• A Canadian architect, Frank Lewinberg, and a psychiatrist, Paul Garfinkel, have teamed up and planned for a nice new neighborhood for "the mentally ill". They acknowledge the limits of their vision, writing that “the history of urban planning is littered with idealistic projects that withered in the harsh light of everyday living.”
A recent article in Canadian Architect quotes Garfinkel:
"People need to be treated in a respectful, dignified, holistic manner that sometimes requires them to be confined in a hospital voluntarily or involuntarily. The more we normalize the hospital stay, in keeping with safety and security, the better it is for the person's recovery, and ultimate reintegration. Normalizing starts with an urban village, like the rest of the city, but it gets into the nature of public space, treatment space, what our hospital rooms look like. We want to make [the hospital] a more homelike setting, just as you would want in a normal community."Dr. Garfinkel claims to be especially critical of the "biological reductivism" fashionable in psychiatry for the last 30 years, a theory that lays great emphasis on medication--often, he believes, at the expense of the patient as a whole person, and at the expense of the settings of his treatment.
I have worked with, and on behalf of, people with psychiatric disabilities for over 20 years. I remain skeptical about the plan. This isn't a plan for a new neighborhood, it is adding more office rental space while tossing a few bones to the clients and community.
Not only because the rationale behind building the great Victorian-Era behemoths that housed "the Insane" was based on providing mad people with sylvan settings; but also due to the fact that the plans ~ as extensively described ~ show more effort going into office space for clinicians than to actual housing. That housing seems to be limited to three ""alternative milieu" dwellings: 72 motel-like rooms, with private washrooms and lockable doors, for patients who still need hospital care, but who have progressed beyond the acute stage of their illnesses."
• "Housing" people in "motel style" accommodations does little to restore a sense of normalcy to one's life, yet that seems to be the only client housing being given serious consideration in the multi-blocked endeavor.
Moreover, if are planning a community, why is there only circumstantial mention of cultural amenities? Instead "...the exact nature and placement of the non-hospital uses have yet to be determined, a grocery store and health club, scientific institutes and laboratories, cafés and private residences have been mentioned."
During the reconstruction phase, The Workman Theatre, a popular visual and performing arts gathering place, "...a space much loved by local residents and others throughout the city...," operated and managed by people with psychiatric disabilities, [and funded, in part by the Centre for Addiction and Mental Health, Canada's largest mental health and addiction teaching hospital and the agency that stands to benefit from reconstruction] will be demolished.
• To destroy the Workman Theatre without having prioritized a replacement structure ~ is patently absurd! It is a popular gathering place, run by clients and former clients of mental health services. Across the continent theatre groups run by ex-patients have shown themselves to helps bolster self-esteem, foster independence and self-determination. Toronto's Centre for Addiction and Mental Health (CAMH) partially funds the theatre group; it is a bafflement that CAMH management would even consider razing a structure so integral to helping mental health service clients in recovering.
• That single action alone speaks volumes about the arrogance of clinicians towards the clients the agency supposedly serves, and makes a lie of any claims that CAMH may make about "...advocating for public policies [and practices] that are responsive to the needs of people with addiction and mental health problems." Why eliminate the Workman Theatre, a truly integrated service, that actually provides supportive services that CAMH claims they want to offer?
If Lewinberg and Garfinkel really wanted to help developing a community that helps "normalize" life for people with psychiatric diagnoses, and help folks integrate into the larger society, why then act like just a real estate developer hawking densely packed office buildings? How about affordable housing and street level spaces for small businesses. So much for an clinical commitment to the Recovery Model. And practically nothing to promoting "Community."
IMAGE CREDIT: Rendering of one of the new buildings by Montgomery Sisam Architects
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