Joseph Workman, MD 1805 - 1894
Mental Health Pioneer
Joseph Workman was born in Ireland. Once in Canada, he became a successful businessman. He went into politics and became an outspoken advocate for the Reform movement. His enemies called him “the most bitter and reckless slanderer”. Encouraged by John Rolph, he went back to his first love, medicine He eventually also taught medicine at the Toronto School of Medicine when it was in Cabbagetown, at the corner of Gerrard and Sackville.
Workman was to take an important role in the development of mental health services in the city. At the time, psychiatry didn’t exist and people with mental health issues were put away. “Quiet lunatics” were kept at home. But, in the growing city, there was more and more a need for a place to care for the “furious lunatics”.
A temporary asylum was opened in 1841 in the old Toronto Jail. It was a horrible place: misery, starvation, overcrowding, etc.
The Provincial Lunatic Asylum opened in 1850 (Queen Street location where CAMH is now) and was not much better: administrative chaos, professional incompetence, and neglect of patients. The place was called “hell hole” and there were even accusations of having turned “the lunatic asylum into a Dissecting Room” for medical students.
In 1853, Workman was appointed the superintendent of the Asylum. He cleaned up the place, so much so that it became a model institution. He remained superintendent for 21 years.
Workman was not only the administrator of the Asylum but also one of the early “alienists” (the term for specialists in the institutional care and treatment of the insane until “psychiatrist” came into use in the 1890s). At the time, it was thought that mental health was a bodily disorder brought on by “functional or structural changes” in the brain or, because of “reflex action” in other parts of the body (for example, hysteria was attributed to disease in the female reproductive organs). At the time, doctors didn’t believe that grief, love, loss of property, religious “excitement”, family quarrels, jealousy, fright, etc. could cause mental illness. It was thought that the only causes were physical: injuries of the skull, apoplexy, epilepsy, parental intemperance, masturbation, and a consequence of tuberculosis or syphilis.
Later, Workman fought (and lost) the government’s desire to increase the capacity of the hospital, without physically expanding it. He retired from the Asylum in 1875. He became president of the Canadian Medical Association, the Toronto Medical Society, and the Ontario Medical Association.