Components: Vancouver – Self-Guided
Timing: 45 Minutes
Mode: In-class; Online
The following texts and sets of audio commentaries and primary historical documents allow students to investigate the ideas behind deinstitutionalization in Vancouver, BC. These self-guided resources are well suited for flipped classroom use with an in-class or online discussion or learning activity. Working in class or online, instructors and learners can select resources that suit the time available and a geographical and topical focus that is of interest.
Ask students to use the following themes to guide their exploration of these components:
- The shift from institutional to community mental health
- Economic and social marginalization
- Relevance and impact of cost-reduction policies
- Underdeveloped community mental health supports
- Paternalism, power inequalities, professional hierarchies
- Psychiatric survivor movement
- Community engagement and input
- Policy developed by service users
Ralph Buckley is a retired Vancouver social worker who graduated from the University of British Columbia in 1970, launching his career in the new world of community mental health. Decades of experience in Vancouver’s community mental health centres and on St Paul Hospital’s psychiatric ward provide a frontline perspective on documents from the era in which these services were being established.
The same John Cumming who had led community mental health experiments in the 1950s that had helped shape the original Saskatchewan Plan wrote a similar document for Vancouver. Download and read the 1972 Vancouver Plan that proposed a range of locally-based professional services for people with serious mental health difficulties, coordinated by Greater Vancouver Mental Health Service (GVMHS) teams. The care pathway set out in Cumming’s plan was designed so that a specific staff person would work with each patient, coordinating care, offering therapy, and serving as an advocate and friend. Emphasizing the mix of humanitarian spirit and economy that underpinned the plan, Ralph Buckley provides a historical context for Cumming’s proposal.
Psychiatrist Hugh Parfitt, the first director of Vancouver’s Kitsilano Mental Health team, shared two documents with us from this period of his professional life. Download and read the first, a brilliant orange brochure which details services offered by one of the GVMHS teams which Cummings had proposed. By 1974 there were nine multidisciplinary GVMHS teams across Vancouver and the nearby suburb of Richmond, working in facilities close to public transit routes and offering drop-in services, free coffee, and opportunities for building basic life skills. Commenting on the brochure, Buckley sketches out scope of work done by the care team, presenting a rebuttal to those who use the term “tyranny of the acute” to critique the current focus.
Download and read the third document in this series, Mental Health Team Comes to Kitsilano: What does it mean to you? – also from Parfitt’s cache. Somewhat unorthodox, the GVMHS teams of the 1970s worked with community groups like Coast Foundation and the radical MPA (Mental Patients Association), and offered after-hours emergency service and a suicide prevention program. In Kitsilano, a 1973 effort led by the MPA to flatten professional hierarchies and facilitate community input into Vancouver’s new mental health system was thwarted by the provincial government. Citizens committees were held as the model in the new GVMHS, addressing psychiatrist John Cumming’s emphasis on bringing local communities on board in his 1972 “Vancouver Plan.” As Ralph Buckley notes, the language about mental health used in this document is different than that used by mental health professionals, offering a rare historical perspective on policy from people who were using early community mental health services.
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