Sites of conscience redressing disability institutional violence

Abstract

Australian victim-survivors of disability institutional violence have been unable to obtain public recognition and justice through conventional court-based processes and legal remedies. Redressing or ‘setting right’ the ongoing and structural phenomenon of disability institutional violence requires a new approach. This article introduces one dimension that might form part of such an approach: re-engaging through sites of conscience practices with former disability institutions. Sites of conscience practices engage the broader community in memories and histories of places of injustice in order to prompt collective action to prevent further injustice through broader social and legal change. The article proposes that through sites of conscience practices former disability institutions in Australia can be part of how we collectively recognise and ‘set right’ disability institutional violence. The article begins by explaining the approach to ‘disability institutions', ‘disability institutional violence’ and ‘redress'. Next, the article uses the example of Peat and Milson Island Hospital (New South Wales, Australia) to discuss how former disability institutions – through demolition/dereliction, repurposing or redevelopment – might sustain disability institutional violence. The article then introduces the concept of ‘sites of conscience’ and presents examples of sites of conscience practices in relation to former disability institutions across United States, Canada, United Kingdom and Denmark. Reflecting on these examples, the article makes preliminary suggestions of how we might re-position engagement with the memories, places and materiality of former disability institutions as integral to redressing disability institutional violence in Australia.

Keywords

Disability institution institutional violence justice memorial reparations redress sites of conscience

Introduction

Disabled people in Australia have suffered significant harm from violence in large-scale disability residential settings (‘Disability Institutions'). After concerted advocacy by Australian Disabled People's Organisations (‘DPOs') – organisations that are led by and made up of disabled people – the Australian government in 2019 called a Royal Commission into violence, abuse, neglect and exploitation of people with disability (Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, 2019). The initial terms of reference did not make explicit reference to redress. However, the Royal Commission's hearing into group homes heard of the failure of a disability service to redress sexual and physical assault that occurred in its group homes (Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, 2020b: 56, 79–80). Subsequently, the Royal Commission stated it will be considering redress in future work, and specifically that it proposes to investigate forms of redress in residential settings and the feasibility of establishing a disability redress scheme (Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, 2020a: 255, 258; Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, 2020b: 80, 87–88).

The Royal Commission provides an important moment to consider how to ‘redress' disability institutional violence. In Australia, victims/survivors of disability institutional violence and the broader disability community have been unable to obtain public recognition and justice through conventional court-based processes and legal remedies. As such, redressing or ‘setting right’ disability institutional violence in Australia requires a new approach which includes practices that engage governments, justice systems and the broader community in responding to and preventing disability institutional violence as an ongoing and structural phenomenon inherent to Disability Institutions.

This article introduces one dimension that might form part of such an approach: re-engaging with former Disability Institutions through sites of conscience practices. Sites of conscience practices engage the broader community in memories, histories and materiality of places of injustice in order to keep present in the minds of members of the community ongoing systemic perpetration of these injustices and prompt collective action to prevent further injustice through broader social change (Lloyd & Steele, 2022; Steele et al., 2020). The article proposes that, through sites of conscience practices, engagement with the memories, places and materiality of former Disability Institutions can be part of how we collectively recognise and ‘set right’ disability institutional violence in Australia. In particular, victims’/survivors’ leadership of sites of conscience practices and the connections made through these practices between memories and histories of disability institutional violence and enduring physical presence of former Disability Institutions might provide opportunities for broader community recognition of ongoing and structural phenomenon of disability institutional violence and inspire collective action towards social and legal change.

The article begins by explaining the approach to ‘Disability Institutions', ‘disability institutional violence’ and ‘redress'. Next, the article uses the example of Peat and Milson Island Hospital (New South Wales, Australia) to discuss how former Disability Institutions – through demolition/dereliction, repurposing or redevelopment – might sustain disability institutional violence. Next, the article introduces the concept of ‘sites of conscience’ and presents examples of sites of conscience practices in relation to former disability institutions across United States, Canada, United Kingdom and Denmark. Reflecting on these examples, the article makes preliminary suggestions of how we might re-position engagement with the memories, places and materiality of former disability institutions as integral to redressing disability institutional violence in Australia.

Disability institutional violence and the challenge of redress

In this section, I set out the key terms structuring the article: ‘Disability Institutions', ‘disability institutional violence’ and ‘redress'.

Disability institutions

In this article, disability institutions (hereafter referred to as ‘Disability Institutions') has a very specific material architectural and geographic meaning. Disability Institutions are large-scale residential settings in which disabled people live in circumstances of congregation and confinement and are segregated and isolated from the community, purportedly in order to achieve goals of health, welfare and control. Examples include lunatic asylums, mental hospitals, disability residential centres and forensic mental health facilities for disabled adults, as well as homes and hospitals for disabled children. Disability Institutions have historical roots in welfare institutions that were central to early Australian nation-building and Indigenous dispossession (Avery, 2018; Coleborne & MacKinnon, 2006) and are a key dimension of the oppression of disabled people in 20th and 21st century Australia.

The focus on Disability Institutions in this article can be situated in a rich body of critical literature theorising institutionalisation, coercion and control. Goffman’s (2017) work on the ‘total institution’ highlights common features of control and degradation across a variety of places of confinement, including asylums, military, hospitals, schools, asylums and prisons. For Goffman (2017), total institutions not only degrade and dehumanise ‘inmates' but ultimately give rise to profound violation of the self, resulting in negation of selfhood. Foucault’s (1979) theorising of carceral (prison-like) control shows how coercion and control can exceed a specific place of confinement and, instead, circulate in power relations in community settings that might conventionally be associated with freedom, inclusion and integration. Drawing on Goffman and Foucault, disabled people's exposure to institutionalisation, coercion and control can be understood as extending beyond Disability Institutions to a range of disability contexts such as group homes, segregated employment, disability case management and community mental health treatment and general settings such as prisons, juvenile detention centres, child welfare homes, residential aged care facilities, and immigration detention centres.

