Institutional Violence and Disability

Punishing Conditions

Kate Rossiter, Jen Rinaldi

• Publisher: Routledge
• Year: 2018
• ISBN:
  9781351022804
• Edition: 1
• Topic: Social Sciences
• Subtopic: Social Work
• Index: Social Sciences

"This was several times with that damn cribbage board. I hate cribbage boards to this very day. They never beat us on the arms or legs or stuff, it was always on the bottom of the feet, I couldn't figure it out." Brian L., Huronia Regional Centre Survivor

Over the past two decades, the public has borne witness to ongoing revelations of shocking, intense, and even sadistic forms of violence in spaces meant to provide care. This has been particularly true in institutions designed to care for people with disabilities. In this work, the authors not only describe institutional violence, but work to make sense of how and why institutional violence within care settings is both so pervasive and so profound.

Drawing on a wide range of primary data, including oral histories of institutional survivors and staff, ethnographic observation, legal proceedings and archival data, this book asks: What does institutional violence look like in practice and how might it be usefully categorized? How have extreme forms violence and neglect come to be the cultural norm across institutions? What organizational strategies in institutions foster the abdication of personal morality and therefore violence? How is institutional care the crucial "first step" in creating a culture that accepts violence as the norm?

This highly interdisciplinary work develops scholarly analysis of the history and importance of institutional violence and, as such, is of particular interest to scholars whose work engages with issues of disability, health care law and policy, violence, incarceration, organizational behaviour, and critical theory.

1 Introduction

“If you weren’t retarded going in, you were fucking retarded coming out.”

Pam, Huronia Survivor

In 2010, former residents of the Huronia Regional Centre, a total institution designed to warehouse people with intellectual disabilities, launched a landmark class action lawsuit against the government of Ontario. The government, they alleged, failed to protect and care for them during their time incarcerated at Huronia. Consequently, they endured years of profound neglect, violent and degrading forms of punishment, and, in some cases, sadistic levels of sexual and physical violence. As the class action lawsuit was prepared for court, Huronia survivors came forward to tell their stories. Some told of severe beatings that left behind a legacy of chronic pain and further disablement. Others spoke of routine humiliation at the hands of staff, such as being forced to “dig worms” – a punishment where residents were forced to lie on the floor with their hands behind their back, often with their face in a plate of food. Others, still, recounted childhood sexual abuse that took place on locked wards in bathrooms, closets, and offices. Some former residents of the Huronia Regional Centre were not able to say anything at all because trauma had rendered their memories shadowy and out of reach; because they were non-verbal to begin with; because they had not survived the institution at all and lay buried in unmarked graves on the institutional grounds.

In many ways, this story is neither surprising nor unusual. Over the past two decades, the public has borne witness to ongoing revelations regarding institutional violence. Such revelations have emerged from psychiatric facilities (Reaume, 1997), orphanages (Sherr, Roberts & Gandhi, 2017), residential and boarding schools (Castellano, Archibald & DeGagné, 2008; Mosby & Galloway, 2017), retirement homes (Chima, 1998) and institutions for persons with physical and intellectual disabilities (Malacrida, 2015; Rossiter & Clarkson, 2013). Common to all of these sites are two features. First, they are places ostensibly designed to provide care for people deemed vulnerable. Second, in each of these sites profound, and even sadistic, forms of violence have been inflicted on residents. Often, it is these extreme and shocking instances of violence that capture the public imagination and media focus, in particular sexual and other forms of brutal physical abuse, especially since such instances seem so distinct and unrelated to the act of caregiving proposed by the institution itself. However, to focus solely on extreme instances of violence is to miss the very fertile groundwork laid by more routine, mundane forms of daily violence that are central to the operation of institutional care. Instead, we collectively wonder how such extreme forms of violence take place, and why they happen with such regularity.

Institutional Violence and Disability: Punishing Conditions takes seriously the widespread problem of institutional violence and explores the issue of institutional violence in depth, particularly as it pertains to histories of disability. Rather than focusing on small-scale or individual assessments as a means of understanding institutional violence, we focus broadly on its many instances, iterations, and intensities, in order to describe the problem of institutional violence adequately and to identify social and organizational patterns that may lead to its ubiquity.

