isaac N. Kerlin in Pennsylvania, Henry Knight
in Connecticut, and William B. Fish in Illinois, among others, were
modeled on programs that boarded insane people in private homes
in Gheel, Belgium, and Scotland. In addition, the Massachusetts State
Board of Health, Lunacy, and Charity created a small program to board
out about 125 quiet and incurable insane people in private homes. He
also, however, employed colonies as a means of defraying asylum
expenses and “institutional population control.”

– Sarah Frances Rose, No Right to Be Idle: The Invention of Disability, 1850-1930. Dissertation, University of Chicago, 2008.  pp. 95-103

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An evocative portrait of the Colquitz internal culture emerges from the
surviving accounts of Granby Farrant, his institutional staff, medical
and provincial authorities, media observers, patients, family, and
friends. As argued above, the overarching feature of life at Colquitz was
the unrelenting presence of regulatory forces in virtually every detail of
daily existence. In what follows I sketch out some of the main features
of the Colquitz social order, showing how expressions of medico-legal
power infused the entirety of patients’ experience, from the seemingly
banal routines of food and dress, activity and sleep, leisure and labor, to
the most conspicuous displays of raw compulsion. I also assert, however,
that institutional regulation and its resistance were immanently
complex and contradictory phenomena, an understanding of which can be achieved only by penetrating beyond the surface manifestations
of discourse and action. 

At Colquitz, much energy was devoted in the early years to humanizing
the institution and furnishing inmates with a few precious amenities
and amusements. But these worthy efforts aside, confinement at
Colquitz was clearly a corrosive and austere existence. In the main it
comprised a numbing repetition of institutional routines, punctuated
by the periodic turbulence of staff-patient conflict, intermittent shifts in
the organizational regimen, the occasional intervention of outsiders,
visitations by delegations of bureaucrats and medical authorities, and
outbursts of inmate aggression, dissent, and escape. Mostly, though,
there was just monotony, inertia, and the ineluctable passage of time.  After the first few entries, the number of remarks recorded by Farrant in
the ward notations for any given patient typically ebbed to a trickle,
usually stabilizing at one or two annually, unless exceptional events interceded. 

 Both patients and attendants dwelled in close, claustrophobic quarters.
The cells of segregated inmates were spartan and confined. For
those living under congregate conditions on wards, virtually all facets
of life unfolded in the company of others, with privacy at a premium. Unanticipated hazards could erupt at any time. The cries and imaginary
conversations of floridly psychotic patients filled the nights in the
tiers of locked cages. Many inmates were simply consigned to their
“rooms” for months, years or decades on end, deteriorating with the
elapse of time, too debilitated to participate in the institutional culture
or too alienated to care.

Examples abound. W. D.’s father signed him into the Public Hospital
for the Insane from a Vancouver Island community in 1921 after the
son had vandalized the father’s car and attempted to plunder his team
of horses. After an escape attempt officials shipped W. D. to Colquitz
four months later, where he languished for the next 42 years. A typical
ward notation from Farrant observed that:

[tlhis patient remains in his room, sullen and morose, refused to stay on ward,
stating that patients interfere with him, becomes aggressive when compelled to
do so.. . he assists with some of the Ward activities and spends the rest of the
time playing with bits of paper in his room. He will not enter into conversation
although occasionally he will answer in monosyllables.“

A middle-aged Chinese immigrant admitted from Victoria in March
1913, C. D. had been "wandering from one town to another throughout
British Columbia and the North West Territories.. . believing… that
he owns a railroad & intends to marry a princess.” Describing him as
hostile and aggressive towards doctors and attendants, authorities removed
C. D. first to Essondale, then to Colquitz in early July 1919. l There, according to Farrant, he “does not come in contact with other patients
except at meals, is clean and tidy in his habits, he understands
anything said to him and readily obeys but will not speak… whenever
he sees me he becomes excited, shakes his fist at me and makes grimaces.”
This life of dismal solitude continued until February 1935 when
officials deported him to China. J. R., a farmer certified from New Westminster
in 1917 at age 44, proceeded to Colquitz two years later. There
he refused to leave the ward for two years, convinced that his enemies
would shoot him on sight. Finally he began tending to the institution’s
pig population, although “he is continually talking to imaginary persons,
frequently hides behind some obstacle, as though to get out of the
line of fire.” By 1923 J. R. began to deteriorate further mentally, “does

not take as much interest in his work, wanders away from it.” He developed
tubercular ulcers later that year. J. R. lingered until 1928, when,
“restless and destructive” to the end, he expired of tuberculosis on
15 May.