Drawing on threads from Goffman and Foucault, critical disability scholars in North America have proposed that institutionalisation, coercion and control of disabled people can be understood in terms of an ‘institutional archipelago’ – a network of ‘diverse services and spaces' that includes Disability Institutions as defined in this article, as well as progressive ‘alternatives' to these such as group homes and community mental health treatment (Chapman, Carey & Ben-Moshe, 2014: 14). The archipelago is situated in interlocking systems of oppression and is undergird by persistent ableist, eugenics and settler colonial logics positioning disabled people as abnormal, sub-human and violable (Chapman, 2014; Chapman, Carey & Ben-Moshe, 2014). Over their lives individuals move between ‘islands' in the archipelago and over time the ‘islands' themselves evolve, recalibrating in response to crisis and progressive social shifts alike. As such, in the context of disabled people, the institutional archipelago has three temporal/spatial/corporeal dimensions. One is specific material architectural and geographic Disability Institution sites being re-purposed over time for different disability institutional purposes or institutionalised disabled populations (such as a lunatic asylum being repurposed for community mental health treatment). Another is the interconnected network of disability and general contexts at any given point in time across penal, welfare and health systems through which disabled people can be subjected to institutionalisation, coercion and control (contemporary options for disabled adults include group homes, mental health facilities, sheltered workshops, disability day programs, community mental health treatment, prisons, immigration detention facilities, and aged care facilities). A third is disabled individuals moving between disability and general contexts of institutionalisation, coercion and control over their lifetime (such as being in a child welfare institution and juvenile justice detention as a child, then in prison, group homes and community mental health treatment as an adult).

The North American scholarship on the institutional archipelago can be considered in the historical and political conditions of Australia, as a settler colonial nation founded as a penal colony. Australian criminology scholarship on racialised incarceration argues that since white British invasion a range of penal, welfare and health institutions including prisons, child welfare homes, Indigenous children homes, and immigration detention centres have been central to settler colonial nation-building in Australia and the ongoing dispossession and elimination of Indigenous people (Baldry, Carlton and Cunneen, 2015; Cunneen, Baldry, Brown et al., 2013). In particular, in Australia (as in other settler colonial nations such as Canada (Chapman & Withers, 2019; Wilk, Maltby & Cooke, 2017)) child welfare systems and criminal justice systems have had significant impacts on First Nations people from invasion onwards, including being directed at and causing disability (Baldry & Cunneen, 2014; Hollinsworth, 2013). In this context, institutionalisation, coercion and control of disabled people in Australia across disability and general contexts is both a dimension of disabled oppression and a dynamic in broader settler colonial nation-building and Indigenous dispossession and elimination (Steele, 2020).

Critical disability scholarship has been central to deepening and complicating understandings of contemporary disabled oppression in the ‘deinstitutionalised community’ (Spivakovsky, Steele and Weller, 2020). Yet, in making important contributions to our understanding of the endurance and evolution of institutionalisation, coercion and control of disabled people beyond the Disability Institution, this scholarship often departs from its critique of Disability Institutions at the point of their closure to follow the evolution of institutionalisation, coercion and control through the archipelago. In contrast, a smaller body of scholarship reminds us that former Disability Institutions continue to have an important role in contemporary disabled oppression even in the aftermath of their closure (Abbas and Voronka, 2014; Voronka, 2003). As such, the specific usage of Disability Institutions in this article is a deliberate choice, directed towards exploring the role of former largescale disability residential settings in redressing the ongoing and structural phenomenon of disability institutional violence.

Disability institutional violence

Institutional violence against disabled people is a systemic problem with serious, long-term and sometimes even lethal consequences. In its narrowest sense, disability institutional violence might be understood as unlawful physical, sexual and emotional interpersonal violence in Disability Institutions. In contrast, this article takes a broader approach to ‘disability institutional violence’, as being more than the sum of individual instances of interpersonal violence and as being an ongoing and structural phenomenon inherent to Disability Institutions. Rossiter and Rinaldi (2019: 3, emphasis in original) define ‘institutional violence’ as: ‘all practices of humiliation, degradation, neglect, and abuse inflicted upon institutional residents, regardless of intention or circumstance. … 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’. This approach to disability institutional violence resonates with Goffman's work on total institutions (discussed earlier) and the long tradition of critical and abolitionist literature theorising the degradation, dehumanisation and violation inherent to prisons, including how violence is sustained through ‘reforms' directed to making these institutions more therapeutic, dignified, safe and caring (Carlton, Sim & Tombs, 2018; Razack, 2015).

By drawing on a set of intersecting ‘dynamics' of violence, we can deepen our understanding of disability institutional violence as an ongoing and structural phenomenon inherent to Disability Institutions. These dynamics include: settler colonial violence, structural violence, epistemic violence, legal violence, economic violence and ontological violence.

Linking to earlier observations about the Australian context, one intersecting dynamic is settler colonial violence: medicalised disability knowledge, interventions and systems that sustain dispossession, displacement and elimination of First Nations people (as discussed by Avery (2018), Chapman (2014), and Burch (2016); see also resonances with scholarship on settler colonial violence in relation to racialised incarceration (Perera and Pugliese, undated)). Structural violence is another dynamic, referring to the organisation of systems and space through Disability Institutions that creates conditions wherein disabled people are deemed of less social value and denied opportunities to flourish (or even live) (Steele, 2020: 84–93).

