There's a gap in our mental health services. I have an idea that can work
In the late 1960s, a young Italian psychiatrist named Franco Basaglia was posted at an old mental hospital in a town in northern Italy.
He was horrified and shocked by the conditions he found patients living in — warehoused, ignored, restrained and secluded, and utterly forgotten by society. This was his moment of radicalization.
He began his ultimately successful work to shut down all mental hospitals in Italy and understood mental illness not as an individual defect but as a problem of relationships requiring a social remedy: one where we must all work together to create respectful and supportive communities.
I have had my own moments of radicalization — seeing desperate folks trying to get admitted to psychiatric beds because they are suicidal, only to be turned away because they do not meet some secret criteria, or simply because there is never any room at the inn.
Increasingly, distressed folks are ending up in conflict with the law — they or a concerned loved one call the police in desperation.
I know of at least two people who ended their lives a few days later.
All the committees, awareness campaigns, official reports, ribbons and wristbands produced over the last 30 years did not help them.
On psychiatric units, I have witnessed staff ignore patients' pleas for a chat or a glass of water, and heard one nurse tell a distraught father whose son was admitted to hospital, "he knows if he is bad, he goes in there," while nodding at the empty seclusion room with only a mat for comfort.
So much for stigma eradication and patient-centred care!
Things go off the rails when police are called
Increasingly, distressed folks are ending up in conflict with the law — they or a concerned loved one call the police in desperation.
The person in crisis becomes frightened and lashes out. They may then be charged with assaulting a police officer or resisting arrest.
Now their distress has been criminalized, they have charges pending, and probably still have not been able to access actual help.
They must also contend with a criminal record, and this may have wide-reaching impacts on their self-worth, employability, and freedom of movement.
And of course, the police are using their valuable resources responding to a health crisis.
The way we're doing things is not working.
It is not accessible, and it is under-resourced. There are a lot of 19th-century attitudes working in our old red hospital, too.
A nurse confided in me once that "they are not like you and me; they don't need privacy, they aren't bothered by any of it."
I must have left my mental patient badge home that day.
I want to build an asylum. A real one
So, in the spirit of Franco Basaglia, and the thousands of women, men and trans folk who have organized their own communities of support and worked for reform in psychiatric hospitals: I want to build an asylum.
Not an archaic red brick building like the Waterford Hospital, with all the trappings of a Victorian mental hospital. We have that.
Not a castle in the air over a flood plain next to the Health Sciences Centre. We may not ever have that — as political winds shift and change, and NIMBY types continue to raise their discriminatory and hateful voices while clutching their latest property assessments.
Our community needs an asylum in the original sense of the word.
A refuge. A sanctuary.
A more simple place. A safe place for folks in pain, distress, confusion and those feeling overwhelmed by their circumstances.
Let's honour the spirit of that sentiment and re-humanize our response to crisis, and end the dehumanization of mental health service users.
A safe place. Designed and run by folks who have been or are mental health service users. A place that would divert people from hospital emergency rooms, police contact — and create a minimum disruption in a person's life.
A place where a person could retreat for a few days in a home-like atmosphere. A place without locked doors. A place that is welcoming to all people, and draws on their strengths and abilities.
A place that provides a holistic, non-judgmental, empathic and respectful service to anyone who needs it.
A place to breathe.
Basaglia wrote, "Madness is a human thing, just like reason."
Let's honour the spirit of that sentiment and rehumanize our response to crisis, and end the dehumanization of mental health service users.
Let's work together with people with lived experience of mental illness, and with service users to create a safe place for people in our city.
ABOUT THE AUTHOR
