Competing ideas for Riverview balance mental-health care with community living
by Travis Lupick on January 14th, 2015 at 12:56 PM

Lower Mainland residents want mental-health care to remain a central component of a redeveloped Riverview grounds in Coquitlam. That’s the first thing B.C. Housing CEO Shayne Ramsay told the Straight when asked what he’s hearing through a consultation process that enters its final phase this spring.

“One of the strong messages we’ve received is a feeling that some mental-wellness services should be continued at Riverview,” he said in a telephone interview.

Though reluctant to provide a time line for when construction might begin, Ramsay said he’s “optimistic” that ground can be broken within two years.

He added that the province is already engaging agencies, including the Fraser Health Authority and Coast Mountain Health. At the same time, he said it remains undecided “to what degree” mental-health care will be a part of Riverview. “But I think it’s safe to say, in the future, that Riverview will continue to be a place for the provision of mental-health services.”

Riverview opened in 1913 as the Hospital for the Mind. It was once home to a peak patient population of more than 5,500 people before the complex was almost entirely decommissioned through a long process that ended in 2012. Some redevelopment has already begun. On December 17, Health Minister Terry Lake toured the newly renovated Brookside and Hillside buildings on the Riverview grounds, where a total of 40 beds accommodate clients with mental illnesses.

Now the public has until January 16 to vote on a long list of illustrated ideas for how best to revitalize the site. The choices range from overarching concepts, such as “integrated community of well and mentally disabled persons”, to small touches, like the inclusion of picnic tables and community gardens.

In order to fulfill a “break-even mandate”, Ramsey said any additional health-care programs developed at Riverview will be paid for by the province and relevant agencies such as Fraser Health. Meanwhile, money to pay for new infrastructure and amenities will be generated on-site, through “commercial, retail, and residential uses”.

After an emphasis on mental health, the idea receiving the second-greatest level of support from the public is to redevelop the site as mixed use.

Ramsay said that could include market-rate housing, an idea he described as “controversial” but also one that is being discussed.

Mixed use is also at the core of an alternative plan for Riverview drafted by a small group of advocates, two of whom are members of the North Shore Schizophrenia Society and others who have diverse experience in the field. Called “Riverview Village”, a draft paper outlines plans for a community where mentally ill and non–mentally ill residents live side by side, “specifically designed to encourage the interaction of the seriously mentally ill with others”.

Market-rate housing would be an integral part of Riverview Village, the report notes, serving as a source of funding that would subsidize below-market supportive housing for people with mental-health challenges.

The community is proposed to consist of “a few hundred to a thousand” people who would undergo a “screening process” and agree to receive a “grounding in mental illness, its symptomology and course, treatment and how it works”.

In a telephone interview, the paper’s author, Herschel Hardin, said such a development would foster relationships that help mentally ill people overcome symptoms that interfere with day-to-day tasks.

“It’s based on interaction between those with an illness and those who are well going on with their lives in much an ordinary way,” he told the Straight. “It depends on community rather than staff.…The purpose is to help those with an illness blossom and have a better quality of life.”

Ramsay said B.C. Housing has received Hardin’s proposal and considers it an “interesting concept” that could work with feedback the province has heard in support of a “balanced community”.

The proposal has also been reviewed by John Higenbottam, a distinguished clinical psychologist who in June 2014 drafted a paper on the future of Riverview for the City of Coquitlam (which the Straight reported on last September).

Higenbottam’s recommendations differ from Hardin’s in that they place a greater emphasis on meeting a need for institutionalized care for the severely mentally ill. But Higenbottam said the “Riverview Village” proposal is worthy of consideration.

“I’m not sure if it’s what I would recommend for the Riverview site, because we still have that remaining need for an acute-treatment capability,” he said. “But, certainly, I think that the idea of a therapeutic community has merit.”

Higenbottam added there is ample medical evidence that peer relationships can be highly beneficial. “Some people with serious mental illness will benefit more from those than they will from psychiatric interventions,” he said.

More information about B.C. Housing’s consultation process can be found online at RenewingRiverview.com.