Re-open Riverview

[flamingfingers]

The decommissioning of Riverview (although some are still kept there) and Tranquille in Kamloops started decades ago and a lot of us in the health care industry wondered where all of these people would go. Seems like the less costly 'care in the community' was thought to be an appropriate model.

Now how has all of this gone down? Has the goal of 'care in the community' been proved effective? We are seeing a push by Delta and Maple Ridge mayors to re-open Riverview as a sanctuary for the more challenged mental health citizens in BC.

Police are often the first responders to a mental health crisis and that is not only costly in terms of attending to these specific issues but also takes away police personnel from other activities that is more in keeping with their training.

Have a read. How do you feel about re-opening Riverview?

B.C. pushed to improve mental health services, reinstate Riverview Hospital

Mayors, police call for provincial support for intervention centres for mentally ill, addicts

By Kelly Sinoski and Lori Culbert, Vancouver Sun August 27, 2013

METRO VANCOUVER -- A young mentally ill North Delta man was taken to hospital by police, given a pill by the doctor and released back onto the streets.

Shortly afterward, he headed to the Alex Fraser Bridge, climbed the railing, and jumped.

“We’ve had some really tragic stories,” Delta Mayor Lois Jackson said. “This is not good enough for our society. There has to be a place where we can take these people so we can protect them from this.”

Such a situation underpins a long-standing call by Metro Vancouver municipalities and local police forces for the provincial government to provide better health care services for B.C.’s mentally ill and addicted population.

In the latest push, the Corporation of Delta and District of Maple Ridge have put forth separate pitches to the Union of B.C. Municipalities next month, seeking provincial support for early intervention centres for mental health and addiction as well as the reinstatement of the 100-year-old Riverview Hospital as a “modern centre of excellence.”

The move coincides with a concern raised last week by Vancouver Police Chief Jim Chu, president of the Canadian Association of Police Chiefs, that police have become first responders in dealing with mental health issues.

Last year, Vancouver police apprehended 2,636 people under the Mental Health Act — a figure that has climbed at a staggering pace in recent years. There were 1,744 mental health apprehensions in 2007, and just 360 in 1999, according to a groundbreaking report released by the VPD in 2008.

That report, entitled Lost in Transition, found 49 per cent of police calls for service in the Downtown Eastside involved at least one mentally ill person.

The five-year-old report’s recommendations — more housing, medical and other services for the medically ill — are still being called for today.

“Police should not be the front line on mental health issues. Lack of funding in the health care system is putting these people on the streets,” Chu said last week. “We need to shift from a point of crisis to preventing the crisis from occurring in the first place.”

Officers responding to a mental health issue will often spend hours in a hospital waiting room until the patient is released, putting a drain on police resources, cities argue.

In Surrey, for instance, the city spent more than $600,000 between 2008 and 2012 dealing with 1,500 calls from just eight mental health patients, RCMP Cpl. Bert Paquet said.

The city has since hired a mental health liaison officer to help find long-term care for such patients. Still, about one-third of all calls to Surrey RCMP is still mental health related.

“There used to be a day when the police were the last resort,” Paquet said. “Over the years we’ve seen police officers be the first to be called.”

To deal with the issue, Delta is calling for the province to work with the federal government and municipalities to open intervention centres to house people suffering from mental health or addiction issues, if a doctor feels they may harm themselves.

Jackson said she would also support a move to reinstate Riverview Hospital, although she would like to see it modernized to ensure patients are protected.

Riverview, which opened in 1913 and had 4,726 patients at its peak in 1955, was eventually phased out in favour of offering community-based psychiatric treatment. Municipalities argue the move has resulted in a provincewide shortage of treatment and housing for those suffering from serious or severe mental illness.

“I don’t know why we don’t have a place where we can take people where they can stay for three or four days,” Jackson said.

Before endorsing the debate to reopen Riverview, Dr. Soma Ganesan, who once headed the psychiatry department at Riverview and now works at Vancouver General Hospital, argues there should be a review of what is truly needed in the mental health system, noting some people don’t require long-term hospitalization.

“If we talk about hospitals first then we will make the same mistake as in the past, that we re-institutionalize them,” he said, adding a focus on partnering with the community could help treat people as quickly as possible and help them function in society.

Maple Ridge Mayor Ernie Daykin agreed the system should be re-evaluated, saying while it was laudable in the 1990s to deinstitutionalize Riverview patients, “what we have now isn’t working.”

