NORTH BATTLEFORD, Sask. — At its peak, the massive red-brick complex with a scenic view of he North Saskatchewan River was a community unto itself.
Saskatchewan Hospital, which first opened to patients in 1914, had its own barns, cattle, grain field, school and chapel — even a curling club and legion.
For more than a century, it has provided care for thousands of mentally ill patients who were untreatable, abandoned and alone.
"We get the worst of the worst individuals in the province and when I say that I mean the most ill. The most ill, the most treatment resistive, the most underdog population of the province," says Linda Shynkaruk, director of Saskatchewan Health North Battleford, who started at the institution 34 years ago as a psychiatric nurse.
"They're the most not heard — the most unvoiced people in the province. They can't advocate for themselves. They can't make the determination about what treatment they need."
This year, the old facility will close its doors. It's being replaced with a new $400-million hospital right next door.
Psychiatric care has changed immensely over the last 100 years. Improved psychotropic drugs mean patients can be better integrated into the community. In the 1950s, there were 2,040 patients. Now there are 156.
"Today we want to keep people connected to the community, so we take people out to those community places like the curling rink, the swimming pool and things like that," Shynkaruk says.
The old buildings are steeped in history.
"We have three graveyards," Shynkaruk said. "There's hundreds and hundreds of patients buried back there. We have a chapel here. We've had weddings there."
There's an old autopsy room and morgue, complete with four wooden body drawers, with "Close This Door" written on it.
Some people believe the site is haunted.
"I have had calls from people who are producing movies ... There are a lot of ghost stories out here," Shynkaruk says. "I just gracefully decline for the patients' sake.
"This is their home and it is the 'One Flew Over the Cuckoo's Nest' stigma and we really need to work hard at reducing public perception of that."
Patients range in age between 18 and 86. The average stay is 18 months.
"We've had patients who've been here 20, 30, 40 years. They're at the tail end of the era and were admitted before psychotropic drugs were invented," says Shynkaruk, who knows most of the patients by name.
"Hi Mike," she says to a senior leaning against the wall. "I'll come back and visit you. I stopped by yesterday but you were sleeping."
Merilee, a woman in her 30s, says she appreciates her relationships with staff.
"We're starting this buddy-buddy action where nurses and patients, they sit down and actually talk to one another," she says. "And the doctors are seeing us more, so it's pretty good."
Day-to-day running of the facility isn't without its problems.
"Violence is a huge issue in mental health and how do you manage that?" Shynkaruk says. "We've undertaken a lot of initiatives in this last year and a half."
Shynkaruk says finding staff who have experience with mental-health issues is also a challenge because it requires extra training.
"It's kind of the 80-20 rule — 20 per cent of your problem children take up 80 per cent of your time," she says. "I would say that we have excellent staff here but it's our responsibility to make sure they're well trained.
"We are trying to do a better job."
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Bill Graveland, The Canadian Press