DEPARTMENT OF PROVINCIAL SECRETARY Mental Health Services PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT FOR TWELVE MONTHS ENDED MARCH 31st 1953 VICTORIA, B.C. Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty. 1953 To His Honour Clarence Wallace, C.B.E., Lieutenant-Governor of the Province of British Columbia. May it please Your Honour: The undersigned respectfully submits herewith the Annual Report of the Director of Provincial Mental Health Services for the fiscal year ended March 31st, 1953. W. D. BLACK, Provincial Secretary. Provincial Secretary's Office, November 24th, 1953. The Honourable W. D. Black, Provincial Secretary, Victoria, B.C. Sir,—I have the honour to submit the Annual Report of the Provincial Mental Health Services for the twelve months ended March 31st, 1953, being the Eighty-first Annual Report. The early history and development of our mental hospitals were being lost in obscurity. As a matter of public interest, and after considerable research, Dr. Gee, Director of Mental Health Services, has outlined in his report the history and development of these Services during the past 100 years. One of the progressive events of the year under review was the enactment of the " Schools for Mental Defectives Act." This Act provides for the direct admission to The Woodlands School of mental defectives, who hitherto were committed to the mental hospitals pursuant to the provisions of the " Mental Hospitals Act." Again, I have the pleasant task of commending to you the high devotion to duty and to the cause of our patients on the part of the staff of the Mental Health Services in all branches. I have the honour to be, Sir, Your obedient servant, R. A. PENNINGTON, Deputy Provincial Secretary. Deputy Provincial Secretary's Office, November 20th, 1953. TABLE OF CONTENTS PART I.—MEDICAL Officers and Staff, List of Report—Director of Mental Health Services Report of Crease Clinic—Dr. Davidson Page 11 15 33 34 35 40 Reports of Provincial Mental Hospital, Essondale— Report by Dr. Caunt Treatment Services—Dr. McNair Department of Occupational Therapy— (a) Women's Division—Mrs. Draper (b) Men's Division—Mr. Herring 41 Department of Recreational Therapy—Mr. Brown 42 Audio-Visual Department—Mr. Walker 44 Library Report—Miss Ruzicka 46 Department of Physical Medicine—Dr. McNair_ __. 47 ___ 48 49 49 49 51 52 55 56 58 Dental Department—Dr. lohnsen Optical Report—Mr. Woodbridge Beauty-parlour Report—Mrs. Townsend. Department of Dietetics—Miss Pelling Department of Neurology—Dr. Fister Laboratory Report—Dr. Nicolson Department of Radiology—Dr. Jackson- Department of Psychology—Miss ElarL_. Department of Social Service—Miss Carroll Department of Nursing Service— (a) Women's Division—Miss Pullan 65 (b) Men's Division—Mr. Creber 67 Department of Nursing Education—Miss Smith 69 Department of Rehabilitation— (a) Women's Division—Dr. McNair 70 (b) Men's Division—Mr. Addison Reports of The Woodlands School— Report by Dr. Sauriol Educational Department—Mrs. Rhodes.. 70 73 78 Department of Occupational Therapy— (a) Girls' Division—Mrs. Jones 79 (b) Boys' Division—Mr. Mercer 80 Department of Recreational Therapy—Mr. Lynes 81 Department of Dentistry—Dr. MacCrostie 83 Department of Dietetics—Miss Paterson 83 Laboratory Report—Dr. Nicolson 84 Department of Radiology—Mr. Barteluk 84 Beauty-parlour Report—Mrs. DeCoene Department of Nursing Service— (a) Women's Division—Miss Sanders. (b) Men's Division—Mr. Elliot Department of Nursing Education— (a) Women's Division—Miss Pullan (b) Men's Division—Mr. Nash 85 85 86 87 87 T 8 MENTAL HEALTH SERVICES REPORT, 1952-53 Reports of The Woodlands School—Continued page Department of Psychology—Miss Cohen 88 Department of Social Service—Miss Carroll 89 Reports of Provincial Mental Home, Colquitz— Report by Dr. d'Easum 94 Department of Occupational Therapy—Mr. Helander 95 Report of Shoe and Tailor Shops—Mr. Campbell 96 Department of Recreational Therapy—Mr. Lowndes 96 Dental Report—Dr. Dempsey 97 Department of Nursing Service—Mr. McLeod 97 Department of Nursing Education—Mr. Lowndes 99 Reports of Geriatrics Division— Report by Dr. Bryson 100 Tables on Movement of Population 103 Reports of Child Guidance Clinics—Dr. Byrne 106 (a) Social Service to Child Guidance Clinics—Mr. Ricketts 112 (b) Psychology Department—Miss Munro 115 Report of Research Division—Dr. Gibson 118 Medical Statistical Tables, Mental Hospitals— 1. Movement of Population 121 2. Summary of Operations since Inception 123 3. Admissions, Discharges, and Deaths 124 4. Districts from Which Patients Were Admitted 125 5. Number of Attacks at Time of Admission 126 6. Reported Duration of Attack Prior to Admission 126 7. Reported Cause of Attack in Patients Admitted 127 8. Probation, Number Discharged on 127 9. Discharges, Alleged Duration of Illness Prior to Admission in Those Discharged 127 10. Deaths, Cause of, and Length of Time in Hospital 128 11. Psychoses of First Admissions ■ 131 12. Psychoses of Readmissions 133 13. Age-groups of First Admissions by Psychoses 135 14. Age-groups of Readmissions by Psychoses 136 15. Economic Status of First Admissions by Psychoses 137 16. Use of Alcohol of First Admissions by Psychoses 138 17. Conjugal Conditions of First Admissions by Psychoses 139 18. Conjugal Conditions of Readmissions by Psychoses 140 19. Education of First Admissions by Psychoses 141 20. Nativity of First Admissions by Age-groups 142 21. Country of Birth of First Admissions 142 22. Citizenship of First Admissions 143 23. Religion of First Admissions 143 24. Age-groups of First Admissions 143 25. Age-groups of Readmissions 144 26. Previous Occupations of First Admissions 144 27. Method of Commitment of First Admissions 145 28. Method of Commitment of Readmissions 145 29. Rural-Urban Status of First Admissions by Psychoses 145 30. Age-groups of Discharged Patients by Psychoses 146 31. Duration of Last Hospital Residence of Discharged Patients by Psychoses 147 TABLE OF CONTENTS Medical 32. 33. 34. Medical 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. T 9 Page 148 148 149 Statistical Tables, Mental Hospitals—Continued Conditions of Patients on Discharge by Psychoses Age-groups of Patients Who Died Age-groups of Patients at Time of Death by Psychoses Statistical Tables, Crease Clinic of Psychological Medicine— Movement of Population 151 Summary of Operations since Inception 151 Admissions, Discharges, and Deaths 152 Districts from Which Patients Were Admitted 153 Number of Attacks at Time of Admission 154 Alleged Duration of Attack Prior to Admission 154 Alleged Cause of Attack in Patients Admitted 154 Number Discharged and Results 155 Reported Duration of Mental Illness Prior to Admission in Those Discharged : 155 Deaths, Cause of, and Length of Time in Hospital 155 Psychoses of First Admissions 156 Psychoses of Readmissions 157 Age-groups of First Admissions by Psychoses 159 Age-groups of Readmissions by Psychoses 160 Economic Status of First Admissions by Psychoses 161 Use of Alcohol of First Admissions by Psychoses 162 Conjugal Conditions of First Admissions by Psychoses 163 Conjugal Conditions of Readmissions by Psychoses 164 Education of First Admissions by Psychoses 165 Nativity of First Admissions by Age-groups 165 Country of Birth of First Admissions 166 Citizenship of First Admissions 166 Religion of First Admissions 167 Age-groups of First Admissions 167 Age-groups of Readmissions 168 Previous Occupations of First Admissions 169 Method of Commitment of First Admissions 170 Method of Commitment of Readmissions 170 Rural-Urban Status of First Admissions by Psychoses 170 Age-groups of First Admissions by Psychoses 171 Duration of Last Hospital Residence of Discharged Patients by Psychoses 172 Condition of Patients on Discharge by Psychoses 173 Age-groups of Patients Who Died 173 Age-groups of Patients at Time of Death by Psychoses 174 PART II.—FINANCIAL Report—Business Manager 175 Expense Statement, Preventive Services 179 Expense Statement, Headquarters 179 Financial Tables— Mental Hospitals— A. Average Residence, Maintenance, and per Capita Cost for Past Ten Years 180 B. Yearly Gross Expenditure, Analysis of, for the Past Ten Years 181 C. Summary of Gross and Net per Capita Cost in All Hospitals 182 D. Expense Statement, New Westminster 183 T 10 MENTAL HEALTH SERVICES REPORT, 1952-53 Financial Tables—Continued Mental Hospitals—Continued page E. Expense Statement, Essondale 183 F. Expense Statement, Saanich 184 Revenue, Table of, for Past Ten Years 185 Expenditures under Federal Health Grants 186 Crease Clinic of Psychological Medicine—Summary of Costs, per Capita, and Population 187 Homes for the Aged— Port Coquitlam— Summary of Costs, per Capita, and Population 188 Average Residence, Maintenance, and per Capita Cost since Inception 188 Vernon— Summary of Costs, per Capita, and Population 189 Average Residence, Maintenance, and per Capita Cost since Inception 189 Terrace— Summary of Costs, per Capita, and Population 190 Average Residence, Maintenance, and per Capita Cost since Inception 190 Summary of Gross and Net per Capita Cost in All Three Institutions 191 PART III.—COLONY FARM General Financial Report—Business Manager 193 Profit and Loss Account 193 Dairy and Herds Department—Profit and Loss Account 194 Work-horse Department—Profit and Loss Account 194 Hog Department—Profit and Loss Account 195 Cannery—Profit and Loss Account 196 Orchard and Truck-garden—Profit and Loss Account 196 Field Crops and Pasturage—Profit and Loss Account 197 Tractors—Profit and Loss Account 197 Trucks—Profit and Loss Account 197 Maintenance and Administration, General 198 Miscellaneous Statements, Inventories, etc.-—■ Produce Supplied to Essondale 198 Produce Supplied to New Westminster 199 Accounts Receivable 199 Remittances to Treasury 199 Summary of Equipment Inventories 199 Orchard and Truck-garden Inventory _-_ 199 OFFICERS AND STAFF Hon. W. D. Black, Provincial Secretary. R. A. Pennington, O.B.E., F.C.I.S., Deputy Provincial Secretary. A. M. Gee, M.D., CM., Director of Mental Health Services. A. E. Davidson, B.A., M.D., CM., Deputy Director of Mental Health Services. T. G. Caunt, M.D., Medical Superintendent. Frederick A. Matheson, Business Manager. PROVINCIAL MENTAL HOSPITAL AND CREASE CLINIC OF PSYCHOLOGICAL MEDICINE, ESSONDALE B.A., M.D., CM., Clinical Director of Radiology. M.D., Director of Labo- Assistant F. E. McNair, Director. J. M. Iackson, M.D., G. A. Nicolson, B.A., ratories. W. P. Fister, M.D., M.R.C.P.(Edin.), F.R.C.P. (Can.), Director of Neurology. W. E. Powles, B.A., M.D., CM, Clinical Director. C. E. Derkson, M.D., CM. R. H. Lawler, M.D. N. L. Richardson, M.D., CM. G. H. Stephenson, M.D. E. E. Leyland, B.S., M.B.(Eng.). R. D. Nixon, B.A., M.D., CM. A. Yakushavich, B.A., M.D., CM. A. P. Gould, M.D., CM. E. S. Gurushantappa, M.B., B.S. (India). T. P. Millar, B.A., M.D., CM. P. DeKoven, M.D. K. G. Phin, B.A., M.D., CM. I. Kenning, B.Sc, M.D., CM. J. Walsh, M.B., B.Ch.(Ireland), D.P.M. T. Dobreva, M.D.(Prague). R. Halliday, M.B., B.Ch.(Ireland), D.P.M. J. W. Hill, M.D. F. G. Tucker, M.B., B.S.(Eng.). H. O. Iohnsen, D.D.S. C. B. Watson, M.A., Administrative Assistant. Miss A. J. Elart, B.A., Psychological Clinic Assistant. J. W. Borthwick, B.A., Psychological Clinic Assistant. W. R. Brown, Director of Recreation. K. Woolcock, Pharmacist. G. H. Walker, Audio-Visual Department. W. Creber, Chief Male Psychiatric Nurse. Miss E. M. Pullan, R.N., B.A.Sc, Director of Nursing. Miss O. J. Smith, B.A., R.N., Instructor of Nursing. Miss A. K. Carroll, B.A., M.S.W., Supervisor, Psychiatric Social Service. Miss H. V. R. Pelling, Chief Dietitian. Mrs. K. Draper, B.A., O.T.Reg., Supervisor, Occupational Therapy (Women's Division). R. Herring, Supervisor, Occupational Therapy (Men's Division). D. Addison, Rehabilitation Officer (Men's Division). Mrs. I. H. Wedge, Branch Secretary. Miss A. D. Dingle, Senior Stenographer. Consultant Staff: F. A. Turnbull, B.A., M.D., F.R.CS.(Can.), Neurosurgery. Iames W. Wilson, M.D., CM., F.R.CS.(Can.), M.S.(Minn.), General Surgery. George T. Wilson, B.A., M.D., CM., F.R.C.S.(Can.), General Surgery. Business: I. F. Anderson, Assistant Business Manager. L. Fox, Paymaster. G. A. Grieve, Cost Accountant. Rev. Iohn F. O'Neil, Protestant. W. Gueho, Cashier. R. Boulter, Steward. Miss A. Mikita, Business Stenographer. Chaplains: Rev. Father J. P. Kane, Roman Catholic. Trades: W. R. Meadows, B.E.(CE.,), Superintendent of Public Works. T. Lamb, Foreman of Works. I. Wright, Chief Engineer. W. R. Parks, Gardener Foreman. T. Harrison, Electrician. G. Matthews, Plumber. Colony Farm: W. B. Richardson, B.Sc. (Agriculture), Superintendent. J. C. Purse, Head Tailor. D. Anderson, Laundryman. A. L. Blair, Barber. W. A. Wardle, Chief Cook. J. C. Merrick, Baker. H. Young, Chief Painter. 11 T 12 MENTAL HEALTH SERVICES REPORT, 1952-53 THE WOODLANDS SCHOOL, NEW WESTMINSTER L. E. Sauriol, M.D., CM., F.A.P.A., F.A.A.M.D., Medical Superintendent. C. E. Benwell, M.B., Deputy Medical Superintendent. R. D. S. Herrick, M.D., D.P.H., D.P.M. A. Gallinger, M.D., CM. M. C. Muckhart, M.B.(Glasgow). H. MacCrostie, D.D.S. Miss V. M. Sanders, R.N., Superintendent of Nurses. Miss A. M. Paterson, B.H.E., Dietitian. Miss M. C. Hardy, Supervisor, Psychiatric Social Work. P. Barteluk, X-ray Technician. Mrs. A. I. Rhodes, School Principal. H. Mercer, Industrial Arts Instructor. J. Lynes, Recreational Instructor. Mrs. M. E. Iones, Occupational Therapist. J. Elliot, Chief Male Psychiatric Nurse. R. Nash, Instructor, Male Psychiatric Nursing. Miss C. Cohen, B.A., Psychological Clinic Assistant. J. B. Woodward, B.A., Psychological Clinic Assistant (on active service). Mrs. M. G. Macgowan, Clerk-Stenographer. W. O. Booth, Deputy Business Manager. Rev. P. C. McCrae, Protestant. C. M. Doyle, Foreman of Works. C. Hauck, Chief Engineer. W. Mercer, Carpenter Foreman. C. Stapleton, Head Gardener. L. S. Davies, Assistant Foreman. G. Coulson, Laundry Manager. P. Brian, Plasterer and Tile-setter. Business: A. Fraser, Steward. Chaplains: Rev. Father D. J. McIntosh, Roman Catholic. Trades: H. W. Brownjohn, Plumber. R. T. Ballard, Shoemaker. L. Arnold, Barber. Mrs. S. DeCoene, Hairdresser. J. Fraser, Head Painter. W. Jenkins, Head Cook. PROVINCIAL MENTAL HOME, COLQUITZ L. G. C. d'Easum, M.D., Medical Superintendent. A. C. C. Loat, Deputy Business Manager. P. McLeod, Chief Male Psychiatric Nurse. HOMES FOR THE AGED B. F. Bryson, B.A., M.D., CM., Medical Superintendent. A. G. MacKinnon, M.D., CM., Medical Super- W. E. Skillicorn, Supervisor, Terrace, intendent, Vernon. CHILD GUIDANCE CLINICS U. P. Byrne, M.D., D.P.H., D.I.H., Director. G. M. Kirkpatrick, M.D. Miss M. Munro, M.A., Supervising Psycholo- L. I. M. Coleman, B.Sc, M.D., CM. gist. W. L. Valens, M.D., CM. D. B. Ricketts, B.A., M.S.W., Supervisor, Psy- Mrs. M. Harvey, R.N., B.A.Sc, Public Health chiatric Social Service. Nurse. RESEARCH DIVISION W. C. Gibson, B.A., M.Sc, M.D., CM., D.Phil.(Oxon.), Director. > o o-g a o >,g -a—-S su w (2 « CO m W 3 oo B W t<0 w H i a a «? H Z w l-H u z l-H > o Pi Ph w u > C M H co .2 a > 0 SB O SB H 9 v, O <o pq < a w 3 '§£? « PQ S ■J _ >i (U w S.S to __c •-D S D 2 ° Q co a w 0 -g.H- 2£ N u H — TO H ri jo D §2 —o—§ s J 11 3 co O 0 B. HJ H CO 7- c d3 a 2 —H- to "Is UJ ?S J3 0 ft aa 3 U 3 S eo fiua ID /-. t/_ __Q < .2 0 •os u _. _SS j II ' Vi cj Cm C3 2 .3 = 13 a £*3 -E C"3ih -||8— 8- ^1 Sou -lav 0 0 -E o a (H on i& 5 «>— B -o £ H w u _E 13 T 14 MENTAL HEALTH SERVICES REPORT, 1952-53 Dr. E. J. Ryan. REPORT OF MENTAL HEALTH SERVICES For the Twelve Months Ended March 31st, 1953 PART I.—MEDICAL REPORT OF DIRECTOR OF MENTAL HEALTH SERVICES R. A. Pennington, Esq., O.B.E., F.C.I.S., Deputy Provincial Secretary, Parliament Buildings, Victoria, B.C. Sir,—In compliance with the " Mental Hospitals Act," the Eighty-first Annual Report of the British Columbia Mental Health Services is submitted herewith. HISTORICAL The earliest record of a mentally ill person in British Columbia dates back to the year 1850. At this time a young Scotch immigrant became mentally ill soon after his arrival in the country. As no facilities were available for treatment, the difficulty was solved by sending him home on a sailing-vessel. It is reported that during the voyage home the patient made a good recovery. During the years 1858 and 1859 there was a great influx of people to the gold-fields in the Cariboo. Victoria, which at that time was a Hudson's Bay Company post, was the chief outfitting depot and point of departure for the Interior. It was the chief port of call for ships coming from San Francisco. Many of the new-comers broke down under the strains and hardships, and had to be returned to California. Following this sequence of events, arrangements were made whereby mental patients from this area were cared for by the mental hospital in California. This generous arrangement on the part of the American authorities was not allowed to continue for long, and in the early sixties it became necessary to house mental patients in the Victoria Gaol. The gaol of those days was a hewn-log structure containing twelve cells; this was replaced some years later by a brick administrative building two stories in height. This site was the same as is now occupied by the Law Courts on Bastion Street. As the gaol cells overflowed with patients, the milder cases were transferred to the Royal Hospital. The Royal Hospital was originally a " pest house," and so was located outside the city on an Indian reserve across the harbour. Both the gaol and the Royal Hospital admitted only men, and a real problem presented itself with the appearance of the first female patient. The problem was met by taking over the Royal Hospital and converting it into the first " Provincial asylum." Thus, on October 12th, 1872, the Mental Health Services of this Province had their humble beginning in a converted " pest house " in Victoria. The management of this new institution was placed under the Provincial Secretary's Department, where the Mental Health Services have remained since inception. Records show that on the opening-day seven patients were admitted. Seven staff members were appointed to operate the " hospital." All matters pertaining to the mentally ill had, up to that time, been carried out without benefit of any special legislation. In 1873 an Act was passed known as the " Insane Asylums Act." 15 T 16 MENTAL HEALTH SERVICES REPORT, 1952-53 In 1877, with a patient population of 37, it was decided that this site could no longer expand to meet the demands, and a decision was reached to move the institution to New Westminster and locate on a Government reserve. The site chosen is that presently occupied by The Woodlands School, the branch of the Mental Health Services caring for the mentally defective group. The first building was erected in the fiscal year 1877-78 at a cost of $24,000. The transfer of 38 patients was effected during the month of May, 1878. The first annual report was published in 1882. It shows that the number of patients had increased to 49, and that overcrowding was becoming intolerable. In 1884 an additional wing was added at a cost of $26,000, providing now for a total bed capacity of 70. Further construction was delayed until 1889, at which time a central administration building was erected and an additional wing added, bringing the capacity to 165 patients. In 1896 it is reported that the wards were "full to overflowing," there being 171 patients in residence. One new building was completed in 1898 to accommodate 55 men, and in 1900 a second building was completed to accommodate a similar number of women. In 1897 the " Hospitals for the Insane Act " superseded the " Insane Asylums Act " of 1873, and the institution became officially known as the Public Hospital for the Insane. Thus, at the close of the century, the hospital had grown until it possessed ten wards and one cottage, with a capacity of 310 patients. Up to this date $155,000 had been spent on construction. During 1904 the Government secured 1,000 acres at the junction of the Coquitlam and Fraser Rivers for future expansion. On July 10th, 1904, a start was made in the work of clearing land and erecting temporary buildings. Eighteen patients, supervised by two staff members, made an initial start on what later was to become the Essondale site of future developments. Clearing and dyking of the land continued over the next few years, and in 1909 construction was commenced on the first patient unit. The site was named in honour of Dr. Henry Esson Young, who at that time was Provincial Secretary. The first unit was opened at Essondale on April 1st, 1913. This building, now known as the West Lawn Building, was originally constructed to house 480 patients. At the present time 1,031 patients are in residence. At the end of that year a total of 919 patients were under care, 683 of whom were men and 236 were women. The admissions for the year were 380; of these, 276 were men and 104 were women. No additional construction was undertaken for some years, and in 1919 further expansion became necessary. A Provincial gaol at Colquitz was taken over by the Provincial Secretary and converted for the use of a group of mental patients who had been convicted of crimes. The building was occupied on March 25th, 1919, when 9 such patients were transferred from the New Westminster unit. Though entirely unsuitable for the care of mental patients, this building still functions as a unit of the Mental Health Services. The year 1924 saw a pronounced step forward in the treatment and care of the mentally ill of the Province with the opening of the second building in the Essondale area. On November 1st, 1924, the Acute Building, or Centre Lawn Building as it is now known, was opened as a receiving centre, and all future admissions were received here, while the admitting service at the New Westminster unit was discontinued. The original capacity of this building was 300 patients, and at the present time it accommodates 489. During this year the institution rapidly began to assume its proper role as a treatment centre, rightly deserving the name " mental hospital." It was in 1924 that the first registered nurse made her appearance as Superintendent of the Nursing Department. Great stimulus was given to the development of organized departments of occupational therapy. In 1926 the first specific therapy for a mental illness was undertaken, with the introduction of intravenous tryparsamide combined with therapeutic malaria for the DIRECTOR'S REPORT T 17 treatment of general paresis and cerebro-spinal syphilis. At this time syphilis was responsible for 6 to 8 per cent of admissions. Subsequent treatment has reduced the incidence of syphilis as a causative factor of mental illness to the vanishing-point. Overcrowding again became very apparent, and in the year 1930 the third large building was opened at Essondale. This building was occupied on October 2nd of that year, and was known as the Female Building, and later renamed East Lawn Building. Again a large group of patients were moved from the New Westminster Hospital, and a better classification of patients was made possible. The building had at the time of construction a rated capacity of 675 patients. The building now houses 1,469 patients. During the same year occupational therapy, as such, received considerable impetus with the appointment of the first trained occupational therapist. Further stimulus to the programme came in 1930 with the appointment of the first social service worker to the staff and subsequent organization of a social service department. During 1932 first concrete efforts toward prevention were developed with the opening on July 15th of the first unit of the Child Guidance Clinic in Vancouver. On September 12th, 1934, a second unit was opened in Victoria. Coincident with these developments of a more active treatment programme was the organization of the nurses' training-school, and subsequent first graduation exercises in 1932. It was at this time that the decision was made to convert the old parent institution in New Westminster to the care of the feeble-minded. A start on remodelling the structure was made in 1930. Complete remodelling of both the interior and exterior was completed by 1945. The population of the hospital continued to rise, and on December 4th, 1934, a new unit was opened at Essondale to house the veteran patients. This building subsequently became the west wing of the completed Crease Clinic. At that time there were in residence 3,080 patients. Due to economic depression and war no new construction was undertaken during the twelve-year period from 1934 to 1946. During this long interval the hospital population rose to 4,151 patients, with resulting overcrowding. The situation became so desperate that immediate space had to be made available. In 1935 the " Provincial Home for the Aged Act " was passed and certain cottages were made available at the adjacent Boys' Industrial School for the use of aged mental patients. The first of these buildings was occupied on May 14th, 1936. Five units in all were taken over from the school—three for patient occupancy, one as a kitchen unit, and one as a nurses' home and administration unit. These buildings formed the nucleus for future developments of the Home for the Aged, Port Coquitlam. A new 100-bed unit was specially constructed for the care of the aged and was occupied on June 27th, 1946, while another unit, also to accommodate 100 patients, was occupied on June 11th, 1947. The pressure upon the Mental Hospital continued, and the problem of overcrowding remained acute. In addition, increased numbers of senile patients were being presented for admission. In order to provide some measure of relief, both to the community and the Mental Hospital, the Government purchased from the War Assets Corporation the Vernon Military Hospital. This structure was given a very thorough renovation and was equipped to function as a Home for the Aged. The building was ready for occupation in the late spring of 1948, but the disastrous floods of that year delayed matters. Finally, on July 4th this new unit was officially opened, and on July 7th the first patients, 137 in number, arrived by special train from Essondale. Later in the year the number in residence was raised to 200, and since then the accommodation has increased to 239. The patients sent to Vernon were specially selected ambulant senile persons for whom the special facilities of the Mental Hospital and Home for the Aged, Port Coquitlam, were not essential. T 18 MENTAL HEALTH SERVICES REPORT, 1952-53 While the new Home for the Aged unit at Vernon provided some relief from the problem presented by the ever-increasing demands for accommodation for the senile, the facilities were soon taxed to capacity. Therefore, in 1949 plans were made to convert the Terrace Military Hospital for use as a Home for the Aged. By the fall of 1950 the hospital had been renovated and converted to its special use, and on October 3rd a group of 153 elderly male patients was moved to Terrace by special train. The next year another group of elderly men was sent to the Terrace Home for the Aged, thus utilizing it to its total capacity of 300. The need for accommodation for the senile has continued to grow, and the most recent beds added to the Geriatric Division are those in the third 100-bed unit at the Port Coquitlam Home for the Aged. These were occupied in 1952. The total accommodation for the psychotic senile in the Provincial Homes for the Aged on March 31st, 1953, was 1,036, or 88.9 beds per 100,000 of the general population of the Province. With the end of the war in 1945, great efforts were made to improve the mental- health facilities of the Province, and these efforts were sustained by an upsurge of public criticism over the unsatisfactory conditions found to exist in some American mental hospitals. While conditions in the British Columbia hospitals never approached the state complained of by the press, nevertheless there was scope for improvement following the inevitable neglect and understaffing of the war years. An early start was made to provide a high-quality residential training centre for the mentally subnormal in the mental hospital at New Westminster. In 1945 a modern school building incorporating an auditorium-gymnasium was opened and the staff of teaching specialists was increased to five. At the same time the programme of vocational training in the domestic and manual arts was reorganized under specialist instructors, while the socialization of these subnormal children received considerable impetus by the appointment of a recreational therapist. As a result of all this educational activity and emphasis, it soon became apparent that this institution could not be truly considered a mental hospital, and accordingly in 1950 the Government granted permission to redesignate the New Westminster institution The Woodlands School. The need to provide more accommodation for the mentally defective became very urgent, and a further building programme was begun. The first of a series of four specially designed reinforced-concrete buildings was opened in February, 1950. The remaining three were opened in 1952, and this new construction raised the capacity of The Woodlands School to 1,182 patients. While the new buildings provided more space for patients, they also permitted an expansion of the various service departments. Thus modern dental and X-ray suites were provided and equipped. A clinical laboratory and dispensary were set up. Provision was made for an admission suite in order that patients might be admitted direct to The Woodlands School without the necessity of being committed to the Provincial Mental Hospital, Essondale. The final step in developing The Woodlands School as the specialized unit of the Mental Health Services for the care and training of the mentally defective was taken by the Spring Session of the 1953 Legislature, when the "Schools for Mental Defectives Act" was passed. Undoubtedly the most significant development in the Provincial Mental Health Services in recent times has been the provision of an active treatment centre for the attack upon mental illness in its early phases. This centre is situated at Essondale, adjacent to the Provincial Mental Hospital, and is known as the Crease Clinic of Psychological Medicine. The contract for this building was let in 1946, and the Clinic was officially opened on November 16th, 1949. The Clinic is a four-story modern structure consisting of three elements: (1) The West Wing, housing the men's wards (formerly known as the DIRECTOR'S REPORT T 19 Veterans' Block and opened in 1934); (2) the East Wing, housing the women's wards; and (3) the Central Wing, incorporating the administrative headquarters of the Mental Health Services and the specialized medical departments for investigation, diagnosis, and teaching. Accommodation for 312 patients is provided in this unit. In order that the active treatment centre might serve the group of mentally ill for whom its facilities were especially designed, it was considered desirable that patients should have access to it as freely as possible. Accordingly, the " Clinics of Psychological Medicine Act" was passed by the Legislature in 1948. This Act makes provision for admission upon the voluntary application of the patient, or by the medical certification of two physicians upon the application of a relative or other interested responsible person. There is, thus, no legal committal with consequent loss of civil rights. Furthermore, the Act does not permit a person to remain in the Crease Clinic for longer than four months. The first patients were received in the Clinic building on April 3rd, 1950, and until December, 1950, this unit served as the admitting centre for the Provincial Mental Hospital, Essondale. The " Clinics of Psychological Medicine Act " was proclaimed effective on January 1st, 1951, and on that date the first patients to receive active intensive therapy under its provisions were admitted. The Provincial Mental Hospital experienced many very serious problems in the early post-war years, including the overcrowded conditions and the lack of staff. The latter situation was not improved without a sustained recruiting programme, aided by the introduction of the eight-hour day in 1947 and a considerable improvement in the salary schedule for nursing personnel. With reference to the overcrowding, the situation has not been so happy. The pressure was relieved from time to time by means of the new beds provided in the Homes for the Aged and The Woodlands School. However, the vacancies created when patients were moved to these units were immediately filled, and the reduced state of overcrowding was only of short duration. To-day the overcrowding in the wards of the continued- treatment buildings, with consequent excessive demand upon the utility services, constitutes a major problem. As noted, the veterans were for some years housed in the West Wing of the Crease Clinic, and in order that this new unit might function, alternative accommodation had to be provided. This was accomplished by erecting a new 295-bed reinforced-concrete structure of modern design situated on Colony Farm. At the present time the North Lawn Building is under construction, and it is anticipated that it will be ready for occupation in 1955. It is a 230-bed hospital unit for the care and treatment of mental patients suffering from tuberculosis, with a limited accommodation for patients with other infectious diseases. Needless to say, the increased bed accommodation provided in the Mental Health Services since the end of the war has necessitated an expansion of many of the service facilities in the hospital plants. New nurses' homes have been constructed at Essondale and New Westminster, adding about 150 staff beds to each unit. The bakeshop at Essondale has been enlarged and equipped throughout with modern machinery. The boiler capacity in the hospital power plants has been increased to serve the new buildings. A four-story combined stores and laundry building is now in the final stages of construction at Essondale. The latest laundry and dry-cleaning equipment is being installed. In the stores section there is ample cold-storage space for perishables, and a modern butcher-shop is provided. At Colony Farm the best of modern dairy equipment has been installed including a homogenizer. The most recent major development in the Mental Health Services has been the establishment of a Research Division. This unit has been organized on the campus of T 20 MENTAL HEALTH SERVICES REPORT, 1952-53 the University of British Columbia, and it is operated upon a co-operative basis with the Faculty of Medicine. Our major research emphasis at this time lies in the field of neurophysiology, where efforts are being made to develop a non-empirical basis for therapy. We are also carrying on studies of the relationship between brain-wave patterns, as recorded by the E.E.G., and personality with a view to obtaining a better understanding of psychopathic personalities. PROGRESS Historically, the first mental-health need to be met in British Columbia was the protection of society from the aggressive behaviour of the dangerously psychotic. It has been recounted above how the gaol and, later, the pest house were employed for this purpose. One can speculate upon the fate of the benign, confused mental patients who wandered away from the settlements and were not seen again. Certainly their plight was not long in being recognized, for, with the establishment of the first Provincial Asylum in 1872, it is evident that the second mental-health need of the Province received recognition in that society made provision for the custodial care of those who by reason of their symptoms were dangerous to themselves. The full details of the early developments will not be reviewed here. It is sufficient to state that the first fifty years—ending with World War I—saw a steady progress to more humane care in the essentials of food, shelter, and clothing; the introduction and development of programmes of occupation and recreation in place of segregation and restraint and, finally, an increasing interest by the medical profession in the needs of the mentally ill. Perhaps the most important advance of the twenties was the transition to a " hospital " point of view. This transition was facilitated by the appointment of young well-trained physicians who, with the encouragement of the administration, introduced, expanded, and modernized the various medical services, such as the laboratories, the radiology department, and the surgeries. To provide the higher level of medical and psychiatric care envisaged by the medical staff, it was necessary to introduce and develop a modern nursing service. The first registered nurse was appointed in 1924, and not long after the Training School for Nurses (now the School of Psychiatric Nursing) was established. It would be difficult to overestimate the improvement in patient care made possible by the provision of a competently trained nursing staff. Other major developments in this period were the appointment of the first trained occupational therapist in 1930, and the appointment of the first social worker in the same year. The services commenced by these pioneer employees have expanded greatly, until to-day each is making a major contribution to the treatment programme. Physical treatment in psychiatry gained in popularity following the successful employment of fever therapy in general paralysis of the insane. This treatment, combined with intravenous tryparsamide, was introduced to the British Columbia mental hospitals in 1926. An exceedingly important advance in the treatment of schizophrenia was the introduction of insulin coma therapy in 1937. This mode of therapy, while it requires a high proportion of staff to patients, is very successful in arresting the progress of the schizophrenic process. Thus the course of the illness is shortened, and many patients are able to be restored to the family and community as functioning personalities. Formerly a vast number of schizophrenics never recovered, but remained hospital residents for twenty or more years, gradually becoming more and more deteriorated and withdrawn from reality. In 1939 metrazol convulsive therapy was first utilized, to be superseded by electroconvulsive therapy in 1942. Experience has shown that the latter is the preferable treatment. With endogenous depressions, electro-convulsive therapy is now regarded as specific. This is a safe and rapid form of treatment, and its use has remarkably shortened DIRECTOR'S REPORT T 21 the duration of depressions, with a consequent extinction of psychic suffering and reduction in the period of hospitalization. While this type of treatment necessitates the provision of larger numbers of trained medical and nursing personnel, it is justified by the high discharge rate of patients receiving this type of therapy. Formerly the period of hospitalization for treatment of depression extended from a year to eighteen months, with concurrent risk of suicide. To-day such cases are relieved of their acute symptoms, stabilized and rehabilitated in four months or less. Lobotomy was first employed in our hospital in 1945, when a group of disturbed patients of long standing was selected for the treatment. The results were encouraging, and we have since evolved criteria for the selection of patients who respond well to this neurosurgical procedure. In highly selected cases that have proved intractible to other therapeutic approaches, lobotomy has been the means of securing a relief from disturbing and disabling symptoms, with consequent healthier adjustment to the life of a hospital resident, while in other cases, after a period of intensive re-education, it has been possible to discharge some patients to their homes and gainful employment. At the conclusion of World War II profound changes occurred in the Mental Health Services. Many who had gained experience in neuro-psychiatric installations of the armed services returned to the staff or joined for the first time. They brought with them an attitude of optimism with respect to therapy in mental conditions, and their enthusiasm was supported by the administration. Thus was commenced a programme of " total push," which has utilized every therapeutic modality available for the cure of the mentally afflicted. The Clinical Psychology Department, which was first established in 1937, grew rapidly and, by means of the provision of internships, attracted young graduates from the universities. The post-war years witnessed a great increase in interest in mental-health problems by the universities, with the result that greatly improved courses of instruction were made available to the students in medicine, nursing, social work, and clinical psychology. We were fortunate in being able to attract numerous recent graduates in all these specialized fields to our institutions and clinics. The Royal College of Physicians and Surgeons (Canada) established standards to be met by those physicians who intended to specialize in psychiatry, and we were able to add to our staff young residents in training who, while they came to us for experience, brought with them enthusiasm for the newer methods being developed in university centres. A particularly significant contribution by this group has been a great increase in psychotherapy, both individual and group, and the spread of therapeutic attitudes to all patient- care staff. There was also an increased awareness of the importance of organic factors in the etiology of mental illness, and this trend is reflected in the development of a Department of Neurology at Essondale in 1947. The neurologist was granted a year of postgraduate study at the Montreal Neurological Institute, and modern diagnostic apparatus was installed in the Crease Clinic. Included in this apparatus were an eight-channel electroencephalograph and eight-channel electrocorticograph, a wave-frequency analyser, and complete facilities for pneumoencephalography. Noteworthy among the ancillary services is the Department of Recreational Therapy. This service was formally set up in 1945, and very rapidly made a significant contribution to the welfare of the patients, and its varied programme of activities has provided for the interests of all. The opening of Pennington Hall, the Recreational Therapy Centre, may be regarded as the culmination of the phenomenal growth of this necessary adjunct to the practice of psychiatry. The Audio-Visual Department was reorganized and its scope extended in 1947. This department has provided a programme of movies and wired music, and has thereby assisted the patients to maintain and develop community interests. The Audio-Visual T 22 MENTAL HEALTH SERVICES REPORT, 1952-53 Department is also housed in Pennington Hall, where, for the first time, they have the advantages of an adequate auditorium. It was found that by proceeding with an active " total push " programme there was developed simultaneously a need for several complementary services. Great reliance was placed upon the Social Service Department, and, as a result, there was a rapid growth both in numbers and in the quality of the professional training. Thus the Social workers were able to provide improved services to the patients and their relatives by means of their special skills in casework. The need for rehabilitation services for patients about to be discharged became more and more evident, and in 1947 the Mental Health Services took over the operation of The Vista in Vancouver as a rehabilitation centre for women. The needs of men on discharge were met by the provision of a Rehabilitation Officer, who assisted those in need of employment to become re-established. ORGANIZATION There have been no major changes in the over-all organization of the Services during the past year. Much has, however, been accomplished toward the delineation of the three major groups of patients coming under our care—the psychotic, the mental defective, and the senile. Up to the present time the mental-health legislation of this Province has not differentiated between mental illness and mental deficiency, so that both mentally ill and mentally defective patients have been accepted by the Provincial Mental Hospital, Essondale. In order that the special needs of the mentally defective person might be met, patients of this type have been transferred to the New Westminster unit of the Mental Hospital as accommodation became available. Over the past fifteen years the New Westminster unit has been remodelled and expanded to prepare it for its special function as a residential hospital-school for the care and training of the mentally defective child and young adult, and in 1950 it was officially renamed The Woodlands School. On March 27th, 1953, the Legislative Assembly of the Province assented to an Act relating to mental defectives, cited as the " School for Mental Defectives Act." This new Act will become effective on October 1st, 1953. After that date all mentally defective patients will be admitted directly to The Woodlands School. The regulations respecting the admission of patients made pursuant to the Act place admissions in the discretion of the Medical Superintendent. Plans for further construction are presently on the draughting-boards, and it is hoped that, in the not too distant future, restrictions on admissions may be removed. Similarly, plans are being evolved for further construction in the Geriatric Division at Port Coquitlam. With the completion of this new admitting unit, it is hoped that admissions may be made directly to the aged section without prior admission to the Mental Hospital at Essondale. When this has been accomplished, we will be able to better segregate these three groups and render more efficient service. In addition, our statistical tables will become more meaningful. To this end, the Division of Vital Statistics will take over the compilation of our statistical tables, effective April 1st, 1953. It is with sincere regret that I record the death of Dr. E. J. Ryan, our Senior Medical Superintendent. The late Dr. Ryan joined the staff on February 26th, 1917. He became Assistant Medical Superintendent at the New Westminster unit in 1921 and was transferred to Essondale in 1930. Dr. Ryan was made Medical Superintendent in 1935 and was accorded the title Senior Medical Superintendent in 1950. He contributed much to the development of the service during a professional lifetime. The loss of Dr. Ryan from the senior staff necessitated some organizational changes, resulting in the appointment of Dr. A. E. Davidson as Deputy Director of Mental Health Services, Dr. T. G. Caunt as Medical Superintendent of the Mental Hospital at Esson- DIRECTOR'S REPORT T 23 dale and the Crease Clinic, Dr. B. F. Bryson as Medical Superintendent of the Homes for the Aged, and Dr. F. E. McNair as Clinical Director in the Essondale area. In order to strengthen the treatment supervision, Dr. W. E. Powles was designated as Assistant Clinical Director. We are still experiencing difficulty in obtaining trained psychiatrists, but this condition will improve as more of our physicians complete their training period. The policy of furthering assistance toward the training of professional personnel is paying good dividends in the development of a stable professional staff. The Nursing Panel set up some years ago greatly facilitates matters with reference to promotions, appointments, and discipline. The Panel is chaired by Dr. Davidson. There has been a great turnover in medical residents, although no difficulty is being experienced in obtaining a sufficient number of replacements. Last year it was found advantageous to remove the appointment of resident physicians from Civil Service, due to the fact that the majority of physicians came to us for one or two years' experience as part of their training programme. The requirements for training in the specialty of psychiatry are laid down by the Royal College of Physicians and Surgeons (Canada). The College advises that no physician proceeding to certification should receive all of his training in any one centre. It is therefore conceivable that we will continue to have a great interchange of junior physicians. Due to the sudden resignation of Professor W. D. Ross from the chair of psychiatry at the University, I regret that a definite training programme has not been worked out for our residents in training. It is hoped that such a training programme may ultimately come under the supervision of the Medical School of the University of British Columbia. The religious aspects of our treatment programme have been strengthened by the half-time appointment of Rev. F. J. O'Neil to the staff. It is hoped that in the coming year arrangements may be completed for Mr. O'Neil's full-time appointment. On May 27th a course of instruction in civil defence was initiated. Thirty-two staff members enrolled in this first course. A good deal of attention has been given to matters relating to the protection of the hospital and also the organization of our hospital staff as a possible reception centre in the event of a major catastrophe. The basic No. 2 course in civil defence was started in February. Courses were held in the fire-hall under the capable leadership of Fire Chief A. P. Lowry. The course was opened by an address from Air Vice-Marshal Heakes. Over 100 staff members have now completed courses. ADMISSIONS AND SEPARATIONS Table I.