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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Jay on February 26, 2007, at 19:09:26
From `inmates' to `clients'
TheStar.com - News -Toronto.
February 25, 2007
It's a Sunday in 1860, and a mother wearing a broad-brimmed hat passes sandwiches to her husband and three children as they sit on a picnic blanket. The boy is wearing a sailor suit. The father points out a patient named Mary. Her hair is dishevelled; her arms hang slack as she shuffles past. She relieves herself in a flowerbed. And the father roars with laughter.This scene is from the early years of the Provincial Lunatic Asylum, precursor to the 1001 Queen St. W. branch of the Centre for Addiction and Mental Health. "They had come here for entertainment," wrote Dr. Joseph Workman, an enlightened humanitarian who was head of the asylum from 1853 until 1875.
"To them, these unfortunates were freaks in some country fair sideshow – to be gawked at, shuddered at, laughed at and forgotten. At no time did the parents wonder if Mary had been a little girl like their daughters or if she had a husband or a son. She was sub-human ...
"Then they left. To go to church."
Since 1850, the site has been home to people who were variously referred as lunatics, idiots, the insane, inmates and patients. The term used at CAMH today is "clients."
Over the years they endured treatments such as immersion in ice-water baths, insulin-induced comas and lobotomies – procedures that would not be tolerated now.
The patients also endured the outside world's fear and contempt. Mothers told children to hold their breath when they passed the hospital, fearing they'd be infected with madness. Some taxis refused to pick up passengers there. Children were told to smarten up or they'd be sent to "999," the shorthand name for the hospital until its street number was changed to 1001 in 1979 in order to evade such ridicule.
Before the asylum was built, people who showed signs of mental illness, including senility, and could not be cared for at home ended up in dank jail cells. Their heads were shaved, their bodies scarred from bloodletting; some were held in leg irons. When the hospital was built, Workman promoted kindness and patience instead.
Inspired by London's National Gallery, architect John Howard's neoclassical structure was one of the most impressive buildings in Upper Canada. It had hot and cold running water, central heating and indoor washrooms.
Three miles from the city centre, it was to provide clean air, healthy food and a protective wall. Soon, however, flaws in the hospital's design became apparent. The much-vaunted ventilation system turned out to be useless, and the building smelled like a cesspool. The stench became a hallmark of the institution.
Within decades, the asylum was overcrowded. It became a dumping ground for the poor and the senile because, as Workman observed, the province made no provision for support of "the destitute and very harmless people."
Freedom was limited. Men were expected to work, unpaid, on the adjoining farm or in workshops, while women toiled in the laundry or did sewing.
"These places were so institutional they were like prisons," says Geoffrey Reaume, an assistant professor of history at York University, and a former psychiatric patient. "It was warehousing of mad people, and it was not a therapeutic environment."
Reaume cites the hospital's walls, built by patients in two stages, in the 1860s and 1880s, as a testament to their capabilities. (The current renovation accommodate the preservation of the remaining east, south and west walls.) "It's very important to fight the discrimination that exists today – that people with psychiatric history are not capable of meaningful work," says Reaume, author of a book about the institution, Remembrance of Patients Past.
By the 1880s, the city that had once seemed so distant engulfed the asylum. The walls, rather than seeming protective, made the hospital seem like a jail.
The environment changed little over the next 70 years. Then, in 1956, a grey, featureless, faintly Soviet-style administrative building was erected in front of the asylum. Twenty years later, the old building was torn down – despite public protests and plans for its reuse by architect Jack Diamond. In its place were constructed the smaller, campus-style buildings, which will in turn be demolished as part of the redevelopment.
Reaume has mixed feelings about the makeover, arguing that what really needs to be renovated is people's attitudes toward the mentally ill. "We have to make sure they are part of the community and not shunned," he says. "It's their community, and for people not to welcome them shows a profound disrespect and ignorance of their long history."
Leslie Scrivener
Posted by Phillipa on February 26, 2007, at 21:43:00
In reply to From 'Inmates' to 'Clients'.., posted by Jay on February 26, 2007, at 19:09:26
Jay you know though in a way it reminds me of what has happened in the USA. Especially familiar in NYC the street people living in boxes with shopping carts flowing with trash are the attempts of deinstitutionalizing the mentally ill here. Love Phillipa
Posted by Jay on February 27, 2007, at 11:23:21
In reply to Re: From 'Inmates' to 'Clients'.. » Jay, posted by Phillipa on February 26, 2007, at 21:43:00
> Jay you know though in a way it reminds me of what has happened in the USA. Especially familiar in NYC the street people living in boxes with shopping carts flowing with trash are the attempts of deinstitutionalizing the mentally ill here. Love Phillipa
I think the problem also, Phillipa, is that when governments 'deinstitutionalized' people, they also cut off the money to them. They said that the focus moved to a 'community-living based' model, but without money, how is 'anything' supposed to happen? So people where dumped on the streets, deprived of desperately needed medication, and forced to live in homelessness, poverty, and squalor. Also, regarding the medication, I've heard some good people and researchers say that back then, the doctor's prescribed way, way too high of doses of meds. That's why people seemed so lost and docile.Even though, many of the clients I work with (some who have developmental handicaps, along with behaviours..etc.) are still being prescribed Largactil (chlorpromazine) But, I would say the younger ones, the newer clients, usually get the atypical antipsychotics.
We need to get governments back to spending quality investment money in community and institutional mental health. I could absolutely never understand how they expect someone to pay for, say a couple of the new medications that are out there. I was surprised, though, recently here in Canada to find that Effexor XR had gone generic.
Jay
Posted by yxibow on February 28, 2007, at 2:02:26
In reply to Re: From 'Inmates' to 'Clients'.. » Jay, posted by Phillipa on February 26, 2007, at 21:43:00
> Jay you know though in a way it reminds me of what has happened in the USA. Especially familiar in NYC the street people living in boxes with shopping carts flowing with trash are the attempts of deinstitutionalizing the mentally ill here. Love Phillipa
Its a huge problem in Seattle, my former college love and hopefully future. Seattle has some of the highest homeless populations, and they include a number of homeless teenagers, among them a number who were kicked out because of their homosexuality.
It also is a gigantic problem in an unnamed coastal city near where I live, and the views go back and forth around it. There is contentions about "feedings", charities who give meals to the homeless on the bluffs and create a spectacle. Its a spectacle regardless, with people talking to voices and generally making the decorum of the area a blight in the eyes of many.This started with the closing of numerous institutions in California in the late 60s due to budget cuts under a certain well known governor, if I recall correctly. What people need is proper medical help and a restoration of their dignity to what is humanly possible, including medication and therapy. There have been pilot projects by such people as the Salvation Army who have built "halfway houses" for homeless families on otherwise wasted land. They actually blend well into the scenery and you would never know that they are homeless residences.
A new name though for all of us who suffer as patients from biological disorders, I believe promoted both by certain parts of the medical establishment and I think NAMI, is "consumers". It creates a better sense of dignity that we use resources, we consume resources of help for the ills that we face. It is likely that you will see this name if you live in an area progressive enough to use it.-- tidings.
This is the end of the thread.
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