Institutionalization emerged in the 19th century as a response to custodial care or segregation of people in jails, almshouses or poor houses, insane or lunatic asylums, and hospitals for long-term sick and disabled people. The rise of institutions throughout the 1800s coincided with a social desire to isolate people in these facilities from mainstream society, often on a presumption of their danger to society. Institutions have played a major role in capturing target populations that were then later subjected to the policies of eugenics; the main institutions included mental hospitals, training schools for children and adults with intellectual disabilities and mental health guidance clinics. The vast majority of approximately 3,000 individuals who were sexually sterilized under Canadian eugenics laws were also institutionalized.
Mental hospitals or asylums became dominant forms of institutional treatment for madness in the eighteenth century. Some scholars argue that the rise of the asylum was a progressive response to the need to help or rehabilitate people with mental disorders. Several scholars, however, are more critical in their appraisal, suggesting that these facilities were never intended for healing or curing but instead merely incarcerated people who did not conform to social expectations, whether through transgression of gender, class, religious or other kinds of prescribed roles. In sum, critics argued that these buildings grew in number and in size and became mausoleums of society’s detritus. Despite such fierce criticism, beginning in the mid-18th century asylums appeared throughout Europe and spread across the Atlantic. Allegedly, the last asylum in the British Commonwealth opened its doors in 1921 in Weyburn, Saskatchewan. Although many of these institutions did not engage directly with sexual sterilization or eugenics per se, they played an important role in segregating individuals and contributing to contemporary ideas of the relationship between mental health and citizenship.
In Canada at least 60 such institutions existed throughout much of the twentieth century. These facilities ranged in size from small cottage-style clinics that housed fewer than 100 patients at any given time, to large scale asylums or mental hospitals with thousands of patients and hundreds of staff. A few institutions also provided specialized services for people considered “feebleminded” or intellectually disabled. These training schools catered primarily to children and young adults and were scattered across the country to provide a specific kind of care for people considered incapable of so-called normal education and learning. Red Deer Alberta was home to the Michener Centre, formerly the Provincial Training School for Feebleminded Children, and Orillia, Ontario housed Huronia Regional Centre, which had been called the Orillia Asylum for Idiots. These specialized institutions have since closed and attracted considerable public attention due to persistent allegations of abuse.
By the early 1960s scholars and activists began to openly question the social value of these long-stay institutions as they were expensive and largely ineffective elements of an increasingly complicated healthcare system. Famously, a Canadian-born sociologist, Erving Goffman, coined the phrase “total institution” referring to places that cut off individuals from the outside world and that produce new rhythms of life inside these walled-off facilities. Moreover he argued that institutions created a sub-culture of existence that is internalized by those who are forced to live under these conditions, especially patients but also staff. He claims that: “their encompassing or total character is symbolized by the barrier to social intercourse with the outside and to departure that is often built right into the physical plan, such as locked doors, high walls, barbed wire, cliffs, water, forests, or moors.” (page 4). Goffman was particularly interested in mental hospitals and the plight of patients as they succumbed to life in these institutions, but he was not alone in his critique of these facilities. By the early 1960s policy-makers, patients, families, psychiatrists, nurses and tax payers leveled criticism at these institutions and gradually these kinds of institutions were downsized, closed and some were even physically demolished.
Whether the institutions were designed to altruistically help individuals or whether they were used as instruments of social control, segregating people from society significantly reduced their capacity to reproduce. Some scholars suggest that incarceration itself is a form of eugenics. In Alberta and British Columbia, however, the institutions were also directly involved in collecting individuals who were then monitored and selected for sexual sterilization surgery. In Alberta, after 1937, institutionalized patients with low IQs were even sterilized without their consent or knowledge. In these cases, institutionalization carried a heavy sentence that permanently eliminated any chance of reproduction for individuals who were considered either a genetic threat or likely to be irresponsible parents, on account of their disability.
The relationship between institutionalization and eugenics is complicated, as often institutions became the main sites for eugenics programs, but being institutionalized in itself functioned as a form of segregation that limited one’s capacity to reproduce. Although in Canada only Alberta and British Columbia passed eugenics laws, other provinces engaged in similar practices, sometimes by segregating people in institutions to control their reproduction. Individuals became institutionalized after being admitted to one of these facilities, whether due to recommendations from family, apprehensions by police or state officials, or referrals from doctors and psychiatrists. Prior to discharge from an institution, patients were judged by doctors and social workers with respect to their general health, intelligence quotient and capacity for responsible parenting. In Alberta, the Eugenics Board recommended sterilization in almost every single case. Some patients fought back, some remained confined, and others challenged what they saw as an abuse of power after leaving the institution. These institutions, however, played a fundamental role in formal and informal eugenic practices.
Although a significant number of Aboriginal people were institutionalized in Indian Residential Schools at the same time and under some similar conditions, these institutions were not formally included in the eugenics program and further research is still needed to determine whether sterilizations occurred in these settings. Collectively, however, all of these institutions, including the residential schools, effectively segregated people from mainstream society and claimed to offer treatment or education that was aimed at reintegrating its subjects into communities as ‘improved’ citizens. This goal borrowed from a variety of techniques that were practiced within the institutions, including elements of discipline, rewards and punishments, structure and some basic skills training.
Michel Foucault, History of Madness (London: Routledge, 2006)
Erika Dyck, Facing Eugenics: Reproduction, Sterilization, and the Politics of Choice (Toronto: University of Toronto Press, 2013)
Erving Goffman, Asylums: Essays on the social situation of mental patients and other inmates (Anchor Books, 1961)
Randall Hansen and Desmond King, Sterilized by the State: Eugenics, Race, and the Population Scare in Twentieth-Century North America (Cambridge: Cambridge University Press, 2013)
Roy Porter, A Social History of Madness: Stories of the Insane (London: Weidenfeld & Nicolson, 1987)
Roy Porter and David Wright, eds. The Confinement of the Insane: International Perspectives, 1800–1965. Cambridge, Cambridge University Press, 2003.
David Rothman, The Discovery of the Asylum: Social Order and Disorder in the New Republic (Boston: Little Brown and Company, 1971)
Andrew Scull, Museums of Madness: The Social Organization of Insanity in Nineteenth-Century England (New York: St. Martin’s Press, 1979)
Harvey Simmons, Unbalanced: Mental Health Policy in Ontario, 1930-1989 (Toronto: Wall & Thompson, 1990)
David Wright Mental Disability in Victorian England: The Earlswood Asylum, 1847–1901 (Oxford, Clarendon Press, 2001)