Questions and answers
1- Community model or
Development of the village
3- The clinical story: a
breakthrough for the seriously mentally ill
5- Relationships and
1 - Community
model or institutional model?
The Riverview Village Project envisages a
multi-purposes community of those with a serious
mental illness and those who are well, living
integrated together on the Lands in an “intentional
community.” Its purpose: to help the seriously
mentally ill break out of their isolation, put down
roots, and have a real sense of belonging, with
ground-breaking clinical as well as social benefits.
“Serious mental illness” mentioned here refers to
serious and persistent mental disorders, for example
schizophrenia or bipolar 1.
This Q.&A. section, “Community model or
institutional model?”, discusses how the community
model is such a good fit for the Lands and where,
along with the Village, treatment facilities might
Q. What’s the best option for the Riverview Lands –
a community model (the proposed Riverview Village)
or an institutional treatment model?
A. The Riverview Village community model makes the
most sense for the Lands because the model grows out
of the unique possibilities provided by the Lands,
whereas institutional treatment facilities can be
Q. What do you mean in saying treatment facilities
“can be located anywhere?”
A. Let’s take psychiatric acute care. The best
location for these extra beds is redeveloped acute
care psychiatric wards. The Royal Columbian
Hospital’s redevelopment plan, for example, calls
for an increase in the number of psychiatric beds
from 30 to 55, almost double current capacity, plus
20 geriatric beds. The HOpe Centre acute psychiatric
ward at Lions Gate Hospital in North Vancouver has
room for many more beds than currently exist.
Q. Why is it so important that the Lands not be
taken up by institutional care models?
A. With institutional treatment facilities in
different locations throughout the Lower Mainland
and B.C., treatment objectives can still be met,
whereas without a Riverview Village, the innovative,
ground-breaking possibilities of the Village for
helping the seriously mentally ill will be
forfeited. Instead of an aggregate benefit to those
with a serious mental illness, there will be a major
loss. The Lands provide a rare opportunity for an
“intentional community” for the seriously mentally
ill – the opportunity for a clinical and social
Q. Doesn’t the problem of the chronic seriously ill
who keep relapsing and going through the revolving
acute-care door, most dramatically exemplified in
the Downtown East Side, justify using the Riverview
Lands for acute and tertiary treatment facilities?
A. No, the contrary is the case. First, as described
above, additional acute and tertiary treatment beds
can be added in other locations. Second, and a key
consideration: The “intentional community” proposed
for the Riverview Lands is aimed at helping to
resolve the very problem cited. A sense of
belonging, meaningful relationships with others, a
window on creative and social activities, support
and understanding throughout one’s community, the
kind of friendly “keeping an eye open” for others
that only a village can provide, and non-threatening
employment possibilities – all these, together with
clinical support from community mental health, have
the potential to break the intractable “vicious
cycle” that has been so detrimental to those with a
Q. What, then, lies behind demands, in some
quarters, for more treatment beds on the Riverview
A. Such demands incorrectly conflate the need for
more treatment beds with Riverview as a geographical
and historical location, because the history and
symbolism of the old Riverview of the past is
associated with treatment. Keep in mind, as well,
that the need for land isn’t what has prevented the
expansion of such treatment facilities. The obstacle
to badly needed extra treatment beds has been the
lack of funding for the physical plant and for
Q. Rumour has it that Vancouver Coastal’s Burnaby
Mental Health and Addictions Centre for concurrent
disorders will be relocating to the northern end of
Riverview, in a facility with 140 beds, and that
B.C. Housing has already approved such a move in
principle. Is such a facility at Riverview a good
idea? Does it conflict with the Riverview Village
A. Such a facility, tucked away at one end of the
Lands, and even a small specialized treatment centre
in that area, is compatible with the creation of the
mixed, multi-purpose Village community on the rest
of the Lands. There are already three Fraser Health
tertiary lodges at that end of Riverview. It’s
important, though, such treatment facilities occupy
just a small part of the Lands, with the Village
being the key component.
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Development of the Village
This Q.&A. section, “Development of the Village,”
discusses ownership and management of the properties
on the Lands.
Q. Who will own the townhouses, condos and/or
apartments making up the Village?
A. As envisaged, the properties themselves (the
land) will continue to be owned by the province,
through B.C. Housing. The residential buildings
themselves will be owned and managed by non-profit
housing societies like Coast Mental Health, RainCity,
and the New View Society, with long-term leases (65
years and up) from B.C. Housing for the land, in
Q. Are there any similar examples of such long-term
A. Yes, they’re not all that unusual. Perhaps the
best known local example is Granville Island, where
the land has been owned by the federal government
through the Central Mortgage and Housing
Corporation, while all of the building
reconstruction and improvements have been looked
after by the leaseholders under their long-term
arrangement with CMHC.
