How mental health on P.E.I. has evolved from the 'lunatic asylum'

P.E.I. has come a long way in its treatment and understanding of mental health, says Tina Pranger.

She should know. 

Not only has she worked in the field for more than 30 years, she has just written Beyond the Asylum — the first complete record of the evolution of mental health care on P.E.I.

It traces the history back to 1846, where P.E.I.'s first mental health facility was known as the Charlottetown Lunatic Asylum. Pranger said the treatment of people with mental health issues has changed primarily because the understanding of what mental illness is has changed.

"It was called lunacy and insanity and madness, to the present day where it's known as an illness, like a disease of the brain. So, hence, care has changed quite a bit over that time."

It was called lunacy and insanity and madness, to the present day where it's known as an illness.— Tina Pranger

Pranger said the idea for the book came about in 2016 when she was approached by Verna Ryan, the CAO of Health PEI, who wanted a record of mental health care that could be used to educate the public.

"There's still a lot of misconceptions around mental illness and a lot of stigma around mental health care," Pranger said in an interview on CBC's Mainstreet P.E.I. "So it's an opportunity to educate and hopefully help provide some direction for the future of mental health care."

In the early days, Pranger said, mental illness was believed to be something people were just born with and was not treatable. People thought they were better off to be committed to an asylum and away from society.

In the 1940s and '50s, lobotomies and radical therapies were introduced — "ones that get a lot of airtime in popular culture like One Flew Over the Cuckoo's Nest," Pranger said.

Psychotropic medication in '60s

In the 1960s, psychotropic medication became an effective way to manage symptoms, she said.

"They allowed people to be much more functional and therefore not need to stay in the mental hospital for nearly as long a period of time because initially people were there for life." 

The book includes several archival photos that introduce the reader to different buildings, equipment and prominent people in the evolution of mental health care.

One of those people was Dr. Alexander James Murchison, a psychiatrist who was the mental hospital's medical superintendent from 1934 to 1960.

"He introduced a very compassionate caring approach and he was a very strong advocate in terms of improving the lives of people who live with mental illness and the need for a broad spectrum of mental health care services," she said.

The book chronicles mental health up until 2017. Pranger said she is optimistic about the state of mental health treatment on P.E.I., and where it is heading.

She hopes the book will be a valuable reference point.

"It's a jumping-off place for further, more in-depth analysis from an academic and it also should inform practise and policy and future plans," she said.

The book was published by the P.E.I. Museum and Heritage Foundation. 

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