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marcus gee

Fear of the mentally ill is among the oldest and deepest of human prejudices. Can it ever be overcome? Walk along a stretch of Queen Street on a weekday afternoon and you begin to hope.

West Queen West near Ossington Avenue has become one of the hippest quarters of Toronto's teeming downtown. An area that used to specialize in greasy spoons and used-appliance dealers now boasts chic cafés, spas and gift shops.

On the south side of the street stands the Centre for Addiction and Mental Health, or CAMH (pronounced Cam-H). It has changed, too. What was once the Provincial Lunatic Asylum is now a sprawling complex for research and treatment that focuses on the care instead of the confinement of the mentally ill. People suffering from obvious mental issues are outside and all around. One guy with pajama pants tucked into his cowboy boots asks passersby for spare change. Another with a grey-yellow beard and flip-flops on his socked feet mutters incoherently to himself as he finds a seat in a roadside park. No one seems to mind. The mentally ill have been a presence on Queen for years now and people are used to having them around. Those who were once demonized, are now just part of the urban scene.

That is just what the designers of CAMH were hoping for when they embarked on a sweeping, multi-year rebuild. Their aim was to integrate the facility and the residents with the surrounding community. Airy new buildings have gone up to replace the grim old institutional structures on the site. Streets have been extended into the CAMH campus to make it feel more connected to the neighbourhood.

It's a far cry from the hulking old asylum that was surrounded by a five-metre high brick wall, built partly by patients. A surviving section of that wall still runs along the east side of the 11-hectare campus, a reminder. When the asylum opened its doors in 1850, it was set apart from the heart of the city. Now the city is all around.

Who would want to live right next to a huge mental-health institution? Plenty of people, it turns out. The converted factory just next to CAMH commands top dollar for its loft residences. Some houses on nearby streets go for a million dollars and more.

People from all over come to visit West Queen West and the Ossington strip for their restaurants, bars, galleries and clothing shops. The area is hopping day and night. A sprawling centre for the treatment of mental illness standing right in the middle of all this has done nothing to deter the transformation of the area.

That in itself is encouraging. What has happened on Queen was impossible to imagine when I was growing up in Toronto in the 1950s and 60s. The place known as 999 Queen was the subject of dark fears and schoolyard jibes. "You belong in 999 Queen." That sort of thing.

Authorities changed the address to 1001 in 1979 to try to remove the stigma, but it lingered on. People have an instinctive fear of the mentally ill. The dirty man on the streetcar talking to himself, the old woman shouting curses on the sidewalk – these characters can often seem threatening, even if the vast majority of them pose no danger at all.

It would be blinkered to ignore the problems that have come with deinstitutionalization of the mentally ill. Many were dumped into shabby halfway houses. Others ended up just living on the streets. Go to a homeless shelter and you can't help noticing that many visitors suffer from addictions and mental-health problems – often both. Police still struggle with how to cope humanely with the minority of disturbed people who do become violent.

But, then, the mentally ill have always been among us. The "village idiot." The "crazy guy" down the street. They were the ultimate outcasts. Now, at last, they are coming out into the light.

Notable figures, from Margaret Trudeau to Olympian Clara Hughes, have gone public about their mental-health struggles. Public-education campaigns and newspaper series have helped us to understand that depression and other forms of mental and emotional disturbance are far more common than we imagined.

Gradually, haltingly but perceptibly, attitudes are changing. You can see it happening right before your eyes on West Queen West.