Mad Pride Week 2008 is July 14 to 21. Some former patients have designed a historic walk around the asylum wall at the infamous 999 Queen Street West location. The 16-foot wall was built by patients, labouring without pay, circa 1860. Because of its notoriety, the address was changed to 1001 Queen Street West back in 1979. Somehow, improbably, it does sound more benign, though most other tour attendees grumble that the stigma has simply shifted to the new number. This is probably the case.

The nearby historic plaque explains the building's origins: "The first permanent mental health facility in Upper Canada, The Provincial Lunatic Asylum was officially opened on January 26, 1850." It was also the biggest such edifice of its kind in the province. The guide says it was 210 feet wide and 140 feet long, with wings 250 feet long. A dome attached to the property was, at 120 feet high, the tallest in Canada, as famous in its day as the CN Tower is now. Part of its oak spiral staircase has been preserved and relocated next to the main cafeteria. Originally, the asylum was in the middle of the countryside: three miles west of downtown Toronto, intended as a shady retreat from the city. The latter caught up by 1879 and the walls had to be moved. At first, the entire property spanned 100 acres. By 1888, it had shrunk to its present dimensions of 26 acres.

When it was first built, the facility was considered technically advanced, with central heating, mechanical ventilation and indoor plumbing. It was designed as humane, despite omnipresent locks and the high brick wall surrounding the premises, the street-facing North side of which was only torn down in the 1970s, but eventually the building became overcrowded and understaffed. The old asylum was demolished in 1975-76 and the present centre, officially called the Centre for Addiction and Mental Health (CAMH), was completed in 1979.

The Mad Pride week guide is Geoffrey Reaume, a self-described former psychiatric patient but not originally from Toronto. This is his 37th tour around the walls of the original psychiatric institute. Patients were recruited to do almost all the work required at the old asylum, including building and carpentry for men and sewing and laudry for women. At one point, 419,800 pieces went through the laundry, done by 17 women. None of the patients were never paid. This enabled the asylum to dismiss all their paid staff.

At one point, patient labourers had to clean up the basement of its sewage because the pipes had been disconnected. Some got very sick doing this, cutting the filth into icy bricks and throwing them into Lake Ontario. The patients also had to build the wooden sidewalks in front of the building, outside the North walls.

While the men got most of the outside jobs, the women were stuck inside the walls - except when they attended the house of the superintendant, later the nurses' residence. This was considered privileged work which gave the workers more freedom to come and go. The dichotomy brings to mind the traditional division between field slaves and house slaves. The men, having more outside work, attempted and succeeded escaping more often. The women got an infirmary in 1896 where they gave birth to unwanted children, some the result of rape by staff members, who of course were never convicted of any crime (one was accused, and acquitted when he claimed the victim was an erotomaniac). Many of these children were refused by neighbouring orphanages because their mothers were insane. One patient documented several incidents of sexual abuse by staff. Her many letters were never taken seriously.

The East Gate, on Queen just east of Ossington, was the asylum's only exit. During the tour, a man in a wheelchair called Mark explains he was a resident for 30 years, until 1995. He wears a Proud to Be Mad T-shirt, red letters on white. He says even in the 1960s, you couldn't get out to go to the restaurant for a coffee or to the store to get cigarettes. As a result, he says, many tried to escape. However, no one has statistics on how many of these were successful in the long term. Apparently, if you could escape and stay ahead of any attempt at recapture for six months, you were "written off the books" and people stopped looking for you.

The most macabre humour of the day comes from finding out that escape attempts, and other forms of protest, were written up into people's files as evidence of their mental illness... This comes up after the guide mentions one woman believed she should be paid for her services, which spanned 17 years in the laundry room. After her discharge, she sent letters asking for what she considered fair compensation: $1,298. She never got the money. Another patient had a demand for pay in her file, accompanied by a note saying "she does not know her place as a patient", with the demand for payment taken as a sign of her insanity.

As in the rest of society, there were class distinctions at 999 Queen Street West. The front wards were for the paying patients, who made up one-third of the total. They had cushions, rugs and better food. The back wards were for the "public" patients, who slept 16 to a dormitory with no privacy at any time.

Also on the tour is some kind of workshop built in 1889 with rusted grills on the windows. It's now a storeroom and a mess. Geoff describes some of the workers who passed through there, in particular a man with the pseudonym of Winston O. who made wheelbarrows, snow shovels, and even a wooden car which he drove around the grounds. This was in 1912, so it was novel. He also worked on an airplane in 1916, but no one ever found out if it could fly. I guess that could have been a little risque, given the possibilities of escape. So obviously, some of these people were very, very intelligent and capable.

Racism was not absent from the asylum, as evinced by the case of a man called Lee F. He was a Chinese immigrant suffering from depression who could speak little English. Interned in 1905, he was the unfortunate target of C.K. Clarke, after whom the Clarke Institute is named today. Clarke was a racist eugenicist who believed non-whites should be deported back to their countries of origin. He was superintendant from 1905 to 1911. Lee was deported in 1907: a death warrant for anyone with his condition. The guide doesn't say what happened to Lee in China and we will most certainly never find out. To comments that Clarke could have been diagnosed as a psychopath, Geoff replies that "unfortunately, Clarke was very normal for his time. The vast majority of patients never harmed anyone." It's "the normals" that create all the problems, he points out, since they have the power.

Parkdale itself, refuge of the hapless patients disgorged from their prisons without warning or support and thus spawning countless flophouses, is increasingly the site of gentrification attempts. One flophouse just in front of CAMH is being converted into fashionable lofts – arriving soon. Further down, furnished rooms with grimy windows are advertised next to a Regency-style condo development. Across the road from the streetcar stop, Trinity-Bellwoods Park proffers its pristine grounds and marble-columned entrance. It must be late Victorian circa 1880, since 999 Queen Street West was out in the country in 1850.

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999 Queen West: A social history of the former Provincial Lunatic Asylum