Changes in care reflected in changes in building
"The walls are ominous," Stephen Crawford said of life in the Centre for Addiction and Mental Health's (CAMH) in-patient rooms. "It's very hard to stay stimulated and active when you are staring at a brick wall."
Crawford, 31, has been diagnosed with clinical depression and mood disorder. He was attending the University of Toronto when he had his first episode of serve depression brought on by stress.
Since then Crawford has been admitted to CAMH on two separate occasions. He knows well the challenges of overcoming struggles with mental health and what is needed to help win the battle. The redevelopment of the CAMH campus, he said, is exactly what is needed.
It's an urban village concept, that CAMH officials say will improve the delivery of client care, integrate mental health and addictions care and eliminate the stigma that hangs over the current Queen Street site. The first phase of the massive redevelopment, which is scheduled for completion in April, included the construction of three Alternative Milieu or "AM" units with 24 beds each. When Crawford was admitted to CAMH, he stayed in the rooms these units replaced. He said they were stark and cold, and not favourable to recovery.
"I've seen what the new units will look like and they are more conducive to wellness," Crawford said. "Your environment really is crucial to promoting self esteem."
When Crawford was admitted to CAMH he said he was very apprehensive about the stigma he feared would be attached to him when he told people he lived at 1001 Queen St. W. - a civic address, he said, that immediately labelled you. Crawford uses a wheelchair for mobility and said he had a very difficult time getting around in the building, particularly getting in and out of the washroom.
The new units each have individual civic addresses and individual entrances and are more accessible for someone who uses a wheelchair.
"That's a tremendous positive that would counteract the stigma I felt upon first being admitted," he said. "All of that makes you feel good and it assists in breaking down stereotypes."
Little things the new units offer, like having your own entrance and set of keys and enabling the clients to interact with the community, foster a sense of self-worth.
"One thing I noticed during my time I've been here is that CAMH really tries to integrate themselves into the community and this project just takes that one step further," Crawford said.
The strides that have been made in mental health care in recent years are not yet reflected in the current buildings on Queen, according to Karen Martin, the administrative director for CAMH's Mood and Anxiety Program.
The new urban village model brings CAMH and the community together with a unique mix of CAMH and typical urban land uses.
Research and results, she said, prove beyond a shadow of a doubt that addiction and mental health problems are quite often connected. But, their treatment systems were not. The redevelopment will bring the mental health and addictions programs together at CAMH.
The Queen Street site will allow staff, clinicians, researchers, educators and health promotion experts to collaborate their care.
"There was a link missing for some of our clients who might be medically stable to go home but there were things that we could to help them get ready to reintegrate," Martin said. "This is a whole new way of delivering care."
The AM units allow for a more flexible environment and educate clients on self-care, managing their own needs and medication in a home-like environment.
"This is a step in de-stigmatizing mental health and addictions," Martin said. "It is allowing people to feel connected with the community."
Christina Bartha, the administrative director for the addictions program, said the model in the new building is similar to what is currently done at CAMH's Brentcliffe Road site.
Upon moving, the addictions program will bring the AM model with them, but the ability to treat psychiatric needs will be enhanced.
"There are a lot of clients who have both mental health and substance abuse problems," Bartha said. "But the two systems were very divorced from each other."
At the new site cross-training of staff will be maximized.
CAMH's president and CEO Paul Garfinkel is tremendously proud of the redevelopment of the Queen Street site. He said it has the potential to completely transform addiction and mental health care.
"It will take some years, decades possibly, to see the actual impact on the treatment of mental health and addiction," Garfinkel said. "The results will be studied over time."
There is no equivalent to this model in the world. There are bits and pieces of what is being integrated here, but this brings it all together and because of that, Garfinkel said the model is getting attention from all over the globe.
