The latest forward step in the treatment of mental illness is a modest two-story building that combines some of the qualities of a hospital, a private home, and a boarding house. This is 7075 Lasalle Boulevard, in Montreal, the first attempt to apply in Canada the "halfway house” principle developed in the United States. Its residents are not yet stable enough to be on their own, but they are not sick enough to be kept full time in a mental hospital.
The new centre is one answer to a question that has troubled psychiatrists for decades: what do you do with a patient w'hen he’s ready for the outside v/orld but the outside world isn’t ready for him? Most of the patients at 7075 are prepared to begin living at home, but either they have no families or their families aren’t ready or able to take them back. To move them directly from Verdun Protestant Hospital to the loneliness of rooming houses or apartments would be to invite relapse. The house at 7075 Lasalle, which is something like an institution and something like a home, provides a gentle transition. It takes patients away from hospital bureaucracy and formality, lets them develop casual relationships with fel-
low patients, and provides a staging point from which they find jobs and gradually reintroduce themselves to the outside world.
The centre (Montreal doctors reject “halfw'ay house” as a term, because they don’t pretend to know when a patient is halfway cured) was built with grants from the Rotary Club and federal and provincial governments. It opened in February. Like its predecessors at Los Angeles and Bcthesda, Maryland. it is small: just 20 private rooms for patients, a cheerful dining room, a lounge, and a TV room. And. also like the American projects, 7075 is run by a layman: Robert Hunter, a retired engineer, and his wife, a nurse, manage it under the hospital’s direction.
At the moment they have only 11 residents. Dr. Charles Cahn, who handles relations between the hospital and the centre, says that picking patients w'ho are ready for it is the most difficult medical problem involved. An American study of the earlier projects points out that not all patients leaving mental hospitals can make good use of the halfway house. Alcoholics, drug addicts, sexual exhibitionists, and “impulse-ridden persons” can destroy the
harmony of the group and provoke antisocial behavior in fellow patients. Dr. Cahn also has to be wary of assigning patients who may not be quite ready to leave hospital; a patient who goes to the centre and then must return to the hospital ward is deeply disappointed. T his has happened once so far.
Patients at the centre are expected to stay about three months. Soon after they arrive they begin looking for work, and two weeks after finding jobs they start to pay board. They pay $20 a v/eek at first, later pay as much as $35 if they can afford it. The increases are intended not only to recover costs but to provide patients with an incentive to break free and find their own rooms or return home. In the meantime they help with the chores and become, briefly, part of a group.
Sometimes just arriving at 7075 brings them closer to mental stability. An advertising executive w'ho went into Verdun after a breakdown was astonished when he moved from the hospital ward to the centre. “I had no idea there was anywhere like this for me,” he said. The atmosphere cheered him, and soon he was back with his job and his family.
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