By the turn of the twentieth century, the “certified insane” had become a central category for national statistics with important consequences for persons with disabilities. Admission to a mental hospital in many Western jurisdictions created a “certification record” that could restrict life-changing decisions such as marriage, acquisition of property, and emigration. As the eugenic movement gained momentum, moreover, a certificate of insanity extended the stigma to relatives and unborn children. Following the ideal of preventing the reproduction of the “unfit,” certification was the starting point for eugenic speculations about racial degeneration, permanent confinement and, in some cases, sterilization.

This paper published on the Canadian Medical Association Journal investigates the connection between contemporary mental health documents used in Canada and certificates of insanity employed in Victorian England. Considering forms for involuntary confinement, it highlights a remarkable history going back to the era of asylums, eugenics, and empires. In the context of the UN Convention on the Rights of Persons with Disabilities (2006), this article reminds doctors and policy makers in Ontario of the insidious legacy of stigmatizing practices in contemporary mental health documents.