Published on May 1st, 2017 | from CAMH
Remembering Joseph Workman
By Nancy Dorrance
Although he lived in the 19th century, Joseph Workman surely qualifies as a Renaissance man. An early president of the Canadian Medical Association, he was also a founding member of the Toronto Board of Trade, first Chair of the Toronto School Board, an accomplished linguist and translator, founder of the First Unitarian Congregation of Toronto and, for a brief time, outspoken editor of the Upper Canada Reform movement newspaper, The Toronto Mirror.
But the position that would define him and become his lifelong legacy was the one he held on July 1, 1867, as Superintendent of what was then called the Provincial Lunatic Asylum. While the British American Provinces celebrated their Confederation, Joseph was in the midst of a 22-year struggle with governments, boards and inspectors to ensure, in his own words, “abundant and timely provision for the treatment and care of the insane.” Today, that facility has evolved into the country’s largest mental health and addictions teaching and research hospital, CAMH.
Joseph Workman was also – though he couldn’t have known it at the time, of course – my great-great-grandfather. I’ve been fascinated by his story for much of my adult life, and the older I get, the more I attempt to channel his wisdom and compassion!
Born in Ballymacash, Northern Ireland in 1805, Joseph immigrated with his family to Montreal when he was 24. After graduating in medicine from McGill, he practiced only a year before moving to Toronto to help his wife’s family run their hardware store, and subsequently opened one of his own. A successful businessman and now city alderman, he returned to medicine in 1846, opening a family practice and joining the faculty of a fledgling Toronto medical school. Seven years later, Joseph was appointed interim superintendent of the troubled provincial asylum at 999 Queen Street.
The Dictionary of Canadian Biography paints a grim picture of “administrative chaos, professional incompetence, and neglect of patients” when Workman assumed control in 1853. The mess he had inherited included, literally, a basement full of sewage due to a lack of proper drainage. Within a year he was able to restore order and efficiency in all departments, however, and “the Toronto asylum became recognized as a model institution, much praised both in Canada and abroad.” Joseph Workman’s interim appointment was made permanent.
Finding medical solutions to the problems presented by residents of the facility proved more difficult, however. As one of the first generation of physicians to become an “alienist” (a 19th-century term for specialists in the institutional care and treatment of the insane), Joseph had to learn his new calling on the job. In consultation with other alienists and asylum administrators at home and abroad, he attempted to implement the best therapeutic practices of the day – replacing restraints, blood-letting, unhealthy diets and excessive medication with fresh air, exercise, good nutrition, useful activity and, above all, kindness.
While patients improved physically and emotionally, this new approach failed to provide the dramatic psychiatric cure rate anticipated by Workman and his colleagues. For the balance of his career, he wrestled with the asylum’s apparent inability to heal the majority of its residents, and fought bitterly against government cutbacks of funding and resources that resulted in overcrowding and poorer quality of care.
“No lunatic asylum, whether intended for the lodgment of those called criminal, or any other class of the insane, should be regarded or considered as a ‘penal institution’,” he wrote in 1859. “Insanity has never been cured, or benefited by, punitive measures. The primary object of all institutions for the insane is the restoration of the afflicted inmates to reason, or failing this, the attainment of the greatest possible amelioration of their unhappy condition.”
Shifting the focus from punishment and deprivation to a positive, nurturing environment where patients developed healthy habits and improved their self-esteem was a huge step forward in the treatment of mental illness. I’m proud that my great-great-grandfather was one of the first proponents of this revolutionary new direction in mental health care at the time of our country’s birth 150 years ago, and that his name is highly regarded today among Canadian and international practitioners.
Photos courtesy of CAMH Archives. All rights reserved.
CAMH’s Queen Street site will be participating in Great Gulf Doors Open Toronto on Saturday, May 27, with a special exhibit by Workman Arts, a partner organization focused on empowered aspiring, emerging and established artists with mental illness and addiction issues to develop and refine their art practice through multifaceted arts training programs and public performance/exhibition opportunities.
Tours of CAMH begin at 10am and run throughout the day. Click here to visit the Doors Open website for more information.