A further dynamic is epistemic violence where disabled people in Disability Institutions are legible and knowable by singular reference to diagnosis and thus denied the opportunity to make their own choices about their bodies and lives and, more fundamentally, about their identity (Beaupert, 2018). A related dynamic is legal violence: legal doctrine (mental health, guardianship law) permits non-consensual interventions in the bodies and lives of disabled people specifically on the basis of disability (such as restrictive practices), and justice systems (through guardianship and mental health tribunals, parens patriae court jurisdictions) and government departments (such as disability service regulatory bodies) administer this legal doctrine so as to regulate (rather than prohibit) these interventions (Steele, 2020; Spivakovsky, 2018). Another dynamic is economic violence: in Disability Institutions the bodies of disabled people are a source of profit extraction including through their use for unpaid or grossly underpaid labour (historically evident in their contributions to building and maintaining Disability Institutions) and the economic efficiency arising from congregate living and neglectful service provision (‘warehousing’, such as in the profit incentives for disability service providers to use restrictive practices on disabled people to save on staff costs) (Ben-Moshe & Stewart, 2017). Finally, and perhaps most profoundly, the dynamic of ontological violence: the envisioning of a desirable future as one without disability and the negation of the legitimate existence of disabled people (Kafer, 2013) justifies and necessitates the continued existence of Disability Institutions and the perpetration of disability institutional violence.

Redress

In this article, ‘redress' is defined expansively as ‘setting right’ or ‘righting wrongs’. This definition is in contrast to the conventional legal understanding of redress as being associated with court-based processes and legal remedies.

Historically, disability institutional violence has been considered therapeutic, protective, necessary and non-violent, and disabled people have been incomprehensible as grievable victims (Spivakovsky, 2018; Steele, 2020). Importantly, many disabled victims/survivors are unable to obtain the redress through court processes and legal remedies conventionally considered integral to government and community responses to violence. In general, court process and legal remedies are directed towards responding to recent instances of unlawful violence against specific individuals, and cannot grapple with the more complex, structural understanding of disability institutional violence proposed in this article. Disabled people experience barriers to accessing police, lawyers and courts. Rules about legal capacity for court standing discriminate against disabled people (Flynn, 2017) and disability itself is stigmatised and pathologised in civil legal causes of action and remedies (Mor, 2018). Limitation periods and the historical nature of some disability institutional violence mean many victims/survivors and their families are no longer alive or able to enforce legal remedies in courts. Moreover, the limited number of instances of disability institutional violence that ever make it to court, the inaccessibility of legal jargon, confidentiality arising from out-of-court settlements, and restricted options for remedies focused on monetary compensation mean that court process and legal remedies do not necessarily provide a vehicle for wider public awareness and recognition of disability institutional violence and structural change. Lawyers can also exploit victims/survivors through predatory acquirement of clients and adopting dispute resolution strategies that maximise their profit. Securing legal remedies also requires identification of specific defendants, and this can present a challenge to addressing the settler colonial, structural, epistemic and ontological dynamics of disability institutional violence discussed earlier. Last, there is no remedy for disability institutional violence which is permitted by criminal and civil laws (Steele, 2020), such as lawful use of restrictive practices or sterilisation. Victims/survivors of disability institutional violence, their families and friends and the broader disability community experience ongoing trauma, grief, distress and injury caused by both disability institutional violence itself and the limitations of conventional court process and legal remedies.

Therefore, instead of technical legal definitions of redress this article adopts a broad definition of ‘redress' in the sense of ‘setting right’ wrongs. This expansive approach to redress engages communal, relational, structural, historical dynamics of setting right and thus reflects Balint et al.'s notion of ‘structural justice’ as ‘being based on historical consciousness and a recognition of the enduring significance of the past; discursively and practically manifest’ (Balint, Evans, McMillan et al., 2020: 139) and as ‘a fundamentally relational phenomenon, grounded in openness and engagement’ (Balint, Evans, McMillan et al., 2020: 140). Such an approach can take the form of a range of practices, such as government administered compensation and psychosocial support schemes, memorials, national apologies, community education and truth commissions (Daly, 2014). At a general level, five features differentiate this approach to from court-based legal remedies: (1) redress involves more affordable and accessible routes for compensation that do not rely on individuals commencing their own litigation, (2) redress is not restricted to compensation of individual injury but extends to non-monetary responses to individual victims/survivors and monetary and non-monetary responses to collective and inter-generational injury, (3) redress does not rely on pinpointing a specific perpetrator to ‘sue’ but focuses on systemic dynamics and complicity of the state and community in allowing violence to occur, (4) redress can enable public (in the sense of community, rather than judicial) recognition of the harms and suffering associated with violence and (5) redress need not be state-led and can be led by victims/survivors and their communities.

This article explores one possible dimension of this expansive approach to redress: Disability Institutions as sites of conscience. The first step in this exploration is to consider the conventional relationship of former Disability Institutions to disability institutional violence.

Erasure and endurance of disability institutional violence

Recently, my daughter went on a school camp to a ‘sport and recreation centre’ – a rite of passage for many Australian schoolchildren. My daughter went to Milson Island Sport and Recreation Centre (‘MISRC’). Situated on the unceded lands of the Darkinjung People on a small island in the Hawkesbury River in New South Wales, Australia, the island is owned by the NSW Government and MISRC is administered by the Office of Sport for a broad range of recreation and hospitality purposes: ‘school camps, family camps, kids' camps, sporting events, weddings, weekend escapes, corporate training’ (Office of Sport, n.d.). The Office of Sport describes MISRC as ‘[a]ccessible only by boat … secluded and stunning with sweeping views of the Hawkesbury River at every turn. Green, manicured lawns, towering palms and landscaped gardens burst with colour while native flora and a rich birdlife add to its overall beauty. A kid's pool, playground and fun games make it ideal for young children’ (Office of Sport, undated a).

