Hospital as a Mirror

Now a blog text written in English for a change! This text is written by my writer colleague from Lapinlahti, Maija Kerko. It is based on presentation by her at the Nordic Summer University Summer Session 2020 in Artistic Research/Performing Heterotopia Circle, Lapinlahti Hospital Park 27.7.2020.

Maija Kerko is writing a book on the recent history of Lapinlahti based on ethnographic research. The book focuses on the hospital area through the significations that has been given to it through the 30 years of civic activism in the area. The working title of the book is ”Kaikki maailman ihanat värit” (All the wonderful colors of the world). The project has been supported by the Kone Foundation, Pro Lapinlahti ry and The Association of Finnish Non-fiction Writers.

Below the presentation by Maija Kerko.

Hospital as a Mirror: A presentation by Maija Kerko

Welcome to my walking lecture tour around Lapinlahti area. As I already told in the discussions I had with many of you yesterday, I am currently writing a book about Lapinlahti seen through the lens of meanings the place has been given during the last 30 years of social activism surrounding the site. Lapinlahti operated as Finland’s first and most prominent psychiatric hospital for over 16 decades, starting from the year 1841, and due to the taboos surrounding the place during the hospital era, it has been given very extreme and contradictory meanings: it has been described as heaven or hell, for example. This walk is a playful exploration into some themes of my book, while at the same time it serves as a short overall introduction to the area and its history.

We shall first walk to the seaside inner garden of the hospital main building, which used to be a recreational garden for patients staying either in the closed ward or in the forensic psychiatric ward, where people who had committed a crime were examined. In recent years, it has been renovated to resemble the garden as it was during the 1920s.

Maija Kerko at the symposium 27.7.2020. Photographer: Elina Saloranta

Currently, the former hospital buildings are rented from the city of Helsinki by two tenants: a cooperative Lapinlahden Tilajakamo on the northern wing of the hospital building and a social enterprise Lapinlahden Lähde – both are leasing workspace for artists, scientists, therapists, artisans, small business owners and the like. 

Lapinlahden Lähde, backed up by MIELI Mental Health Finland association, also promotes mental well-being in the area, producing activities supporting social and working life integration of people at risk of social exclusion and organizing events related to culture or the nature of the area that are open and easily accessible for everybody. The idea is to create a ”diagnose-free zone” without categorization or discrimination. This is an activity that relies on the cultural heritage resources of the area and it has roots in social activism dating back to the 80 s, promoting the protection of the area’s historical values.

A historical process, which during the 1980s led to questioning the authority of the Lapinlahti hospital, the flagship and symbol of whole Finnish psychiatry, serves as a background in understanding the motives of the activism over the years. During the last three decades, the Finnish mental health care system has gone through a complete transformation process from a hospital-centered, centrally administrated system into open, fragmented mental health care practices emphasising preventative actions and outpatient care. As part of this process, the Lapinlahti hospital was closed in 2008.

Although the movement’s activists, who had fought for the preservation of the hospital activity since the 80s, could not finally prevent the place from closing, they have been able to stop the plans for the area’s future that would compromise the heritage of the area. This has mainly been done by interpreting the values of the place in a way that is meaningful and understandable to the present day citizens of Helsinki, even though the psychiatric activities have been seen as outdated, and thus helping the citizens to see that the place is important and worthwhile preserving. This way, the area’s cultural heritage has been kept alive, which is in the present situation seen in the activity which at the same time reflects the history of the place and adapts to the present day psychiatric trends.

The place is characterised by its layered history. By looking at its concrete details, one could tell thousand and one stories that date back far beyond the last three decades. By looking at the main building designed by Carl Ludvig Engel, the same architect who designed the most important administrative buildings in Helsinki, one could tell a story about the reconstruction of Helsinki as a new capital city of the Grand Duchy of Finland in the first decades of the 19th century, and how the Russian emperor Nicholas I put a special emphasis on presenting his human values to the Western world by building a big, modern hospital as part of the city’s monumental architecture.

