DEPARTMENT OF PROVINCIAL SECRETARY
Mental Health Services
PROVINCE OF BRITISH COLUMBIA
ANNUAL REPORT
FOR TWELVE MONTHS ENDED
MARCH 3 1st
1957
Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1957 To His Honour Frank Mackenzie Ross, C.M.G., M.C.,
Lieutenant-Governor oj the Province oj 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, 1957.
Provincial Secretary's Office,
December 9th, 1957.
W. D. BLACK,
Provincial Secretary. The Honourable Wesley D. Black,
Provincial Secretary, Victoria, B.C.
Sir,—Pursuant to the provisions of the following Statutes—" Mental Hospitals Act,"
" Clinics of Psychological Medicine Act," " Schools for Mental Defectives Act," " Provincial Child Guidance Clinics Act," and " Provincial Mental Health Centres Act"—
I have the honour to submit the Annual Report of the Provincial Mental Health Services
for the twelve months ended March 31st, 1957, being the Eighty-fifth Annual Report.
I have the honour to be,
Sir,
Your obedient servant,
R. A. PENNINGTON,
Deputy Provincial Secretary.
Deputy Provincial Secretary's Office,
December 6th, 1957. TABLE OF CONTENTS
Page
Officers and Staff, List of 11
PART I.—HEADQUARTERS
Report—Director of Mental Health Services 15
Tables—
Comparative Summary of Increases and Decreases in Resident Population
by Major Divisions of Provincial Mental Health Services 33
Comparative Summary of Total Patients under Care by Major Divisions
of Provincial Mental Health Services 33
Movement of Population in Individual Institutions of Mental Health
Services 34
Report—Business Manager 35
Financial Tables 39
Report—Personnel Officer 47
Report—Supervisor of Social Work 51
Report—School of Psychiatric Nursing 54
PART II.—CREASE CLINIC OF PSYCHOLOGICAL MEDICINE
AND PROVINCIAL MENTAL HOSPITAL
Report—Crease Clinic 55
Report—Mental Hospital 57
Report—Treatment Services 65
Report—Laboratory 74
Report—Department of Neurology 77
Report—Department of Radiology 78
Report—Department of Physical Medicine 79
Report—Pharmacy 80
Report—Dental Department 81
Report—Optical Department 81
Report—Dietary Department 82
Report—Department of Nursing, Women's Division 83
Report—Department of Nursing, Men's Division 84
Report—Psychology Department 85
Report—Social Service Department 8 6
Report—Occupational Therapy Department 92
Report—Industrial Therapy Department 94
Report—Chaplain 95
Report—Recreational Therapy Department 97
Report—Audio-Visual Department 99
Report—Library 101
Report—Rehabilitation Service 102
Report—School-teacher 103
Statistical Tables—
Crease Clinic of Psychological Medicine—
Table 1.—Movement of Population 104
Table 2.—Summary of Operations since Inception 104
Table 3.—First Admissions by Health Unit and School District of Residence and Sex 105 Q 6 MENTAL HEALTH SERVICES REPORT, 1956-57
Statistical Tables—Continued Page
Crease Clinic of Psychological Medicine—Continued
Table 4.—First Admissions and Readmissions by Method of Admission,
Age-group, and Sex 106
Table 5.—First Admissions by Mental Diagnosis, Age-group, and Sex 107
Table 6.—Readmissions by Mental Diagnosis, Age-group, and Sex 110
Table 7.—First Admissions by Marital Status, Mental Diagnosis, and Sex 112
Table 8.—Readmissions by Marital Status, Mental Diagnosis, and Sex 114
Table 9.—First Admissions by Mental Diagnosis, Years of Schooling, and
Sex 115
Table 10.—Readmissions by Mental Diagnosis, Years of Schooling, and
Sex 115