However, this idyllic playground has a much darker past. Purchased by the NSW Government in 1901, the Island was originally intended by government (but never ultimately used) as an inebriate institution for men (Mitchell, 2018: 51–54), and from 1908–1920 was used as an experimental farm for the extermination of rabbits, then a quarantine station and a hospital for returned WWI soldiers with venereal disease (Ellmoos & Andersen, 2010: 29). In 1921 Milson Island was repurposed again as a mental hospital (Mitchell, 2018: 64). This new use was prompted by overcrowding of the nearby Rabbit Island Mental Hospital for ‘males classified feeble-minded or mentally defective’ (Mitchell, 2018: 56), which was situated on the nearby Rabbit Island (later named Peat Island). From 1924 onwards the two island sites operated as the one institution: Rabbit and Milson Islands Hospital, later renamed Peat and Milson Islands Hospital (‘PMIH’) (Ellmoos & Andersen, 2010: 29).

In a history of the Milson and Peat Island Hospital commissioned by the NSW Government's disability department (uncomfortably titled ‘Our Island Home’), Ellmoos and Andersen (2010: 30) note that in PMIH's earlier years: ‘The bare basics were covered, but no more … they made sure that patients and hospital wards were kept clean and tidy, but no attempts were made to provide emotional or physical comforts, or to rehabilitate or prepare the patients for re-entry into society.’ Following a series of government reports (including a Royal Commission) on the state of NSW mental health facilities and media coverage of the living conditions at the hospital (Ellmoos & Andersen, 2010: 54), during the 1960s and 1970s a number of changes focused on ‘improve[d] sanitation and maintenance of the wards' and ‘[o]ccupational therapy and industrial training’, involving segregated education and employment opportunities (e.g. sheltered workshops) (Ellmoos & Andersen, 2010: 56–62). While not documented in the official history of PMIH (Ellmoos & Andersen, 2010), first person accounts of other Disability Institutions (see, eg, Walker, 2015) suggest PMIH residents were actively resisting their living circumstances and contributed to deinstitutionalisation and disability rights movements.

By June 1973 the Milson Island site of PMIH was closed because its overcrowded and dilapidated buildings presented risks of fire and infection. Patients from that island were transferred to the Peat Island site of PMIH and to a variety of other mental hospitals such as Cumberland Hospital at Parramatta Female Factory Precinct (Ellmoos & Andersen, 2010:62–64). The Milson Island site was transferred to the Department of Corrections for use as a low security prison and subsequently became MISRC (Ellmoos & Andersen, 2010: 64), where each year hundreds of schoolchildren (such as my daughter) go to have fun educational experiences, without learning of the very different experiences of the disabled children who lived there in earlier decades.

While PMIH ceased to operate on Milson Island, PMIH (now renamed Peat Island Centre) continued to operate on Peat Island until its closure in 2010 (Ellmoos & Andersen, 2010: 88). When Peat Island Centre was closed, residents were moved into one of two facilities, both of which offered congregate-style living arrangements (Fisher et al., 2013: 3–4). One of these – Casuarina Grove – was based on an aged care model specifically for ‘people with intellectual disability and complex needs associated with ageing’ (Fisher et al., 2013: 23). People with Disability Australia commenced litigation against the NSW Minister of Disability related to the provision and funding of the facilities being in breach of the Minister's statutory duty, on the basis the new accommodation had an institutional style and did not promote social integration. This litigation was unsuccessful on procedural grounds (People with Disabilities Australia Incorporated v Minister for Disability Services [2014] NSWSC 1669). NSW State Government currently has a ‘masterplan’ proposal to redevelop Peat Island for recreational use such as parklands and cycling tracks to ‘revitalise Peat Island’. This involves ‘opening up Peat Island to the public for the first time in 100 years' and allowing public access to this prominent Hawkesbury River foreshore’ (Property NSW, undated).

PMIH is emblematic of many of the issues identified earlier about the inherent violence of Disability Institutions and the challenge of redress. Some residents experienced interpersonal unlawful violence (Mitchell, 2018). At a structural level, all residents lived in circumstances of isolation and segregation from the broader community, were denied basic educational, social and medical services, and were denied the opportunity to flourish. Moreover, law enabled and regulated confinement of individuals at PMIH and subjection of some of them to non-consensual interventions such as restrictive practices. Last, residents were a source of economic extraction, including through their involvement in unpaid labour to develop the grounds and contribute to the operation of the institution (such as building a bridge to the mainland) and their labour in sheltered workshops as part of the ‘reform’ of PMIH.

PMIH also reflects the three temporal/spatial/corporeal dimensions of the institutional archipelago discussed earlier. Across its two islands, PMIH was repurposed for a variety of institutional uses: quarantine, civil and forensic mental health and disability, and prison. Purported improvements to PMIH, focused on daytime engagement in segregated schooling and sheltered workshops, reflect the endurance and evolution of institutionalisation, coercion and control despite ‘progressive’ social shifts. On the closure of each of PMIH's two island locations, residents were moved to other contexts of institutionalisation, coercion and control ranging from other mental health facilities, group homes and aged care. During its operation, PMIH was situated in a network of sites across penal, health and welfare systems that included prisons, disability residential centres, mental hospitals, group homes, residential aged care facilities, sheltered workshops and segregated schools.

While PMIH closed in 2010, closure itself, simply shutting the doors, did not redress the wrongs of the disability institutional violence experienced at this Disability Institution. There was no recognition and accountability in relation to disability institutional violence and the state government did not systematically offer redress to residents. Indeed, those PMIH residents who were moved to other institutional settings continued to be subjected to disability institutional violence, and disability institutional violence continues to be a systemic problem in Australia to this day as evidenced by the current Royal Commission. Instead of being a catalyst for redress, the aftermath of PMIH's closure has facilitated erasure and endurance of disability institutional violence. Past disability institutional violence is erased from collective consciousness and government and community accountability and yet the legitimacy of institutionalisation itself and possibility of future violence (on the same site or elsewhere) endures. While material architectural traces of PMIH remain on the island sites of this former Disability Institution, the rich (and violent) history of the hospital is absent from the contemporary use and representation of these islands. In relation to Milson Island, the former use as a hospital is not part of the official branding of MISRC, nor is it part of the curriculum during school camps (Office of Sport, undated b). In relation to Peat Island, Property NSW's masterplan for the island is promoted as involving ‘preservation of the historical significance of Peat Island and historical buildings for reuse’, including for short-term accommodation (Property NSW, undated). Yet a closer look at the current masterplan heritage report indicates that heritage preservation is not considered from the perspectives and experiences of former residents or the disability community (Urbis, 2014).