By experiencing its old parks and gardensand their twilight atmosphere and by looking at the versatile flora rich in plants that are very rare in other parts of Helsinki, one could tell a story about the hospital’s former botanist doctors who designed the gardens with artist’s piety and about the patients who mainly did the actual work in turning the bare, rocky area into an idyllic, pastoral landscape during the first decades of the hospital’s history.

Or by looking at the barely visible shallow paths on the grass that lead to nowhere on the southern side of the park, bordered with lines of trees, one could tell stories of places that no longer exist, as the city of Helsinki started taking over the place piece by piece for the use of the growing industry of the capital. This process started in the first decades of the 20th century from the most southern places of the area around where now Kaapelitehdas in Ruoholahti is situated.

One could talk about passages leading to bathing huts, a bowling alley, meadows and a small grove of oaks. Or one could talk about a large, secretive garden in the middle of the hospital area, which was the centre of the doctors’ botanical experiments, surrounded by a fence of large spruce trees. There one could find fish ponds and groves of cherry and pear trees, for example, and all of the passages circulating around the hospital area seemed to finally end there. The place is now occupied by a large, blue office building, which you pass if you enter the area from the Ruoholahti side.

A map over Lapinlahti Hospital area about 1894. (KA, RakH II lea 71.43 56M 6/4) 

And getting lost in the main hospital building with its mazy structure with endless doors separating the different spaces from one another, one could tell a story about the hierarchy of an old psychiatric hospital with a strict control of passage depending on the status of the visitor.

The story that was told in the first wave of social activism in the 1980s was a story of patients who, in their letter to editors published in prominent Finnish newspapers, gave detailed descriptions of the area and the experienced healing interaction with it. As such, the writings shed light to the area described in Helsingin Sanomat as a ”black spot in the city”.

The writings showed that the surroundings experienced through a sensory system have a strong interconnection with identity. As was written in one text: ”The arched vaults of our minds stem from here.” They portrayed the place as paradise-like in contrast to the prejudice and fear expressed towards it from the outside, and, as such, they were not the first in the hospital’s history. For example, a physician who had spent her childhood in the area as a daughter of a doctor described the area experienced in her childhood as Sleeping Beauty’s castle with its fairytale-like forests, gardens and seashores, and as a community that stood for the weakest of the society.

These ideas were later the inspiration for new writings, which described the area’s values in a more scientific manner, looking to environmental psychology and aesthetics, and connected the patients’ experiences to nature’s alleged healing power in the time of the hospital’s construction. This was a selective tradition that looked more into the history written from an aesthetic rather than psychiatric point of view. More than the actual psychiatric reality, it looked into the idealistic ideas behind its construction. As such, it was history told to specifically protect the place from the plans to hand the place over to commercial development after the hospital activity would come to an end.

In the beginning of the 21st century, it was time for the public to take the place into their hearts. The selling of the hospital buildings from the Helsinki University Central Hospital to the city of Helsinki as part of the plan to shut the hospital down triggered a wide social movement with thousands of participants who rejected the plan as a part of a process of tearing down the society’s safety nets in the evolving neoliberal society. As compared to the cluster of business enterprises under construction in the neighbouring district Ruoholahti, Lapinlahti was now described as being rooted in the nation’s consciousness as a place for emphatic understanding of the fragility of the human mind and a ”paradise on the last shore”.

Now, the symbolism of hope linked to the sensory impressions experienced in Lapinlahti became available to the public in a brand new way. While mourning for the death of the welfare society in a radio program made by Lapinlahti activists, 10 000 flower bulbs were planted in the hospital’s park as symbols of faith in the future.

This was a clever popularisation of the way interaction with nature works; how we ourselves give the meaning for the surprises that it offers. The impressions experienced in the hospital atmosphere were many times before and after interpreted as symbolising threat or hope, as the text about Lapinlahti written by famous Finnish writer Märta Tikkanen in Hufvudstadsbladet in 2002 shows:

The sunlight streamed over the green vegetation, in front of the window the flowers of the linden trees were deliciously lime-green, the leaves of birch trees were just about to blossom. Behind the trees loomed one of the new glass façades, cold and cobalt blue, totally inappropriate and alien, not belonging to this place. But a couple of golden-eyed birds zoomed on sight on their way out to the sea. And everywhere on the carpet of grass there were stubborn groups of tulip, narcissus, daffodil and crocus buds growing, soon to explode in colorful joy.

