Disability & Institutionalization

Learning Outcomes 

 Define ‘institutionalization’ 
 Describe the history of institutionalization in Ontario 
 Discuss motives underpinning practices of institutionalization 
 Discuss the impact of institutionalization on distinct social groups 
 Explain criticisms of deinstitutionalization 
 Define ‘transinstitutionalization’ 
 
The Era of Institutionalization - period of time as well as a state of mind  
 In Europe and in North America… 
o 18th C Mental hospitals or “asylums” 
o 19th C Institutions for intellectually disabled or “feeble-minded” 
 Language defining impairments were not as defined as today 
 Not a lot distinguish between each disability  
o Institutions started divided between them  
 Canada - 60 institutions stayed open into the 20th century  

What an institution is: 

o Large scale resident institutions  
o Big lawn or field  
o Daunting building  
o Housed people with intellectual disability - maybe physical impairments as well  
o Resemble jail or school  
o Their function: where particular ideologies are carried out  
 History of residential schools  

In Ontario… 

 Orillia Asylum for Idiots was one of the las asylums to close in Ontario
 In 2009, the last 3 closed their doors for good
Why Institutions?
 An alternative to incarceration
o Progressive idea
o People deserved and needed different things
 Needing support
 Lack of community supports
o People who weren’t able to take care of themselves or strive in a normal society,
did not have the kind of community support we have today
 Enlightenment & Industrial Revolution
o Society is changing fast – living conditions
o Human wellbeing is a new idea at this time
 Intervention & medicalization
o Growth of medicine

Social Trends Promoting Institutionalization

1. Increased value of education and its possibilities for human development 

o Idea that people with disability could be educated  
 Ex. Learn how to take care of themselves
o Institutions were places where people could be taught and learn how to integrate into
society  
 Temporary learning spaces - then later reintegrate into society  
o Institutions were seen as training centres  
o Residential institutions were a parallel to universities where researchers go to learn and
study 
2. The rise of humanitarianism 
o Philosophical perspective that shows concern for the wellbeing of humanity  
 The differences between people should be treated with kindness
o We can and should do better for people who are more disadvantaged in society  
3. The strong acceptance of eugenics in the latter decades of the 19th century.  
o Tied to Darwinism  
o People who are best suited/fit to belong in society will adapt with it  
o Less desirable people shouldn’t reproduce/have children - these traits shouldn’t exist in
the world  
o Nazi eugenics  
 Eugenics around the world was at its height in the 1920-1930’s
 These ideals still carry into today’s society  

Eugenics: survival of the fittest

The Effects of Institutionalization

 1. Dehumanization
 Not enough space and resources for everyone
 People were treated as cases
 Useless eaters – people who quickly become a burden and who use resources
2. Families torn apart
 People with disabilities don’t belong with their family and to send them off to an
institution
 Thought of not having any inherited value
 would be a burden on families
 Huge traumatic loss for parents and siblings when their child/sibling is sent away
 Families would be instructed to forget about their family members
3. Dominant medical ideology shrouds alternatives
 Medicalized spaces
 The effects of medicine - best way to manage/deal with people to try to fix and correct
them  
 One way to care and support them
4. Hiding difference reinforces stigma and stereotypes
 Hiding disabled people reinforced stigma and negative stereotypes about disability  
 Having disabled people around you helps you understand disability a lot better  
5. Challenges of inclusion
 No need to build things for people in wheelchairs or people with sensory impairments  
 We lacked infrastructure and ways to integrate those with disabilities  
o This is because of institutions  
 We lacked in the understanding on how to integrate those with disabilities
o Ex. Those with sensory impairments and how they learn better

The Era of Deinstitutionalization

1950’s to 2000s

 We start hearing people talk about large scale societal change  

 Civil rights era  
 Phasing out and closing of large public facilities 
o Change of public discourse and awareness of rights 
o Community living better than institutions  
 Changing practices: reduced and shorter admissions  
o People were sent to stay for shorter periods of times  
 Increase in community resources (housing, medical, rehabilitation) 
o Community supports had to be developed in order for there to be appropriate places for
people to go to receive the supports they need

