Mental Health and Covid-19: Revisiting Riverview (or, on the varieties of epistemic experience)

So many people are talking about mental health needs these days it has become almost fashionable.  Those who abide by Covid-19 protocols may suffer from isolation and anxiety, if not depression, while anti-maskers might be considered by the rest of us as truly crazy, if not stupid.  But now more than ever we should revisit the idea of establishing a new mental hospital at the Riverview site. As someone who has worked with schizophrenics locally – I am convinced that closing Riverview was a mistake.

Deinstitutionalization was a global phenomenon gone too far, guided by ideology, cost-cutting, advances in medication, and in BC’s case it has led to a hospital vacated.  Those who advocated for Riverview’s closure included Bob Hunter, co-founder of Greenpeace and local resident.  Other principal actors were: former Premiers Dave Barrett, a Coquitlam MLA who had degrees in Social Work; Bill Vander Zalm, who introduced the preliminary plan to replace it in 1987; and, Gordon Campbell who continued with the logic of Glen Clark’s policy of decentralization despite the former having learned – in adulthood – of his father’s death by suicide.

Self-determination was considered key; after all, the late 1960’s and early 1970’s were a time of “liberation”.  The Vancouver experience with the patient-led Mental Patients’ Association, a first in Canada, was spearheaded in 1971 by Lanny Beckman and the late Dave Beamish.  Their approach shaped the BC branch of the Canadian Mental Health Association (an institution guided in policy these days by some in academe – yet another kind of institution) which argued in 2013, the year after Riverview closed, that: “Our Government has made the right decision.”  The Riverview model, it said, lacked “compassionate care.”

If we look closer at the historical record – for example the BC Legislature Hansard for Dec. 1, 1987 – we even find something of an alliance between the Socreds and the CMHA: both parties wanted the downsizing of Riverview to continue.  This is despite local NDP MLA John Cashore’s objections to the then Minister of Health Peter Dueck: “The minister knows full well that there have been comments from street workers, community workers and health workers about the number of ex-mental patients who have fallen between the cracks and ended up on the streets of Vancouver and other locations.”

It is an irony that we have mentally ill people on the streets at least in part because of ex-patient advocacy.  Those displaced onto our alleyways were deemed to be better served by “housing options” in “community-based settings” – a further indication of utopianism, given present-day property costs and availability.  In my opinion, this abysmal and long-standing failure to deal with the here and now of those in despair reflects poorly on all people of British Columbia.

I do not see the squalor of some Vancouver streets and our tent cities as less stigmatizing than Riverview, which is depicted in popular culture – to this day – as an “asylum”.  Without specialized treatment acute needs can go unmet – it is that simple.  I am not advocating for a Riverview reincarnated but for a new reimagining.  Now is the time to abandon rhetoric and search for solutions: clearly Covid-19 teaches us that mental ill-health can be everywhere and affect everyone.