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Reviews

Rememberance of Patients Past
2003-03-11

If you have an interest in the fields of psychology, psychiatry and the mind, an understanding of history is essential to provide context and continuity to new work. While manuals like the DSM are updated every few years (conveniently erasing, for example, memory of the days when homosexuality was considered a psychological disorder) writers of other books strive, often passionately and with a sense that the work they do is urgent, to chronicle the changes in thought and technique over the years.

Take Remembrance of Patients Past, Geoffrey ReaumeÆs meticulous history of patient life at the Toronto Hospital for the Insane between 1870 and 1940. Later the Queen Street Mental Health Centre and now amalgamated into the multi-tentacled Centre for Addiction and Mental Health, the Toronto Hospital for the Insane at 999 Queen St. W housed 18,819 people during the 70-year period of ReaumeÆs meticulous historical study.
ItÆs not often that we û therapists and members of the public û get the chance to see things from patientsÆ perspectives. Reaume was himself diagnosed with paranoid schizophrenia in his teens and was an in-patient and an out-patient at several psychiatric hospitals. He is now the Hannah Visiting Research Fellow at the Institute for the History and Philosophy of Science and Technology at the University of Toronto û altogether, an impressive set of credentials to write this solid and empathetic account of patientsÆ lives and of the attitudes holding up the mental health system at the time.

Reaume shows that patients led difficult lives û abuse, monotony and forced treatments ranging from lobotomy to insulin injection to shock therapy in the later years. He cites patient Ralph M., who wrote poignantly, "Oh that I had wings I would fly like a dove and be at rest I would fly out of this asylum". Others creating meaningful relationships with staff and fellow patients and performed unpaid work for the hospital. Another patient, Winston O., built violins, built a car from scratch and drove it around the asylum grounds, and was supposedly working on building an airplane at the time of his death.

Reaume also celebrates the relatively humanitarian, holistic approach of Superintendent Daniel Clark, who between 1875 and 1905 instituted free, voluntary dental care for patients, believed that exact classification of mental illness symptoms was impossible, and resisted over-prescription of drugs in favour of fresh air and recreation.

Throughout the work, Reaume argues that despite the many problems with æ999Æ, as the hospital was called, the institutional support it offered was critical. He draws parallels with todayÆs situation, in which institutions have been virtually abolished but the necessary supports to let people lead fulfilling lives in the community are not in place.

A valuable resource for policy planners, community mental health workers and people who have experienced the mental health system as a patient or as a therapy professional, Remembrance of Patients Past resurrects the past to shed light on mental health treatment and the humanity of patients today.

- C.Z.

by: carly

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