The story of PMIH speaks to a broader contemporary phenomenon of erasure and endurance of disability institutional violence through repurposing of Disability Institutions (Abbas & Voronka, 2014; Betiks, 2012; Moon, Kearns & Joseph, 2015; Punzi, 2019; Voronka, 2003). In their in-depth exploration of the uses of former psychiatric asylums across United Kingdom, New Zealand and Canada, Moon, Kearns, and Joseph propose a ‘four-fold heuristic framework’ (Moon, Kearns & Joseph, 2015: 6). One use is ‘retention’, involving mental health care uses, albeit with a progressive, ‘community’ flavour (e.g. outpatient services). Another use is the site being ‘transinstitutionalised’ into another institutional use such as a prison or university. A third use is ‘residential use’ such as expensive housing developments – here the links between seclusion and therapeutic landscapes take on a new, desirable meaning. Last there is ‘dereliction’, where the buildings and site are ‘abandoned upon closure’. Moon, Kearns, and Joseph argue that in these subsequent uses, two strategies reflect the typical limits of remembering the former asylum – strategic forgetting (co-opting institutional features such as isolation, seclusion, etc. as positive features with no explicit recognition of the earlier psychiatric use of these for repressive ends) and selective remembrance (heritage preservation of ‘architecturally-distinguished buildings') (Moon, Kearns & Joseph, 2015: 25–26, 129–130).

Erasure and endurance of disability institutional violence through re-use of former Disability Institutions, might be further facilitated by the conventional rhetoric of deinstitutionalisation. This rhetoric focuses on institutionalisation as a ‘bricks and mortar’ phenomenon and deinstitutionalisation is correspondingly associated with physical acts of reducing beds, throwing open doors and shutting down buildings. Temporally, the justice of deinstitutionalisation is associated with the moment of closure of an institutional site. And, the ‘dark past’ of former Disability Institutions is ‘repackaged by the psychiatric [and legal and political] elite to show how far the psychiatric profession [and society] has progressed’ (Flis & Wright, 2011: 102). Yet, drawing the line of in/justice at this point allows society to move on without reckoning with and redressing the full complexity, scope and ongoing impacts of that institution, including the harms and injustices of disability institutional violence and also obscures the continuities of violence in the ‘progressive’ reforms and alternatives that follow closure (Altermark, 2017).

Reuse of former Disability Institutions can be contrary to setting right the wrongs of disability institutional violence and can serve as a vehicle for legal and political irresponsibility. Yet, it might be possible to disrupt the injustices of disability institutional violence and its erasure and endurance, by re-engaging with sites of former Disability Institutions as part of how we do justice, through sites of conscience practices.

Sites of conscience

Sites of conscience practices are activities such as walking tours, education programs, survivor-authored social histories, and artistic works situated or generated on sites of systemic harm, suffering and injustice. Sites of conscience practices provide the opportunity to ‘remember the past to build a better present and future’ and organisers of these activities make a ‘specific commitment to democratic engagement through programs that stimulate dialogue on pressing social issues today and that provide opportunities for public involvement in those issues' (Brett, Bickford, Ševcenko & Rios, 2007: 1; see also Lloyd & Steele, 2022). Tumarkin (2022: 331) defines sites of conscience as ‘a movement and a methodology of community-led place-making and place-tending around histories of violence, loss, dispossession, displacement, incarceration (and so, in the same breath, histories of survival, resistance, and activism)’. Tumarkin proposes sites of conscience practices are characterised by movement, rather than memory, the ‘ability to move us “from memory to action”, from isolation to community, from social invisibility to cultural legitimacy, from looking away to looking at, from neglect to vitality, and, finally, from safely in the past to powerfully and palpably present' (Tumarkin, 2019: 16).

Writing in the context of gendered violence, Tumarkin (2022: 331) proposes that a site of conscience could keep ‘the fact of gendered violence's dogged persistence alive in the public imagination as a wound that refuses to scab, let alone heal’. Thus, in the context of disability institutional violence, sites of conscience practices do not involve remembering disability institutional violence as a historical phenomenon, but in eliciting public reckoning with disability institutional violence in terms of an open wound or continuing phenomenon that causes ongoing trauma to victims/survivors and the broader community. Sites of conscience can be a dynamic aspect of redress as ‘setting right’ – serving as a vehicle for constantly reminding the community of harms and injustices that are yet to be reckoned with and set right, and in a way that is led by the impacted community.

The International Coalition of Sites of Conscience (‘ICoSoC’) is a global network of over 300 diverse sites of conscience organisations in 65 countries. Member organisations span a wide variety of social justice issues including armed conflict, disappearances, environmental destruction, slavery, migration, women's rights and colonialism but are ‘united by their common commitment to connect past to present, memory to action’. ICoSoC focuses on capacity building ‘through grants, networking, training, transitional justice mechanisms and advocacy’ (ICoSoC, undated a). Australian ICoSoC members are Parramatta Female Factory Precinct Project or ‘PFFP Project’ (child welfare institutionalisation, discussed further below), The Addison Road Community Centre – Living Museum (cultural diversity) and the Migration Museum (racism and migration) (ICoSoC, undated d).