The UBCM resolution will ideally get cities talking together about solutions, and convince the province they need help.
Health ministry spokeswoman Cindy MacDougall would not comment on the UBCM recommendations but said in an email that the move to deinstitutionalize Riverview patients was done to improve patients’ lives.

Although Riverview Hospital is closed, she added, the lands are being used to house some community-based mental health facilities designed to help patients transfer out of the Forensic Psychiatric Hospital.

The government has also committed $138 million in capital funding to build or expand mental health facilities in B.C., MacDougall said, with 715 mental health beds opened at the end of 2012.

But Vancouver police spokesman Const. Brian Montague noted many recommendations from the Lost in Transition report have yet to be fulfilled.

For example, he said, there has been no net increase in long-term beds in mental health institutions, the city has no “urgent response centre” to assess and triage people with mental illness, and the coroner has not considered holding inquests for all people who commit suicide after receiving recent psychiatric care.

Some recommendations have been met, such as the creation of a specialized outreach team (ACT) that provides community-based treatment. And additional supportive housing has been built, although much more is needed.

[email protected]

[Donald G]

Since W.A.C. Bennet first started to close the mental health treatment facilities in the 1970s, like the 1,200 mental patient Tranquille facility in Kamloops, EVERY B.C. provincial government since then has furthered the mental health treatment facility shutdown.

Much of the reason for the initiation of the shutdown was threefold;

1. The fact that the WORDING AND INTERPRETATION of our Canadian Rights resulted in out of control drug addicts and medicated patients (who were only violent when not medicated) were declared by our Criminal Court Judges NOT to be persons who constituted "a danger to themselves or other persons".

Under the provincial Mental Health Act the requirement to have a mental patient admitted for treatment at such a facility was that two doctors or one judge had to determine a person taken before them as being a danger to themselves or others.

Under the new wording and judicial interpretation of the Charter the fact that out of control addicts or those being medicated for any number of mental illnesses who had gone off of their medication were no longer considered as being of danger to themselves or others in the community. The constant drug trafficking and criminal activity required to support their lifestyle was not considered to be a danger. Nor was the well proven accelerated path they took toward death as a result of their lifestyle considered an acceptable danger.

2. The change in our Canadian Rights enabled a large number of lawyers to find clients within the institutions who, using any number of applications of the reinterpreted Canadian Rights as it applied to the Provincial MHA and start numerous expensive lawsuits. There was IMO a literal legal stampede to the door. The media at the time, as they have since, were more interested in printing highly emotionalized stories than helping society to see the matter clearly.

3) At about the same time people from the Mental Health Agencies started a move to convince people that mental health patients were best treated in the community. Unfortunately once they realized the full ramifications of what they had done those extremely vocal mental health advocates most responsible for the seriously questionable changes either disappeared into the woodwork or denied any responsibility for the resulting mess.

Over time the police, by default, have become our front line mental health workers and our jails have become our mental health treatment centers.

The "crimes against humanity" continue to this day and are most visible in places like the Downtown East Side which, along with our jails, have become the new "public holding units" for those awaiting their early death because of the greed and outright stupidity of small groups of people in the position to wreak the havoc they did a few years back.

Those most responsible continue to make themselves invisible.

[Queen K]

From what I see and experience every day, re open Riverview.

We know someone in a five person care home for the mentally ill, that person is very lucky to be there. But for how long? How long before this rabid right winged bean counting anti-humanitarian govt. gets their claws into a home so small as to be thought insignificant and costly, a money loser so therefore expendable? Like as if their lives are expendable. I worry about this all the time, no kidding.

Riverview represents a safety net for those who won't have anyone to stand up for them, those who can't speak for themselves or who won't have the capacity, like we would, to do something about the inequity and loss should my worst fears be realized.

[Donald G]

To me two things have to change;

The REINTERPRETATION of the Charter by our judiciary has to be changed back to again permit the INVOLUNTARY treatment of out of control drug addicts and alcoholics; for as long and as often as necessary. Treatment centers like PART OF Riverview have to be reopened to receive them. Otherwise they will continue laying about the streets and parks until death claims them.

Medication monitoring (out patient if possible) has to be provided for the large number of mental patients suffering from medical conditions that require the patient to remain on their medication to retain their 'normalcy. The foundation for it has already been laid in the various B.C. Street Nursing and Nurse Practitioner programs.

Both the Federal and Provincial Governments have to fund an increased number of well founded SCIENTIFIC studies to determine if drugs like those inherent in marijuana cause psychosis or can help cure psychosis as claimed by various opposing proponents.

