[Saint-Jean-de-Dieu: A short history of Montreal's madhouse, 1873-1973]

Objectives The primary objective of this article is to paint an institutional portrait of the Saint-Jean-de-Dieu Asylum over the first hundred years of its existence, from 1873 to 1973. The secondary objectives are as follows: 1) explore how prevention policies at the end of the 19th century had the effect of increasing the asylum population rather than reducing it; 2) discuss mental health policies that sought to "treat the social" outside the walls of the asylum in an effort to decrease the population; and 3) address the arrival of psychopharmacology that opened the doors of the asylum and turned it into a modern psychiatric hospital, soon renamed Louis-Hippolyte-Lafontaine. Method Since the past exists in silence, and finding data that will enable us to reconstruct a history of Saint-Jean-de-Dieu is a challenge. Our data collection includes all the primary sources we were able to gather (Institut universitaire en santé mentale de Montréal archives, annual government reports on asylums and articles in the magazine L'Union médicale du Canada) as well as secondary sources produced over time, i.e., books and articles published on the history of Saint-Jean-de-Dieu. The qualitative analysis of this data is based on analytical induction (Pascale, 2012). After several readings of the documents, the content is associated with key concepts according to theoretical saturation (Laperrière, 1997) and the data is analyzed according to the most significant key concepts. In our corpus, the key concept of overcrowding in asylums was central to our interpretation. Results This article highlights the improbable primary mission of curing mental disorders at the Saint-Jean-de-Dieu asylum. At the end of the 19th century, as urban impoverishment became increasingly marked, medical theories advocated policies of hasty internment. Despite several provincial laws reiterating that the chronically ill could only be admitted if they were "dangerous, scandalous or monstrous," the population admitted grew steadily until the end of the 1940s. At the same time, the patient/psychiatrist ratio was at best 300 to 1. The creation of a French-speaking psychiatry department and compulsory internships between the World Wars meant that more doctors were trained to work there. But it was the discovery of neuroleptics that enabled a new generation of psychiatrists to open the doors of the institution in the 1960s. The era of the asylum thus came to an end in the form it had taken for just over 100 years. Conclusion The asylum quickly lost its original meaning, that of a place of refuge, and gradually became associated with the seclusion of the insane, thereby increasing the prejudices and taboos surrounding mental disorders, some of which still affect us today.