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VN The stigma that has been attached to Whitby Psychiatric Hospital is something that people like Administrator Dianne Mac- farlane and Psychiatrist-in-Chief Donald Wasylenki are trying to change. With new programs and specialized services, the hospital " Making modern advances in the field of mental health. See story Township of Scugog PUBLIC NOTICE The Township of Scugog owns 4 single family lots on the east side of Simcoe Street, south of Carlan Drive and north of the Lawn Bowling Site. The said lots are surplus to council's needs and thus are to be sold. Sealed offers will be received for all 4 or any one up until 3:00 p.m., August 7th, 1986, to the undersigned, clearly marked "lot tender". Lowest or any tender not necessarily accepted, brokers protected. E.S. Cuddie, AMC.T., CMC. Clerk-Administrator Whitby Psychiatric Hospital has + come a long way but it still has an even longer way to go. When many people think of it, if they think of it at all, it is with con- fusion, ignorance and an ingrained set of myths that date back to the days of shock treatments, padded walls, straight-jackets and other assorted horrors. In truth, Whitby Psych is far- reaching in its attempts to 'treat mental health problems with olen problem-solving, and in its attempts to free itself from the stigma of being an "asylum." From the very , when the hospital was built in 1913, Whit- by Psych was considered a leader in « . its field. The Ontario Hospital, as it was called then, was a new idea in the mental health field, and was the first institution of its kind in Canada not to be called an asylum. For the first time in Canadian ~ _ history, a psychiatric hospital was not constructed as a single building with walls around the grounds and bars on the windows. Made up of about 20 cottages and a number of larger buildings used as infirmaries and acute hospitals, the institution took full advantage of the fresh air and open space in a park- like setting on the shores of Lake Ontario. Even today, it looks more like a - university campus, with asphalt paths winding through tall, stately shade trees, leading to each '"cottage-like" building. A walk through the grounds reveals no barred windows or padd- ed rooms. Instead, there is a tennis court, a bowling alley, and many porches, filled here and there with patients sitting around talking, reading, or trying to cool off on a hot summer's day. There are locked doors, and there are many seriously ill people at Whitby Psych, but for the most part, patients are free to come and go as ~ they please. ATTITUDES As staff members point out, gone are the days when people were com- mited indefinitely. These days, pa- tients can sign themselves in or out at will. A doctor can try to convince a patient to stay, if he thinks it's in the patient's best interests, but if a patient insists, he can walk out at any time. In it's heyday, the hospital often had as many as 1700 patients at a time. These days, the numbers are down as low as 400, thanks to new thinking that puts more emphasis on rehabilitating a patient to be able to live in the community rather than in an institution. "We're looking to change people's attitudes about mental hospitals,' said Dr. Donald Wasylenki, Psychiatrist-in-Chief and Clinical Director. 'We are really developing a model here about how a state hospital should be run in the 1980's, 1990's."' Dr. Waslyenki was just one of a small group of hospital staff members who toured represen- tatives of the media through the hospital last week. The tour lasted the better part of a day but because the hospital grounds are so mammoth, and the programs are so many, only an in- kling of what goes on at the hospital was gained. To fully appreciate what goes on, one might have to spend a week or even a month. Things are changing at the hospital every day, and the more the government looks at de- institutionalization, the more the hospital will continue to change. Some day, staff members admit, Whitby Psych won't even exist in its present form. The buildings, they say, are too old to facilitate op- timum modern treatment. Roofs leak, paint peels, and maintenance costs continue to rise. SUPPORT SYSTEMS Ideally, the government and men- tal health professionals would like to see the institution disappear en- tirely, to be replaced by solid com- munity support systems. For the time being, however, that support just isn't there and more often than not, a discharged patient simply cannot cope with the outside world on his own. In the end, he or she usually winds up in the hospital again. Of course, this doesn't happen to all patients. Dr. Jacinta O'Hanlon, a soft- spoken woman with a thick Scotch accent, is the psychiatrist in charge of Community Mental Health Ser- vices. She says that many patients she sees don't require much more than one visit. Others are not so lucky, and those with serious men- tal problems often require constant care just in order to carry out basic everyday functions. : On the day of the tour, reporters find her in the Admissions building, where a team of professionals decide who needs treatment, who doesn't, who needs to be