Asylums had been celebrated before, especially at the beginning of the nineteenth century, when the institutions were first presented as modern and humane alternatives to “madhouses.” However, the promise of the asylum had begun to fade, by some assessments, as early as the 1850s.2 By the First World War, asylums had become warehouses,3 and the experience of shell shock in the war lent a new sense of urgency to the cause of psychiatric reform. In the context of this postwar push to move beyond the asylum, the Weyburn Mental Hospital and the optimism that surrounded it seemed to be anachronistic. However, viewed within the context of postwar Saskatchewan, the reasons for its celebration become clear. Political currents formed in the early settlement period, such as the culture of prairie boosterism and the desire to transplant allegedly British institutions in the west, combined with increased anxiety over the loss of a British and rural identity for the province, fostered a positive understanding of the Weyburn Mental Hospital. In the turbulent postwar years, the hospital came to represent an economic opportunity and a beacon of hope for the Anglo-Canadian settlers during what was considered a critical period in the province’s history. Ultimately, these deeply rooted regional, social, and political forces determined the public’s understanding of the asylum, not the foreign ideas of mental hygiene reformers or a concern for the well-being of those who would be confined to the institution.

Following the war, those who had doubted the significance of shell shock took it more seriously when the problems associated with it came home. With such a large number of formerly “normal” men suffering such a terrible affliction, the public became more receptive to the idea that large mental hospitals were not an effective means of treating mental illness and that there was a place for psychiatry outside the “asylum.” In the urban centres of Ontario and Quebec, public opinion was against sending mentally ill war heroes to overcrowded and neglected mental hospitals. Veterans, relatives, and politicians lobbied for access to effective psychiatric treatment outside such institutions.9 These factors, combined with an increasing public willingness to view the state as a benevolent agent for social change, put Canadian psychiatrists in an unprecedented position to suggest improvements to the state of mental health care.10

One Canadian psychiatrist whose career benefited from psychiatry’s wartime ascent was Charles Kirk Clarke, one of Canada’s most well-known psychiatrists. He had been the superintendent of the Toronto General Hospital since 1911 but had spent much of his career working in asylums.11 Prior to the war, Clarke was disappointed with his lack of professional autonomy, and he became increasingly bitter toward a public that seemed to demand overnight solutions to what he considered complex medical problems. He believed that psychiatry needed to be more integrated into society to facilitate the early detection and treatment of mental illness. He advocated, for example, the psychiatric examination of immigrants and schoolchildren for the purpose of early detection and treatment of mental deviance. Believing that mental illness was something to be treated by doctors in hospitals, Clarke did not entirely disagree with the idea of the asylum, but he was frustrated with what it had become. In his view, the asylum had become an overcrowded repository for incurable welfare cases, and it was impossible to provide meaningful care to the mentally ill.12

By 1905, Clarke had begun to advocate for a new kind of mental hospital. He believed that a different kind of psychiatric institution, one situated near a medical school and general hospital, would be able to provide the best care for the mentally ill by placing mental diseases in firm relationships with physical diseases under the care of medicine.13 When the Toronto asylum needed expensive renovations, as superintendent he suggested that it be torn down and that this new kind of institution be built. Despite the announcement by the Ontario government in 1908 that it would adopt his suggestion, it later changed its mind, increasing his pessimism and dislike of politicians, the general public, and even his colleagues.14 The government’s refusal to adopt his plan was only one in a long series of disappointments for Clarke. However, following the Great War, his ideas reached a much larger audience and gained much wider acceptance with the push for mental hygiene reform.

In a pattern consistent with most postwar reform movements, groups concerned with mental deficiency, immigration, health, and schooling existed before the war but were significantly changed by the war experience. In Ontario, Helen MacMurchy addressed many of the problems later attended to by the postwar mental hygiene movement. Trained as a doctor, MacMurchy established herself as a scientific authority on social problems, often using eugenics to explain the social problems of mental incompetence and moral degeneracy. In 1914, she worked with Clarke to establish a psychiatric clinic in the Toronto General Hospital15 and was appointed the chairperson of a Canadian Medical Association committee on mental hygiene.16 However, many pre-war social reformers had no interest in psychiatry. Many maternal feminist groups, in contrast to MacMurchy’s “scientific” approach, relied on the so-called natural resources of their gender and ideal images of the family to determine who should be subjected to institutionalized care based upon social norms.17