Q. Will developers be able to run roughshod over the
Village in attempts to put more of the Lands under
development and to optimize returns?
A. No. In this model, commercial developers don’t
even enter the picture. The non-profit ownership
structure,made up of organizations dedicated to the
well-being of the mentally ill, provides the best
assurance for the protection of the integrity of the
Lands and for their use as an “intentional
community” for the mentally ill.
Q. What about the argument that wherever you have
people paying market rates for their residences – in
this case, by the residents who don’t have an
illness and have good incomes – then, by introducing
the market mechanism, you open the door to
developers? A. The argument simply doesn’t apply.
It’s a non-sequitur in this case. Rental revenue
accrues to the non-profit housing societies, for the
creation and maintenance of the Village.
Q. The Riverview Village model calls for many
multi-purpose buildings. As envisaged, Centre Lawn,
for example, would have not just apartments but also
studios and some retail space. Who would be in
charge of those spaces?
A. Good question. The same might be asked about some
of the buildings along the Lougheed Highway
corridor, to be rented out commercially, say for the
film industry or bio-medical companies. B.C.
Housing, as the ultimate landlord, might look after
such commercial buildings. For the non-residential
parts of the residential buildings and their
immediate vicinity, on the other hand, our
preference is to have those owned and managed by the
respective housing societies or by those societies
together in a consortium, because the function of
those spaces (arts, artisanal crafts, performance
and meeting spaces, coffee houses, and so on) are an
integral part of the intentional community and the
opening of its doors to the seriously mentally ill.
Q. Does the ownership structure of the Village mean
that none of the residents will be owners?
A. Yes, that’s correct. There are several reasons
for this. It would allow everyone to have the same
standing: those who are mentally ill, and unlikely
to be able to afford ownership of a residence, along
with those who are well. This avoids having two
classes of residents with, potentially, different
interests arising from some having ownership, for
example, being concerned with resale value.
Increases in the market value of residences,
moreover, reflected in the rental rates, need to
accrue to the housing societies through appropriate
rent increases, as part of the revenue flow to
sustain the Village. At the same time, regular
renter leasing agreements (up to five or ten years),
as well as month-by-month rentals, while providing
for security of tenure, allow for more flexibility
in people wanting to move if they decide the
community isn’t for them.
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3 – The clinical
story: a breakthrough for the seriously mentally ill
This Q & A section, “The clinical story: a
breakthrough for the seriously mentally ill,”
discusses the crucial difference this community will
make for those with an illness.
Q. What is the most serious dilemma facing those
with a serious mental illness?
A. The absence of a “cure” for such illnesses. This
is particularly a challenge for those with
schizophrenia. Treatment does work, especially in
controlling psychotic symptoms like delusions and
hallucinations. Support services like community
mental health teams, assertive community treatment,
assured housing, and rehabilitation programs,
together with medication on the clinical side, have
greatly improved the lives of those with a serious
mental disorder., generally speaking. Nevertheless,
far too many remain dislocated and isolated and,
often lacking insight into their illness, are
subject to relapse. The suicide rate of those with
an illness remains relatively high. So does
vulnerability to substance abuse (addiction to
street drugs or alcohol). Even many who are able to
manage their illness end up isolated, are plagued by
residual symptoms like lethargy, lack of motivation,
and anxiety; suffer from the lack of meaningful
relationships, and have their horizons limited.
Q. What does an “intentional community” bring to the
seriously mentally ill that the above-mentioned
programs and treatment options don’t include?
A. Meaningful relationships with those who are well,
a sense of belonging, support and understanding
throughout the community, non-threatening
employment, artistic, and social possibilities –
genuine integration rather than isolation. The model
brings the power of community to bear, a therapeutic
component which so far has been ignored.
Q. How important is such a dynamic?
A. It’s of crucial importance, both clinically and
psychologically. It will help those who are ill
centre themselves; reduce relapses and falling back
into addiction; help avert tragedy; and, in breaking
the isolation of those with an illness, open up
horizons and enrich their lives.
Q. Are there benefits from the model over and above
the immediate clinical ones?
A. Yes, the model provides an alternative to the
“social epidemic” of recurrent psychosis and
addiction and what comes with them – continuous
police activity, unnecessary involvement of the
courts, the cycle of acute and tertiary care (the
“revolving door”), and degraded neighbourhoods.