—Showing Patients in Residence, April 1st, 1952, and March 31st, 1953, by Institutions Institution In Residence, Apr. 1, 1952 Men Women Total In Residence, Mar. 31, 1953 Men Women Total 111 132 243 1,764 1,655 3,419 287 287 628 457 1,085 150 320 470 107 127 234 290 290 3,337 2,691 6,028 Increase (+) or Decrease (—) Crease Clinic Mental Hospital, Essondale.. Mental Hospital, Colquitz The Woodlands School Home for the Aged, Port Coquitlam.. Home for the Aged, Vernon Home for the Aged, Terrace Totals 100 115 215 1,843 1,641 3,484 286 286 439 369 808 158 260 418 106 128 234 293 293 2,513 | 5,738 I +28 -65 — 1 +277 +52 -3 +290 Table I shows at a glance the number of patients in residence in each of the institutions at the beginning and at the end of the fiscal year 1952-53. The degree in which we have been successful in bringing about a better reclassification of patients is evident. It T 24 MENTAL HEALTH SERVICES REPORT, 1952-53 should be noted that, in spite of a heavy admission load to the Mental Hospital, we have been able to relieve the desperate overcrowding in the Essondale unit by 65 patients. This has been accomplished by the opening of new construction at The Woodlands School, accounting for the increase of 277 patients in that area. The in-residence population of the Crease Clinic shows little in the way of fluctuation, inasmuch as the maximum period of residence is set by Statute at four months. Only on one occasion has the maximum accommodation been taxed, and that only on the men's wing. Table II.—Mental Health Services, April 1st, 1952, to March 31st, 1953 Men Women Total Intake Psychotic and neurotic. Non-psychotic Senile Mentally defective.. Returned from probation _ Returned from escape Totals Separations Discharged in full to community- Discharged on probation Discharged on escape Deaths - Totals.. 849 168 140 113 33 5 923 39 101 111 35 1 1,772 207 241 224 68 6 1,308 1,210 2,518 746 183 20 247 708 178 9 137 1,196 1,032 1,454 361 29 384 2,228 Intake Separations Net increase.. Summary 2,518 2,228 290 Table II indicates the total admissions and separations, in broad diagnostic groups, in all institutions. Table III gives a comparative analysis of admissions over the past eight years. Table III. —Mental Health Services Year Total Admissions Admissions over 65 Years Admissions under 15 Years Voluntary Admissions Population Increase Index of Increase 1945-46 834 880 v 1,111 1,260 1,415 1,811 2,175 2,512 206 207 225 270 230 262 306 357 49 52 69 63 72 148 97 179 33 40 91 165 297 504 637 768 147 140 316 354 306 235 285 290 17.62 1946-47 1947-48 15.91 28.44 1948-49 -- 1949-50 1950-51 _ _ 28.09 21.62 12.98 1951 52 - - 13.05 1952 53 - 11.54 In reviewing these tables, one notes again that there is a heavy rise in the admission rate. However, in spite of it, the separations have kept pace and the increase of population per 100 admissions continues to fall. Reference to Table IV below shows that over one-half of the admissions to the Mental Health Services occurred in the Crease Clinic, where the return of the patient to the community is rapid. The continued rise in the admission rate merely indicates that a greater service is being provided to the public and that the public is accepting the available facilities more readily. It does not mean that there is any alarming increase in the incidence of mental illness. The increase in population is due, for the most part, to the increasing admission of the mentally defective and senile groups; 465 admissions fell into these two groups. DIRECTOR'S REPORT T 25 An interesting investigation into the life expectancy of patients admitted to the Home for the Aged reveals that the average male patient lives 15.1 months after admission, whereas the average female patient lives 28.42 months after admission. This is reflected in the death rate shown in Table II. I would draw your attention to the favourable increase in voluntary admissions, as set forth in Table III. This is probably the best single indication of an improving type of service; 768 patients, or 30 per cent of the total admissions, were by voluntary admission; 534 of these were to the Crease Clinic and 234 were to the Mental Hospital. Table IV.—Admissions and Separations, Crease Clinic, April 1st, 1952, to March 31st, 1953 Men Women Total Intake Psychotic and neurotic. Non-psychotic Totals.. Separations Discharged in full to community Discharged in full to Mental Hospital _ Deaths Totals- 509 20 687 5 518 675 1,196 25 529 692 1,221 431 72 15 612 57 6 1,043 129 21 1,193 Intake Separations.. Summary Net increase.. 1,221 1,193 28 Table IV shows the intake and separations taking place in the Crease Clinic during the twelve months under review. It will be noted than an increase in the admission rate has occurred; 963 patients were admitted the previous year in comparison to 1,221 in the current year. This is to be anticipated as facilities improve and as the public becomes educated to the acceptance of early treatment. In studying this table it must be remembered that all patients are discharged at the end of the four-month treatment period, by Statute. Discharge may be to the community or to the Mental Hospital by commitment. A total of 1,172 patients was separated, exclusive of deaths. Of this number, 89 per cent were returned to the community and only 11 per cent discharged to the Mental Hospital for a further and more prolonged treatment period. A recent effort was made to determine the sustained improvement, or recovery, of those patients discharged from the Clinic to the community. The first twelve-month period of operation of the Clinic was taken, and the discharges for that period were surveyed. It was found that one year after discharge 85.1 per cent of the group were still in the community, 9 per cent had returned to the Clinic for a further short treatment period, and 5.1 per cent had been admitted to the Mental Hospital. GENERAL COMMENTS Fortunately, we have been free this year from any major outbreak of infectious diseases in the Essondale area. This is largely due to the active immunization programme that is constantly being carried out in both the patient and staff populations. The problem of the infectious diseases of childhood is still a major one in The Woodlands School. Generally speaking, the health of the entire patient group has been satisfactory. Mental Health Week was observed throughout Canada during the week May 5th to 10th. A good deal of prominence was given to mental-health activities through the press and radio. The week's programme culminated with open house being held on May 9th I T 26 MENTAL HEALTH SERVICES REPORT, 1952-53 at The Woodslands School and the Crease Clinic. At the former institution, one of the new residential units was on display, as well as school and classroom activities. Seven hundred guests availed themselves of the opportunity to see these facilities. The attendance at the Crease Clinic during the afternoon and evening was estimated at 2,500. Many worth-while exhibits were arranged throughout the building, and the staff was well organized to supervise and conduct the guests. In addition to the Crease Clinic, the facilities of Pennington Hall were demonstrated. The event was a great success, and it was considered that much was accomplished in public education and the promotion of good public relations. The twenty-first graduation exercises in psychiatric nursing were held in the auditorium of the New Westminster Junior High School on May 8th. A capacity audience greeted the graduating class. The Deputy Provincial Secretary acted as chairman. The address to the graduating class was delivered by the Right Rev. Godfrey P. Gower, Bishop of New Westminster. One hundred and fifty-one graduates received diplomas in psychiatric nursing, and nine registered nurses received diplomas in postgraduate psychiatric nursing. The Canadian Mental Health Association held a dinner meeting in Vancouver on June 13th, at which meeting the British Columbia Division of the association was inaugurated. A board of directors and a scientific and advisory council were named. Dr. J. D. M. Griffin, the medical director of the parent association, addressed the group. It is hoped that a strong Provincial body will be developed and that much will be accomplished to further public education along the lines of mental-health activities. The fifth annual sports day was held at Essondale on August 28th. This annual feature of the recreational department concludes the summer outdoor activities, and is an event of great interest to the patient population. A full day of sports was held on the lower lawns. Hot-dogs, ice-cream, lemonade, and cookies were served from an outdoor food-bar. Some 1,500 patients spent the day on the lawns. The Vancouver Firemen's Band provided music for the occasion. We were pleased to have with us on that day our Minister, the Honourable W. D. Black, and the Deputy Minister, Mr. R. A. Pennington. A good deal of attention has been focused throughout the year on the problem of drug addiction. Meetings were held in Vancouver, sponsored by the Community Chest and Council. Federal and Provincial representatives were present from the Departments of Health and Welfare, the Provincial Secretary's Department, as well as law-enforcement representation. Subsequent meetings have been held throughout the year, and it has been proposed that a research project be undertaken covering those cases of drug addiction currently in Oakalla Prison Farm in an endeavour to determine the psychological components of these individuals, their background, and other related problems. Financial assistance is to be sought from Federal Mental Health Grants. The investigation and research are to be under the aegis of the University of British Columbia. I am pleased to report that we have been able to make the first step toward direct admission of mentally defective patients to The Woodlands School. Effective December 1st, 1952, arrangements were completed for the direct admission of children under 6 years of age. It is hoped that this will be enlarged to include all mentally defective patients in the not too distant future. The surgical suite has been opened for use. The suite was utilized for a short time for minor surgery. As the staff became acquainted with working facilities, general surgery was introduced. It is planned to add neurosurgery and orthopaedic surgery at a later date. The suite of rooms on West 2 Ward has been set up as an isolated unit for the post-operative care of surgical cases. Distinguished out-of-Province visitors included Professor McDonald Critchley, Dean of Medicine at the Institute of Neurology, Queen Square, London, England; Dr. C. A. Roberts, Director of the Division of Mental Health, Department of National Health and DIRECTOR'S REPORT T 27 Welfare, Ottawa; Dr. Samuel Laycock, Professor of Psychology, University of Saskatchewan; Dr. Daniel Blain, Medical Director, American Psychiatric Association, Washington, D.C.; the Honourable McKinnon Phillips, Minister of Health and Welfare, Province of Ontario; Dr. R. G. Montgomery, Director of Mental Health Services, Province of Ontario; and Mr. H. Cotman, Chief Auditor, Department of Health and Welfare, Ontario. During the year the Crease Clinic has been host to meetings of many organizations interested in the mental-health programme. We have been pleased to entertain the following groups: The Fraser Valley Firemen's Association, the Greater Vancouver Dietetics Association, the Neuro-psychiatric Section of the Vancouver Medical Association, the Mathewson Road Ratepayers' Association, British Columbia X-ray Technicians' Association, the British Columbia School Trustees' Association, and the British Columbia Society of Laboratory Technicians. Three new 100-bed units at The Woodlands School were occupied during the year. This gives us much needed space in this area, and has enabled the admission of many small children from the waiting-list, as well as provided for transferral of mentally defective children from the Essondale Mental Hospital. Tenders have been called for the construction of a new building at Essondale. This building, to be known as the North Lawn Building, is designed as an infectious unit and will house chiefly those men and women suffering from pulmonary tuberculosis. In addition, there is a unit for infectious cases other than tuberculosis. The building has an estimated capacity of 224. The service of the Child Guidance Clinic has been expanded with the establishment of a full-time operating unit at Victoria. This was made possible by securing the services of Dr. W. L. Valens as psychiatrist in charge. This unit gives service to the Vancouver Island area. MENTAL HEALTH GRANT The Government of Canada, through the Department of National Health and Welfare, again made available a sum of money to be used in improving the Mental Health Services in this Province. This grant is known as the Mental Health Grant and this was the fifth year that it has been made available to British Columbia. The patterns of administration and utilization of the grant this year closely follow those established in previous years. We have continued to receive the helpful understanding and cooperation of the Department of National Health and Welfare in the examination and approval of our project submissions. In 1952-53 the total expenditure was $357,339, some $10,000 more than in 1951-52. Reference to the major areas of expenditure is made in the succeeding paragraphs. Professional Training Miss Margaret Stewart completed one year of postgraduate study in psychiatric social work at McGill University in July, 1952. Dr. G. H. Stephenson commenced one year of postgraduate study in psychiatry at the University of Toronto in September, 1952. Dr. N. L. Richardson commenced one year of postgraduate study in psychiatry at McGill University in January, 1953. Dr. A. E. Davidson and Mr. F. A. Matheson attended the Fourth Annual Mental Hospitals Institute at Columbia, Ohio, in October. Mrs. J. C. Morton, of the Psychology Department of the Crease Clinic, attended Dr. Bruno Klopfer's ten-day workshop on the Rorschach method at Asilomar, Calif., in August. Dr. MacDonald Critchley, of the Institute of Neurology, Queen Square, London, England, conferred with our Neurologist and with our Research Director, and also presented a clinic on Huntington's chorea to the assembled medical staff. The visit of Dr. Critchley was made possible by an honorarium provided by the Mental Health Grant. T 28 MENTAL HEALTH SERVICES REPORT, 1952-53 Grants to the Department of Psychology and to the School of Social Work at the University of British Columbia were continued in 1952-53 but were again reduced in accordance with the established plan. The purpose of these grants is to aid in the provision of graduate instruction in clinical psychology and psychiatric social work in order that trained personnel in these fields may be available for the Mental Health Services. Two teachers from the public-school system completed the course in mental hygiene for teachers at the University of Toronto and returned to the Province in July. With the reopening of the schools in September, these teachers were appointed Mental Health Co-ordinators—one in North Vancouver and the other in Kelowna. Eight teachers in the school system have now completed the course at the University of Toronto, and, as a result of their work, we are able to detect a greater sensitivity to the mental-health needs of the school-child. Equipment and Supplies Occupational-therapy equipment and supplies were again authorized for the Crease Clinic and Provincial Mental Hospital at Essondale and for The Woodlands School at New Westminster. Our recreational-therapy programme has also benefited from supplies made available by the grant. Specialized laboratory equipment has been provided for our clinical laboratories and for the Research Colony at the University. The Research Colony was also provided with special facilities for the housing of the laboratory animals. For the first time it was possible to obtain a Mental Health Grant for our Geriatric Division, the necessary authority for the purchase of some equipment for the Home for the Aged at Vernon being granted. Community Mental-health Programmes As in previous years, the mental-hygiene programmes of the health departments of Vancouver and Victoria have received support through the provision of staff and travelling expenses. The Greater Vancouver Metropolitan Health Committee mental-health programme was aided by the provision of a bursary to permit a male social worker to take postgraduate studies in New York. The psychiatric services of the Vancouver General Hospital were again assisted by the provision of a grant to pay the salaries of a psychiatric social worker and an occupational therapist. St. Paul's Hospital in Vancouver was given a grant to purchase an electroencephalograph. The Royal Jubilee Hospital in Victoria was given a grant to obtain electro-convulsive therapy apparatus. Staff Increases The consultants in neurosurgery and general surgery were again supported by the Mental Health Grant, and a consultant in orthopaedic surgery was added. Continued support for our Rehabilitation Department was forthcoming, and the detailed report upon this service is printed elsewhere in this Report. The large projects to provide salaries for physicians, psychologists, laboratory technicians, occupational therapists, dietitians, and psychiatric nurses have been continued in 1952-53, and the provision of this personnel has done a great deal to make possible the active treatment programme. COUNCIL OF PSYCHIATRIC NURSES The annual meeting of the Council was held at Essondale on April 15th, 1952, and at this meeting the Chairman of the Council was empowered to authorize the Registrar to DIRECTOR'S REPORT T 29 issue licences to psychiatric nurses with credentials from a school of psychiatric nursing approved by the Council. This delegation of power by the Council alleviated the need for frequent meetings to the extent that there was only one other meeting in the year. There was only one change in the composition of the Council this year: Dr. A. L. Swanson resigned upon moving to Toronto, and the Hospital Council appointed Dr. B. F. Bryson, Medical Superintendent, Home for the Aged, Port Coquitlam, to replace him. No licences were cancelled or suspended in the year under review, but in one instance the Council declined to authorize the issuance of a licence. At the conclusion of the year there were 668 licensed psychiatric nurses in the Province, an increase of 312 over 1951-52. STAFF CHANGES We have maintained the policy of " in-service training " residencies for our junior physicians. Physicians come to us now for a period of twelve or twenty-four months, during which time they remain on temporary appointment. As a consequence, there are many changes occurring each spring. We have been fortunate to secure the services of several physicians who are completing their period of training and who look forward to joining our permanent staff. In the meantime we are continuing to send a small select group of physicians who are on the permanent staff to outside university centres for educational purposes. The following physicians received appointments during the year: Dr. W. L. Valens, Dr. E. S. Gurushantappa, Dr. C. E. Cobb, Dr. T. B. Millar, Dr. P. DeKoven, Dr. R. J. Hanna, Dr. M. C. Muckart, Dr. P. G. Phin, Dr. A. Gallinger, Dr. T. Dobreva, Dr. R. Holliday, Dr. J. Walsh, and Dr. J. W. Hill. The following resignations were received: Dr. A. J. E. Rowe, Dr. W. R. Laidlaw, Dr. I. Kent, Dr. S. W. Jackson, Dr. M. Bryant, Dr. A. L. Swanson, Dr. C. E. Cobb, Dr. A. K. Hancock, and Dr. K. G. Phin. Dr. L. I. M. Coleman returned to the staff following a two-year course of study in various English centres. Dr. P. M. McLean, specialist in orthopaedics, was appointed to the visiting staff. Dr. C. R. Young resigned from the dental staff, and Dr. G. D. Campbell was appointed to fill the vacancy. We have developed a very high-class dental service for the patient population in the Essondale area. The staff is now composed of two full-time dentists, a dental mechanic, and two dental assistants. The present year saw the retirement of many employees who had been with the service for long periods of time. The following were superannuated:— Essondale area: Mr. William Cross, Deputy Chief Psychiatric Nurse; Mr. J. H. Wilson, Chief Engineer; Mr. W. H. J. Moore, male nurse; Mr. R. P. Fogg, male nurse; Mr. H. J. Clark, male nurse; Mr. H. McAllister, male nurse; Mr. D. Paterson, garden foreman; Mr. C. E. Bess, farm employee; Mr. W. Headridge, storekeeper; and Mr. R. T. Hall, Director, Male Occupational Therapy Department. The Woodlands School: Mr. H. A. Myton, male nurse, and Mr. A. Waller, male nurse. Mental Hospital, Colquitz: Mr. J. M. Arnold, male nurse, and Mr. J. F. Stamford, stores clerk. It is with regret that I report the death of two employees in the service—Dr. E. J. Ryan, recorded elsewhere in this Report, and Mr. H. J. Mullin, male nurse, The Woodlands School. FUTURE POLICY There is no change in the general over-all statement of our future policy. It continues to be directed toward two aims:— T 30 MENTAL HEALTH SERVICES REPORT, 1952-53 (1) To further increase early active treatment facilities in order to prevent patients from entering into the long-treatment mental-hospital area: (2) To further alleviate the present overcrowded conditions that exist in our mental-hospital buildings. The overcrowded conditions presently existing in all of our buildings were brought about by the complete lack of expansion during the depression and subsequent war years. During the period between 1934 and 1946 no construction took place and no new beds were acquired. It was not until 1948 that any definite programme of expansion was undertaken. The Mental Health Services have constructed or acquired the following beds since 1948:— Essondale— Beds Veterans' unit 295 Crease Clinic 167 462 The Woodlands School— Cedar Cottage 177 Pine Cottage 160 Beech Cottage 120 Willow Cottage 120 Homes for the Aged— Port Coquitlam 100 Vernon 239 Terrace 300 577 639 • Total 1,678 During the past year the Government has given great impetus to the expansion of services to meet our needs. The North Lawn Building at Essondale is under construction. It will be available for occupancy early in 1955. It is to be utilized as an infectious building, and will provide adequate facilities for the modern treatment of those mental patients suffering from pulmonary tuberculosis as well as other infectious maladies. At the present time, plans are well under way for a 300-bed unit at The Woodlands School. This building is being planned to care for the crib cases as well as a group of sick and infirm older mental defectives. At the Home for the Aged, Port Coquitlam, it is planned to build a 300-bed admitting and sick-and-infirm unit. These architectural plans are in the preliminary stage. Plans are nearing completion for the new Child Guidance Clinic and Day Hospital Centre. In addition, plans are going forward for a new Recreational Therapy Centre for The Woodlands School and a Nurses' Home and Training Centre for the Essondale area. It is hoped that these plans will all be finalized and ready to tender for construction by early summer of 1954. ACKNOWLEDGMENTS It seems fitting to close a report of this nature with some expression of appreciation to the many individuals and organizations who have helped us to develop a better service. In the not too remote past, mental hospitals were operated in a complete state of isolation and seclusion from community life. Such isolation has had its origin in the minds of mental-hospital administrators, and an apparent rejection and complete lack of understanding of such programmes on the part of the general public. It has been further fostered by the remote geographic location of such institutions. However, I am glad to DIRECTOR'S REPORT T 31 report that year by year we are drawing closer to the communities of people whom we serve. The natural city growth is enveloping our institution, and modern means of travel have depreciated distances. In addition, the staff members of hospitals are no longer living within the institutional setting to the extent of former years, but now commute from adjacent cities. This in itself brings us in closer contact with the community. We look forward to the day when mental illness and mental hospitals will be accepted by the people in just the same manner that physical illness and general hospitals are accepted to-day. In spite of this general apathy, the public has in recent years shown great interest in the subject of mental health and particularly child development. A new phase in the development of public education began with the formation of the British Columbia Division of the Canadian Mental Health Association in June, 1952. This Provincial division has as its general objectives: To lessen the heavy toll of mental and emotional disorder, and to foster activity to raise the standard and knowledge of mental-health principles throughout the general population. The Mental Health Services have gained a great ally by the formation of this organization, and I commend it to you with my whole-hearted support. I would like to express my appreciation of the various veterans' organizations and the Women's Auxiliaries of the Canadian Legion. They have done much to add to the comforts of our veteran patients by personal visits and by the presentation of many gifts. A good number of concerts have been made available by organizations too numerous to mention. I would refer you to the report of the Recreational Department for details of the work carried out in this important treatment field. I would, however, like to mention the Vancouver Firemen's Band, who have over the years played for our annual sports day. Special mention should be made of the splendid co-operation existing between this department and other departments of the Government. Our work brings us into close association with the Departments of Health and Welfare, Public Works, the Attorney- General, and Finance, the Civil Service Commissioner, and others. I would like again this year to express my appreciation of the co-operation which this office receives from the British Columbia Government Employees' Association, the British Columbia Psychiatric Nurses' Association, and other organizations within our service. I would commend to you the superintendents and directors of the various divisions of the Mental Health Services, and refer you to their individual reports. I am pleased to report a very high degree of co-operative effort from all departments. As the services have grown, we have endeavoured to decentralize administration as much as possible, with the result that added responsibilities have been delegated. I would like, Sir, through you to convey my gratitude to the Honourable W. D. Black, who has championed our cause in an aggressive and effective manner. On his appointment to office, he readily assumed his obligations and rapidly familiarized himself with our problems by frequent personal visits to our institutions. We look forward to great improvement and expansion of our services to the public. To you, Mr. Pennington, I convey the gratitude of the entire staff for the splendid leadership which you have given over the years. Your personal knowledge and close contact with all our own problems has enabled you to interpret our needs to legislative bodies. The improvements which have taken place in our services during recent years are in large part attributable to your endeavours. I have the honour to be, Sir, Your obedient servant, A. M. Gee, M.D., CM., Director of Mental Health Services. T 32 MENTAL HEALTH SERVICES REPORT, 1952-53 Graduation ceremonies, April 30th, 1953. REPORT OF THE CREASE CLINIC T 33 REPORT OF THE CREASE CLINIC OF PSYCHOLOGICAL MEDICINE A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—I submit herewith the annual report of the activities of the Crease Clinic of Psychological Medicine for the fiscal year April 1st, 1952, to March 31st, 1953. During the past year the facilities of the Crease Clinic have been used to capacity during the greater part of this period. The following table gives a summary of the movement of population during the fiscal year:— Men Women Total In residence, April 1st, 1952 New admissions during the year_. Discharged during the year In residence, March 31st,1953 100 529 518 111 115 215 692 1,221 675 1,193 132 243 With our total bed capacity being 302, we have had as many as 277 patients domiciled in the Clinic at one time. There is need to keep a number of beds in readiness for admissions at all times as our peak of admissions in one day has been sixteen, and it is common to admit as many as eight in a day. It is satisfying to note the number of patients who have come for psychiatric treatment voluntarily. During the year we have had 211 men and 323 women, making a total of 534, voluntary admissions. This is approximately 45 per cent of our total admissions who are seeking psychiatric help on a voluntary basis. It is also pleasing to note the large number of patients who come to the Crease Clinic as their first psychiatric referral without previous treatment. Regarding our discharges, it has been possible during the past year to return a vast majority of our discharged patients back to the community. It has only been necessary to commit 129 of our discharged patients to the Provincial Mental Hospital. The operating-room in the Crease Clinic and the surgical ward of 8 beds were opened for general surgery on February 14th, 1953. Patients are received here from the Crease Clinic, the Mental Hospital, The Woodlands School, and the Homes for the Aged for various forms of surgery. To date, we have operated on twenty cases. It is to be expected that this service will be extended greatly in the coming year, and the surgical specialties of orthopaedic surgery and neurosurgery should be added. We have been able to put in operation an open ward for women during this past year. This ward functions in the same manner as the men's open ward, and creates a very beneficial and pyschological effect on those who are able to be cared for in this way. Our educational programme has continued to be quite active. The lecture and conference rooms are in daily use for the educational programme of our staff, for university students, and for visiting organizations. Our own medical staff has continued to hold weekly evening seminars during the fall, winter, and spring terms. A great deal of interest in the Crease Clinic has been shown by many lay groups requesting permission to inspect our facilities. This culminated in the holding of Open House Day on May 9th, 1952, during Mental Health Week. It is estimated that approximately 2,500 persons visited during the day and observed the facilities of our Clinic. This is certainly one of the best ways to acquaint the general public with some of the problems of mental health. Respectfully submitted. A. E. Davidson, M.D., Deputy Director of Mental Health Services. 3 T 34 MENTAL HEALTH SERVICES REPORT, 1952-53 REPORTS OF PROVINCIAL MENTAL HOSPITAL, ESSONDALE REPORT OF THE MEDICAL SUPERINTENDENT A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C Sir,—I submit herewith the annual report of the Provincial Mental Hospital at Essondale for the fiscal year April 1st, 1952, to March 31st, 1953. Examination of Table No. 1 of the Mental Hospital statistical tables during this period is the chief source of the statistics used in this particular report. In residence on April 1st, 1952, there were 1,843 men patients and 1,641 women patients; 110 patients were on probation; and 3 patients were carried on escape, thus making a total of 3,597 patients on our books. During the year 1,332 patients were admitted, making a total under treatment at the Mental Hospital at Essondale for the year of 4,929 patients. Of the number admitted, 1,024 were by ordinary admission; 41 were by urgency committal; 180 men and 54 women, making a total of 234 patients, were voluntary admissions; 10 were admissions from the Yukon; 1 admission was by warrant; and 22 admissions were by Order in Council. The total admissions were thus 794 men and 538 women, making a grand total of 1,332 patients. The separations during the fiscal year were very satisfactory. There were 704 men and 489 women separated from the Mental Hospital at Essondale during this period, making a grand total of 1,193 patients. In residence on March 31st, 1953, there were 1,979 men and 1,757 women, making a grand total of 3,736 patients in residence at the end of the fiscal year. There are several points of interest in this report. First, the gross admissions which reveal the ever-present need for continued care of large numbers of patients. The majority of the 234 patients who were voluntary admissions were alcoholics. During this fiscal year it was found expedient to reserve a limit of 25 male beds for the use of this type of case. These 25 beds are occupied almost constantly by this particular type. There has been no reservation made regarding women alcoholics. Our total admissions were 1,332 patients, and our total separations, including deaths, were 1,193 patients. Fifteen patients were discharged from the Mental Hospital at Essondale to be admitted to the Crease Clinic, and we received for committal from the Crease Clinic a total of 127 patients during the year. The percentage of patients recovered and improved, as compared to admissions, was 21.09 per cent. The percentage of deaths to the number under treatment was 3.14 per cent. The percentage of discharges to admissions (exclusive of deaths) was 77.93 per cent. The daily average population was 3,440.35. We cared for an average of approximately 100 Federal charges; this number constantly changed, but averaged 8 patients from the British Columbia penitentiary, 30 patients from the Yukon, and 62 patients from the Department of Indian Affairs. This number was exclusive of the large group of Federal cases which come under the Department of Veterans' Affairs. There have been many great changes within this division of the Provincial Mental Health Services. The greatest of these, I feel, was our loss in the death of Dr. E. J. Ryan, Senior Medical Superintendent, on July 2nd, 1952. Dr. Ryan had spent the greater part of his fife working in this service, and took a large share in its development and growth. He had an extremely full knowledge of the workings and activities of all departments, patients, and staff. The Mental Health Services have suffered a great loss in his death. Mr. William Headridge, Chief Stores Steward, after a great many years of service, was retired, and the vacancy caused by his retirement was filled by Mr. A. Boulter. REPORTS OF MENTAL HOSPITAL, ESSONDALE T 35 Mr. William Cross, Deputy Chief Psychiatric Male Nurse, who had been with us for many years, retired on superannuation. Mr. R. T. Hall, Supervisor of Industrial Therapy, Trades and Occupational Therapy, Men's Division, retired, and his position was filled by the appointment of Mr. R. Herring. Dr. A. L. Swanson, Deputy Medical Superintendent, resigned during the year. These men all filled important positions in the Mental Health Services and contributed much to the high standard of service provided. The general health of the patients has been satisfactory during the year. There have been no severe infections of an epidemic nature. There have been minor infections of a respiratory type which have been localized in extent. An additional service in the care of our patients was the opening of the operating- room on February 18th, 1953, in the Crease Clinic. Considerable elective surgery and emergency surgery has been performed. This surgery has been done by our consultant surgical specialists. At a later date it is anticipated that our neurosurgery will also be performed here. The active treatment of patients is being stressed, and the case-load this year has been a very heavy one. The various forms of physical therapy are still used quite extensively and will be dealt with in detail in the Clinical Director's report. There remains considerable overcrowding in both the men's and the women's divisions, as has been noted in previous Reports. It is anticipated that the new building for tubercular patients will assist in this regard. A total of 282 patients was transferred to The Woodlands School in New Westminster during the year. This was made possible by the opening there of new buildings. A milestone this year was the direct admission to The Woodlands School of all those patients under the age of 6 years. This procedure commenced on December 1st, 1952. It is hoped that in the foreseeable future it will be possible to admit all mentally defective patients directly to The Woodlands School. This, together with the separation of approximately 350 mentally defective patients from the Provincial Mental Hospital at Essondale, would relieve the pressure here considerably. In addition, the separation of 500 patients at Essondale who are 65 years of age and the admission of the aged directly to the Home for the Aged would further relieve the pressure on this overtaxed division of the Provincial Mental Health Services. I wish at this time to gratefully acknowledge all those individuals and departments who are in any way concerned with the care and treatment of patients or maintenance of facilities, and to express my appreciation of their co-operation in this work. This report covers some of the more important points in this division of the Provincial Mental Health Services following my appointment as Medical Superintendent of the Provincial Mental Hospital at Essondale and the Crease Clinic of Psychological Medicine on October 1st, 1952. Respectfully submitted. _ ^ •_ _, _ r T. G. Caunt, M.D., Medical Superintendent. TREATMENT SERVICES A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—The following is the report of the Treatment Services in the Mental Health Services, Essondale. Both in the Crease Clinic and the Provincial Mental Hospital, during the week following admission, a medical investigation and psychiatric assessment of each patient's T 36 MENTAL HEALTH SERVICES REPORT, 1952-53 condition are undertaken by his attending doctor with the aid of the nursing, psychology, and social-service personnel. Consultation with our visiting surgeons is also undertaken where indicated. Ward rounds are held each week in both hospitals, both for men and women patients, to discuss the admissions of the week before and plan the treatment programme. These conferences are attended by the medical staff, and also by representatives of the nursing, occupational-therapy, and social-service departments. In the broadest terms, our treatment is aimed to improve the patient's ability to live with himself and others. Many approaches to treatment are outlined in these pages, and these reports contain the smaller detail of much creative work provided, and diver- sional activity organized, so that people who are mentally and emotionally disturbed may find themselves once again. A newer emphasis in hospital psychiatry is on relationship therapy, which is another way of saying that understanding and acceptance carried through to the patient from all levels of staff must go along with more specific measures employed. Listed below are the number of physical treatments, or somato- therapies, as they are now called, given in the course of a year. This is tangible evidence of the efforts we have put forth to help our patients regain their health. An effort has been made to determine what the results have been for each procedure. It is very hard to assess results in these terms, as some patients have received, in addition, considerable psychotherapy, and the hours devoted to this treatment are not recorded statistically. More time could be spent profitably in psychotherapy if we had the staff to do it. The place of somatotherapy, then, is to relieve the symptoms of distress and restore the patient's initiative in working toward his recovery so that he can give up the isolation of his illness and participate socially once again. We have endeavoured to foster new approaches in treatment in the clinic which can be carried over to the Mental Hospital, both in its admitting department and the continued-treatment services. We have endeavoured to provide our patients with a more relaxed hospital atmosphere in which individuality can be preserved. The appointment of a musical therapist and a padre broadens the scope of the approaches we can make to patients. In the Clinic, two wards are now functioning as open wards, in which reliance is placed on morale instead of on scrutiny. Use of seclusion rooms on other wards is less frequent. Other evidences of this trend have been the institution of periodic ward meetings and the provision of a polling-booth for those able to exercise their franchise on election-day. Group psychotherapy is achieving a place of increasing importance. Two groups have been meeting in the Clinic twice weekly under medical direction and with the competent assistance of our psychologists. This service will shortly be doubled. In the Mental Hospital there have been three groups meeting for psychotherapy; namely, on the women's rehabilitation ward, on the women's lobotomy ward, and in the men's alcoholic clime. A most significant achievement was recorded during the year in the Mental Hospital, when on August 14th, 1952, the use of physical restraint was abolished. This step was the culmination of at least two years' intensive work in this direction. We have now embarked on a much more comprehensive task, which we call our reactivation programme, in which we are endeavouring to improve the social standard of living of the patients who are domiciled therein. This programme is already under way on the top floor of the East Lawn Building with the active and enthusiastic teamwork of the nursing, occupational-therapy, recreational-therapy, and medical staff making it possible. A ward programme for the adult mental defectives has been started by the ward staff, and this area is one in which musical therapy has been employed to advantage. A small reactivation programme has been commenced in the West Lawn Building, and will be expanded in the coming year. An effort has been made to deal conscientiously with the large number of men patients presenting themselves for treatment for alcoholism. Certain changes in the Provincial Statute have been asked for and have been made whereby we might deal more satisfactorily with those patients whose motivation to be REPORTS OF MENTAL HOSPITAL, ESSONDALE T 37 helped is strong. It is to be hoped that before long this department of treatment will be lifted out of the Mental Hospital setting altogether. The facilities for treatment in the Centre Lawn Building, or the Admitting Building to the Mental Hospital, are keeping step with the Clinic, with the exception that no provision has yet been made for insulin coma therapy. The deficiency is to be made up during the coming year. Both to lend encouragement to our reactivation programme and to speed rehabilitation, we have commenced ward rounds in the East Lawn Building by going to one ward each week in rotation. We are grateful to the psychiatric social workers for the support they have given this venture. Of course, rehabilitation services must expand to keep pace with the increased number of patients coming for treatment. Much of the burden of rehabilitation planning falls upon the social workers. We have noted a lessened problem of discrimination in job placements. Sometimes special placements are necessary, and in this regard we have had the full co-operation of the National Employment Service. The women's rehabilitation home, The Vista, has accommodated almost twice the number of patients that it did last year, and there is a clear need for a rehabilitation home for men, as indicated in the report of the Rehabilitation Officer. The various forms of physical therapy are still actively used, and the following tables are of interest. (a) Coma Insulin All patients receiving coma insulin are at present being treated in the Clinic. These facilities are actively used in the treatment of the many schizophrenic disorders. Record of Coma Insulin Treatment from April 1st, 1952, to April 1st, 1953 FEMALES 0 l-H Vi u — .0 ci |s u t- Si > O o Si Pi Si > o a | T3 Si > O a, I s 5a u S3 -c Vi a ii BS.S •a V 3 2 ° Manic Depressive 1 1 i 1 1 — i Schizophrenia 14 10 23 53 3 21 24 1 4 3 2 12 8 18 39 17 20 2 2 3 10 4 2 14 10 21 49 3 21 24 1 1 ..__ 1 ...... ______ 1 ______ 2 1 4 j ...._. ...... | ...... ______ | ...... ______ | __ ______ | ______ 2 2 2 1 Latent 1 148 11 114 23 142 6 8 2 1 1 2 1 1 2 1 1 _ Epilepsy with psychosis - - Alcoholic psychosis Anxiety reaction Totals 4 3 1 4 1 — 1 I 153 11 118 24 147 6 ....__ 8 L_ T 38 MENTAL HEALTH SERVICES REPORT, 1952-53 Record of Coma Insulin Treatment from April 1st, 1952, to April 1st, 1953—Continued MALES §1 2.H. I ii Bo tax Manic Depressed. Other Totals. Manic Depressive Simple Hebephrenic. Catatonic Paranoid Schizophrenia Acute schizophrenic reaction. Latent Schizo-affective psychosis __. Unspecified Totals Paranoid state Pathological personality.. Epilepsy with psychosis .„ Alcoholic psychosis- Neurotic depressive reaction. Anxiety reaction. Obsessive compulsive neurosis, Psychoneurotic disorders Hysterical reaction Totals Grand totals . 161 1 I 1 1 I 1 I 15 6 16 72 9 23 13 10 4 4 11 8 47 3 6 1 18 1 11 17 107 | 5 2 1 17 4 1 30 13 6 15 70 23 13 1 1 1 2 1 148 | 5 [ 1 | 113 12 (b) Convulsive Shock Therapy This form of therapy is actively used both in the Clinic and in the Mental Hospital. In the Clinic it is chiefly used for the relief of disturbances of mood, either elation or depression, with gratifying results. Crease Clinic of Psychological Medicine RESULTS Number of Patients Recovered Much Improved Improved Unimproved 65 227 62 23 4 5 10 13 2 28 161 44 4 Schizophrenia Miscellaneous 49 11 Totals _ _ 354 32 25 233 64 DISPOSAL Discharged Discharged Later Discharge Pending Transferred to Insulin Transferred to E.N.T. Transferred to Mental Hospital Died Later 56 81 53 3 6 1 115 2 6 2 21 3 2 Schizophrenia Miscellaneous 1 190 9 1 115 10 26 3 REPORTS OF MENTAL HOSPITAL, ESSONDALE T 39 Provincial Mental Hospital results Number of Patients Recovered Much Improved Improved Unimproved 32 232 48 7 3 8 7 2 18 131 30 6 Schizophrenia 87 13 312 10 17 179 106 DISPOSAL Discharged Discharged Later Discharge Pending Transferred to Insulin Transferred to Lobotomy Transferred to E.N.T. Remaining in Mental Hospital Died Later Manic depressive .... Schizophrenia Miscellaneous 12 34 14 9 5 1 3 10 — 4 1 10 1 14 162 26 1 2 Totals 60 17 4 10 4 12 202 3 (c) Electronarcosis This form of therapy continues to give beneficial results in a limited number of patients. Frequently patients who have failed to respond to other forms of therapy will have favourable results with electronarcosis. Crease Clinic of Psychological Medicine results Number of Patients Recovered Much Improved Improved Unimproved 9 30 20 2 1 7 12 15 2 Schizophrenia __ _ 15 5 Totals 59 2 1 34 22 DISPOSAL Discharged Discharged Later Discharge Pending Transferred to Insulin Transferred to E.N.T. Remaining in Clinic Died Later Manic depressive Schizophrenia Miscellaneous 6 12 15 2 2 4 3 1 13 1 Totals 33 8 3 15 Provincial Mental Hospital RESULTS Number of Patients Recovered Much Improved Improved Unimproved Manic depressive Schizophrenia _ Miscellaneous 2 15 1 1 — 1 13 1 2 Totals 18 1 15 2 T 40 MENTAL HEALTH SERVICES REPORT, 1952-53 Provincial Mental Hospital—Continued DISPOSAL Discharged Discharged Later Discharge Pending Transferred to Insulin Transferred to Lobotomy Remaining in Hospital Died Later Manic depressive , Schizophrenia Miscellaneous 2 9 1 2 4 12 2 4 (d) Lobotomy The majority of patients treated by this method have been those who have presented disturbing and troublesome problems of adjustment in hospital. RESULTS Number of Patients Recovered Much Improved Improved Unimproved 18 2 .... 10 1 3 1 5 Miscellaneous Totals. 