Urban Planning for the Mentally ill

article image
Courtesy of Centre for Addiction and Mental Health (CAMH)

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.”

In-depth coverage of eye-opening issues that affect your life.