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  • Managing Madness: Weyburn Mental Hospital and the Transformation of Psychiatric Care in Canada by Erika Dyck and Alex Deighton
  • Megan J. Davies
Managing Madness: Weyburn Mental Hospital and the Transformation of Psychiatric Care in Canada Erika Dyck and Alex Deighton Winnipeg: University of Manitoba Press, 2017, 321 p., $27.95

Erika Dyck, co-editor and instigator of this ambitious volume, was my fellow principal investigator on the sprawling After the Asylum project, which spawned three websites, one set of academic articles, several book chapters, a documentary, and a living history exhibit. It is therefore an interesting task to measure Managing Madness, not simply as an important book in its own right, but as another chapter in the ongoing project of producing inclusive, activist mad history in Canada.

Much of the work of the After the Asylum project was about engaging with a range of stakeholders (community activists, individuals with mental health histories, educators, academic researchers, young people with an interest in social justice) in an effort to make the history of deinstitutionalization available to a broad public. Although mention is made of community presentations, Erika Dyck and her colleagues have essentially gone in the opposite direction, producing an academic study that will fit comfortably on the shelves of a university library, but which has an "unorthodox and complicated authorship." The team Dyck assembled for the project included keen former students, an important provincial architect of deinstitutionalization, a mental health activist, a retired government bureaucrat, and a deceased psychologist. The implication is that these individuals variously contributed important documents, professional recollections, unpublished work, or insights drawn from work/life experience, while Erika Dyck and Alex Deighton wrote the majority of the text. I will not be the only reader who wishes for a more fulsome description of the astounding alchemy by which the book was envisioned, developed, and composed. Additionally, we learn at the outset that the book's creators hold a range of opinions about the merits of the asylum. But how was this diversity negotiated, and how is it reflected in the finished volume? [End Page 203]

The title of this book suggests a Foucauldian approach to controlling the mad, but its scope is in fact much broader. The book's creators conceptualize the asylum as a significant institution now fading from public and professional memory, but one that needs to be remembered and appreciated as a place where multiple and often intersecting histories were enacted over time: a healthcare version of prairie boosterism à la historian Alan Artibise; the promotion of "modern" psychiatry through LSD therapy or careful community placements; a place for building political fortunes or careers in psychiatry; a neglectful and even cruel environment where the goal of healing was lost in fiscal cost-cutting. I greatly admire this wide reach, which clearly demonstrates the multiple ways in which healthcare institutions need to be understood as connected to larger economic, political, professional, and social trends. At times, however, I thought the book shifted too far away from Weyburn, leaving the reader a bit adrift from the narrative.

Yet the ambitious reach of Managing Madness, while sometimes problematic, also means that it delivers valuable history on a range of topics. I learned a lot from reading this book. The introduction is a masterful and extremely useful overview of institutional practice, patient populations, mental health policy, and mental health legislation. The first chapters demonstrate how local political agendas, rather than contemporary ideas about treatment, dominated at Weyburn in its early years. I suspect that these interpretations would hold true for many other Western Canadian asylums. We also are presented with important information about how ordinary people and communities regarded mental health differences. The refusal of the Weyburn town council to allow patients to be buried in the local cemetery speaks volumes in this regard. Readers engaged with issues of social justice will note many human rights abuses at Weyburn: naked patients kept in the basement where raw sewage regularly flooded the space; an institutional practice of destroying patient correspondence; a woman being given "medical" advice to sign in her distressed husband as a permanent patient and insert his obituary in their community newspaper. Key chapters dealing with...

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