Appendix A: Historical context

The following are some examples of discriminatory practices against people with psychosocial disabilities that mark an unfortunate part of Canada’s history. Many of these practices still have a profound impact on people’s sense of inclusion and their ability to exercise their rights today. People with mental health disabilities or addictions and others have responded to many of these issues by actively seeking changes to laws and policies to achieve social justice.

Immigration laws

From the late 1800s, Canadian immigration laws systematically prohibited people determined to be “lunatics” (people who were perceived to be mentally ill or have mental health challenges) and people determined to be “idiots” (people who were perceived to have intellectual or development disabilities) from entering the country. These laws first barred people who were not accompanied by families that could provide financial support. The fear was that individuals would become dependent on state institutions and charities.[297] By the early 1900s, immigration laws identified people with mental and physical disabilities as being in the “inadmissible” classes of immigrants. These laws reflected perceptions of people with mental health issues and cognitive and developmental disabilities as being “morally degenerate,” with mental affliction being attributed to sin and moral weakness, and later associated with criminality and disease.[298] Restrictive immigration laws also led to the deportation of many people, based on assumptions of racial inferiority and presumptions of insanity and “feeble-mindedness.”[299] Until the Immigration Act was amended in 1967, people with disabilities were still in the “undesirable” class of potential immigrants to Canada.

Involuntary sterilization

In their harshest form, the eugenics ideology and movement[300] sought to make sure that the more “fit” or socially desirable members of society had children while “undesirable elements” were bred out of the population.[301] In the late 1920s, Alberta and British Columbia introduced sexual sterilization legislation. Alberta sterilized over 2,800 people from 1929 until the law was repealed in 1972, with several hundred sterilizations occurring from the 1960s until 1972, often without the knowledge or consent of people or their parents. The Alberta Eugenics Board ordered sterilization for people declared “in danger of transmitting mental deficiency to their children, or incapable of intelligent parenthood.”[302] This was rationalized on the basis that people with mental disabilities would make poor parents, and produce children prone to crime and other social problems.[303] People who were declared “mentally defective,” “mentally deficient,” “psychotic,” “demented,” etc. were sterilized, as well as people who had epilepsy, neurosyphilis, and Huntington’s chorea.[304] Over 800 people sued the government of Alberta for having been involuntarily sterilized. The Government of Alberta made an official apology in 1999 and provided financial compensation to the victims.[305]

Marriage laws

Several Canadian provinces, including Alberta, British Columbia and Prince Edward Island passed marriage acts that prohibited people from marrying who were declared “mentally disordered,”[306] “insane or mentally incompetent,”[307] etc., regardless of whether they had the capacity to marry.

Voting restrictions

Historically, people with mental health disabilities and intellectual disabilities have been assumed to be incapable of making significant decisions affecting them. In 1988, the Federal Court of Canada declared that a section of the Canada Elections Act was invalid and inconsistent with section 3 of the Canadian Charter of Rights and Freedoms which states that “Every citizen of Canada has the right to vote in an election of members of the House of Commons or of a legislative assembly and to be qualified for membership therein.” The law prohibited people with mental disabilities detained in institutions, and people who did not have personal control of their property, from voting in federal elections. The Federal Court rejected the “assumption that a person suffering from any mental disability is incapacitated for all purposes, including voting.”[308]

Insane asylums

The first permanent psychiatric institution or “insane asylum” opened in Québec in 1845. Other asylums opened across Canada from this time until 1914.[309] Despite the initial benevolent motives behind the asylum movement and the intent to provide care and treatment,[310] many inhumane practices occurred in these institutions.[311] Many patients, once admitted, spent the rest of their lives in the asylum isolated from family and community.[312] Overcrowding was common, relationships between patients and staff were paternalistic,[313] and patients reported experiencing verbal, emotional, physical and sexual abuse by other patients and staff.[314] Asylums often became custodial institutions, providing limited food and shelter with inadequate treatment. There was an over-reliance on seclusion and chemical and physical restraints.[315]

Deinstitutionalization

Starting in the 1960s, under a policy of deinstitutionalization, people were moved away from long-term psychiatric facilities with the goal that they would be provided services and supports in the community.[316] It was thought that patients would be admitted to the hospital briefly when unwell, but otherwise would live successfully in their communities.[317] Unfortunately, the result was that people with less severe mental health disabilities were more likely to be admitted to psychiatric units in general hospitals, while many people with severe and persistent mental health disabilities were left to rely on provincial psychiatric hospitals that had fewer specific mental health resources.[318] Ultimately, the shift from institutional to community care was marked by a lack of community supports, such as affordable, safe housing and a lack of accountability for the care of people with severe mental health disabilities.

People with addictions

The dominant view in Canadian society in the 19th century was that addiction was a moral failing and resulted from a “lack of will power or from personality defects.”[319] In the early 1900s, drug addiction, such as cocaine and opium addiction, was considered a form of mental disorder that could lead to admission to an insane asylum.[320] As such, some people with addictions who were admitted to insane asylums experienced the same isolation from family and community, overcrowding and mistreatment from asylum staff that is described above. 

People with addictions were often viewed by the public as dangerous.[321] Sometimes this perception was fuelled by racism. For example, xenophobia in British Columbia resulted in stereotypes of Chinese immigrants who smoked opium and ran opium dens as “drug villains.”[322] However, “the larger number of predominantly middle-class and middle-aged Caucasian users who were addicted to the products of the established pharmaceutical industry” were generally not considered dangerous.[323]

Canada developed stringent criminal drug laws in the early 1920s as non-medical substance use was considered a law enforcement problem.[324] It was not until the early 1950s that a focus on treating alcohol and drug users emerged.[325]

Movements for change

In response to the discrimination experienced by people with mental illness, many different patient groups formed across Canada during the 1970s, some of which are still in existence today.[326] These groups formed the consumer/survivor/ex-patient movement. The general goals of the movement were to bring about change to the mental health system, educate other ex-patients and the public to challenge stereotypes about mental illness, advocate for patient rights, and create alternatives to psychiatric institutions, such as facilities organized and controlled by people with mental health disabilities.[327] In the late 1980s, a number of patient groups along with other advocates successfully lobbied for changes to the Mental Health Act, including granting patient access to mental health records and restricting the ability of doctors to restrain patients.[328]

Following a series of deaths in a psychiatric hospital, groups also advocated for investigations into psychiatric care practices, which eventually led to the establishment of the Psychiatric Patient Advocate Office.[329] Other initiatives included developing formal and informal groups for “peer support,” developing businesses completely run by ex-patients, educating the public, and networking with other ex-patients through magazines and newsletters.[330]