20 — 11 4 5 DISPOSAL Discharged Transferred to Coma Insulin Transferred to E.C.T. Remaining in Hospital 8 1 2 8 Miscellaneous _ _ 1 2 Totals.. _ 8 2 10 F. E. McNair, M.D., Clinical Director. DEPARTMENT OF OCCUPATIONAL THERAPY Women's Division A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale,B.C. Sir,—This year the staff of the Women's Occupational Therapy Department was increased by six members—four occupational therapists, an industrial therapist, and a stenographer-instructor, so that we now number twenty-four and supervise activities in four occupational-therapy workshops and six industrial departments. The fact that we have a larger staff and have had only three resignations during the year has enabled us to expand our programme in the following ways:— The workshop at the Home for the Aged was reopened in May with a full-time therapist in charge. Patients are visited twice a week on the wards, and the workshop is opened to patients each afternoon. In August the ward programme in the East Lawn Building was reorganized so that daily visits are made to all wards except two. This programme has been most beneficial to those patients unable to attend the workshop, and REPORTS OF MENTAL HOSPITAL, ESSONDALE T 41 constructive work has replaced destructive activities. Mention should be made of the cooking class held for a very deteriorated group of patients. Having a stenographer has relieved the staff of stenographic work and has facilitated the keeping of records and supplies. Instruction has also been given to patients interested in shorthand and typing. The average number of patients registered for treatment during the year was 763, as compared to 473 last year. The number of treatments given during the year was 151,506. The number of patients admitted for treatment was 1,848, and the number discharged, discontinued, or transferred was 1,329. Miss Stella Hincks, our assistant supervisor, resigned in April and was replaced by Miss Marie LeBlanc, who has been a member of our staff since 1947. A period of three months' clinical training was provided for two University of Toronto students and two students from the College of Puget Sound, Tacoma, Wash. Lectures were given to the affiliate and student nurses, and the former spent one week of observation in the departments. We have also had visiting therapists from Vancouver and Salem, Ore. Exhibits of handicrafts were presented at the Fraser Valley Art Show, New Westminster; at the Women's Institute, Port Coquitlam; and at the Parent-Teacher Association, Port Coquitlam. Proceeds from the annual Christmas sale amounted to $1,243.75. This money becomes part of the Patients' Comfort Fund and in the past has gone toward the purchase of the organ at Pennington Hall. This department assisted also at Christmas with decorations, packed 4,273 bags of candy for patients, made 150 toys for The Woodlands School, and designed the hospital Christmas card. Included in the personnel of this department is a school-teacher who teaches English to non-English speaking patients and supervises extension courses. We wish to thank you, the medical staff, the nursing staff, and all others who have given so freely of their time and counsel during the year. Respectfully submitted. Kathleen Draper, Director, Occupational Therapy Department ( Women's Division). Men's Division A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—I beg to submit herewith the annual report of the Trades Training and Occupational Therapy Department (Men's Division) for the fiscal year April 1st, 1952, to March 31st, 1953. (a) Trades Training.—From February to the end of April, 1953, the patient population was increased from 65 to 104 patients; in the same period, 17 patients were discharged. The Tailor-shop shows a continual turnover of patients. A large percentage of patients discharged from the Tailor-shop have benefited from their training, and have proved their interest and ability while in this department. The Mattress-shop is doing an excellent work in rehabilitating patients from the lower-level brackets to the higher trade levels in the training programme. The Cabinet-shop features a new department for the repair of hardwood chairs and small furnishings. It also serves as a training area for the Cabinet-shop. The latter is to be congratulated on the fine workmanship turned out for the operating-room. T 42 MENTAL HEALTH SERVICES REPORT, 1952-53 The Upholstery-shop, Shoe-shop, and Machine-shop show a profit for the year, with a good patient turnover. The Metal-shop deserves mention for its fine workmanship in the manufacture of stainless-steel kitchenware. The Printing-shop was moved from the Centre Lawn Building up to the Trades Training Building in February, and is proving an asset to the training programme. (b) Occupational Therapy.—Crease Clinic: A staff of two occupational therapists and one handicraft instructor supervise the treatment programme in the Crease Clinic. The total number of patients treated was 1,292. The total number discharged was 291, and 38 patients were transferred to the Mental Hospital. Mixed wood occupied 609 patients; weaving, 246 patients; pottery, 228 patients; and the remainder were employed at miscellaneous crafts. Veterans' Building: One occupational therapist supervised the treatment programme, which comprised a total of 18,750 treatment-hours. The patients in this unit are to be commended for their untiring efforts in toy-manufacture. These toys are donated to the various veterans' organizations for Christmas distribution. Deserving mention is the scale contour map of the Hospital grounds and buildings. The lengthy project took nearly a year to complete. The finished model was installed in a mahogany case, built by the Trades and Training Department, and now adorns a central position in the rotunda of the Crease Clinic. Centre Lawn Building, D 5: The activities in this unit have been increased, a greater variety of crafts are in use, and the patient population and interest have also grown. One therapist is in charge. The average number of patients treated daily is 27. Visits are made to D 2 hospital ward, and a treatment programme has been started. The gardening and landscaping project, supervised by Mr. A. B. Finnie and assisted by the therapist from Centre Lawn, is showing outstanding results as a diversion for the occupational- therapy patients and serves as an outlet for those not interested in shopwork. Mr. R. T. Hall, who was retired on superannuation in January, 1953, leaves us with memories and standing monuments of this department's services to the Hospital during his years as Supervisor of Trades Training and Occupational Therapy. I wish to express my sincere thanks for the co-operation given by the Trades Training and Occupational Therapy Department staff during the past months of adjustment. The staff of the Trades Training and Occupational Therapy Department wish to thank you, Dr. Gee, the medical staff, the nursing staff, and Public Works Department for their counsel and co-operation during the past year. Respectfully submitted. R. Herring, Supervisor of Trades Training and Occupational Therapy (Men's Division). DEPARTMENT OF RECREATIONAL THERAPY A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—I beg to submit herewith the following report showing programme and attendance figures of the activities promoted by this department during the fiscal year April 1st, 1952, to March 31st, 1953. REPORTS OF MENTAL HOSPITAL, ESSONDALE T 43 Patients' Recreation Physical-education and gymnastic classes Badminton classes Bowling 392 Dances Visiting band concerts Visiting choir and concert groups Concerts presented to individual wards by patients' glee club and gymnastic group.._ Variety parties and social gatherings Swimming Softball League activities Reactivation programmes Fifth annual sports and field day Staff recreation 279 Number of Programmes Total Attendance 97 2,021 61 454 392 6,857 81 13,996 6 3,810 4 2,413 17 1,649 27 1,651 72 1,987 50 8,000 54 1,280 1 1,200 279 3,818 Totals 1,141 49,136 Following are special, or progressive, inaugurated events to our programme during the year, and additional remarks:— 1. In September, 1952, a musical therapist ,was appointed. During the ensuing months, the musical therapist, in conjunction with the Recreational Therapy Department, held a total of 83 periods of activity. These included the formation of a Hospital glee club, Protestant Church choir, individual ward music-appreciation hours, and community sing-songs, which provided musical entertainment to 6,744 patients. 2. Reactivation Classes.—During the month of October, 1952, a new type of activity was started with small groups from both the men's and women's refractory wards, with highly encouraging and beneficial results. More attention is being given to this type of activity weekly. 3. During the past fall indoor season, specific emphasis was placed on all types of gymnastic work, both elementary and advanced, also with encouraging and beneficial results. This has proven so satisfactory that plans now call for a regular annual display at the end of the fall season, which will be very similar to our annual field and sports day which is held at the end of the summer season. 4. The newly formed Inter-building Softball League was a complete success for both players and spectators. This Softball League will also be a regularly scheduled annual activity. 5. The physical-education and gymnastic classes listed above consisted of calisthenics, both elementary and advanced, and indoor games of every type and too numerous to mention. 6. The concerts listed above were organized by the musical therapist and the Recreational Therapy Department, and were presented mainly on wards with patients who would not ordinarily get out to the auditorium activities. 7. Staff recreation was carried out mainly in the late evening hours, and their activities consisted of badminton, bowling, dancing, gymnastics, picnics, and swimming. 8. Variety party and social gatherings listed above consisted of bingo groups, cribbage, checker, chess, and bridge tournaments, and other types of social activities not scheduled under the regular recreational programme. 9. Activities not supervised by the Recreational Therapy Department, but carried out in the new Pennington Hall auditorium:— (a) April 3rd, 1952: Hospital student-body dance. (b) June 17th, 1952: Devotional service of Vancouver Diocesan Anglican Church clergy. T 44 MENTAL HEALTH SERVICES REPORT, 1952-53 (c) October 23rd, 1952: Hospital graduate nurses'reunion. (d) December 17th, 1952: Red Cross blood donor clinic. (e) December 20th, 1952: Provincial Employees' Association kiddies' Christmas party. (/) February 20th, 1953: Credit Union annual meeting. (g) March 26th, 1953: Alumna; nurses'fashion show. Once again I would like to express my thanks and appreciation for the assistance and co-operation given this department by so many of the staff personnel and allied departments in the promotion of our various recreational activities. Respectfully submitted. „, „ „ v • W. R. Brown, Director of Recreational Therapy. Sixth annual sports day, August, 1953. AUDIO-VISUAL DEPARTMENT A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—Attached herewith is a summary of the basic functions of this department for the fiscal year April 1st, 1952, to March 31st, 1953. On May 19th, 1952, the first 35-mm. movies were shown in Pennington Hall, and later in the year the stage curtains were installed. Many comments have been received in regard to the fine quality of the equipment and its performance. A number of first-run pictures have been shown, much to the delight of the patients. Owing to quarantine restrictions, recreational movies, both 16-mm. and 35-mm., were curtailed somewhat, reducing the number of shows by sixty-seven over last year. REPORTS OF MENTAL HOSPITAL, ESSONDALE T 45 At the same time the total attendance, despite this reduction, increased from 94,315 to 94,666. This is largely due to the facilities of Pennington Hall. It would appear that if more transportation were provided, the total attendance to movies would be over the 100,000 mark. On February 24th, 1953, owing to overcrowding at The Woodlands School, a third showing of 35-mm. movies became necessary. The educational film library now contains 147 films, and an average of five of these are shipped out each week, necessitating the use of a Kardex system, with a number of printed forms, to keep track of the details in connection with the lending library. Fifty- one more educational films were presented over last year, which almost balances the number of recreational shows not given. As I mentioned in last year's report, the weekly average of movies shown could not be exceeded without an increase in staff or a deterioration in other phases of the department. The increasing demands placed upon this department, with a limited staff, have not been without some sacrifice, and the vast amount of technical and maintenance work required in itself, and in service to others, is not being carried out. Photography and all its branches, such as copy work, slides, etc., continues to be of value in many ways, and the report below gives this pertinent data. Recorded music has been relayed, whenever time has permitted, through the sound system on channel three to the Crease Clinic and the Veterans' Building at Colony Farm, throughout the year, and also the lawns in the summer-time. Gradually some fine long-playing records are being secured for the record library which will be used in connection with the four-channel sound system, and it is unfortunate that the West Lawn, the Centre Lawn, and East Lawn Buildings are as yet not part of this system. Some of the more musical types of concerts given on the stage of Pennington Hall have been broadcast on an experimental basis. The padre also makes use of this equipment during his evening broadcasts. Owing to current requirements absorbing nearly all available time, much equipment is still installed on a temporary basis, and the results of its performance often are of the same nature. A great deal of time and engineering are still required before all equipment is put into place and functioning smoothly. Recreational Motion Pictures Number of Shows 35-mm. presentations at Essondale 135 35-mm. presentations at The Woodlands School.. 85 16-mm. presentations at Essondale, Home for the Aged (Port Coquitlam), and Colony Farm 420 Total Attendance 40,968 17,063 36,635 Totals 640 94,666 16-mm. Films Shipped to Other Institutions Mental Home, Colquitz 95 The Woodlands School 96 Home for the Aged, Vernon 46 Provincial Home, Kamloops 46 Girls' Industrial School , 43 Boys' Industrial School 49 Allco Infirmary, Haney 49 The 16-mm. projection equipment was loaned out 183 times. T 46 MENTAL HEALTH SERVICES REPORT, 1952-53 Educational Motion Pictures Number of Total Shows Attendance 16-mm. presentations at Essondale 213 10,988 16-mm. films loaned 231 7,514 Photography 4x5 negative exposed, black and white 250 4x5 negatives exposed, colour 45 8x10 prints produced 490 5x7 prints produced 24 314x4 colour transparencies produced 40 3%x4 black and white transparencies produced 49 2x2 slides produced 1 17 16-mm. motion-picture film exposed, black and white, and colour (feet) 300 Records and Recordings Domestic records loaned 677 Hours of music played ; 280 Minutes of recorded material for clinical and miscellaneous purposes 391 G. H. Walker, Director, Audio-Visual Department. LIBRARY REPORT A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C Sir,—Attached herewith is a report of the medical and patients' libraries for the fiscal year ended March 31st, 1953. Mrs. H. M. Fraser, Librarian, resigned in February, and to date the position has not been filled. Weekly book service to the wards continues, also to the Home for the Aged, Veterans' Building, and The Vista in Vancouver. Many donations of magazines were received, and these were distributed to the wards. The Library co-operated with the National Research Council of Ottawa in the compilation of a union fist of scientific periodicals in Canadian libraries. When the project is completed, our Library will be listed with the symbol " BEC." A portion of the Federal Mental Health Grant was again made available to the medical library for the purchase of basic works in medicine and Psychiatry- Patients' Library Book collection 4,276 News books added 300 Donations 124 4,700 Book losses 58 Book discards 91 — 149 4,551 Current magazine subscriptions 10 Number of books circulated 15,757 REPORTS OF MENTAL HOSPITAL, ESSONDALE T 47 Medical Library Book collection 1,639 New books added 202 Book losses Journals (medical and psychiatric) 70 Journals (technical, other departments) 45 Journals (bound volumes) Pamphlets Books borrowed on inter-library loan Books lent on inter-library loan Number of books circulated Respectfully submitted. 1,841 18 1,823 115 154 536 38 5 883 (Miss) A. Ruzicka. DEPARTMENT OF PHYSICAL MEDICINE A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—Following is a report of the treatments given in the Physiotherapy Department of the Provincial Mental Hospital and Crease Clinic of Psychological Medicine from April 1st, 1952, to March 31st, 1953:— Male Female Total 220 869 236 45 965 139 695 148 287 5 64 189 1,323 57 66 88 506 835 207 550 1,684 1,184 1,731 73 34 726 1,704 443 595 2,649 1,223 2,426 221 321 5 15 62 2,284 63 820 79 Wax bath 251 3,607 120 886 88 5,396 543 10,048 598 15,344 1,141 Respectfully submitted. F. E. McNair, B.A., M.D., CM., Clinical Director. T 48 MENTAL HEALTH SERVICES REPORT, 1952-53 DENTAL DEPARTMENT A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—I beg to submit herewith the annual report of this department for the fiscal year April 1st, 1952, to March 31st, 1953. The past year has seen the Dental Clinic brought up to full working capacity. An additional dental nurse and a dental mechanic have been added to the staff, and have both proved themselves very capable. New equipment in the laboratory has made it possible to handle all types of mechanical work quickly and efficiently, and no work has been sent out to city laboratories since our dental mechanic had his equipment installed. This required a considerable amount of rewiring. Besides our own work, we also take care of the mechanical work for The Woodlands School. In the operating-rooms new equipment and new lights over the chairs have made for better working conditions. These lights were part of the original equipment, but as the ceiling fixtures were designed for ceilings under 10 feet, they were not mounted when the other equipment was installed. With the co-operation of the two electricians, 4-foot extensions have been added, and the lamps mounted on these extensions so that they now hang 8 feet above the floor and thus give excellent light for working at the chairs. A new system of requisition for dental work, signed by the patient's doctor, has worked out very well and enables the nurse to plan appointments more efficiently. Examination of patients at the Home for the Aged has been completed, saving a good deal of transportation of these old people to and from the Dental Clinic. We now have lists of these patients on whom dental work is required. Examination of patients on Wards H 1 and H 5 has also been carried out, and lists of patients requiring dental work under general anaesthesia made out, also lists of patients whose dental work it is believed possible to handle in the Dental Clinic with local anaesthesia. New dentures made in our laboratory are all marked with the patient's number and are easily identified, but a number of old dentures are lost and cannot be traced back to their owners when found. The dental mechanic has now worked out a satisfactory method for marking these dentures, and all dentures on Ward H 2 are now marked. This work will continue as time permits. The following is a summary of the work done during the year:— Examinations 1,999 Extractions 1,759 Fillings 1,134 Prophylaxis _' 296 Treatments 189 X-rays 470 General-anaesthetic cases 63 Dentures made 226 Dentures repaired 175 Dentures relined 39 Bridges repaired 16 Bridges made 1 Gold inlays 7 Crowns 1 Respectfully submitted. H. O. Johnsen, D.D.S. REPORTS OF MENTAL HOSPITAL, ESSONDALE T 49 OPTICAL REPORT A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—The following is the report of the optical work done at the Provincial Mental Hospital and the Crease Clinic for the fiscal year April 1st, 1952, to March 31st, 1953:— Refractions 348 Major repairs 243 Minor repairs and adjustments 100 Respectfully submitted. H. H. Woodbridge, Optometrist. BEAUTY-PARLOUR REPORT A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C Sir,—Following is the report of the above department for the fiscal year April 1st, 1952, to March 31st, 1953, covering the Mental Hospital and the Crease Clinic:— Shampoos 6,572 Finger-waves 6,466 Marcels 44 Permanents 1,006 Hair-cuts 7,148 Manicures 1,684 Scalp treatments 17 Shaves 1,926 Oil treatments 2,344 Respectfully submitted. (Mrs.) M. Townsend. DEPARTMENT OF DIETETICS A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—The following is a report on the work done in the Department of Dietetics during the fiscal year ended March 31st, 1953. The department was sorry to lose Mrs. M. W. Spencer, Acting Chief Dietitian, in July, who is now devoting her full time to housekeeping, and Mrs. G. Kitos, who moved to the United States with her husband, but welcomed the addition of Miss C. L. Neighbor, who transferred from The Woodlands School, Miss E. J. Jones, Mrs. E. E. J. Garside, and Miss R. L. Neal as dietitians. Throughout the year the department strove to improve the quality and variety of the meals served to the patients. Fresh fruit was served while in season, also garden vegetables and salads throughout the year. The surplus beans and cauliflower were frozen, and served when other green vegetables were not available. T 50 MENTAL HEALTH SERVICES REPORT, 1952-53 Toward the end of the summer thirty-six insecticide vapourizers were installed in all kitchens and dining-rooms. Considerable time was spent in investigating these thermal generators, but we were well rewarded when the flies and cockroaches were brought under control. The plastic sectional trays introduced after the war have been replaced by plates in the Crease Clinic and on some wards in the East Lawn, but this programme cannot be completed until the new dish-washer is installed in this building. The tables in the Lawn Buildings have been re-covered with arborite, which is a vast improvement and has considerably brightened the dining-rooms. The kitchens in the Home for the Aged and Centre Lawn Buildings have been completely renovated and electrified, and are proving more economical and sanitary. During the coming year we hope to complete the programme for converting the kitchens from coal to electricity with the renovation of the West Lawn kitchen. The establishment of the central butcher-shop will enable us to control the consumption of meat and enable the kitchens to serve a greater variety of meat dishes; the new diet kitchen will give better facilities for serving and controlling more accurate diets in the East Lawn Building. The two cooks and seventeen patients in the scullery have done excellent work preparing all the vegetables for the kitchens throughout the year under very adverse conditions; it is hoped that the scullery will soon be moved to a more suitable building and equipped with adequate facilities for continuing this very monotonous and thankless job.. Files have been made up of all large equipment in the kitchens and dining-rooms; these will facilitate fuller use of the equipment in planning new kitchens and eliminate much of the wastage arising out of the previous system. Departmental information files have also been enlarged and brought up to date. The Hospital diet manual is being completely revised and rewritten, and will be ready for publication in 1953, when it will be used throughout the Hospital and at The Woodlands School, and used as a text-book for the nurses-in-training. A standard recipe book has been compiled and will be used in all kitchens. Monthly stock-taking of expendable commodities was introduced this year, as was a simplified costing system, which enable the dietitians to improve the menus without increasing the expenditure per diem. Training programmes have been extensive this year and have embraced four different groups. Miss Jones has given a series of lectures in nutrition and diet therapy to all classes of student nurses, and Miss A. Paterson has given lectures on feeding of infants and old people. The cooks' training programme has remained as a one-year course, with eight students this year. Of the six graduates from the 1951—52 course, one was transferred to Colquitz immediately as a Grade 1 cook; one promoted in September, four in February, and one in March. Mr. Quayle, Grade 3 Cook, left in January to reside in the United States, and the total number of promotions during the year was thirteen. A short course of training was given to the kitchen helpers employed this year; it consisted of instruction and films on sanitation, food service and dish-washing, given by the dietitians, and a lecture on the effect of good food and service for psychiatric patients, which was given by Dr. McNair. The fourth programme was in showing a coloured film on the correct methods of dish-washing to the patient-workers, who seemed to enjoy the show and were suitably impressed with the lesson it contained. The year ended with the following staff in the Department of Dietetics: 1 Chief Dietitian, 5 dietitians, 3 Grade 5 cooks, 2 Grade 4 cooks, 8 Grade 3 cooks, 16 Grade 2 cooks, 14 Grade 1 cooks, 27 kitchen helpers, 16 dining-room stewards, and 107 patient-workers. _ REPORTS OF MENTAL HOSPITAL, ESSONDALE T 51 I would like to take this opportunity of thanking the heads and staff of all departments for their co-operation throughout this year, for without it the progress of the Department of Dietetics would have been greatly retarded. Respectfully submitted. (Miss) Heather V. R. Pelling, Chief Dietitian. DEPARTMENT OF NEUROLOGY A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—I beg to submit a report of the activities of the Department of Neurology for the fiscal year April 1st, 1952, to March 31st, 1953. The demand for neurological consultation and investigation has shown an increase over the previous year. This is mirrored by the number of electroencephalograms, which has risen from 642 in 1952 to 1,079 in 1953. There has been also a further increase in the number of pneumoencephalograms performed, which totalled 237 in 1953, compared with 221 in 1952. Twenty-five patients were referred to the neurosurgical service of the Vancouver General Hospital for further assessment and treatment. The majority of these suffered from space-occupying lesions, either of neoplastic or vascular origin. They have undergone surgical treatment. One case of focal epilepsy was treated with ablation of the epileptogenic region. One case of depressed skull fracture was surgically dealt with. The rest were seen by the neurosurgeon for various other diagnostic studies, such as ventriculograms and angiograms, which were necessary for their final evaluation. The survey of all resident patients with a history of seizures, which was begun in 1952, has been completed. In conjunction with Dr. Kennard, a preliminary study of the electroencephalographic relationship to mental illness was carried out, and 100 selected cases with the clinical diagnosis of schizophrenia and psychopathy were examined. Repeated lectures on neurological subjects and techniques were given to both the medical and nursing staff. For six weeks in April and May, 1953, the Neurologist was engaged as demonstrator in neuroanatomy at the Faculty of Medicine of the University of British Columbia. Clinical demonstrations were given to first-year medical students and to students of applied psychology. Respectfully submitted. W. P. Fister, M.D., Director of Neurology. T 52 MENTAL HEALTH SERVICES REPORT, 1952-53 LABORATORY REPORT A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—The following is the report of the work performed in the laboratories at Essondale from April 1st, 1952, to March 31st, 1953:— Blood— Kahn, negative 2,732 Kahn, positive 63 Kahn, quantitative 39 Red-blood count and haemoglobin 3,321 Haemoglobin 598 Haematocrit 1 js White-blood count and differential 3,476 Arneth count 1 Eosinophile count 7 Thorn test 2 Sedimentation rate 1,165 Grouping 3 Cross-matching 2 Sternal marrow 3 Bleeding time 39 Coagulation time 36 Prothrombin activity 29 Platelet count 13 Reticulocyte count 26 Fragility . 1 Culture 9 Widal 13 Agglutination for B. abortus 9 Paul Bunnell 16 Glucose 361 Glucose tolerance curve .. 11 Amylase 2 Non-protein nitrogen 139 Urea nitrogen 14 Uric acid 6 Creatinine 11 Carbon monoxide 1 C02 combining power 4 Cholesterol 80 Barbiturate 4 Bromide 29 Chloride 9 Sodium : 5 Potassium 5 Iron 2 Calcium 14 Phosphorus 10 Alkaline phosphatase 24 Acid phosphatase 9 Icterus index 29 REPORTS OF MENTAL HOSPITAL, ESSONDALE T 53 Blood—Continued Van den Bergh 47 Total protein 16 Albumin-globulin ratio , 13 Hanger flocculation 23 Albumin 2 Bromsulphalein excretion 3 Congo red test 1 Ascorbic acid 1 Thymol turbidity 11 Cerebrospinal fluid— Kahn, negative 243 Kahn, positive 15 Kahn, quantitative 16 Colloidal gold curve 249 Cell count 512 Total protein 736 Glucose 4 Chloride 6 Ultra-violet absorption spectrum 223 Urine— Routine 8,344 Acetone 1,091 Quantitative sugar 251 Benzidene 717 Bromide 2,325 Chloride 1 Calcium 3 Phosphate 1 Amino nitrogen 47 Copper 51 Quantitative albumin 197 Bence Jones protein 3 Two-hourly 14 Friedman 64 Pregtest 11 Bile 23 Urobilinogen 21 Phenylpyruvic acid 82 Phenolsulfonphthalein 1 Barbiturates 2 Urea 1 17-ketosteroid 9 TB. (24-hour specimen) 5 pH 2 Smears— Miscellaneous 1,163 G.C. 55 TB 25 Vincent's organisms 12 Trichomonas 8 Diphtheria 2 Fungus 1 T 54 MENTAL HEALTH SERVICES REPORT, 1952-53 Sputum— TB 457 24-hour specimen for TB 4 72-hour specimen for TB 3 Cultures— Miscellaneous 606 Antibiotic sensitivity 56 Diphtheria 3 Typhoid 1,221 Dysentery 1,884 TB 17 Fungus 1 Water 10 Milk 4 Gastric contents— Analysis 8 Occult blood 4 TB 52 Faeces— Parasites 127 Occult blood 71 Bile 1 TB 18 B.M.R 141 E.C.G - 228 Surgicals 25 Autopsies 116 Animal autopsies 47 Sections 6,092 Agglutination for typhoid 3 Agglutination for dysentery 86 Pleural fluid routine 1 Semen examination 2 Injections— Typhoid vaccine 641 Diphtheria toxoid 159 Pollen antigen 27 Skin tests— Tuberculin 744 Brucellergen 2 Schick 225 Smallpox vaccinations 150 Total _. 42,262 Respectfully submitted. G. A. Nicolson, M.D., Pathologist. REPORTS OF MENTAL HOSPITAL, ESSONDALE T 55 DEPARTMENT OF RADIOLOGY A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—The following report is the work performed in the Department of Radiology from April 1st, 1952, to March 31st, 1953:— Crease Clinic of Psychological Medicine Number of films taken 4,030 Number of patients X-rayed 1,995 Patients Films Chests 1,272 1,292 Extremities 62 205 Spines 380 596 Skulls 110 232 Pneumoencephalograms 102 1,240 Barium meals 21 257 Barium enemas 5 58 Ribs 5 8 Abdomens 12 16 Gall-bladders 6 40 Pelvis 6 18 Intravenous pyelograms 5 36 Sinuses 1 4 Shoulders 1 2 Jaws 5 17 Barium swallows '. _.. 2 9 Totals 1,995 4,030 Provincial Mental Hospital Number of films taken 13,191 Number of patients X-rayed 9,147 Patients Films Chests 7,879 7,950 Extremities 513 1,501 Spines 178 435 Skulls 177 382 Pneumoencephalograms 116 1,407 Barium enemas 31 345 Barium meals 40 548 Intravenous pyelograms 21 135 Ribs 17 36 Pelvis 58 128 Abdomens 58 136 Jaws 14 43 Gall-bladders 19 116 Sinuses 10 35 Noses 7 18 Shoulders 4 8 Barium swallows 3 23 Mastoids 3 9 Totals 9,147 13,191 • Respectfully submitted. j M ^^ M D Director of Radiology. T 56 MENTAL HEALTH SERVICES REPORT, 1952-53 DEPARTMENT OF PSYCHOLOGY A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—Following is a report of work performed for the fiscal year ended March 31st, 1953, at the Provincial Mental Hospital and the Crease Clinic of Psychological Medicine. During the year the Department of Psychology continued in its chief capacity of providing psychological evaluations of those patients referred by the medical staff. Participation in various phases of the educational programme of the Mental Health Services was also continued. A new field of activity, group therapy, was commenced, and the evaluation of nursing applicants was discontinued. Miss M. E. Davidson and Mr. J. T. Hamilton, both formerly of Shaughnessy Hospital, joined our staff in August and September respectively. Miss F. J. Darroch completed an internship in psychology and returned to the University of Toronto for postgraduate training. Miss B. J. Leslie began a year's internship which will be completed in the forthcoming fiscal year. Mrs. J. C. Morton attended the Rorschach Workshop at Pacific Grove, Calif., under the direction of Dr. Bruno Klopfer, the leading authority on the use of the Rorschach method of personality diagnosis. The department examined a considerably greater number of patients than in previous years. This was made possible by a larger staff. A relatively wider use of projective techniques was employed as a consequence of an increase in the level of training of the staff. Projective techniques are time-consuming, but their worth in providing valuable clues to the personalities of the patients warrants their use. The quick turnover of patients at the Crease Clinic and the need for their rapid evaluation has increased the number of referrals to the department. The institution of referral cards has provided a useful and efficient means of keeping a check on those patients who are to be seen. Attendance at ward rounds offers a means of selecting those cases in which psychological examinations would be of most value and in determining the cases to be given the highest priority. Four hundred and twenty-seven patients were examined and reported on during the year. A total of 1,325 tests was administered. Abstracts of psychological examinations made elsewhere totalled eighteen. The weekly clinical conferences were attended, and the Psychologist's findings were presented. During the first three months of the year one qf our members provided psychological services at The Woodlands School on a one- day-a-week basis. The following is a tabulation of the tests administered in the Crease Clinic and Provincial Mental Hospital:— Arthur Point Scale 7 Bender Gestalt 42 Benjamin Proverbs 29 California Test of Personality 2 Children's Apperception Test 3 Draw-a-Person 92 Differential Aptitude 3 General Clerical 4 Goldstein Scheerer 31 Goodenough Intelligence 7 House-Tree-Person 1 Incomplete Sentences 30 Kent Emergency Scales 3 Kent-Rosanoff Word Association 1 Kuder Preference Record 12 REPORTS OF MENTAL HOSPITAL, ESSONDALE . T 57 Lee-Thorpe Occupational Interest 22 Lowenfeld Mosaic 8 Make-a-Picture Story 15 Mechanical Comprehension 1 Meier Art Judgment 3 Mill Hill Vocabulary 2 Minnesota Multiphasic Personality Inventory 22 Nebraska Test for Deaf Children 1 Otis Arithmetic Test 1 Otis Self-administering 5 Picture Concepts 1 Porteus Mazes 99 Practical Judgment 2 Primary Business Interests 3 Progressive Matrices 9 Rorschach Method of Personality Diagnosis 230 Rosenzweig 1 Shipley-Hartford 122 Stanford-Binet Forms L and M 35 Symonds Picture Story 12 Szondi 21 Thematic Apperception Test 106 Wechsler-Bellevue Forms I and II 302 Wechsler Memory Scale Forms I and II 20 Wechsler Intelligence Scale for Children 12 Wide Range Achievement 3 Total 1,325 The administration of a battery of psychological tests to new student nurses and aides was discontinued in November. Two hundred and twelve were examined from April to November. The following is a tabulation of the tests administered:— Army Alpha 200 California Test of Personality _._.._ 200 Kuder Preference Record 200 Thurstone Test of Mental Alertness 12 Psychologists took part in various aspects of the educational programme of the Mental Health Services. One intern completed and another commenced a year's practicum in clinical psychology. Fifty-six hours of lectures in basic psychology were delivered to psychiatric nurses-in-training. Examinations, totalling 489, were set and marked. Members of the department participated in seminars with members of the medical staff and presented eight papers. Teaching clinics for University of British Columbia students in abnormal psychology were attended by a staff member, who contributed the psychologist's view-point on the mentally ill. Members of the staff participated in two round- table discussions concerning the Mental Health Services. Four showings of the film " Breakdown " to Parent-Teacher Association groups were introduced and discussed by staff members. A new duty which has been found to be very rewarding is that of group therapy. In conjunction with the medical staff, members of the department have been working with groups of patients who discuss their problems and increase their skills of interpersonal relationships. Both acutely ill patients and patients who have had lobotomies make up these groups. Eighty-two sessions of approximately one and one-half hours each were completed during the year. T 58 MENTAL HEALTH SERVICES REPORT, 1952-53 It is felt that during this year the Department of Psychology has increased considerably in its contribution to the hospital team. The high number of admissions, to the Crease Clinic especially, has made a great demand on our staff. It is important in an intensive treatment centre that the psychological study should be made shortly after admission. It is undesirable that treatment should be delayed while the Psychologist completes his investigations, but, on the other hand, once certain treatments begin, the findings tend to be distorted. At the present time there is usually a lag between the time of referral and the time examinations begin because of the large number of referrals. An increased staff to cope with this load would be desirable for the future. Respectfully submitted. Alice Elart, J. W. Borthwick, Psychological Clinic Assistants. SOCIAL SERVICE DEPARTMENTS, PROVINCIAL MENTAL HOSPITAL, HOMES FOR THE AGED, AND CREASE CLINIC OF PSYCHOLOGICAL MEDICINE. A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—The report of the Social Service Departments for the past fiscal year is here presented and considered under three sections:— I. Changes in the organizational structure and administrative responsibilities in social services. II. Review of social services to patients over the past fiscal year. III. Social-service trends as seen in realtion to the service needs of patients and their families. The social-work job all the world over is concerned with helping people to make conscious adjustments and adaptations to their life situations, individually, through group experience, and by the provision of social-welfare resources in the community. Functions and processes, such as teaching, supervision, administration, and research, have evolved. The basic principles and methods contained in these functions are in process of continuous restatement and refinement to the end that social work make as effective a contribution in the service of people and in the service of the health and welfare agencies as possible. The social-work job in the psychiatric hospitals and clinics is generically the same as the aforedefined but with these additional skills and responsibilities: A knowledge of the content of the problems dealt with in psychiatric hospitals and clinics; an ability to use the social-work skill in a collaborative working relationship with the many other professional disciplines in the psychiatric setting—all of which are also concerned with the specific problem as presented by the individual patient. In short, the essence of the social-work job in the psychiatric hospital and clinic setting is the effective incorporation of its skills and body of knowledge into hospital and clinic practice. Over the past fiscal year, in their work in the Provincial Mental Hospital and Crease Clinic, the social workers have been purposefully studying how best to incorporate social work into the purpose and services of each setting; how best to dovetail social-work effort to achieve therapeutic unification to the end that patients are better served. REPORTS OF MENTAL HOSPITAL, ESSONDALE T 59 I. Changes in the Organizational Structure and Administrative Responsibilities of the Social Services, Provincial Mental Hospital and Crease Clinic In May, 1952, a decision was made whereby the existing social-service staff at the Provincial Mental Hospital was divided into two separate Social Service Departments— one located in the East Lawn (Women's Section) and Centre Lawn (Admission Section); the second department located in the Crease Clinic on Wards East 2, East 4, Centre 4, and West 4. II. Review of Social Services to Patients over Past Fiscal Year 1. Social Service Department, Provincial Mental Hospital There are two sections to this department—one concerned with admission (intake and reception services around the admission of patients), brief case-work services to patients and families, as well as selection and referral of patients and families to longer- term case-work services given by the second section, the Continued Case Work Services Section. The present social-service staff at Provincial Mental Hospital consists of one social worker in the Admission Section (this worker is supervised by a case-work supervisor having responsibility for all the social services given at the time of admission both in the Hospital and the Clinic), six social workers in the Continued Case Work Services Section in the Provincial Mental Hospital, and one case-work supervisor over this section. (a) Work of the Admission Section, Social Service Department, Provincial Mental Hospital, April, 1952, to March, 1953.—Social services during the admission period are directed to assisting in the interpretation of hospital services and programme to patients and families. This will often entail helping the family to deal with problems arising out of the admission of the patient. Help will also be given to the relative and patient, with their feelings of uncertainty and worry arising out of the fact that hospitalization has to be considered. The whole focus during this period is in establishing a relationship with the family which encourages them and helps them to see the hospital and the patient's need for treatment or a period of care in a positive non-rejecting way. With the growth of this feeling, the family can play its part in the patient's treatment programme and finally be ready to receive the patient on discharge from hospital and help him in his adjustment to family and community life. During reception into Hospital the patient himself is helped to accept his need for hospital care. Attempts are made to relieve the patient, if at all possible, of the fears and threats embodied for him in the security setting of the mental hospital. At this time the social worker, along with the other disciplines, explains hospital routines and procedures and helps the patient to understand that the social worker serves as a link between him, his family and community. It is important that family life and community ties be maintained. The admission and reception of the patient sets the whole tone of his response to treatment. During the admission period the social worker begins the social study of the patient, his interpersonal and interfamilial relationships, his experiences, and his ways of feeling, thinking, and responding to these experiences. REPORT OF ADMISSION SECTION, PROVINCIAL MENTAL HOSPITAL, APRIL, 1952, TO MARCH, 1953 Apr. May June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. Mar. Total Total admissions, Provincial Mental Hospital Referrals for social-history study Interviews with patients at time of admission- _ Interviews with psychiatrists at time of 86 32 7 11 15 11 4 105 41 11 9 20 29 6 101 37 18 15 24 18 10 133 51 20 9 18 11 4 112 46 17 6 21 30 4 102 40 23 7 17 34 8 147 61 42 13 37 33 8 101 57 31 18 25 37 12 107 34 21 21 14 42 10 116 48 14 16 23 15 12 101 40 12 8 20 17 10 121 37 38 91 1,332 524 254 Brief social services to relatives and 27 | 261 11 1 ins Ward rounds following admission clinics on admission 12 100 T 60 MENTAL HEALTH SERVICES REPORT, 1952-53 This table records the year's activity of the social worker on admissions in the Provincial Mental Hospital. In review, the table shows that an average of 111 patients are admitted monthly to the Provincial Mental Hospital; some 39 per cent (524) of all patients admitted yearly are being extended social services at the point of their reception into hospital. The social worker on admissions is active with the following patients: — (i) The Young Psychotic.—This is the largest group to which social services are being extended at the point of the patient's reception. These patients and their families are in great need of long-term case-work services. A large number of the patients in the young psychotic group are transfers from the Crease Clinic at the point where the four-month treatment has lapsed with relatively little change in the pattern of the patient's illness. To this transferred young psychotic group the social worker in the Admis- mission Section serves as a liaison between the Crease Clinic Continued Case Work Services worker and the Provincial Mental Hospital Social Service Department. This transferred group of patients needs the understanding and supportive help of the social worker, for the very fact that they have failed to respond to treatment at the Clinic is distressing and disturbing to them. Often this transfer is felt to be rejection of the patient, (ii) The Older Group of Mentally III.—Included in this group are a large number of readmissions, which patients come to the Admission Section for an interim evaluative study. The social worker assesses again the family situation, discusses the patient's prognosis with the psychiatrist, thus determining what the extent of Continued Case Work Services is likely to be, and then, through conference, transfers the patient to this section, (iii) The Mentally Retarded Patient over the Age of 6 Years.—To this group brief case-work services are given by the social worker on admissions to the patient's family at the time of reception. Parents of these patients require much help with their sorrow and interpretation around why their child must be committed to a mental hospital before entering The Woodlands School, (iv) The Alcoholic Patient.—The psychiatrist treating this group of patients often requests the social worker on admissions to undertake a social diagnostic study so that he may assess whether the patient is suitable or ready for the extensive treatment programme in the alcoholic clinic. The table further shows that 261 families were given brief case-work services, that 354 interviews were held with patients at the time of reception, and that the collaborative function of social worker at the time of admission was furthered through 156 interviews with the psychiatrists and attendance at 100 clinics and ward rounds. In the ward round, presided over by the clinical director, the individual and social dynamics which go to make up the patient, his illness, and his total response to life are studied. It is here that the social worker on admissions makes her contribution out of her study of the family-patient-community interrelationship. Here, too, the social worker gains in understanding of psychodynamics and patient-care needs in hospital. (b) Work of the Continued Case Work Services Section, Social Service Department, Provincial Mental Hospital, April, 1952, to March, 1953.