It is estimated that one in five Canadians will be diagnosed with a mental illness at some point in their lives.
Yet one in four of us would not want to socialize with a depressed person, and about one in two would say the same of a schizophrenic, according to a recent study by Dr. David Goldbloom and his colleagues at the Centre for Addiction and Mental Health (CAMH) in Toronto.
The stigma associated with mental illness is also evident in the media. Quoting an article published last year in Toronto Life magazine, Goldbloom tells of the attitude of locals walking by the division of CAMH on Queen Street West. “The instinct is to cross the street where there is less chance you will be mistaken for someone who has any business with the place.”
Speaking at the first of three lectures at U of T on political power and mental health, Goldbloom admits that when it comes to mental illness, “the pathologizing of the other” is still a problem confronted by both mental health patients and professionals.
One of the keys to removing stigma is through changing the design of the care facility to make it less alienating to the public and the patients.
In the last half of the 1800s, when doctors began to treat what was then called “madness” as a physical malady, massive asylums were built one after another throughout Europe and North America to care for so-called “lunatics” and “idiots.”
Goldbloom contested the view put forth in the 1960s and 1970s by scholars like philosopher Michel Foucault and feminist critic Elaine Showalter-that mental hospitals were essentially an instrument of oppression and social control, built to round up “the poor, vagrant, elderly, women, religious and ethnic minorities”-and said these institutions actually provided workshops and field work such as farming to supplement the care for these patients. It was due to overcrowding and shortage of staff, as opposed to any ill intentions of authorities, that many patients did not receive the level of attention they needed, he said.
Dr. David Wright, specializing in the history of medicine at McMaster University and also a speaker at the lecture, researching patient documents admitted to psychiatric hospitals in Ontario from the mid-1800s to about 1904. About 30 to 45 per cent of admitants had a length of stay of 12 months or fewer. Many of those admitted were at the prime of their life; most of them were employed before the onset of their disorder. Roughly equal numbers of men and women were admitted, and the patient population consisted of individuals from all walks of life.
In addition, Wright points out, their reasons for admission bore an “almost uncanny” resemblance to the major psychiatric disorders known today. With this information, many notions held by critics of institutionalization start to fall apart.
Fast forward to the 21st century. The division of CAMH on Queen Street West will undergo a major redevelopment that will transform it into what Goldbloom calls an “urban village,” with facilities for clinical care, education and research. There will be restaurants, galleries and plenty of green space integrating the surrounding neighbourhood to promote a healing environment. Rather than maintaining an imposing institutional faade, the site will consist of many small buildings.
“The rehabilitative model takes on a holistic perspective,” says Goldbloom. “It takes into account all areas of patients’ lives-personal, vocational, social, residential, and educational.”
