Riverview Village aims to improve quality of life
for mentally ill
Herschel Hardin, July 16, 2017. This article
first appeared in the Vancouver Sun.
Herschel Hardin is president of the Riverview
Village Intentional Community Society.
We fret about the future of the Riverview Lands as
if they were an idyllic place fixed in time, where
any change to the way we use the Lands, or any
imaginative idea for them, is hard to countenance.
We should instead ask
ourselves how the Lands can best be used to help
those who suffer from serious mental illness - the
historical legacy of Riverview - and take it from
With that as our
imperative, we're proposing, as the backbone of the
an "intentional community" in which those with serious
mental illness, stabilized in acute and tertiary
care, will live together with others without a
mental illness in an integrated community
purpose-built to help the seriously mentally ill
We've named the proposed community Riverview
It's a new and innovative option for the future.
A little bit of clinical
background will help to understand the rationale,
because the introduction of
anti-psychotics for those with schizophrenia has
changed the paradigm from the days of the old
Before anti-psychotics, there was no satisfactory
treatment for psychosis, with its delusions,
hallucinations, often paranoia, and related symptoms
Anti-psychotics deal with these symptoms and
in most cases stabilize people, after which they can
be discharged from hospital.
It's why we no longer need a huge,
institutional treatment complex on the Lands, with a
correspondingly huge number of patients and staff.
What happens after discharge, though?
Anti-psychotics don't help reintegrate people
into society or expand their horizons.
And, indeed, there's a whole other range of
symptoms, ongoing chronic symptoms, that for many of
those with schizophrenia pose great difficulty.
Profound loss of motivation often accompanies
such illness ("avolition" it's called, in clinical
Poor social interactions are another
difficulty, exacerbated for many by their having
fallen ill in their late teens when social skills
are usually developed.
Dampened feelings and responsiveness, trouble with
rhythm and clarity of speech, slowed movement, and
cognitive deficit can be other difficulties.
These problems do not respond well to existing
Unlike anti-psychotics for psychotic
symptoms, for example, there's currently no
effective medication for them. Also, unlike
acute-care treatment which is relatively brief,
these challenges may last for the rest of people's
Many people end up isolated and languish, with
limited activities and seemingly bleak futures.
They are said to be "in the community," which
sounds nice, but they're not "of the community." As
long as they don't cause trouble, we may in fact not
have any contact with them at all.
The intentional community we're proposing both
recognizes and addresses this new paradigm, where
anti-psychotics allow for deinstitutionalization but
continuing chronic symptoms endure.
In the proposed community, those with a mental
illness will establish real relationships with those
without a mental illness, breaking their isolation.
A community centre will anchor the village and a
wide range of activities.
Meaningful work will be arranged for those
who can manage it. An arts hub is proposed, with
studios and retail shops, whereby the mentally ill
can connect with artists and craftspeople, and where
those with an aptitude become part of that artistic
community and sell their work. Community
facilitators will help bring people together and
keep the community vibrant.
Most of all, the Village will give those with
serious mental illness a true sense of belonging
It will bring the strength of community to
bear, something already demonstrated in existing
intentional communities with therapeutic objectives.
There will be critical clinical benefits as well
from this community engagement and support.
Relapses - going through the "revolving door"
in and out of acute care or the justice system - will be reduced, with economic savings as a bonus.
Acute and tertiary beds will be freed up, and
also freed up by the increased access to housing.
Keep in mind what the goal is here: to help those
with serious and persistent mental illness contend
with their residual chronic symptoms and achieve a
better quality of life.
Make no mistake, either, about how challenging those
difficulties are and the degree of attention we
should give to them.
Even if they're not dramatic and intrusive
like psychosis, they're every bit as serious in
their own way.
Dawn Velligan and Larry Alphs, two American
specialists on the subject, remind us, in a clinical
article in the
Psychiatric Times, "it may be that the negative
[chronic, enduring] symptoms of
schizophrenia... contribute more to poor functional
outcomes and quality of life for individuals with
schizophrenia than do [psychotic] symptoms."
This is where the Riverview Lands offer a unique
possibility - a community that those with a serious
mental illness will be able to consider their own
and where they will have the best chance to
Creating the common good in community
Michael Clague February 25, 2017.
Michael Clague is a former director of the Carnegie Community Centre, Vancouver and executive director of the Social Planning and Research Council of B.C., among many other things in a varied past. While at the Carnegie Centre he discovered the power of the arts for building community, and later went on to work with arts stakeholders in the Downtown Eastside, supporting residents' participation in the arts. His most recent book is called Staying True, Staying the Course: A Study of Ten Successful Community Service Organizations in British Columbia (1997-2008).
The redevelopment of the Riverview lands is a once-in-a-generation opportunity to make a significant statement about community and the values inherent in healthy communities. The proposal for a Riverview Village by the Riverview Village Intentional Community Society is an important example of these values: inclusion, respect, recognition, and contribution in a welcoming, supportive environment.
The Riverview Village idea is to create a community which recognizes and accepts that everyone of us faces challenges to our mental well-being over our life-time. Some much more so than others. In this proposal people living with mental illness and those not facing these conditions will live together as neighbours in active relationship with one another. People who are mentally well will move into Riverview knowing that they will be community-building with those with mental-health challenges. Undertaking neighbourhood projects together, looking out for one another, and the concomitant development in personal relations - these are what building a healthy community is all about.
Inclusion is not just about putting people of diverse backgrounds together in the same physical location. It is about setting up the conditions, expectations and incentives for people to positively engage with one another in mutual learning, in play, in mutual help and in contributing to community life. This is what good local citizenship is all about. As someone who has worked with and learned from people with mental illness, who has experienced family and friends so affected, I can attest to the value of this approach - creating the "common good" in community.
The common good is that which helps all to have a better life. Jean Vanier, 1998 Massey Lectures, Becoming Human.
A bold and valuable initiative that deserves
all possible encouragement
Mike Jay, April 5, 2015.
Mike Jay is a UK writer and cultural historian, and author of a feature article on Geel, Belgium, "The Geel question," in aeon.co. His most recent book is This Way Madness Lies, Thames & Hudson, London and New York, 2016.
Therapeutic communities for those suffering from mental illness have a long and remarkable history. I have made a particular study of Geel, a town in Belgium which has taken the mentally unwell into the care of local families since medieval times. Its model was widely adopted across Europe in the nineteenth and twentieth centuries and remains a proud tradition today.
There is abundant evidence that being supported by a wider community is beneficial for many sufferers: in the old adage often quoted in Geel, 'care is cure'. The main problem, today more than ever, is finding those with the will,
commitment and expertise to design and realise a community in which the mentally unwell can be accommodated.
Riverview Village proposes an 'intentional community' to which this goal would be integral. Such a community would offer great prospects to all involved. The seriously ill residents will be able to lead a life that would be impossible for them to sustain elsewhere, and which for many will be their best chance of fulfillment and happiness. Psychiatric and care services will be enriched with new therapeutic options, and the chance to develop groundbreaking models of care. The non-mentally ill residents will be residents and partners in a community brought together and bonded by its ethos of mutual support. This is a bold and valuable initiative that deserves all possible encouragement.