A view from CAMH

CrossCurrents

"Insanity.

"Does not the word bring to the recollection of almost every reader some face - a friend, a relative perhaps - of one who, though living, is counted among the dead?

"What sad chapters in many a family history have been written and must be written to the end of time bearing that terrible title - insanity.

"Where is the mind so inflexible as to view undisturbed, or the heart so adamantine as to pass without sadness, the tomb of the living dead? Men who are reckless in all else, who laugh at death even, become sad and tender in the presence of insanity. With the rolling of time's stream down through the ages many a mighty boulder of prejudice has been worn away, and in no department of human experience more than in the treatment of the insane."

These eloquent words appeared on the front page of the Saturday Globe, a Toronto newspaper, describing a visit by a reporter to the Provincial Lunatic Asylum (as it was officially named) in April 1890.

In its day, the asylum was considered a great leap forward in care. Indeed, in 1850 it was the first such asylum built in Canada and was far better than the absence of care that preceded it. It was architecturally magnificent and modern in design, but soon succumbed to both overcrowding and the persistently negative views of people with mental illness. Its name changed several times over the years, but its address on Queen Street - "999" - became part of the cultural history of Toronto. Children were told they would be sent to "999" if they didn't finish their vegetables.

These 19th century buildings endured for more than 120 years before being torn down and replaced with concrete and cinderblock buildings reflecting a 1970s school of architecture known as "brutalism." The term says it all. The buildings will be torn down less than 40 years after they were built, to be replaced by a series of buildings that reflect a different approach that includes:

• patient and family input into the design
• provision for dignity and privacy
• promotion of activity and recovery
• recognition of the broad determinants of health

This development, which will take place on 27 acres of downtown Toronto land, will be the biggest building project in Canada devoted to the needs of people with mental illness and addiction issues. It reflects an opportunity that seems to come around about once per century. The question is, Will we get it right?

Dr. David Goldbloom
Senior medical advisor, Education and Public Affairs
Centre for Addiction and Mental Health

Professor of Psychiatry
University of Toronto

 

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