This section contains an overview of mental health care in the 19th century, mental distress in Waterloo, and how those with mental distress were treated at the Waterloo County House of Industry and Refuge. If you would like to skip to a specific topic, you can do so here
In the early 19th century the rise of psychiatry occurred in Europe and in North America as treatment methods for mental health went through many advancements and changes. These therapies originated from early European alienist Pinel in France and Tuke and Browne in Britain that believed insanity could be cured . Before the ascendency of psychiatry there were ideas about mental illness that illustrate how mental illness has historically been misunderstood. For example, there was the idea that mental illness was contagious; that it was an airborne disease or spread through water and food. The medical community also believed in the notion that women had a propensity to be consumed with quests for romantic love that led to hysteria 
Before the 19th century, it was believed that mental illness resulted from demons or an “act of God” but in the mid-19th century additional sources of causation were being proposed. By 1852, a lengthy and certainly not exhaustive list of 184 causes of mental illness included physical causes such as “measles, small pox, ‘suppression of perspiration’ and ‘suppression of hemorrhoids,’ injuries due to ‘a kick on the stomach’, ‘sleeping in a barn filled with new hay,’ or ‘tight lacing,’ and moral causes such as ‘preaching 16 days and nights,’ ‘blowing the pipe all night’ and even, students beware, ‘study excessive’” 
The link between poverty and mental health was equally as prevalent during the 19th century as it is today. A number of Houses of Refuge were built in the 19th century in response to the social issue of poverty . The predominant view of poverty was that it was due to a moral failure unless it was due to physical incapacity  . In parallel, asylums were erected in Upper Canada to house the growing mental health population. The confinement of the mentally ill brought along with it the rise of psychiatry and shifting societal views of mental health. Subsequently, the mentally ill were confined with vagrants, vagabonds, criminals and anyone else seen as a nuisance. Interestingly, the mentally ill complained that they were confined with criminals and criminals complained they were confined with the insane 
In pre-Confederate Upper Canada, there were almost no hospitals for the mentally ill. Care was provided by an assortment of domestic and local community arrangements, many of which were ad hoc and by county and philanthropic resources  In the language of the day, “lunatics’” may have been confined in a shed on family property or in a room at home or with a relative
In the early part of the nineteenth century there emerged a reform movement based on the premise that insanity could be cured given proper institutional treatment. Originally associated with religious institutions, moral treatment was co-opted by an emerging group of psychiatrists intent on creating national systems of public asylums under medical control. The origins of Mental health policy in Ontario can be traced back to 1850 when Upper Canada’s first insane asylum was built in Toronto. This marked the beginning of the institutionalization era in Ontario. The British North America Act of 1867 gave jurisdiction over health care to the provinces of Canada. By 1891, there were four asylums in Ontario located in Toronto, Kingston, London, and Hamilton 
When public asylums were created, there was an exodus of the mentally ill out of other welfare institutions such as poorhouses and jails and into the asylums. The sudden increase in the recorded residential insane population was largely reflecting the shift from one type of custodial institution to another  . Asylums sequestered the mentally ill away from the stress of community and family life in an environment where all daily activities were scheduled and orderly  The removal of the mentally ill to rural locations was favored by popular opinion which viewed the asylum and its residents as a nuisance.
Prior to asylums, the poor were to be kept in “the common gaol” until “a house of correction” was available . In 1890, The Houses of Refuge Act was passed in which each county or union of counties was to provide a house and an associated “Industrial Farm” . With this Act, Ontario finally arrived at what the middle class had been seeking; the removal of the indigent and acute cases of the mentally ill from town and organizing it as a matter of administration as had been the case in England After 1890, the out of sight, out of mind principle became inherent in the asylum approach  .