The severities and indignities of life at Colquitz were everywhere in evidence
throughout the medical files of these 100 men. For some, the bonds
of humanity and hope seemed to evaporate inside the institutional walls.
M. A., an Austria-bom strikebreaker sentenced to seven years imprisonment
in 1914 for attempting to dynamite a Nanaimo labor hall, landed in
Colquitz five years later where he “refuses to lie in bed, says he must be let
out, they are killing him with electricity that he can feel it tickling all over
his body.” Contracting tuberculosis in the early 1950s, he too returned to
Essondale only to die in that hospital’s infirmary. 

Perhaps more so than any other, the case of G. S. exemplified the
depths of debasement to which the Colquitz patients could at times descend.
A Doukhobor man who had wandered away from his community
in the British Columbia interior, G. S. was homeless and alone
when police arrested him in Bumaby in April 1929 for throwing stones
at a group of taunting boys. Verbally abusive to the judge, he landed in
Essondale under the Mental Health Act, then in Colquitz on 27 April
1929. By mid-August of that year, Granby Farrant was depicting him in
the following terms: “Patient is in a condition nearing an animal more
than any human being I have seen, if not closely watched, he will mix
his food with his excretion, smear it all over the floor, then gather it up
and devour it, he is becoming very emaciated physically, it is impossible
to keep clothing on him, other than a heavy canvas lined blanket.”
On 31 October another ward note read: “There is not any change in patient’s
condition, he is still confined to his room, spoon fed, bathed two
and three times a day as he is most filthy, smears himself with excretion,
urinates anywhere, spits all over the room, he is noisy, incessantly crying
‘let me out.’ ” Three days later, the patrolling night attendant found
I G. S. dead in his west ward cell. The attending physician attributed his
death to exhaustion from dementia.

Yet amid all this squalor and despond, there were also expressions of
generosity and compassion. Corresponding with his sister in 1929, C. F.
reported that “I have met quite a number of real men here, both the staff
and among the patients.” He requested that she send along “some Imperial
smoking mixture and a roll of snuff to give to some Swede boys
here.” Farrant described in 1924 how W. C., a chronic dementia case
first admitted to the PHI in 1905, “in the afternoons leads patient M. W.
about grounds, who is totally blind, he is very attentive to him.” D. M.
petitioned British Columbia Attorney-General Gordon Sloan (without
success) to undertake an inquiry into a fatal assault on a fellow patient by attendants that D. M. claimed to have witnessed in 1932. W. J. H., an
Order-in-Council patient found NGRI after attempting to shoot a friend
while in a trance-like state, managed to elope from Colquitz in September
1926. Two months later, having eluded recapture, he authored a
poignant plea to Farrant on behalf of a less favored patient:

Dear Friend-I write you a line in case you are busy and I would not want to
bother you anyhow I guess you are bothered enough by others with out me.
What I would like to ask you is to give P.S. a little consideration by allowing
him if not out on parole, to at least allow him [to] sleep in the room there where I
[was] as there is an extra bed and let him have the priviage of spending the evenings
in the pool room, I believe if he got a chance that he isn’t a bad sort of a
chap and I have know him now about a year, being he has German blood in him
I believe he feels that, that is held against him and when one feels that the world
is against him it is pretty hard to help one of that sort.… I fully relisize the responsibility
of your situtation and I know you would only be glad to help anyone
who you figured would be on the square with you; you no doubt could tell
me of cases where ungratefulness was given in return for kindness as some of
the attendants over the way have told me but P. seems to have no one to speak
for him and I trust if you will give this matter you kindest consideration, and
that good results will be obtained no doubt you will agree with me that it seems
a pity to see a fine young chap in such a place and now Xmas approaching the
change would bring a little cheer into his life.

