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 Hôpital Saint-Jean-de-Dieu
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The back of a postcard which reads, "This postcard would not have been possible without the considerable assistance of John Court at the CAMH Archives, Toronto who provided research material editorial assistance, and photographic images. Author: Sheila Gibbons"
A painted arial view of a large institution surrounded by trees and a large fountain at the front.

Information at a Glance

Institution Names

  • Centre for Addiction And Mental Health (1998)
  • Queen Street Mental Health Centre (1966)
  • Ontario Hospital, Toronto (1919)
  • Hospital for the Insane, Toronto (1907)
  • Asylum for the Insane, Toronto (1871)
  • Provincial Lunatic Asylum (1850)

Location

Toronto, Ontario

Originally 999 Queen Street West
Address changed to 1001 Queen Street West in 1979.

Timelines

  • Opened:1850
  • Period of Deinstitutionalization:1966, building demolished in 1976
A watercolour painting of a very large institutional building.Trees surround the buildings and a large fountain is at the front.

Picture of the Institution, 1890: an 1890 watercolour painting by William James Thomson of Upper Canada’s first “Provincial Lunatic Asylum,” opened at Toronto in 1850—now the Centre for Addiction and Mental Health (CAMH) in successor buildings on the same (Queen Street) site. The artist depicted people strolling casually, enjoying the elegant gardens and landscaped grounds while others arrive in horse-drawn carriages. The painting initially appeared as a lithograph in the Toronto Globe newspaper on April 5, 1890.

Source: Thomson, Picture of the Institution, 1890.

Patient Demographic

Patient Statistics by Year and Sex
Year Male Female Total
1850 211
1919 1270
1960 731 627 1348
1965 777 615 1392
1967 463 622 769
1976 339

Source: Ontario Department of Health, Annual Report.

Deinstitutionalization

In 1839, the Province of Upper Canada passed an act legislating the creation of the asylum. On January 26, 1850, the Provincial Lunatic Asylum opened its doors to its first 211 patients who were transferred from a former jail. The design for the building was described by architect J. G. Howard as “a building for the care, not incarceration, of about 500 of the insane of Upper Canada.”

In 1894, C. K. Clarke, then-Medical Superintendent of the Rockwood Asylum at Kingston, declared in his annual report that “it is a difficult matter to get the nonprofessional and sometimes the professional men to realize that an insane person is one suffering from bodily disease as much as the patient with typhoid fever. They can understand the delirium that accompanies fever but regard the excitement so characteristic of mania as the disease itself rather than evidence of disease … We have hospitals for patients suffering from fever, why not hospitals for persons suffering from insanity?” (Ontario Legislative Assembly, Sessional Papers). This sentiment spearheaded a movement to remove the term “asylum” from its name and, in 1907, the Queen Street facility was renamed The Hospital for the Insane, Toronto.

In 1956, a new administration and central building was completed that obstructed the front of the old building and included a walkway that broke through the front of the old asylum. In 1964, the Ontario Ministry of Health announced plans to replace the Queen Street Asylum structures with new buildings on the same site, and in 1966, the institution’s name was changed to the Queen Street Mental Health Centre. Construction of the new units began in 1970, and by 1976, the original 1850 building had been demolished.

A photo of a modernist, many-windowed institutional building with a covered entrance and a drive way leading up to it.

Queen Street Administration Building is Complete, 1956.

Source: Courtesy of the CAMH Archives.

Health Minister Dennis Timbrell officially dedicated the newly completed Queen Street Mental Health Centre (QSMHC) in 1979. In an effort to symbolically disconnect the new centre from its stigmatized past, its address was changed from 999 to 1001. A ministry press release announced that the old Queen Street facility had been brought into modern times. It stated:

[G]one now are all the vestiges of an earlier time when mental illness was something that society kept out of sight—the high wall that encircled the grounds and effectively isolated patients from the outside world, corridors that reeked of an atmosphere of listlessness and boredom, and heavily screened windows that contributed to the prison image. In their place stands a facility that reflects the new thinking on the treatment of mental illness, a policy that opens doors both for the patient and the community.

