Alternatives Module

Module Takeaways

• Appreciate the importance of sharing power and hearing and meeting community members preferred mental health practices in organizational design and function
• Recognize the critical need for daily necessities, community connections and/ or opportunities for creative self-expression in mental health supports
• Recognize the value of innovative and non-medical practice models directed by those who use or provide services
• Celebrate the power of artistic expression for healing, for activist engagement, and for building collective identity

Module Components

• An artwork called “days” by River, a artist and maker, who self-identifies as a mad gender-nonconforming/gender diverse trans mixed person of colour, that documents their mood, mental health, and life events a series of interview excerpts in which River contextualizes their art.
• A gallery of art and creative productions created by racialized mad artists – paintings, drawings, poetry, song, screenplays, and multimedia works – contextualized by accompanying artists’ statements or reflections.
• An array of images and text introducing students to the world of Toronto’s PARC, born in 1980 as a drop-in offering basic services to former psychiatric patients, but recognized today as a “living room to thousands” and an important civic institution.
• Powerful audio clips, images and documents setting out the story of Edmond Yu, a chronicle of inadequate social supports and poor policing with a hopeful postscript – the creation of supportive housing for marginalized people.
• Video footage – past and present – telling the surprising story of pioneering dementia care innovations at BC’s Valleyview Hospital in the late 1978s and 1980s.
• A 10-minute documentary created by a Mad School community expert that explores the inner workings of Unity Housing, an innovative community housing run by and for service users.
• A 10-minute video introducing Vancouver’s Gallery Gachet, an artist-run centre that works at the intersection between art, healing, and social justice.

Module Assessment

Ask your students to write a 250-word letter about hope and promising mental health practice, incorporating characteristics and values of best practice that they have gained from their examination of module components. Students should address their letter to one of the following people featured in this module:

• River
• a Gallery Artist
• a PARC member
• Edmond Yu
• Moyra Jones
• John Hatfull or Alex Verkade
• Karen Ward

Module Learning Lens

In the mental health world the notion of a “space of hope” speaks to a wish for asylum – a place of refuge, support and healing, where the judgments that often surround emotional distress and mental difference are suspended. Indeed, popular memories of “disappeared” spaces of hope, such as BC’s early MPA and the Vancouver Emotional Emergency Centre, live on within local communities of people who have mental health histories.

While it is easy to dismiss these reminiscences as nostalgic dreams, the utopian perspective is always an important marker of best practice. Our community partners were clear about what they considered best practice in mental health, emphasizing shared power and decision-making and programs that incorporated pathways to empowerment, community, and wellbeing. Their “utopian” vocabulary included the following descriptors: friendly/enabling interventions, sharing of knowledge, self-determination, developing community, connectedness, peer support. Researchers have generally focused on the last item on this wishlist, pointing to the long history of successful peer models in alternative residential treatment centres and housing programs. But some critics warn that recent moves to integrate trained peer-support workers into mainstream services replicates the power imbalances found in professional-patient relationships, creating divisions within the larger “peer” community.

The initiatives profiled in this module measure up well next to our experts’ inventory of best practice descriptors. They also support the argument that community mental health services with a high level of involvement from service users enhance equity and provide a critical kind of support to people with mental illness. The rich history of the PARC Drop-In illustrates the importance of creating spaces where service users are members, not patients, and which offer services that foster personal health and safety, identity, and social relationships. Edmond Yu’s story is a tragic tale of inadequate social supports and poor policing, but his unnecessary death inspired the creation of “Edmond’s Place”, a supportive apartment unit that gives marginalized people dignity and decent place to live. Unity Housing is a small consumer-driven Vancouver organization that offers affordable housing and runs its houses on the principle of participatory democracy. These organizations are purposely situated on the margins of the mental health system, at arm’s length from professional services. All stress the importance of equality and the collective. And all have built strategies for empowerment and support into their operational model.

Our unit chronicling the pioneering work of BC geriatric rehabilitation therapist Moyra Jones tells a different tale of promising practice and innovation, one embedded in professionalism and provincial mental health policies of the 1970s and 1980s. Under Jones’ leadership, creative arts and rehabilitation programs were developed which wove together social, emotional and physical therapies to meet the little-understood needs of patients with what we now know as dementia or Alzheimer’s disease.

River, in their art and interview excerpts, adds a personal desire for alternatives, including different therapeutic modalities such as writing and art, and approaches derived from Eastern medicine and identifies the pressing need for more 2SQTBIPOC mental health professionals in Canada. River’s artwork and narrative expose the multiple ways the dominant mental health system is inadequate to meet their own needs, and their creative responses to this inadequacy. The Mad Artists Gallery is a kaleidoscope of politics, aspirations, identity, and emotions, speaking to multiple ways in which the mainstream mental health systems must diversify.