The stretch of Queen Street West between Shaw and Dovercourt was crowded with strollers and dogs and couples walking hand in hand. Groups of people peered into tiny eateries trying to find one with enough space to accommodate a brunch crowd. The breeze made the humidity slightly more tolerable. Across the street, in a small park, children tossed around a Frisbee, laughing at its zigzagging flight. Lone readers and people sitting in twos and threes occupied the benches and picnic tables. And scattered throughout this scene were mental health patients -- in various stages of recovery -- being treated at the Centre for Addiction and Mental Health (CAMH) that sits smack in the middle of this tiny strip of street.

It's the kind of scene that is at the heart of CAMH's most recent multi-million dollar redevelopment: the idea that de-institutionalizing mental health care, integrating patients into their surrounding community while they are treated, is critical to patient recovery.

Back in the mid 1800's, the Queen St. W. CAMH site used to be the Toronto Lunatic Asylum. The story goes that people walking past the imposing Victorian building would hold their breaths, fearful they might catch something from the patients within. As prevailing wisdom about how best to treat mental health changed so too did the language and architecture of mental health care.

This shift in thinking means the large concrete buildings that form the heart of the Queen St. site are being taken down and replaced with a series of smaller-scale buildings integrated into the local Queen St. W. community. The institutional model has been let go in favour of one that embraces openness and social integration as part of good treatment.

I met with Alice Liang, an architect with Montgomery Sisam Architects and the project principal on the redevelopment. I set off with her for a tour of the site to see what's being changed and why. The project is still in its early days and an optimistic assessment says the entire redesign will be complete by 2020.

Liang points to the large renderings on the hoarding outside the construction site where the main CAMH building once stood. It will house inpatients with various mood and anxiety disorders. "The idea is that over the last 10 or 15 years the model of care has changed to become a focus of recovery, ultimately, so whatever it takes for that to happen is kind of the genesis of the urban village vision, to bring the community in first and then that will help (patients) to bridge that gap between being at a hospital and then being out in the community," she says.

Hospitals are usually massive buildings, typically consisting of endless corridors and dull lighting, sitting isolated in a green field. Patients and staff feel warehoused and cut off. The urban village concept is based on the idea that patient and community are one and that the hospital exists as part of the neighbourhood fabric with buildings sometimes offering up dual-use spaces. One of the new CAMH buildings, for example, will have a public place where artists -- patients and others -- can display their work.

The key thinking behind CAMH's urban village model is that patients feeling like a part of a community will recover faster. The future patient rooms are designed so that those living in them can see themselves as everyday people. "Their day to day life on the unit gives them a sense that they are in a normalized environment. If I showed you one of these apartment-like buildings right now and we'd go in it you wouldn't know you're in a so-called mental health institution because it's totally de-institutionalized," says Liang.

The CAMH redevelopment is a first of its kind in Canada and Alice Liang spends a good part of her time taking foreign delegations on tours of the site so they too can see the centre's innovative new design. But that certainly doesn't mean there is universal support for the project.

Some residents have said replacing the centralized model with a series of smaller buildings will overwhelm the trendy West Queen West district it sits in, altering the character and environment. Others say that recreating the CAMH facility so that patients get as much (voluntary) exposure to the community as possible will put patients and the broader community on a collision course.

While Alice Liang and I walked around, several people in various states of lucidness stopped us to ask for change and one man became fairly aggressive. While those interactions were fleeting and not particularly dangerous -- and quite common in many parts of Toronto -- some residents say such incidents will be far more common since the new facility will have more patients in a more decentralized setting.

But the patients who would be heavily integrated into the local community are those on the tail end of their treatment who need help in transitioning from hospital to home. Chris Whittaker was once one of those people. He's a former patient and now works in the CAMH resource centre.

"There's a whole bunch of other support you can get besides just a medical model and this is going in that direction. It's feeling like part of a neighbourhood where you're living, you're receiving critical clinical care if that's what you need but you're also part of a relaxed supportive neighbourhood," says Whittaker.

"I think just generally it feeds into the feeling [that asks] do people want to be housed in a hospital for any period of time for any reason? I found [the old Queen Street site] intimidating and cold and I look at White Squirrel Way [a new street through the property named after famous squirrels living in nearby Trinity Bellwoods Park] now with its residential buildings and its low rise buildings and it's more of a welcoming appearance than the cinder block walls I was walking through," he says.

"I appreciate the change that is coming."

Naheed Mustafa is a freelance journalist living in Markham.