[grammafreddy]

http://www.urbanghostsmedia.com/2013/07 ... um-canada/

[GordonH]

Since W.A.C. Bennet first started to close the mental health treatment facilities in the 1970s, like the 1,200 mental patient Tranquille facility in Kamloops, EVERY B.C. provincial government since then has furthered the mental health treatment facility shutdown.

1983 West Lawn is permanently closed
1985 Tranquille is closed
1990 Replacing Riverview with smaller, more specialized regional facilities
1992 Crease Clinic becomes the second large Riverview building to close
1996 Woodlands will close
1997 A new state-of-the-art Forensic Psychiatric Hospital opens at 70 Colony Farm Road in Port Coquitlam, replacing the original Riverside Unit.

So please inform me which places did W.A.C Bennett close down, just out of curiosity.

[Piecemaker]

Gordon, the closing of the large institutions to house the mentally ill began in the 60s and 70s during W.A.C. Bennett's tenure as premier. It takes several years to complete such an undertaking as de-instutionalization. However, I would not "blame" him as it really happened due to an ideological shift in thinking about mental health care and in economics. These shifts in thought and treatment of mental health clients were happening elsewhere as well.
Some of those institutionalized then would not be so now due to the advances made in drug therapies and increased knowledge and understanding about brain chemistry. As well, there has evolved an increased awareness as to how those with mental illness can be included in mainstream society in positive ways.
The idea to provide mental health care in the patients' home communnities had merit. Unfortunately adequate funding did not follow to establish the community-based services.
Then you have the issue of forcing people to take medication and the challenges of getting them to follow through with regular contact with their physician and mental health professionals. So many only re-engage (albeit ever so briefly in many cases) when they are in a mental health crisis.
That is when the police and emergency medical services (and possibly addiction treatment services) become involved. This is very non-efficient (costly).
While there may be a need for a larger "institution" for some, many could have better mental health stability with less costly measures.
Some sort of supported housing could prevent many from getting to that crisis stage. (Similar to what was done with the old hotel a few winters ago as a special project to reduce homelessness in Kelowna.)
Having a mental health outreach person to accompany the police, and then having that person remain at hospital until patient was admitted (provided the patient was not violent). That would free up police to return to policing sooner.
Mental health, addictions and isolation or homelessness are all contributing factors to the issue.
There are many who live in a supported living arrangement or totally on their own that participate in community-based mental health services effectively. We need to find a way to expand that. And yes, it will take some money. Doesn't it always? And as a more extreme measure for some we do need to be able to provide an institutionalized setting. Some it would be for a relatively short period of time and for some much longer.

[GordonH]

Gordon, the closing of the large institutions to house the mentally ill began in the 60s and 70s during W.A.C. Bennett's tenure as premier. It takes several years to complete such an undertaking as de-instutionalization. However, I would not "blame" him as it really happened due to an ideological shift in thinking about mental health care and in economics. These shifts in thought and treatment of mental health clients were happening elsewhere as well.
Some of those institutionalized then would not be so now due to the advances made in drug therapies and increased knowledge and understanding about brain chemistry. As well, there has evolved an increased awareness as to how those with mental illness can be included in mainstream society in positive ways.
The idea to provide mental health care in the patients' home communnities had merit. Unfortunately adequate funding did not follow to establish the community-based services.
Then you have the issue of forcing people to take medication and the challenges of getting them to follow through with regular contact with their physician and mental health professionals. So many only re-engage (albeit ever so briefly in many cases) when they are in a mental health crisis.
That is when the police and emergency medical services (and possibly addiction treatment services) become involved. This is very non-efficient (costly).
While there may be a need for a larger "institution" for some, many could have better mental health stability with less costly measures.
Some sort of supported housing could prevent many from getting to that crisis stage. (Similar to what was done with the old hotel a few winters ago as a special project to reduce homelessness in Kelowna.)
Having a mental health outreach person to accompany the police, and then having that person remain at hospital until patient was admitted (provided the patient was not violent). That would free up police to return to policing sooner.
Mental health, addictions and isolation or homelessness are all contributing factors to the issue.
There are many who live in a supported living arrangement or totally on their own that participate in community-based mental health services effectively. We need to find a way to expand that. And yes, it will take some money. Doesn't it always? And as a more extreme measure for some we do need to be able to provide an institutionalized setting. Some it would be for a relatively short period of time and for some much longer.

1951 Essondale reaches its peak population of 4,630 patients. Pennington Hall opens, providing recreational services to patients.

1955 230-bed Tuberculosis Unit (now called North Lawn) opens at Essondale. The introduction of improved medications, along with the opening of community mental health centres, boarding homes, and general hospital psychiatric wards, results in the start of a decline in Essondale’s patient population.

