The state of mental health in British Columbia is nothing to be proud of. It is in a sad sad state and much of that comes from the closing down of Riverview Hospital in Coquitlam, formerly known as Essondale Hospital. The hospital was founded in 1913 as a mental hospital for 480 patients. Over the decades additional buildings got constructed to deal with over crowding or specific issues and by 1956 over 4300 patients called Riverview home.
By the 1960s Essondale management and ownership transferred to the newly formed Department of Health Services. With it came the transition of patient reduction which continued on until 2004. Over those decades Riverview went from 4300 patients to 800 beds. The decision to downsize the hospital came as early as 1967. The idea was to have mental health services as accessible as physical health services. By 1970 there were 17 Mental Health Centres in BC with 12 that had opened up within the previous 4 years.
By 1990 a decision had officially been made to reduce Riverviews population to 358 beds. By 2002 it still had 800 beds in all of Riverview. Additional buildings closed over the years and by 2012 the hospital lost its last patients and officially closed. The number of beds started to be implemented in alternative mental health facilities and the actual amount that was implemented do not even amount to the beds that where closed in Riverview in its last year.
In 1992 about 8,000 of the yearly emergency admissions to Vancouver’s mental health were people with both drug addiction and mental illnesses. One of the reasons for this high number was stated it was related to Coquitlam’s Riverview Hospital being emptied with the sick being thrown to the coyotes.
in 1990 the provincial government was supposed to invest $26 million in addition funding over the following 10 years for mental health. Only the first payment was initiated and in 1992 the second payment came through 18 months overdue.
The Greater Vancouver Mental Health service only had 115 full-time workers with over 4000 patients.
The closing of Riverview hospital had a large impact on the region. Ex-patients of Riverview where often left without help or financial aid which caused them to flock to the Downtown Eastside of Vancouver and to a less extent the downtown cores or main business districts of the regions cities including Surrey, Langley City, Port Coquitlam and New Westminster to name a few. This facilitated the Downtown Eastside at becoming a mental health ghetto. Many of the schizophrenic patents committed suicide after discharge due to a failure to properly medicate form no professional supervision.
Essentially the province did not want to keep all these patients in a single centralized institution so mental health moved to a smaller more distributed and regionalized system.
I personally believe this was a mistake. While is helpful for families and friends if a patient is cared for closer to home, the amount of beds lost from Riverview has never been recovered provincially leaving less capacity to deal with mental illness then before.
I fail to see how this additional freedom to ex-patients benefits any one. The people are in distitude conditions, they lack stable clean safe housing, they lack mental health services and effectively live on the streets with no treatment. Further more the problems have spread through out the cities of the regions its no longer a Vancouver, Surrey, New Westminster problem.
I personally would like to see the return of a single centralized institution like Riverview. I would like laws amended that give the health authority the power to force people in to the facility with very strict rules and guidelines to prevent mistakes. I would like to see the institution be developed into a small city that provides all the services of a city like a post office for example while keeping people confined to a hospital to treat. A mini city approach so the more well off can enjoy a level or normality.
Yes this approach seems like a solution tailored to removing these people from the streets. Yes it actually is. But its for the good of these people who need care. They shouldn’t have to figure out how to house themselves and feed themselves and not be expected to take medications right with out supervision. We need to get them off the streets for the safety of the homeless, addicts and mentally ill people into warm, caring environments something a large hospital of this nature can provide. I would also imagine it would be far cheaper to manage then hundreds of tiny facilities that just duplicate resources over and over again. A large hospital ground like Riverview can easily create a full and functional community for these people. It would clean up most of the streets around the cities and reduce a great number of homeless people. The modern approach of small facilities is not working because its to expensive to operate at the capacity we need.
I personally think its best for the patients to have a stable environment with the burden of day to day living removed. We need to look back at solutions that worked and asses the mistakes we made.