Déjà-vu psychiatry
By Jesse Reynolds
jreyno7@uwo.ca
It’s a quiet spring morning on Toronto’s Queen Street West, with only the gentle rumbling of streetcars sliding past to disturb the silence. Michael Lewin sits in the back office of a building that used to be a church, pondering a busy week ahead at The Raging Spoon, the catering business he manages. Everything seems normal, but there’s more to this place than meets the eye.
At this business, every employee has a history of mental illness.
Lewin believes this puts his business at a disadvantage, but it also provides the workforce with a lot of extra motivation.
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Photo by Jesse Reynolds
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| Michael Lewin battles prejudice to deliver quality food for a good cause. |
“We’re trying to produce high-quality ‘work our asses harder than other people’ kind of food,” he says. “We go the extra mile – stuff that no other business would do – because we’ve got a lot to prove.”
The Raging Spoon has been around almost 11 years now, and it’s finally clearing the hurdles and starting to do well for a small catering operation – but it hasn’t been easy. Many people tend to question the safety of their product at first, says Lewin. He suffers from severe depression and is used to battling the societal stigma around mental illness.
“If a schizophrenic pushes someone off a subway, then all schizophrenics are dangerous,” he says. “They think that if people suffer from mental illness, they can’t function or do the things that other people do.”
When this alternative enterprise was started by two psychiatric “survivors,” as they call themselves, the goal was to provide equal employment opportunities for people with mental illnesses who might otherwise not be able to find work.
While it may seem like a relatively new approach, this revolutionary form of treatment can be traced back more than 100 years to a London, Ont. psychiatrist whose work is being showcased in the Cultivating Care exhibit at Museum London through the end of May.
In some schools of psychiatric thought, the mentally ill are believed to benefit psychologically from the physical and mental activity of work. Former London Asylum superintendent Dr. Richard Maurice Bucke was a pioneer of the movement towards occupational therapy in Canada.
In the mid- to late-19th century – what was called the moral treatment era – caregivers were realizing that if you provided the mentally ill with something to do, you could reduce their need for restraint or even cure them.
“They saw work and activity as an essential element of treatment and as the opposite of a rest cure,” says Judith Friedland, professor emerita of occupational therapy at the University of Toronto.
Just over three kilometres outside London’s city limits, the asylum was built on a property of 121 hectares, 81 of which were used for cultivation. Patients worked in the fields as well as the kitchens, the dairy, the workshop, the blacksmith and more.
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Courtesy of Museum London
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| Patients at the London Asylum cultivated award-winning produce. |
They had everything that a small town would have, and the asylum essentially became a self-sustaining community, says Maya Hirschman, curator of regional history at Museum London.
Instead of the de-humanizing, barbaric practices often associated with early psychiatry, Bucke saw treatment in a different light.
“He was very much interested in the human condition, in re-humanizing patients,” says Hirschman. “His belief was that through things like what we now call occupational therapy – activity, labour, recreation, nature and faith – people would be brought back to sanity, to mental health.”
He believed that all people were curable, and insisted on finding gainful employment for each of his patients. Treating patients humanely had significantly positive effects.
“At one point, Dr. Bucke had almost his entire asylum living drug- and alcohol-free, and it didn’t seem to affect them negatively like some people thought it would,” says Hirschman.
But the dream couldn’t last forever.
New medications came into use in the early 20th century, changing how care was given. From there came de-institutionalization, in-patients became out-patients and occupational therapy as it was known had changed for good.
Friedland believes that today, occupational therapy at its best is missing – there is a definite need in society, but the programs just aren’t out there.
“Occupational therapy helps people with mental illness to do what they want to do and what they need to do to live satisfying and productive lives,” she says, acknowledging that businesses like The Raging Spoon are a bright light in the present situation.
“So much of our identity is caught up with what we do, and more so if we’re paid to do it.”
Joyce Brown couldn’t agree more. She’s the co-director of the Ontario Council for Alternative Business, which operates four companies, including The Raging Spoon, that employ only mental health survivors.
“Work is a huge part of self-esteem, and how people define themselves, and it puts structure in people’s lives,” she says. “As important as the financial end is, it’s also just giving people an opportunity to be contributing members of society.”
One of those people is Carol Ann Kristensen, who works at Parkdale Green Thumb Enterprises, a gardening and landscaping business also operated by OCAB.
“It’s been absolutely fabulous, getting back into the community and feeling worth,” she says.
Before she started at Green Thumb, Kristensen often worked in hotel restaurants, but found it hard to keep a steady job while being affected by severe depression.
“I could always find work; it was just about keeping work.”
Kristensen was so depressed so often that to function normally had become difficult. Sometimes she couldn’t even motivate herself to leave the house.
“Getting back to work helps so much, to say you are okay and you have a place in this world. The isolation disappears.”
Just a few minutes east on Queen Street from Parkdale Green Thumb Enterprises is the Centre for Addiction and Mental Health, home to another employment program for people with mental health problems.
The Urban Market Garden was created in 2002 in a partnership between CAMH and Foodshare, a sustainable food and urban agriculture company.
Each year, Foodshare hires 12 CAMH clients in the summer and 12 in the winter to grow vegetables, herbs, sprouts and belief in themselves.
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Courtesy of Foodshare
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| Mental health clients use their green thumbs at the CAMH Urban Market Garden. |
“They’re getting work skills, and more than anything they’re gaining confidence,” says Ravenna Barker, a community food program co-ordinator at Foodshare who oversaw the garden for two years.
Once the food is grown, it’s sold on Queen Street or to local restaurants and businesses.
The level of interest in the program is huge, says Barker, and they are never short of job applicants.
“We could quadruple the program no problem. So many people want to be a part of it. There’s such a stigma around mental health issues, so there’s a huge demand for employment.”
Barker has seen first-hand how people benefit mentally from working.
“People often say that they’ve learned to nurture themselves by nurturing plants. It can transform a person, understanding that care is important.”
Back at The Raging Spoon, Michael Lewin unlocks the door for the first employee of the day and sets him to work. Both as an employer and as a mental health survivor, Lewin has experienced the therapeutic value of working for a living.
“It can be therapeutic in a sense that there’s an integrity attached to your paycheque. It’s real, it’s viable, and you’re a part of something,” he says, recalling that he’s seen employees bawl their eyes out upon receiving their first wages.
But Lewin doesn’t want to be seen as a mental health survivor – just a guy trying to earn a living.
“I don’t even like to identify with it too much. Why does your existence come down to this one title? There’s way more to my identity.”