—In this section, case-work services are brought to the patient during his treatment period, along with correlative family therapy. Another service is that of pre-convalescent planning, as well as the service of convalescent care. This latter involves after-care social services to the patient on extended visit (probation), besides case-work services of an after-care nature to the voluntary patient discharged in full of hospital care. Dr. Alan A. Lieberman, of Elgin State Hospital, Elgin, 111., has recognized that " the social worker's contribution to therapy in work with the mentally ill will be pri- REPORTS OF MENTAL HOSPITAL, ESSONDALE T 61 marily in his understanding of human relations, and he will strengthen the healthy aspects of the patient's personality in order to enhance adjustment to reality problems." Throughout the treatment period the social worker is concerned with all aspects of the patient's relationship with medical and nursing staffs, with other patients, family, friends, and community. REPORT OF CONTINUED CASE WORK SERVICE SECTION, SOCIAL SERVICE DEPARTMENT, PROVINCIAL MENTAL HOSPITAL, APRIL, 1952, TO MARCH, 1953 Treatment Pre-conva- lescence Convalescence Total 1,116 1,327 1,341 525 138 42 474 270 636 258 60 27 867 471 375 57 9 15 2,457 2,068 2,352 840 Conferences with community agencies 207 84 4,489 1,725 1,794 8,008 Total number of patients referred 607 Total number of ward rounds and clinics —._ _ 108 This table records the total number of patients (607) referred during the past fiscal year to the Continued Case Work Service Section of the Social Service Department, Provincial Mental Hospital. During the treatment period of hospital care, the social worker's contact with the patient on the ward is directed toward building a supportive, understanding relationship through which the patient is helped to hold to whatever reality functioning he may possess. Interest in wife, husband, children, and parents, etc., is maintained, besides which the patient is helped to work through those problems of which he is aware and about which he expresses concern. During the treatment period 607 patients and families received case-work services involving 4,489 interviews. Some 24.8 per cent of these were directly with the patient. Some 29.5 per cent of all interviews were extended to retaining the interest of the family and friends in the patient. This is accomplished by familiarizing the family with the nature of the illness, its treatment, hospital routines; by helping the relative with his own feeling about mental illness and the mentally ill patient. In this way is the family helped to see what it can do in becoming a part of the treatment programme and rehabilitation planning. Some 29.8 per cent of all interviews were directly concerned in conferences with the psychiatrist; 14.7 per cent with nursing, occupational therapy, etc.; and 0.93 per cent with community agencies. The latter interviews show the extent of the social workers' collaborative working relationship with the other professions during the treatment period. As the patient approaches the termination of treatment, a review of the content and meaning of the patient's living experiences before hospitalization and during hospital care is undertaken by the treatment team in hospital. At this time some attempt is made to pool together and arrive at some social rehabilitation programme for the patient. During the past fiscal year 1,725 interviews were extended in case-work services to patients during the period of pre-convalescence. Of these, 27.4 per cent of all interviews were directly with patients; 15 per cent with family; 36.8 per cent with psychiatry; 18.4 per cent with nursing, occupational therapy, etc.; and 1.5 per cent with community agencies. Convalescent care is the re-establishment of the patient in the community. During this period the patients on probation remain the responsibility of the Hospital. The social worker assists in the discharge of this responsibility by supervising the patients and by making available for the use of the patients all the resources in the community helpful to their readjustment. The family is helped to understand the patient. The patients are T 62 MENTAL HEALTH SERVICES REPORT, 1952-53 helped to regain economic security by helping them to locate work and by encouraging the interest and acceptance of the employer group. Besides the latter committed patient group, social workers also bring similar convalescent services to the voluntary patient discharged in full of hospital care. During the past fiscal year 768 patients were referred for convalescent services. Some 1,794 interviews were directed to helping these patients. Some very significant developments have taken place during the past year in the Continued Case Work Services Section of the Social Service Department, Provincial Mental Hospital. In spite of the large number of referrals and staff shortages, two social workers began to work full time on two wards. The appointment of social workers at ward level is the only soundly efficient operative level for social work in the large Provincial mental hospital. Working at this level, the social worker works closely with nursing, psychiatry, psychology, and occupational therapy in a " total push " relationship. This relationship brings added skills and vitality to the understanding of the patients, to treatment, and to socialization through dynamically oriented ward living. The social worker's responsibility on the ward has been directed toward establishing a case-work relationship focused on helping the patient to move in a meaningful way to ward activities, such as occupational and industrial therapy; to be a liaison person between the hospital and the patient's relatives; to bring to the other professions working on the ward pertinent information regarding family relationships; and to secure and bring into play rehabilitative resources for the patients. 2. Social Service Department, Crease Clinic of Psychological Medicine There are two sections to this department—one concerned with admission (intake and reception services at the time of the admission of the patient), brief case-work services to patients and their families, as well as selection and referral of patients and families to longer-term case-work services given by the second section, the Continued Case Work Services Section. The present social-service staff at the Crease Clinic is made up of two social workers in the Admission Section (these workers are supervised by the case-work supervisor in charge of all admission services at the Provincial Mental Hospital as well as Crease Clinic), five social workers in the Continued Case Work Services Section in the Crease Clinic, and one case-work supervisor has responsibility for the supervision and co-ordination of the work of this section. The Social Service Department of the Crease Clinic has had 1,100 patients referred for service over the past fiscal year. (a) Work of the Admission Section, Social Service Department, Crease Clinic, April, 1952, to March, 1953.—The work of this section in the Crease Clinic began in the summer of 1951, and by June, 1952, it was felt that the service was accepted by all other professions and functioning well as a service. During the eight-month period to June, 1952, the Admission Section (then consisting of one worker) received referrals on 175 patients at the time of their reception into the Clinic out of a total of 766 admitted. In the next four months to October, 1952, these referrals increased to a total of 33 per cent (518 patients per year) of all patients admitted. As there was one admission worker at this time, the need was seen for increased staff, with a view to covering 50 per cent (800 patients per year) of all patients admitted. In January, 1953, this section was increased to two workers. REPORTS OF MENTAL HOSPITAL, ESSONDALE REPORT OF ADMISSION SECTION, CREASE CLINIC, APRIL, 1952, TO MARCH, 1953 T 63 Apr. May June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. Mar. Total 107 21 13 25 15 14 12 120 25 25 27 18 19 8 119 32 23 32 21 10 8 83 21 33 26 28 17 4 86 29 21 22 19 11 4 92 23 22 24 23 12 8 94 26 24 28 20 15 12 89 17 20 29 12 14 12 88 81 51 103 9 54 8 129 121 36 101 7 47 8 108 99 32 89 11 23 8 106 78 24 85 16 82 12 1,221 573 Interviews with patients at time of admission. Interviews with psychiatrists and 324 591 199 Brief services to patients and relatives Ward rounds following admission clinics on admission 318 104 This table records the year's work of the two social workers on admissions. Some 1,221 patients were admitted to the Clinic, and, of these, 573 patients (46.9 per cent) were extended social services at the time of their reception into the Clinic. Some 318 of the 573 patients and families were carried in the Admission Section and received casework services of an enabling and supportive nature over a brief period. Some 324 patients of the 573 patients seen by Admission Section were helped individually at the time of their reception into hospital. The table further indicates that 562 conference interviews were undertaken by the Admission Section with the psychiatrists and nurses, to the furtherance of a collaborative working relationship, in the light of the best service possible for the patient. (b) Work of the Continued Case Work Services Section, Social Service Department, Crease Clinic, April, 1952, to March, 1953.—Case-work services are brought to the patient in the Crease Clinic and his family throughout the period of treatment in hospital, as well as in planning discharge (pre-convalescent service) and after discharge (convalescent service). REPORT OF CONTINUED CASE WORK SERVICE SECTION, SOCIAL SERVICE DEPARTMENT, CREASE CLINIC, APRIL, 1952, TO MARCH, 1953 Pre-conva- lescence Convalescence Total Interviews with patient Interviews with family Conferences with psychiatry Conferences with nursing — Conferences with other disciplines Conferences with other agencies Total number of interviews Total number of patients referred Total number of ward rounds and clinics 1,590 1,385 1,635 272 48 225 948 368 795 236 40 336 768 681 699 18 368 3,306 2,434 3,129 508 106 929 5,155 2,723 2,534 10,412 1,100 101 This table shows that 1,100 patients were active with the Continued Case Work Section of the Social Service Department of the Crease Clinic. Some 5,155 interviews (49.5 per cent of all interviews) were extended to the patient and his family during the period of hospital care. Some 2,723 interviews (26.15 per cent of all interviews) were extended to the patient and his family in planning for discharge, while 2,534 interviews (24.4 per cent of all interviews) were given to patients and families following the patient's discharge in full of the Clinic's service. It is in the aforementioned post-discharge service that we see the social workers operating in an area of service which is an increasing need of patients, that is, an outpatient clinic facility of the Crease Clinic. Over the next fiscal year the demand for the service is bound to increase. The Vista rehabilitation centre has continued to make an outstanding contribution in the rehabilitation of women patients without resources in family or friends, or whose T 64 MENTAL HEALTH SERVICES REPORT, 1952-53 families are unable to give the supportive help necessary in their rehabilitation. During the past fiscal year the Social Service Departments of the Provincial Mental Hospital and Crease Clinic have conferred with the supervisor at The Vista on 201 occasions and made 286 visits to patients in residence at The Vista. The success of The Vista is such that the possibilities of increasing this type of rehabilitation facility should receive purposeful thought and study as to ways and means. (c) Report of Participation in Education and Training of Social Service Departments, Provincial Mental Hospital and Crease Clinic.—One of the first responsibilities of social workers in education is to their own profession—social work. For the past three fiscal years, under Federal Mental Health Grants, twenty-eight social-work students have had their field-work placement in the Provincial Mental Hospital and Crease Clinic. Although direct responsibility for the supervision of the students was with the School of Social Work training supervisor, plans for introduction and orientation to the Social Service Departments of Hospital, Clinic, and community agencies were evolved with the participation of the department. The introduction of the students to interdepartmental co-operation between the Social Service Departments and other departments of the Hospital and Clinic, and policies relating thereto, as well as intercommunity agencies' policies, was the responsibility of the Social Service Departments. The Social Service Departments have attempted to help the students feel the basic underlying philosophy of the service by working closely with them and sharing through staff meetings and special studies. The contribution of the training supervisor and the students to the growth of the social services in Hospital and Clinic has been rich and valuable. Fourteen planning sessions around the training project were held during the fiscal year. The Social Service Departments have a second responsibility in education and training, which is directed to staff development and training. This is achieved through two media—social-work supervision and participation in staff meetings. During the past fiscal year forty staff meetings were held, and the contribution of the social workers in the organization, administration, refinement of social-work skills and services has been of the highest order. (d) Report of Administrative Procedures, Social Service Departments, Provincial Mental Hospital and Crease Clinic, April, 1952, to March, 1953:— Admission Sections— Supervisory conferences 96 Case-assignment conferences 48 Policy conferences with doctors 42 Social-worker staff conferences re assignment of cases 144 Interpretation-to-public sessions 56 Administrative reports prepared 38 Interdepartmental administrative meetings 36 Supervision of social workers (hours) 216 Ward rounds 101 Staff meetings 37 Teaching clinics 24 Orientation professional groups 12 Continued Case Work Services Sections— Supervisory activities— (a) Supervision of case-workers (hours) 577 (b) Conferences with clinical director on policy matters— 72 (c) Conferences with individual psychiatrists 204 (d) Conferences with community agencies re individual patients 66 Ward rounds 96 REPORTS OF MENTAL HOSPITAL, ESSONDALE T 65 Staff meetings 40 Medical climes 12 Educational activities— (a) Social-work education— (i) Clinical presentations 4 (ii) Supervision of students (hours) 24 (b) Nursing education— (i) Interpretation to psychiatric nurses (hours) 16 (ii) Interpretation to postgraduate nurses (hours) 12 (iii) Interpretation to affiliate nurses (hours) 9 (c) Orientations— (i) Social workers (hours) 16 (ii) Psychiatric fellows (hours) 5 (d) Ward-round conferences, Mental Hospital and Crease Clinic 208 Clinical conferences 21 III. Social-service Trends in Relation to Patients' Needs Over the past fiscal year there has been an 11.7-per-cent increase in the number of patients referred to the Social Service Departments. During the 1951-52 fiscal year 2,100 patients were referred, whereas during the past fiscal year 2,475 patients were served by social workers. This past fiscal year has seen a 61.1-per-cent increase in case-work service interviews to patients in the Hospital and Clinic. In the fiscal year 1951-52, 13,221 service interviews were extended to patients. During the past fiscal year 21,298 interviews were given in the service of patients. Another very noticeable trend is that of the increasing number of patients referred to Social Service from the long-term patient group. Some 267 patients from this group were referred during the past fiscal year for social case-work services, focused on helping the patient to use more purposefully and effectively the treatment services of the Hospital. This is a most progressive step in the use of all available professional services in the mobilization of patients on long-term treatment wards—a mobilization directed to patient study, treatment, and rehabilitation. (Miss) Alice K. Carroll, B.A., M.S.W., Provincial Supervisor of Psychiatric Social Work. DEPARTMENT OF NURSING SERVICE Women's Division A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—Presented herewith is the report of the Department of Nursing Service (Women's Division) for the fiscal year ended March 31st, 1953. The nursing staff has improved this past year. It has been increased by 91 personnel. Some of the increase was due to fewer resignations, but mainly through improved recruitment. The year ended with the following personnel:— T 66 MENTAL HEALTH SERVICES REPORT, 1952-53 Registered nurses 35 Psychiatric graduate nurses 114 Psychiatric nurses-in-training 139 Psychiatric aides 187 Postgraduate students 2 Student psychiatric nurses 105 Home housekeepers 24 Nurses' Counsellor 1 Total 607 During the year there were 281 resignations, 12 transfers to other departments, and 397 new appointments. The attrition rate has continued to be high, but resignations had decreased by 15 as compared with the previous year. The reasons for resignation are as follows:— Marriage 38 Illness 24 Illness in the family 16 Unsuited to psychiatric nursing 13 To take student Psychiatric Nursing Course 14 To take another position 21 To take General Nursing Courses 12 To gain further experience 12 To return to school 8 To resume household duties 22 Completion of postgraduate course 4 To reside in another Province 11 To travel 2 Transportation difficulties 1 Temporary staff 65 Services terminated 18 The increase in the staff was required to open new units of the hospital. During the year, Cottages 8 and 9 of the Home for the Aged were opened. The third ward of the three women's wards of the Crease Clinic was opened. This is an open ward where patients are assisted in their rehabilitation. The patients are given considerable freedom but also more responsibility. We were also able to open the operating-room after many delays. The first operation was performed on February 9th, 1953. The surgical ward located in the corridor of West 2 Ward was opened March 3rd, 1953. This provides facilities enabling the staff to give the very best post-surgical nursing care. The School of Psychiatric Nursing has had an extremely busy year. The volume of students who have received the Psychiatric Nursing Course has been in excess of last year. The instructors are to be commended for their management of the situation. This past year we were able to extend the affiliation programme to include the Schools of Nursing of the Royal Inland Hospital and the Royal Jubilee Hospital. The Schools of Nursing of the University of British Columbia, Vancouver General Hospital, and the Royal Columbian Hospital continued to send some of their students. Graduation exercises were held for the third time in the New Westminster Junior High School. A total of 150 students graduated from the three units at Essondale, The Woodlands School, and Colquitz. Nursing education has been broadened to include psychiatric aide and the graduate groups. Prior to October 1st, psychiatric aides were not given any instruction. This being unsatisfactory, arrangements were made to give each group of psychiatric aides a REPORTS OF MENTAL HOSPITAL, ESSONDALE T 67 course of instruction during the first week of employment. The adjustment and the quality of work has been greatly improved. A programme of lectures and demonstrations was arranged for the graduate nurses. This programme was primarily arranged for the charge nurses from both the women's and men's divisions. Assistant charge nurses and graduates were invited to attend. There has been considerable minor illness among the staff. Many have been treated in the Nurses' Infirmary. We have been fortunate indeed to have had the services of Dr. Yakushavich and Dr. Dobreva. An active programme of immunization for tuberculosis has been in operation through the use of B.C.G. vaccine. All students, graduates, and aides are vaccinated. We hope that the incidence of tuberculosis will be reduced by this programme. During the year three student nurses were ill with tuberculosis and two were ill with pleurisy with effusion. Mrs. E. Gibson was appointed as Nurses' Counsellor. She comes to us with wide experience in nursing and counselling. We are fortunate indeed in securing the services of Mrs. Gibson, as the need for a counsellor among the student group was very great. Activities and social events are being organized and are proving very successful. There have been several changes in the senior staff of this department. Miss M. Thieman transferred to the Home for the Aged, Vernon, to take the position of Superintendent of Nurses, which was vacated by Miss C. E. Clark. Miss F. Logan, R.N., transferred to the Pearson Hospital. Miss J. Shand, R.N., resigned her position as instructor to take a position in the United States. During the past year we have seen some stabilization of our staff, which is encouraging. However, we still have too few who are able to take positions which require special training in teaching and supervision. In order that we may have sufficient staff with these qualifications, I would suggest that a plan be laid to encourage our senior psychiatric nurses to augment their present training by additional training at a general hospital and then allowed the advantage of a course in teaching and supervision at a university school of nursing. The interest, patience, and tolerance which have been shown by the senior ward staff has been most encouraging. Their problems have been many, and they are to be commended for the efficient way in which they have given care and treatment to our patients. We also appreciate the assistance which has been given so generously by all departments. Respectfully submitted. (Miss) Edith M. Pullan, R.N., Director of Nursing. Men's Division A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—On April 1st, 1952, the total male nursing staff, including student-nurses, psychiatric aides, and utility staff, was 376. In the following twelve months there were thirty-one resignations, four superannuations, five transfers to other departments, and two dismissals—forty-two in all. During this period forty-six student-nurses and twenty-eight psychiatric aides were added to the staff. Also during this time sixty-eight completed their third school term, graduating as male psychiatric nurses. One of this group resigned. Fifty completed their second term; of these, four resigned. Two also took their third term. Thirteen student male nurses commenced classes as of April, 1953. The standing, therefore, at March 31st, 1953, was as follows:— T 68 MENTAL HEALTH SERVICES REPORT, 1952-53 Male psychiatric nurses _ Psychiatric aides Second-year male nurses (regular staff) _ Second-year student-nurses First-year student-nurses New students 260 75 29 18 13 13 Total 408 These were distributed as follows:— Psychiatric Nurses and Second Year Aides Students Total 58 170 35 1 3 15 7 4 48 12 1 10 7 15 3 13 6 69 Essondale. . . 233 50 1 ni 4 25 7 13 6 Totals 289 75 44 408 Since our last report for the Male Nursing Department, our new surgical ward has been opened, as of March 3rd, 1953. This ward is operated with a complete staff of registered nurses and male and female psychiatric nurses. There are four male psychiatric nurses regularly attached to this ward. The number of patients who have been treated here to March 31st is fourteen. The Crease Clinic recreational and occupational departments contribute a great deal to the improvement and recovery of patients. Our records shown an ever-increasing number of patients discharged, creating interest in the public in general and influencing many to voluntarily apply for admittance. On the psychiatric nurses and aides depend largely the care and improvement of the patient, and at this time I wish to commend the nursing staff for its good work. We can look back with a great deal of pride to the night of April 30th, when the largest graduation class ever held for our psychiatric nurses from Essondale received diplomas, and the great interest of the public was gratifyingly demonstrated by the very large audience. I would like to take this opportunity to thank all those who have given of their valuable time to bring the very fine and much appreciated lectures on a variety of subjects for the benefit of charge and assistant charge nurses, as well as general-duty staff. In this regard our special thanks go to Miss Street, instructor in the School of Nursing at the University of British Columbia. To all the doctors, nurses, clinical staff, and heads of departments who have helped in no small measure the nursing staff, we are extremely thankful. Respectfully submitted. W. Creber, Chief Male Psychiatric Nurse. REPORTS OF MENTAL HOSPITAL, ESSONDALE T 69 DEPARTMENT OF NURSING EDUCATION A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—I wish to submit the following report. The activities of the School of Psychiatric Nursing have increased during the past year due to several factors. It was necessary to include greater numbers of three-year students in each class in order to complete the course within the prescribed time. The number of students enrolled in the two-year course has steadily increased, a fact which may be attributed to visits made to the schools throughout the Province by Mrs. Lundahl two years ago, and to the better integration of classroom teaching and ward experience, which has produced an improved course. Following are the numbers of students who received instruction:— Three-year students— Essondale— Women 290 Men 95 Woodlands School— Women 96 Men 56 Total 537 Two-year students— Women 147 Men 5 6 Total 203 Affiliate students— Vancouver General Hospital 32 Royal Columbian Hospital 15 Royal Jubilee Hospital 4 Royal Inland Hospital „ 4 University of British Columbia (degree course) 3 Total 5 8 Postgraduate students 9 In May and June, 1952, thirteen Public Health Nursing students came from the University of British Columbia in groups of two and three to observe the activities of the various departments of the Mental Health Services. The selection of students, the planning of their rotation through the different departments to obtain a balanced experience and at the same time contribute the necessary service, and the arrangements for affiliation with The Woodlands School are responsibilities which have been assumed by the Department of Nursing Education. The instructors have also contributed to the programmes arranged for charge nurses and their assistants. By increased contact with those in charge of wards and other departments, we are endeavouring to better understand their needs and so interpret them to the student-nurses. To our Students' Counsellor and all staff of the Medical, Nursing, Psychology, Dietary, Physiotherapy, Audio-Visual, Occupational Therapy, and Recreational Therapy Departments who have so graciously assisted us in achieving our aims, we offer our sincere thanks. Respectfully submitted. ... . _ r ' (Miss) Orma J. Smith, Senior Instructor. T 70 MENTAL HEALTH SERVICES REPORT, 1952-53 DEPARTMENT OF REHABILITATION Women's Division A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—The increased services now available at The Vista have been used to much better advantage during the past year. The active participation of the psychiatric social workers in assisting with job placements has shortened the stay of individual patients in The Vista. The new supervisor, Mrs. Rees, and her assistant have worked capably and industriously in the rehabilitation of the patients in their care and toward a general improvement of the establishment. We are now using an introductory letter with which to acquaint the patients proceeding to The Vista with an understanding of its operation. Our present undertaking is to allow patients to stay for two or three weeks, with an extension of this allotment available to those patients without funds who have taken employment. However, the patient is then asked to secure private accommodation as soon as she has received a pay-cheque. A number of the patients discharged via The Vista come back for periodic visits or out-patient interviews after they have moved, and this is considered evidence of the good relationship they enjoy with the rehabilitation division and not an indication of continued dependency. There have been few times during the year that the 7-bed accommodation has not all been filled. Reference to the following table would show that we have nearly doubled the number of patients admitted to The Vista from last year, and that fifty-four patients have been rehabilitated through this agency, forty-five coming from the Clinic and thirteen from the Mental Hospital. The majority of these patients have been placed in employment. Total number admitted to The Vista from the Crease Clinic 45 Total number admitted to The Vista from the Provincial Mental Hospital 13 Number returned to the Crease Clinic 3 Number returned to the Provincial Mental Hospital 1 Rehabilitated to the community 6 Rehabilitated to own home Rehabilitated to job and lodging 39 Total rehabilitated 54 Respectfully submitted. F. E. McNair, M.D., Clinical Director. Men's Division A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—I take pleasure in submitting the annual report of the Men's Division of the Rehabilitation Department for the fiscal year April 1st, 1952, to March 31st, 1953, together with a statistical summary of the cases assisted. There has been a substantial increase in the number of patients placed in employment and assisted in their rehabilitation plans in spite of it having been a rather difficult REPORTS OF MENTAL HOSPITAL, ESSONDALE T 71 year as far as general employment was concerned. There are a number of reasons for this: One is the increased acceptance by the general public and employers in particular of the recovered mental patient. The intensive treatment programme of the Crease Clinic of Psychological Medicine and its gratifying results have done much to educate the public of the hopefulness of psychiatric treatment. Another reason is the general impetus in all fields of rehabilitation of handicapped persons. This again is a good medium of education and liaison, and continually brings to the attention of the employer the potential man-power that is usefully available. A third reason is that the department is becoming better known as time goes on. In this the careful selection of patients is important. Successful and continued placement depends on receiving a good report from the employer, thus building up his trust in psychiatric treatment and the placement techniques of the Rehabilitation Department. There is still a great deal of work required in a liaison and interpretive sense, but the ex-mental patient is increasingly being accepted for his employ ability assets. There are still many needs to round out a first-class rehabilitation job, and the following are suggested for your perusal:— (1) An in-town rehibilitation centre:— (a) To eliminate loss of time in transporting patients by ones and twos to Vancouver and back to the hospital: (b) To relieve overcrowding in convalescent wards: (c) To facilitate interviews with prospective employers. (2) Increased staff. The job of the Rehabilitation Officer is becoming increasingly more in demand. With the increase in discharges, particularly from the Crease Clinic of Psychological Medicine, the number of interviews, not only with patients and staff, but with employers, agencies, and families, plus the increased transportation of patients to and from centres of employment, is more than one person can do efficiently. (3) More adequate funds available for rehabilitation of patients:— (a) The question of initial maintenance is a very serious one. At the point of discharge, the patient needs not only considerable reassurance, but material assistance until he receives his first pay-cheque. (b) Many patients would benefit psychologically by retraining or brush-up courses. Possibly the proposed Schedule R may produce an answer to this. In conclusion, the general trend in this Province tends to move toward the establishment of secondary industries, not only to utilize the products of primary industries, but to cope with the ever-increasing problem of unemployment caused by the influx of workers and new citizens to the West. In this I see increased hopes of a greater variety of occupations as well as more suitable types of work for the ex-patient. Our department, as a pilot project in the field of rehabilitation, should be looking to the future and to the welfare of the increasing number of patients that are ready for resocialization and re-employment. In submitting this report I again want to thank all members of the Hospital staff for their co-operation and teamwork during the past year, and to express appreciation for the acceptance, assistance, and interest of outside agencies, business concerns, and industry. T 72 MENTAL HEALTH SERVICES REPORT, 1952-53 Summary of Referrals tn as CN s in o\ QJ 3 3 1-1 CN o\ 3 H 3 < CN >o 0> tt Si e u o, Si Vi <N V. cr. \- Si £ o o O ON Si XI a Si > O Z "O U XI e V u u Q m m b S3 3 >-_ cn & 3 CO u Vi 0 H Schizophrenia _ -„ Manic depressive Alcoholic psychosis - 11 2 1 4 1 2 2 1 1 12 2 1 1 1 1 1 8 1 2 1 1 15 2 4 1 1 8 2 1 4 12 2 1 1 1 1 11 1 1 1 2 2 1 1 6 1 1 1 1 3 1 1 1 2 2 1 1 4 1 10 3 1 5 1 16 1 7 1 12 4 1 2 1 123 11 3 28 Idiopathic epilepsy with psychosis, ,.. Idiopathic epilepsy without psychosis Epilepsy with mental deficiency 3 4 5 14 12 12 Involutional melancholia G.P.I 1 6 Brain tumour with psychosis Mental defective - 1 2 Psychosis with somatic symptoms Behaviour problem 1 1 1 1 1 1 4 26 1 19 2 13 3 23 1 15 1 18 4 21 1 16 2 11 1 21 ...... 26 3 ... 21 230 Resumed treatment 11 8 Total active rehabilitation cases _ 25 17 10 22 14 14 20 14 10 21 23 21 211 17 8 140 9 8 136 3 7 88 12 10 114 11 3 102 10 4 79 10 9 107 6 8 102 7 3 77 13 8 109 8 15 122 15 6 117 122 Cases assisted by referral and casework. Total interviews (doctors, staff, patients, employers, etc.) _ 89 1,293 Respectfully submitted. J. D. Addison, Rehabilitation Officer. REPORTS OF THE WOODLANDS SCHOOL T 73 REPORTS OF THE WOODLANDS SCHOOL, NEW WESTMINSTER REPORT OF THE MEDICAL SUPERINTENDENT A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—It is with pleasure that I submit the report of The Woodlands School, New Westminster, for the fiscal year April 1st, 1952, to March 31st, 1953. The reports of the various departments are included. This residential training-school for the mentally retarded had, on April 1st, 1952, a patient-pupil population of 439 males and 369 females, totalling 808. In addition, we had 6 males and 3 females on probation, totalling 9, making a grand total of 817. On March 31st, 1953, we had an actual total in our hospital-school of 628 males and 457 females, totalling 1,085, and, in addition, 7 males and 5 females on probation, totalling 12. This made a grand total on our hospital-school register of 1,097. s all Pine, Beech, and Willow Cottages at The Woodlands School. Effective December 1st, 1952, children under 6 years of age were admitted directly to The Woodlands School under the " Mental Hospital Act" instead of to Essondale as heretofore. Children under 6 years of age are on a waiting-list basis and are admitted when accepted by the Medical Superintendent here. The waiting-list, previously at Essondale, was turned over to the Medical Superintendent at The Woodlands School for December 1st, 1952. The new Act relating to Mental Defectives went through the last Legislature, but with the transfers of the mentally retarded from Essondale and the direct admissions of those under 6 years of age, our accommodation for new admissions or T 74 MENTAL HEALTH SERVICES REPORT, 1952-53 transfers will soon become nil. At the time of writing there are no beds vacant for female patients. From December 1st, 1952, to March 31st, 1953, there were forty-one admissions directly to The Woodlands School under 6 years of age. We propose to have admission facilities on the third floor of our present administration building when admissions take place directly to The Woodlands School, for the admission procedure only. As the social-service staff increase, office space is being used on the third floor (back corridor). Throughout the year there were many telephone calls for information concerning our school. Many of the parents who telephoned were interested in the admission of their child to The Woodlands School and not to Essondale. There were many requests for admission of babies under 12 months of age—some in cases of Mongoloids. Telephone calls were received one day or a few days after the birth of the child. The usual visiting and interviews took place at The Woodlands School. Relatives of prospective pupil admissions visited the School and Social Service Department and the Medical Superintendent for information and orientation. Some parents of pupils who are admitted at Essondale and have not previously seen The Woodlands School wish to visit here before they themselves return home. In April Dr. Pauline Gould gave lectures and clinical demonstrations to Psychiatric Nursing students of the third year from April 7th to 27th. Dr. Herrick lectured to the third-year Psychiatric Nursing students on mental deficiency from March 4th to 18th, inclusive, giving approximately twelve hours of lectures and a final clinical demonstration. The month before, February, Dr. Gould, at Essondale, gave another group a similar course. A visit orientation and clinical demonstration with visit to the School and one or two cottages was given to various groups, as in previous years, throughout the year. The Medical Superintendent welcomed the groups and taking part was our usual clinical team—Social Service Department, Psychologist, and school-teachers. The cottage ward nurses have always helped in this orientation. Dr. Gould took charge of the clinics until September, when she transferred to Essondale, and Dr. Herrick carried on. The groups consisted of University of British Columbia Social Service students; postgraduate psychiatric nurses; Vancouver kindergarten teachers; public health nurses from Abbotsford district; affiliate students at Essondale; social-service workers from the vicinity of New Westminster, Burnaby, Vancouver, Port Moody, etc.; teachers from Bellingham Summer School (Western Washington College) who were taking the course on Exceptional Children; medical students who were at Essondale for the summer; five teachers from the Greater Victoria School Board (for special study of four days); Dr. Whitbread, Medical Health Officer at Chilliwack, and a nurse and welfare worker, plus six parents of retarded children who are at home; the Cerebral Palsy staff from the Western Rehabilitation Centre in Vancouver, plus eight occupational therapists and some students from the University of Toronto, here at the moment at Essondale; eighteen school principals, School Inspector, and some other teachers; students from the University of British Columbia School of Nursing; second-year students from St. Paul's School of Nursing (Pediatric Division); teachers from the Deaf and the Blind School, Vancouver; and forty students from the Provincial Normal School, Vancouver. We have continued to give some small groups an intensive orientation course of three days or more. Many individual persons who were interested in the mentally retarded also had an opportunity to visit and receive an orientation to our School. During the fiscal year we have had staff clinics at the School one afternoon a week, as in the past. The monthly conferences were held in the Medical Superintendent's office as usual. Those present were the school-teacher's department, two representatives each from the REPORTS OF THE WOODLANDS SCHOOL T 75 male and female psychiatric nursing staff, as well as the Superintendent of Nurses, Chief Male Psychiatric Nurse, Foreman of Works, and our Deputy Business Manager. Dr. C. A. Roberts, Director of the Federal Mental Health Services, visited in June. Dr. Daniel Blaine, Medical Director of the American Psychiatric Association, visited The Woodlands School on Monday, September 8th. Miss M. Craig, mental health co-ordinator and school-teacher, was here one day in September. Dr. Margaret Muckart, physician, came on duty July 7th. Dr. Angela Gallinger, physician, came on duty August 1st. Dr. H. MacCrostie, dental surgeon, came on duty July 15th as full-time dentist, replacing Dr. Mathisen, who was previously part-time dentist. It was obvious for some time that a full-time dentist was absolutely necessary in order to carry out the required care in an expanding patient-pupil population. Dr. Mathisen, who had been doing good work in his part-time duties, could not be expected to do all the work a full-time dentist could accomplish. Miss D. Martyn, dental assistant, came on duty July 15th. Mrs. J. DeCoene, hairdresser, came on duty July 2nd, and established a beauty- parlour department here. Miss C. Cohen came on duty July 8th as full-time psychologist. She has been doing excellent work here and has been carrying on in the clinical team. She has not been hampered by doing a battery of tests alone, but has been encouraged to carry on as clinician. Miss Herchmer, our Assistant Superintendent of Nurses, requested a transfer to the Pearson Tuberculosis Hospital in Vancouver, September 1st, to be in closer proximity to her home. Mrs. K. McKinnon was promoted to this vacancy. On October 1st, 1952, Miss A. Paterson came on duty as dietitian. Miss Neighbor had previously been transferred to Essondale. Mrs. Lind, assistant bacteriologist, came on duty November 1st, and later Miss B. Seymour, bacteriologist, took charge of our new laboratory in Pine Cottage. At the end of the fiscal year it was working to the best advantage. Previous to our new laboratory being opened, all the work was done by the laboratory at Essondale. Some special tests will still continue to be done there. On December 8th, Miss Mcintosh, social worker, came to work, being transferred from Essondale. I regret to report that Mr. H. Mullins, psychiatric nurse, died suddently at his home on December 23rd, 1952. Mr. Mullins had been with us since April 3rd, 1941. Mrs. P. Smith, school principal, resigned in October; she was replaced by Mrs. A. I. • Rhodes. Miss Glover, speech therapist, who had been coming to The Woodlands School one day a week from the Child Guidance Clinic, returned to England. In the latter part of April, 1952, the roads to the three new cottages were completed. On Friday, May 9th, there was " open house " at The Woodlands School for the first time in its history. This was held in Mental Health Week and was in conjunction with the Crease Clinic " open house " day. Beech Cottage, which was unoccupied, was open for inspection, and equipment and furniture were in place. It is estimated that a total of 700 visitors took advantage of the day to visit the School. In the latter part of May, 1952, Beech Cottage and Pine Cottage, new buildings, were opened and occupied with transfers of patients from Essondale. On December 9th Willow Cottage, the last of the three new cottages, was opened and occupied. Later, fifty-eight male patients sleeping in two dormitories over the store were transferred to Willow Cottage, forty-two of whom, by January 5th, 1953, were sleeping in two dormitories on the ground floor of this cottage, and no patients were now T 76 MENTAL HEALTH SERVICES REPORT, 1952-53 sleeping over the store but were attached to the V.T.B. Building for meals, dayroom, and bathroom facilities. The dormitory facilities for these forty-two patients who are working during the day seem quite satisfactory. The female occupational therapy was returned in the autumn of 1952 to the established department over the stores. A few years ago this department had to vacate to make room for a dormitory for female patients. However, these patients were earlier transferred to one of the new cottages. On January 4th, 1953, the new Nurses' Home No. 3 was opened and has accommodation for 100 nurses. The grounds around the new units were seeded and landscaping has been done. School classes are now being held in Beech and Pine Cottages, in addition to the usual classes in Cedar Cottage. The classrooms on the ground floor of these cottages are very satisfactory and provide the extra classrooms over and above those in the school building. More classrooms were required, due to our increased population during the fiscal year. New equipment has been installed in the kitchen. The new boiler was put into use to heat the new buildings and in the new Nurses' Home, and has worked very satisfactorily. On December 1st, 1952, the bakery, with the electrical ovens, was abolished, and wrapped and sliced bread is now being delivered from Essondale. After necessary alterations, the bakeshop will be used as a dayroom for forty-two V.T.B. patients instead of the present dayroom close to their dining-room. Mr. Copp, the baker, was transferred to Essondale. The airing-court and playground were taken up by the new buildings. There is now the problem of giving adequate outdoor recreation. There is no space except near the school building, which is not practical. There should be a playground large enough to accommodate at least 600. The recreational instructor recommends an outdoor swimming-pool in the area of a building that would serve as a recreation-auditorium hall. The annual gymnasium display took place in April, and was an outstanding success. The Ladies' Auxiliary of the Army, Navy, and Air Force gave a concert in our auditorium for the girls on October 9th, and for the boys on October 16th. On December 15th, 1952, the Fraternal Order of Eagles gave an excellent performance for the benefit of our patients. Owing to the increase in population, an additional picture show (35 mm.) is being given each week. On March 16th an amateur hour took place in the auditorium. Participants were the pupils of various ages. It was one of their first efforts, and the Psychiatric Nurses' Chapter of The Woodlands School sponsored the idea. The Recreational Therapy Department co-operated in this event, and the entertainment was most successful. The annual picnic took place on July 29th to Second Beach, Vancouver; ninety- seven of the patient-pupils were able to attend. The chapter of the Psychiatric Nurses' Association co-operated with the management through Mr. Lynes, recreational instructor, and a most enjoyable afternoon was spent. Three buses supplied transportation, and a picnic supper was held. The usual parties were held on special occasions. The mixed dances took place once a week. The usual Christmas and New Year's Eve dances were held, and on Christmas Day Santa Claus visited all the wards. Graduation exercises of the Mental Health Services of this Province took place in the Junior High School Auditorium, New Westminster, at which graduates from The Woodlands School received their diplomas. During the year we have suffered the usual childhood diseases amongst our patient- pupil population. Due to the considerable overcrowding, it was at times most difficult REPORTS OF THE WOODLANDS SCHOOL T 77 to control the situation. It is proposed that in the new building which is contemplated there should be an infectious section with suitable equipment. In January we had one case of Shiga dysentery which cleared up quickly. There were no other cases. However, we had some dysentery which, on examination of the fasces by the laboratory, showed, culturally and serologically, Shigella sonnei. Some of the wards of the cottages were temporarily quarantined and later reopened. At the end of the fiscal year there was very little dysentery clinically. Many of the positive reports from the laboratory were from patients who did not have any clinical dysentery. In March, 1953, The Woodlands School was able to provide suitable accommodation for post-operative care for some of our major operations performed at the Crease Clinic. In the latter part of April the new equipment in the Shoe-shop was put into operation and the old shoe department was vacated. There is great need for increased bed accommodation to fulfil the public demand for admission. It is hoped that the proposed new building will soon be erected. The three new buildings completed during this present fiscal year are now almost filled to capacity. It is not possible to accommodate all the requests made for admission of children under 6 years of age, and despite the acceptance of some from the waiting-list, this list is again increasing rapidly. It is to be remembered that our patient-pupil population is of various ages, from infants to adults. They are intellectually retarded in varying degrees of intelligence. Our citizens in British Columbia are becoming aware that there are many causes for mental retardation, and are more anxious than heretofore to have their child placed in a residential school if conditions warrant. It should be noted that in our population at The Woodlands School there are a number of mentally retarded who also have cerebral palsy and are handicapped in varying degrees. In our hospital-school we give nursing and medical care, education and training, with socialization stressed, so that our children can be happy, contented, and know how to get along with others. Our ultimate aim is to return back to the community those who are able to carry on in the tasks given them by their employers in the community, and make satisfactory adjustment to their environment and to those with whom they come in contact. Our Social Service Department is doing an excellent service on a pre-admission and admission basis. Its work continues on during hospitalization and in making plans for rehabilitation. The latter project entails a great deal of time and good public relationship. The prospective employer requires to have some knowledge regarding the limitations and feelings of the intellectually retarded, and this form of education is the responsibility of the Rehabilitation Officer from the Social Service Department. If this can be accomplished, then it is considered that our discharge rate will materially increase. With the opening of new units, our population has grown, and, with the proposed arrangements for direct admission, it will be necessary to further augment our social- service staff. As in time past, I would again recommend a rehabilitation centre in a large community where our boys and girls who are returning to the community could have a place for intermediate guidance and direction. We should seek board-out care in proper homes, and funds should continue to be available for this purpose. We now have a " Schools for Mental Defectives Act," but at the present time all mental defectives are not being admitted directly to The Woodlands School. Before closing, I would like to thank you for your understanding and support of our objectives in aiming toward a high standard of care and training of our intellectually retarded. Through you I would like to extend to the Provincial Secretary and his Deputy Minister my appreciation of their co-operation in all circumstances pertaining to this branch of the Mental Health Services. Respectfully submitted. L E Sauri0L; m d Medical Superintendent. T 78 MENTAL HEALTH SERVICES REPORT, 1952-53 EDUCATIONAL DEPARTMENT L. E. Sauriol, M.D., F.A.P.A., F.A.A.M.D., Medical Superintendent, The Woodlands School, New Westminster, B.C. Sir,—I respectfully submit the annual report of the Educational Department for the fiscal year