Mental Health and Canadian Society: Historical Perspectives (review)

The history of mental health has largely focused on asylums or other institutions of incarceration. What is refreshing about this collection is that, while many of the papers examine the world of the asylum, others go beyond it. The nine short contributions cover the period from the 1840s to the late 1960s and aspects of the history of mental health illness in the provinces of Nova Scotia, Quebec, Ontario, Saskatchewan, and British Columbia. An added bonus is the presence of an index, a rare thing in a collection of essays but very useful for both researchers and students.

In a short review it is impossible to examine each article, but what stands out is the number that introduce new approaches, questions, and subject matter to the study of mental health. Among the topics are the phenomenon of visiting asylums as a site of education and curiosity (Janet Miron); insanity in the world of the family (Thierry Nootens); patients as unpaid workers in the asylum (Geoffrey Reaume); community and incarceration (André Cellard and Marie-Claude Thifault); the beginning of forensic psychiatry (Allison-Kirk Montgomery); the experience of Aboriginal patients (Robert Menzies and Ted Palys); an intellectual study of Brock Chisholm and his support for sterilization vis-à-vis the mentally ill (Ian Dowbiggin); an analysis of psychiatric research of disasters (Judith Fingard and John Rutherford); and the early study of psychedelic drugs in Saskatchewan (Erika Dyck). Some authors follow a social control interpretation, but one that both looks at the victimization of patients within the asylum and acknowledges the resistance that individuals could mount. Other authors try to understand why those in charge (or the opinion-makers) had the visions of care or treatment that they did.

It is unclear what such a disparate collection says about the state of mental health studies, other than that it keeps growing and refreshing itself. The irony is that the title of the book is a misnomer; the focus is not on mental health, but on those who are perceived to be without it. In many of the articles mental health is still associated with madness, a problem so serious that many in the past thought incarceration was the best care possible. While historians have long critiqued the institutionalization of the insane and the mentally ill, often the underlying critique was based on a romanticized view of community and family care. That lives could be also damaged by community attitudes and family responses was overlooked. Neither did the historiography expend much effort in understanding the institutional response and why it became so dominant. For that reason, the articles on the modern period in this collection that attempt to understand a different way of looking at mental health or responding to it are particularly welcome.

The editors argue that previous historians of mental health in Canada bypassed the revisionist phase of the historiography that was so strong elsewhere and engaged in a rather vigorous denunciation of the emergence of modern psychiatry. While Canadian historians did not take up the social control interpretation in any major way, I'm not persuaded that the reasons for it lie in the regional or the 'colonial configuration of British North America,' as the editors suggest. Historians were well aware of revisionist approaches, but saw them as exaggerated and one-dimensional. They didn't ignore them, they simply did not accept them in the way presented elsewhere. In the beginning of their introduction, the editors also note that there is no synthesis yet in the Canadian historiography on mental illness. After reading Mental Health, there is still no synthesis suggested. What the book does do, however, is to provide a fascinating, readable collection of essays on some of the newest research in the field – a significant contribution to the future synthesis.