Table 11.—First Admissions by Citizenship, Age-group, and Sex 115
Table 12.—First Admissions by Religion and Sex 115
Table 13.—First Admissions by Previous Occupation and Sex 115
Table 14.—Live Discharges by Condition on Discharge, Disposition to,
and Sex 115
Table 15.—Live Discharges by Mental Diagnosis, Condition on Discharge,
and Sex 116
Table 16.—Live Discharges by Mental Diagnosis, Age-group, and Sex 117
Table 17.—Live Discharges by Mental Diagnosis, Length of Stay, and Sex 120
Table 18.—Deaths by Mental Diagnosis, Age-group, and Sex 122
Table 19.—Deaths by Cause of Death, Age-group, and Sex 122
Provincial Mental Hospital—
Table 1.—Movement of Population 123
Table 2.—Summary of Operations since Inception 124
Table 3.—First Admissions by Health Unit and School District of Residence and Sex 126
Table 4.—First Admissions and Readmissions by Method of Admission,
Age-group, and Sex 127
Table 5.—First Admissions by Mental Diagnosis, Age-group, and Sex ___ 128
Table 6.—Readmissions by Mental Diagnosis, Age-group, and Sex 130
Table 7.—First Admissions by Marital Status, Mental Diagnosis, and Sex 132
Table 8.—Readmissions by Marital Status, Mental Diagnosis, and Sex 133
Table 9.—First Admissions by Mental Diagnosis, Years of Schooling,
and Sex 134
Table 10.—Readmissions by Mental Diagnosis, Years of Schooling, and
Sex : 134
Table 11.—First Admissions by Citizenship, Age-group, and Sex 134
Table 12.—First Admissions by Religion and Sex 134
Table 13.—First Admissions by Previous Occupation and Sex 134
Table 14.—Resident Population by Mental Diagnosis, Age-group, and
Sex 135
Table 15.—Resident Population by Mental Diagnosis, Number of Previous Admissions, and Sex 136
Table 16.—Resident Population, 25 Years of Age and under, by Mental
Diagnosis, Length of Stay, and Sex 137
Table 17.—Resident Population, 26 to 50 Years of Age, by Mental
Diagnosis, Length of Stay, and Sex 138
Table 18.—Resident Population, 50 Years of Age and over, by Mental
Diagnosis, Length of Stay, and Sex 139 TABLE OF CONTENTS Q 7
Statistical Tables—Continued Paoe
Provincial Mental Hospital—Continued
Table 19.—Live Discharges by Condition on Discharge, Disposition to,
and Sex 140
Table 20.—Live Discharges by Mental Diagnosis, Condition on Discharge,
and Sex 141
Table 21.—Live Discharges by Mental Diagnosis, Age-group, and Sex— 142
Table 22.—Live Discharges by Mental Diagnosis, Length of Stay, and Sex 144
Table 23.—Deaths by Mental Diagnosis, Age-group, and Sex 145
Table 24.—Deaths by Mental Diagnosis, Length of Stay, and Sex 146
Table 25.—Deaths by Cause of Death, Age-group, and Sex 147
Table 26.—Deaths by Cause of Death, Length of Stay, and Sex 148
PART III.—THE WOODLANDS SCHOOL, NEW WESTMINSTER
Report—Medical Superintendent 150
Report—Education Department 159
Report—Laboratory 161
Report—Radiology Department 163
Report—Physiotherapy Department 163
Report—Dental Department 164
Report—Speech Therapy Department 164
Report—Department of Dietetics 165
Report—Department of Nursing, Women's Division 165
Report—Department of Nursing, Men's Division 166
Report—Department of Psychology . 166
Report—Social Service Department 167
Report—Occupational Therapy Department, Girls' Division 169
Report—Occupational Therapy Department, Boys' Division 169
Report—Recreational Therapy Department 170
Statistical Tables—
Table 1.—Movement of Population 171
Table 2.—Summary of Operations since Inception 171
