Part one of an ongoing series, Riverview Stories, commemorating the closure of the province's largest mental hospital in Coquitlam.
The history and evolution of mental health care and Riverview Hospital travel from west to east.
On the west end of the property, the nearly 100-year-old West Lawn building languishes like a dowager queen with her paint peeling and her concrete stairs crumbling, a reminder of an era when dorm living, bracing work, peaceful surroundings and wholesome food were considered cures for mental health concerns.
It's at West Lawn where the province's mentally ill were first housed - 340 male patients on opening day, April 1, 1913 - where the tour of the Riverview Hospital grounds begins. Buildings get progressively younger, and less impressive, the further one travels east along the charmingly named streets of the property's interior road system (Boxwood Drive, Fern Terrace) until a sharp switchback called Campion Way, where three new buildings offer a glimpse into the present state of mental health care.
On this northeastern edge, hidden in the trees, Cottonwood, Connolly and Cypress lodges represent a sharp departure from the modest, aging structures in the middle and east of the property, buildings where patients were recently housed but are now closed. These newer lodges represent the modern face of health care, officials say, where people can live independently as much as possible, with private rooms, comfortable living spaces, kitchens where they can make their own snacks, and access to community programs a short drive away.
But the story of Riverview Hospital as we know it is about to end and, ironically, it's in one of the oldest buildings where the last remaining patients needing specialized care now reside. In the next few weeks, 40 patients being cared for in the 88-year-old Centre Lawn building will be moved to new facilities in Willow Pavilion in Vancouver and Timber Creek in Surrey.
Riverview Hospital - an icon, an enigma a landmark - will close.
Some mental health care will continue on the 244-acre property. The Fraser Health-run lodges, built since 2000, will continue to house about 60 people. The film industry and a few non-profit and government agencies lease space on site but for, largely, the giant hospital, once home to more than 4,000 patients - and the Tri-Cities' leading employer - is shutting down for good.
By mid-July all the patients will be gone and about 200 staff who remain will move on to other postings. Others, including Lynn Cook, will retire.
A 34-year-veteran of Riverview Hospital, Cook is taking part in the closing of the facility where she once trained as a young rehabilitation worker. It's a bittersweet moment for the site operating officer as she says good-bye to colleagues and friends.
Still, she's not sentimental. "We are losing the culture of Riverview," she said, "but at the same time the first priority is the patients."
The patients will be living in better surroundings, she said. They'll have more privacy. The younger ones can plug in a phone or an iPod charger (there are no outlets in rooms available to patients at Centre Lawn) and older patients can have a TV in their own rooms. Bathrooms won't have to be shared. It will be like living at home but with supports.
"[The staff] want patients to succeed. They see the benefits."
Cook marches briskly out of the Administration Building, a grey-stuccoed two-storey structure with dark-panelled walls and Craftsman-style details. Trained in rehabilitation, she had planned to work with seniors but "working in mental health gets in your blood." She has been on staff since 1978.
A showcase
From the day the hospital opened, Riverview was considered a showcase in therapeutic care, although many of the practices - dorm-style living with 50 people to a ward, work details, such as requiring some patients to clear the property or work on Colony Farm - were discontinued and controversial treatments such as lobotomy surgery to calm patients were carried out into the 1950s but eventually abandoned. Many important drug trials were conducted that helped improve patient treatment, Cook said, and allowed them to be more independent and reintegrate into community life.
As an educational facility, Riverview achieved provincial stature and national recognition. A nursing school was established there and some of the buildings, such as the Henry Esson Young building, built in 1976 with an auditorium, held classes until recently. Some of the other buildings on site are being used for educational purposes - but not by the hospital.
An example of how important Riverview was in mental health care is the Crease Clinic, whose massive frame with its ornate window treatments and decorative brick work looms over Lougheed Highway. Now used frequently for film productions, Crease was a model for patient care when it opened in 1949, providing short stays of up to four months for patients suffering acute symptoms; it also contained a complete surgical suite, a radiology department and laboratories.
Today, Riverview is home to a lush collection of trees, security guards who buzz around the property like pollinating bees and several empty shells of buildings. A former bank, a telephone exchange and recreational hall, complete with a bowling alley, suggest there was once a thriving sense of purpose and community at Riverview. Now, they are silent because current treatment philosophies no longer encourage withdrawal from community life.
No magic bullet
At the far eastern edge of the property, three cozy bungalows - Connolly, Cottonwood and Cypress - look well lived-in, neatly maintained and comfortable, boasting cedar siding, large windows and attractive landscaping. Cook is proud of planning, building and piloting the first of these - Connolly Lodge - and says a study still underway shows patients do better and have a better quality of life when they take care of their own needs.
"It's not a magic bullet to cure schizophrenia," she said, "but it helps people improve in their treatment."
Where a visitor sees a ghost town or an aging film set from a 1950s-era movie, Cook sees a vibrant hub peopled with former colleagues and memories of a time when Riverview was a leading provincial hospital and a centre for mental health research. If anything, she is wistful that those who work in mental health care today and in the future will have little idea of the role the hospital and staff played in establishing best practices.
"The site is gorgeous but the site has not cured anybody. It's the service that people have created and the legacy of caring and compassion."
Acknowledging that much work is still needed to reduce the stigma of mental health and challenges remain in meeting the needs of patients in a community setting, Cook says mental health care is still evolving and Riverview should not be forgotten.
In the next few months, as Riverview Hospital closes and the property enters its 100th anniversary in 2013, The Tri-City News will publish an ongoing series of stories about the people who worked, lived and had family there.
Next: A Grand Plan