In Support of Deinstitutionalization
 Factors
o Changing societal attitudes
 o Human rights advocacy
o Cost
 Institutions were somewhat costly to implement
 Where the money should be placed – repairs, staff or community
supports
o Increased community supports
 Makes it possible to close institutions and change the way the properties
are being used
o Development of psychiatric drugs
 Pharmaceutical companies could control the symptoms and help
integrate them into society
 Voices
o Families
 Saying it isn’t right for their family to be taken away despite medical
advice
 Families hearing about abuse from their loved ones in the institutions
o Self-advocates
 Disabled people having to advocate for themselves
o Community advocates
 People who are aware of the conditions of institutions
 They see this is not a humane practice
o Professionals
 Seeing a decline of conditions
 Seeing the abuse taking place
o Researchers/scholars
o The media
 Everyone coming together to agree that it needs to be closed down

o Competing Interests 
 Concerns about lack of community supports 
o If institutions are going to close, where is the money going to come from?  
 Concerns about safety 
  Fear/doubt of unknown 
 Concerns about job loss/economy - heavy conversations that were had 
o Vs 
 Recognition of abuses/mistreatment  
o Increase societal awareness  
 Humanization, argument for human rights 
o Reversal of dehumanization  
o Recognition for human rights  
 Resisting medicalization cost  
o Maybe medicine isn't the only answer  
o Worried about the cost - are there better ways to distribute resources  

In Ontario…

 1975-1986 - closure of institutions  

o Massive change in the number of people receiving services 
o Number of people receiving services increase to 25 thousand  
o Increase in funding from 10 million to over 180 million from institutions to community
services  

Criticisms of Deinstitutionalization

 Too fast, insufficient planning 

o Many people were left behind and without resources 
 Co-optation of activist initiatives (opportunity to cut funding) 
o Taken over for a different purpose  
o Cut costs and wanted to save money  
 Led closing of larger institutions led to the creation of smaller, institution-like settings
(re-institutionalization) 
o As large institutions closed, hospitals/long term care homes were available  
 Institutionalization ideology perpetuated through restrictive and invasive community
care (transinstitutionalization) 
o Institutionalization still carries on in many ways through community services 
  Not in institutions, but when people go to apply for services like social
supports - they are subject to many controls and surveillance on their
behavior  
 Still very medicalized  
 Area of institutionalization still lives on in less visible ways  

 
Summary & Conclusion 
 The era of institutionalization spanned 133 years in Ontario 
 Institutions were strongly supported by economic and cultural trends, and accompanying
philosophical rationales  
 The effects of institutionalization and implications for societal inclusion of disabled people
are long-lasting 
o Effecting both disabled people and their families 
 The institutional mind set persists through transinstitutionalization 
o The idea that institutional mind set is still evident in different support systems that are
available today  

Archival Footage

The first institutions

 1876 Ontario government opened the first institution in Orillia 
 Originally called the Ontario Asylum for Idiots then changed to the
Huronia regional center to show ith as changed to better understand
people with disabilities  
 At its peak - home to more than 2500 people  
 Why were they built? 
o Lack of services and support 
o Way people viewed people with a developmental disability  
 Considered patients - needed to be treated and protected from everyday
life 
 Continued in the 1960 
o Doctors encouraged people to send their children here 
 By 1960 - Ontario had 16 institutions for people with developmental disability  
o More than 6000 people lived in these - children and adults  

One of every street

 Communities where people with disability are understood  
 Once called asylum for idiots - now called community: the Ontario hospital school 
o Have expert staff, facilities  
o These kids were victims of "retardation"  
 Highly trained staff that was crowded but up to date  
 London, Ontario was researched the cause and control of retardation  
 Smiths hall also had one to care/treat their patients 
  Coburg - another hospital In Ontario 
 Each individual needed to be tested 
o Fit into three categories  
 Mildly retarded  
 Regular school classes - like normal school 
 Each child's schooling is attuned to their mental age  
 Some students even can read for their own pleasure  
 Some boys allowed to help in the kitchen for skills they can use later in
life  
 The girls are given cooking classes  
 Some become waitresses and can graduate from the school  
 Moderately retarded  
 Severely retarded 
o Had to take IQ tests  
o No one is pushed beyond their mental capacity   
o Girls are pushed to take up sewing and to make garments for themselves as an
incentive 
o Shoe shop at the school provides practical benefits for the boys  
 They learn stuff about factory relationships  
o Smith falls had girl and boy scouts 
 Skills = badges of honors  
 Mildly retarded girl learn hair dressing   
 All girls have their hair done regularly  

What was it like to live in one of Ontario's institutions for people with development mental disability?    
o Rideau regional facility opened in 1955  outside of smith falls
o By 1955 - 2600 resident lived there, mostly children and teenagers
o When it first opened it had two buildings  
o Took a lot of staff to run - 2200 staff worked there
 Provided treatment and training  
 Social workers, teachers, doctors etc were there…  
 Other staff took care of operations: housekeeping, cooking, cleaning, sewing, maintance etc.
o These people were self-contained and self-reliant