Now, we will walk pass the gallery corridor connecting the hospital’s wing together, through an area where used to be the hospital’s chapel and a reception room, into the hospital’s front yard, where I will continue my walking lecture.

Maija Kerko at the symposium 27.7.2020. Photographer: Elina Saloranta

To attune to the immediate surroundings, letting it affect the emotions and be the inspiration to future actions can be an extremely political state. In the three wide social movements during the last three decades, Lapinlahti and its destiny have become a concrete, clearly outlined symbol of the complexity of the surrounding world and its present challenges.

The most recent peak of social activism resulting in a wide social movement happened this spring and early summer, opposing the plans to sell the buildings of the area to an international real-estate developer NREP. If realised, the plans would have meant building three big four and five-storey buildings, one of them a hotel, in the hospital park and commercialization of the area.

The citizens of Helsinki expressed their concerns about the plan in hundreds of letters sent to the Helsinki Urban Environment Committee. In many of them, Lapinlahti was described as being rooted to the Helsinki city structure as a protective place. It represented the experienced feeling of basic trust as a balanced, delicate composite of history, the present activity reflecting it, the buildings and the park, all these together forming the place’s still living cultural heritage. If the city had moved along with the plan, it would have violated the trust given to Helsinki’s political organisation and its promises of sustainable development of urban planning and citizens’ right to participate in it.

As a result of activists’ work and the public pleads of experts and citizens, a sharpening picture about an alerting new trend in the urban planning started to build up in the media. It seemed, that in its willingness to receive money from private investors, the city had lost control of the evolving city structure to the real-estate developers, and previously respected cultural heritage values were ready to be sacrificed in the process. If this development had previously been seen as unproblematic workings of a capitalistic society, now a moral plea for more democratic, transparent processes started to be cried out.

It is often said that psychiatry is a mirror that reflects society’s values and practices. For the Pro Lapinlahti movement, committed to the place and its scenery, the meanings of the place have always been connected to the values that represent its practices in their ideal state. Through these idealised interpretations, the place, that was actually surrounded by taboos in the hospital era, has become a mirror of the society, reflecting it critically. But if you turn the mirror around, you will see paradise on the last shore, Sleeping Beauty’s castle: utopia.

The patients who first started the movement wanted to turn the utopia they were presenting in the media into reality with their plan to establish an anti-psychiatric community in Venetsia-talo (the Finnish for “the Venice building”) on the seashore of the Lapinlahti area. While planning it, they were organizing peer support activity that was ahead of its time in the building. The administration of the hospital did not approve of the demands of equality and criticism pointed towards it, and the activities of the patients in the building were shut down.

During this spring, difficult questions have been raised to both me and others who have been engaged in the activism concerning the future of Lapinlahti. How should the area and its layered history be preserved so that everyone would have the equal right to interpret it freely from their own perspective and get their voice heard? Through what kind of maintenance would the area continue to encourage to look inside one’s own mind bravely, to enrich the imagination and awaken political awareness? For these are the meanings among many others that have been given to the place during the last thirty years and this spring.

After all, the ending words of Michel Foucault in his article ”Of other spaces”, describing a boat as a heterotopia by virtue of excellence applies well to Lapinlahti too, being often described as the flagship of Finnish psychiatry:

In civilizations without boats, dreams dry up, espionage takes place of adventure, and the police take the place of pirates.

Olisiko vihdoinkin aika kaikkien Lapinlahdelle?

Istun taas työhuoneessani Lapinlahdessa kesälomatauon jälkeen ja yritän suunnitella tulevaa, vaikka korona-aikana kaikenlainen suunnitteleminen onkin haasteellista.