April 1st, 1952, to March 31st, 1953. The school enrolment has shown a marked increase during the past year. This increase has been largely due to the opening of the three new cottages. With the appointment of our ninth academic teacher in September, it was possible to organize several new classes. Many of our new pupils were accommodated in these classes. The need for a tenth teacher is now being keenly felt as our patient-pupil population continues to increase. During the past year three teachers resigned from the staff. Mrs. Kines left us in July. Mrs. Smith, school principal, resigned in October, and Mrs. Roberts' resignation was submitted in March. We were fortunate in having Mrs. Siddall rejoin our staff in September, after having spent the past year teaching in Ontario. Under Mrs. Siddall's direction, lipreading classes were organized. Mrs. MacKinnon was also appointed to our staff in September. She took charge of the morning ward classes and the afternoon pre-school classes in Pine Cottage. In January Mrs. Brankley was transferred to our staff from the Girl's Industrial School. Mrs. Roberts was granted a leave of absence to attend the Summer School of Education in Victoria from July 2nd to August 7th. During her absence her classes were taken over by Mrs. Walsh, who was employed for the months of July and August. We are now using the classrooms in Cedar, Pine, and Beech Cottages. On April 1st, 1952, Miss H. Lenihan, a psychiatric aide, joined the school staff. It is her responsibility to bring the girls to school and to return them to the various wards after their classes. She also cleans the classrooms in Pine and Cedar Cottages. The sixth annual gymnastic display was held in April, under Mr. Lynes' direction. The school building and Beech Cottage classrooms were open for inspection on " open house " day, May 9th. Each teacher arranged displays of various types of academic work, handwork, and teaching equipment. The Occupational Therapy Department had a display of work in the school gymnasium, along with a display of recreational equipment. Staff holidays began on June 16th and ended on September 28th. Each teacher had the regulation two weeks' holiday. The increased enrolment made it necessary to hold four picnics to accommodate all the school-children. Approximately seventy children attended each of the two junior picnics. About sixty attended the intermediate and senior picnics. The senior group had its picnic at Queens Park, where they enjoyed a baseball game, followed by refreshments. Painting of the classrooms, halls, and gymnasium was completed during the summer. Pastel shades were used throughout the building. Three Hallowe'en parties and a masquerade dance were held in the school gymnasium the last week in October. Approximately 400 pupils attended the four affairs. Because of the increased enrolment and other added duties, the work at the school became too great for one male psychiatric aide. Consequently, in October, Mr. G. Ewles was appointed to assist Mr. S. Smithman with this work. In December the annual Christmas concert was presented. There were three performances held for the patient-pupils at The Woodlands School, and one for relatives of the school-children and other invited guests. We were fortunate in having fine REPORTS OF THE WOODLANDS SCHOOL T 79 weather, and had a capacity crowd on visitors' day. Three parties and a Christmas dance were also held during the festive season. Preparations were made to hold the usual three Valentine parties and one special dance. The first junior party was held, but we were forced to cancel the others because of the prevalence of dysentery within the School. We are extremely grateful for the ready co-operation received from all departments during the past year. Respectfully submitted. (Mrs.) A. I. Rhodes, School Principal. DEPARTMENT OF OCCUPATIONAL THERAPY Girls' Division L. E. Sauriol, M.D., F.A.P.A., F.A.A.M.D., Medical Superintendent, The Woodlands School, New Westminster, B.C. Sir,—I respectfully submit the annual report of the Department of Occupational Therapy for the fiscal year ended March 31st, 1953. This past year has been a year that will lay a new foundation for the many changes to take place in this department in the future years. Up until September of last year the Occupational Therapy Department shared a room with the Linen and Clothing Department. With the opening of the new buildings, we were able to get back our original workroom above the stores. This room was being used for a girls' dormitory to relieve overcrowding on the wards. This year there are thirty girls receiving benefit from occupational-therapy training, an increase of ten since last year. It is hoped that by this time next year we will have doubled our attendance record. The present expansion programme has been interrupted while waiting for an order to be filled for more chairs and tables. There is only one therapist in charge of this entire department. There is a great need for a larger staff. If the staff were increased, it would be possible to establish a more concrete therapeutic-ward programme. There is a large number of patients that cannot attend the therapy classes because of physical disabilities, spasticity, or who are bedridden because of illness, both among the male as well as the female patient-pupils. An endeavour is being made to reach approximately twenty of these cases, but there are many more who cannot possibly be helped until such time as the staff situation is relieved. At " open house," held in the school gymnasium on May 9th last year, we had a display of work done by the girls of this department. Again this year we decorated the tables in the cafeteria at Christmas time. We also made Christmas decorations, which were sold to the staff. We did not have our annual sale of work this year owing to the confusion of moving and the reorganization of the department. Two new experiments were tried this year. The first of these was elementary drawing and painting, which was most successful. One of the girls progressed sufficiently far that she was able to create a design for a hooked rug. When the rug was made up, she found the results very gratifying. Another girl drew a border of flowers. She then transferred it on to material, and thus made a delightful runner. This is only a small beginning of something that I hope will grow into an entirely new field for the mentally retarded. T 80 MENTAL HEALTH SERVICES REPORT, 1952-53 The second project was gardening, conducted on a small scale in window-boxes, and confined to flowers. This spring permission was received to plant a full-sized garden plot outside the O.T. Building. This project was chosen to see how the mentally retarded would react to a group project. I cannot at present tell you what the eventual results of these two projects will be, but it will be most interesting to note at some later date what has been accomplished. Respectfully submitted. (Mrs.) Elizabeth M. Jones, Occupational Therapist. Boys' Division L. E. Sauriol, M.D., F.A.P.A., F.A.A.M.D., Medical Superintendent, The Woodlands School, New Westminster, B.C. Sir,—I hereby submit a report covering the above department for the period from April 1st, 1952, to March 31st, 1953. New equipment added to the shop consisted of a variety of hand-tools and accessories to the existing equipment. One power-carver was supplied. Repairs were nil, and replacements due to wear were of a very minor nature. All tools were maintained in excellent working-order. Much credit is due to the boys for their care and appreciation of good tools during a whole year of consistent and practical use. Expendable supplies have been used judiciously. Strict supervision has kept quantities used within reasonable limits. Some new kinds of lumber and finishing materials have been introduced to stimulate interest. The resulting projects have shown continued improvement in accuracy and finish. The boys have shown a marked appreciation of shop methods and their own skills. Where feasible, many projects have been executed for other departments within the School. Discipline in the shop continues to be very good, satisfying to the boys and the instructor. Safety first has been stressed continuously, resulting in a complete absence of accidents or injuries. Harmony and industry have resulted. The shop has had many visitors during the year from the public, from the doctors and staff. Doctors and nurses have given encouragement and co-operation unstintingly. Mutual assistance between the departments of the whole School has been excellent. The work in this department is being seriously hampered by lack of space. All stock, tools, benches, and projects are confined to the one room. As projects increase in size and numbers, the working area is reduced in proportion. Ventilation is quite inadequate both from health and work angles. Lighting, too, leaves much to be desired. The tangible results of the year's work have been excellent, showing marked improvement over the preceding period. The boys have become more proficient in their work, more useful to themselves and the School at large, happier and more contented in this environment. Respectfully submitted. Harold Mercer, Industrial Arts Instructor. REPORTS OF THE WOODLANDS SCHOOL T 81 DEPARTMENT OF RECREATIONAL THERAPY L. E. Sauriol, M.D., F.A.P.A., F.A.A.M.D., Medical Superintendent, The Woodlands School, New Westminster, B.C. Sir,—I respectfully submit my annual report from April 1st, 1952, to March 31st, 1953. With our increased population our recreation classes have increased in attendance, and it has been necessary to limit our evening classes for lack of floor space in our gymnasium. Our classes should be increased at least 30 per cent to allow all our resident members participation in our recreation programme. In planning for the future, for a recreation-auditorium building we should consider an outdoor swimming-pool in the area of the recreation-auditorium building which would eliminate the need of dressing- rooms, toilet and shower facilities. We should plan for a playground and playing area large enough to accommodate 600. At present we are sending our boys and girls out to small areas around our cottages that have no conveniences and have no playground equipment or playing area. Last summer over ninety boys and girls were taken by bus to Second Beach for a picnic. Before lunch a softball game was played, and later in the afternoon we went in for a swim and wound up the day with pop and ice-cream. .., A group was taken to the exhibition in September to see the exhibits and the Shrine Circus. We again staged our New Year's dance, with the trimmings of noise-makers, hats, streamers, and everything that goes to make a New Year's party a success. A new undertaking was an amateur hour, which proved so successful that further series are planned. The sixth annual display of recreation and physical education climaxed the winter activities. Four displays were staged—two for resident members and two for the general public. The Woodlands School, in its training programme, can look forward to a full programme in recreational therapy. Our members, though mentally retarded, are, in the majority, physically fit and capable of enjoying our varied programme. During the week there is a 35-mm. show and a 16-mm. show; the men and ladies have two gym. nights a week and a dance; the juniors and tiny tots have four periods a week. Special events are held during the year in keeping with holidays and special days as Hallowe'en and St. Valentine's Day. In the recreational-therapy programme we have found that our boys and girls have become well socialized, are physically in good condition, and, most important, we have a happy and contented population. Respectfully submitted. J. A. Lynes, Chief Instructor of Recreation. T 82 MENTAL HEALTH SERVICES REPORT, 1952-53 REPORTS OF THE WOODLANDS SCHOOL T 83 DEPARTMENT OF DENTISTRY L. E. Sauriol, M.D., F.A.P.A., F.A.A.M.D., Medical Superintendent, The Woodlands School, New Westminster, B.C. Sir,—I beg to submit the report of the Dental Department for the year ended March 31st, 1953, at The Woodlands School. This clinic was opened on a full-time basis on July 15th, 1952, with the services of Dr. H. MacCrostie, D.D.C., and a capable dental assistant. Prior to this the necessary dental treatment was performed by Dr. Mathison on Wednesday afternoons only. There is a well-equipped two-chair office, with the addition of two Panovision operating lights installed in November, 1952. Summary Number of visits to patients 2,209 Examinations 2,209 Extractions 994 Fillings 557 Scaling 629 Prophylaxes 383 Miscellaneous treatments 342 Full dentures 21 Partial dentures 11 Repair and refine dentures 9 Respectfully submitted. H. MacCrostie, L.D.S., D.D.S., D.D.C., Dental Officer. DEPARTMENT OF DIETETICS L. E. Sauriol, M.D., F.A.P.A., F.A.A.M.D., Medical Superintendent, The Woodlands School, New Westminster, B.C. Sir,—The following is the annual report of the Dietary Department for the fiscal year ended March 31st, 1953. With the completion and subsequent opening of the three new units, extra work was involved for those in the kitchen. Our staff was increased accordingly. Mr. W. Jenkins was promoted to Grade 4 cook, while one Grade 3 cook and one kitchen helper were added to the staff. Our bakeshop equipment was moved to Essondale and was amalgamated into the large central bakeshop there. Mr. V. Copp, baker, was transferred to Essondale also. The bread, which is sliced and wrapped, is now delivered to us daily from Essondale and distributed to the wards. The baking of cakes and cookies, which was formerly done by the bakeshop, was taken over by the kitchen staff. The problem of flies in the summer is still a serious one, and we are looking forward to have " deflyer " machines in use in the near future. Several pieces of large equipment have been installed in the past year, including a potato-peeler, a three-decker electric oven, a French fryer, and a griddle. With these in operation, a greater variety of food can be prepared. As in the past, lectures in nutrition were given by the dietitian to first- and third- year students at Essondale, as well as to the psychiatric aides at The Woodlands School. T 84 MENTAL HEALTH SERVICES REPORT, 1952-53 Approximately 1,000,000 meals were served to the patients during the year and 46,466 to the staff. Respectfully submitted. (Miss) Audrey M. Paterson, Dietitian. LABORATORY REPORT L. E. Sauriol, M.D., F.A.P.A., F.A.A.M.D., Medical Superintendent, The Woodlands School, New Westminster, B.C. Sir,—On November 1st, 1952, a clinical laboratory, fully equipped and staffed by two technicians, was opened, in facilities provided in Pine Cottage. The work undertaken so far has been mainly organizational, and actual laboratory procedures carried out have dealt mainly with the outbreak of dysentery prevalent in the hospital during the past six months. Laboratory procedures carried out during the period from November 1st, 1952, to March 31st, 1953, were as follows:— Red-blood counts 68 White-blood counts 85 Haemoglobin estimations 2 Sedimentation rates 49 Routine urinalyses 4 Benzidine tests 2 Faeces examinations for typhoid and dysentery 519 Total 729 Respectfully submitted. G. A. Nicolson, M.D., Director of Laboratories. DEPARTMENT OF RADIOLOGY L. E. Sauriol, M.D., F.A.P.A., F.A.A.M.D., Medical Superintendent, The Woodlands School, New Westminster, B.C. Sir,—I respectfully submit the annual report of the Department of Radiology for the fiscal year ended March 31st, 1953. In the past year we have added a large mobile X-ray unit to the department, which was opened three years ago. This was made necessary because our infant population has doubled during the past year, and that transportation was no longer available to the X-ray Department. Now this mobile unit is moved to each children's ward, and everyone is X-rayed without too much difficulty. This unit is also used to radiograph any patient who cannot be transferred to the department by stretcher. During the past year three new wings were opened. The pupil-patient population and staff have increased to such an extent that 60 per cent more work is being done now compared to last year. All radiographic and clerical work, except for the reading and filing of the films, is done here by one operator. It is hoped that when the proposed new 300-bed unit is opened, an assistant will be added to the department. REPORTS OF THE WOODLANDS SCHOOL T 85 The following work was accomplished during the last fiscal year:— Chests 3,534 Extremities 116 Shoulders 26 Spines 48 Ribs 12 Skulls 16 Abdomens 10 Teeth 27 Number of exposures 4,255 Number of films 3,980 Respectfully submitted. Peter C. Barteluk, R.T., Radiological Technician. BEAUTY-PARLOUR REPORT L. E. Sauriol, M.D., F.A.P.A., F.A.A.M.D., Medical Superintendent, The Woodlands School, New Westminster, B.C. Sir,—I respectfully submit my report, covering the period from July, 1952, to March 31st, 1953. Shampoos 425 Finger-waves 1,019 Permanents 142 Hair-cuts _. 1,075 Respectfully submitted. (Mrs.) Jacqueline DeCoene, Hairdresser. DEPARTMENT OF NURSING SERVICE Women's Division L. E. Sauriol, M.D., F.A.P.A., F.A.A.M.D., Medical Superintendent, The Woodlands School, New Westminster, B.C. Sir,—I respectfully submit the report of the Women's Division of the Department of Nursing Service for the fiscal year April 1st, 1952, to March 31st, 1953. The year ended with the following personnel: Registered nurses, 4; psychiatric nurses, 54; psychiatric nurses in training, 36; student psychiatric nurses, 16; psychiatric aides, 91; and home supervisors, 12. New appointments for the year were 151, with 89 resignations for the following reasons: 111 health, general training, household duties, unsuited to the work, and to be married. There have been a few changes within the senior staff of our department. Miss Elizabeth Herchmer, R.N., transferred to the Pearson Tuberculosis Hospital in September from her position of Assistant Superintendent of Nurses. She had been with this Department since 1946. T 86 MENTAL HEALTH SERVICES REPORT, 1952-53 Mrs. K. McKinnon, R.N., who held the position of head nurse in Cedar Cottage, was appointed Assistant Superintendent of Nurses in September, 1952. Miss D. Curie, R.N., completed her postgraduate course at Essondale and was appointed head nurse in Pine Cottage, which was opened in May, 1952. Mrs. M. Mowat, R.N., was appointed head nurse of Cedar Cottage in November, 1952. Nurses' Home No. 3 was opened in January and has filled a great need for comfortable accommodation for the students. Our psychiatric aides are now being given one week in the classroom prior to going on the wards, and we hope to be able to complete instruction for those already on staff in the near future. Our recreational activities have been enjoyed by all able to attend, and we have been able to increase the number of patients with parole privileges. The Social Service Department has been very active all year and has rendered valuable assistance in the interpretation of the patients' needs to the relatives and the adjustment of the patient to the School. To all those who have helped through a busy and active year, we are very grateful. Respectfully submitted. (Miss) V. M. Sanders, R.N., Superintendent of Nurses. Men's Division L. E. Sauriol, M.D., F.A.P.A., F.A.A.M.D., Medical Superintendent, The Woodlands School, New Westminster, B.C. Sir,—I respectfully submit this annual report of the Men's Division of the Department of Nursing Service for the fiscal year April 1st, 1952, to March 31st, 1953. We have increased our male staff this past year, a necessity brought about by the occupation of Beech and Willow Cottages, which have a combined capacity of 240 pupils. A large percentage of our new staff being psychiatric aides, it has been necessary to redistribute our psychiatric nurses to give trained coverage to all wards. The nurses have done exceedingly well both in keeping up the standard of nursing care and in training the increased number of new staff. Psychiatric Nurses Albert Waller and Herbert Myton left on retirement; Harold Mullins passed away unexpectedly in December during his twelfth year of service. I am pleased to note Mr. Hugo Lind has been able to return for duty after a lengthy illness that entailed several operations. Our psychiatric students, twenty-four in number, who will graduate in April, 1953, will complete the accelerated nursing course put into effect in the fall of 1951. In future we will draw our psychiatric nurses as graduates from the School of Nursing, Provincial Mental Health Services, being operated at Essondale. Student-nurses will rotate through The Woodlands School for three months' training in the care of mentally retarded children. Social activities with staff assistance have become a daily occurrence. Dances, concerts, amateur programmes, a visit to the exhibition and Shriners' Circus, playground periods, moving pictures, gymnasium activities, and seasonal parties were included in this programme. Our increased population is being rapidly absorbed in all activities, and we now find the gymnasium at the School and the old auditorium are far too small. Our airing-court and sports field were taken up by the new buildings; this has created a problem that should be remedied at an early date. REPORTS OF THE WOODLANDS SCHOOL T 87 Nurses and students have enjoyed weekly attendance at the School's staff clinics, with monthly representation on the departmental staff meetings, as well as our own senior staff meetings, which are on a monthly schedule. We appreciated having our older wards equipped with additional closet space and lockers, which have made it much easier for our staff in caring for pupils' clothing and toys. Two of the older wards have been completely redecorated, with replacement of worn floor coverings where needed. In the past year I feel the pupils in our care have received a high standard of ward instruction and nursing care, with a genuine endeavour by our staff to fill the needs of this large family of growing boys. To all who have so ably assisted with our many problems, we extend our sincere thanks. Respectfully submitted. J. N. Elliot, Chief Male Psychiatric Nurse. DEPARTMENT OF NURSING EDUCATION Women's Division L. E. Sauriol, M.D., F.A.P.A., F.A.A.M.D., Medical Superintendent, The Woodlands School, New Westminster, B.C. Sir,—The report of the Women's Division of the Department of Nursing Education for the fiscal year ended March 31st, 1953, is respectfully submitted herewith. Under the centralized system of nursing education, the students have received their courses of lectures at the school of Psychiatric Nursing at Essondale. The students have received the benefit of uniformity of instruction as well as opportunities to be in closer contact with actual practice of psychiatric nursing procedures. Many students have been given the opportunity to accelerate their progress through the school. Twenty-eight students graduated this year. Fourteen students took the first- and second-year term of classes in one year. Next year the remaining students who are employed as psychiatric nurses-in-training will graduate if they are successful in the academic programme. Respectfully submitted. (Miss) Edith M. Pullan, R.N., Director of Nursing. Men's Division L. E. Sauriol, M.D., F.A.P.A., F.A.A.M.D., Medical Superintendent, The Woodlands School, New Westminster, B.C. Sir,—I respectfully submit the report on the Men's Division of the Department of Nursing Education for the fiscal year ended March 31st, 1953. During the past year, lectures have been presented on the block system of classes in the School of Psychiatric Nursing at Essondale. This system has enabled The Woodlands School students to gain a better understanding of psychiatric nursing. The majority of lectures were given at Essondale; the rest, on the treatment and care of the mental deficients, were given at The Woodlands School. T 88 MENTAL HEALTH SERVICES REPORT, 1952-53 This year twenty-four students completed the course in psychiatric nursing. This group will be the last graduating class from The Woodlands School, due to a change in the training-school policy. Student-nurses from the School of Psychiatric Nursing spend three months on the wards, rotating from ward to ward, which enables them to further their knowledge in the treatment and care of the mentally deficient children. A course of training for psychiatric aides in psychiatric nursing and nursing arts is in progress, and they are finding it very helpful to them. To all those doctors, nurses, and heads of departments who have helped greatly with the educational programme, we are extremely grateful. Respectfully submitted. Ronald F. Nash, Instructor of Male Nurses. DEPARTMENT OF PSYCHOLOGY L. E. Sauriol, M.D., F.A.P.A., F.A.A.M.D., Medical Superintendent, The Woodlands School, New Westminster, B.C Sir,—Following is a report of work performed for the fiscal year ended March 31st, 1953, at The Woodland School. Mr. J. B. Woodward, Psychological Clinic Assistant, commenced a leave of absence in February, 1952, when he joined the Canadian Army. In March, 1952, two members of the Essondale staff made weekly visits to provide for the more pressing cases. This service was continued until July, 1952, when Miss C. Cohen joined the staff as Psychological Clinic Assistant. The Department of Psychology has, first of all, provided psychological evaluation of pupil-patients. Referrals have been accepted from the medical staff, the Social Service Department, the school, and the nursing staff. Intelligence tests, manual dexterity tests, personality tests, educational tests—all the available techniques have been utilized. Projective techniques such as the Thematic Apperception Test have also been used on an exploratory basis. In assessing the pupil-patient the prime considerations have been, first, the programme of training—that is, whether academic or occupational—second, the possible need for therapy, and, finally, the question of rehabilitation. This department and the Social Service Department have worked together closely on all these problems, particularly the latter one. All academic prospects have been screened through and graded by this department. Several of the adult patients have been seen in regular weekly interview, and several of the children have been seen in play interview. Some of these patients have been referred to the Occupational Therapy Department, and many others have been worked with in conjunction with the Occupational Therapy Department. Some assistance has been given to the Occupational Therapy Department in its reorganization and expansion programme. Twenty-eight Wednesday afternoon staff clinics have been attended to present psychological findings. A short talk has been given at each of nine visitors' clinics. This department has been present at 177 daily staff conferences throughout the year. An orientation clinic was given to members of the medical staff and the Social Service Department. A number of patients have been examined prior to their admission by psychologists of the Child Guidance Clinic. Forty-four abstracts of their findings were made, to be placed on the clinical files. One hundred and eleven patients were examined by this department during the year. A total number of 508 tests were administered. REPORTS OF THE WOODLANDS SCHOOL T 89 The following is a tabulation of the tests administered:— Test Number Arthur Point Scale 3 Bennet Hand Tool Dexterity 2 Bender Gestalt 79 Crawford Small Parts Dexterity 15 California Test of Personality 9 Goodenough Draw-a-Man 63 Kent E.G.Y. 72 Kuder Preference Record 1 Minnesota Multiphasic Personality Inventory 2 Minnesota Rate of Manipulation 7 Progressive Achievement Tests 7 Progressive Matrices 13 Porteus Maze Test 97 Stanford-Binet Form L 62 Thematic Apperception Test 14 Vineland Social Maturity Scale 2 Wechsler-Bellevue Intelligence Scale Form I 26 Wechsler-Bellevue Intelligence Scale Form II 13 Wechsler Intelligence Scale for Children 6 Weigl-Goldstein-Scheerer Color Form Sorting Test 15 Total 508 Respectfully submitted. C. Cohen, Psychological Clinic Assistant. DEPARTMENT OF SOCIAL SERVICE L. E. Sauriol, M.D., F.A.P.A., F.A.A.M.D., Medical Superintendent, The Woodlands School, New Westminster, B.C. Sir,—The report of the Social Service Department of The Woodlands School for the past fiscal year is herewith submitted for consideration. The report is concerned largely with:— I. A review of social services to pupil-patients, with some interpretation regarding the relationship of these services to the function of social workers in a school for the education and training of the mentally retarded. II. A review of the beginning of social services directed to the rehabilitation of the mentally retarded, together with some interpretation as to immediate basic resources needed to develop a minimal rehabilitation programme. I. Review of Social Services to Pupil-patients, April 1st, 1952, to March 31st, 1953 The important contribution of social workers in a programme geared to the understanding, education, training, and rehabilitation of the mentally retarded is that of forming a fink between the institutional School, the pupil-patient, his family and community. This link is forged by purposeful helping and interpretation undertaken by the social workers. Such help and interpretation is directed toward the development, mainte- T 90 MENTAL HEALTH SERVICES REPORT, 1952-53 nance, and furtherance of the responsibility of family and community in the provision of services geared to the continuing social adjustment of the mentally retarded both within the School and community. Social workers begin to help the family at the point when the use of the School is being considered for one of its members, as well as helping the family with problems which often arise at the time of admission, discharge, or rehabilitation of the pupil-patient. During the pupil-patient's education and training period, social workers help him to cope with any problem he may face in his relationships within the institutional School. This help may be given to pupils individually by a case-worker or by a group-worker to groups of pupils. During this period also, social workers help some parents who have deep feelings about their child's mental retardation. Through this help many parents can be freed to become active with the School throughout the pupil-patient's training period and ultimately free to assume their responsibility in his rehabilitation. 1. Analysis of Social Services of an Interpretative Pre-admission Nature Rendered to Families and Community, April, 1952, to March, 1953.—Over the past fiscal year 132 families inquired about the services of The Woodlands School for the use of a mentally retarded member. All 132 families were interviewed by social workers. Of this number, 60 families were referred to Social Welfare Branch field services or other agencies either for help with a family-living problem which was recognized as the problem basic to the family's acceptance and adjustment to the mental retardation of its member, or referred for help with a serious marital problem which was seen as the source of the family's unhappiness. Referral of a family to another agency for service must be done in a way that is both supporting and mobilizing to the family as well as informative and helpful to the agency whose service is being requested. To this end, the social workers engaged in 252 referral services to parents and agencies. Social services were brought directly within the department to 72 families seeking information about the School programme. Some 264 interviews of a helping nature were given to this group, together with 180 consultative conferences with the School's psychiatrists in the interest of this group of families. The social workers in the School recognize that they have a real responsibility to help parents and relatives as they consider placement in the School for a mentally retarded member. The aforementioned 444 pre-admission interviews were directed to this end. Part of the help given by the social workers at this time is directed toward a careful screening of the applications so that needless commitments not in the interests of the family and child are prevented. When the application has been screened, help must be given parents to enable them to prepare their mentally retarded child for the separation from the home and from the familiar family ways of doing and living. At The Woodlands School such help to parents is partly extended through a carefully planned and purposefully directed orientation to the School, which permits the observation of the School programme and through a helpful supportive relationship which grows up between the parents and the social worker. The latter affords the parents an opportunity to recognize or work through to a degree the feelings of disappointment, often shame, rejection, and guilt which exist around having a mentally retarded child and become ascendent when the parents seek institutional care for him. During the past fiscal year 80 parents were oriented to the School and its programme during this pre-admission period. In summary, during the fiscal year social workers have given 444 helping interviews to 80 parents prior to the admission of the child. 2. Analysis of Social Services at the Time of the Pupil-patient's Admission and Reception to the Provincial Mental Hospital and The Woodlands School, April, 1952, to March, 1953.—The procedure for the admission of the mentally retarded in operation REPORTS OF THE WOODLANDS SCHOOL T 91 in the Mental Health Services is that of committal to the Provincial Mental Hospital under the " Mental Hospitals Act," with the mentally retarded person remaining in Hospital until a bed becomes available in The Woodlands School. This procedure has distressed many parents, and because of this the social workers have felt a real responsibility for supporting and helping parents and relatives both prior to and during the admission of the mentally retarded family member. During the month of January, 1953, The Woodlands School began to admit the child under 6 directly to the School. At this time also, an additional social worker was appointed to the staff of The Woodlands School, bringing the number employed to three. The social workers at The Woodlands School, assisted by the Provincial Mental Hospital social worker on admissions, have taken responsibility for the reception into the Hospital of 175 mentally retarded persons. Parents of mentally retarded children have had 234 helping interviews extended to them at the time of the admission and reception of their mentally retarded family member. Some 223 consultative interviews with other disciplines and agencies have been undertaken in the interests of parents and pupil-patients at the time of reception. One hundred and nine studies of the child, the degree of retardation, his family relationships and experiences have been completed. From January to March, 1953, some 30 children under the age of 6, their parents and relatives were helped by social workers at the time of admission to the School. Some 103 helping interviews were given to parents. In summary, during the past fiscal year the social workers helped receive into Hospital and School 205 pupil-patients, and gave to pupils and parents some 560 helping interviews at this time. In all, 1,004 helping-interviews involving patience and skill have been directed to meeting parents' feelings about their defective child and about the decision they were reaching to commit. The goal of social work at the time of admission is to help parents to work with the School staff throughout the pupil's education and training, and to see the School as a rehabilitation process for their child. Only as a last resort do we want the School seen by parents as an institution for the permanent custodial care of their child. Another social-work goal at this time is to assess through study the rehabilitation potential in the child. 3. Analysis of Case-work Services to Pupil-patients in Residence at The Woodlands School, April, 1952, to March, 1953.—The patient and skilful meeting of parents' feelings about their defective child, helping them to work with the School staff throughout the pupil's education and training period, is a step-by-step treatment programme undertaken through a team approach by doctors, nurses, teachers, psychologists, and occupational, industrial, and recreational therapists, and dietitian and social workers. Briefly, during the fiscal year 251 pupils in residence were referred to the Social Service Department. Some 1,244 helping interviews were extended to these pupils. The social workers, together with other disciplines, participated in 242 clinical study sessions which were directed to the understanding and formulation of training and rehabilitation goals for pupils in residence. Inter-co-operative conferences with other agencies directed to planning for specific pupils in residence numbered 24. During the education period when the mentally retarded child is in residence, social services are directed toward keeping the interest of the parents and studying and developing the child's rehabilitative potential. 4. Responsibility Assumed by Social Service Department in Education and Training, April, 1952, to March, 1953.—The first responsibility of social workers in education and training of personnel is toward their own profession—social work. The social workers at The Woodlands School during the fiscal year participated in a teaching clinic for sixty first-year social-work students of the School of Social Work, University of British Columbia. Three second-year social-work students were oriented for a three-day period. A number of in-service-trained workers attended a specially arranged teaching clinic. Five groups of public health nurses, postgraduate nurses, and nursing affiliates were oriented to the School programme, as well as to the part played by social services in a school for the education and training of the mentally retarded. T 92 MENTAL HEALTH SERVICES REPORT, 1952-53 A group of thirty-five teachers and another group of thirty kindergarten teachers spent time studying education in this setting and the part social service plays related to education. Four representatives of rehabilitation and social-work agencies spent time in the Social Service Department, and three service clubs visited to study the School programme. II. A Review of the Beginning of Social Services Directed to the Rehabilitation of the Mentally Retarded, Together with Some Interpretation as to Immediate Basic Resources Needed to Develop a Minimal Rehabilitation Programme. During the year five pupils were rehabilitated—four into working convalescent care and one into family convalescent care. Of the four for whom working convalescent care was planned, two returned to the School before the expiration of the six-month probationary period. The reason for return was due to a temporary breakdown in the pupil's adjustment to the demands of the job. In the case of one long-institutionalized pupil, the job selected was beyond his emotional integration to cope with. In the case of the other pupil, the employer's demands exceeded his comprehension. Lack of praise on the job also made him unsure of himself and his ability. The latter pupil had also been in the institution for long years. Much work is demanded of the social workers in preparing the pupils for placement in working convalescent care. The pupil must be studied and assessed. Social work shares a responsibility with other disciplines in study and assessment of pupils for whom rehabilitation is being planned. In preparation for rehabilitation of the five pupils, 205 interviews of a preparatory, supervisory, and supportive nature were given. Employment and financial assistance agencies were conferred with on 33 occasions. In this preparatory period the psychiatrists were consulted on 165 occasions, psychology on 86, occupational therapy on 19, recreation and industrial on 45, education on 81, and 15 study clinics were attended by the social workers. Study and selection of the working home, too, involves careful work on the part of the social workers. Some 45 visits to assess working homes were undertaken by social workers. Contacts with other agencies in assessment of these homes numbered 21. Some 68 follow-up visits were paid to pupils and employers over the period of placement. One 40-year-old woman who had been deserted by both parents on placement in an orphanage was committed to The Woodlands School about twenty-five years ago. While in the School her progress had been remarkable from the medical, psychological, and sociological aspects. When first admitted to the School at the age of 15, she was described as imbecile, given to hysterical attacks and fainting. Pre-rehabilitation study after her education and training period revealed her to be of dull-normal intelligence. In April, 1952, she approached the Social Service Department, and after numerous interviews with the pupil and contact with a distant relative a programme for her eventual rehabilitation was initiated. There was, however, some doubt in the psychiatrists' minds as to this pupil's ability to adjust to the outside community, having regard to her long residence in the School, which had not presented her with an opportunity for competition with individuals her own age. Social Service, however, proceeded with the rehabilitation process, working closely with the pupil, and initiated a programme geared to helping her face the world with new confidence and reassurance. The result was a finely integrated personality, assured signs of emotional and social maturity, and, most important of all, the pupil's desire to return to community. After four months the National Employment Service was contacted, and after careful selection by the Employment Service and the School social worker a job on a chicken- REPORTS OF THE WOODLANDS SCHOOL T 93 farm was investigated and selected with the co-operation of the pupil and other School staff. The employer was given a complete picture of the pupil's emotional level, and it was explained that she would need constant and close supervision, and that she would need to be trained by simplified methods in order to learn. A visit to the working home was planned for the pupil, and a starting wage of $50 monthly offered. Since placement, an intensive follow-up programme has been carried out. Employer and employee were both seen from time to time, and on each occasion highly satisfactory reports were received. The pupil's enthusiasm and improvement in both appearance and behaviour was such that when the six months' probationary period was about to expire, the employers agreed very readily to an extension of probation as everything was working out well. The pupil has been given increasing responsibilities and has proved reliable in every respect to date. A review of the foregoing case-history of the rehabilitation of a pupil indicates the long, detailed, and skilled work involved. To ensure the development of this programme, certain basic resources must be forthcoming from the Mental Health Services: Increase of social-work staff; availability of rehabilitation funds within the Mental Health Services; extension of The Woodlands School as a midway home for the pupils' use over the early placement period; the gearing of the School to the early assessment of the rehabilitative potential of the pupils; the continuing study of the pupil, directed to formulation and reformulation of education and training goals in the light of this potential. Early consideration must be given to the establishment of a midway home at a distance from the institutional School. Following these resource developments within the School and Mental Health Services, it will be necessary to develop the understanding, support, and service of community in the field of rehabilitation of the mentally retarded. Respectfully submitted. (Miss) Alice K. Carroll, B.A.,M.S.W., Provincial Supervisor, Psychiatric Social Work. T 94 MENTAL HEALTH SERVICES REPORT, 1952-53 REPORTS OF PROVINCIAL MENTAL HOME, COLQUITZ Dr. A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—The following is the report of the Medical Superintendent for the fiscal year ended March 31st, 1953. It was with sincere regret that we learned early in the year of the passing of Dr. E. J. Ryan, Senior Medical Superintendent. His visits to this institution were always looked forward to, and I have missed his kindly advice and guidance. The work of the various branches and departments of this hospital has gone forward smoothly, if routinely, during the year, and there has been no outstanding event to report. However, the departments have been active, and the fine co-operation from and between the department heads is still in evidence. Our patient-count at the beginning of the year was 286 and at the end of the year was 287. During the year twelve patients were transferred to this institution from the Provincial Mental Hospital, Essondale. One patient recovered sufficiently to be returned to the British Columbia Penitentiary, and one patient was discharged on probation to himself. There was one elopement during the year, the patient being returned after an absence of only four hours by members of the nursing staff. Ten deaths occurred among the patient population, the cause of death in the majority of cases being chronic heart- disease. One patient returned from probation. We continue to have about 60 per cent of the patients usefully employed. Dr. G. Hall continues to care for the physical health of the patients. Dr. A. Beattie, of the Saanich and South Vancouver Island Health Unit, arranged for the mobile unit of the Division of Tuberculosis Control to visit the institution on March 17th, 1953, and all the patients and the majority of the staff were chest-plated. The tuberculosis clinic in Victoria has continued to be most co-operative in rechecking suspicious cases at regular intervals. There are only two cases isolated at the present time because of tuberculosis. Dr. W. Dempsey, of Victoria, has replaced Dr. T. W. James as part-time dentist, the latter having resigned. The visits of the dentist have been increased from once to twice monthly, and new equipment has been installed, thereby improving the dental services to the patients. The recreational and occupational facilities continue to be used to the limit both afternoons and evenings. A good standard of moving pictures has been shown to the patients twice weekly, and again this year we have been fortunate in having a number of fine concerts, some being organized and put on by the patients themselves, assisted by members of the nursing staff. It is regretted that the training-school here is to be discontinued as of May 1st, 1953. It is noted, however, that the instructor is to be retained, and it is hoped that by lectures to the psychiatric aides and postgraduate lectures to the psychiatric nurses, the high level of interest reached by the nursing staff in its work will be maintained. A number of the staff left our employ during the year for various reasons and were replaced by new men (see Chief Psychiatric Nurse's report). Mr. J. F. Stamford, stores steward, having reached the age of retirement, left our employ in January, 1953, and was succeeded by Mr. P. Tempest. Attached herewith are detailed reports from the heads of the various departments. I wish again to express my appreciation for the assistance and support during the past year from yourself, the members of your staff who have visited here in a consulting capacity, and to the staff members of this institution. Respectfully submitted. T _, -, _, _, „ _ v J L. G. C. d Easum, M.B., Medical Superintendent. REPORTS OF MENTAL HOME, COLQUITZ T 95 DEPARTMENT OF OCCUPATIONAL THERAPY Dr. L. G. C d'Easum, Medical Superintendent, Provincial Mental Home, Colquitt, B.C. Sir,—Following is the annual report on the Occupational Therapy and Maintenance Department for the fiscal year ended March 31st, 1953. The usual crafts and hobbies have been carried on as in the preceding year and included cabinetmaking, wood-turning, furniture-building, inlay, built-up woodwork, picture-framing, art metal, copper repousse, and tooling. Carving and moulding of plastics and all the different aspects of leatherwork, wood-carving, weaving, and metal- turning were also done. An electric oven was constructed in the shop during the past year. An electric element and a three-heat switch were purchased; the rest of materials used were from salvaged sheet iron and angle iron, making the initial cost of this oven very small. It is used to heat plastics and has proved to be very satisfactory. The repair of all buildings was done by our department, also all painting and decorating, as well as all window-washing and general cleaning. One of the major accomplishments of the shop during the past year was the conversion of the room doors in the Lower East Ward from the old lever system to individual locks for each door. We devised a method of installing locks for a maximum of efficiency with a minimum of expense. These locks should prove more satisfactory than the West Ward locks, which were installed some