Urban Planning for the Mentally ill

| July-August 2010

  • Urban Planning for the Mentally ill Image

    Courtesy of Centre for Addiction and Mental Health (CAMH)

  • Urban Planning for the Mentally ill Image

Urban planners often have to deal with the legacy of a building site, such as groundwater pollution or soil erosion. The developers behind a multibillion-dollar project in Toronto are addressing a different kind of historical remnant: the stigma of mental illness. A psychiatrist and an architect have teamed up to create an urban village based around the Centre for Addiction and Mental Health (CAMH) on the site where the Provincial Lunatic Asylum once stood—a facility still known to local residents as “the nuthouse,” according to a 2006 Toronto Globe and Mail article.

“This project will be the first and only example we know of in the world where a city asylum has been torn down and replaced by an urban village where people with mental illness and addictions mingle in an everyday way with other people,” write Paul Garfinkel and Frank Lewinberg in Spacing (Winter 2009–10).

“When it’s completed, in 2019, the property where the old asylum once stood will no longer be cut off from Toronto. Instead, it will become an ordinary part of urban life, with tree-lined streets, shops, restaurants, offices, and apartments.”

Garfinkel and Lewinberg have a significant stake in the project’s success: Garfinkel, the psychiatrist, is president and CEO of CAMH, and Lewinberg is a planner and architect whose company, Urban Strategies Inc., is its master planner. They also acknowledge the limits of their vision, writing that “the history of urban planning is littered with idealistic projects that withered in the harsh light of everyday living.”

They are guarding against failure in several ways. To smooth relations with neighbors, they asked about their perceptions and concerns. To ensure better outcomes, they are providing treatment for psychiatric problems and addictive behaviors in tandem at one site, acknowledging that 20 percent of mental health patients also struggle with drugs or alcohol. And perhaps most importantly, they’re integrating patients into the real world rather than locking them away.

“When [neighbors] see patients every day,” Garfinkel and Lewinberg write, “they may stop defining them by their illness and start thinking of mental illness like any other chronic ailment—something you live with and try to minimize in terms of its impact on quality of life.”
Will Brady
7/18/2010 9:58:14 AM

I have worked with, and on behalf of, people with psychiatric disabilities for over 20 years and while I would not regret the tear downs of structures that serve as grim reminders of the worst of past mental health treatments, I find it ironic that this grand scheme seems more about burying existing park space under be more monolithic buildings mostly devoted to office space for clinicians and bureaucrats. "Housing" people in "motel style" accommodations does little to restore a sense of normalcy to one's life, yet that seems to be the only client housing being given serious consideration in the multi-blocked endeavor. And to destroy the Workman Theatre without having prioritized a replacement structure, a popular gathering place that is run by clients and former clients of mental health services; which helps foster independence and self-determination, AND which is partly funded by Toronto's Centre for Addiction and Mental Health (CAMH), is patently absurd! That part of the plan alone speaks volumes about the arrogance of clinicians towards the clients the agency supposedly serves, and makes a lie of any statements the mental health agency may make about "advocating for public policies [and practices] that are responsive to the needs of people with addiction and mental health problems."

MaryJo Matheny_1
7/9/2010 7:58:50 AM

I think this is a trememdous undertaking, and I commend the initiators and developers of this. The time delay worries me. We can predict that there wil be mental illness in 2019, but what other unforseen living problems will we have to deal with? How outdated will be today's ideas? Will "normal" people be more parinoid than they are today, more fearful of the one who is different?

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