The Centre for Addiction and Mental Health (CAMH) was created in 1998 in response to a report by the Health Services Restructuring Committee, which advised merging the Addiction Research Foundation, the Clarke Institute of Psychiatry, the Queen Street Mental Health Centre, and the Donwood Institute to create a new public hospital.

Sources: CAMH, Breaking Down the Barriers; CAMH, New Mental Health Centre; Pollock, “Social Policy”; QSMHC, Summary.

Transinstitutionalization

In 1933, a “boarding home” was introduced, which allowed for the care of selected outpatients supervised by the hospital.

The Queen Street Mental Health Centre launched three satellite community service programs in 1968. The first, The Dundas Day Care Centre (located at 349 Ontario Street), was a program that emphasized outpatient care for those with mental disorders and was aimed at reducing the resident population at the 999 Queen Street location. The centre provided psychiatric assessments, counseling, day care, aftercare, and home visit services. Its objectives included supporting patients discharged from the Queen Street Centre and enabling them to make “the sometimes difficult transition from in-patient status to that of productive citizen.”

The Community Inn program provided a broad range of services both to discharged patients from the Queen Street Centre and other members of the community who faced “real-life problems.” Its clients could access several therapeutic and rehabilitation services.

Lastly, for Toronto southeast, Spectrum implemented a multifaceted program of services to help maintain 200 outpatients in the community. It provided consultation services, public health nurses, social and welfare agencies, and staff for home visits to patients and families in crisis.

Later, in 1976, three half days a week, The Archway would offer preventive programs such as counseling services to single parents and consultations with community agencies. Between fifty and eighty former in-patients at Queen Street received routine aftercare services from The Archway.

By the 1970s York Community Services was sponsored by several health and social agencies, provided legal aid resources, and employed several part-time psychiatrists, social workers, and psychiatric nurses.

A black and white photo of two buildings - a newer modernist structure in the left foreground, and an older building in the right background.

QSMHC Old and New 1972: many early mental-health landmarks of colossal proportions were replaced during the second half of the twentieth century, sometimes in the midst of spirited debate, as ideas changed concerning the optimal design and scale of treatment facilities. This 1972 photo at the former Queen Street Mental Health Centre (Toronto) depicts the controversial demolition of its nineteenth-century asylum structures as their modern replacements were constructed.

Source: Photo, 1972, courtesy of the CAMH Archives.

Sources: QSMHC, Hospital Procedures; QSMHC, Patients and Visitors; QSMHC, Summary.

Work Therapy into Occupational Therapy

The first Occupational Therapy graduates from the University of Toronto provided staffing for Queen Street beginning in 1927.

The development of services aimed at reincorporating patients into the community began when a number of in-patient units were converted into day care and self-care programs in the Centre. During this period, an off-campus industrial therapy workshop was developed (on Christie Street). Within this program, up to sixty day care patients supervised by four staff members were employed by subcontract work. The QSMHC offered multiple similar therapy programs beginning in the late 1950s.

A photo of a large room with many round tables and chairs in it. Artistic or craft supplies adorn each table. Four women in black and white uniforms perform various tasks in the room.

Occupational Therapy Studio—Queen Street Administration Building, 1959.

Source: Photo courtesy of CAMH Archives.

In 1960, the Department of Health established a Rehabilitation Branch with the goal of providing services for both in- and post-hospital stages. The branch was to act as a consultative and advisory body to “both public and voluntary agencies in all phases of social and vocational rehabilitation.”

Though the branch developed educational and training services in 1966, the organization recognized that formal technical training institutes were inadequate for the needs of patients discharged from a hospital for the mentally ill. To fill this gap, “Operation New Start” was introduced with a strong emphasis on the rehabilitative needs of mentally ill patients. One such program authorized “industrial rehabilitation centres” within all Ontario hospitals, enabling hospital superintendents to employ patients for work in their hospitals. Under this policy, programs operated on a six-hour workday, five days per week, and patients were paid for their labour (Pollock). Similarly, the Vocational Rehabilitation Act allowed for the further development of workshops and other training programs that provided an incentive and support to enable people with mental illnesses to reside in their own homes. In 1967, an amendment to the Secondary Schools Act required school boards to provide services to those deemed “trainable retarded.”