Mennyt koronakevät oli raskasta ja jännittävää aikaa monella tavalla, ja kaiken taistelun keskellä ei löytynyt aikaa päivittää blogiani. Tässä välissä on tapahtunut paljon, ja kamppailu Lapinlahden tulevaisuudesta oli paljon esillä mediassa keväällä ja kesällä. Yksi tärkeimmistä medianäkyvyyksistä oli New York Timesissa kesäkuussa (12.6.2020) julkaistu juttu, jossa Moomin Characters ilmoitti vetäytyvänsä NREP:in kilpailuehdotuksesta. Juttu sai paljon huomiota ja heikensi Lapinlahden kevät -ehdotuksen uskottavuutta, mutta oli varmasti myös suuri brändimenetys Moomin Charactersille.

Toukokuussa olin helpottunut siitä, että kaupunkiympäristölautakunta päätti 12.5.2020 hylätä Lapinlahden rakennusten myymisen ja rakennusoikeuden varaamisen NREP Oy:lle. Päätöksessä todettiin, että asia vaatii lisäselvityksiä ja eri mahdollisuuksien perusteellisen arvioinnin. Päätöksellä oli laaja tuki lautakunnassa ja myös kaupunkilaiset, asiantuntijat ja järjestöt tukivat sitä. Olimme hetken iloisia ja ehdimme jo nostaa lasin kansalaistaistelun välivoitolle, kunnes pormestari Jan Vapaavuori 15.5.2020 ilmoitti Twitterissä ottavansa poikkeuksellisen keinon käyttöön ja vievänsä jo kerran päätetyn asian vielä kaupunginhallituksen käsittelyyn.

Keisarin uudet vaatteet

NREP:in päivitetty ehdotus oli esillä kaupunginhallituksen 15.6.2020 järjestetyssä kokouksessa, jolloin esitys jäi pöydälle (Sazonov Daniel, kok.). Seuraavaksi se oli esillä kaupunginhallituksessa 22.6.2020, jolloin ehdotus onneksi kaadettiin äänin 9-6. Vapaavuoren sooloilua jäi tukemaan vain kokoomuslaiset ja perussuomalaiset: Terhi Koulumies, Pia Pakarinen, Mika Raatikainen, Wille Rydman, Daniel Sazonov ja Jan Vapaavuori. Tämän jälkeen Vapaavuoren johtamistapoja nousi kritisoimaan 20 kaupungin virkamiestä, taustaorganisaatioissa työskentelevää henkilöä ja keskeistä poliitikkoa, jotka Helsingin Sanomien 29.6.2020 julkaistussa jutussa, moittivat Vapaavuorta ”ohijohtamisesta”. Samana päivänä myös johtamisen asiantuntijat kyseenalaistivat saman lehden toisessa artikkelissa (29.6.2020) Vapaavuoren johtamistyylin ja Vihreiden, Vasemmistoliiton ja SDP:n riveissä toimivat kunnallispoliitikot vaativat julkisesti selvitystä työhyvinvoinnin tilasta.

NREP:n uusi ehdotus (10.6.2020) poikkesi vanhasta siinä, että nyt ehdotettiin Helsingin kaupungin ja NREP:n hallinnoiman rahaston omistaman yhtiön perustavan yhteisyrityksen. Ehdotuksen mukaan kaupunki luovuttaisi vanhat rakennukset NREP:lle ja kiistellyt hotelli- ja kerrostalorakennukset sijoitettaisiin edelleen puistoon. Päivitetyssä ehdotuksessa ehdotettiin lisäksi, että kaupunki voisi tuoda ”esimerkiksi mielenterveyspalveluita ja kaupunkilaisille avointa kansalaisjärjestö- ja kulttuuritoimintaa” siipeen, jota NREP oli aikaisemmin kaavaillut hostellikäyttöön. Loppuun sairaalarakennuskokonaisuudesta sijoitettaisiin ”voittajasuunnitelman mukaista käyttöä”.

