CTV News Reality Check: Why reopening Riverview wouldn't solve B.C.'s mental health crisis

Debate over reopening B.C. psychiatric institution In the lead-up to the election and after a terrifying attack in Vancouver – some are calling for B.C. to reopen Riverview.

Every time British Columbians are rattled by an act of random violence like last week’s shocking homicide and maiming in downtown Vancouver, there are calls to reopen the Riverview Psychiatric Hospital, but that’s not the solution some think it is.

In fact, there continue to be treatment beds for 289 people in several buildings at the 244-acre site in Coquitlam, amidst dozens of buildings in various stages of collapse. The Red Fish Healing Centre and two lodges operated by Coast Mental Health, plus supportive housing, provide in-patient services and treatment for those with severe mental illness, addiction, or both.

With public safety and the handling of mentally ill people likely to become key election issues, CTV News is reexamining the factors that make the “reopen Riverview” idea much more complicated than it seems; these issues are explored in-depth in our six-part series that aired last year, Riverview in Focus.

Demolition by neglect

Former Riverview CEO Alex Berland oversaw the site from 1998 to 2000 and is surprised there continues to be discussion about opening and using buildings that have sat empty for decades, some of which are literally collapsing.

“The oldest buildings are 100 years old and if you're going to spend millions of dollars to renovate old buildings... why would Riverview be the place to do that?” he asked.

Last week, B.C. mayors renewed calls to do just that.

Coquitlam Mayor Richard Stewart, for his part, has been doing so constantly since the hospital formally closed in 2012. The site has since seen “demolition by neglect,” as he describes it.

Riverview saw its peak occupancy in the 1950s as traumatized soldiers brought the resident population to 4,700. The early years of the hospital were dark, with lobotomies, forced sterilization, and electro-shock treatments in addition to forced manual labour. By the 1960s, a new era of psychiatric drugs saw the population begin to decline as people were able to return home and live relatively normal lives in the community.

More detained under the Mental Health Act now

Further downsizing in the 1990s under the New Democrats and the full closure under the BC Liberals in 2012 saw waves of displaced patients going where they could afford to live on social assistance, with many ending Vancouver’s Downtown Eastside where they were preyed on by drug dealers.

There’s a common misperception that since Riverview Hospital’s formal closure, few people are institutionalized due to mental illness. But the advocacy group Health Justice says in B.C. “we detain and involuntarily treat far more people now than we ever did at the height of Riverview’s institutional population.”

Dr. John Higenbottam, who was clinical vice president of Riverview, and Marina Morrow, a York University professor who documented Riverview’s closure while at SFU, both pointed out the safety net that was supposed to help patients post-treatment was insufficient, with supportive housing a major shortfall – a pattern that continues to this day.

“People want simple solutions and they're usually wrong,” said Berland. “It's an enormously complex problem so it makes any kind of solution extra difficult.”

Uncertain future

CTV News spent months trying to get an update on the NDP government’s plans for the site, renamed Sumiqwuela several years ago, which were quietly halted last year.

In an interview last March, Housing Minister Ravi Kahlon insisted “we feel the urgency” of moving forward with plans for the site, but that they were taking the time needed to discuss the site’s future with the Kwikwetlem First Nation, who expressed confidence in the agreed-upon process.

Last week, a ministry spokesperson emailed a written statement from Kahlon, who raised the issue of a civil claim brought by the KFN in 2016 which the province was committed to a negotiated agreement rather than an adversarial court process.

“This is complex, sensitive work that takes time and we are committed to doing the work in a good way,” the statement said.

Berland gives Premier David Eby credit for “doing many of the right things," including speaking about the options around involuntary treatment and overseeing the expansion of peer support workers. But he emphasized thatany option is going to be complicated an expensive, with pros and cons to decentralized care as well as a consolidated, expanded campus of care at the old Riverview site, if that’s what ultimately happens.

“We have a saying in public health: Until we build a fence at the top of the cliff, we need ambulances at the bottom,” he said. “I believe we are not going to solve the basic problem and we need to help society accept that there are many varieties of mental illness.”