Attendants, like patients, were profoundly affected by the institutional
ecology of Colquitz. For employees, who were typically unskilled and
considered fortunate to have secured one of the coveted provincial public
service positions (all the more so as the Great Depression descended,
and the number of applications far exceeded available placements), life
at Colquitz was characterized by austerity, a near-military regimen, and
a grinding routine: “[the staff at this period lived on the premises… in
bed at 10:30, lights out and front door locked at 10:30 pm, no smoking in
hours of duty, taking drilling by the chief attendant, rising on signal at
5:40 am. Married staff with families residing in the hospital vicinity received all-night permits on alternate evenings only.” The work at Colquitz
was more onerous than at the mainland institutions, owing to
“construction of the building.. . lack of opportunity for promotion as
compared with Essondale [and] higher cost of living on the land.” Hours were long (there were two daily 12-hour shifts); remuneration
was low relative to wages available elsewhere; and earnings were further
undermined by the 1931 restraint program. In 1933, following a
2% wage cut two years earlier)46 under-attendants were earning $1,080
annually, with night men receiving five dollars extra per month. The supervisor,
in comparison, enjoyed a yearly salary of $2,700. 

Some staff were not above pilfering hospital provisions to make ends
meet. Farrant unceremoniously dismissed night attendant R. in February 1933 when he surprised the latter at 5:00 am in the act of purloining
food from the hospital pantry. Farrant dispatched another employee
after the latter was “recognized by some of the patients as having
served with them in the Penitentiary. This is not conducive to good discipline,
though I hate to kick a man when he is down.” Attendants
could be fired on a whim, or because they transgressed the Supervisor’s
political principles. They usually bore the brunt of blame for inmate
escapes, they frequently became embroiled in scuffles with patients,
and were sometimes the subjects of unprovoked assaults. 

At least one attendant died on duty when in 1927 he was buried by a
gravel pit cave-in. In response, the Workmen’s Compensation Board
awarded his mother $100 to cover funeral expenses, and Granby Farrant
conveyed to her a letter of commiseration: “Our acquaintance with
H. was but brief,” wrote Farrant, “yet we had time to appreciate his
many good qualities, my hopes for his future were cruelly shattered,
nevertheless we must give way uncomplainingly to the One who sees
all things for the best. I am enclosing Cheque #4916 for $67.95, being
November salary, less 5 days W.C.B.” Judging from the contents of
her letter delivered to Farrant the following spring after the WCB had
rendered its judgment, the mother was less than impressed.

At the same time, during a period when public service employees
were often recruited as much for their political as their vocational suitability,
at least a proportion of attendants were plainly deficient and unsympathetic
to the suffering of inmates. While it is difficult to estimate
the prevalence of physical and psychological abuse, some incidents did
come to Farrant’s attention. Attendant G., for example, was dismissed
in October of 1921 after having severely flogged one of the patients.
Medical Superintendent H. C. Steeves expressed astonishment that one
of the institution’s personnel might be capable of such conduct. “I feel
very much distressed,” he remarked to Farrant, “that any man in our
employ should have so very little humanity in him as to treat any patient in this manner, particularly an unfortunate case of dementia,
whose mentality has become so low that he is unable to know right
from wrong, or to protect himself.”

In responding to attendant violence Farrant seemed as preoccupied
with institutional legitimacy as with the safety of inmates. After attendant
H. had attacked patient C. in 1928, fracturing the latter’s jaw, Farrant
declined to summon police. “I would have put him under arrest,”
he explained to A. L. Crease, “had it not been, for worrying patients’
friends, when they saw the case in court.” On other occasions staff
held patients directly accountable for their own victimization: “[Attendant
D.] wilfully kicked the patient’s hand,” reported Farrant, 

to cause the patient to release his hold on the bars, this inflicted several abrasions
of the skin. The patient was visited by a friend within an hour of the occurrence,
Mrs G. of Vancouver [the patient’s wife] may possibly call upon you
for an explanation, it will be quite in order for you to say that the patient has not
been seriously injured, his mental condition is unimproved, that he is giving a
fair amount of trouble, he is exceedingly annoying to both patients and staff.

Perhaps not surprisingly, no further mention of this incident appears in
the case file.”

– Robert Menzies, “"I Do Not Care for a Lunatic’s Role": Modes of Regulation and Resistance Inside the Colquitz Mental Home, British Columbia, 1919-33.” Canadian Bulletin of Medical History. Volume 16: 1999. pp. 187-194

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