admitted and who can be treated as an out- patient. Generally, she says, those who need to be admitted are one or more of these three things: 1) They are in- capable of looking after themselves; 2) They are a danger to themselves; or 3) They are a danger to the public. Only those who have committed some crime and are at the hospital because of a court order, are oblig- ed to stay. : Most others are there on a recom- mendation from their doctor. Some are self-referred. Whatever the reason why they are there, it is the people in Admissions, with the help of a committee, who decide whether or not a patient is admitted. More and mare often, the people who arrive on the Admis- sions doorstep become out-patients. It's part of the trend towards de- institutionalization. To help with the growing load of out-patients, clinics have been set up in communities throughout Durham Region, including Port Perry, Uxbridge, Keswick, Beaver- ton, Lindsay and Bowmanville. In Port Perry, a psychiatrist works out of the Medical Associates building on Paxton Street one full day a week. In the interim, a nurse stands by to make appointments, see patients, and in emergencies, to refer people to the hospital. It's a system that allo 's more ac- cess to psychiatric help than ever before. In small communitties like Port Perry, patients often don't have the opportunity to travel to Whitby for help. This is ever more true in places like Beaverton which is further away. The clinics, called "satellite clinics," are the wave of the future. Eventually, mental health profes- sionals would like to see an allotted number of psychiatric beds in each and every hospital. The province of Ontario is divid- ed up into ten "catchment-areas," each one with a psychiatric hospital, operated by the Ministry of Health, that is similar to Whitby Psych. LARGE AREA Whitby"s catchment-area is the largest in the province with more than 2 million people to serve, rang- ing from the eastern end of Toron- to, to Bowmanville, and north to Psychiatric hospital changes with the times places in Victoria County like Kirkfield. In this catchment-area, there are nine general hospitals with psychiatric beds and eight satellite clinics, such as the one in Port Perry. Still, Whitby Psych is the largest single provider of mental health ser- vice in the entire area and running the hospital is the job of Dianne Macfarlane. "We'd like to see ourselves in the future being able to offer a level of service not available anywhere else in the catchment area or even in the rest of the province," she said. In order to see that dream come true, the hospital has already im- plemented a number of brand new programs designed to turn it into "an ideal psychiatric treatment centre." The new programs are just part of the specialized in-patient units that include the Short Term Assess- ment and Treatment Unit (STAT), a 70 bed in-patient centre where most people are discharged within three to four weeks; the Psychoterapy Unit (PTU), where character disorders are treated; the Psychiatric Rehabilitation Unit (PRU), which is the next step before patients are released into the com- munity again; the Schizophrenia Treatment and Education Program (STEP), a brand new program that specializes in the treatment of young schizophrenics; the Psychiatric Retarded Evaluation Module (PREM), a unit designed to help those with a dual diagnosis. of developmental handicaps and pyschological problems; the Neuropsychiatric Unit (NPU), for people with specific organic brain disorders; the Adolescent Unit, for children with severe psychiatric problems; and the Psychogeriatric - Unit (PGU), also brand new, designed to deal with the unique psychologic problems of the elderly. STEP Possibly the most innovative pro- gram at the hospital is STEP (Schizophrenia Treatment and Education Program), established in August 1984 as part of the re organization of Whitby Psychiatric Hospital. The Unit serves young adults (ages 18 to 35) with an established - diagnosis of schizophrenia. Schizophrenia is a chronic debilitating disease affecting many areas of functioning in activities of daily living. The illness usually begins during late adolescence or early adulthood. As a result there is often an interference with the natural maturation process. The il- Iness can be disruptive and stressful for the entire family. Patients are referred to the Unit from the other hospital units and from the Assessment and Crisis In- tervention Service. Average length of stay on STEP is three months, but like other units, it sometimes stret- ches longer. STEP provides the opportunity for a person with schizophrenia to learn and cope with his or her illness within a caring and supportive at- mosphere. This rehabilitative pro- gram consists of four overlapping pahses -- Assessment, Treatment, Discharge Planning and Day Treatment. During Assessment, the patient's level of functioning and strengths are identified and the family is con- tacted for information. Each patient has an individualized program established by the multidisciplinary treatment team. Independence is promoted by active patient involve- ment in all aspects of the Treatment (Turn to page 15)