Understanding the roots of institutional violence, and its lasting effects, is crucial for two reasons. First, much of the Western world has a long history of incarcerating populations deemed unruly or in need of management under the guise of care provision. This includes people labelled as having a developmental or intellectual disability, Indigenous peoples, orphans, people coping with psychiatric disability, immigrants and refugees, and the elderly. People who have experienced institutionalization return to mainstream, non-institutional society carrying the oft-invisible burden of institutional violence, which may manifest itself as post-traumatic stress disorder (PTSD), depression, anxiety, enduring physical pain and disablement, addiction, or the inability to get or maintain education or employment. We bear the collective responsibility for responding to individuals who have experienced institutional violence.

Second, while some large-scale institutions have been closed, some have not, or have been replaced with similar care situations. This is to say, institutionalization is still a common practice, particularly in communities already marginalized by disability, race/immigration and socio-economic status. Further, societal attention has shifted focus from the ostensible provision of care for ‘needy’ populations to the punitive incarceration of criminalized populations. Importantly, however, these populations may be one and the same. While crime rates have dropped over the past two decades, prison populations are growing, and contain disproportionately large numbers of people with developmental and psychiatric disabilities as well as Indigenous and racialized people – populations that have historically been forced into incarceration due to perceived need rather than criminality. Thus, it is imperative to have a clear analysis regarding how and why institutional violence prevails.

Shockingly, while patterns of institutional violence are clear, little scholarly work exists that endeavours to explain how and why institutional violence seems to occur with such regularity. In fact, much literature pertaining to institutional violence focuses on violence enacted against staff by institutional residents. We ask: what kinds of organizational structures obliterate everyday moral codes and make way for extreme violence? How and why does caregiving itself comprise a necessary category of violence? What kinds of social and psychic mechanisms allow staff to erase or disavow their own practices of violence? Finally, how is institutional violence inscribed in and on the lives and bodies of those who have been incarcerated, and how do these inscriptions reassert forms of institutional practice over a lifespan, even after one has left the institution?

In this introductory chapter, we provide an overview of the problem of institutional violence. To do so, we provide a short discussion of what we mean by institutional violence, the ways in which institutional violence has been treated in scholarly literature so far, and why we believe institutional violence is a pressing social issue. We then provide an overview of the history of disability and institutionalization, with particular focus on Canadian history, and making connections to similar histories in both the United States and the United Kingdom. Following this overview, we turn to our own work and describe the methods and data we use to make our arguments. Specifically, this highly interdisciplinary work draws from multiple forms of data, including case law, oral history, and ethnographic observation; and multiple forms of analysis, including legal and discourse analysis, to thoroughly engage the topic at hand.

What is institutional violence?

What is institutional violence? For the purposes of this work, we rely on a broad definition. This is partly because we want to capture the nuances of this sort of violence, and partly because we believe extreme forms of violence, such as rape and battery, are connected to smaller and seemingly more mundane forms of violence, such as routine instances of verbal humiliation. Thus, we qualify institutional violence as all practices of humiliation, degradation, neglect, and abuse inflicted upon institutional residents, regardless of intention or circumstance. It is all too easy to dismiss institutional violence as a relic of past social attitudes toward disability and difference, or the unpleasant by-product of a difficult job, or the sign of a badly run institution. We propose instead that, while institutional violence is never acceptable, institutions themselves are inherently violent in form. We believe that practices of incarceration are in and of themselves violent, and necessarily produce further violence. To this end, we believe that other forms of care are not only possible, but absolutely critical as a project of justice.

Drawing from Goffman’s (2007) seminal work regarding asylums, our work focuses on total institutions, which he describes as “a place of residence and work where a large number of like-situated individuals cut off from the wider society for an appreciable period of time together lead an enclosed formally administered round of life” (p. 11). In other words, total institutions are residential facilities separated from communities, where persons are committed to live, sleep, and perform all daily activities including work and school. Residents are subjected to around the clock surveillance, cannot leave without permission, and may live in the facility for prolonged periods of time: months, years, even lifetimes. While this definition could include jails and other detention centres, our work particularly focuses on institutions designed for care rather than punishment. This is not because violence does not occur in places like jails and detention centres – it does, with great regularity and intensity. Our definition is narrow because the fact that these spaces are designed for punishment and remediation makes the violence more socially palatable. However ugly this sentiment might be, there is some sense that those who end up in jails deserve violence or are more likely to perpetuate it. We, of course, vehemently disagree, but in order to circumvent such argumentation, we focus here only on institutions ostensibly designed for care.

