Chief Kwikwetlem William – the man for whom the suburban community of Coquitlam is named – knew first-hand the perils of living near a hospital for the mentally ill. The chief – who lived to be 110, was there when the first steamboat arrived, and met the first white man to enter his community – was attacked by a pitchfork-wielding patient at Colony Farm during the 1930s. The Kwikwetlem First Nation and old press clippings say the chief suffered a head wound from the attack and lost vision in at least one eye.
The chief's scars were visible, but those of the Kwikwetlem people are more difficult to spot. Band members, including Fred Hulbert, now a Kwikwetlem band councillor, recall growing up on the reserve and sprinting from one residence to the other in perpetual fear of shadowy figures. The fear remains to this day. The first of the Kwikwetlem's two reserves, on which the band office sits, is a short walk down a windy road from the now-notorious Forensic Psychiatric Hospital at Colony Farm – home to, among others, those found not responsible for their crimes due to mental disorders.
Colony Farm (as it is widely known) has had a home for the mentally ill on its grounds, in one form or another, since 1909. In recent months, the hospital made headlines due to patient escapes and employee safety concerns. The federal government last week announced it would introduce a bill to make it tougher for offenders who are mentally ill to be released from custody. The Kwikwetlem – who once numbered in the thousands but now have about 70 members – have for more than a century opposed having a mental hospital on what it calls its territorial land. While other Coquitlam residents might express concern about escapees, for the first nation people, it's a pressing problem in their own backyard.
Dale Lessoway, the Kwikwetlem's lands and resource manager, says the band has met with hospital officials multiple times, pleading for quick notification when a patient walks away. Speaking in a conference room inside the band office, a drum emblazoned with the Kwikwetlem logo behind his head, Mr. Lessoway's frustration with Colony Farm is readily apparent. He thought the parties were on the right track earlier this year when the band was notified within an hour of a patient's escape. But when 60-year-old Charles Hansen walked away from the hospital last week, Mr. Lessoway said, the band learned about it through the media, undoing any sense of progress.
The first nation has a protocol to respond to an escape. Every band member is called and a photo of the patient is uploaded to Facebook. On the most recent occasion, Mr. Lessoway met the band's children after school to ensure they made it home safe.
"How would any other community react to this?" he asks. "It's just going to be a matter of time before something bad happens."
The purpose of the Forensic Psychiatric Hospital is to make something good happen – and in the end, most patients leave safely.
"The vast majority of patients improve in terms of their mental illness," said Johann Brink, clinical director of the current 190-bed facility. "They respond to treatment, they respond to our rehabilitative efforts and treatment programs. They are well enough to leave the hospital."
Overall, treatment is the focus. The hospital does court-ordered assessments of patients as well as housing those who are found not criminally responsible for crimes.
"Patients, by default, have a major mental illness, so they receive medication," said Dr. Brink, who has been at the hospital for 11 years, and in his current position for five years. "We have programs to address their mental illness, to improve their understanding of the illness, to understand the medications they are taking. We have anger-management programs. And we had addiction programs, because many of our patients have concurrent disorders."
The average length of stay is three years, although Dr. Brink acknowledges that some patients will never leave. Men and women "intermingle" on hospital grounds if they have appropriate privileges, but there is a segregated residential unit for women, who represent about 10 per cent of patients.
Six levels of privileges determine a patient's ability to move around the hospital grounds. Zero is restriction to a unit. Level One includes the option of being escorted by two staff to limited programs, such as the gym, within the secure area of the hospital. Level Three would be access to the grounds during specified hours. Dr. Brink said the facility is distinct in Canada for having a mix of security levels through which patients move, depending on their progress, within the same secure premises.
Dr. Brink said the bucolic setting between Lougheed Highway and the Fraser River helps with the treatment. "There is no hustle and bustle of the city," he said. "It has a tranquil feel to it, which, I believe, helps patients in their recovery."
But all is not entirely tranquil. Although he plays down violence on the wards, Dr. Brink acknowledges it happens, but tries to put it in context. "To describe it as a place where people should expect patients to steal up from behind and hit them over the head – that really is dramatizing matters. We have violent incidents. Yes. We have troubling incidents. Yes. It is a challenging population, so we have had some incidents of significant concern."
However, he points to various measures to boost safety, including enhanced training for staff, better risk assessment and management – even having staff wear personal alarms and two-way radios.
The units have no uniformed guards, but Dr. Brink said that nurses and health-care workers are trained in "aggression management," including how to subdue a patient. They are backed up by security staff who are ready to come into the units as required.
Darryl Walker, president of the B.C. Government and Service Employees' Union, worked as a nursing aide at the predecessor of the current facility. Mr. Walker said Colony Farm is a challenging place to work because of the uncertainty involved. "You almost have to have eyes in the back of your head. The potential for violence is there, but it can come in many forms. It may not come at all. It may come from someone you least expect it to come from. … It's very, very demanding."
And then, of course, there's the safety issue for those outside Colony Farm's blue gates. Dr. Brink said he is sympathetic to the hospital's neighbours, specifically the Kwikwetlem First Nation, and their anxiety about escapees. "I certainly understand and appreciate their concerns. They ask the appropriate questions and express the concerns," he said.
He concedes the hospital failed to notify the band when a patient took an unauthorized leave recently, but "otherwise we do and it's our commitment to do that." He said he has met with the band on the issue. As part of an effort of outreach, he said band officials have toured the hospital. There has even been talk about aboriginal programming that would presumably focus, initially, on the 10 to 14 per cent of patients who are first nations, but eventually involve others.
"They have a right to want to know how the hospital operates and they need to have confidence in the way we run this hospital."
The history of mental-health treatment in the Colony Farm area begins in the early 1900s, when the area was used to grow food for patients at the Provincial Hospital for the Insane in New Westminster, B.C. Around the same time, work began on a new mental health facility, Riverview Hospital, on the slopes north of Colony Farm. Patients worked the farmlands as part of their treatment, eventually supplying produce and meat for Riverview. "The farm was considered the province's showpiece and people came worldwide to see the farm, cattle and prize-winning Clydesdale horses," area historian Anna Tremere wrote in a chronicle of Colony Farm. In time, residences for the mentally ill, including returning war veterans with mental-health issues, went up on-site. Farming operations were ended in 1983.
Even with all that history, it was not assured that the Forensic Psychiatric Hospital – which opened in 1997 – would be at Colony Farm. Opposition came not just from the first nation, but from a city councillor who said the hospital should be in the Rocky Mountains "or on an island somewhere." A 1993 report by the hospital developer said the south side of Delta's Alex Fraser Bridge and Boundary Bay Airport were both explored. Traffic congestion was among the reasons both sites were nixed. Colony Farm was praised in that report for its agricultural capability and seclusion, among other things.
Mr. Lessoway said band members have enough day-to-day issues to tackle, such as poverty. He said they should not have to carry such concern for their personal safety. At one point he said, "We have been looking into our options." He does not go further, or explain if legal action is on the horizon.
In another instance, he concedes the fear might not always be rational – that those who escape might not be the most dangerous, that they might always head for the highway instead of for the reserve.
But the fear, like the memories of those who have lived near Colony Farm for all of their lives, remains.
On the record
Cases at Forensic Psychiatric Hospital where patients have not arrived at a pre-arranged destination or returned from unescorted leave at agreed time or have not notified staff:
-42 unauthorized absences since 2010 among 19,000 leaves (20 unauthorized absences in 2010; 17 in 2011; five in 2012)
-Thirty-one of the 42 returned within 24 hours. One is still missing.