Q. Will the Riverview Village community provide
treatment as well?
A. Relationships and belonging are at the heart of
the proposed “intentional community,” but clinical
help won’t be excluded or downplayed. Mental health
services will be provided by a community mental
health team or by an ACT team, just as they would be
elsewhere. Similarly, if someone relapses and
becomes destabilized, treatment in psychiatric acute
care will come into play, just as it would
Q. How will mental health services benefit by the
“intentional community” dynamic?
A. They will benefit in several ways. Because of the
support and integration the community provides for
those with an illness, and hence better stability
and outcomes, the burden of care and monitoring by
mental health teams will be less than otherwise.
Psychiatric acute care will also benefit from
lighter patient loads. Village residents, as friends
and neighbours of those with an illness, will also
serve as extra eyes in noticing any deterioration or
psychosis, thereby helping mental health services to
be pro-active in getting people who are
decompensating back on track before their condition
grows worse and treatment requirements escalate.
Q. Does this mean that in creating Riverview
Village, we will at the same time be lessening the
need for what might be described as a more
institutional kind of care and lessening the need
for acute care?
A. Yes, relative to the scale of the Village, but
there may still be a need for an institutional
long-term residential setting, in small and secure
tertiary residences for a narrow cohort of those
most severely affected. The clinical jury is out on
this. Some psychiatrists argue that with ACT teams
and their intensive supervision, often described as
a “hospital without walls,” the need for
institutional long-term residential beds is minimal.
Others maintain that for those most severely
affected, even ACT teams are inadequate and, in
fact, on occasion, ACT teams find themselves having
to return a person to tertiary care. The benefits to
the seriously mentally ill of the proposed
‘intentional community” for the Riverview Lands,
however, remain compelling regardless of that
debate, as does the logic of using the Lands for
just such a community.
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4 – Economic
This Q.&A. section, “Economic aspects,” discusses
how the various components of the proposal come
together to meet the financial requirements of
renewing the Riverview Lands.
Q. The provincial government has stipulated that any
renewal of the Riverview Lands must break even. Will
the proposed Riverview Village meet that
A. Yes, and perhaps better than any of the current
alternatives. Costs of the housing for those with an
illness will be provided for separately in the same
way that such housing is provided for elsewhere –
through capital housing grants, monthly allocations
from disability allowances for rent, and rental
supplements. Revenue will also be generated by the
leasing of some of the buildings and spaces along
the Lougheed Highway corridor for commercial use,
like the fllm industry, as envisioned in the model.
Government services on the lands, say a community
mental health office, will also pay full market
rates. Riverview Village, however, will also have an
additional, key revenue source – market-rate rent by
residents without an illness and with decent
incomes, plus rents paid for studio, office, and
retail space in mixed-purpose buildings.
Q. Why is such additional revenue necessary?
A. Such revenue is necessary to renew the Lands – to
save, and redesign and/or reconstruct the interiors
of, selected heritage buildings like Centre Lawn and
East Lawn, to rehabilitate the long-neglected
“arboretum” collection of trees, and for other
renewal and innovations.
Q. Some people say that having residents without an
illness living on the Lands will destroy the public
purpose of the Lands and undermine their potential
to help the seriously mentally ill. They just don’t
want any “market housing” on the Lands, period.
A. Those residents without an illness, in the model,
are part of the therapeutic concept itself – the
“intentional community.” Their participation is
integral to helping their neighbours with an illness
and to providing the clinical breakthrough inherent
in the model. Their housing, consequently, is better
described as “community housing at market rates”
rather than impersonal “market housing” as the term
is generally understood. If such residents are
earning decent incomes, moreover, it only makes
sense they pay market rates and contribute, that
way, to the renewal of the Lands.
Q. In the olden days, many hospital staff lived on
the Lands. Is there a difference between that and
your non-ill community residents living on the
A. Conceptually, in terms of those without an
illness living on the lands, and also in terms of
being an integral part of helping the mentally ill,
there is no difference. There is, however, of
course, a difference in modality, between the
Village’s community model and the old Riverview
Hospital’s institutional model.
Q. What’s to stop the number of people without an
illness living on the Lands being increased and
increased again and again, in order to generate more
A. The model itself prevents it, with 40 per cents
of residents drawn from those with an illness, 40
per cent those without an illness, and the share of
the remainder to be determined by how the model
evolves. It’s important to remember, moreover, that
those without an illness aren’t there to generate
revenue. They’re a component of the therapeutic
model. The net revenue their rent will provide is a
fortuitous by-product, generating the extra revenue
within the intentional community and its therapeutic
objectives rather than through unrelated “market
housing” that might otherwise be imposed on the
Lands to cover the costs of renewal. The model also
forecloses the pressures developers might bring
towards increasing market housing (see “Questions
and Answers 2 – Development of the Village” for more
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Relationships and belonging
This Q.&A. section, “Relationships and belonging,”
provides extra detail on how the model will work.
