Dear Dr Titi Sulastri,You probably are interested to know how people with mental disorder being treated here in Vancouver. They are being taken care of in the Provincial Government "Riverview Hospital" located in Coquitlam. The hospital provides specialized treatment and rehabilitation for patients ages 18 and older. General Hospitals usually have a small unit to take care of temporary stay psychiatric patients. If the patients become unmanageable, too aggressive for example, then a Psychiatrist will refer them to Riverview Hospital to stay for further assessments. The hospital opened in 1913 on 1000 acres of crown land, by using British hospital as a model of operation. It was originally designed for 1800 patients, housed in several buildings that were constructed in stages. The first building was called "West Lawn" built in 1913. Then "Centre Lawn" in 1924, "East Lawn" 1930, "Crease Clinic" 1934, "North Lawn" 1955 and "Valleyview" in 1959. "Pennington Hall" was constructed in 1950 to provide recreational facilities for the patients. Patients population peaked in 1951 to 4630. Incredible isn't it.
The patients are grouped together in wards that have similar type of illness and according to ages to better coordinate their program of treatments. They are divided into "adult programs" for ages 18-64, and "geriatric programs" for 65 and older. The type of mental illness are based according to the terminology of psychiatric and psychoactive substance use disorders that are classified in the "Diagnostic and Statistical Manual DSM-IV".
Wards to include in the "adult programs" are: acute assessment and treatment units (wards located at Centre Lawn), psychiatric intensive care unit (ward E4/East Lawn), refractory psychosis unit (ward F2B/East Lawn), neuropsychiatry units (wards S2&N3/North Lawn), and rehab/community preparation units (Brookside and Leeside buildings).
The "geriatric programs" with wards in: neuropsychiatry geriatric unit (ward S3/North Lawn), geriatric acute and treatment unit (N2/North Lawn), psychotic and affective disorder treatment units (2X&2Y/Valleyview), acute aggressive behaviour rehabilitation units (N1/North Lawn), behaviour stabilization units (wards 3X&3Y/Valleyview) and psycho geriatric extensive treatment units (4X&4Y/Valleyview).
Those are all jumble of words in psychiatric terms. Schizophrenia is the most common type of mental illness, both genetically or drug induced, and many of the programs above are connected in some ways with this illness. The electroconvulsive therapy "ECT" treatments are used at the hospital for patients with severe cases of depression both unipolar and bipolar with some success, but it is always a controversial issue. There is a motto written on the hospital ground that says "transforming mental illness into mental wellness". I think it is more of a clise than anything else, because majority of the patients will never become mental wellness again, due to the severity of their illness. Most of the patients are very long terms.
In 1995 there was a plan to close the hospital. A committee was formed to study and prepare for a replacement. But that was only it, a plan. There were opposition to the hospital closure from strong union employees and from patients' relatives. Also the cost of building a hospital was very expensive, and with the government at that time running a large deficit, they decided not to proceed with the closure. But in 2004 a new government of anti labour union was in power, and the hospital closure was inevitable. A committee already made a recommendation to decentralize the mental hospital into smaller hospitals located in various geographical areas. So the government speed up the closure, as the budget now is easier to manage. Many patients have been moved to new smaller facilities nearer to where they come from. Many buildings at Riverview Hospital are already closed, the patients there are now numbered in the hundreds, and eventually will be completely closed. The large track of crown land now sitting in the desirable booming Coquitlam, will become a source of fund to the Provincial Government, ostensibly to pay for the new facilities.
