Still Searching For Answers

It was 1869 when two sisters described as “middle-class school teachers” were declared insane and by court order, removed from Victoria’s 10-year-old hospital – The Royal – better known as “the Asylum,” a health care facility with accommodation for a handful of patients suffering what the doctors of the day called “routine” afflictions.

The “hospital” was a two-storey building, and administrators were stressed to the limit trying to provide separate accommodation for male and female patients, “different” accommodation for patients of Chinese descent, and meeting what they regarded as the impossible demand to provide beds and care for “maniacs.”

We should spend a sentence or two with the Chinese problem because it is so difficult to believe. Affluent citizens in the 1800s and well into the 1900s hired servants of Chinese descent to clean their homes and do their laundry, their cooking, and everything else that contributed to good health practices – but couldn’t share a hospital ward with them because, well, they were not white.

The white people felt themselves to be cleaner, morally superior and deserving of softer pillows and better care than the Chinese.

Amazing but true. 

The Chinese and “the whites” did agree on one thing: That maniacs, the crazy people, should not expect, or get, the same care and hospital attention as the “normal” sick.

And, that brings me back to the sisters mentioned in my opening paragraph, “teachers of the middle class and deemed insane.” They were ordered to be transferred from Victoria’s hospital, certified as “insane,” and incarcerated in the Victoria City jail – with the key presumably thrown away. 

The charge against them? “These insane ladies were noisy and physically violent, and one refused to wear any clothing (so) they were kept locked in a bare brick cell in the Victoria City jail (and here’s a key phrase) with only male staff supervision.”

But there was a third sister who took up the battle on behalf of her siblings, challenged the touted “respectability” of Victoria citizens and drew commanding attention to the almost total lack of care for mentally impaired citizens. She mounted a letter-writing campaign to the press appealing for common decency and the need for women to be looking after her afflicted sisters.

Public hearings followed with resignations of old hospital officials, and, in 1873, the passing of the BC Insane Asylum Act as a shocked public forced subsequent governments to seek solutions for the care of the mentally ill. It has never been a pleasant battleground. As recently as 1901, psychiatric literature in BC still listed the causes of insanity as “hereditary, intemperance, syphilis and masturbation.”

How to handle the mentally sick among us would continue to be a significant problem. In 1904, the government thought it was on the way to a solution when it purchased 405 hectares of land in New Westminster-Coquitlam (including Colony Farm) for the construction of a new therapeutic centre for the mentally ill. In 1913, it opened its first ward – the Male Chronic Building. It is not a record to boast about, but within a month, it was filled with 900 patients, double its planned capacity.

Colony Farm was part of what was now known as Riverview, a central model of psychiatric health care quickly named internationally as one of the most progressive asylums in North America. Its patients worked the grounds, and at its peak produced up to 700 tonnes of crops and 20,000 gallons of milk a year.

But the idea of big hospitals and institutions was losing favour as various regions of the province sought solutions “closer to home” populations. In 1998, the government announced plans to close Riverview, but two years later said a new 20-bed unit would be built to house patients who found it difficult to obtain treatment in home area residential centres.

In 2000, Riverview and the provincial government were attacked for the hospital’s use of controversial electroshock therapy. The dispute led to the resignation of the president of the medical staff who had fought against the practice. The same year a group of former patients launched a lawsuit claiming male and female patients had been illegally sterilized between 1933 and 1968. Evidence revealed 200 patients had been sterilized. Nine women received settlement totalling $450,000.

Most of the land today is included in a land claim by the Kwikwetlem Nation and is recognized provincially as a botanical garden and architectural heritage site. Some old buildings are still in use by private companies, others stand empty like acid tears shed for a worthy cause that went awry.

And the problems of how to best handle the mentally fragile among us remains unanswered. If a fully modern care facility staffed with the finest mental health advice and backed by a working food-producing farm isn’t the answer – what could be? Not unsanitary instant – hovel tent shambles disgracing boulevards and parks. And surely not the unused rooms of basic motels built primarily for overnight stays not for extended stays.

(The Internet is jammed with stories pre-Riverview and the Colony Farm; stories of enlightenment and ignorance, hope and regret, fear of the mentally ill, and the discomfort many of us still feel in its presence. The history of Psychiatric Nursing in BC provides a useful timeline on the long battle for a better way in BC. So does Riverview Hospital a brief history/CBC News. And with “Society, Place, Work –The BC Public Hospital for the Insane” BC Studies, autumn 2011, provides its usual excellence research.)

I have no suggestions, but welcome yours.


  1. I am not surprised that you have no suggestions. And I have none either. What I’ve noticed throughout my life, however, is that the experts, psychiatrists and such, cannot seem to agree on who is insane or how to treat someone they might think is insane.

    When I was a boy people were institutionalized for basically aberrant behaviour. It took a few decades to discover that this was probably a mistake. Then it was decided to release most of these people. The pendulum swung too far and people were released who should have been kept inside because they could not function on the outside.

    Many of them are today’s homeless or the inhabitants of the tent cities you refer to.

  2. Hi Jim,

    Thank you for this fascinating history of how mental illness has been treated over the years in BC.

    I have always subscribed to the concept that mental illness is a condition defined by the community rather than by the professionals. Historically in societies it is the unacceptable behaviour of individuals in a community that defines who is mentally ill.

    To-day it seems that “homelessness” is the surrogate definition of mental illness by society. Instead of building “Riverviews” and other places to house those with “mental illness” they are being accommodate in hotel rooms and other institutions (like Mount Edwards) and at the Youth Detention Center in View Royal.

    Of course it is realized that amongst those who are “homeless” are those with serious Psychiatric illness (like Schizophrenia) and those with drug and alcohol addictions and those that have both.

    Many “homeless” people will have a long history of dysfunctional family upbringing in early childhood, poverty and lack of education. These are the determinants of health that Governments (both left and right wing) find difficult to address. Meanwhile the rich get richer and the poor get poorer and more end up “homeless”. The phenomenon is observed in any Western city that I have visited.

    Thank you for your much appreciated commentaries.

    Dr Shaun Peck

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