Mental Health and Canadian Society: Historical Perspectives.

• Author: Kaiser, H. Archibald
• Position: Book review

Canada is by no means inundated by scholarship surrounding the history of people with mental health problems or intellectual disabilities. Despite the existence of some fine essays and treatises on narrower topics, as the Editors of this excellent collection opine, "there have been very few attempts at national synthesis." (1) Worse still, from the perspective of the potential of research to foster a critical climate in an area rife with deference towards mental health professionals and discriminatory attitudes towards the citizens who are the subjects of the law, is Canada's having been "bypassed [by] what is often referred to as the 'revisionist' phase of the 1970s," which had provided "an unprecedented scholarly attack on the traditional view." (2) Mental Health and Canadian Society: Historical Perspectives helps to fill these gaps, even if, as an edited collection spanning about one hundred seventy years and several regions, it cannot remedy decades of comparative scholarly inattention.

What Mental Health in Canadian Society does, in the main, is provide a wide range of insightful essays, continuing a modern trend of "doing medical history 'from below,' or rewriting the history of health by bringing patients' perspectives to the fore." (3) Indeed, for the reviewer, used to searching vainly for newly written historical material, it is hard to temper one's enthusiasm for this estimable book with the need to provide a sober assessment. Its readership will include historians, lawyers, mental health professionals and consumers--basically anyone concerned with finding an explanation for the present sorry state of affairs, where "[m]ental health has often been described as one of the 'orphan children' of medicare." (4)

What one will glean from the papers is, in part, obvious. Canada's inattention to the promotion of mental health and its tendency to devalue and segregate (either physically or socially or both) those who experience mental illness has deep historical roots. However, the lessons of history are usually poorly learned, given the momentum of discrimination and the difficulty of perceiving the contingent and mutable nature of the present range of responses to mental illness. Good historical accounts ought to invoke humility and occasionally, at least, elements of hope, and this book delivers both. In their thoughtful and incisive accounts of legal and institutional issues, several of the essays can be readily linked to contemporary themes. Others, dealing with trends in research and professional development in psychiatry, demonstrate in a different setting the same sociological awareness that helps to illuminate the present clearly.

To give some sense of the scope of this volume, four of the nine chapters focus on subjects emerging from Ontario, two from Quebec, two from the West and one from Nova Scotia. Five papers concentrate upon the nineteenth century, while the balance address more contemporary subjects extending through to the late 1960s. Five chapters engage the resort to or experience within segregative institutions, and four canvass aspects of psychiatric research, theory and professionalization. All the essays offer admirable combinations of demanding research standards and balanced critical judgments. For readers with a particular interest in its effects on marginalized communities, most of the papers integrate the law's hovering presence effectively with descriptions and analyses of the experience of people with mental illness and their families. The chapters are sufficiently varied and innovative that they each deserve a brief summary and comment. Those dealing with institutional responses to mental health problems will be reviewed first, followed by a discussion of the balance, which emphasize research and professionalization. The apparent contrasts with modernity often fade upon closer scrutiny.

Janet Miron's "'Open to the Public': Touring Ontario Asylums in the Nineteenth Century," covers what initially appears to be the most unusual topic of the collection in its survey of the practices and controversy surrounding "[t]housands of tourists ... [who] strolled across the grounds and walked through the wards of Ontario's mental hospitals." (5) Even at the time, there was a lively debate about the legitimacy of the practice, with its defenders urging that it was "an important part of the process of social legitimization," (6) and its opponents urging that "patients should not be treated as spectacles by visitors." (7) Miron concludes that the phenomenon "illustrates" the "interaction and fluidity" of the relationship between the asylum and society, as opposed to the perception of "unilateral segregation and alienation." From a contemporary...