The asylums had important incentive effects on professional interests. Primarily, they lead to the development of psychiatry as a profession, which did not exist before the end of the eighteenth century. As stated in a speech on the history of mental health policy in Ontario, “The asylum created the profession”. Public ownership gave substantial power and authority to psychiatrists in policy-making in Ontario. The superintendent was in charge of each asylum and reported directly to the Ontario Department of Health. Furthermore, the rural settings of many asylums meant the public was generally unaware of what happened in mental hospitals and in the psychiatric profession in general. Subsequently, policy was determined almost exclusively by a small circle of decision makers consisting of psychiatrists, the superintendents of the asylums, and those few government officials concerned with mental health policy. On the whole, the daily life of mental patients in asylums passed in isolation from the media and the political realm. This meant that from the early days, no consumer or family-based mental health interest group developed. The asylums took the problem away from citizens in the community and relieved the burden for family members who had struggled with caring for someone with mental illness. The public were fearful and rejected the fact that mental illness was common so to the general public getting people out of the community was acceptable 
The needs of the mentally ill in far-away asylums were much less visible to the public than other local needs which altered the public perception of insanity. Since only those with more severe disorders were sent to asylums, the public came to recognize mental illness only at its most extreme . Although those with more moderate illness remained in the community, they were not necessarily recognized as having a mental illness. As a result, the lack of familiarity meant the public became less comfortable around people with mental illness. This prevented mental health from developing the public support needed for community-based mental health reform. Most psychiatrists were reluctant to switch to an unproven, less prestigious and potentially less lucrative community-based system 
Those who were admitted to the Waterloo House of Industry and Refuge for mental health issues were often labelled as an Idiot or Lunatic. Rules were clear that Idiots or Lunatics were not accepted at the House. As stated in the county minutes in 1876
“Your committee are sorry to report that they find several lunatics are confined in the house, and would recommend that the inspector be instructed to notify all reeves, deputy reeves and magistrates by circular to desist from committing lunatics to the house of industry and refuge in future” (Waterloo County Minutes 1876, Source: Region of Waterloo)
Governing bodies from other municipalities often would inquire about the upkeep and admissions at the house. When writing in reply, the county clerk is very clear about who is accepted to the poorhouse, as stated in 1881 “We do not receive any Lunatics or Idiots or any person suffering from any contagious disease.” (Letterbook 8 pp.34).
Those deemed as “Idiots” or “Lunatics” were removed from the House and sent to to nearby asylums. As stated in a letter by the clerk in 1888 “We have two imbeciles (idiots) in the House now – we do not receive Lunatics – once in a while there is on smuggled in – but we get them off to the London or Hamilton Asylums as soon as we can” (Letterbook 8 pp. 991). Among many who were sent to one of the Asylums were the siblings known as the “Groff Idiots”. Nancy, F ranklin, Noah and Leah Groff were taken from the House of Refuge to the Hamilton Asylum, and later resided at the Orillia Asylum (Huronia Institute). Read more about the Groff family here (link). Another resident of the House of Industry and Refuge, Frederick Salm, is described by William Jaffray as “the worst idiot in the place”. He resided at the poorhouse from 1869-1879, and was then sent to the Hamilton asylum. Read more about Frederick Salm.
Those who were deemed as “Dangerous” Lunatics, perhaps exhibiting violent behavior, were often sent to the county Gaol from the poorhouse, and then may have been sent to an asylum. Such was the case for Frederick Helwig and Catherine Chipchase. Click to read their stories.
Inmates of the House of Industry and Refuge who were deemed as Idiots, Imbiciles, or Lunatics were either sent to the Orillia Asylum for Idiots and the Feeble Minded, The London Asylum for the Insane, or the Hamilton Asylum for the Insane. Click on the picture for More information about the History of each Asylum
Orillia Asylum for Idiots and Feeble-Minded (Huronia Institute)
London Asylum for the Insane
Hamilton Asylum for the Insane
There is record of confinement cells, known as “Idiot Cells” being built at the poorhouse, however no clear indication of how frequently, or on what occasions they were used. As seen in the minutes, there was a plan proposed by the keeper for a building “to be used as a Wash House, Woodshed and cells for Idiots and for purposes of discipline” (Minutes 1874 pp.49) .
There is also a request made later in the minutes for doors on these cells, stating “That a plan be made for the Iron cell doors and tenders be invited for the making of same – and if possible to work in the old Iron taken down from the Gaol”(Minutes 1874 pp. 53)
Letterbooks, County Minutes, and Minutes of Standing Comittee Sourced from the Region of Waterloo