Q. Interaction between those with an illness and
those who are well is a key objective of the
creation of the Village. How will these
A. The way all relationships develop, naturally and
over time. The gradualness of it will also suit
those with an illness.
Q. Are the residents without an illness expected to
spend a given amount of time, say a minimum number
of hours per week, with those who have an illness?
A. No. In any case, being obliged to spend time
together is not the best way for relationships to
develop. Relationships aren’t established on order,
but develop from paths crossing, seeing each other
in different places, participating in events
together, mentoring, working together, and so on.
And don’t underestimate curiosity: wanting to know
about other people and their lives.
Q. Are there special factors that will add to
A. Yes, starting with who chooses to live in the
community. People who self-select to live in the
Village are going to be interested in being part of
the community and its purpose. Otherwise, why would
they choose to live there, given they (most of them)
will be paying market rates, or close to market
rates, for their residences, and hence could live
elsewhere? Some of those choosing to live in the
community, moreover, will have a prior, strong
interest in the mentally ill, perhaps from having
someone in their own family with an illness. Also,
given the stigma associated with the seriously
mentally ill – not justified, but there it is – it’s
not likely someone is going to want to live in the
Village unless they’re open-minded and genuinely
interested in the community’s objectives.
Q. Your proposal calls for a couple of social
animators cum program directors in the community,
with the possibility of adding a couple more
depending on the scale of population. They would be
Village staffers. What is their role?
A. Their function is to act as catalysts,
facilitating interaction: helping those who are ill
follow through on their interests by linking them to
others in the community (shared interests,
mentoring, classes with a well community member or
artist/crafts person working in a studio on the
Lands); helping to initiate community, social, and
sports events that bring people together; scheduling
small “coffee meetings” to help people get to know
each other; facilitating employment arrangements;
hanging out and keeping in touch with the diverse
residents to know who’s who and help make
connections; encouraging those who have difficulty
socializing and participating to become more active,
perhaps going with them the first few times;
connecting people to programs; liaising with mental
health services, and so on. They can be thought of
as the “engine room” of the community. Note,
however, they’re not meant to be in charge of the
community and its events. It’s up to the residents
themselves to get involved and assume leadership.
They will, however, as facilitators, help people
make connections and add energy and ideas.
Q. Will community planning also play a role?
A. Yes, not just with the general layout of the
Village but also in the juxtaposition of residences
and the use of space. For a start, those who are ill
and those who are well will not be hived off into
separate areas of the Lands. but will be intermixed.
The Village will be designed to promote common
spaces, community activities, informal meeting
places, and other interaction, while also providing
special places for residents to sit quietly alone if
they want. It’s a matter of planners using their
social imagination to help residents flourish.
Q. What will be required from those with studios,
retail spaces, and commercial operations on the
A. Part and parcel of their being located on the
Lands will be commitments to workshops and mentoring
(in the case of artists and crafts people), and to
providing employment opportunities where applicable,
written into their respective commercial leases.
Relationships will also develop throuugh work in the
proposed horticultural centre and museum.
Q. Is there anything else that will further
A. Yes, the pleasure and reward of getting to know
people with an illness and, in knowing them, sharing
their stories, struggles and achievements. Those
without an illness living in the Village will have
their lives enriched by the experience and feel,
justifiably, there’s something special about being
part of the community.
Q. Is Riverview too remote a location for an
intentional community, so that people living there
will feel isolated?
A. No, quite the opposite. Think of the vision of
community at the core of the Riverview Village
concept. In its current state, Riverview is lonely
and largely abandoned. The “intentional community”
we foresee, however, will be very different. Living
in Riverview Village will be like living in a small
town where everyone knows each other and there are
all kinds of connections, people crossing paths,
services, group activities (including gardening),
employment opportunities (and working with others in
that connection), access to the arts and crafts
(complete with mentoring), meeting places, a
performance space or two, interfaces with the larger
public (through the museum and the
arboreal/horticultural centre, for example),
co-housing components, perhaps a satellite community
mental health office, and above all relationships.
Improved public transit, say with the addition of a
shuttle bus, will provide connections to the larger
city. And if something extra needs to be added? All
the more reason to use one’s ingenuity and make it
happen in the Village.
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