There are some examples of sites of conscience in the context of disability. The Pennhurst Memorial and Preservation Alliance in Pennsylvania (USA) is an online museum about the former Pennhurst State School and Hospital (‘PSSH’). PSSH is an institution for persons with intellectual and physical disabilities that operated during 1908–1987. PSSH closed following a US District Court finding violations of PSSH residents’ constitutional rights to adequate and non-discriminatory habilitation and freedom from harm (Halderman v Pennhurst State School and Hospital 446 F Supp 1295 (ED Pa 1977)). PMPA aims to create an online museum that can use ‘this tragic story as well as its landmark victories' to educate people about the ongoing civil rights struggle of Americans with disabilities, to ensure the ongoing impact of the decision and ‘to assure that we never go back’ ((PMPA, undated). PMPA operates in an online capacity, because a businessman, who purchased the site from the State for $2 million, initially developed a composting business on the site but after this was not sufficiently profitable turned it into a commercial haunted house attraction (Betiks, 2012). The site has since been sold to new owners that continue to operate the haunted house (Betiks, 2020; Guest, 2021).

Another US-based site of conscience is the ‘Willowbrook Mile’ – a self-guided walk around former Willowbrook State School on Staten Island – now a campus of College of Staten Island, City University of New York. The walk is a collaboration of Staten Island Developmental Disabilities Council, College of Staten Island and New York State Office for People with Developmental Disabilities (College of Staten Island, undated). Like Pennhurst State School and Hospital, Willowbrook State School's closure was prompted by a court decision – New York State Association for Retarded Children v Rockefeller in New York 596 F.2d 27 (Ben-Moshe, 2020: 55) and ‘the national attention over Willowbrook led to the adoption of the first federal civil rights legislation protecting disabled people, which served as the building blocks leading to the passage of the Americans with Disabilities Act in 1990’ (Fritz & Iwama, 2019: 68). The aim of the walk is to ‘preserve the site's history and create a visionary presence that acknowledges the deinstitutionalization movement to empty large ineffective institutions as well as the crucial initiation of sustained rights for people with disabilities’ (College of Staten Island, undated).

Dorothea Dix Park, situated in Raleigh North Carolina, is on the site of the former psychiatric hospital, ‘Dorothea Dix Hospital’. The site was once used for hunting by First Nations people, then became the site of a slave plantation, followed by its development as Dorothea Dix Hospital which was built with slave labour and was initially predominantly servicing white people (ICoSoC, undated c). The hospital closed in 2012 (National Park Service, undated). The site has been subject to significant environmental degradation including by reason of its use as a pre-regulatory landfill (ICoSoC, undated c). The mission of the Dorothea Dix Park ‘is for it to serve the city, state and region by honoring its layered legacy while restoring natural and built spaces to become a park for everyone, created by everyone’ (ICoSoC, undated c). The site of conscience brings together race, mental health and environmental issues in attempting to grapple with the site's complex intersecting histories of Indigenous dispossession, slavery, racial segregation, psychiatric institutionalisation and environmental destruction. Recent engagement with this site includes a 2019 performance piece ‘The Will of the Father’ exploring the site's earlier use as ‘Spring Hill Plantation’ and the role of slaves in farming the land and building the Hospital (‘the hospital that would not admit them’) (Black on Black Project, undated).

In Canada, psychiatric survivors/consumers have worked to preserve a 19th century brick boundary wall, the last remaining structure of the former Toronto Asylum (now Centre for Addiction and Mental Health (CAMH)). This wall reflects the unpaid labour of residents directed towards their confinement: ‘the historical importance of this site was re-oriented to being one of the last remaining physical symbols of unpaid patient labour from the Toronto Asylum era. This was a particularly evocative symbol in that patients were made to build the very walls behind which they were confined’ (Reaume, 2016). The wall is used by psychiatric survivor and Mad communities ‘as a site of both commemoration and public education’, including through plays, walking tours and plaques which draw a connection between the site's history and contemporary prejudices against people with psychiatric disability (Reaume, 2016; see also Voronka, 2003).

In England, the Workhouse in Southwell which is operated by the National Trust is a ‘prototype of the 19th century workhouse’, to ‘preserving an example of a workhouse’ and ‘interpreting its historic meaning as both a refuge and a warning to the millions who lived near subsistence level in 19th century Britain’ (ICoSoC, undated f). The Workhouse also includes the ‘Firbeck Infirmary’ for poor individuals too sick to work in the Workhouse. When the workhouse system ended in the 1920s, the infirmary evolved into an aged care facility that operated until 1989 with one research volunteer at the Workhouse observing ‘the care provided in Firbeck in the 1980s bore more resemblance to that in 1871 than 2018’ (National Trust, undated). The National Trust explains: ‘Oral history testimonies from former staff, relatives of inmates, children of staff who lived on site, homeless residents and visiting professionals (such as welfare officers and hairdressers), describe these spaces from the 1920s to the 1980s and have given us detail about how little changed as well as how much.’ (National Trust, undated).

In Denmark, the Danmarks Forsorgsmuseum (the Danish Welfare Museum) ‘preserves and works collaboratively to secure the heritage and memories of the institutionalised, the poor and the socially vulnerable, aiming for a Danish social history which not only sheds light on the stories from the welfare system that are not told, but also works within the field of social justice and museum activism’ (Smed, 2020: 36). The museum has a ‘Panel of Experience’ which consists of ‘people with special personal knowledge of the welfare system’ (Smed, 2020: 39). In the past decade, the museum has been engaged and funded by the Danish Ministry of Social Affairs to lead two national inquiries into institutional abuse: the Godhavnsundersøgelsen (‘Inquiry into abuse and medical experiments on the residential school of Godhavn and 18 other children's homes during the period 1945–1976’) completed in 2010 (Rasmussen and Rytter, 2015; Sköld, undated), and a current inquiry into institutions for people with physical and/or mental disabilities during the period 1933–1980. The results of the Godhavn inquiry were presented in a written report and in a museum exhibition, the latter serving to expose the inquiries ‘often heartbreaking stories to a bigger audience’ (Rasmussen and Rytter, 2015: 103).

