In | Between the walls: A rare look inside the Waterford Hospital

Earlier this month, Isobel Keefe, Eastern Health's director of mental health and addictions services, and psychiatrist Nizar Ladha, gave CBC Newfoundland and Labrador a tour of the Waterford Hospital in St. John's. 

The tailored walkthrough focused on five areas: an old patient bedroom, the outpatient ambulatory unit, the hospital chapel, the electroconvulsive therapy department, and the patient art therapy zone.

If you've ever wondered about what the inside of the Waterford looks and feels like, this is your chance to go into the hospital that is often discussed but rarely seen.

Centre Block, Third Floor: Patient room from 1855

When the hospital opened in 1855, there could have been as many as a thousand different people staying at the Waterford Hospital. From individuals who were stuck in a fit of psychosis because of a break in their mental wellness, to others who would go on to spend their entire lives at the institution.

Currently, there are 137 beds at the Waterford, about a tenth of what existed 161 years ago.

In a century and a half, the treatment that occurs at the Waterford Hospital has shifted from one of seclusion and isolation to that of medicine and community support.

Today, the focus is to have a person re-enter the community, when they're able, in an attempt to return to their family, as well as to their social and work lives.

There is still a unit for individuals with severe mental challenges, and a separate area for individuals entering the hospital through the justice system.

But many of the people who need to use the Waterford in 2016 are passing through the outpatient ambulatory care unit, seeking treatment for conditions such as psychosis, depression and schizophrenia, to name a few.

West Block, Main Floor: Ambulatory care

Numbers from the Newfoundland and Labrador Centre for Health Information show that during 2012-2013, only 30 per cent of all hospitalizations for mental health and addictions services occurred at the Waterford, the province's only psychiatric hospital.

During the same year at the hospital, 94 people were admitted strictly because of addiction.

Another 182 people were admitted and diagnosed with having issues related to both addiction and mental health.

An additional 688 people were admitted to the Waterford, solely due to a decline in their mental health.

Two years ago, 6.5 per cent of all hospitalizations in Newfoundland and Labrador could be clearly and directly attributable to someone seeking mental health and/or addictions services.

In 2012-13, the average length of stay at the Waterford Hospital was 22.7 days. However, Dr. Ladha says one's stay could mean you'll be sharing a room with five other patients, with nothing more than a curtain between you and the next person.

North Block, Main Floor: The chapel

The design of the Waterford Hospital may have worked in the past, but today, treatment areas and aspects of the building, such as the chapel, are spaced far apart and kept secure under lock and key.

While standing in the chapel, Isobel Keefe said, "I think there are things that we have to do in this building because of the way that it is laid out ... that in a new building you would be able to build safety features within the design."

There are a number of different quotes and inspirational messages posted throughout the Waterford Hospital.

CBC: Do you ever think there will be a day in society when mental illness no longer exists?

Ladha: "Oh absolutely not, I mean, you know, we were made very imperfect. We are fraught with deficiencies as homo sapiens, you know — our bones creak, our hearts deteriorate, our minds deteriorate, we become ill. Sometimes we become ill, very ill in life, sometimes in the middle of life, sometimes, much later, but we do become ill [...] I don't think mental illness is going to go away, that is a very utopian thought."

Among the various treatments offered at the Waterford Hospital is electroconvulsive therapy, or ECT.

North Block, Main Floor: Electrotherapy

Dr. Ladha said he can give up to 1,200 ECT treatments each year, the majority of them for individuals suffering from a major depression.

He added the theory of ECT suggests that electric currents sent to the brain stimulate, in part, neurotransmitter production.

The ECT department has three rooms. In the first, patients are put on stretchers. The second is where the treatment is given, then they're wheeled into the third, a recovery room.

Though side effects can range from minor muscle and headaches, Ladha said memory loss can last for up to six months, adding that he sees a success rate with ECT treatment of 90 per cent.

While electroconvulsive therapy may shock the minds of patients, the works of art located in the art therapy zone come from within the inner workings of the patients' minds.

East Block, Ground Floor: Art therapy

The walk to the art therapy area takes you downstairs and into a long hallway. On your way, you're greeted by a mosaic of patient-created tiles that are mounted on a wall.

This is one of the first patient self-portraits that you see.

Since 2008, direct operating costs for Newfoundland and Labrador because of mental health and addiction services totalled $370-million.

Some $86.6-million of that total was spent in 2012-2013 alone, with about half going to mental health and addiction services in the community, with the other half being spent on mental health and addiction services in hospitals.

Rebuilding a newer facility has been estimated with costs of anywhere between $300-million to $500-million.

In: A series

This has been the ninth instalment of In, a series that aims to take you inside places we don't often see. If you have a place or a topic that you think Kenny Sharpe should explore, send him an email (kenneth.sharpe@cbc.ca) or follow him on Twitter.

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