years ago, in that they will need very little upkeep. The initial cost of installation, too, was very much less. I feel that we saved the institution considerable expense on this project. Patients help to do new construction and concrete-form work and thus learn the proper procedure and methods of building, which will be an aid toward rehabilitation. We find, however, that the majority of patients in the shop prefer to do hobbies and crafts, and take great pride in making difficult and intricate projects. As usually a lot of thought and time must be expended in making these things, we feel that one of the main objects in an occupational-therapy shop is accomplished as the patient forgets his own troubles in concentrating and doing this intricate work. As there has been mention made of a new boiler-room, I would like to make a suggestion for your consideration regarding the old boiler-room and engineer's present office. After the old boilers are removed, I would suggest that we remodel and convert that space into an occupational-therapy shop. I am sure that if it were equipped with some tools and small machines, it would prove a very valuable addition to our department in benefiting patients that we have not the space for now, or who are not fit to come out to our present shop. In closing, I would like to express my thanks and appreciation for your assistance and counsel during the past year, and also the staff for their co-operation. Respectfully submitted. H. Helander, Instructor of Trades and Maintenance. T 96 MENTAL HEALTH SERVICES REPORT, 1952-53 SHOE AND TAILOR SHOPS Dr. L. G. C d'Easum, Medical Superintendent, Provincial Mental Home, Colquitz, B.C. Sir,—During the past year in the Shoe-shop there has been a great increase in repair work, such as half-soling, heels, and patching. More work in the rebuilding of boots has been started. For those patients who have destructive tendencies, we now make boots with cloth tops, old soles, new insoles, and rubber heels cut with heel dies from old rubber boots. They are comfortable, look well, and are more economical. A considerable portion of our time in the Tailor-shop has been spent on repair work, especially on canvas articles. Repair slips show a total of 6,093 pieces repaired and returned to the wards. During the year there was an average of seven patients employed in the Shoe and Tailor Shops. Respectfully submitted. G. Campbell, Foreman. DEPARTMENT OF RECREATIONAL THERAPY Dr. L. G. C d'Easum, Medical Superintendent, Provincial Mental Home, Colquitz, B.C. i Sir,—Recreational activities were very well attended during the past year, starting with the tennis-courts in front of the main building, which were placed in operation in April. During April and May a combination of indoor and outdoor activity was occasioned by the changeable weather conditions. In June softball was attempted in the new airing-court, using bats made by our Occupational Therapy Department. It was so successful that more equipment was secured and a backstop made, and every Thursday evening until fall the diamond was put to good use. Patient interest was excellent. Evenly matched teams were chosen by the more active patients, and on several occasions we had patients umpiring the games. A tennis-court was also installed in the new recreation centre, and equipment was made available and put to use almost daily. In addition, the original tennis-courts were in constant use both afternoons and evenings, and golf, lawn-bowls, and croquet were participated in by a considerable number of patients. Patients outside in recreational activities are governed by the number of staff available to supervise and participate. The ward staff encourages these activities whenever possible, with softball and tennis in the summer and volleyball in the main dining-room during the winter being the major attractions. Each Thursday evening during the year some form of organized recreational activity takes place—outdoors in summer and inside in winter. Indoors we have a bingo game each month, and usually a special bingo party around Christmas time, when we give each one attending a gift of home cooking or candies, etc., donated by the staff. Other Thursday evenings, card games, chess, etc., have been enjoyed by patients from all wards in the Top East Ward, which has proved ideal for such endeavours. Ice-cream is usually served and is obviously enjoyed. Any time which the classroom schedule allows is spent in recreation. Walking- parties, table-tennis, lawn-tennis, golf, lawn-bowls, volleyball, card games (including canasta, which is very enthusiastically played at the present time), chess, and checkers REPORTS OF MENTAL HOME, COLQUITZ T 97 provide a variety of activities which can be conveniently fitted into ward routine as the time and opportunities present. The number of patients engaged varies considerably— from one to fifty-six—at any one time. Fifty-six is the greatest number to attend a bingo game (average around fifty), up to thirty-five at card games, twenty-five at softball, and smaller groups kicking a football and playing catch, etc. The number of patients who participate and the interest they show in recreation are conclusive proof of the value of the programme; yet, we still have a fairly large group whose working activities occupy much of their time, and the older age-group whose interest is mostly passive. Although these latter groups see the twice-weekly moving pictures and several concerts yearly, I believe they would greatly appreciate the opportunity of being taken for a drive on some of the scenic routes and to local places of interest; using institutional machines, the cost should not be too great. During the regular operator's absence on holidays, etc., I ran the movie projector for approximately 20 per cent of the scheduled shows. Respectfully submitted. J. Lowndes. DENTAL REPORT Dr. L.G.C d'Easum, Medical Superintendent, Provincial Mental Home, Colquitz, B.C. Sir,—I should like to submit herewith a report of my work as visiting dentist at the Colquitz Provincial Mental Home. During the period from October 31st, 1952, to March 31st, 1953, the following has been done: Examinations, 40; extractions, 74; prophylaxes, 5; restorations, 15; relining of dentures, 4; repairs of dentures, 7; and new dentures, 5. In addition to the actual treatments listed above, some effort has been made toward the establishing of a dental unit at the Hospital. Prior to accepting the position as visiting dentist, some patients were treated in my office. Six extractions and three restorations were done between June 24th, 1952, and October 1st, 1952. At all times I have been assisted by members of the Hospital staff. The capable manner in which they performed their duties has been most gratifying to me. Respectfully submitted. W. G. Dempsey. NURSING SERVICES Dr. L. G. C d'Easum, Medical Superintendent, Provincial Mental Home, Colquitz, B.C. Sir,—There was no change in the accommodation available for resident patients at this institution since the report submitted last year. With the exception of one patient assigned for outside work on the farm at 5 a.m., six for kitchen work at 5.30 a.m., and six to assist in the dining-rooms at 6 a.m., the remainder of the patients did not arise until 7 a.m. During the year we had a daily average of 35 patients with full ground privileges, 5 patients with supervised lawn privileges, and 3 patients with full poolroom privileges, with a daily average of approximately 105 engaged in some form of useful occupation in the various departments, together with 70 engaged in ward routine activities. The 7 T 98 MENTAL HEALTH SERVICES REPORT, 1952-53 daily average of patients confined to their rooms was 13.48—4.86 physically ill and 8.62 mentally disturbed. The recreation-courts were in use daily during the year when weather permitted— in the summer from 1 to 4 p.m. and 6.30 to 8.30 p.m. During the winter, active patients with supervision were allowed out in the afternoons for exercise, using the sidewalks. Two picture shows of Australia were screened by Mr. and Mrs. I. Day, of Victoria. Five concerts sponsored by service clubs and organizations and one concert arranged by the patients and staff augmented the entertainment programme during the winter months. The programme of entertainment and recreation activities every day of the week was made possible by the enthusiasm and active participation of the nursing staff. The radio continued to provide enjoyable entertainment for the patients. The individual receiving set in the recreation-room on the grounds was replaced by a speaker and an additional speaker placed in the recreation-court. Several patients have private radios which they were permitted to use. Patients with musical instruments were encouraged to practise, and the piano was available for those able to play. The Red Cross Society and the Britannia Branch of the Canadian Legion with the Women's Auxiliary to the Britannia Branch provided comforts for ex-service patients monthly. Other organizations supplied comforts at times. The Salvation Army held service in the morning of the first and third Sunday of each month. They were accompanied by their band on seven occasions and the songsters three times. They also distributed Christmas packages to each patient. The Church of England minister held service in the afternoons on the second and fourth Sunday of each month. Roman Catholic patients were visited and mass was held by the priest each month. The Travelling Library, Public Library Commission, Victoria, continued to look after our reading requirements and changed the library twice during the year. Popular magazines were provided by organizations and individuals. The Victoria Daily Times provided cross-Canada daily newspapers each Friday. Time lost through sick-leave and other causes by the staff amounted to 478 working- days. This included the dietary department and stores, where relief was provided from the nursing staff to keep these departments operating efficiently. Consequently, it was necessary to employ an additional psychiatric aide as temporary help on January 24th, 1953. During the year eleven members of the nursing staff left the service for the following reasons: Resigned for other employment, 4; resigned due to ill health, 3; left the service on reaching the age of 65, 1; granted leave of absence to join the Royal Canadian Navy, subsequently resigned, 1; resigned on account of housing difficulties, 1; promoted to Grade 4 stockman from psychiatric nurse, 1. Members of the staff were detailed to special duty at St. Joseph's Hospital, Victoria, for 104 eight-hour shifts. Several members of the staff attended a course on instruction in Civil Defence. Mr. K. A. Thompson, psychiatric nurse, qualified as a special instructor in basic general training, Parts 1 and 2, upon completion of Course No. 12 at Victoria. The co-operation between the different departments was excellent, and the staff are to be commended for the manner in which they performed their duties. Respectfully submitted. P. T. McLeod, Chief Psychiatric Nurse. REPORTS OF MENTAL HOME, COLQUITZ T 99 TRAINING-SCHOOL Dr. L. G. C d'Easum, Medical Superintendent, Provincial Mental Home, Colquitz, B.C. Sir,-—The following is the report of the training-school activities during the year April 1st, 1952, to March 31st, 1953. Number of students attending classes, April 1st, 1952, 15; resignations during year, 2; number of students attending classes, March 31st, 1953, 13. In May, 1952, fourteen students from previous terms graduated at the ceremonies in New Westminster and received their certificates as psychiatric nurses. Though the time on the Mainland was short, the students were very appreciative of the arrangements made, and the glimpse they did obtain of Essondale made them realize what values could be derived if the opportunity for closer contact were made possible. Classes were held on a continuous basis throughout the year, and the total number of hours devoted to classroom instruction was 366. No failures were recorded, and no students were required to rewrite any examinations. With the concentration of lectures during this period, all students should be ready for graduation in April, 1953. This, I believe, will complete the three-year training programme here, when all eligible to graduate will have done so. I believe that the value of the training-school here is demonstrated continuously in the care accorded the patients in the phases of hospitalization which this institution provides. Though actual bedside nursing opportunities are few, whenever occasion demands, the staff is responsive and takes a keen interest in whatever problems are presented. Interest has been maintained as in the past, and the attitude and marks of the students have been very gratifying. Rapport is good, and co-operation has been excellent from all departments in connection with the training-school activities. Respectfully submitted. J. Lowndes, Instructor. T 100 MENTAL HEALTH SERVICES REPORT, 1952-53 REPORTS OF THE GERIATRIC DIVISION, PORT COQUITLAM, VERNON, AND TERRACE REPORT OF MEDICAL SUPERINTENDENT A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—I hereby submit the seventeenth annual report of the Geriatric Division of the Provincial Mental Health Services, with attached tables, for the fiscal year April 1st, 1952, to March 31st, 1953. On November 1st, 1952, Dr. T. G. Caunt left the Division consequent to his appointment as Medical Superintendent of the Provincial Mental Hospital and the Crease Clinic at Essondale, and Dr. B. F. Bryson commenced duty as Superintendent of the Homes for the Aged the same date. On behalf of the nursing and clinical staffs and members of all departments of our three units, I would like to express our appreciation to Dr. Caunt for the many years of interest and effort he devoted to the welfare of the patients of this Division. The three units of this Division have continued to function smoothly and efficiently during the past year and have been running practically to capacity at all times. There has been no decrease in the demand for the type of service offered by this Division of the Mental Health Services, but rather, especially on the women's side, there has been a considerable increase in the number of applications received. A total of 294 applications for admission were received during the year. Inquiries from various sources relative to the proposed committal of men and women over 70 years of age to this Division totalled 404 during the year. These inquiries took the form of office interviews, telephone calls, and letters, and much time was spent in explaining to anxious relatives and others our frequent inability to accept patients because of lack of accommodation. It is still impossible to keep pace with the applications for the admission of aged women, whereas male vacancies have been more frequent, and the rate of admission of aged men has maintained a minimal number on the waiting-list. The demand for this type of service will likely increase in the years to come. Throughout the year every opportunity has been taken to encourage efforts for the care of the aged at the community level or in the home, and wherever a patient's condition has improved sufficiently, relatives have been encouraged to make arrangements for their care outside the Hospital. It is felt that efforts in this way will help conserve the available bed space for those persons most in need of our type of care. As will be noted in Table No. 1, there were 557 men and 388 women, a total of 945 patients, in the three Homes on March 31st, 1952. During the year the total in residence increased to 994, as of March 31st, 1953. This increase is primarily due to the opening of H.A. 9, which provided additional accommodation of 49 beds for women. Tables Nos. 2, 3, and 4 will show that a total of 257 patients, 126 men and 131 women, were admitted to the three Homes during the year. During the same period 294 applications for admission were received, leaving a total of 37 patients who needed care but could not be accommodated, thus increasing thereby the existing waiting-list. All applications from Vernon and Terrace districts were handled promptly by direct admission to those units. Accumulated vacancies in these two units also allowed for a relief of pressure on the Port Coquitlam unit. On October 6th, 1952, 12 men were transferred to Terrace by train. This move was organized by Dr. T. G. Caunt, and Dr. A. G. MacKinnon supervised the patients en route. The trip was uneventful, and all patients REPORTS OF THE GERIATRIC DIVISION T 101 were taken to the Terrace Home safely. On March 3rd, 1953, 25 patients were taken to the Vernon Home by train, under the supervision of Dr. Bryson. This group consisted of 12 men and 11 women transferred from the Port Coquitlam unit, with 2 women admitted from the Provincial Mental Hospital, Essondale. This transfer was also carried out smoothly and without incident. There was a total of 180 deaths during the year in the three units—119 men and 61 women. This continued discrepancy in the death rates for men and women accounts, in large part, for the lack of accommodation for the many applications for admission of women to this Division. Discharges for the year totalled 28 — 17 men and 11 women. It is felt that the discharge rate could be increased if the services of a social worker were obtained to work with the patients and their families. The general health of the patients has remained good throughout the year, and there have been no epidemic infections or serious medical problems. During the year 11 patients were referred for surgical consultation from the Port Coquitlam Home, 2 of whom required emergency surgery, which was carried out at the surgical unit of the Crease Clinic. Several others benefited physically by elective surgical procedures. Orthopaedic care was required for 12 women and 3 men, most of whom suffered fractured hips as a result of unavoidable accidental falls, and have received nursing care in the infirmaries at Essondale. The nursing and ward services at the Port Coquitlam unit have continued to function smoothly, and many comments have been received concerning the kindly attention given to patients by the nursing staff. The weekly church services have been greatly appreciated by many patients, and the frequent ward movies, the monthly bingo parties, the occupational therapy, and other activities continue to bring pleasure and stimulation to the daily routine of the patients. The lack of radio facilities in Wards H.A. 8 and H.A. 9 is regretted, as the daily radio programmes do much to preserve contact and interest in life outside the Hospital, as well as providing musical pleasure. Ward H.A. 9 was opened for patients' occupation on September 9th, 1952, and has been occupied to capacity since. On November 18th Miss Unger was assigned to the Port Coquitlam unit as the night nursing supervisor. This increased supervision has been reflected in better nursing care and service to our patients. All other departments continue to function satisfactorily, and their co-operation has contributed much to the welfare of the patients. A number of Public Works improvements have been completed or are under way, such as the installation of outdoor lights, renovations in the H.A. kitchen, and grading and seeding of the lawn west of H.A. 8. A number of projects, however, remain to be done, and I would like to stress particularly the need for completion of the new road through the Home for the Aged property, the complete painting inside and out of all buildings, provision of radio facilities in Wards H.A. 8 and H.A. 9, outdoor urinals, and screened housing for garbage- cans at the rear of each cottage. During the year several notable visitors were received at the Port Coquitlam unit. On September 8th, 1952, Dr. Daniel Blain, medical director of the American Psychiatric Association, visited and inspected the various buildings. He was able to give us several useful ideas from his varied experience and visits to similar institutions elsewhere. He was quite favourably impressed with the service provided here. On October 2nd, 1952, we were fortunate in having the Honourable W. D. Black, Provincial Secretary, and Mr. Pennington, Deputy Provincial Secretary, visit the Home at Port Coquitlam. They were both favourably impressed with the services provided here and showed much interest in conversing with our aged residents. On December 3rd, 1952, Mr. Gunnar Sjobeck, public assistance councillor of the Royal Board of Sweden, inspected our facilities and showed much interest in the new buildings. He was quite complimentary in his remarks concerning the facilities here, and at his request he was provided with information concerning the problem of the care of the aged in this Province. T 102 MENTAL HEALTH SERVICES REPORT, 1952-53 Dr. A. G. MacKinnon reports a satisfactory year at the Home for the Aged, Vernon, where the general health of the patients has been quite satisfactory. They have had no major medical problems, and the various departments have functioned at a satisfactory level of efficiency. The close relationship of this Home to the Vernon General Hospital has facilitated the necessary surgical care of our patients, and the co-operation of the local surgeons has been excellent. I visited the Vernon unit in March, 1953, and was impressed with the excellent condition of the buildings and equipment and the care which is being provided for our patients there. This Home has been able to care for all the aged men and women requiring our type of care in this area of the Province. In May, 1952, Miss Elizabeth Clark, R.N., Superintendent of Nurses at Vernon, left our service to join the staff of the Kelowna General Hospital. Miss Clark was a most active and willing worker and did a great deal for the nursing staff at Vernon. She was well liked by all, and it was with regret that we saw her leave. This position was filled in October, 1952, by the arrival of Miss Thiemann, R.N., from the nursing staff at Essondale, who has carried out her duties as Superintendent of Nurses with efficiency and dispatch. Miss Thiemann and Dr. MacKinnon have been actively engaged throughout the year in carrying out an instructional and educational programme for the nursing staff. Such a programme not only creates interest and enthusiasm on the part of the staff, but is reflected in better care for our patients, and should be encouraged whenever possible. Mr. W. E. Skillicorn, Supervisor of our Home for the Aged at Terrace, reports all departments functioning satisfactorily. The general health of his patients has continued to be very good, and there have been no epidemic infections during the year. Only two patients required surgical attention and two patients had the misfortune to suffer fractured hips. During the year Dr. Weare left Terrace for a practice of his own at Smithers, B.C. For a time Dr. Hicks was assisted by Dr. H. Leighton, but at the present time is without an assistant. He continues to supervise the medical care of our patients at Terrace regularly and satisfactorily. The religious needs of the patients have been well cared for by regular Protestant and Catholic services, which are held on alternate Sundays. The efforts of the staff to provide suitable entertainment for their patients continues to be hampered by the lack of radio or recorded entertainment. It is hoped that provision will soon be made for either radios for the dayrooms or, better still, the wiring of the Hospital for combined record-playing equipment and radio reception. One weekly picture show continues to be the most popular form of entertainment. The problem of maintaining adequate staff coverage at the Terrace Home remains a prominent one. During the winter months adequate staff was available, but with the coming of summer vacations the problem of holiday relief is a pressing one. This Home has never operated with a full complement of nursing staff. The chief factors leading to this situation appear to be the acuteness of the local nursing situation and the availability of higher-paying jobs in the community. The increased efficiency of this unit has been facilitated by the completion of many projects during the past year; namely, the completion of renewing concrete piers and posts under three of the apartment buildings; repairs made to the laundry sewage- disposal system; erection of a suitable fence to separate the institutional buildings from the residential area; completion of the airing-court; overhauling of the plumbing and sewage system under the Hospital kitchen; redecoration of wards and corridors; renewing of the substructure and flooring under Dormitories 2 and 3; housing of the fire equipment; the new garbage-room to the rear of the kitchen; and the purchase of a new Farmall Cub tractor. REPORTS OF THE GERIATRIC DIVISION T 103 In concluding this annual report of the Geriatric Division of the Mental Health Services, I wish to gratefully acknowledge and commend the co-operation and assistance rendered by all members of the staffs in the Port Coquitlam, Vernon, and Terrace Homes for the Aged. Especially do I wish to express appreciation to yourself and Dr. Caunt for advice and assistance offered to me since taking over this position as Superintendent of the Homes for the Aged. Respectfully submitted. B. F. Bryson, M.D., Superintendent, Homes for the Aged. TABLES ON MOVEMENT OF POPULATION Table No. 1.—Movement of Patient Population, Provincial Homes for the Aged, Port Coquitlam, Vernon, and Terrace, April 1st, 1952, to March 31st, 1953. Male Female Total Total Male Female Total 158 106 293 260 128 418 234 293 557 126 388 131 In residence, Vernon, March 31st, 1952 In residence, Terrace ,March 31st, 1952.— 945 257 Total under treatment, 1952-53 __ 683 519 1,202 150 107 290 320 127 470 234 290 Total in residence, Port Coquitlam, March 31st, 1953 Total in residence, Vernon, March 31st, 1953 __ Total in residence, Terrace, March 31st, 1953 547 447 Grand total in residence, Port Coquitlam, Vernon, Terrace, March 31st, 1953 994 Table No. 2.—Movement of Patient Population, Home for the Aged, Port Coquitlam, April 1st, 1952, to March 31st, 1953 Male Female Total Total Male Female Total In residence, Port Coquitlam, March 31st, 1952 158 97 2 260 124 1 418 221 3 257 107 385 65 642 Separations, 1952-53— 12 12 12 71 9 11 45 21 23 12 116 172 150 ' 320 470 T 104 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 3.—Movement of Patient Population, Home for the Aged, Vernon, April 1st, 1952, to March 31st, 1953 Male Female Total Total Male Female Total In residence, Vernon, March 31st, 1952 Admissions, Vernon _ Admissions from Provincial Mental Hospital, Essondale_... Transferred from Port Coquitlam 106 25 12 128 5 2 11 234 30 2 23 143 36 146 19 289 Separations, 1952-53— 4 30 2 2 16 1 6 46 3 55 107 127 234 Table No. 4.—Movement of Patient Population, Home for the Aged, Terrace, April 1st, 1952, to March 31st, 1953 Male Female Total Total Male Female Total In residence, Terrace, March 31st, 1952 Admissions, Terrace _ Transferred from Port Coquitlam 293 4 12 293 4 12 309 19 309 Separations, 1952-53— 18 1 18 1 Discharges 19 290 290 REPORTS OF THE GERIATRIC DIVISION T 105 Variety gymnastic display in Pennington Hall. Patients' Christmas dance in Pennington Hall. T 106 MENTAL HEALTH SERVICES REPORT, 1952-53 REPORTS OF CHILD GUIDANCE CLINICS REPORT OF DIRECTOR A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—Attached herewith are consolidated summaries of the work done in the Provincial Child Guidance Clinics from April 1st, 1952, to March 31st, 1953. Table No. 1 is a summary of the general activities of the Clinics. Once again there has been a significant increase in the number of clinics held throughout the Province. This increase has been most marked in the Victoria area and was brought about by the appointment of Dr. W. L. Valens as psychiatrist and Mr. Paul Laeser as psychological clinic assistant, both on a full-time basis. This permits a continuous but limited service on Vancouver Island. In the Vancouver area, clinics are held on regular schedule at the Children's Hospital, the Health Centre for Children at the Vancouver General Hospital, and the Western Society for Physical Rehabilitation. Clinics were held for the first time at Smithers, Williams Lake, and at the Isolation Department Hospital attached to the Vancouver General Hospital. These will be continued as required. During the year it was possible to develop the pre-clinic conference as a regular feature of the functioning clinic team. The attendance at the Clinic of a psychiatrist-in-training from the Mental Hospital and Crease Clinic service has been mutually beneficial. Table No. 2 shows a definite increase in the total number of cases seen, particularly new cases. There has been an increase in the number of children seen, particularly males, with a decrease in the number of adults, again most noticeable in the male sex. The latter has resulted from the establishment by the Department of the Attorney-General of their own screening team for the Borstal and Young Offenders' Unit. The professional members of this team were recruited from the staff of the Vancouver Child Guidance Clinic. Table No. 3 again confirms a distinct trend which was noted in last year's report. While the total number of cases examined for social agencies is almost identical with the previous year, the relative proportion of these cases continues to decline. This development is discussed in greater detail in the report of the Social Service Department. The increase in cases referred by medical and health agencies, private physicians, parents, and relatives shows a growing awareness of the value of the Clinic's services. Table No. 4 shows the problems and disorders presented by new cases given a complete examination. It shows the reason for the original referral to the Clinic. Table No. 5, an analysis of age-groups and intelligence shows that the majority of cases seen by the Clinic are pre-adolescents of at least average intelligence. It is a justifiable inference that the majority should respond to suitable treatment. The interesting developments in the Psychology Department are covered in the report and accompanying Table No. 7, by Miss Munro; those in the Social Work Department are covered by the report of Mr. Ricketts with its accompanying Table No. 6. These reports are drawn to your particular attention. One of the basic objectives of the Clinic is to bring the potential skills of each Clinic worker to an optimal realization. Policies that are supportive of effective service to the patient are emphasized. Every endeavour is being made to maintain high standards of practice and opportunities for the professional growth of each Clinic member. The high standards that have been maintained have brought about the acceptance and approval of the Clinic by other agencies and by the community at large. REPORTS OF CHILD GUIDANCE CLINICS T 107 Another basic objective of the Clinic is its contribution to the total mental-health needs of the Province through its activities in various communities. In addition to its mediative and co-ordinative role in furthering the concept of integrative community activity in behalf of the health and welfare of the individual, the Clinic staff has concentrated on an educational programme. Various members of the staff from all departments have attended meetings with all types of groups where there are mental-health overtones. This has meant working with these groups in an active, practical, and constructive manner in an endeavour to further mental-health education. The establishment of the British Columbia Division of the Canadian Mental Health Association should give impetus to this programme and further diffuse its benefits. The staff of the Vancouver Clinic has been stimulated and encouraged by the opportunity to study the plans of the proposed centre to include Child Guidance Clinic, Adult Out-patient and Day Ward. The need for such a centre is well established, as is that for an observation and treatment centre for pre-adolescents suffering from emotional disturbances of such severity that their treatment in their own or foster homes is not possible. In Victoria it is recommended that the establishment of the Vancouver Island team be filled, and the present quarters be renovated to provide adequate and suitable accommodation for the staff. Table No. 1.—Summary of Clinics' Activity, April 1st, 1952, to March 31st, 1953 Mainland Travelling Clinics Vancouver Island Clinics Number of clinics held.. Physicals Urinalyses Playroom observations Agency case conferences Consulting case conferences. Private case conferences Psychiatric interviews — Pre-clinic conferences 299 675 212 87 624 304 151 1,595 135 43 1523 27 13 13 27 18 10 21 15 12 20 17 491 1,053 405 110 919 338 252 2,375 135 T 108 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 2.—Number, Sex, and Status of All Cases Examined at Child Guidance Clinics, April 1st, 1952, to March 31st, 1953 u Si > a o o > Mainland Travelling Clinics Vancouver Island Clinics £ Vi 0 X X < M o cd J O £ "ra T> u SJ > O 0 M O O Jd c es U d 0 u V. 0 41 « 0 c o Q M u O U. ■0 c eo 0 60 o. o o 1 _: c c _c 1 c o ~o Z c 5 ci u a. hi Si > 5 "a. * o tt, 4> i- O a. 0 o> ,g °k 0. U a a. u 5 n_ "3 c si ■=■ o SI 1 CO c3 H d 0 c u > a. M rt J i i c i- u _Q < M C Si a o 0 « u n 3 D o £ § Z 'C o > Vi O H New cases 595 4 1 2 1 4 18 12 1 5 6 1 2 3 24 4 4 4 7 2 2 3 7 9 1 6 2 9 12 3 6 3 12 1 1 1 1 2 5 3 1 1 2 1 1 7 8 6 2 8 7 1 4 2 2 2 9 9 1 4 4 3 1 2 12 10 4 1 5 1 ~1 11 6 1 3 2 2 2 8 8 1 3 2 2 10 7 6 1 1 1 8 4 1 2 1 4 3 1 2 1 1 4 24 1 17 1 5 3 1 2 13 1 8 4 10 1 4 5 10 6 2 2 2 2 12 9 6 3 2 2 11 13 5 5 1 3 1 18 4 4 4 20 3 10 7 5 5 25 119 2 73 4 40 19 929 Males— Adults 85 306 42 162 136 102 Children- Females— Adults .„ 509 55 263 Repeat cases 203 Males— Adults 17 73 8 38 1 10 8 138 24 108 Females— Adults 9 62 27 23 731 1,132 REPORTS OF CHILD GUIDANCE CLINICS T 109 Table No. 3.—Sources of All Cases Referred to Child Guidance Clinics, April 1st, 1952, to March 31st, 1953 Agency or Source Number of Cases Total Percentage of Distribution 1. Social agencies _ Children's Aid Society Social Welfare Branch Catholic Children's Aid Society- Child and Family Welfare Family and Children's Service. Family Welfare Bureau... City Social Service Department Young Women's Christian Association- Loyal Protestant Home 2. Institutions—New Haven.. 3. Medical and health agencies.. Public health nurses Children's Hospital- Vancouver General Hospital, Social Service Department- Saanich Health Unit _ Simon Fraser Health Unit Crease Clinic Western Rehabilitation Centre- Health Centre for Children... 4. Schools.. Public- School Board- Teachers Other- Boys' Industrial School- Girls' Industrial School School for the Deaf and the Blind- School Counsellor 5. Juvenile Court.. Provincial Probation Officer- Young Offenders' Unit 6. Adult Court—Borstal.. 7. Private physicians 8. Parents, relatives, self, friends.. 9. Other—Speech therapist Totals 194 219 31 1 16 15 10 1 1 130 32 1 1 1 1 31 12 6 34 77 29 7 3 57 1 35 70 115 1 1,132 488 43.11 209 18.46 156 13.78 35 70 115 1 3.09 6.18 10.17 0.09 1,132 100.00 T 110 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 4.—Problems and Disorders Presented by the New Cases Given Full Examination by Child Guidance Clinics, April 1st, 1952, to March 31st, 1953. 1. Primary behaviour disorders— (a) Habit disorders— Nail-biting _ Thumb-sucking_ Enuresis Masturbation ___ Tantrums Soiling _ Feeding difficulties _ Other (b) Personality disorders- Seclusive states..— Depressed states ... Day-dreaming. Excessive introspection _ Feelings of inadequacy— Sensitiveness Phantasy Aggressiveness Negativism Other (c) Neurotic disorders— Tics and habit spasms . Sleep-walking Stammering.__ Overactivity Fears Nervousness _ Nightmares — Anxiety.—. Other (d) Conduct disorders— Truancy _. Fighting and quarreling. Untruthfulness Stealing _ Destruction of property- Use of alcohol - Cruelty Disobedience Setting fires Sex offences. Vagrancy. Running away Staying out late Breaking and entering _ Assault Other 2. Psychotic and prepsychotic- Manic depressive Schizophrenia _ With juvenile general paresis . With epidemic encephalitis Undifferentiated Other 3. Psychoneurosis and neurosis- Hysterical type _ Psychasthenic type . Anxiety type Other- Children M. 4. Convulsive disorders— Epilepsy Other 5. Psychopathic personality 6. Educational disability— (a) Associated with dull-normal or border-line intelligence. (b) Special mental disability— Writing Reading. Arithemtic. Other__ (c) Social adjustment. 2 24 3 21 4 5 2 6 2 21 2 4 8 4 2 16 3 6 47 3 13 4 2 1 3 19 3 3 2 12 2 18 2 3 9 4 12 2 1 13 Adults M. 24 3 1 14 4 1 12 2 2 Total 2 5 36 7 33 6 7 5 8 3 27 2 5 9 6 4 5 9 11 2 2 10 27 3 10 87 3 5 16 4 22 4 8 1 34 7 10 10 2 18 3 32 J REPORTS of child GUIDANCE CLINICS T 111 Table No. 4.—Problems and Disorders Presented by the New Cases Given Full Examination by Child Guidance Clinics, April 1st, 1952, to March 31st, 1953—Continued. Children Adults Total M. F. M. F. 7. Behaviour disorder associated with somatic disorder— 3 3 11 4 14 2 2 1 1 1 1 36 5 10 23 6 10 18 55 4 1 8 5 1 7 1 4 — 2 17 5 14 6 2 12 55 1 1 2 2 1 2 1 31 1 1 1 6 2 1 4 3 8. Mental deficiencies— (a) Familial (b) Mongolism _ 21 9 1 23 2 3 1 (i) With other organic disorders (j) Undifferentiated _ _ (k) Other _„ 5 1 3 54 10. No ascertained mental deviation— 10 26 31 8 10 (/) Social problems— (1) Placement (2) Adoption ___ _ 30 110 6 2 (5) Other (g) Unascertained _ 4 (0 Sight problem_ 2 3 12. Borstal 31 Totals _ 519 257 97 56 929 T 112 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 5.—Chart Comparing Ages with Intelligence Quotients of All New Cases Seen at Child Guidance Clinics from April 1st, 1952, to March 31st, 1953. Males Females 0-19 20-49 9 9 1 1 2 _ 22 50-69 ____ _ 5 16 5 7 33 70-79 3 8 9 1 1 22 80-89 _. -. 7 19 26 16 2 16 15 18 7 2 22 23 10 7 1 5 11 14 10 1 1 1 1 52 90-99 — 68 100-109 69 110-129 41 130-139 5 140+ - - 4 1 5 Totals 91 91 79 49 3 2 2 317 Respectfully submitted. Ultan P. Byrne, M.D., D.P.H., D.I.H., Director, Child Guidance Clinics. Intelligence Quotient Age in Years 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40+ Total 0-19 . 7 9 6 19 20 42 33 2 1 5 37 16 23 41 50 31 2 2 5 17 12 34 31 34 23 1 1 6 8 14 23 27 16 2 1 1 1 2 1 2 4 20-49 — 19 50-69 _ 70 70-79 80-89 90-99 100-109 110-129 42 92 116 155 107 130-139 140+ - Totals 6 5 139 207 157 98 11 612 SOCIAL SERVICE DEPARTMENT U. P. Byrne, Esq., M.D., D.P.H., D.I.H., Director, Child Guidance Clinics, 455 West Thirteenth Avenue, Vancouver 10, B.C. Sir,—During the 1952-53 year the work of the Social Service Department has continued to develop along the lines experienced in recent years. The demand from the community for increased direct service to children and parents has continued, and much of the staff thinking and energy has been directed to services in this area. Social-work responsibilities in the Child Guidance Clinic include participation in diagnostic and consultative services to health and welfare agencies and institutions, various teaching and educational duties, and services to parents and children seeking direct help from the Clinic. They also involve work in various joint staff projects and committees, interpretation and co-ordination with other agencies, and planning and arranging of services as in Travelling Clinics. Several surveys and research activities have also been undertaken, including a follow-up study of the effectiveness of Travelling Clinic services which is just under way. REPORTS OF CHILD GUIDANCE CLINICS T 113 There has been some decrease in services to other agencies except for the Travelling Clinic, which has continued to take the full time of one staff member of this department. In the educational area, social workers have continued to contribute to various professional and community groups and projects. We have also participated in teaching and orientation of student-nurses and social workers. On several occasions we have been called upon to teach in-service training class for the Provincial Social Welfare Branch, and one of our workers has given time to teaching part of a course in research at the University of British Columbia School of Social Work. We have also introduced a number of visitors from other countries to social services here. The Federal mental-health project for students training in conjunction with the University School of Social Work has continued for the second year, with eight students in the campus unit. Lack of space made location outside of the Clinic necessary, and while this is not desirable it has worked out quite satisfactorily. It is expected that the Mental Health Services will gain four master's degree students from this project after completion of their training. When those coming to the Child Guidance Clinics have joined the staff, eleven of our sixteen social workers will be people trained in these student projects of the Mental Health Services. Direct services to families have again shown a tendency to increase in relation to other services. The social workers take considerable responsibility in intake. They obtain information, explore the problem with parents and children, help them toward good use of Clinic services or referral to a more satisfactory source of help, and they assess the problem in terms of social and parent-child relationships. A beginning was made this year in establishment of a social-work intake section, and it is hoped that this approach can be broadened as a means of giving earlier and more helpful service. The Social Service Department has also taken part in inaugurating the use of pre-Clinic team conferences as a part of intake procedure. This is seen as an aid to making early decisions which will facilitate and focus our services. From their continuing case-work help following intake, the social workers contribute to diagnosis and treatment planning. They also carry a responsibility in most continuing cases for case-work services to parents and children. They have responsibility for integrating and co-ordinating their work with that of other team members and also for bringing to the client the community resources which they can use. The following statistics give some indication of the services given, and they indicate the continued trend toward more direct and intensive services. In the Vancouver Clinic there were 344 applications for " direct" help which were handled by the Social Service Department. The case-count indicates only those cases which were incorporated in caseloads for continued services. The over-all intake was up from the previous year by about 44 per cent (Victoria, 170 per cent, and Vancouver, 15 per cent), and cases carried over to the next fiscal year were up about 31 per cent (Victoria, 61 per cent, and Vancouver, 24 per cent). Total cases carried increased about 26 per cent (Victoria, 74 per cent, and Vancouver, 15 per cent), and direct interviews with clients showed an increase of 44 per cent (216 per cent in Victoria, and 29 per cent in Vancouver). The steady increase in numbers has been evident for some years and would seem to reflect increased public awareness, resulting from the Clinic's growth in ability to give needed services. The latter part of this fiscal year has particularly seen a considerable increase in applications, with the result that present facilities and staff are taxed and there is usually a waiting period for appointments. One feature of the statistics is the outstanding growth in services at the Victoria Child Guidance Clinic. This is, of course, a result of the establishment of a full team there. It was possible to add a second social worker last summer to meet the demands on the new team, and a third worker is needed in the near future. While these statistics are focused mainly on case-work services, some indication of other aspects of social services is given by a total of 1,105 cases from other agencies, T 114 MENTAL HEALTH SERVICES REPORT, 1952-53 including Travelling Clinics. In addition to the quantitative aspects of these statistics, there are several figures which, at least, suggest a qualitative interpretation. The number of case-work interviews has again increased more rapidly than case-count; there is a considerable increase in inter-professional conferring and there is an increaase in supervisory consultation within the department. These are aspects of professional practice which can be expected to reflect in better services to the individual. At the beginning of the fiscal year there was an unusual turnover of staff in this department, resulting in many vacancies. Replacements were made by the end of the summer, and the case-work staff was at that time almost completely new. This, of course, caused some dislocation, but the new staff made it possible to avoid too much disruption of services, and they have taken a real interest in their work and in various staff projects. The members of the staff who left last year were well-trained social workers whose child- guidance experience contributed to their qualification for the jobs to which they moved. Higher compensation and the opportunity for advancement were factors in most of these moves. One of our supervisors moved into administration of a large medical social- service department and another into the development of a child-placement agency. One took a position in another Province, and other workers moved to family, children, and correctional fields in this area. As our own services have expanded, the gaps in community resources have become more and more obvious. We are often called upon to give services to severely disturbed children who are in real need of care and treatment in an institutional setting. Over and over again we are seeing the need for a residential centre for these children, who cannot respond to help in a normal home or foster-home setting. There are excellent developments in the correctional field, but we are still finding that services are hampered by gaps in this area. In many cases where there is a necessity for temporary removal from home during treatment, adequate facilities are lacking. Our workers also find a continuing need for psychiatric out-patient facilities, and we are sometimes in the position of giving child- guidance services where adult out-patient help is greatly needed by the parents. It is hoped that some of these gaps can be filled in the near future. The Social Service Department is pleased at the prospect of a new clinic building. Efficiency and adequacy of service have been seriously handicapped by present space and facilities, and it is hoped and expected that the new quarters will provide the essentials for better service. REPORTS OF CHILD GUIDANCE CLINICS T 115 Table No. 6.—Social Services of Provincial Child Guidance Clinics, April 1st, 1952, to March 3 1st, 1953 Case-work Services Vancouver Victoria 1952-53 Totals 1951-52 Totals Cases brought forward from previous fiscal year- New cases Reopened during year Reopened from previous year. Total intake Total cases carried. Cases closed during fiscal year Cases carried over to next fiscal year- Number of applications for service. Total casework interviews with and regarding clients _ Conferences attended in agency diagnostic service Conferences attended on cases carried by Clinic Consultations with team members Periods of supervision _ _ __. Travelling Clinics (total days).. Cases given service in Travelling Clinics _ 157 36 231 8 17 256 405 210 195 344 7,860 687 700 367 757 701/2 320 129 2 12 143 177 117 58 1,555 47 89 63 34 17 51 193 360 10 29 399 582 329 253 9,415 734 789 430 791 87 V2 371 200 230 24 23 277 453 267 193 6,100 1,017 397 359 677 80 275 Respectfully submitted. Donald B. Ricketts, Supervisor, Social Service Department. PSYCHOLOGY DEPARTMENT U. P. Byrne, Esq., M.D., D.P.H., D.I.H., Director, Child Guidance Clinics, 455 West Thirteenth Avenue, Vancouver 10, B.C. Sir,—Attached herewith is a tabulated summary of the work of the Psychology Department of the Provincial Child Guidance Clinics from April 1st, 1952, to March 31st, 1953. A comparison of this table with that of last year shows trends which reflect, but do not explain, some important changes. One of these is the decrease in the number of tests administered for Borstal screening purposes at Oakalla. This was due to the appointment in July, 1952, of Mr. R. V. McAllister, of our staff, to establish the first full-time position as psychologist at Oakalla. Another change is indicated in the increase in the amount of work done in Victoria. In January, 1953, Mr. Paul Laeser was transferred to Victoria to become the first full-time psychologist on the Vancouver Island Clinic team. Until that time the work had been done periodically by psychologists from Vancouver, who still assist Mr. Laeser on Up-Island Clinics. The increase in the volume of work since the Vancouver Island Clinic has been established on a full-time basis indicates that another full-time psychologist is now necessary. The increase in time devoted to play interviews shows that we have made some progress in the extension of our service in this area. However, in view of the need to meet the demands for diagnostic service, its chief value at present is that it provides experience for our staff in the use of play techniques. During this year eleven children were seen for periods varying from six months to one year. In addition, three children were seen over lengthy periods for reading tuition, three were seen for extensive observation, and four others for interviews concerned with vocational planning. T 116 MENTAL HEALTH SERVICES REPORT, 1952-53 In addition to the staff changes already mentioned, Miss Mavis Plenderleith resigned in September to continue postgraduate studies at the University of California, Berkeley, and Miss Mona Hopkins and Miss Susan James joined the staff as psychological interns. Our contribution to the educational programme continues, with an increase in the number of talks to interested groups and in the orientation of other professional persons. This year, for the first time, three groups of students from postgraduate courses in Clinical Psychology at the University of British Columbia spent a day at the Clinic observing psychologists in action. This brief orientation is suggestive of the contribution which we may be able to make in the future through co-operating with the University in its clinical training programme. The development over the past year has been gratifying, not only in the general extension of our services, but in the quality of the work which a more experienced staff has been able to contribute. Respectfully submitted. Marjory Munro, M.A., Psychologist. REPORTS OF CHILD GUIDANCE CLINICS T 117 IEJC-X coc.r---HncqotnM»ncncN'-'^^^*-»-M<o'nc»c<l.