THE HOSPITAL HISTORY PROJECT
Lithographs of the first five asylums in Ontario; left to right: Hamilton, Orillia, Toronto, London, Kingston
The Provincial Asylum System
Between 1850 and 1878, the province of Ontario opened five "Lunatic and Idiot Asylums" in the towns of Toronto, London, Kingston, Hamilton, and Orillia. These institutions were each managed by a physician who held the title of Medical Superintendent and were overseen collectively by the Inspector of Prisons & Public Charities.
The asylum was the primary location for government-run mental health care throughout the 19th and much of the 20th century. It was based on the initial premise that a person had to be removed from their home and admitted to a purpose-built institution where they would receive treatment (see the Treatment page for more details).
The Challenge of Overcrowding
Table showing the increase in asylum population in Ontario between 1877 and 1888.
Originally published in the "Twenty-first Annual Report of the Inspector of Prisons & Public Charities for the Province of Ontario, being for the year ending 30th September, 1888."
By the 1880s, the demand for space in Ontario's asylums exceeded the number of beds available. Worse still, it was believed that rates of insanity were on the increase province-wide.
Daniel Clark, Medical Superintendent at the Toronto Asylum, attributed the prevalence of insanity in North American society to “the high tension under which so many people live” (The Globe, 1884, January 29). He cited a range of determinants based on his own review of thousands of cases, including intemperance, worry of one kind or another, business troubles, religious excitement, sexual excesses, and a variety of other factors.
Overcrowding posed not only an administrative and space challenge, but was also considered detrimental to the effectiveness of treatment. Treatment during this period required physical space because the environment of the institution was intended to play a key therapeutic role (see the Treatment section for more information).
Due to the lack of beds available at the asylums, a growing number of individuals were admitted to the jail system - in spite of never having committed a crime. Even more than an overcrowded asylum having a negative effect on a person's chances of recovery, physicians worried that confinement to a jail may render would-be patients incurable or even lead them to a life of crime.
Mimico: For the Chronically Insane
To cope with the growing population numbers, superintendents at the existing Ontario institutions began to explore potential solutions. Most proposals focused on segregating the patient population: designating institutions for sub-populations, including the so-called criminally insane, inebriate, and chronically insane. Kingston was initially designated for the former category while a new facility was proposed for the latter two.
When approval was granted to establish a branch asylum in 1888, the intention was for Mimico to be specialized for the care of those believed to be chronically insane. The term was used to describe individuals who had been ill and / or institutionalized for so long that their chances of recovery were deemed doubtful; this was in contrast to acute or newly diagnosed cases which were considered the most likely to be cured. By transferring all chronic cases to Mimico, the earlier asylums would be able to open space to treat acute cases (see the Treatment section for more information).
The Mimico Branch Asylum was planned to accommodate 500 patients across 10 cottage buildings, a size that the Inspector of Prisons & Public Charities for Ontario, W. T. O'Reilly, described as being "for a few years to come, ... sufficient for the wants of the western part of the Province" (O'Reilly, 1888).
Headline from The Globe published May 18, 1885
The Mimico Branch Asylum officially opened its doors on January 21, 1890 - a full decade after administrators at the Toronto Asylum had first set their eyes on the farmland in Mimico for possible expansion - but before the first year was even complete, a radical change in vision would be presented.
Just over five months into Mimico's first year, the Inspector of Prisons & Public Charities for the Province of Ontario, Dr. W.T. O'Reilly, died suddenly while on a routine visit to the Kingston Asylum. Rather than picking up from where he left off, his replacement, R. Christie, challenged the entire system underlying the administrative structure of the province's mental health system.
In his first annual report, written in November of 1890, Christie expressed doubts that the planned size of the Mimico Branch Asylum would be sufficient to meet the demands of the province. With a continuously growing patient population, Christie estimated that available space at Mimico would be surpassed by the end of 1891.
With concerns of a worsening overcrowding crisis, Christie questioned the very foundation on which the Mimico Branch Asylum had been established: the care of the chronic insane. He argued that the idea of providing provincial accommodations for a population deemed by their very definition to be less likely to improve in health or recover all but guaranteed failure. Rather than increasing the number of beds available in the province, Christie suggested that asylum administrators be restricted to those individuals who were deemed treatable (or curable) and that responsibility for the chronic insane be passed to the individual counties.
Christie continued to pursue his ideas of eliminating provincial responsibility for the chronic insane over the subsequent year, even going so far as to send a detailed questionnaire to Ontario's five Medical Superintendents to elicit their opinions. Perhaps unsurprisingly from a group who had advocated for the existing system for many years, they unanimously - and strongly - opposed Christie's vision.
A Branch of Toronto
Through its establishment and first four years of operation, Mimico shared a superintendent with Toronto. Nearly from day one, Toronto Asylum administrators complained about the extra time required to manage two institutions and so it was likely inevitable that Mimico would eventually separate and become an independent institution. The only real change that came from this separation, aside from a new administrative structure, was the transition away from exclusively serving a supposed chronic class of patients - a population who, according to the philosophy of the day, would most benefit from the rural environs and arrangement of the cottages - to serving all cases from the surrounding region. In other words, Mimico shifted from providing a service for a specific population to providing generalized service for the Western provincial region more broadly. Opening its doors to a broader patient population reflected the overarching administrative priorities of the Inspector of Prisons & Public Charities, W. T. O'Reillly, to relieve overcrowding throughout the five institutions. This action superseded the treatment-oriented vision that had been put in place by the Toronto superintendent Daniel Clark when the two institutions had been linked.