Tämä oli sinänsä harhaanjohtavaa, sillä Lapinlahden kevät -ehdotuksen päävuokralainen Moomin Characters oli jo pari päivää aikaisemmin (blogin alussa mainitussa) New York Timesin jutussa ilmoittanut vetäytyvänsä kilpailusta. Näin ollen NREP ei olisi pystynyt sijoittamaan ”voittajasuunnitelman mukaista toimintaa” sairaalan päärakennukseen, eivätkä päättäjät tämän suunnitelman pohjalta olisi pystyneet ottamaan kantaa sairaala-alueen tulevan toiminnan luonteesta. Elokuussa (6.8.) tuli tieto, että Moomin Characters on lopullisesti vetäytynyt alueelta ja löytänyt uuden toimitilansa kaupungin keskustasta.

Avoimuuden merkitys

Vaikka toukokuussa iloittiin siitä, että kaupunkiympäristölautakunta hylkäsi Lapinlahden kevät -ehdotuksen ja päätti asettaa selvityshenkilön Lapinlahden tulevaisuuden selvittämiseksi, päätöslausunnossa on monta kriittistä ja ongelmallista kohtaa. Yksi päätöksen linjauksista oli, että ”voittaneen ehdotuksen toimijat ja suunnitelma pidetään mukana kokonaisuuden selvittämisessä”. Vaikka voittajaehdotus päätettiin jättää toteuttamatta ja vaikka NREP:n päivitetty ehdotus kaatui myös kaupunginhallituksen kokouksessa 22.6.2020, NREP on ainoa taho, jota on edelleen pakko kuulla prosessin aikana. Muiden tahojen kuulemisesta ei ole mainittu päätöksessä.

Yksi ideakilpailun suurimmista ongelmista on ollut se, ettei asiantuntijoita ole kuultu prosessin aikana. Samoin kaupunkilaisten aito mahdollisuus ottaa kantaa Lapinlahden suunnitelmiin estyi, koska Kerrokantasi-palvelussa esiteltyjen suunnitelmien puutteelliset tiedot antoivat vääristynyttä tietoa Lapinlahden kevät -ehdotuksen sisällöstä. Ehdotuksen kolmesta havainnekuvasta puuttui täysin ehdotettu laaja ja koko aluetta hallitseva hotellilisärakennus. Prosessia on kritisoitu myös siitä, ettei se ole ollut riittävän avoin, eikä esimerkiksi mitään kaikille avointa keskustelutilaisuutta ole järjestetty.

Avoimuuden ja osallisuuden nimissä olisi nyt erittäin tärkeää, että uudelleen avatun prosessin aikana kuultaisiin alusta alkaen laajasti eri alojen asiantuntijoita. Lapinlahden tulevaisuudesta päätettäessä olennainen asiantuntemus kohdistuu esimerkiksi osallisuuteen, mielenterveystyöhön, saavutettavuuteen, kulttuuriperintöön ja maisema-arkkitehtuuriin liittyviin aloihin. Myös Lapinlahden pitkäaikaisia toimijoita ja Lapinlahden säilyttämisen puolesta toimineita henkilöitä tulisi kaupungin osallisuusmallin mukaisesti kutsua mukaan suunnitteluun. Nyt on aika rakentaa mielenterveyden kulttuurihistoriaa vaalivaa, sosiaalisesti kestävää, osallistavaa ja kaikille saavutettavaa Lapinlahtea yhdessä tuleville sukupolville.

Tai, kuten Tampereen yliopistot tutkijat Jonas Sjöblom, Antti Wallin ja Sanna Rikala, jotka ovat hankkeen Kohti ekohyvinvointivaltiota (ORSI) puitteissa tutkineet Lapinlahtea ja Helsingin kaupungin osallisuusmallia, ilmaisevat asian:

Osallisuutta syntyy ja se vahvistuu itsestään yhdessä tekemisen myötä. On tärkeää, että kestävän kaupungin tavoittelussa tunnistetaan omaehtoisen ruohonjuuritason toiminnan merkitys ja tehdään toimijoiden kanssa yhteistyötä.