-<csvoio*OTi'.SrHCsi'-<.-'- oscor. .-cm.* o.cs me..- -h -nr-r- t»** HNMH00<SC.O0\O^-)r^h ^. ^< r* ci-* t> o\ cn .-< -h --co cn U~i Os O H cs in 3 Ph < H PS O P. a Pi < z z < H cn 3 o I-l o a o CO Ph u U w u z a p a Q ri S u o w 3>[E-I SIUEIIIIM iiip-'iiNiriur j ! i eijopiA UOUJ3A Osctcn ! |*M NH I | ! \O0\O \ ! i ire-iX I ! sjaqiitus i i : I-US3U0 jjsdng soupd I I j I.-* | I I J«f> |»* j j I ICS^HCS j i i i ! ! ! j i ! ! MM 38JO-O 3onri_[ U-iO\ j ! ! I j j [Tf _._A!H H-MOJ It- ! ikniT) aopiiuad ! ! |M I i ill I i i I i i I uospk en ien I i»h OUIIEUE{<[ UOISSTp^ EU/aopx III!! ! I I I I I i-*r--< ! I ! I ICO sdooiuiE"}[ III!! III! I I I I I ir-r- i S3I-IOJ pUEJQ I I I ! I I I I I I I I r UEDUUQ 3(33.0 UOSMEQ inn 1 | "7~CN</. UO}S3__3 I I I HC. 3)00jquEi3 XEU3)_inoo l l | jO-^h Mill JJOEMinillD i^H"<t^o I i-h mjsqiv piojsjoqqv ! ! Ml 3JJU30UOT)EJ!I!q -EipH uisjs3A_ «3JPIWD JOJ 3JJU33 miE3H I i pnidsOH s.nsjpino ICH I — ^ U3AEJJ M3>J (EHE_lBO) 8U1 -U33JDS tElSJOg ^ i ! (Ni-h ! i^*0 tS J3AtlODUBA «h i r. vo s-> t> a cs \osc- \Ooo II •0*0 t-< '- op Qfifl ,9 u _,_c-c:^ _ u u u d 3 O P S « fl « oo£ u.S2o 3 o 3 a u_§ » __.§£ 0 ts — 8 c .S1 >. 8! «3 o_ Ih m <u2S«P'QQHUa! c^ 00.3 .a «M_<i.H^„ ifi rtti'P .. h^nW ^ <3 u o g « g3 >,a SqQ0K_jS<-_ b'P I o o^: _, 2 <u c 0> OOi> c o PT1 Jj S cd C ^__-_0S _. >j fi 3 .2 _§8*-assl-gs f.j_ m si o^ g dra, '-iii's 8.sfl >,« 3813IIPI Zm2P.H2h3p.M o 31» 5 ?;§£____ t; o <u o T 118 MENTAL HEALTH SERVICES REPORT, 1952-53 REPORT OF RESEARCH DIVISION A. M. Gee, Esq., M.D., CM., Director of Mental Health Services, Essondale, B.C. Sir,—I beg to submit herewith the annual report of the U.B.C.-Crease Clinic Research Unit for the fiscal year April 1st, 1952, to March 31st, 1953. The two main research problems reported in our last annual statement continue to occupy the laboratory: (a) The physiological and anatomical basis of lobotomy; (b) the electroencephalogram in abnormal personality. Because of delay in obtaining suitable personnel, the second of these has been carried on to only a limited extent. This problem will shortly be rectified. Dr. Kennard has succeeded in producing some very interesting results in cats and monkeys with frontal, temporal, and other removals. The catatonia ensuing in cats following cingulate gyrectomies has been remarkable, and coloured moving pictures of such animals have already been taken. Mr. Roy Griffiths, B.A., a research fellow working for his Master of Science degree in this department, has continued his very interesting work on the effect of removal of brain tissue upon already established conditioned reflexes. On the study dealing with electroencephalographic differences in abnormal personalities, a trial run has been made of approximately 100 patients at the Crease Clinic on whom Dr. Fister, Director of the Neurological Department, has made the E.E.G. recordings. These have been grouped with approximately 1,000 other records which Dr. Kennard has from previous clinical work on behaviour disordered children, long- term criminals, sexual psychopaths, and other inmates of gaols or mental hospitals. It is obvious that the correlation of E.E.G. and clinical psychological findings which we propose to carry on during the next twelve months will be of great importance in prognostic work. Dr. Gibson's work has been continued on establishing methods for the tracing of interrupted fibre pathways in the human brain following lobotomy operations. A silver staining method has been worked out which has given excellent results in a normal control brain and two lobotomized brains. This work was reported during March, 1953, for the North Pacific Society of Neurology and Psychiatry meeting in Portland, Ore. It is hoped that sufficient personnel may be attached to the laboratory in the next year to make this method well worth while. The Surgeon-General of the U.S. Army has given us access to a large collection of lobotomized brains, and he has recently sent four to us for anatomical study. The work which was commenced over a year ago by Dr. John Harvey on the problems of cerebral vessels has been discontinued in this laboratory and will be carried on in the Department of Anatomy of the University, in which department Dr. Harvey has been made a professor. During the year Dr. Kennard travelled to the meetings of the American Neurological Association and of the American E.E.G. Society, held conjointly at Atlantic City. She presented a paper on " The E.E.G. and Psychopathology " in a symposium on this subject. Dr. Gibson attended the meetings of the American Neurological Association and those of the American Society of Neuropathology, held jointly at Atlantic City. VISITORS Visitors to the laboratory have included Dean Macdonald Critchley, of the Institute of Neurology, London, England; Sir Philip Livingston, D.M.S. (Air) (retired), of the R.A.F.; Professor Stuart Morson, of the Department of Neurosurgery, University of Sydney, Australia; Dr. Thomas Greenaway, of the Department of Medicine, University of Sydney; Maj.-Gen. George E. Armstrong, Surgeon-General of the U.S. Army; Pro- REPORT OF RESEARCH DIVISION T 119 fessor Robert Dow, University of Oregon; and Professor Robert Ray, University of Washington Medical School, Seattle, Wash. During the year, also, Dr. Jenkins, of the Department of National Health and Welfare, inspected the monkey cages provided for out of Ottawa grants, in company with representatives of the Treasury Board and Dr. Horowitz, of Ottawa. They appeared well pleased with the accommodation provided for the monkeys, cats, and other laboratory animals, and seemed satisfied that their money had been wisely spent. EQUIPMENT Apart from cages to house the monkey colony and our cats, the only large addition of apparatus has been photographic enlarging equipment, which has made the greatest difference to the work of the laboratory for publication. BUDGET The budget for the year consisted of Ottawa grants-in-aid to the amount of $32,182.64, together with an operating and apparatus account from the Mental Health Services of British Columbia and a small appropriation from the University to the Department of Neurological Research for items of equipment, repairs to apparatus, and special services, not otherwise provided for. PUBLICATIONS Publications from the laboratory have included six during the year 1952-53 by Dr. Margaret Kennard. Dr. Gibson gave a paper on "Human Cerebral Synapses," presented for us at the First International Congress of Neuropathologists at Rome, about to appear in " Science " in the United States. Dr. Kennard and Dr. Gibson have spoken widely on subjects of neurological interest and of the physiological basis of mental disease. DISPLAYS Displays of work being carried on at the laboratory have been made at the annual " open house " at the Provincial Mental Hospital and at the International Congress of Neuropathology at Rome in September, 1952. COMMITTEES Dr. Kennard and Dr. Gibson have been asked to serve on the University Committee on Narcotic Addiction and on the Medical Board of the Cerebral Palsy Association. PUBLIC RELATIONS Relations with the University have remained very cordial throughout the year, and it is a matter of great regret to the Dean of the Faculty of Medicine that additional space for this laboratory has not yet been provided. However, as soon as estimates permit, the conversion of two large classrooms in the medical-hut quadrangle is proposed. For limitation of space, it has been necessary to cut down drastically on the number of people who can assist with the work, including many voluntary student workers, among whom mention must be made of Miss Anne Worth, who did an excellent piece of work in the summer of 1952 under Dr. Kennard's direction. NEEDS The needs of the laboratory continue to be adequate space and a relief from the ever-present danger of fire. Further, a Grass eight-channel electroencephalograph is urgently required, together with a stroboscope and conditioning movie projector for T 120 MENTAL HEALTH SERVICES REPORT, 1952-53 research on E.E.G. in psychopathology, which must eventually include a number of non- hospitalized cases. The need for the maintenance of continuity in the work of the laboratory is evident to all who have had experience in scientific institutions. The delays associated with Ottawa grants have made it very difficult to acquire the personnel required to begin at the first of each fiscal year. CONCLUSION Mention must be made in closing of the active co-operation of the many departments of the University of British Columbia upon which we have called for help and advice during the past year. The care afforded our animals by the Department of Animal Nutrition is second to none on this continent. The Department of Physics, its workshops, and in particular Professor Arthur Crooker, of the Department of Optics, have rendered us assistance on many occasions. Finally, the library of the University has been our mainstay, and we have had excellent co-operation from all its branches. W. C. Gibson, M.D., Director of Research. STATISTICAL TABLES—MENTAL HOSPITALS T 121 MENTAL HOSPITALS STATISTICAL TABLES Table No. 1.—Showing the Operations of the Mental Hospitals—Essondale, Colquitz, and The Woodlands School, New Westminster—from April 1st, 1952, to March 31st, 1953. Movement of Population Male Female Total Total Male Female Total 1,843 439 286 44 7 2 2 1 1,641 369 66 2 1 3,484 808 286 110 9 2 3 1 2,624 794 2,079 538 In residence, The Woodlands School, New Westminster, March 31st, 1952___ _ On probation, carried forward from 1951-52, Essondale.— On probation, carried forward from 1951-52, The Woodlands On probation, carried forward from 1951-52, Colquitz On escape, carried forward from 1951-52, Essondale- On escape, carried forward from 1951-52, The Woodlands On escape, carried forward from 1951-52, Colquitz 4,703 Admitted during the year 1952-53— 559 28 180 7 1 19 465 13 54 3 3 1,024 41 234 10 1 22 1,332 Total under treatment, Essondale, The Woodlands School, New Westminster, and Colquitz, April 1st, 1952, to March 31st, 1953- _ - Discharged during the period of April 1st, 1952, to March 31st, 1953— (a) Essondale—■ 23 134 167 209 2 71 4 94 29 105 170 46 1 76 1 61 52 239 337 255 3 147 5 155 3,418 739 2,617 505 6,035 Not insane - Died _ 704 489 1,193 (b) New Westminster— 1 4 7 9 1 6 9 1 5 13 18 Died 21 16 37 (c) Colquitz—■ 1 2 1 10 1 2 1 10 Died 14 14 Total discharged from Essondale, The Woodlands School, New 1,244 Total in residence, Essondale, The Woodlands School, New 2,679 2,112 4,791 T 122 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 1.—Showing the Operations of the Mental Hospitals—Essondale, Colquitz, and The Woodlands School, New Westminster—from April 1st, 1952, to March 31st, 1953—Continued. Movement of Population Male Female Total Total Male Female Total Essondale— Total on books, March 31st, 1952 _ Admitted during 1952-53 1,889 776 2 1,708 515 16 3,597 1,291 18 2,667 903 2,239 584 Received from New Westminster, The Woodlands School- 4,906 Discharged during 1952-53- 704 187 12 489 95 1,193 282 12 1,487 446 205 371 118 817 313 1,764 1,655 3,419 New Westminster, The Woodlands School— Total on books, March 31st, 1952 • 651 23 489 32 1,140 21 2 16 16 37 18 55 289 12 289 12 Total in residence, The Woodlands School, New Westminster, March 31st, 1953 , 628 457 1,085 Colquitz—■ Total on books, March 31st, 1952 — 301 14 301 Discharged during 1952-53 14 14 14 Total in residence, Colquitz, March 31st, 1953 287 287 Total in residence, Essondale, March 31st, 1953 Total in residence, The Woodlands School, New Westminster, March 31st, 1953 _ _ Total in residence, Colquitz, March 31st, 1953 1,764 628 287 1,655 457 3,419 1,085 287 Grand total in residence, Essondale, The Woodlands School, New Westminster, and Colquitz, March 31st, 1953 2,679 2,112 4,791 Percentage of patients recovered and improved to admissions- Percentage of discharges to admissions (.deaths excluded) Percentage of deaths to number under treatment- Daily average population ..22 (21.99) 67.64 3.03 ___ 4,674.37 STATISTICAL TABLES—MENTAL HOSPITALS T 123 Table No. 2.—Showing in Summary Form the Operations of the Mental Hospitals since Inception Year Discharges O si 0) V « o ca •"•n_.e 3 z. ill «__ M ^ S_h I III iill OS'S x *xi o> P ea B 5! H.QZH 1872 1873 1874 1875 1876 1877 1878 1879 1880 1881 1882 _ 1883 1884— 1885 1886 1887 1888 ___. 1889 1890 1891 1892 1893 1894 ______ 1895 1896 1897 - 1898 1899 1900 1901 1902 1903 1904 1905 _ 1906 1907 1908 1909.— 1910 1911 1912 1913 1914 1915 1916 1917 1918 Jan. 1, 1919, to March 31, 1920 1920-1921 1921-1922 1922-1923 1923-1924 1924-1925 1925-1926 1926-1927. 1927-1928 1928-1929 1929-1930 — 1930-1931 1931-1932 1932-1933 1933-1934 1934-1935 1935-1936 18 15 12 29 22 14 16 18 17 13 7 8 10 20 27 36 26 41 52 49 52 44 80 62 64 74 81 101 113 115 121 139 115 123 150 221 230 232 280 332 375 380 402 332 353 371 375 574 489 478 438 447 461 475 494 542 543 602 632 562 635 610 653 679 1 10 4 3 11 4 7 4 5 5 3 4 2 5 10 15 12 14 17 19 17 14 13 29 23 20 27 31 38 40 30 38 46 43 361 48 681 732 84 67 * 741 904 58 83 732 88 75 116 88 96 91 842 63 57= 76* 75* 92s 118i 701 58 « 444 613 711 631 6 5 6 5 6 4 10 18 19 11 25 8 13 32 27 20 31 37 26 33 43 43 56 77 82 114 128 146 126 91 96 78 95 221 173 178 167 121 242 240 171 252 294 311 235 299 323 309 349 304 1 5 3 10 5 3 5 5 2 3 2 5 6 5 3 4 12 20 13 14 19 20 9 14 19 21 29 25 25 26 26 27 28 39 57 40 41 60 76 67 74 89 80 106 132 132 122 114 133 163 138 142 161 147 181 223 191 181 195 200 321 291 16 14 19 32 35 38 36 41 48 48 49 49 51 61 66 77 82 100 117 123 135 133 162 164 171 203 221 234 258 284 311 349 321 348 388 461 507 536 595 690 752 919 1,027 1,090 1,205 1,301 1,347 1,458 1,566 1,649 1,697 1,784 1,884 1,995 2,125 2,269 2,347 2,411 2,550 2,676 2,824 2,960 3,080 3,180 5 13 3 3 5 7 2 10 5 11 5 18 17 6 12 29 2 7 32 18 13 24 26 27 38 27 43 73 46 29 48 105 62 167 108 63 115 96 46 111 108 83 48 87 100 111 130 144 78 64 139 126 148 136 I 120 I 100 28 18 31 26 48 54 49 54 54 58 61 55 57 59 71 88 102 103 123 152 166 175 179 213 224 228 246 285 327 356 377 413 466 480 505 552 666 765 816 896 1,034 1,065 1,264 1,364 1,437 1,527 1,650 1,753 2,025 2,043 2,137 2,180 2,234 2,327 2,434 2,565 2,743 2,914 3,063 3,148 3,214 3,390 3,530 3,721 3,838 5.55 66.66 33.33 10.34 50.00 28.57 43.75 22.22 29.41 38.46 42.85 50.00 20.00 25.00 37.03 41.66 46.15 34.15 32.69 38.77 32.69 31.81 16.25 46.77 35.93 27.03 33.33 30.69 33.63 34.78 24.79 27.34 40.00 33.33 23.03 21.30 28.30 31.00 30.00 19.57 18.90 22.63 14.43 25.00 20.68 23.72 20.00 20.20 14.17 20.08 20.77 18.56 13.66 12.00 15.38 13.28 16.76 19.10 10.60 10.32 6.92 10.00 10.87 9.27 5.55 80.00 33.33 26.89 63.63 78.57 62.50 27.77 29.41 61.54 57.14 62.50 60.00 25.00 59.25 55.55 69.23 46.34 44.23 46.94 51.92 72.72 40.00 64.51 75.00 37.83 49.38 62.37 57.52 52.17 50.41 53.96 62.61 61.78 52.06 41.20 53.90 64.60 59.28 54.42 53.80 62.10 45.77 52.41 47.87 44.74 45.33 58.71 72.60 57.32 59.36 64.20 66.16 62.53 50.00 60.33 71.07 71.26 64.24 63.52 58.42 60.65 64.32 54.05 5.55 16.12 11.53 20.83 9.35 6.12 16.16 14.81 8.62 8.19 3.63 5.26 3.33 6.94 6.81 4.80 2.87 3.25 7.64 11.69 6.95 7.60 8.92 8.92 3.94 5.69 6.66 6.42 8.14 6.63 6.06 5.57 5.42 5.34 5.04 5.08 7.44 6.40 4.57 5.83 7.02 5.30 5.43 6.19 5.24 6.42 7.47 6.51 5.97 5.33 6.10 7.25 5.93 5.83 6.27 5.36 6.21 7.28 6.06 5.63 5.75 5.66 5.94 7.58 1 Three not insane. 6 Five not insane. 2 One not insane. s Two not insane. 1 Four not insane. 5 Six not insane. T 124 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 2- -Showing in Summary Form the Operations of the Mental Hospitals since Inception—Continued c/_ a o 'vi Vi •a < Discharges 0 [fl 3 a. Year •a Si > o u si p. ■a 0 u 0 > 0 VI £ el u 0 erf 0 c3 Z"Sw a. u S 0 3 H U 0) P § "S3 „ co rt'C-2 C > co S a."0 c § to"2 8-Sll o.Q<pa O n ew.c w a 3 a c||l ^^ e_ t_ OhOZH 1936-1937 — 1937-1938 1938-1939 1939-1940 1940-1941 1941-1942 793 834 827 869 864 834 803 840 822 834 880 1,111 1,260 1,415 78s 74 72 3 111' 107 e 718 91° 87 9610 117» 9710 124" 13712 195 300 330 345 455 410 400 443 423 377 352 496 560 748 787 268 207 208 230 254 255 260 309 300 240 238 240 209 202 3,301 3,487 3,612 3,710 3,836 3,902 3,925 3,960 4,019 4,110 4,151 4,269 4,355 4,602 121 186 125 98 126 66 23 35 59 91 41 118 86 247 — 4,067 4,255 4,471 4,713 4,781 4,843 4,919 4,965 4,960 5,014 5,174 5,447 5,758 5,999 9.96 8.87 8.71 11.39 12.38 8.51 11.32 10.36 10.46 14.02 11.02 11.34 10.87 13.78 63.60 67.30 78.72 88.50 79.97 56.46 66.50 61.66 58.39 57.43 68.18 63.64 76.59 69.40 6.59 4.86 4.65 4.88 5.31 6.54 1942-1943. 1943-1944— 1944-1945 1945-1946 .. .. 5.31 6.02 6.04 5.84 1946-1947 - . 1947-1948.. .." 1948-1949 1949-1950 4.59 4.40 3.63 3.37 r/J e .2 'in CO 1 Discharges Q u 3*8 So erf 0 S3 •MS S H O a eq es p U u Q 1-1 B f 3 *■* 0 0 Oca ■0 p ss 08; — fll P- M loG.1 8-§21 fl<PL<a<; u ■a S2 1 llli B__'9q 4>__ Is oSg Mo P ssa «.__.\_ 0 s< u si S a Year •a u u 0 > 0 0 u « •a u > 0 u a E •0 0 > 0 u a S 1 QQ M ■^. CO 1950-51 - 1951-52. 1,499 1,217 1,332 169 138 53 421 301 240 414 438 350 284 252 258 223 188 183 4,538 4,578 4.791 40 213 64 4,815 6,020 6.035 39.35 36.07 21.99 67.04 92.77 67.64 3.53 3.12 1952-53 3.03 3 Two not insane. 10 Seven not insane, psychosis. " Five not insane. 7 Twelve not insane. 11 Three not insane; 196 without psychosis. 8 Ten not insane. 12 Two not insane; 8 Eight not insane, seventy-eight without Table No. 3.—Showing the Total Number of Admissions, Discharges, and Deaths in the Mental Hospitals from April 1st, 1952, to March 31st, 1953 Months Admissions Discharges Deaths Male Female Total Male Female Total Male Female Total 1952 April 58 69 57 88 74 66 85 59 61 58 58 61 28 36 44 45 38 36 62 42 46 58 43 60 86 105 101 133 112 102 147 101 107 116 101 121 58 31 30 41 48 52 58 38 29 57 52 47 31 22 25 18 27 46 25 25 38 26 29 40 89 53 55 59 75 98 83 63 67 83 81 87 8 18 8 10 7 7 8 7 13 12 7 8 4 9 5 5 3 5 2 5 6 9 9 8 12 27 June __ July 13 15 August September 10 12 10 November December 1953 January February „ March 12 19 21 16 16 Totals 794 538 1,332 541 352 893 113 70 183 STATISTICAL TABLES—MENTAL HOSPITALS T 125 Table No. 4.—Showing What Districts Contributed Patients from April 1st, 1952, to March 31st, 1953 Place of Residence Male Female Total Place of Residence Male Female Total Abbotsford _ 6 1 1 2 1 1 1 1 1 1 18 1 1 8 8 1 2 1 2 1 1 1 2 1 6 1 3 1 1 1 1 1 2 1 2 1 1 1 1 2 1 9 1 1 1 13 2 1 3 1 1 1 1 1 1 1 23 1 2 1 1 1 2 11 1 1 2 1 3 1 2 1 1 2 1 2 1 2 1 1 1 1 1 1 1 3 — 1 1 1 3 1 4 4 5 9 1 2 3 1 1 1 1 2 1 1 1 1 1 41 1 2 1 1 1 1 3 19 9 1 1 4 1 3 1 1 4 2 1 3 1 3 2 1 1 6 1 3 1 1 3 1 1 1 3 1 1 1 2 1 3 2 1 1 1 1 1 3 1 1 12 1 5 1 1 17 7 1 119 1 2 2 2 1 1 1 3 1 1 2 1 1 1 1 1 1 1 2 4 1 1 4 1 1 6 5 63 1 12 2 14 3 3 1 1 3 1 4 6 1 4 1 7 12 2 2 2 2 1 1 4 3 2 1 1 1 2 103 3 2 1 2 2 1 2 2 3 1 2 1 5 5 1 39 18 3 1 1 1 7 1 3 3 1 1 3 1 6 4 1 4 3 2 1 5 1 i 222 Kimberley Kinnaird Alberni _ - 3 1 4 3 4 1 1 Lang Bay Black Creek Langford. Langley 3 Brocklehurst Lantzville Loos 1 1 Bull River Lulu Island __ 3 Burnaby- Lumby Lynnmour Lytton Mabel Lake 2 1 1 1 2 1 Maillardville Maple Bay.. - Chase ' 1 4 Matsqui— - 2 Merritt - Cobble Hill 4 Colquitz - _. 1 Comox . 2 Coquitlam 6 Monte Lake — Montreal, Que Courtenay- 1 1 11 10 New Hazelton — 1 New Westminster 102 1 Dawson, Y.T. North Vancouver 30 Notch Hill 2 Delta Oakalla Prison Farm 17 Oak Bay 4 3 2 1 Oyster Bay _ 1 10 1 Ponoka, Alta - 1 Falkland 9 1 Field Port Kells 1 1 7 2 13 16 2 Fort St. John 6 2 5 1 3 1 9 3 2 1 1 1 1 2 1 Glade Hope- Hot Spring Cove _ Saturna Island Kamloops Kelowna Sechelt Kemano ',., Shutty Bench Carried forward 119 103 222 331 247 578 T 126 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 4.—Showing What Districts Contributed Patients from April 1st, 1952, to March 31st, 1953—Continued Place of Residence Male Female Total Place of Residence Male Female Total 331 2 4 1 1 1 1 8 1 1 1 2 1 1 3 371 247 3 1 3 3 3 1 1 2 6 208 578 5 5 1 1 3 1 4 11 1 1 1 2 4 1 1 9 579 730 1 2 41 1 1 1 3 1 3 4 3 1 1 1 478 1 4 40 1 2 4 3 1 2 2 1,208 Vanderhoof 1 Vernon 6 81 Wardner Webster's Corners 1 1 3 Steward Wells 3 1 Telkwa 4 Whitehorse White Rock __ 6 Tofino 5 Toronto, Ont. Yale Trail Yarrow 1 Totals - Carried forward 730 | 478 1,208 794 538 1,332 Table No. 5.—Showing the Number of Attacks in Those Admitted from April 1st, 1952, to March 31st, 1953 Number of Attacks Male Female Total 320 73 18 3 1 2 1 1 1 25 317 32 224 76 21 6 2 2 27 163 17 544 149 Third - 39 9 Fifth - 3 Sixth- . 4 Eighth Tenth 1 52 49 Totals _ 794 538 1,332 Table No. 6.—Showing the Reported Duration of Mental Illness Prior to Admission in Those Admitted from April 1st, 1952, to March 31st, 1953 Duration of Attack Male Female Total Unc 45 91 29 27 26 15 2 2 4 317 230 6 39 72 14 25 15 29 4 4 163 169 4 84 163 ' 6 „ . 43 ' 12 , 52 ' 41 ' 5 „ 44 * 10 „ - — 6 15 , 6 r 15 „ .. .. - - - 4 Wit Unl Life 480 399 10 Totals - 794 538 1,332 STATISTICAL TABLES—MENTAL HOSPITALS T 127 Table No. 7.—Showing the Reported Cause of Attack in Those Admitted from April 1st, 1952, to March 31st, 1953 Alleged Cause Male Female Total 33 59 6 1 2 1 2 258 1 7 11 1 1 1 90 1 1 1 317 5 17 1 4 235 1 6 1 4 100 1 163 38 76 7 1 2 1 6 493 1 1 13 1 15 1 1 1 190 1 1 1 1 480 794 538 1,332 Table No. 8.—Showing the Number Discharged on Probation and Results from April 1st, 1952, to March 31st, 1953 Results Male Female Total Discharged recovered- Discharged improved- Discharged unimproved- Discharged without psychosis- Totals _ 24 135 171 211 541 Disposition of discharged— Discharged to Homes for the Aged- Discharged to Crease Clinic.. Total discharges to community.. Totals 97 10 434 541 Returned to hospital from probation On probation and still out at end of year__ 29 105 171 47 352 126 4 222 352 25 82 53 240 342 258 893 223 14 656 893 50 162 Table No. 9.—Showing Reported Duration of Mental Illness Prior to Admission in Those Discharged from April 1st, 1952, to March 31st, 1953 Alleged Duration Male Female Total 32 51 16 11 18 36 27 6 17 235 92 27 54 21 12 25 24 10 3 27 62 87 59 105 37 „ „ 3 „ _ 23 „ „ 6 „ - 43 „ „ 12 „ _ _ 60 37 „ 3 „ — - 9 44 297 179 541 352 893 T 128 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 10.—Record of Deaths from April 1st, 1952, to March 31st, 1953, in the Mental Hospitals, Essondale, New Westminster, and Colquitz Sex Age Time in Hospital Certified Cause Years Months Days M. 23 3 1 10 Haemoptysis; bilateral pulmonary tuberculosis; catatonic schizophrenia. F. 66 4 4 Bronchopneumonia; myocardial degeneration; arteriosclerotic heart-disease. F. 77 . 10 13 Bronchopneumonia; myocardial degeneration; arteriosclerotic heart-disease. M. 59 12 6 28 Terminal bronchopneumonia; bilateral pulmonary tuberculosis; paranoid schizophrenia. M. 70 2 1 1 Bronchopneumonia; hypertensive heart-disease; nephrosclerosis; encepha- Iitis-Schilder's type-with-psychosis. F. 1 2 Acute intestinal obstruction; intussusception. M. 56 11 Pneumonia; hypertensive cardiovascular disease; arteriosclerotic dementia. M. 71 2 6 15 Coronary thrombosis; arteriosclerosis; adhesive pericarditis; cirrhosis of the liver. M. 64 8 Spontaneous subarachnoid cerebral haemorrhage; cerebral sclerosis; generalized arteriosclerosis; chronic pyelonephritis. F. 78 1 2 26 Bronchopneumonia; chronic arteriosclerosis. M. 66 1 1 17 Acute pulmonary oedema; chronic myocardial degeneration; pre-senile dementia. M. 66 26 Bronchopneumonia; chronic peptic ulcer; arteriosclerotic dementia. F. 77 32 2 7 Bronchopneumonia; senile dementia. F. 68 2 9 5 Bronchopneumonia; chronic arteriosclerotic heart-disease; arteriosclerotic dementia. M. 66 1 8 Bronchopneumonia; cerebral arteriosclerosis; arteriosclerotic dementia. F. 67 is 11 5 Nephrosclerosis; amyloid disease; uremia; paranoid schizophrenia. M. 71 1 15 Pulmonary tuberculosis; senile dementia. M. 69 5 20 Coronary occlusion; chronic myocarditis; chronic pyelonephritis; pre-senile dementia. M. 51 22 1 8 Bilateral pulmonary tuberculosis; paranoid schizophrenia. F. 91 6 7 Bronchopneumonia; hydrocephalus; congenital heart-disease; idiot. M. 50 29 12 Peritonitis following resection of volvulus of sigmoid colon; mental deficiency with psychosis. M. 91 9 Bronchopneumonia; senile dementia. F. 66 7 28 Chronic myocarditis; arteriosclerosis. M. 51 17 8 5 Toxemia and cachexia; carcinoma-of the stomach with abdominal metastasis; general paresis of the insane. M. 62 28 Chronic myocarditis; arteriosclerotic dementia. M. 60 1 4 24 Bronchopneumonia; arteriosclerotic dementia. M. 65 4 5 Lobar pneumonia; generalized arteriosclerosis; pre-senile dementia. F. 52 16 8 18 Status epilepticus; epilepsy; hydrocephalic idiot. M. 66 19 7 25 Massive pulmonary embolus; thrombophlebitis of the lower leg; paranoid schizophrenia. M. 36 8 7 8 Bilateral pulmonary tuberculosis with cavitation; mental deficiency with psychosis. M. 52 8 7 21 Cerebral embolism; alcoholic psychosis. M. 67 5 2 3 Bronchopneumonia; arteriosclerotic dementia. M. 71 4 22 Bilateral pulmonary tuberculosis; paranoid schizophrenia. F. 56 3 6 Bronchopneumonia; Huntington's chorea. F. 39 6 ~10 2 Cerebral anoxia; sodium pentothal anaesthesia; Mongolian idiocy. M. 64 5 11 22 Cerebral thrombosis; general paresis of the insane. M. 65 2 9 Lobar pneumonia; chronic bilateral subdural haematoma; pre-senile dementia. M. 62 19 Bronchopneumnia; meningioma of the brain; generalized arteriosclerosis; psychosis due to brain tumour. F. 59 3 29 Bronchopneumonia; cerebrovascular accident. F. 58 3 10 21 Bronchopneumonia; simple schizophrenia. M. 21 1 18 Bronchopneumonia; congenital cardiac defect; Mongolism. M. 72 ~4 1 22 Pulmonary cedema; diabetes mellitus; chronic pyelonephritis; arteriosclerotic dementia. M. 70 2 9 24 Bilateral pulmonary tuberculosis; arteriosclerotic dementia. F. 68 2 7 7 Bronchopneumonia; chronic myocardial degeneration; arteriosclerotic dementia. M. 72 15 11 2 Carcinoma prostate; paranoid schizophrenia. M. 67 3 15 Bronchopneumonia; arteriosclerotic dementia. F. 45 7 Bronchopneumonia; torula meningitis. M. 7 5 8 26 Bronchopneumonia; inanition of idiocy; idiocy. F. 41 7 Bronchopneumonia; Mongolian idiot. M. 66 12 4 6 Bronchopneumonia; generalized arteriosclerosis; psychosis due to Huntington's chorea. M. 75 8 Coronary thrombosis; congestive heart failure; senile psychosis. F. 2 . 1 2 Bronchopneumonia; cerebral agenesis; cerebellar agenesis. M. 78 1 4 Diabetes mellitus; arteriosclerotic dementia. M. 39 9 18 Brachial artery occlusion with gangrene of left forearm; luetic cardiovascular disease; general paresis of the insane. F. 62 24 10 Auricular fibrillation; myocardial degeneration; paranoid schizophrenia. 1 Months. STATISTICAL TABLES—MENTAL HOSPITALS T 129 Table No. 10.—Record of Deaths from April 1st, 1952, to March 31st, 1953, in the Mental Hospitals, Essondale, New Westminster, and Colquitz— Continued. Sex Age Time in Hospital Certified Cause | | Years Months Days M. 67 5 1 Bronchopneumonia; cerebral thrombosis; arteriosclerotic dementia. F. 45 3 9 13 Bronchopneumonia; toxic psychosis. F. 51 6 Intussusception of the jejunum; bronchopneumonia; congenital heart- disease; cerebral agenesis; idiot. M. 42 . 4 7 29 Coronary thrombosis; arteriosclerosis; paranoid schizophrenia. F. 44 8 10 20 Bronchopneumonia; asthma; mental deficiency. M. 1 1 20 Bronchopneumonia; cerebral atrophy; idiocy. M. 62 2 2 Cardiac decompensation; hypertensive cardiovascular heart-disease; psychosis associated with organic disease. M. 39 13 23 Bilateral pulmonary tuberculosis; catatonic schizophrenia. M. 40 15 1 24 Pulmonary tuberculosis; catatonic schizophrenia. F. 64 4 6 4 Bronchopneumonia; chronic myocardial degeneration; arteriosclerotic confusion. M. 24 15 1 18 Acute intestinal obstruction; volvulus; Mongolian idiot. M. 55 7 25 Pulmonary oedema due to cachexia; carcinoma of stomach with generalized abdominal metastasis; pre-senile psychosis. M. 72 19 2 Pulmonary tuberculosis; involutional melancholia. F. 55 10 4 Bronchopneumonia; hypertensive cardiovascular disease; arteriosclerotic confusion. M. 58 3 13 Myocardial infarction; coronary thrombosis; generalized arteriosclerosis; cerebral atrophy of undetermined origin. M. 19 13 3 Bronchopneumonia; aortic stenosis (congenital); Mongolian idiot. F. 64 2 8 20 Acute intestinal obstruction; volvulus of terminal ileum; old operative adhesions; pre-senile dementia; chronic arteriosclerotic cardiovascular disease; latent syphilis. F. 60 2 2 16 Bronchopneumonia; generalized arteriosclerosis. M. 65 23 6 4 Congestive heart failure; myocardial infarction; arteriosclerotic heart- disease; paranoid schizophrenia. M. 65 34 7 23 Cerebral vascular accident; hypertensive cardiovascular disease. M. 58 30 10 26 Cancer of lung; paranoid schizophrenia. M. 63 27 2 20 Myocardial infarction; coronary occlusion; paranoidal schizophrenia. F. 58 2 11 12 Bronchopneumonia; chronic hypertensive cariovascular disease; chronic mixed schizophrenia. M. 49 19 Secondary carcinoma of the brain; primary unknown; psychosis with somatic disease. M. 69 2 30 Chronic myocarditis; arteriosclerotic heart-disease; organic psychosis due to cerebral arteriosclerosis. M. 10 8 1 ' 29 Staphlococcic meningitis; staphlococcic pyelonephritis; hydrocephalic idiocy. M. 63 6 22 Bronchopneumonia; cerebral vascular haemorrhage; hypertensive cardiovascular disease; arteriosclerotic dementia. F. 68 1 1 7 Coronary occlusion; arteriosclerotic heart-disease; generalized arteriosclerosis; bilateral subdural haematoma. F. 63 3 9 26 Bilateral lobar pneumonia; generalized arteriosclerosis. M. 69 5 9 17 Mesenteric artery thrombosis; arteriosclerotic dementia. F. 66 11 25 Bronchopneumonia; cerebrovascular accident; hypertension; arteriosclerotic dementia. F. 73 3 3 Auricular fibrillation; arteriosclerosis; hypertensive psychosis; Paget's disease; gangrene of left leg; fracture of left femur: amputation of left leg. M. 30 24 11 8 Septicaemia; acute nasal pharyngitis; multiple abscesses of lungs; mental deficiency with epilepsy. M. 77 7 5 19 Bronchopneumonia; cardiac decompensation due to arteriosclerotic hypertensive cardiovascular disease; paranoid schizophrenia. M. 61 22 18 Acute pulmonary oedema; hypertensive heart-disease; generalized arteriosclerosis; general paresis of the insane. M. 70 4 4 2 Bronchopneumonia; gangrene of right leg; pulmonary tuberculosis; bilateral syphilitic aortitis; general paresis of the insane; generalized arteriosclerosis. M. 64 8 25 Cerebral haemorrhage; arteriosclerotic hypertensive cardiovascular disease; arteriosclerotic dementia. M. 83 8 Bronchopneumonia due to uremia; senile dementia. M. 71 9 8 14 Bronchopneumonia; chronic rheumatoid arthritis; paranoidal schizophrenia. M. 61 2 16 Pulmonary oedema; hypertensive cardiovascular disease; residual haemi- plegia; arteriosclerotic dementia. M. 63 3 10 Bronchopneumonia; cerebral haemorrhage; hypertensive cardiovascular disease; arteriosclerotic dementia. F. 65 22 3 17 Carcinomatosis; carcinoma of pancreas; ulcer of stomach (benign) with massive haemorrhage. M. 69 19 Uremia; chronic glomerular nephritis; psychosis due to uremia; arteriosclerotic heart-disease. F. 70 17 Bronchopneumonia; cardiac infarction; hypertensive heart-disease. l Months. 9 T 130 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 10.—Record of Deaths from April 1st, 1952, to March 31st, 1953, in the Mental Hospitals, Essondale, New Westminster, and Colquitz— Continued. Time in Hospital Certified Cause Sex Age Years Months Days F. 28 3 10 20 Pulmonary tuberculosis; simple schizophrenia. f. 76 8 4 Bronchopneumonia; hemiplegia. F. 28 1 7 25 Pulmonary tuberculosis; manic depressive psychosis. F. 52 8 6 11 Carcinoma of liver; carcinoma of stomach; paranoid schizophrenia. M. 66 1 7 11 Mitral stenosis; cerebral arteriosclerosis. M. 77 16 6 11 Carcinoma of the stomach; paranoid schizophrenia. M. 64 2 12 Cerebral oedema; status epilepticus; generalized arteriosclerosis. M. 74 19 5 14 Myocardial degeneration; paranoid schizophrenia. M. 55 1 24 Bronchopneumonia; hypertensive cardiovascular disease; arteriosclerotic dementia. F. 81 1 7 Asphyxia; sodium penathol anaesthesia; mental deficiency. M. 71 6 Asphyxia due to hanging; paranoid schizophrenia. M. 69 7 27 Bronchogenic carcinoma; arteriosclerotic dementia. M. 67 5 1 23 Subarachnoid haemorrhage; cerebral sclerosis; pre-senile psychosis. F. 65 7 9 11 Uremia; bilateral pyelonephritis; carcinoma of cervix; mental deficiency with psychosis. M. 62 10 16 Bronchopneumonia; cerebral arteriosclerosis and hypertension. M. 49 1 2 27 Subarachnoid haemorrhage; general paresis; chronic pyelonephritis. F. 33 1 2 1 Acute myocarditis; bronchopneumonia; cretinism; mental deficiency (imbecile). F. 51 2 1 18 Intracerebral haemorrhage; chronic hypertensive heart-disease; arteriosclerotic dementia. M. 10 6 1 7 Bronchopneumonia; congenital deformity of chest; cerebral palsy; idiot. M. 17 5 1 6 Pulmonary tuberculosis; congenital malformation of the heart; congenital mental deficiency. F. 70 26 11 26 Septicaemia; bronchopneumonia; empyema of gall-bladder; schizophrenia. M. 52 8 Cerebral oedema; subdural haematoma; psychosis due to tumour. M. 46 19 8 11 Haemorrhage from oesophageal ulcer; schizophrenia. M. 68 7 10 Toxaemia; gangrene of leg; arteriosclerosis; confusional psychosis due to heart failure. M. 17 8 4 8 Bronchial pneumonia; mental deficiency with epilepsy. F. 20 6 7 1 Bronchopneumonia; lung abscess; idiocy. M. 60 33 8 9 Bilateral pulmonary tuberculosis with cavitation; simple schizophrenia. M. 53 10 2 Congestive heart failure; schizophrenia. M. 72 37 8 27 Congestive heart failure; hypertensive heart failure; pulmonary tuberculosis (healed). F. 26 22 3 26 Bronchopneumonia; mental deficiency (moron). M. 55 3 7 1 Myocarditis; general cardiovascular degeneration; arteriosclerotic dementia. F. 85 3 7 Diabetic coma due to diabetes mellitus; hypertensive heart-disease; nephrosclerosis. M. 68 5 23 Bronchopneumonia. M. 65 26 Bronchopneumonia; cirrhosis of the liver; chronic pyelonephritis. F. 20 1 11 15 Pulmonary tuberculosis; schizophrenia (imbecile). M. 80 2 Coronary thrombosis; senile dementia. M. 62 3 25 Cerebral oedema; colloid cyst of third ventricle of the brain. F. 68 1 8 17 Congestive heart failure; coronary occlusion and fatty infiltration of heart; diabetes mellitus; generalized arteriosclerosis; manic exhaustion. F. 64 — 14 Terminal bronchopneumonia; carcinoma of urinary bladder with metastases to regional lymph nodes and left lung. M. 66 2 4 Bronchopneumonia; cardiovascular degeneration; cerebral arteriosclerosis. M. 72 2 11 21 Terminal bronchopneumonia; generalized arteriosclerosis. F. 10 2 2 14 Bronchopneumonia; exhaustion of idiocy; spastic paralysis. M. 25 3 1 20 Tuberculous enteritis; bilateral pulmonary tuberculosis; mental deficiency with epilepsy. M. 61 1 3 25 Pulmonary embolism; arteriosclerotic heart-disease; pre-senile dementia. M. 68 5 30 Pulmonary oedema; hypertensive heart-disease; nephrosclerosis. F. 62 21 4 20 Pulmonary oedema; chronic myocardial degeneration; diabetes mellitus; paranoid schizophrenia. F. 8 6 6 9 Bronchopneumonia; exhaustion of idiocy; spastic cerebral palsy and convulsions. F. 73 5 3 10 Bronchopneumonia; generalized arteriosclerosis; cerebral atrophy. F. 80 2 2 28 Bronchopneumonia; myocardial infarction. M. 64 11 14 Pulmonary oedema; congestion due to coronary thrombosis; arteriosclerotic heart-disease; psychosis with cerebral arteriosclerosis. M. 72 9 4 14 Terminal bronchopneumonia; encephalomalacia; cerebral arteriosclerosis. M. 70 37 11 26 Coronary thrombosis; paranoid schizophrenia. M. 3 1 7 17 Bronchopneumonia and gastroenteritis; exhaustion of idiocy; congenital spastic paralysis. M. 70 30 10 11 Phthisis pulmonalis; paranoid schizophrenia. 1 Months. STATISTICAL TABLES—MENTAL HOSPITALS T 131 Table No. 10.—Record of Deaths from April 1st, 1952, to March 31st, 1953, in the Mental Hospitals, Essondale, New Westminster, and Colquitz— Continued. Sex Age Time in Hospital Years I Months I Days Certified Cause M. M. F. F. F. M. F. F. F. M. F. M. F. F. M. F. M. M. F. F. F. M. F. F. M. M. M. F. M. 65 1 7 53 1 5 56 3 20 1 4 1 50 11 18 83 5 2 29 65 3 22 54 4 11 11 73 3 6 20 93 21 51 6 2 8 47 4 10 23 57 25 9 25 77 1 9 82 1 1 12 57 13 11 22 55 20 15 61 5 17 45 4 10 4 64 24 21 19 2 6 67 4 22 77 29 5 2 38 4 9 15 84 7 10 16 69 8 60 10 10 26 65 4 8 17 78 10 10 23 63 11 20 Terminal bronchopneumonia; arteriosclerotic heart-disease; generalized arteriosclerosis. Pulmonary congestion and oedema; hypertensive heart-disease and generalized arteriosclerosis. General paresis. Bronchopneumonia; exhaustion of idiocy. Cardiac and respiratory arrest due to nitrous oxide therapy; schizophrenia. Congestive heart failure, auricular fibrillation; myocardial degeneration. Meningitis (staphylococcal); chronic pyelonephritis; prostatectomy; generalized arteriosclerosis. Pulmonary tuberculosis; simple schizophrenia; fractured left hip. Bronchopneumonia; paraplegia. Bronchopneumonia; hypertensive heart-disease. Terminal bronchopneumonia; cerebral thrombosis; organic dementia. Pulmonary tuberculosis; paranoid schizophrenia. Carcinoma sigmoid; paranoid schizophrenia. Bronchopneumonia; congestive failure. Pulmonary embolism; thrombophlebitis to left iliac and femoral veins; general arteriosclerosis. Bronchopneumonia; encephalomalacia; cerebral thrombosis; generalized arteriosclerosis. Bronchopneumonia; cerebral atrophy. Cerebral oedema; secondary carcinoma of brain; turban tumour of the scalp with additional metastasis to lymph nodes and lungs. Cerebral haemorrhage; hypertensive heart-disease. Congestive heart-failure; auricular fibrillation; organic psychosis. Epilepsy; epileptic idiot; hemiplegia birth injury. Bronchopneumonia; hypertensive heart-disease; organic dementia. Coronary thrombosis; manic depressive. Chronic lymphocytic leukemia with massive infiltration of lungs, liver, and spleen; schizophrenia. Terminal bronchopneumonia; senile dementia. Bronchopneumonia; congestive heart failure; auricular fibrillation; cerebral haemorrhage. Terminal bronchopneumonia. Bilateral pulmonary tuberculosis; generalized arteriosclerosis; arteriosclerotic dementia. Bronchopneumonia; chronic myocarditis; senile dementia. Terminal bronchopneumonia; brain tumour; brain tumour with psychosis. Table No. 11.—Showing Psychoses of First Admissions from April 1st, 1952, to March 31st, 1953 Psychosis Male Female Total Schizophrenic disorders, totals.. (a) Simple type__ (6) Hebephrenic type.. (c) Catatonic type (d) Paranoid type (e) Others- Manic depressive reaction, totals- (a) Manic and circular (b) Depressive— (c) Other-. 135 16 4 14 77 24 6 3 3 Involutional melancholia Paranoia and paranoid states . Senile psychosis- Pre-senile psychosis Psychosis with cerebral arteriosclerosis- Alcoholic psychosis 5 2 89 3 56 23 100 14 6 9 50 21 5 1 4 3 6 93 6 17 3 235 30 10 23 127 45 11 4 7 8 8 182 9 73 26 T 132 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 11.—Showing Psychoses of First Admissions from April 1st, 1952, to March 31st, 1953—Continued Psychosis Male Female Total Psychosis of other demonstrable etiology, totals_ (a) Resulting from brain tumour.. (b) Resulting from epilepsy and other convulsive disorders (c) Psychosis secondary or due to infective or parasitic diseases (d) Psychosis due to allergic, endocrine, metabolic, and nutritional diseases.. (e) Psychosis due to diseases of circulatory system... (/) Psychosis due to diseases of nervous system and sense organs__ (g) Psychosis due to drugs and other exogenous poisons (ft) Psychosis due to accidents and violence (i) Psychosis due to other conditions_ Other and unspecified psychoses, totals__ (a) Psychosis with psychopathic personality- (b) Psychosis with mental deficiency (c) Other unspecified Psychoneurosis, totals (a) Anxiety reaction (b) Hysterical reaction- (c) Phobic reaction.- (d) Obsessive-compulsive reaction.. (e) Neurotic-depressive reaction- (/) Psychoneurosis with somatic symtoms—circulatory system_ (g) Psychoneurosis with somatic symptoms—digestive system.... (h) Psychoneurosis with somatic symptoms—other systems - (i) Psychoneurosis—other types Syphilis and its sequelae, totals _ (a) Congenital syphilis _ (b) Tabes dorsalis.. (c) General paralysis of insane— (d) Other syphilis of central nervous system- Undiagnosed psychosis _ Without Psychosis Pathological personality, totals__ (a) Schizoid personality __ (6) Paranoid personality (c) Cyclothymic personality-, (d) Inadequate personality (e) Anti-social personality (/) Asocial personality (^) Sexual deviation.— (7.) Other and unspecified- Immature personality, totals (a) Emotional instability— (6) Passive dependency (c) Aggressiveness- (d) Enuresis characterizing immature personality (e) Other symptomatic habits except speech impediments- (/) Other and unspecified-— Alcoholism - (a) Acute — (b) Chronic (c) Unspecified- Drug addiction. Primary behaviour disorders— Mental deficiency, totals (a) Idiocy- (&) Imbecility.. (c) Moron (d) Border-line.. (e) Mongolism- (/) Mental deficiency with epilepsy.- (g) Other and unspecified types.. Other and unspecified character, behaviour, and intelligence disorders.- Epilepsy.. (a) Petit mal_ (b) Grand mal- (c) Status epilepticus- (d) Other and unspecified- Neurological disease without psychosis Observation without need for further medical care—mental- Head injury of other and unspecified nature Undiagnosed- Senility without psychosis.. Totals 23 6 4 1 14 6 1 10 96 96 2 1 111 21 23 24 5 19 6 13 1 1 591 19 19 103 30 24 7 1 22 4 15 3 2 385 32 6 4 6 6 3 7 2 1 1 21 7 2 10 1 1 15 ~~2 13 115 115 2 1 214 51 47 31 6 41 10 28 3 6 1 1_ 976 STATISTICAL TABLES—MENTAL HOSPITALS T 133 Table No. 12.—Showing Psychoses of Readmissions from April 1st, 1952, to March 31st, 1953 Psychosis Male Female Total Schizophrenic disorders, totals- (a) Simple type__ (b) Hebephrenic type.. (c) Catatonic type— (d) Paranoid type (e) Others- Manic-depressive reaction, totals.. (a) Manic and circular (b) Depressive (c) Other Involutional melancholia Paranoia and paranoid states.. Senile psychosis- Pre-senile psychosis Psychosis with cerebral arteriosclerosis- Alcoholic psychosis- Psychosis of other demonstrable etiology, totals . (a) Resulting from brain tumour.. (6) Resulting from epilepsy and other convulsive disorders- (c) Psychosis secondary or due to infective or parasitic diseases.. (d) Psychosis due to allergic, endocrine, metabolic, and nutritional diseases.. (e) Psychosis due to diseases of the circulatory system... (/) Psychosis due to diseases of nervous system and sense organs.. (g) Psychosis due to drugs and other exogenous poisons (h) Psychosis due to accidents and violence (i) Psychosis due to other conditions Other and unspecified psychoses, totals- (o) Psychosis with psychopathic personality ~ (6) Psychosis with mental deficiency. (e) Other unspecified— Psychoneurosis, totals.. (a) Anxiety reaction (6) Hysterical reaction _ (c) Phobic reaction- (d) Obsessive-compulsive reaction.. (e) Neurotic-depressive reaction_. (/) Psychoneurosis with somatic symptoms—circulatory system.. (g) Psychoneurosis with somatic symptoms—digestive system (h) Psychoneurosis with somatic symptoms—other systems (i) Psychoneurosis—other types Syphilis and its sequelae, totals_ (a ) Congenital syphilis— (6) Tabes dorsalis... (c) General paralysis of insane _ (d) Other syphilis of central nervous system.. Undiagnosed psychosis Without psychosis, totals.. Pathological personality, totals__ (a) Schizoid personality (b) Paranoid personality ... (c) Cyclothymic personality__ (d) Inadequate personality.... (e) Anti-social personality—. (/) Asocial personality- (g) Sexual deviation- (/0 Other and unspecified- Immature personality, totals (a) Emotional instability— (b) Passive dependency (c) Aggressiveness (d) Enuresis characterizing immature personality- (e) Other symptomatic habits except speech impedimentS- (/) Other and unspecified Alcoholism— (a) Acute__ (6) Chronic.. (c) Unspecified.. Drug addiction- Primary behaviour orders. Mental deficiency, totals— (a) Idiocy- (&) Imbecility (c) Moron (d) Border-line._ (e) Mongolism.. (/) Mental deficiency with epilepsy.. (g) Other and unspecified types 56 12 2 7 21 14 16 9 7 2 3 1 3 10 4 11 2 1 1 5 94 5 2 76 76 11 1 2 5 70 17 8 6 27 12 19 11 8 2 2 6 1 4 2 6 1 3 32 6 15 15 126 29 10 13 48 26 35 20 15 4 5 7 1 7 12 10 1 5 4 2 2 18 6 2 2 5 126 11 2 91 Tl 18 3 3 7 1 3 1 T 134 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 12.—Showing Psychoses of Readmissions from April 1st, 1952, to March 31st, 1953—Continued Psychosis Male Female Total Other and unspecified character, behaviour, and intelligence disorders.. Epilepsy- (a) Petit mal- (6) Grand mal _ (c) Status epilepticus- (d) Other and unspecified- Neurological disease without psychosis Observation without need for further medical care—mental- Head injury of other and unspecified nature Totals 203 153 356 CO in ON H (0 o S 3 o H IO Os h a) 2 - o erf ft CO W co O a u >* CO z o < H co erf o co a o prf 9 w o < o z o 33 CO O w ►J » o a TS S E Tf 2 «i_£ fi Ov co CO S I ™ CS ! CJ rH Tf nNroHHtn r- CS ihhhN M^NtS*' CS w (N CS Tf I cs ri qw. «* I rH Ovh (N h CS rn cS Hin ■£> i-i in m i th i cs j cn Tt I i "" I ! cn th i cn tH j Ov rH : cn 3(2 i ! A3 cs>" Tt g <?ra CS?-1 ill: i cs i I j cn i <** i i i m ■a'fi . Ill C>H o H oo cs >n cs i ov_on\om^c r- cn cn cS t-« m ^o cn cs Os cn m y "a» o fl 2- •a w ifl ShQ s sis y S S S art 2 « c ■3t 9 P- O *3 O ra 3 ll'S « oa > ra <-> ** ra o?J2 .S3 o M d o h fl tb >, ra u ui cn Cm CO Ph Ph O g «.a.S3 H5.S 0*3 t-< 0 <_> o o u CO o >. •-_3 co *3 O C is a fe co "O SI I Vi Jg B.0 8 S3 ll If a & to ■—1 _4 Sag §.s a a fa fc a a M/.P 3 !_. tJ-a 2 o .a a ■a a q. aj is ill 1 a rt Soe. . ii o QB.S ei o w XI "O u Uh J= ,Q O 6 3.2 •fit co liil a a »j_ wz o 3 i <u & H I (- 2-3 § SI'S Hil__!JS * S A S S 2 H 8 «-S S J slaf- _- * cop 135 CO in ON o H of to o. 2 ft o prf ft co CO O a o >< co n, eo CO z o s Q w ft o co a. O 05 O ■ w o < o z o X Vi o H i-l eo BD _* « > J-a S a H CS «" rH | r> j 1 | ! 1 1 s ft -1 ri II 1 Mill MMM MM ! ! ! OO S *~m *"M*"M ii i iiii: ! i i' i i i i i i i iii 1 1 i ! i ! 1 { i i ! Mill! I ! i i ! i i m H MO\hh |w tnr-i i-h M rH '""M H IH ! I 1 II ! ! 1 j j cn CS ft r r " i i r ii i r 111 11 i i 111 cs s ! i 1 Mill ! 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U CL 1 C _o T C C OJ t- c c t> c I \ cz _j h <u .£ *5 s I a -a I '£ c. s c X c C 0 i E c c c c > c co CU cd co ■s o a TO v &*£ T) C a -c « a TO w 0 C q a ra S ra c Oh (/ D 0 c > c a 'E t 6 'u Oi u ra TO -O u w 1 V .2'v SE -c s ft | a. i 3 1 el i fl 0 ! S 1 CO I "O .23 »-« gl •So >.^ .a .2 a 0 § = o-g-2 U ft U jjjj etj D. 0 O >t a ■5 1 o n Ph o C V "o qq <u TJ *ra c a> fi "si co ^ « C O C JD £\ o u >* > CO c/1 Ph P- B "5 s c a. V XI \ | I 1 e - j c e a 0 1 c 8 I * — _. 1 1 ^ i- 3 5 ' 0 C * - ft s s c X e a. > 0 B c _ P _ (■ C a £ E y C c (. < c c co JH -a Ih O Vi •3 § _ u cc j__ a, |i J> Sh ^^ I-i u o G 2S to a o S c •a -G > o wa -a v B qj « a. co ,■ 3.2 t _» rt £ £ * C O > c tf 3 O u co ra o TJ *? > O 1 G ra ■Ofl'l a i> — <u c ra c T I S o = g fl h 5 G 3 TJ TO (U .5 cc > -G '£ a3 C "O J 5_ 3 ra c n «*h <u SB O S3 C > c s 1 ±_ > C OJ 4 •a 0 c oo r3 -S 5 V c h 136 STATISTICAL TABLES—MENTAL HOSPITALS T 137 Table No. 15.—Showing Economic Status of First Admissions by Psychoses from April 1st, 1952, to March 31st, 1953 Psychosis Total Dependent Marginal Comfortable M. F. T. M. F. T. M. F. T. M., F. T. 135 6 5 2 89 3 56 23 23 1 14 11 6 1 96 2 1 111 4 I 1 100 5 3 6 93 6 17 3 9 1 7 4 2 1 19 103 3 2 1 235 11 8 8 182 9 73 26 32 1 1 21 15 8 2 115 2 1 214 3 6 1 1 1 17 3 1 74 2 22 5 2 3 2 1 5 1 97 1 15 1 "74 ~~6 ~~3 1 2 102 1 32 1 3 1 148 2 28 5 5 4 2 1 7 1 199 1 1 118 6 2 1 15 1 34 18 21 1 11 9 5 .1 91 2 14 4 1 85 4 3 6 19 6 11 3 6 1 6 4 2 1 17 1 2 2 1 203 10 5 7 34 7 45 21 27 1 1 17 13 7 2 108 2 15 2 6 1 1 — Alcoholic psychosis — Psychosis with psychopathic personality— — Psychoneurosis Undiagnosed psychosis- .„ Without Psychosis Pathological personality Alcoholism — - ....- Other and unspecified character, behaviour, Neurological disease without psychosis Observation without need for further medical care—mental- Head injury of other and unspecified nature Totals 591 385 976 236 205 441 355 180 535 — T 138 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 16.