Goffman’s definition, and our resultant analysis, also leaves out places like group homes and halfway houses. Again, we believe that these are spaces in which violence occurs with some regularity, although there may be differences in terms of how, when, and how often such violence occurs. As such, they are worthy of further investigation and critical attention. However, our interest here is in understanding the dynamics of total institutions that are productive of violence so that survivors of such institutions are better understood and so that these kinds of institutions are closed for good and not built again.

Historical overview

While this work focuses broadly on the centrality of violence against people with disabilities in institutions, much of the source material comes particularly from the study of institutions designed to warehouse people with developmental or intellectual disabilities, psychiatric disabilities, and physical disabilities such as seeing and hearing impairments. Some of these institutions have been closed, yet others remain open or have been replaced with similar caregiving situations. These institutions bear the weight of historical attitudes regarding the treatment of disability, difference, and vulnerability. It is therefore important to understand how such institutions came to be, what they meant to accomplish, and how they were run. While this historical overview focuses on institutions in Canada, and particularly Ontario, the legacy of institutionalization is remarkably similar across the United States, the United Kingdom, Australia, and beyond (e.g., Johnson & Traustadóttir, 2005). Further, this historical overview is particularly concerned with custodial institutions for people diagnosed as having an intellectual disability, but growth of such institutions was concomitant with, and similar to, the design and development of institutions for people with other diagnoses, in particular those who were considered ‘insane,’ ‘deaf,’ or ‘blind.’ Finally, a historical overview necessitates using previously entrenched language for clarity’s sake, though we recognize much of the terminology is dated, and has fallen out of use because it has been found inaccurate or even degrading.

Institutionalization and disability

The modern rise of the state wrought many changes in terms of understanding and caring for those perceived as vulnerable. One such change has been the development of large-scale, state-run institutions such as hospitals and asylums. In Canada, institutions were placed under provincial control and management following the confederation of Canadian provinces in 1867 (Park, 1990). In Ontario, the Department of Provincial Secretary was responsible for asylums, charities, prisons, and public institutions until 1931, when responsibilities were transferred to, and shared by, the newly created Departments of Health and Public Works.

By the mid-nineteenth century, the treatment of people with disabilities increasingly fell under the purview of science and medicine, and thus diagnosis, classification, and treatment of people with perceived disabilities became an occupying concern. The development of medical practice, pedagogical notions of “physiological treatment” (see Stuckey, 2013, p. 237), and rehabilitation sciences ushered in the development of new methods of treating and educating ‘deaf,’ ‘dumb,’ ‘blind,’ ‘idiot,’ and other ‘backward’ children based on seemingly indisputable models of biological deficiency (Williston, 1971).

In Canada, the impact of socially legitimized scientific testing and resultant diagnoses led to the growth of specialized institutions such as the Orillia Asylum for Idiots, as well as schools for deaf and blind children, such as W. Ross MacDonald School for the Blind in Brantford and the Institut Raymond-Dewar for deaf and hard of hearing students in Montréal. Urban centres such as Toronto established education systems based on new “scientific methods of intelligence testing,” which helped to rank and separate ‘defective’ children, calling on and perpetuating the popular notion that disability and ‘feeble-mindedness’ was an increasing urban threat (Chupik & Wright, 2006, p. 80). The diagnostic procedures that identified many individuals as in need of institutional care paved the way for later justifications for violent treatment. Williston (1971), for example, argued in a report identifying institutional conditions that early beliefs regarding the diagnosis and care of people with intellectual disabilities in Canada caused three damaging institutional tendencies that remained throughout their existence: isolation, overcrowding, and perpetual cost containment. The report characterized these early trends at such institutions as paving the way for much larger issues including gross neglect and maltreatment – issues that form the backbone of the allegations laid in recent class action lawsuits.