The postwar period saw a greater degree of cooperation between social reformers and psychiatrists under the label of “mental hygiene.” It was an arrangement that proved to be politically advantageous. Reformers could lend an air of medical legitimacy to their claims, and psychiatrists could demonstrate that their profession had relevance outside the asylum. Mental hygiene reformers formed the Canadian National Committee for Mental Hygiene (CNCMH) in 1918. Founded by Clarence M. Hincks, who had apprenticed under and worked with Clarke at the Toronto psychiatric clinic, the CNCMH was described as “a movement for the conserving of the mental and nervous health of the Canadian people, the prevention of mental and nervous disorders, [and] the increase of human happiness and efficiency through the application of mental hygiene principles.”18 Many of the group’s efforts, such as lobbying for the care of returned soldiers, were explicitly tied to the war and shell shock, and the committee often drew on the rhetoric of the war to bolster its cause.19 The committee emphasized the need for early detection and treatment of mental illness and for smaller mental hospitals located near general hospitals and medical schools. The position was essentially that of Clarke, who became the committee’s first medical director.

Although its leadership was medical, the CNCMH’s membership was a diverse representation of the Anglo-Canadian elite, including politicians, businessmen, philanthropists, and social reformers.20 Although support from the academic world gave the committee the air of scientific respectability, the ability of Hincks to recruit members and donors with deep pockets ensured that the committee had the necessary resources to carry out its projects.21 He also benefited from the assistance of Clifford Beers, head of the American National Committee for Mental Hygiene, which had been operating since 1909. As a member of the elite who had been a mental patient, Beers often reinforced what many prospective donors had already learned from the war, that mental illness could affect even the best members of society and that the mental hospital system might not be the most humane and effective way of treating mental illness.22

One of the defining features of the CNCMH was its eastern-centric and Anglo-Protestant character. Although it claimed to be a “national” committee, two-thirds of its membership was drawn from Ontario and Quebec.23 The committee’s first major projects, surveys of the Protestant public schools of Montreal and the non-Catholic schools of Toronto, where children were “examined for neurotic conditions, psychosis, and physical defects,”24 were typical of its eastern Canadian focus. Since many Canadian soldiers who had fought in the war had come from the English-speaking urban centres of Ontario and Quebec, they were where the most shell shock cases and desire to reform psychiatry lay.

As Clarke and Hincks championed the cause of mental hygiene reform in eastern Canada, a very different conversation on the treatment of mental illness was taking place in Saskatchewan. Despite the tendency of mental hygiene reformers to see large, isolated mental hospitals as regressive and ineffective, the people of Saskatchewan celebrated the announcement of their huge new mental hospital outside the small city of Weyburn. Newspapers portrayed its enormous size and isolated location as virtues and expressed optimism for its curative potential.25

Saskatchewan’s response to psychiatric reform stood apart from that of its counterparts to the east. This was partially because of the fundamental differences between the two regions. Compared with the urban centres of Ontario and Quebec, Saskatchewan had been settled only recently, joining Confederation in 1905, and it remained a largely rural province.26 The first asylum had been built in the province in 1914, whereas the more settled parts of Canada had a much longer history of institutionalization. Throughout the nineteenth century, reform groups in eastern Canada had advocated on behalf of mentally ill people, laying the foundations for a mental hygiene movement that flourished after the First World War, but no such reform had taken place in Saskatchewan.27 In eastern Canada, the institutionalization of people deemed mentally ill and the activism that went along with it increased with the end of the pioneer stage of settlement as urbanization took hold and people had more time to devote to non-subsistence activities.28 In Saskatchewan, this pioneer stage was much more recent. While Clarke was lobbying for psychiatric reform in the 1890s, many settlers in the area that would later become Saskatchewan were struggling to access even the most basic medical care.29

Moreover, Saskatchewan’s role in the war did not create conditions favourable to mental hygiene reform. Whereas Quebec and Ontario had supplied the bulk of the troops, Saskatchewan had played more of an economic role in the war by growing vast amounts of wheat for the military. Given the rural character of the province, shell shock was not only less of a problem but also a less visible one. As numerous historians have shown, the demand for state mental health services tended to be stronger in urban areas.30 In other parts of Canada, soldiers returned to cities, where neighbours were close and families lobbied to secure access to psychiatric c...