The nineteenth-century psychiatric facility known as the asylum operated on the principle that environment could contribute greatly to the state of health. Asylum grounds were accordingly laid out in a park-like fashion and various recreational pursuits were offered to divert attention from unhealthy obsessions.
But the front-line staff who interacted with the patients every day were of great importance. Recognizing this, Dr. Charles Clarke of the Toronto Asylum for the Insane prepared a handbook for ward attendants in which he outlined their duties and responsibilities. The following edited excerpts are from Dr. Clarke’s 1881 publication and from the 1880 Superintendent’s Journal: