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' Next step to 'normal' life Whitby Psych's Cottage 16 Ideally, patients remain in Cot- tage 16 of the Whitby Psychiatric Hospital for three months. But there are exceptions. One woman has lived in Cottage 16 for 42 years. The building has become her home and staff treat her with familiarity and respect. She is a fix- ture in the place, and most times, - she is regarded with affection. When she is feeling good, she appears to be healthy enough to leave the hospital. But about twice a month her illness takes over, transforming this quiet woman into a screaming, violent unfunctioning hysteric. Because she suffers from a heart condition, as well as mental health problems, she cannot be treated with the regularly prescribed drugs for fear of a heart attack or stroke. As a result, she will probably never leave. In many ways, she is represen- tative of the way things used to be at Whitby Psych and at mental health hospitals across the 'conti- nent. At one time, not too long ago, people suffering from mental illness such as schizophrenia, manic depression, developmental han- dicaps or major despression, were simply confined to institutions for long periods of time with little hope of ever being able to function on their own outside the walls of a hospital. Few thoughts were given to- rehabilitation and even those who were eventually thought to be - recovered enough to release, were on their own once they stepped off the hospital grounds. It's just not that way anymore. As head nurse Bill Bergstrom points out, places like Cottage 16 were once the backbone of the hospital. At one time they were fill- ed with chronic patients who had nowhere else to go. Times have changed, however, and now Cottage 16 (one of three similar wards at Whitby Psych) has changed its emphasis to rehabilita- tion. In most cases, Cottage 16 is the last step to being completely discharged from the hospital. "The focus has changed,"" Mr. Bergstrom says. "It's more dynamic. We've re-evaluated the needs of the patients; have looked at where their skill deficits are, and are teaching them the skills they need to make it in the community." Through treatments involving education, medication, self-security and even basic things like daily hygiene, patients are prepared for the outside world. The preparation is designed to _ suit where the individual will even- tually end up living, whether it is in a private home, a nursing home or a group home. i "We look at the individual and what would best suit that in- dividual," Mr. Bergstrom explains. When paitents first arrive in Cot- tage 16, from other parts of the hospital where they were treated for the acute stage of their illness, they are still being treated, in most cases, for the semi-acute stage of their illness. Intensive treatment with a small staff to patient ration brings most patients through the semi-acute stage of their illness and enables them to move on to rehabilitation. Thirty beds for both men and women occupy the two-storey cot- tage, most of which are in open dor- mitory style. When journalists toured the cottage last week, 27 peo- ple were living in the cottage, in- cluding, as Mr. Bergstrom puts it, "three who are here at the Lieutenant- Governor's leisure." The three people in question have all been found guilty of one crime or another. They are the only three in the building who are not free to come and go as they please. "Ironically," Mr. Bergstrom says, "they're usually the highest functioning people here." The patients can rangen age from 18, when they are frst ac- cepted, to a maximum of 65. People over 65 are usually transferred to the hospital's Psychogeriatric Unit for special care. Except for the afore-mentioned three, all patients of Cottage 16 have ground privileges, town privileges and the right to sign themselves out if that's what they want. Doctors and nursing staff will often try to discourage a patient from leaving if they believe he or she is not ready, but they have no ultimate power to keep the patient there. Most patients, however, aren't in a big hurry to leave. The cottage itself is as homey as possible with a comfortable living room (complete with television, VCR, cozy couches and chairs), supervised kitchen area (which pa- tients can use to do their own cook- ing), and a wide range of recrea- tional activities. A blackboard in the hall lists the daily events that might include TRIS NTT SP FRR TT RRS TTR, SR. 0 Sew § Sn A Gigs som afi 87 7 gigi 7 fitness classes, bowling league, or a trip into town. Not only is the cottage a comfor- table, busy place to be, it is also a chance for the patients to recover from whatever illness is plaguing them. Most patients realize they have problems and understand that the staff of the hospital are their best chance of living a comparably normal life again. Mr. Bergstrom, a nurse at the hospital for 10 years, is happy with the way things work at Cottage 16 but says places like it might not be so full of patients if there was enough support in the community. '""There's a real lack of communi- ty support for these people," he says. 'Even with the existing resources, there just isn't enough. We need more housing, sheltered workshops, more money, and more community services. It's a long, tough road." As expected, the finances are equally tight within the cottage. All - 'extras' like the television or the VCR, are paid for by the patients by fundraising activities. "We've become expertd at doing - a great deal with very little,"' Mr. Bergstrom says. Whitby Psychiatric changes with times (From page 14) program. Schizophrenia Education is, part of the treatment, an information group which focuses on different aspects of the illness. This provides the patient with an opportunity to learn about the illness and discuss impact on his or her life. DRUGS-ALCOHOL Medication Awareness is also an information group which teaches the patient about medications, and the harmful effects of drugs and alcohol as related to the illness. Recognition of side effects and the importance of continuing to take medication as prescribed are em- phasized. Most patients will have to rely on medication for the rest of their lives. The Insight Group is a forum for discussion of issues related to men- tal illness. The goal of this group is to help the patient adjust to the il- Iness and the related problems. The Expression Group is a group with structured activities to assist the patient in express thoughts and feeling to the staff. The Relaxation Group offers structured exercises designed to promote relaxation and decrease tension. The patient 1s assisted in developing effective relaxation strategies. Social Skills is a structured skill training group which teaches the pa- tient how to interact with others. Observation, self-awareness, com- - munication, listening, and socially accepted behaviours are the main skills taught. LIFE SKILLS : Life Skills is a group which pro- vides the patient with the opportuni- ty to learn independent living skills and communication skills through - information, discussion and activity. Community Awareness provides group excursions to help the patient learn about community recreation resources. And Discharge Preparation, essential to promote on-going recovery and rehabilitation, is the linkage to follow-up by community agencies. It is recommended for the patient to provide continuity, con- . sistency and comprehensiveness in post discharge treatment and rehabilitation. The Day Treatment and Out- Patient programs continue to sup- port the schizophrenic after he or she is released. 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