1959 Essondale’s last major patient residence, Valleyview 300, opens. The former Tranquille provincial tuberculosis sanitarium in Kamloops is converted to a residential facility for the developmentally disabled.

1964 The Colquitz forensic psychiatric hospital is closed and its patients transferred to Riverside Unit at Colony Farm.

1966 Essondale is renamed Riverview Hospital, although Valleyview continues to operate independently until 1986.

Just thought you would like to know.

[the truth]

reopen riverview ,best idea ever,should of never closed in the first place.

[Piecemaker]

Not sure what you are getting at Gordon. The process of moving some patients out of the larger institutions and into smaller institutions in (or closer to) their home communities started by the early 70s. Many patients who would have historically been sent to the larger institutions ceased to be during that time.
The ideological shift in thinking about taking care of the mentally ill was happening during W.A.C. Bennett's tenure during the 50s and 60s.It was Grace McCarthy, an old soldier from his cabinet, who was the minister for Social Services and Housing who closed Riverside in the mid-80s. Changes in policy and practice do not usually happen in a year or two. They can be decades in the making.
Nevertheless, as I said, it was not something I would blame Bennett or anyone else for during that time. It was intended to be better for patients and their families, as well as more economically prudent. It would have happened regardless of whether it was a Social Credit Government or not. De-centralization of Mental Health services didn't stop when the Social Credit lost the 1972 election.
The point of this thread is the question as to whether or not Riverview should be re-established?
We need something more than we have now to assist the mentally ill. I think we do need a "Riverview", but I also think we need additional development of community supports. Our policing and general health care resources should not be how the mentally ill are assisted. It isn't working...for anyone.

[Donald G]

To Piecemaker ...

Good post. People who are unaware of the progressive reality that existed and operate strictly from history books that give a set date for the multi year progression involved in a shutdown seem to think that the various treatment facilities were all of a sudden shut down in one day. People who lived through it look at it differently.

The eventual wide ranging shutdowns were, in large part, a result of the new REinterpretation of the our Canadian Rights by the PET left wing extremists.

[Piecemaker]

At the same time, Gordon is correct in that it really wasn't W.A.C. Bennett who was Primier during much of the time of the de-institutionalization of the mentally ill. What some may not realize is that historically those with developmental disabilities and those with an "insanity" diagnosis were all treated under Mental Health Services (as well as some housing and care of the elderly). We didn't have the same segregation between the groups of "patients" as we do today. The developmentally disabled aren't even referred to as "patients" today. It was the de-institutionalization of the mentally challenged who used to be housed in those institutions and their services that became community-based first, before those with an "insanity" diagnosis.
Regardless of who was premier, the change in services to the mentally ill would have happened. The NDP would have probably pushed for it just as hard or harder than the Social Credit did. It was a national and international trend. It was viewed as better for the patients, their families and of course, fiscally.
There were some "patients" at the time when the institutions closed who were left in out in the cold, so to speak. They ended up homeless and in dire circumstances. Twenty-five years later we can see that there were more than a few flaws in the plan and the execution of the plan.
We have people and communities with challenges as outlined in the article quoted by the OP. As well, the developmentally disabled do not receive adequate funding and services under the CLBC programs. We fall short in caring for the vulnerable be they developmentally challenged, mentally ill, brain injured, addicted or elderly. (Many fit into more than one category.)

[hobbyguy]

Something like 40% of homeless people are mentally ill. That certainly needs addressing.

Is going back to very large institutions like Riverview the way to go? Given the past abuses, that is questionable.

Perhaps a new model is required, and parts of the Riverview site can be adapted as a pilot. Even that is questionable, as it doesn't deal with the reasons that so many congregate in Vancouver's DT east side.

[grammafreddy]

the reasons that so many congregate in Vancouver's DT east side.

Birds of a feather flock together.

That's where they are understood and not judged and also can have someone to watch their back and their shopping cart. They are their own community down there.

[Donald G]

Like many things that mankind does the previous mental health committal and treatment centers exceeded the initial intent envisioned for such centers. Ignorance played a role in many of the excesses that resulted.

At the present time the pendulum has swung too far in the opposite direction and we are expecting mental patients completely lacking in the ability to cope, including out of control addicts, to continue to make their own way in the world.

We now have the ability to far more readily identify the many DIFFERENT kinds of mental illness but we continue to try to treat all such DIFFERENT kinds of mental illness the same. One NOW NEEDLESS extreme is as bad as the other.