Sources: Pollock, “Social Policy”; QSMHC, Hospital Procedures; QSMHC, Patients and Visitors; QSMHC, Summary.

Patient Into Person

In 1966, the hospital was renamed the Queen Street Mental Health Centre to reflect a new approach to mental health.

The first phase of redevelopment was a community centre complex, which included a day-care treatment area plus facilities for patients, staff, and the public. A gymnasium, swimming pool, and cafeteria surrounded a large public visitation area.

Coinciding with “Putting People First,” a provincial policy document that prioritized the needs of people living with mental illness, the Centre initiated a “therapeutic community” approach in which patients and staff collaborated in the treatment process.

The Queen Street Patients Council was established in 1992. This “Empowerment Council” has an independent board of directors and continues its work in patient advocacy to date. The council is intended to be a voice for the people on the receiving end of hospital services. It provides a voice for clients, survivors, and ex-clients of mental health and addiction service providers.

Four people (2 men and 2 women) flank a large colourful CAMH banner adorned with phrases such as 'CAMH in the Community', 'Health Promotion', 'Diversity', and 'Collaborative Partnerships'.

CAMH in the Community: the approach to serving the community is broadly defined with a range of perspectives, some of them itemized in this on-site display.

Source: Photo, ca. 2012, courtesy of the CAMH Archives.

Sources: QSMHC, Summary.

Staffing in the Deinstitutionalization Era

The final phases of demolition and rebuilding in the early 1970s had a dramatic impact on the perception of 999 Queen. One staff member remarked that “professionals are starting to see us as a place to refer people, not just a dumping ground.” The new buildings and new treatment regimens generated pride, enthusiasm, and hope among the staff.

In 1973, it was reported that staff included psychiatrists, physicians, nurses, social workers, psychologists, occupational therapists, chaplains, rehabilitation officers, and recreational personnel who all contributed to treatment. Working together, this staff developed treatment programs specifically designed to each individual patient.

A black and white photo of 6 women sitting in a small room with a large desk and a shelf full of binders. One woman appears to be talking while the others listen.

Staff Meeting in a Treatment Unit: a staff meeting in the chart room of a 1970s-era in-patient unit, reflecting the important clinical role carried out by psychiatric nurses and other allied health professionals.

Source: Photo, 1970s, courtesy of the CAMH Archives.

Sources: Baird, “999 Queen”; Court, “999 to 1001 Queen Street”; QSMHC, Patients and Visitors.

Bibliography

Baird, George. “999 Queen: Why Was it Torn Down?” City Magazine 2, no. 3&4 (Summer 1976). Clarke Institute Fonds, CAMH Archives.

Ballon, Diana. “Looking Back: Reflections on Community Mental Health in Ontario.” Canadian Mental Health Association, Ontario Division.

Centre for Addiction and Mental Health (CAMH). New Mental Health Centre is Officially Dedicated. Toronto: CAMH, January 30, 1979.

Court, John P. M. “From 999 to 1001 Queen Street: A Consistently Vital Resource.” In The Provincial Asylum in Toronto: Reflections on Social and Architectural History, edited by E. Hudson, chapter 10. Toronto: Toronto Architectural Conservancy, 2000.

Ontario Department of Health. Ontario Department of Health Annual Reports–Mental Health Branch. Toronto: Archives of Ontario. 1950–1967.

Pollock, Sheila Joy. “Social Policy for Mental Health in Ontario, 1930–1967.” PhD dissertation, University of Toronto, 1974.

Queen Street Mental Health Centre (QSMHC), Asylum File 722. Informational Booklet: For Our Patients and Visitors. 1973. CAMH Archives.

Queen Street Mental Health Centre (QSMHC), Asylum File 722. Hospital Procedures: Homes for Special Care Programme. 1973. CAMH Archives.

Queen Street Mental Health Centre (QSMHC), Asylum File 722. Summary of Queen Street Mental Health Centre. 1977. CAMH Archives.

Thomson, William James. Picture of the Institution, 1890. Watercolour painting. Collection of the Centre for Addiction and Mental Health Archives, Toronto.