Sites of conscience practices have also been utilised across a range of penal and welfare institutions (in which disabled people have been confined alongside other marginalised populations as part of broader settler colonial and eugenics logics). Through PFFP Project, former residents of the Parramatta Girls’ Home (‘Parragirls') utilise art and social history to connect their memories and experiences to contemporary debates about institutionalisation in Australia (Hibberd & Djuric, 2019; Steele et al., 2020; Wilson & Carlton, 2022). The Parramatta Female Factory Precinct site has been used for a variety of other penal and welfare purposes, including a mental hospital (to which some former residents of PMIH were moved, as earlier discussed). There are emerging sites of conscience in relation to Magdalen Laundries in Ireland (McAtackney, 2022; Open Heart City Collective, undated).

In relation to First Nations child welfare institutions, in the United States the Carlisle Indian School Farmhouse Coalition prioritises ‘[c]reating a safe space where descendants can remember, honor, and commemorate their loved ones' (ICoSoC, undated b; see also White, 2018). In Canada, the Shingwauk Residential Schools Centre on the site of the former Shingwauk Residential School shares the Residential School history from the survivor perspective through guided tours, talks and exhibitions (ICoSoC, undated e; see also Cooper-Bolam, 2019). In Australia, the Kinchela Boys Home Mobile Education Centre (KBHMEC) is led by survivors of the Kinchela Aboriginal Boys Training Home which was ‘one of the most notorious state institutions for the forced removal of Aboriginal boys from their families and state assimilationist practices of the 20th century’ (Kinchela Boys Home Aboriginal Corporation, et al., 2022: 185). KBHMEC has transformed ‘a disused commuter bus into a mobile education centre (MEC) for the purposes of truth-telling and healing, and to preserve the collective memories of KBH survivors for future generations' (Kinchela Boys Home Aboriginal Corporation, 2022: 185).

Last, there are numerous sites of conscience in relation to prisons, including Holloway Prison in England (Holloway Prison Stories, undated), the Long Kesh/Maze prison in Northern Ireland (McAtackney, 2014: 225–279) and Prison for Women in Kingston Canada (Guenther, 2022; Naphtali, Sharma and the P4 W Memorial Collective, 2021).

This brief survey highlights the sheer breadth and diversity of sites of conscience practices related to former Disability Institutions. Between these examples there are key differences in terms of physical access and custodianship of the site, leadership or other role given to victims/survivors, the extent to which past and present violence is named as such rather than implicit in the history of the site, and the relationship of sites of conscience practices to formal legal/justice processes. In the next section of this article, I will turn to offer some preliminary reflections on the potential role of sites of conscience practices in redressing disability institutional violence, and identify specific lines of inquiry for future empirical exploration of this topic.

A role for former disability institutions in redress?

Instead of former Disability Institutions facilitating the erasure and endurance of violence, sites of conscience practices might provide opportunities for engagement with the memories, places and materiality of former Disability Institutions to be vehicles for redressing disability institutional violence. In particular, sites of conscience practices might provide tools to grapple with the complex dynamics of violence introduced at the start of this article and thus usefully supplement conventional legal remedies and court processes.

Sites of conscience practices can centre the perspectives of individual survivors in ways not possible through conventional court process and state-led commissions of inquiry, and in doing so address the epistemic violence perpetrated through Disability Institutions, courts and governments who have denied wrong. The Danmarks Forsorgsmuseum presents an interesting example where a site of conscience itself leads national inquiries, and thus connects survivors, impacted communities and members of the broader community throughout the inquiry process and afterwards in keeping alive in the public mind the inquiry's findings. Another example is the PFFP Project. Parragirl Djuric and her artist collaborator Hibberd have explained the importance of this project as a way to tell Parragirls’ stories and experiences in ways not possible through the Australian Royal Commission into Institutional Responses to Child Sexual Abuse which relied on channelling their experiences through psychological and legal discourse. An immersive film produced by the women ‘offers them a position of authority, in contrast to the victim's identity as a powerless dependent of the state’ (Hibberd et al., 2019). For the survivors of Kinchela Boys Home, the KBHMEC is 'an experiential site of learning, memory, and resistance' that 'includes an opportunity to meet and talk with the KBH Uncles'. (Kinchela Boys Home Aboriginal Corporation, 2022: 188). Focusing on survivors’ experiences can also situate disability institutional violence in a fuller context of experiences of Disability Institutions that extends to resistance and friendship that emerged in these harmful conditions. Indeed, Rossiter and Rinaldi (2019: 92–93) note that while the ‘legacies of violence haunt survivors, and carry long past their time spent institutionalized … where we find the residue of violence, we also find strategies for resistance – lived and enacted and embodied’.

However, realising epistemic justice through sites of conscience practices might depend on many factors in terms of the roles of victims/survivors or the broader disability community in the leadership and operation of sites of conscience practices. As McAtackney (2022) notes in relation to Magdalen Laundries in Ireland, there is diversity of experience of institutionalisation and diversity of views on how (and if) they should be memorialised. Recognising epistemic authority of victims/survivors also means leaving open the possibility of diverse views amongst survivors – there might be those who simply want the site destroyed or its history forgotten. The approach in the Holloway Prison Stories project creates space for multiplicity of experiences and perspectives that resists a reductive, singular narrative. These two examples suggest that meaningful processes of discussion and consultation must form the basis of the development of sites of conscience practices. If these practices are instead led by academics, government bureaucrats or heritage professionals, they can simply become another layer of epistemic violence and disempowerment. Thus, moving forward it is important to listen to disabled people themselves – what do they want known and remembered about Disability Institutions, in their view what would be a respectful and ethical way to engage with victims/survivors, and what role do they want to play in these practices? Epistemic justice might also depend on the extent that the state and/or owner of a particular site permits access to or custodianship of the site (see, e.g. PMPA). For sites of historical disability institutional violence, choices will need to be made about how to ethically reinterpret sites and archives in ways that gives voice to those who are no longer living or instead explore the violence through its intergenerational impacts, as has been noted in the context of the Carlisle Indian Residential School (White, 2018).

