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Canada Cyril Greenland helped move psychiatric patients out of hospitals

Cyril Greenland

James Lewcun/The Globe and Mail/James Lewcun/The Globe and Mail

When Cyril Greenland arrived from Great Britain in 1958 to be the director of social work at the provincial psychiatric hospital in Whitby, Ont., his biggest challenge was pavilion 2B, a filthy overcrowded ward for the most uncontrollable and violent patients. Because the men there insisted on walking about naked, they could not be cared for by the female psychiatric nurses, only by the less qualified male attendants.

One of them was a furious one-eyed Polish war veteran with aggressive fists who knew little English. Because he had a Polish name that staff couldn't pronounce, they gave him a simpler moniker, which fed the man's paranoia that the authorities were destroying his personality. When Greenland looked up his real name and insisted that he be called that, the man calmed down. Then Greenland contacted an association of Polish war veterans in Toronto. Its representatives visited the patient, and before long found him a home and removed him from the hospital.

Greenland learned that the patients on 2B refused to wear clothes because all available clothes were size extra large and since the patients could have no belts or suspenders, they could not keep their pants up. He obtained well-fitting clothing for patients and eventually oversaw the release of most of them into the community.

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Greenland died of leukemia in Toronto on Jan. 1 at the age of 92. Psychiatric social worker, professor of social work at McMaster University in Hamilton, government adviser, researcher, author of a half-dozen books, co-founder of an important archive of Canadian psychiatry, gifted woodworker, mentor, enthusiast for the arts and history, he left his mark on Canadian social policy on child welfare, the rights of the blind and humane treatment of the mentally ill. No one was better at listening to damaged and disadvantaged individuals.

"After the Second World War, there were three streams in Canadian psychiatry," explained Edward Shorter, Hannah professor of the history of medicine at the University of Toronto, who worked with Greenland on a book of essays titled TPH: History and Memories of the Toronto Psychiatric Hospital, 1925-1966. "Biological psychiatry, which continued from before the war; psychotherapy, which was just coming on; and social and community psychiatry. Cyril was associated with the latter. Social psychiatry looked to external circumstances like poverty and unemployment for the origins of mental illness."

Because of his success at so-called remotivation (reorienting long-term mental patients toward the outside world), Greenland was retained by the Ontario government between 1960 and 1966 to plan how to empty the province's crowded psychiatric hospitals. This push was underpinned by studies showing that long-term patients developed "hospital neuroses" and never actually got better. The trend was accelerated by the introduction of drugs that could control symptoms of mental illness on an outpatient basis.

"In the seventies, there was a reduction of psychiatric beds in hospitals across the world, a limiting of patients and a shortening of hospital stays for psychiatric disorders," recalls Federico Allodi, a retired professor of psychiatry who was Greenland's colleague and friend. They worked together, starting in 1966, at the then newly founded Clarke Institute of Psychiatry (now Centre for Addiction and Mental Health).

"In those days, some countries had 150 beds per 100,000 population and now the average Western country has 30 per 100,000," Allodi says.

Two decades later, with mentally-ill homeless people wandering the streets of every major Canadian city, Greenland admitted that de-institutionalization was not an unqualified success. "We were perhaps a little naïve and we failed to consider the need to carefully build community supports," he said in an interview that appears in the 1989 book, Pioneers of Mental Health and Social Change.

At the Clarke Institute, Greenland researched violence and mental illness, a subject he continued to examine after he left to be a professor of social work at McMaster in 1970. He retired in 1984 to write a study of child abuse and neglect, and pursue other interests.

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"He loved poetry, especially the works of Robert Lowell, and he was a great reader of biographies," recalls Toronto writer John Robert Colombo. "He was an authority on Ernest Jones (Sigmund Freud's biographer and disciple), who lived in Toronto 1910 to 1914 and made many contributions to psychoanalysis while here. Cyril assisted (the Anglo-American author) Brenda Maddox in tracing those four years of Jones' life when she wrote Freud's Wizard and is thanked in the book."

He was also an expert on Louis Riel and on the Canadian psychiatrist Richard Maurice Bucke, Walt Whitman's literary executor. Greenland collaborated with Colombo on Walt Whitman's Canada, a scrapbook about the short period the great American poet spent here. "He brought heart to psychiatry and was always for the underdog, the disadvantaged," says Colombo.

In 1990, Greenland founded an archive with John Griffin of materials relating to the history of psychiatry in Canada since 1850, housed at CAMH. He and Griffin rescued thousands of old hospital records and other material on the verge of being discarded.

Two famous novels that deal with the treatment of the mentally ill in Toronto show his influence. "He worked with Timothy Findley on Headhunter and with Margaret Atwood on Alias Grace," says Linda Brown, who was mentored by Greenland as a young psychiatric nurse and founded Workman Arts, an arts company linked to CAMH. "He taught me the importance of history. In the 1980s, he wanted to start a museum about the history of psychiatry, but nobody then understood what he was trying to do, the educational value of it. There is now such a museum, the Het Dolhuys in Haarlem in the Netherlands, and it is a great museum."

Born Dec. 20, 1919, to Henry and Annie (née Levy) Grundland, Cyril was the second of five children in an impoverished Jewish family living in Bethnal Green in London's East End. "Jews were marginalized during the Depression, but all of the families helped each other," according to Greenland's daughter Eya. Henry Grundland abandoned the family and Cyril's mother struggled to feed her brood. Yet she never turned away anyone in even greater need. Annie, who had a great influence on him, suffered from chronic depression and died in 1949 in a mental hospital, of liver cancer.

Cyril left home at 16 to become an apprentice watchmaker, but later managed to take a degree in social work at the London School of Economics, and much later a PhD at the University of Birmingham. It was while he was at LSE that he and his elder brother, Ben, changed their names to Greenland. "Nobody wanted to be Jewish in the East End of London," says his daughter.

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He worked at various hospitals in England, ending up at Crichton Royal Hospital in Dumfries, Scotland, where he met Jane Donald, a psychiatric nurse. They married and started a family that was to include five children. Greenland made much of the furniture in their home, along with wood carvings in the style of Henry Moore.

In his efforts to study where people in trouble turn for counselling, Greenland found that an English women's magazine had kept 20,000 letters from readers asking for help, which the magazine made available to him. The resulting scholarly paper made news, bringing Greenland to the attention of the Ontario government, then recruiting British social workers. When Greenland was offered the job in Whitby, the family moved to Canada.

"My parents were very loyal to each other," says Eya. When Jane fell ill with colon cancer and declined to be hospitalized, Greenland nursed her skillfully for two years, until her death in 1990.

In 2002, Cyril Greenland was diagnosed with leukemia and lymphoma, for which he refused treatment. He leaves children David, Hamish, Lesley and Eya, six grandchildren, and one great-grandchild. He was pre-deceased by a grandson, and by his eldest daughter, Erika, who died in 2005.

Special to The Globe and Mail

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