—Showing Use of Alcohol in First Admissions by Psychoses from April 1st, 1952, to March 31st, 1953 Psychosis Total M. F. T. Abstinent M. F. T Temperate M. Intemperate M. Schizophrenic disorders. Manic-depressive reaction- Involutional melancholia- Paranoia and paranoid states.. Senile psychosis Pre-senile psychosis.. Psychosis with cerebral arteriosclerosis- Alcoholic psychosis- Psychosis of other demonstrable etiology- Psychosis with psychopathic personality— Psychosis with mental deficiency Other and unspecified psychosis Psychoneurosis.- Syphilis and its sequela?.. Undiagnosed psychosis— Without Psychosis Pathological personality- Immature personality Alcoholism Drug addiction . Primary behaviour disorders.. Mental deficiency- Other and unspecified character, behaviour, and intelligence disorders Epilepsy- Neurological disease without psychosis Observation without need for further medical care—mental Head injury of other and unspecified nature _ Senility without psychosis Undiagnosed 135 6 5 2 89 3 56 23 23 Totals- 591 100 5 3 6 93 6 17 3 9 1 111 103 4 3 2 1 1 1 385 235 11 182 9 73 26 32 1 1 21 15 2 115 2 1 214 3 6 1 1 1^ 976 1 1 103 264 102 3 1 1 303 118 8 5 6 137 5 38 ~19 1 1 9 3 1 1 205 3 2 1 567 27 1 1 1 9 2 3 104 2 3 2 33 3 25 161 50 211 10 1 10 1 23 3 13 1 12 1 10 26 4 115 1 166 32 198 STATISTICAL TABLES—MENTAL HOSPITALS T 139 to W to O a u !* to Oh >< pa r/i 7. 0 to CO </•> P, o> a '—i < H H 10 (/i ^H 5. CO u. ffi ft o u < CO 7. £ O O H H Q Z o 0 p-i „ f H « to P Z o 2 CJ ft < 19 z a t* o o ft o Z w S3 3 ■o i- n Oh 4) t/J H VO i-H 1 I> 1- tn cs 1 - VO - " o m P. Mrn | |C4rH !h j | 1 M *"M 1 1 [ 1 1 1 1 j j j Ml 00 cs cs s t | ! 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CS rH | | | 1 j rH CS MMM MN i M M i i I '• '• i i I i i i M i i I M iii i i i i iii 00 s cs c. j j j j i| | ;i|cs|| cs|i-h||| || | | ill Ov u § o > S h hh ! ! | ! |cs | th ii j j | | i »r» || j j j j | iii II 11 i i Mill 1 r 1 M II i i mi © CS pel i-h||||| | rH | rH j 11 j j j I CS I I I || | | ii! >o s [ rn l | j l ;i-h | |l!|l! Ilcnill | 1 I | 1!! to ■__ 1 0 •o p H vo r- j *-< cs j h ! i-h | | ;h i ! h |« i i i I j | j Mi i i 1 i i i i i i M ! i i i i i M Tt CS ft. WITtlrHtSli-ilrH Illi-Hli IIIIII ' ' ' '• II! 1 | | m | M MMM Mil IO $ t-Hcniii! ii | IIIIII i-iiTtiii i: : i iii ON 13 c_) i H i-HcncSTtm. Tt Tt cn j I l O rH j Ttlrniii icS j III mrH Mi*-1 "* ? Pel inOrHrHTti cn! cn i i I to l : cnirnlll ICS I | 111 m~ ! 1 Mill MM! 1 iiMi OO s vocnt-HcnrH! fHTt 1 1 4 ( «H rH 1 i-H 1 Q. I I | ■! I ! Ill rn cn | VO VO 4) on s H TtiHCSiii-. Mm Tt i-csi»nii Tt i oo 1 1 oo iTt i j ill s- M I M r iiH i IIMI Tt Hi £^~ I |h j j i j^Mj j m i j 1 i1" M ! 1 M ! Tt S t- t- ** ( [ I CSm Tt HH It 1 1 i-H|00!|rH ICS ! I III en j»h- j jrn | Tt Os 1 H VO "1 Tf m T~~ rn t-- cS O CSCSlOOi-Hj H IH I 100 IVO 1 1 II! fs)Cn 1-HrH jrH rH|0\||rH VO IO cn fc oovcscsvoi-h Ttcs ^ rHrHir-i! vo s to : . t- iTt i i iii t--' ill r i i ■ I I i i i I cn to s vo'OCScnt-Hi cno Tt rHt-Hit-Ht-H: in |\0 1 M . cS 1 I II! VO^ *H |-H r- jrH cn o CS J 1 fl ] 5 a H or 4. TJ 1- c 0 t3 4, fi: c C N t. c .2 ~ a fl '- > s £ c i ■? u £ .5 "c J= c c ,5 ~Z E 0 c _C 5 C > 1 M 1 <D TJ 'o 5 ft-3 TJ C B X CC P cd ^ o c S o- cu C Ph cr '5 C s. 2 > c i a c 4 4 t- P- 6 C 4) t- CCS *c3 I-l XI CJ Ih 4) CJ -cj 11 1% Vi Ph y C fit (_. > c/ c, £ < CD 3 Ih Vi fi O S 4) !_. o 0 .2 1 o£ & c u £ >, a. ft. Ih 4) ft U "cd ft O •S !>, ft eg > "2 ~ O R .fi C Ph j j cj .22 1 55 <D o "■S ■S K fl) _- •o a S"_! +_ a> a <c 5 fl> , ■SCc s^ - .S3 a 1 o n c Jd r. X "u fit >t-C > <« _r* c/ Ph OP- CJ 3 a 43 tf i = , ft > C > c - 4 C E 1 * 1 ^ c A* O : § i , 1 c fl fl. > ■fli c c (■ si E a; _. o E E 1 c j= c < p c t TJ « S c c i- 4 TJ i- C Cf TJ 1- : c '> K 0. > 'I > CJ I CC 4 I 1- w H "H *j TJ E5 __, 4J _5 c .2? "8-i CJ H tfl B § « 3 „ Ih TJ 3 9 .2 rt s * cd a. S'S'E _= X) c 5 Ci c c Cfl ft 3 O ? OJ Vi ta u TJ « CJ W) ."o g 3 ■= - Sj c- lH Ih O ^"5 TJ ^ 4> 5 i o E fil ra S u !*■« §S s f 5 u __•£ O n 3 T) c fl) o — si o| bg -2.TJ B a ■3 cc 'c Tj 4 cd C CO c/ S3 Cfl Vi 0 fii u >t Cfl ft 3 1 O -, !| > o ^ 0 >, M .« c_ ii t/3 P c h CO ft. CO C5 ffi U >< (/) Oh >< m V) Z o c-> Cfl LO UI ON § ^ O < w « P. Ph D. o u ci z o < 5 H o Q H Z 0 CN u CO ON ^ < o 5 E-i R 7, 0 kJ u « o z PL, < !t S o u m Pt c^_ ftn o eq EH STATISTICAL TABLES—MENTAL HOSPITALS T 141 Cfl w Cfl O X U s* Cfl Ph |x ft. m Cfl Z LT) fit O Cfl UI H 2 1/5 -—1 Q m < X H u ui S a <i fi s ft. n o H z ^ n o-l L/i H at < u P Q H Cfl W .—i n -1 z 3 V* 0 < § 1 o 1 « ON Ph .—I ri Z w -J P5 < H w M 4> > "3 H 00 cs ^ s Tt CS - » oo cn ft. CS vo 1 1-1 | II II 1 ! Mill II i ! iii Ov 5. VO CS rn lift | cn cs i-h | | | | | II Qs II Ov CS o o ■8 Cfl ft g H CSVOlioOcn oo i-h O iiiOooi iOi-HTtcS!VO icn i-h i III io vo cn i-h cs j j i 1- oo IO Tt ft. © cn r- cs cn 00 vo s <N^ti ** © ■* : i i «io : m : o. o) ! ^ ir) ! : 1 1 ! <N j <S rH -H MO cs IO cs o o fl Cfl a o S 1 u H VOcSvOCSTtlO TtCS © iHHOrt | CS rH ©V 1 rH 1> ! m 1 IrHrH •O Ov CSrHrHi rn; ,_h | ,-h j 1 1 1 III' R ft. oo rH cn cS r~ cn i- cs cn | th i io i iicsiir^ ih i i M ! I Mil j I III VO Ov s oo *h cn cn I—cs cn© r- iir-iocni dr.[~- iho ics i ; ihh Tt CS rH rH rH >o M 4) 1 •a § Vi ■O A3 fl) H Tt rHr-© | ^rH rH II | rH w j rH | rH | | CS II j 1 III Ov "O p. vo | t-H cS | || i | | | | i r» i| | | ill VO s 00 "* OOltOrHrH >l|rHrH! rH I TH I t <0 1 ! I ! III. 1 ill i ill- 1 1 ! I 1 1 i m Tt fl) M fl) 3 HH H fcn th | i t-rn mi ! i | 1 icn I i i cs 1 I ov «n i i i iii II ! II i i 1 ll IS IIIIII cn Ov ft. TtrH | Id j rn | j ! ! 00 lili : i I : : 1 i i III © a - 1 IV.H rH | i ! i : <N 1 MIIIS II f ! : : : MM i i i i i i°° ii i i iii cs CTt O H H lOrHQooorSOt cnvo CS 1 rH rH rH tr» 1 oo M m N >h d1 cnvo rH 1 Ihh cnrH 00 t— CS cn 1 CS i-< ! i-h i-h i CS rH ! | rH CS I | VO Ov Ph ©tocnvocnvo r-cn o\ i i-h i c- Tt l cs t-n ct\ i i cn cncS rn i III © OS rH 1-H | j © «o 00 cn s <o vo <o cS Ov cn vo cn cn | i *h Tt »h | vo i-h \o cs i-h i— iTt 1 1 |wn cn oo io ts cs t-it-i! q^^h OS ( Ji 0 3 J >. /> H a ■ u a TJ %- t X {. c 4. t- J= c c h fi t V 1 c cc 4, 4 | 1 « c fi c c * 4. E — a L C = C > E c c s ; c e _ s r c c a L 0 p. V c 1 cr V l 5 xr c > cr CJ C <u 4J 1- P- 6 u w *c3 H X) OJ Ih 4) CJ -fi i " £ 1] fl j E " gj Cfl Ph c -fi U > C t. o -fi o u < cd H Cfl B O H CJ •o ii 0 ^& II cj x >i CJ Cfl Ph 5. o IS o, o XI 0 >, s, 1 cfl ^ o a t§ >> Cfl Cfl Ph O .2 B i S o u ^ U cfl •a ft JJ CJ B D c 1 B 4> 1 5 c i* = h cflTj g o M o fl h •* O CJ o >.-fi > cfl i. a. Ph OPh j c B a CJ V •c c cd fi p > 1-0 i ^9 1 % • 0 > «•«.*: | |"S •g Ph C __-.■«__<« ft o J •a S " si S! cc 1 & -a 5 1 cd r TJ £ 5 £ > B C c a 2 E E E V C O c < c .5 t TJ TJ C3 01 a Q Ih QJ TJ Ih o tj Ih 5 > O u ■g c 4= u QJ CC Xl 4J cd f U Cfl S3 CJ cd m ■81 "83 s s CJ "" 4) ^t s S B w 3 Ih "9 5 B Q ccj p cfl cd a l- -fi T 4> CJ £ fl ifi 0 O > Cfl B _CJ 0 co ft 3 O 1 09 a CJ •a CJ o o 11 r 1 Ii ■o S § A° |S"s| > ei . p B " £ c on .2,-a S fl) *a fl Si x: cd D _D *. Q) c^ o a Vi "cn o -B o >. Cfl ft 3 O r-t ____ ^c S 4J S cfl El >_ 00 .t; cd ■3 t3 CO P c H T 142 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 20.—Showing the Nativity of First Admissions by Age-groups from April 1st, 1952, to March 31st, 1953 Age-group Total M. I F. I T. I I Canadian Born M. F. T. British Born M. F. I T. Foreign Born M. F. T. Unknown M. Under 15 years- 15-19 years.. 20-24 „ - 25-29 „ 30-34 „ 35-39 „ 40-44 „ 45-49 „ 50-54 „ - 55-59 „ 60-64 „ 65-69 „ 70 years and over- Totals 85 84 20 7 28 18 40 23 44 25 40 28 40 19 41 22 34 18 24 11 47 24 44 22 104 84 591 385 169 27 46 63 69 68 59 63 52 35 71 66 188 80 17 25 34 34 33 25 19 19 9 13 13 37 84 6 17 19 21 20 12 11 7 3 10 4 29 164 23 42 53 55 53 37 30 26 12 23 17 66 2 3 4 3 2 3 9 10 38 976 243 ] 601 111 75 1 2 1 9 5 12 11 7 8 24 32 74 5 3 1 5 2 4 7 14 10 10 18 9 30 186 66 3 2 8 4 9 10 22 19 15 23 17 47 184 Table No. 21.—Showing Country of Birth of First Admissions from April 1st, 1952, to March 31st, 1953 Country Arabia Austria- Australia- Belgium China Czechoslovakia- Denmark England Finland France Germany .. Greece _ Hungary- India Ireland- Italy- Japan Lithuania New Zealand _ Norway Poland Roumania Russia Scotland- Sweden— Switzerland— South Africa- Ukraine United States- Unknown Wales Yugoslavia Canada—■ Alberta- British Columbia- Manitoba New Brunswick- Newfoundland Nova Scotia Ontario Prince Edward Island.. Quebec- Saskatchewan Yukon Territory- Totals Male 1 6 3 2 10 2 1 59 7 2 4 3 1 13 1 1 2 5 13 1 3 32 1 27 26 4 3 24 154 34 9 1 14 58 2 17 33 3 591 Female 51 1 1 1 2 1 1 8 1 1 3 2 1 5 16 8 1 1 18 14 16 127 21 5 3 5 32 6 19 1 385 Total 1 6 7 4 11 3 1 110 8 3 5 1 5 2 1 21 1 1 3 1 8 15 2 8 48 16 2 1 1 45 40 4 7 40 281 55 14 4 19 90 2 23 52 4 976 J STATISTICAL TABLES—MENTAL HOSPITALS T 143 Table No. 22.—Showing the Citizenship of First Admissions from April 1st, 1952, to March 31st, 1953 Citizenship Male Female Total Canadian by birth- British born who have resided in Canada five years or more- British born who have resided in Canada less than five years.. Alien born (naturalized).. Alien born who have resided in Canada five years or more (not naturalized) Alien born who have resided in Canada less than five years Unknown Totals- 346 103 2 123 5 6 6 591 234 580 71 174 2 4 69 192 4 9 2 8 3 9 385 976 Table No. 23.—Showing the Religion of First Admissions from April 1st, 1952, to March 31st, 1953 Religion Male Female Total 129 1 2 15 1 3 2 6 4 2 2 1 30 2 5 1 2 16 7 1 43 103 120 2 72 19 81 11 4 1 6 1 2 1 1 1 21 3 4 7 3 2 22 79 59 1 3 4 60 8 210 1 2 26 Buddhist - __ 1 4 4 8 7 6 3 3 2 51 5 9 1 2 23 10 3 65 182 179 1 5 4 132 27 Totals 591 385 976 Table No. 24.—Showing Age-groups of First Admissions from April 1st, 1952, to March 3 1st, 1953 Age-group Male Female Total 85 20 28 40 44 40 40 41 34 24 47 44 104 84 7 18 23 25 28 19 22 18 11 24 22 84 169 27 20-24 „ 46 25-29 „ - - - 63 30-34 „ 69 35-39 „ - - 68 40-44 „ . -. - 59 45^49 „ .. - - 63 50-54 „ 52 55-59 „ - - 35 60-64 „ - - - 71 65 69 „ . - 66 188 Totals - - 591 385 976 T 144 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 25.—Showing Age-groups of Readmissions from April 1st, 1952, to March 31st, 1953 Age-group Male Female Total 2 2 8 20 29 30 31 26 18 6 16 12 3 2 2 9 9 29 26 18 10 7 14 8 11 8 4 4 20-24 „ 17 25-29 „ — 29 30-34 „ _ _ 58 35 39 „ - _ 56 40 .. „ - — - — - 49 45-49 „ . - _ — 36 50-54 „ - 25 55 59 „ - 20 60-64 „ . . 24 6S 60 ., 23 11 Totals — - 203 153 356 Table No. 26.—Showing the Previous Occupations of First Admissions from April 1st, 1952, to March 31st, 1953 Occupation Male Female Total Occupation Male Female Total 7 1 1 1 1 1 1 1 11 1 1 1 1 2 8 1 3 1 4 19 1 7 1 2 1 2 3 1 147 1 24 2 1 2 1 5 3 3 1 5 1 120 1 1 1 4 3 3 8 121 9 1 1 1 128 4 7 1 1 1 1 1 1 1 1 1 1 11 1 1 5 1 2 11 1 3 3 1 4 19 1 7 1 2 1 2 8 121 3 1 156 1 1 24 2 1 2 1 5 4 4 1 5 1 248 4 401 1 1 5 42 1 1 1 1 1 1 2 3 1 61 11 1 1 7 1 2 1 3 1 2 1 1 4 1 1 1 2 2 1 1 6 9 4 1 1 1 1 286 38 33 2 3 1 9 1 2 3 6 1 687 Actress Advertiser Office-worker — 1 1 Painter- Pensioner 5 80 1 Beautician ...._ — Pianist _ _ 1 1 Bricklayer — Butcher— Carpenter Plumber Porter Poultryman - 1 1 1 2 Railwayman Reporter- Retired 3 Clerk 1 94 11 Cook 2 1 Decorator - - Domestic. Driller Sawyer.— Seaman Seamstress Secretary ..__ 1 7 3 1 3 Shipwright— Smelterman Steam engineer Steel-worker Stenographer— Steward ___ ., Storekeeper Student Surveyor.— 1 Fisherman Foreman.— Forestry- 3 1 2 9 Gardener Housekeeper— _ __._ Housewife 1 2 4 1 1 1 Taxi-driver. 2 2 Logger Longshoreman Machine operator Marine engineer Telephone operator. Tiemaker Trapper .„• ; Truck-driver 2 1 1 6 12 Waiter 4 6 Min e op e rator Miner Moulder None Warehouseman. Watchmaker Watchman Winchman Totals 591 385 976 401 286 687 STATISTICAL TABLES—MENTAL HOSPITALS T 145 Table No. 27.—Showing the Method of Commitment of First Admissions from April 1st, 1952, to March 31st, 1953 Method of Commitment Male Female Total 459 94 2 12 18 6 349 23 1 10 2 808 117 2 Otherwise— 13 Urgency — 28 8 Totals 591 385 976 Table No. 28.—Showing the Method of Commitment of Readmissions from April 1st, 1952, to March 31st, 1953 Method of Commitment Male Female Total 98 91 8 5 1 115 31 2 4 1 213 122 Otherwise— 10 Urgency 9 2 Totals — 203 153 356 Table No. 29.—Showing Rural-Urban Status of First Admissions by Psychoses from April 1st, 1952, to March 31st, 1953 Psychosis Total Rural Urban M. F. T. M. F. T. M. F. T. 135 6 5 2 89 3 56 23 23 1 14 11 6 1 96 2 1 111 4 1 1 100 5 3 6 93 15 17 3 9 1 7 4 2 1 19 103 3 2 1 235 11 8 8 182 9 73 26 32 1 1 21 15 8 2 115 2 214 61 2 1 1 33 2 27 5 8 6 4 3 1 17 47 2 46 3 2 4 24 1 7 1 5 1 1 1 4 44 1 107 5 3 5 57 3 34 6 13 5 4 1 21 91 2 1 74 4 4 1 56 1 29 18 15 1 8 7 — 3 79 2 1 64 2 1 1 54 2 1 2 69 5 10 2 4 1 6 3 — 1 1 15 59 3 2 128 6 5 125 20 Without Psychosis 4 2 1 123 Other and unspecified character, behaviour, and intelligence Observation without need for further medical care—mental Totals _ 591 385 976 220 145 365 371 240 611 10 CO X o pi < o H CN v. ON PS 0. < o B. n. to w CO O 63 u -0 Oi « co H Z 2 H Q W | < a u co s. O co p. O PS a ■ w o < i O a X/i o d w a P3 < 2 S3 a > o c H oo vo en eS "H m cs w 1 [ —1 m ^ ^ i r ts pel StN^S { rt 1 p. ! 1 I H I llll !*h l| | | «H OO | H j es es 5. rtNrtHf" 1 *trt l 1 IHdH llll II II 1 1 f- rH 0 Ov v> *?£ "0.2 H r-ommr-T-i © j *h i IiHW h \o i cs 1^1 ft \cnnH\OH rt i | j i inn MM M !l '' '' Tt es 00 ts s HhfvlrlH 1 « | rH if II rH H !« j jj ■* 82 H tC ^r cs i«h i Tf es cs : ; i cs i-h i ioo i i ; i i i i •H v 0 «!t H. t^ w eS I H | CS H 1 ,'jll! llll II II 1 1 i i llll!! MMM Mil Tt s t»n 1 i i i on « | ; j cs n | | oo i ii ii | j SO CN H Hinnt. IH ji-i j j : ; cn I h jco i ji cn cn Pt. oo cn i-i i-i | ] I h j j j | CS l | |>h | j | | i | | r- s CON J*h Ih II | llji-Hj rH | f- I ' ' M J ! so Hi \£> CS CS h | | ih i-h : j j f*" 1 r-i [ Os \ | \—t \ n | i •h Mi :cs I es vo B. O. 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V * JS 2 -2 M e3 fii 0 50 ___ a w S « > Tj g 2S "3. g a ^ w «*a c " s-s &« a k « O ed <v .^ = a «; cos1? « > a F 2 H H%W c e. > P C CJ s d '1-1 <o H c3 *S Ih 0. 0> 0 -g ^« S£ _n <l In <_/ c t c fi. < 0 3 C O a I-l 1) 4S> 0^ Ja c u T >i a. 1 0 cd & >. Vi p. > Vi f- 1 vi a »0 E j__ 0 HI 0_ » Rn 0 •_$ B O .2-0 U O CO >. Xi P4 3 "8 20 a © sac « S E 0 rt c TJ » c_ ChOh OJ *S .__! ,5 0 •- 3 W 2 cr S> f S £ 8 w -^ a a a c C | S .2 C c 60 A. > . c c - c E c < c c t I c H 3 O '? cd fi: u XI T3 0 O ^3 2 2 s__. •- <h 73 d 0 "C« Ah > c C 1 'I tp d ■0 0 c S s $ | CU 00 11 0 s fi -a Se > u « s - a. u a B lAC <u u .^ XI ,0 T 0 e a. C H 3 O fj 1 (U co c3 CJ Cfl T3 *c3 „ "Si 3 2 , OJ P z O H ^ C _ <D 8f a ™ 0 ° •S-3 O C « 2 1 oj 5 Cfl 3 «jD "*h 0 c t- 146 STATISTICAL TABLES—MENTAL HOSPITALS T 147 1 1 i cn r- t. (H 1 I 1 1 1 llll o c h n ft! iriHH | es i w i ^ VO CS 1 1 i 1 H ^H S H MM rH j j j ' Tt CS Cfl H Mil 1 1 1 1 en ea W > PU h | | 1 es *"• T-1 | tn 00 o X iiii t s cn : : I MM rH Tt u > rH TH ,_ Ph Cfl H 1 1 1 CQ CD ft. r- i i i Tt i I i i MM es | ] | ■s H cn ^ Z 5^ MM ft. HH H < llll Tt 1 H | CS ^ Cfl h ts llll 1 1 i Tt PL, ID Tt _ Tt Q ft. MM iiii 1 I BJ . 0 BS es OS n 1 | |f Tt 1 H j o a iiii 1-1 3 a. co Cfl H H CS O n eS CS r- Tt H cn cs h | | m n ! i tn 1 1 | t- 1 Tf cs 00 00 0) cn ^ [M ft. es n> — o w s r- so i es i cs H ; Iffir 10 || 1 i N es Tt a. co U __H int | es | cn CS 1 1 1 H en i en l Tt h es o a3 a* 0 H 1 H ' | | n I ,_ 2 Ph i II 1 cs co ^j « O cs tS j 1 1 r- ,_, : es e?v 00 S cs cn .J H < - t: \n | vo Cfl 5 H cs c- §2 Tt Tt tS 1 CS j i *" i Tt 2 OO 4 Ph Ph H to " 1 -1 § h c-J 1 I cs cs 1 rH | Tt h i in en M m Tt I CS l en cn CS. 1 rH j 00 ON H VO H CS hJ 5 -c Ch P* es m es l Tt h r H CS 1 >n j CS | o f Ph 1 Z 5 8 i >r 1 CS 1 rH r- | I vo j oo o s es i ^ i VO _: * H ts PS Q §5 *"• 1 H : 1 1 en 6 S \o r- 1 1 1 H h i es i I ,_, , ft. t- 1 o o z m oc ts ! H T-H O 1 1 Tt 1 cn s VO *"' '"", 1 OS 1 ts £ MHrtr.o\r as as oc en Tt t-h m tj as i h CO H cn r cn Cfl CS H | cs 00 o H Tt o r- Tt h t- t- Ti Tt i i i r- i- t- 1 ts 1 «-i 1. ft. cn cs as i m i 1-1 Tt H Tf 00 00 r- m Tt h oo ci Si o cs r- ts r- ts H | 00 | CS Tt O A U Ih Cfl Z cd D. u .59 T3 Tj -a 5 b. 1 Cfl cd "cfl 0 S o 3 o t-i hJ 0 75 « to >, ^a _o §- S 3 fc •111 o rt C H* fe •= o B t >»5 > Ph O ft. O a < Cfl O o 5? Ph ir t- tU t c V x e. 'c u 1- c c c. «_ B c i 0 4 0. _> a a 0 s fl s i eel o3 -c o P CO C3 fc. H 8,-s c T3 o 0 ■ I Oti « '•S'S p £ c v o * r: > b e r* « OJ £Ph w w 0 C 0 > I c a u fl Ih J3 s Ih ID U .2*5 S£ •4 I g u _n "" Cm [/ "S c fi\ t > (/ P C c J= c t < o S <D 1 o t*H ,« .a S S5 JS 0 O X cd a c s: CJ >. D, •5 1 i o J3 u >. a > c c 5 = a a. V 0 1 a p ej I 1 c3 fi G S O fl s i S c I-H OJ ri c | a O = "o ei <S £ fl E E cy C fi: C c < c .9 Z. X X r c > ed fii <L> -o O O & *a O >. £ 1 c Eh > £ CL CU c d 5 U u S g CO 5 fli Ih 1 0 <D .3 -a S ri Ih 3 O 5 2 ri o o C J5 c > c c H a u n 3 c S '% a 0 ri > ID in 8 C I U "ra Q •5 u s u u £1 0 0 c h T 148 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 32.—Showing Conditions of Patients on Discharge by Psychoses from April 1st, 1952, to March 31st, 1953 Pyschosis Total Recovered Improved Unimproved Without Psychosis and Unclassified M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Schizophrenic disorders 104 21 4 8 78 1 22 15 14 3 4 1 28 3 12 189 23 9 2 134 20 7 4 91 1 17 4 4 7 1 7 32 15 4 4 238 41 11 12 169 2 39 19 18 3 4 1 35 4 19 221 38 4 13 2 4 2 2 8 1 5 19 7 1 1 1 — 23 9 1 2 9 1 6 71 18 3 4 1 5 5 5 2 2 17 72 9 6 2 2 1 2 3 2 5 1 143 27 9 6 3 1 7 8 7 2 2 22 1 29 1 1 2 77 1 17 2 8 1 2 1 6 3 23 43 4 2 89 15 2 —. 1 15 72 5 1 4 166 1 32 2 10 1 2 1 7 3 38 12 | 7 189 | 32 1 4 9 | 4 2|„ Senile psychosis- Psychosis with cerebral arteriosclerosis- Psychosis of other demonstrable etiology Psychosis with psychopathic personality.. Without Psychosis 19 ?,?,1 Primary childhood behaviour disorders- Other and unspecified character, behaviour, and intelligence disorders Epilepsy Neurological disease without psychosis— Observation without need for further 4 13 7. Totals 541 352 893 22 29 51 133 105 238 174 171 345 212 | 47 759 Table No. 33.—Showing Age-groups of Patients who Died from April 1st, 1952, to March 31st, 1953 Age-group Male Female Total Under li 15-19 ye 20-24 6 3 2 1 1 3 2 4 7 10 21 28 25 9 3 3 1 2 1 3 6 6 8 11 17 15 3 5 25 29 4 30-34 2 35 39 5 40-44 ' 3 45-49 7 50-54 13 55 59 16 60-64 29 65 69 39 70 years 42 Totals - - - 113 70 183 ON <N ft. CO o X u tn pq ffi H < Ph Q b. o w s H H < cn H Z w H < Ph Ph O 1/3 B< U o Pi o I B. 0 < o z o a. 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CO •3 ■3 o,» '11 z _o •0 0 Si si Si c cf j_. 4) _3 *h _H § ge r3 Ih fl a> O V e 149 L T 150 MENTAL HEALTH SERVICES REPORT, 1952-53 Sixth annual sports day. STATISTICAL TABLES—CREASE CLINIC CREASE CLINIC STATISTICAL TABLES T 151 Table No. 1.—Showing the Operation of the Crease Clinic from April 1st, 1952, to March 31st, 1953 Movement of Population Male Female Total Total Male Female Total 100 318 211 115 369 323 215 687 534 100 529 115 692 215 Admitted during the year 1952-53— 1,221 55 271 95 82 15 41 456 106 66 6 96 727 201 148 21 Total number under treatment, April 1st. 1952, to March 31st, 1953 Discharged during the year April 1st, 1952, to March 31st, 1953— 629 518 807 675 1,436 Unimproved _ ' Died „ 1,193 Total in residence, Crease Clinic, March 31st, 1953 111 132 243 Daily average population - - Percentage of discharges on admissions (not including deaths).. Percentage of patients recovered and improved to admissions Percentage of deaths on whole number under treatment 230.77 94.35 67.39 1.46 Table No. 2.—Showing in Summary Form the Operation of the Crease Clinic since Its Inception a o '55 1 T_ < Discharges ■S Si a V S |H Mi Z a o u a o CJ C a CL) Ih O a 6 O fl Percentage of Patients Recovered and Improved to Admissions Percentage of Discharges to Admissions (Deaths Excluded) Year ■a a. 4) > o u B. U > 0 | ■a a. O a § a D Vi 11 •5 cj Percentage of Deaths to Whole Numbe under Treatme January, February, and March, 1951. 1951-52 264 963 1,221 26 158 96 38 496 727 23 155 201 7 97 148 12 21 170 215 243 45 28 264 1,133 1,436 24.24 67.91 67.39 35.61 94.19 94.35 1.06 1952-53..__._ _ 1.46 T 152 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 3.—Showing the Total Number of Admissions, Discharges, and Deaths from April 1st, 1952, to March 31st, 1953 Month Admissions Discharges Deaths Male Female Total Male Female Total Male Female Total 1952 49 48 51 36 33 39 38 39 48 63 42 43 58 72 68 47 53 53 56 50 40 66 66 63 107 120 119 83 86 92 94 89 88 129 108 106 40 41 46 54 50 43 30 25 26 48 41 59 43 69 65 60 53 48 50 51 62 39 66 63 83 110 111 114 103 91 80 76 88 87 107 122 1 1 2 1 1 1 5 1 1 1 2 1 1 1 1 3 May 1 2 July - — . 1 August— — — September October November December — 1953 January 1 2 5 2 2 2 Totals 529 692 1,221 503 669 1,172 15 6 21 STATISTICAL TABLES—CREASE CLINIC T 153 Table No. 4.—Showing What Districts Contributed Patients from April 1st, 1952, to March 31st, 1953 Place of Residence Male Female Total Place of Residence Male Female Total 6 1 2 2 2 1 1 1 1 12 2 2 1 4 6 3 1 4 2 1 1 2 1 1 1 4 1 1 1 1 2 1 1 1 1 1 4 3 1 4 1 1 1 6 6 3 3 1 1 1 2 1 2 2 3 1 1 1 1 3 1 2 1 4 2 1 1 1 1 1 1 1 1 21 1 1 T_ 6 1 1 4 2 1 1 1 5 1 1 1 1 1 5 1 2 1 1 1 5 3 3 1 2 1 1 5 18 1 1 1 4 1 1 3 8 3 2 1 1 1 4 1 1 11 1 1 10 1 4 3 1 2 1 1 2 1 1 1 1 2 33 3 2 2 4 24 9 1 1 1 8 4 1 2 3 1 1 6 1 1 1 1 5 1 1 1 6 2 4 1 1 1 1 6 1 4 1 7 4 1 6 2 1 2 11 24 3 4 2 1 5 2 3 1 3 10 5 2 4 13 2 1 Brought forward 134 5 20 1 16 __ 1 1 1 1 1 1 1 1 6 1 8 2 6 1 1 2 1 2 17 11 1 ...... 1 1 2 1 1 1 2 1 1 1 2 1 1 1 1 4 2 1 4 1 1 1 196 4 34 2 1 3 2 1 1 1 2 1 1 1 1 179 6 46 1 1 19 1 3 1 2 2 6 1 5 4 3 2 4 7 7 1 1 2 2 4 1 3 5 1 1 3 1 1 1 6 2 2 1 5 1 274 1 1 5 38 1 1 1 11 1 6 1 1 1 4 1 313 11 66 Aldergrove North Bend . ~ 1 1 1 35 Oak Bay 1 5 Beaver Falls Bella Coola Okanagan Centre 1 1 Okanagan Mission Oliver Osoyoos Parksville Peachland Peardonville- Penticton Pitt Meadows 2 Bradner Bralorne _ Burnaby 1 3 1 3 Canyon Chase Chemainus 1 12 2 13 2 Cobble Hill Port Coquitlam.. 10 1 4 Courtenay 4 1 6 24 18 1 Cumberland Qualicum 1 1 Dawson, Y.T 2 3 Quilchena 1 Drewry 1 Duncan 6 1 Endako 1 1 Esquimalt- 4 7 1 Flood 1 Fort St. John 2 1 5 1 1 Sinclair Mills Smithers 1 1 Haney 1 Hazelton.- „ 1 1 Hope 10 4 1 Kaslo _ 6 Terrace Tofino Trail Kelowna 1 5 Kimberley 1 1 1 Ladner 470 Lake Cowichan 1 1 Lang Bay 9 Victoria Webster's Corners Wellington.— 2 Lumby 1 West Summerland 2 14 Maillardville Masset 2 Matsqui 2 Whalley- 1 Midway 1 Milner Milne's Landing Mission White Rock Whonnock 8 2 1 Montney— 1 Mount Lehman 1 Namu Nanaimo — Yahk 1 4 Naramata- _ 1 Needles _ 1 Carried forward- 134 179 313 Totals.. 529 692 1,221 T 154 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 5.—Showing the Number of Attacks in Those Admitted from April 1st, 1952, to March 31st, 1953 Number of Attacks Male Female Total First 172 142 27 5 1 2 1 1 10 87 81 229 -247 47 10 4 1 2 12 58 82 401 389 Third - 74 Fourth 15 Fifth 5 Sixth _ 3 1 Fiohth 2 Ninth 1 22 145 163 Totals 529 692 1,221 Table No. 6.—Showing the Reported Duration of Mental Illness Prior to Admission in Those Admitted from April 1st, 1952, to March 31st, 1953 Duration of Attack Male Female Total 68 139 17 11 25 10 5 1 1 87 165 80 204 55 19 33 9 8 1 58 225 148 343 „ 6 „ 72 „ 12 „ _ . 30 58 5 „ - 19 „ 10 „ -- 13 „ 15 „ . 2 Over 15 „ 1 145 390 Totals 529 692 1,221 Table No. 7.—Showing the Reported Cause of Attack in Those Admitted from April 1st, 1952, to March 3 1st, 1953 Alleged Cause Male Female Total 24 7 7 1 394 1 2 1 1 2 2 87 3 12 3 603 4 4 1 3 1 58 27 19 10 1 997 4 5 3 1 1 5 3 145 529 692 1,221 STATISTICAL TABLES—CREASE CLINIC T 155 Table No. 8.—Showing the Number Discharged and Results from April 1st, 1952, to March 31st, 1953 Results Male Female Total Discharged recovered Discharged improved Discharged unimproved _ Without psychosis Total discharges Discharged to Mental Hospital— Discharged to Home for the Aged _ Total discharged to community. 55 271 95 82 503 41 456 106 66 669 57 96 727 201 148 1,172 129 1,043 Table No. 9.—Showing Reported Duration of Mental Illness Prior to Admission in Those Discharged from April 1st, 1952, to March 31st, 1953 Alleged Duration Male Female Total Less th 43 77 48 20 18 22 11 6 19 82 157 53 79 76 40 63 40 17 17 11 66 207 96 156 • 124 3 60 6 „ —- 81 , 12 „ _. 62 28 3 ,, _ - 23 30 V T 148 364 Totals - 503 669 1,172 Table No. 10.—Record of Deaths from April 1st, 1952, to March 31st, 1953, in the Crease Clinic, Essondale, B.C. Age Time in Hospital Certified Cause Years Months Days F. F. M. M. M. M. M. M. F. M. M. M. M. M. M. F. M. F. M. M. F. 50 24 50 50 69 37 31 62 68 25 60 70 29 49 20 51 52 38 51 38 57 1 1 3 3 2 2 3 1 1 9 13 4 20 30 3 16 13 14 6 9 8 13 9 21 13 3 7 3 15 Gastro-intestinal haemorrhage; ulcerative carcinoma of stomach with metastasis to liver and adrenal glands; epilepsy with psychosis. Multiple fractures and compound fracture of the skull with laceration of the brain; trauma; psychosis resulting from brain tumour. Carcinoma of the brain; bronchogenic carcinoma; arteriosclerotic dementia. Cerebral ha.morrhage; intracranial hypertension; cerebral neoplasm; phy- chosis with cerebral neoplasm. Bronchopneumonia; glioblastoma multiforme of right temporal lobe; psychosis associated with brain tumour. Acute cardiac failure; chronic toxic myocarditis; chronic anoxaemia; pulmonary tuberculosis with thoracoplasty. Asphyxia due to drowning in Coquitlam River while mentally unbalanced; simple schizophrenia. Asphyxia due to drowning (suicide); reactive depression. Thrombophlebitis; pulmonary embolism; manic depressive (manic). Glioblastoma; psychosis resulting from brain tumour of the left temporal lobe. Cerebral thrombosis; hypertensive arteriosclerotic cardiovascular disease; auricular fibrillation; arteriosclerotic dementia. Left ventricular failure; coronary pulmonale; emphysema. Cerebral oedema; coma insulin-therapy reaction; paranoid schizophrenia. Subarachnoid haemorrhage; ruptured aneurism; mixed schizophrenia. Asphyxia due to hanging; acute schizophrenic reaction. Secondary metastasis in the brain; cancer of sigmoid colon. Cerebral haemorrhage due to astrocytoma right cerebral hemisphere. Pulmonary embolism; thrombophlebitis of femoral and iliac veins; right middle lobectomy; catatonic schizophrenia. Coronary occlusion; arteriosclerosis; cerebral arteriosclerosis. Pulmonary oedema; cerebral oedema; brain tumour; organic psychosis due to brain tumour. Chronic pyelonephritis with toxaemia; chronic dilation of the bladder; pernicious anaemia with sub-acute combined degeneration. T 156 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 11.—Showing Psychoses of First Admissions from April 1st, 1952, to March 31st, 1953 Psychosis Male Female Total Schizophrenic disorders, totals.. (a) Simple type.. (6) Hebephrenic type~ (c) Catatonic type (d) Paranoid type (e) Others- Manic-depressive reaction, totals.. (a) Manic and circular (b) Depressive— (c) Other- Involutional melancholia- Paranoia and paranoid states„ Senile psychosis Pre-senile psychosis- Psychosis with cerebral arteriosclerosis- Alcoholic psychosis- Psychosis of other demonstrable etiology, totals.. (a) Resulting from brain tumour_ (b) Resulting from epilepsy and other convulsive disorders (c) Psychosis secondary or due to infective or parasitic diseases (d) Psychosis due to allergic, endocrine, metabolic, and nutritional diseases- {ei Psychosis due to diseases of circulatory system.. (/) Psychosis due to diseases of nervous system and sense organs.. ig) Psychosis due to drugs and other exogenous poisons (ft) Psychosis due to accidents and violence— (i) Psychosis due to other conditions Other and unspecified psychoses, totals— (a) Psychosis with psychopathic personality.. ib) Psychosis with mental deficiency (c) Other unspecified Psychoneurosis, totals.. (a) Anxiety reaction (ft) Hysterical reaction.. (c) Phobic reaction.. (d) Obsessive-compulsive reaction.. (e) Neurotic-depressive reaction.. (/) Psychoneurosis with somatic symptoms—circulatory system.. (g) Psychoneurosis with somatic symptoms—digestive system (ft) Psychoneurosis with somatic symptoms—other systems (i) Psychoneurosis—other types Syphilis and its sequelae, totals __ (a) Congenital syphilis. — (6) Tabes dorsalis- (c) General paralysis of insane.. (d) Other syphilis of central nervous system- Undiagnosed — Pathological personality, totals- Without Psychosis (a) Schizoid personality- (b) Paranoid personality (c ) Cyclothymic personality__ (d) Inadequate personality— (e) Anti-social personality-— (/ ) Asocial personality (g) Sexual deviation.- (ft) Other and unspecified- Immature personality, totals— (a) Emotional instability— (b) Passive dependency— ic) Aggressiveness- (d) Enuresis characterizing immature personality.. (e) Other symptomatic habits except speech impediments „ (/) Other and unspecified Alcoholism, totals (a) Acute (b ) Chronic ic) Unspecified Drug addiction- Primary childhood behaviour disorders _ 203 27 4 16 108 48 25 11 14 10 6 2 2 7 15 15 6 2 1 1 4 1 6 5 1 108 55 6 3 31 20 4 2 2 4 3 5 5 2 2 249 49 7 30 101 62 45 26 19 24 8 2 3 13 2 15 3 6 1 181 78 14 1 4 46 1 13 24 1 15 1 1 5 5 1 1 1 7 4 1 1 452 76 11 46 209 110 70 37 33 34 14 4 5 20 17 30 9 1 1 4 4 2 6 5 1 289 133 20 1 7 77 3 16 32 3 35 5 2 1 7 9 4 6 1 12 6 3 1 1 13 STATISTICAL TABLES—CREASE CLINIC T 157 Table No. 11.—Showing Psychoses of First Admissions from April 1st, 1952, to March 31st, 1953—Continued Psychosis Male Female Total Mental deficiency, totals.. (a) Idiocy- (b) Imbecility (c ) Moron id) Border-line (e ) Mongolism (/) Mental deficiency with epilepsy.. (g) Other and unspecified types.. Other and unspecified character, behaviour, and intelligence disorders- Epilepsy, totals- fa) Petit mal- (6) Grand mal (c) Status epilepticus (d) Other and unspecified- Neurological disease without psychosis- Observation without need for further medical care—mental__ Head injury of other and unspecified nature Undiagnosed Totals. 12 7 481 2 10 2 4 4 6 2 1 596 4 28 3 9 16 13 7 4 1,077 Table No. 12.—Showing Psychoses of Readmissions from April 1st, 1952, to March 31st, 1953 Psychosis Male Female Total Schizophrenic disorders, totals.. (a) Simple type- (6) Hebephrenic type _ ic) Catatonic type (d) Paranoid type ie) Others- Manic-depressive reaction, totals.. (a) Manic and circular (6) Depressive ic) Others- Involutional melancholia Paranoia and paranoid states.. Senile psychosis- Pre-senile psychosis Psychosis with cerebral arteriosclerosis- Alcoholic psychosis- Psychosis of other demonstrable etiology, totals- (a) Resulting from brain tumour— (6) Resulting from epilepsy and other convulsive disorders- ic) Psychosis secondary or due to infective or parasitic diseases.. (d) Psychosis due to allergic, endocrine, metabolic, and nutritional diseases- (e) Psychosis due to diseases of circulatory system.. (/) Psychosis due to diseases of nervous system and sense organs- ig) Psychosis due to drugs and other exogenous poisons (ft) Psychosis due to accidents and violence— (i) Psychosis due to other conditions Other and unspecified psychosis, totals - (a) Psychosis with psychopathic personality- (b) Psychosis with mental deficiency (c) Other unspecified Psychoneurosis, totals.. (a) Anxiety reaction (b) Hysterical reaction (c) Phobic reaction W) Obsessive-compulsive reaction.. (e) Neurotic-depressive reaction- (/) Psychoneurosis with somatic symptoms—circulatory system__ (g) Psychoneurosis with somatic symptoms—digestive system (ft) Psychoneurosis with somatic symptoms—other systems ii) Psychoneurosis—other types — 17 4 1 2 6 4 4 13 8 3 1 1 42 6 1 6 20 9 16 32 18 3 1 7 59 10 2 8 26 13 20 8 12 5 2 45 26 3 1 10 1 4 T 158 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 12.—Showing Psychoses of Readmissions from April 1st, 1952, to March 31st, 1953—Continued Psychosis Male Female Total Syphilis and its sequelae, totals.. fa) Congenital syphilis fa) Tabes dorsalis fa) General paralysis of insane _ (d) Other syphilis of central nervous system.. Undiagnosed Pathological personality, totals.. fa) Schizoid personality- fa) Paranoid personality- Without Psychosis (c) Cyclothymic personality„ (d) Inadequate personality—.. (e) Anti-social personality- (/) Asocial personality fa) Sexual deviation... (ft) Other and unspecified _ Immature personality, totals (a) Emotional instability.... (ft) Passive dependency (c) Aggressiveness (d) Enuresis characterizing immature personality.. (e) Other symptomatic habits except speech impediments_ (/) Other and unspecified Alcoholism, totals- (a) Acute (ft) Chronic- (c) Unspecified _ Drug addiction- Primary childhood behaviour disorders- Mental deficiency, totals (a) Idiocy- fa) Imbecility fa) Moron id) Border-line- fa) Mongolism __ (/) Mental deficiency with epilepsy- fa) Other and unspecified types- Other and unspecified character, behaviour, and intelligence disorders . Epilepsy, totals (a) Petit mal.. (b) Grand mal- (c) Status epilepticus.. 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CQ a o fl TJ a cn g bo a 1 0 5 160 STATISTICAL TABLES—CREASE CLINIC T 161 Table No. 15.—Showing Economic Status of First Admissions by Psychoses from April 1st, 1952, to March 31st, 1953 Psychosis Total Dependent Marginal Comfortable M. F. T. M. F. T. M. F. T. M. F. T. 203 249 452 13 15 28 190 234 424 25 45 70 1 1 2 23 44 67 1 1 10 24 34 1 1 8 22 30 2 1 3 6 8 14 6 8 14 2 2 4 2 2 4 2 3 5 2 3 5 7 13 20 2 2 3 13 16 2 2 15 2 17 15 2 17 15 15 30 1 1 15 14 29 5 5 1 1 4 4 1 1 1 1 108 181 289 4 2 6 102 178 280 2 1 3 2 1 3 1 1 2 1 1 20 15 35 1 1 2 19 14 33 5 7 12 1 1 5 6 11 6 2 8 6 2 8 1 1 1 1 8 5 13 6 3 9 2 2 4 5 3 8 3 1 4 2 2 4 2 2 4 1 1 2 1 1 2 18 10 28 7 2 9 11 8 19 7 6 13 1 1 6 6 12 5 2 7 1 1 2 4 1 5 3 1 4 1 1 2 1 3 481 596 1,077 42 30 72 431 564 995 8 2 10 Schizophrenic disorders Manic-depressive reaction Involution al melancholia Paranoia and paranoid states S enil e p sychosis _ Pre-senile psychosis Psychosis with cerebral arteriosclerosis Alcoholic psychosis Psychosis of other demonstrable etiology Psychosis with psychopathic personality Psychosis with mental deficiency. _ Other unspecified psychosis Psychoneurosis Syphilis and its sequelae Undiagnosed psychosis Without Psychosis Pathological personality Immature personality _ Alcoholism Drug addiction Primary behaviour disorders Mental deficiency Other and unspecified character, behaviour, and intelligence disorders Epilepsy -— Neurological disease without psychosis Observation without need for further medical care—mental Head injury of other and unspecified nature - Undiagnosed (not psychotic)-— Totals T 162 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 16.—Showing Use of Alcohol of First Admissions by Psychoses from April 1st, 1952, to March 31st, 1953 Psychosis Total Abstinent Temperate Intemperate M. F T. M. F. T. M. F. T. M. F. T. Schizophrenic disorders _ 203 25 10 6 2 2 7 15 15 5 1 108 2 20 5 6 1 8 5 2 18 7 5 3 249 45 24 8 2 3 13 2 15 181 1 15 7 2 " 5 3 2 10 6 2 1 452 70 34 14 4 5 20 17 30 5 1 289 3 35 12 8 1 13 8 4 28 13 7 4 102 11 7 4 1 4 6 3 53 11 1 7 4 1 16 5 5 2 203 40 24 7 2 3 13 12 150 12 3 4 3 2 9 6 ~2 305 51 31 11 2 4 17 18 3 203 23 4 11 7 3 25 11 ~ 7 2 80 11 3 1 2 1 3 6 2 43 2 7 2 1 1 1 1 1 1 1 43 5 1 2 24 2 4 1 1 1 123 16 3 2 2 1 3 8 2 67 2 9 6 1 2 1 1 2 1 2 21 3 1 15 3 1 12 2 2 6 1 1 3 2 1 7 1 1 2 24 3 Involutional melancholia 1 Pre-senile psychosis — 17 Psychosis with other demonstrable etiology Psychosis with psychopathic personality 4 Other and unspecified psychosis Psychoneurosis Syphilis and its sequelae __ 1 19 1 Without Psychosis 3 2 8 Other and unspecified character, behaviour, 1 1 Observation without need for further medi- Head injury of other and unspecified nature Totals 481 596 1,077 243 495 738 170 84 254 68 17 85 STATISTICAL TABLES—CREASE CLINIC T 163 Table No. 17.—Showing Conjugal Conditions of First Admissions by Psychoses from April 1st, 1952, to March 31st, 1953 Psychosis Total I M.|F. T. Single M.IF. IT. I I Married M. F. T Widowed I I M.IF. T. Divorced M.IF. |T. I I Separated I M. F. I T. Schizophrenic disorders ___ Manic-depressive reaction-- Involutional melancholia Paranoia and paranoid states Senile psychosis Pre-senile psychosis Psychosis with cerebral arteriosclerosis— Alcoholic psychosis — Psychosis of other demonstrable etiology Psychosis with psychopathic personality Psychosis with mental deficiency Other and unspecified psychosis Psychoneurosis Syphilis and its sequelae. _ Undiagnosed psychosis Without Psychosis Pathological personality _ Immature personality _ „ Alcoholism.— - Drug addiction— Primary behaviour disorders — Mental deficiency Other and unspecified character, behaviour. and intelligence disorders Epilepsy — Neurological disease without psychosis Observation without need for further medical care—mental Head injury of other and unspecified nature __ Undiagnosed (not psychotic) _ Totals 203 25 10 6 2 2 7| 13 15 2 15 15 481 452 70 34 14 4 5 20 17 30 5 1 289 3 596 1,077 245 19 111 62 356 187 385 572 11 13 51 62 11 13 10 24 27 12 36 25 4 63 T 164 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 18.—Showing Conjugal Conditions of Readmissions by Psychoses from April 1st, 1952, to March 31st, 1953 Total Single Married Widowed Divorced Separated 1 I M. 1 F. 1 T. 1 1 1 M.IF. T. 1 1 M. I F. 1 T. 1 1 1 M. 1 F. 1 T. 1 1 1 M.IF. 1 T. 1 M.IF. 1 T. 17 4 5 1 1 13 1 3 1 2 1 42 59 10 1 1 1 4 1 2 10 1 3 1 2 20 2 1 1 7 2 4 1 1 6 31 37 1 1 1 1 3 1 1 2 3 1 1 1 1 1 — 16 1 32 2 2 1 20 5 2 1 45 3 5 1 1 2 3 3 1 7 1 12 1 28 15 3 2 35 1 Senile psychosis — 1 — Psychosis of other demonstrable etiology 1 1 1 1 Syphilis and its sequelae _ Without Psychosis 1 2 2 Other and unspecified character, behaviour, and Observation without need for further medical care—mental — Head injury of other and unspecified nature . Totals 48 96 144 22 17 39 21 72 93 3 6 9 — 1 1 1 2 ?, STATISTICAL TABLES—CREASE CLINIC T 165 Table No. 19.—Showing Education of First Admissions by Psychoses from April 1st, 1952, to March 3 1st, 1953 Psychosis Total Illiterate Reads and Writes Common School High School University M. F. T. M. 1 F. IT. 1 M. F. T. M. F. T. M.I F. 1 T. M. F. T. 203 25 10 6 2 2 7 15 15 5 1 108 2 20 5 6 1 8 5 2 18 7 5 3 249 45 24 8 2 3 13 2 15 181 1 15 7 2 5 3 2 10 6 2 1 452 70 34 14 4 5 20 17 30 5 1 289 3 35 12 8 1 13 8 4 28 13 7 4 2 2 16 1 15 4 1 31 5 1 133 17 6 4 2 1 3 8 9 5 1 61 1 14 2 3 5 2 1 9 5 5 2 136 27 13 1 3 8 9 108 9 3 2 3 2 1 8 3 1 269 44 19 4 3 4 11 8 18 5 1 169 1 23 5 5 8 4 2 17 8 6 2 42 4 3 2 1 2 1 3 28 1 4 3 2 2 3 2 81 10 8 8 1 2 4 55 4 4 1 1 1 1 123 14 11 10 1 1 4 1 7 83 1 8 7 2 2 1 1 3 3 1 12 3 1 15 4 1 77 7 1 1 7 1 5 2 7 1 1 1 1 4 1 2 1 10 1 1 2 1 1 1 2 7 3 17 1 1 1 3 1 1 5 1 1 1 10 2 2 8 1 3 Alcoholic psychosis - 1 2 2 1 2 2 2 1 Psychosis with mental deficiency Other and unspecified psychosis — 18 Without Psychosis 3 1 1 Other and unspecified character, behaviour, 1 1 1 1 1 1 7 1 Observation without need for further medical care—mental — Head injury of other and unspecified nature 1 Totals 481 596 1,077 6 4 10 41 40 81 299 337 636 103 181 284 32 34 66 Table No. 20.—Showing the Nativity of First Admissions by Age-groups from April 1st, 1952, to March 31st, 1953 Age-group Total Canadian Born M. F. T. M. F. T. 14 2 16 14 2 16 28 22 50 25 22 47 55 41 96 41 38 79 61 73 134 49 55 104 68 97 165 55 79 134 60 83 143 50 64 114 55 88 143 31 60 91 35 62 97 17 28 45 33 43 76 19 16 35 21 34 55 6 12 18 27 28 55 8 8 16 18 20 38 5 4 9 6 3 9 1 1 2 481 596 1,077 321 389 710 British Born M. Foreign Born M. Unknown M. Under 15 years 15-19 years 20-24 „ 25-29 „ -- 30-34 „ 35-39 „ 40-44 „ 45-49 „ 50-54 „ 55-59 „ 60-64 „ ___ 65-69 „ __ 70 years and over Totals.-. 1 6 2 6 3 6 3 6 4 I 8 I 10 I 5 I 60 | 103 1 7 10 16 14 19 20 19 12 21 18 6 10 7 7 18 15 8 11 11 3 163 100 2 10 20 15 15 33 32 22 25 18 11 1 104 204 T 166 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 21.—Showing the Country of Birth of First Admissions by Age-group from April 1st, 1952, to March 31st, 1953 Country Male Female Total 1 1 6 3 3 3 44 1 2 1 5 6 1 2 3 4 9 13 1 6 15 1 5 1 1 19 3 3 27 139 29 3 1 8 35 1 13 62 2 4 1 1 1 1 4 56 2 3 2 1 1 1 8 2 1 1 1 12 2 20 34 1 3 3 31 5 4 64 142 49 3 8 39 1 11 70 1 1 3 10 1 Brazil 1 1 3 4 7 100 3 5 1 Holland _. 7 7 1 2 10 Italy - — 5 1 4 1 10 Poland 25 3 26 49 1 1 8 1 4 50 8 7 Canada—■ 91 281 78 6 1 16 Ontario 74 2 24 132 1 Totals 481 596 1,077 Table No. 22.—Showing the Citizenship of First Admissions from April 1st, 1952, to March 31st, 1953 Citizenship Male Female Total Canadian by birth— - British born who have resided in Canada five years or more— British born who have resided in Canada less than five years.. Alien born (naturalized)- Alien born who have resided in Canada five years or more (not naturalized).. Alien born who have resided in Canada less than five years Unknown.- Totals - 321 52 8 50 22 28 481 389 93 10 62 23 19 596 710 145 18 112 45 47 1,077 STATISTICAL TABLES—CREASE CLINIC T 167 Table No. 23.—Showing the Religion of First Admissions from April 1st, 1952, to March 31st, 1953 Religion Male Female Total 1 101 2 19 5 1 2 5 5 11 4 38 6 2 1 1 4 10 24 76 2 92 2 1 66 132 1 15 2 3 5 5 1 3 40 19 3 9 1 42 123 ----- 94 1 1 5 1 89 1 1 Anglican _ 233 3 34 Christian Science - — - 7 1 2 8 10 16 5 3 78 25 2 1 1 7 19 1 66 199 2 186 1 1 7 Sikh 1 1 155 1 Totals 481 596 1,077 Table No. 24.—Showing Age-groups of First Admissions from April 1st, 1952, to March 3 1st, 1953 Age-group Male Female Total Under 15 years . 15-19 years 20-24 „ - 25-29 „ 30-34 „ - 35-39 „ 4(M4 „ 45^*9 „ ___ 50-54 „ ____ __. 55-59 „ 60-64 „ ___ 65-69 „ 70 years and over- Totals 14 2 16 28 22 50 54 41 95 62 72 134 68 97 165 60 83 143 55 89 144 35 62 97 34 43 77 20 34 54 27 28 55 18 20 38 6 3 9 481 596 1,077 T 168 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 25.—Showing Age-groups of Readmissions from April 1st, April 1st, 1952, to March 31st, 1953 Age-group Male Female Total Under 1 15-19 ye 20-24 , 1 3 4 6 11 2 5 3 1 4 4 4 3 3 16 15 22 8 12 4 8 3 2 1 6 7 25-29 , 22 30-34 , 26 35-39 , 24 40-44 , 13 45-49 , 15 50-54 , 5 55-59 , 12 60-64 , 7 65-69 , 6 Totals— - 48 96 144 STATISTICAL TABLES—CREASE CLINIC T 169 Table No. 26.—Showing the Previous Occupations of First Admissions from April 1st, 1952, to March 31st, 1953 Occupation Male Female Total Occupation Male Female Total 5 1 1 1 2 2 1 1 1 1 1 3 11 1 7 1 9 1 2 1 1 1 2 1 2 2 8 30 3 1 8 2 1 1 3 1 4 1 119 2 34 4 1 2 1 9 1 1 10 1 1 1 2 4 id 1 27 1 1 1 1 13 424 2 1 2 6 1 1 1 1 2 1 2 1 1 3 1 1 3 11 4 1 7 1 19 1 2 1 1 1 1 2 28 2 1 2 8 30 1 3 1 8 1 2 1 1 3 1 13 424 1 4 1 121 2 1 34 4 1 2 1 9 1 1 12 309 13 5 1 1 1 1 3 1 4 1 1 2 1 2 1 2 15 1 13 11 1 4 1 4 1 2 1 2 1 2 3 31 2 3 2 1 1 13 1 1 3 3 6 1 1 1 493 5 13 5 1 1 1 3 2 2 2 14 2 22 8 4 6 11 1 802 Aide Miner — None Nurse Nurse's aide Oiler Optometrist __ Orchardist- Painter— Paymaster Pensioner.- 13 Artist _ - 10 14 5 1 Banker Barber 1 1 3 1 4 1 1 1 Cashier Chef Plumber _ ___ 2 1 2 Clergyman _ Clerk Preacher Printer _ _.._ 1 2 1 1 Retired— __ 18 1 13 13 1 2 2 4 Electrician Service-station attendant 1 4 Farmer Shipper ._ - Smelterman 1 2 1 2 Stenographer ___ 14 1 Foreman _ _. Forester Steward _ Storekeeper Student - Tailor 2 5 53 Gardener— — _ 2 11 2 Telephone operator 4 1 1 13 Typist - 6 1 1 3 Waitress 11 3 Mailman _.. - Welder — 6 1 1 1 1 Totals- 481 596 1,077 309 493 802 T 170 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No 27.—Showing the Method of Commitment of First Admissions from April 1st, 1952, to March 31st, 1953 Method of Commitment Male Female Total 290 191 324 272 614 463 Totals 481 596 1,077 Table No. 28.—Showing the Method of Commitment of Readmissions from April 1st, 1952, to March 31st, 1953 Method of Commitment Male Female Total 28 20 45 51 73 71 Totals 48 96 144 Table No. 29.—Showing Rural-Urban Status of First Admissions by Psychoses from April 1st, 1952, to March 31st, 1953 Psychosis Total Rural Urban M. F. T. M. F. T. M. F. T. 203 25 10 6 2 2 7 15 15 5 1 108 2 20 5 6 1 8 5 2 18 7 5 3 249 45 24 8 2 3 13 2 15 181 1 15 7 2 5 3 2 10 6 2 1 452 70 34 14 4 5 20 17 30 5 1 289 3 35 12 8 1 13 8 4 28 13 ~~7 4 39 6 2 4 2 4 2 28 2 2 — 1 2 1 8 3 1 50 11 \ 1 1 4 8 34 2 —- 2 2 2 -- 1 89 17 6 3 1 1 8 2 12 62 2 4 1 4 1 10 5 1 1 164 19 9 4 2 2 3 13 11 3 1 80 2 18 3 6 1 7 3 1 10 4 5 2 199 34 19 7 1 2 9 2 7 147 1 15 5 2 5 1 2 8 4 1 1 363 53 Involutional melancholia - 28 11 Senile psychosis _ 3 4 12 15 Psychosis of other demonstrable etiology Psychosis with psychopathic personality 18 3 1 227 3 Without Psychosis 33 8 8 Drug addiction __ __ - Primary behaviour disorders 1 12 4 Other and unspecified character, behaviour, 3 18 Neurological disease without psychosis Observation without need for further medical care—mental Head injury of other and unspecified nature—. 8 6 3 Totals 481 596 1,077 108 124 232 373 472 845 p-i l <* a> s s H ! i | i i ! i _H0 2 c I rH rH I 1 1 1 i 1 CS iiiiii ll 1 ! Tf ft i Mi! i M i M i I 1 ! 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C I c -c c t < c c $ Vi U *a u o Vi '"& u 3 > o u rt.2 fl u 4) IP S3 § «_ ^ i o .2? •si S c 3 3 a 3 o fl "1 o Vi a y t/i *3 73 3 M O ■g OJ c. s o -5 It r; 5 ol > u fl O or ei c 41 t C P fi I •V | t c > _ e 'I i e 0- 1/ a u 0- 4_"? Oh c < •S2 S 8r9 >. a Vi Ph .23 ■£ o cc fl c 1 s § fe ei t E a E xs X n 8 I? Is ■o O * §i r. £ -a v u i: £ rO C o > cr c <u 'E n oc o y 2 c 3 x r c a St <s •a a 13 h 171 T 172 MENTAL HEALTH SERVICES REPORT, 1952-53 Table No. 31. — Showing Duration of Last Hospital Residence of Discharged Patients by Psychoses from April 1st, 1952, to March 31st, 1953 Total Less than 1 Month Less than 2 Months Less than 3 Months Less than 4 Months 4 Months M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Schizophrenic disorders . 220 26 16 6 1 8 12 12 3 110 4 21 8 6 1 7 3 2 17 12 2 5 1 283 55 16 11 1 3 8 1 12 1 1 210 1 29 5 2 6 2 12 8 1 1 503 81 32 17 2 3 16 13 24 1 4 320 5 50 13 8 1 13 3 4 29 20 2 6 2 11 1 2 1 8 31 7 3 3 1 1 2 3 2 1 1 30 6 4 1 1 3 5 42 7 3 2 3 1 1 1 1 1 41 7 6 1 1 1 3 8 5 73 14 6 5 1 3 2 3 6 2 2 2 23 10 5 2 3 2 8 1 32 2 9 4 3 1 2 1 9 3 47 17 4 2 5 1 5 83 8 1 1 1 5 3 70 27 9 61 5 3 84 19 5 3 1 1 1 1 1 41 1 8 1 6 2 145 24 8 5 1 1 2 2 4 1 1 65 2 10 1 4 8 3 83 9 4 2 2 89 8 1 3 1 172 17 5 5 1 2 42 1 2 33 5 2 2 75 6 4 4 2 8 2 ?, 1 1 Alcoholic psychosis- - 3 13 1 115 2 17 5 3 2 2 2 14 6 2 3 24 1 2 1 3 2 1 1 1 2 2 7 1 1 1 1 2 1 8 2 1 i Psychosis with psychopathic personality.. 7 Psychoneurosis Syphilis and its sequelae 16 2 36 4 52 6 15 1 Without Psychosis 3 1 Alcoholism 2 2 2 1 1 3 2 3 1 1 1 Other and unspecified character, behaviour, and intelligence disorders 7 ? Observation without need for further medical Head injury of other and unspecified nature 3 3 Totals 503 669 1,172 80 112 192 123 183 306 112 175 287 126 145 271 62 54 116 STATISTICAL TABLES—CREASE CLINIC T 173 Table No. 32.—Showing Conditions of Patients on Discharge by Psychoses from April 1st, 1952, to March 31st, 1953 Psychosis Total Recovered Improved Unimproved Without Psychosis and Unclassified M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Schizophrenic disorders 220 26 16 6 1 8 12 12 3 110 4 21 8 283 55 16 11 1 3 8 1 12 1 1 210 1 29 5 503 81 32 17 2 3 16 15 24 1 4 320 5 50 13 8 1 13 3 4 29 20 . 2 6 2 25 6 4 1 7 1 11 13 10 3 1 1 13 38 16 7 1 7 1 1 1 24 147 17 9 4 5 5 4 2 76 2 .... 208 39 12 6 1 7 1 8 1 173 355 56 21 10 1 12 6 12 3 249 2 48 3 3 2 1 2 8 23 2 3 - 62 6 1 5 1 2 1 3 24 1 I — 110 9 4 7 2 2 3 11 47 3 3 21 8 6 1 7 2 17 12 2 5 1 29 5 2 6 2 12 8 1 1 — Pre-senile psychosis Psychosis with cerebral arteriosclerosis — Psychosis of other demonstrable etiology Psychosis with psychopathic personality .... Psychoneurosis _ _ _ Undiagnosed psychosis Without Psychosis 50 13 6 1 2 8 1 7 3 2 17 12 2 5 1 6 2 12 8 1 1 1 Primary childhood behaviour disorders 13 Other and unspecified character, behaviour, 4 29 Neurological disease without psychosis Observation without need for further medi- 20 2 Head injury of other and unspecified nature 6 2 Total s _ 503 |669 1 1,172 55 41 96 271 456 727 95 106 201 82 66 148 Table No. 33.—Showing Age-groups of Patients Who Died from April 1st, 1952, to March 31st, 1953 Age-group Male Female Total 1 2 1 - 2 1 3 3 1 1 1 1 2 1 1 20 24 „ - —
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Mental Health Services PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT FOR TWELVE MONTHS ENDED MARCH 31ST… British Columbia. Legislative Assembly [1954]
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Title | Mental Health Services PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT FOR TWELVE MONTHS ENDED MARCH 31ST 1953 |
Alternate Title | MENTAL HEALTH SERVICES REPORT, 1952-53 |
Creator |
British Columbia. Legislative Assembly |
Publisher | Victoria, BC : Government Printer |
Date Issued | [1954] |
Genre |
Legislative proceedings |
Type |
Text |
FileFormat | application/pdf |
Language | English |
Identifier | J110.L5 S7 1954_V02_10_T1_T199 |
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Sessional Papers of the Province of British Columbia |
Source | Original Format: Legislative Assembly of British Columbia. Library. Sessional Papers of the Province of British Columbia |
Date Available | 2017-06-26 |
Provider | Vancouver : University of British Columbia Library |
Rights | Images provided for research and reference use only. For permission to publish, copy or otherwise distribute these images please contact the Legislative Library of British Columbia |
CatalogueRecord | http://resolve.library.ubc.ca/cgi-bin/catsearch?bid=1198198 |
DOI | 10.14288/1.0348641 |
AggregatedSourceRepository | CONTENTdm |
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