Having one material architectural Disability Institution as a focal point through sites of conscience practices can provide a starting point to map out – spatially, temporally, corporeally and legally – the institutional archipelago and thus the continuities of institutional violence across lives, generations, places and laws, thus materialising for the community disability institutional violence as the ‘wound that refuses to scab, let alone heal’ (Tumarkin, 2022: 331). The one Disability Institution can tell us much about the harms within that specific institution as well as the harms of a larger set of practices, sites and logics through which institutionalisation, coercion, control and disability institutional violence endure and evolve over time.

Sites of conscience practices might facilitate a shift to a more active and ongoing notion of justice as ‘structural justice' (Balint, Evans, McMillan et al., 2020) by keeping ‘alive’ the justice of a court judgment well after the decision is made. Critical disability scholar Kim notes that ‘justice—in demands for reparations and apologies for harms inflicted—is often cast as a universal and final outcome that cannot be revisited. Justice is described as ‘not done yet’ or ‘done’, as if justice were something to be completed at a certain time by a set of actions upon which affected people and society in general agree’ (2019: 3). Responding to Kim's critique, sites of conscience practices might enable justice to ‘always be in motion and in relation’ and to be ‘an ongoing commitment to conduct rather than an isolated act of finality’ (Steele, 2020: 208). This is reflected by PMPA and Willowbrook Mile which focus on sustaining the ongoing, national (even international) impacts of court decisions related to the closure of specific Disability Institutions beyond the act of closure and beyond those particular sites. In this way, sites of conscience practices can have systemic impact through engaging the broader community in ongoing ethical accountability to make real these judgments in everyday relations. The enduring materiality of Disability Institutions coupled with centring the voices and experiences of survivors in the interpretation of these sites is a reminder that injustices and harms live on and that we should all be accountable for those in our everyday personal and professional lives (Steele et al., 2020). Moreover, focusing on the materiality of a specific Disability Institution and hearing from survivor accounts of everyday routines and experiences living in the institution, can draw attention to the role of victims’/survivors’ labour in the very physical existence of an institution and wealth generated on and through the site, as is demonstrated by the Toronto Asylum Wall. Giving a tangible context to economic violence might give rise to community support for reparations, particularly at a time when sites of former Disability Institutions are being sold or otherwise monetised.

Sites of conscience practices provide possibility of redressing legal violence, such as lawful use of restrictive practices and sterilisation, which is disability institutional violence that is by definition beyond the scope of legal remedies. However, redressing legal violence through sites of conscience practices might require extending the focus beyond Disability Institutions to include direct engagement with places where this violence is enabled and regulated such as court houses, parliaments and government administrative offices. Such an approach could draw on sites of conscience practices utilised in relation to transitional justice in post-conflict and post-colonial contexts, many of which are situated on sites of former judicial and government buildings. Such an approach might also involve integrating sites of conscience into university legal education, as I have done through including PFFP Project and KBHMEC in my disability law teaching (Steele et al., 2020).

Sites of conscience approaches might also provide an opportunity to engage with settler colonial dynamics of disability institutional violence, particularly because these practices ground violence in specific places, land and Country. This depends on the extent that sites of conscience practices in relation to Disability Institutions move beyond a singular set of disability injustices and grapple with multiple (intersecting) injustices on land and Country that is itself at the core of Indigenous dispossession, displacement and genocide. Aspects of such an approach might be evident in the relation to Dorothea Dix Park. However, it is also necessary to consider how sites of conscience practices can become implicated in settler colonial violence. For example, Andrew and Hibberd suggest that the very notion of a ‘site’ of conscience is a settler concept and there is a need to shift to include understandings of ‘Country’ and Indigenous worldviews and approaches to memory (Andrew & Hibberd, 2022).

Conclusion

The Royal Commission provides a grounded and urgent reason to give serious consideration to how we truly set right wrongs of disability institutional violence in Australia. This consideration must extend to such violence that is still occurring now, as well as that which occurred years and decades earlier. To return to PMIH, from which this article began, the current redevelopment of Peat Island for recreational and tourist purposes, the use of Milson Island for educational purposes and the state ownership of and capacity for public access to both of these islands presents us with a timely and grounded opportunity to think more carefully about the current role of former Disability Institutions in the ongoing and structural problem of disability institutional violence. This article has argued that through sites of conscience practices, engagement with the memories, places and materiality of former Disability Institutions such as PMIH can be re-positioned as central to how we collectively recognise and ‘set right’ disability institutional violence in Australia.

Footnotes

Acknowledgements

Thank you to Sheila Wildeman for feedback on an earlier draft, Fiona Yeh and Joy Twemlow for their research assistance, and Audrey Salmon for sharing her experiences of Milson Island Sport and Recreation Centre. Thank you to the special issue editors Claire Loughnan, Claire Spivakovsky and Diana Johns, and the anonymous reviewers for their feedback on the manuscript. The discussion of Peat Island in this article is current as at May 2021 (information on more recent developments can be found at ).

Author's contribution

This paper draws on papers presented at Health Law and Policy Seminar Series, Schulich Law School, Dalhousie University, 29 November 2019 and Confinement: Spaces of Care and Control, University of Melbourne, 9 August 2019.

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This work was supported by the University of Technology Sydney (grant number Law Health Justice Research Centre).

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