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Editorial: Asylum needed for seriously ill

The term “insane asylum” fell into disfavour long ago, but asylum is what some mentally ill people need. The province should heed the call from B.C.’s municipalities to provide more secure spaces for psychiatric treatment.

The term “insane asylum” fell into disfavour long ago, but asylum is what some mentally ill people need. The province should heed the call from B.C.’s municipalities to provide more secure spaces for psychiatric treatment.

Vancouver’s mayor and police chief say their city has a crisis situation with people with severe mental illness. They have asked the province to consider, among other things, reopening the Riverview psychiatric hospital as a “modern centre of excellence” in mental-health care. Other municipal politicians, gathered in Vancouver for the Union of B.C. Municipalities annual convention, are also asking for new early-intervention facilities for mental health and addictions, as they and their police departments wrestle with problems caused by mentally ill people.

In Victoria, 10 people, most with mental-health issues, accounted for 3,000 negative contacts with police over a six-year period. Mentally ill people with nowhere else to turn are also a disproportionate drain on hospital emergency departments and social services.

Once, they would have been put in institutions such as Riverview Hospital, which opened 100 years ago as the Hospital of the Mind in rural Coquitlam. At its peak in the mid-1950s, it housed nearly 5,000 patients.

In the Victorian era, mental hospitals were known as insane asylums and many were dismal places where people who didn’t fit in were deposited and forgotten. Insanity — and the definition was broad — was a cause for shame. While 20th-century B.C. institutions were not as bad as that, the name Riverview still resonates darkly for a generation of British Columbians, partly because our society still struggles with the stigma associated with mental illness.

Dr. Andre Masters, now a Victoria psychiatrist, saw the good and the bad in such institutions. He began his career in 1961 in one of England’s largest mental hospitals. He said much good was being done there, but he also found much that was wrong. His findings led to a British national inquiry that uncovered patient neglect, fraud and maladministration, echoes of the past when patients were subject to abuse and questionable treatment.

More enlightened views came to the fore. As community-based psychiatric care became more prominent, many mental hospitals were phased out — Riverview’s last patients were moved out in 2012.

That hasn’t worked for everyone, Masters says.

“Some people are not coping and will never cope,” he said. “They need some sort of care.”

Mentally ill people without resources are susceptible to drug abuse as they try to self-medicate.

“They should be in the country, in a pleasant environment” where they can receive competent treatment, Masters said, “away from the people pushing drugs.”

He says those shouldn’t be massive places like Riverview, but smaller centres like the Vancouver Island Health Authority’s Seven Oaks Tertiary Mental Health Facility, which has 35 beds for adults with severe and persistent mental illnesses.

In Victorian times, people with obvious mental illnesses were rounded up and warehoused in mental hospitals with little or no treatment. People put in these grim places often couldn’t get out. Now, those in distress have difficulty getting into safe, secure places where effective treatments can be administered.

We still need asylums, in the true sense of the word — places of peace, safety and effective therapy, refuges for people in distress who can’t cope by themselves.