Ontario’s institutions were founded with optimistic, yet nonetheless marginalizing, beliefs regarding the segregated care of people with disability. Stuckey (2013) argues that the Victorian-era “medico-pedagogic method” (p. 237) that informed the growth of institutions in North America at this time was based on progressive ideals of well-rounded education for people with disability. Armstrong (2002) locates the growth of vocational training within the bureaucratic development of asylums and workhouses as a method of rendering institutionalized populations both productive and controllable. Similarly, residential schools for deaf and blind children were established across North America throughout the nineteenth century with the intention of lifting the ‘afflicted classes’ of deaf and blind children out of poverty and social reliance through punitive forms of vocational training alongside the regular educational curriculum. Deaf children were entreated to particularly restrictive forms of treatment-based education following an 1880 ban on the use of sign language deaf classrooms in favour of oralism – that is, lip reading and vocal articulation. Deaf children who persisted in using American Sign Language (ASL) were punished with physical abuse and restraint, including at schools in Canada (Baynton, 1998).

These views stand in contrast with earlier beliefs, which perceived disability as a social, legal, and even religious concern, but not a concern of medicine or education: “It was considered a regrettable and incurable condition about which medical practitioners, both orthodox and unorthodox, could do little” (Wright, 2011, p. 28). Thus, given pervasive views regarding the treatment of people with disability, Ontario care-related policies during the early twentieth century generally promoted segregated, custodial care within closed institutions (Park, 1990) for the twinned purposes of education of people with disabilities, and, in the case of psychiatric and intellectual disability, for the putative protection of the broader society (Park, 1990; Williston, 1971).

From their inception, life within Canadian institutions was unrelentingly oppressive; however, many years of financial strain, provincial neglect, chronic overcrowding, and prevailing cultural attitudes of fear, abjection, and the need for social isolation left institutional residents vulnerable to widespread abuse. Staff frequently used physical abuse as forms of punishment (Stewart & Russell, 2001). As early as 1906, C.K. Clarke, Superintendent of the Toronto Hospital for the Insane, claimed that amenities such as toilets and bathing facilities were “a menace to the health of the inmates” (Reaume, 1997, p. 79). Secluded areas “between doors” or “cross hall” were used to hide abuses from incoming family or friends who were often abruptly escorted out of the building. Sexual assault was common across institutionalized populations at this time (see, for example, Sullivan et al., 1987).

If medical discourses of the late nineteenth century saw the forced confinement and isolation of people with disabilities within institutions, the early twentieth century heralded an equally monstrous turn in the employment of scientific and medical discourse in the care of disabled and institutionalized persons. Out of earlier ambivalent Victorian philosophy, which sought both to educate and to control persons with disabilities, grew the eugenics movement, which endeavoured to ‘improve’ society’s genetic stock through limiting the reproductive capabilities of people deemed socially undesirable. For example, public opinion feared that the ‘feeble-minded’ would overpopulate, preventing progress to a utopian nation: “[n]o political machinery can prevent an aggregate of degenerate citizens from being a degenerate nation” (Inge, 1909, p. 26). As such, a growing objective of long-term institutionalization was to control the proliferation of those diagnosed as ‘feeble-minded’ or ‘mentally deficient’ (Park & Radford, 1998), two terms that extended to the ‘morally enfeebled’ and the ‘incurable,’ meaning people who had “heritable intellectual disabilities” (p. 318). Throughout the twentieth century, the Canadian public believed that the number of people with genetic abnormalities threatened to exceed the number of people with ‘good’ genetic stock, and thus public debate regarding the use of mandatory sterilization policies as a form of protection rather than a means of punishment arose (Dyck, 2013; Park & Radford, 1998). Sterilization programs existed under provincial law in Alberta (1928 – 1972) and British Columbia (1933 – 1973).

While Ontario managed to escape the grip of legally sanctioned eugenics policies, the social power of the eugenics movement impacted the insti...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• List of figures
• Acknowledgements
• 1 Introduction
• 2 The Institutional Cases and the conditions for moral abdication
• 3 The institutional violence continuum
• 4 Thoughtlessness and violence as work culture
• 5 Quantifying and re-inscribing violence
• 6 Embedded trauma and embodied resistance
• 7 Conclusion
• Bibliography
• Index