Table 3.—First Admissions by Health Unit and School District of Residence
and Sex 171
Table 4.—First Admissions by Method of Admission, Age-group, and Sex 172
Table 5.—First Admissions by Mental Diagnosis, Age-group, and Sex 172
Table 6.—First Admissions by Mental Diagnosis, Years of Schooling, and Sex 172
Table 7.—First Admissions by Citizenship, Age-group, and Sex 172
Table 8.—First Admissions by Religion and Sex 172
Table 9.—First Admissions by Previous Occupation and Sex 172
Table 10.—Resident Population by Mental Diagnosis, Age-group, and Sex 173
Table 11.—Resident Population by Mental Diagnosis, Length of Stay, and Sex 174
Table 12.—Live Discharges by Mental Diagnosis, Condition on Discharge, and
Sex 175
Table 13.—Line Discharges and Deaths by Mental Diagnosis, Age-group, and
Sex 176
Table 14.—Live Discharges and Deaths by Mental Diagnosis, Length of Stay,
and Sex '. 177
Table 15.—Deaths by Cause of Death, Age-group, and Sex 178
Table 16.—Deaths by Cause of Death, Length of Stay, and Sex 179 Q 8 MENTAL HEALTH SERVICES REPORT, 1956-57
PART IV.—PROVINCIAL MENTAL HOME, COLQUITZ
Page
Report—Medical Superintendent . 180
Report—Dental Department 181
Report—Department of Nursing Service 181
Report—Industrial and Occupational Therapy Department 182
Statistical Tables—
Table 1.—Movement of Population 183
Table 2.—Tranfers by Health Unit and School District of Residence 183
Table 3.—Transfers by Method of Admission and Age-group 183
Table 4.—Transfers by Mental Diagnosis and Age-group 184
Table 5.—Transfers by Mental Diagnosis and Marital Status 184
Table 6.—Transfers by Mental Diagnosis and Years of Schooling 184
Table 7.—Transfers by Citizenship and Age-group 184
Table 8.—Transfers by Religion 184
Table 9.—Transfers by Previous Occupation 184
Table 10.—Live Discharges by Mental Diagnosis and Condition 185
Table 11.—Live Discharges and Deaths by Mental Diagnosis and Age-group 185
Table 12.—Live Discharges and Deaths by Mental Diagnosis and Length of
Stay 186
Table 13.—Deaths by Cause of Death and Age-group 186
Table 14.—Deaths by Cause of Death and Length of Stay 186
PART V.—GERIATRIC DIVISION
Report—Medical Superintendent 187
Statistical Tables—
Home for the Aged, Port Coquitlam—
Table 1.—Movement of Population 199
Table 2.—First Admissions by Health Unit and School District of Residence and Sex 199
Table 3.—First Admissions by Method of Admission, Age-group, and Sex 200
Table 4.—First Admissions by Mental Diagnosis, Age-group, and Sex 200
Table 5.—First Admissions by Mental Diagnosis, Marital Status, and Sex 200
Table 6.—First Admissions by Mental Diagnosis, Years of Schooling, and
Sex 201
Table 7.—First Admissions by Citizenship, Age-group, and Sex 201
Table 8.—First Admissions by Religion and Sex 201
Table 9.—First Admissions by Previous Occupation and Sex 201
Table 10.—Live Discharges by Mental Diagnosis, Condition on Discharge,
and Sex 201
Table 11.—Live Discharges by Mental Diagnosis, Age-group, and Sex 201
Table 12.—Live Discharges and Deaths by Mental Diagnosis, Length of
Stay, and Sex 202
Table 13.—Deaths by Cause of Death, Age-group, and Sex 203
Table 14.—Deaths by Cause of Death, Length of Stay, and Sex 204
Home for the Aged, Vernon—
Table 1.—Movement of Population 205
Table 2.—First Admissions by Health Unit and School District of Residence and Sex 205
Table 3.—First Admissions by Method of Admission, Age-group, and Sex 205
Table 4.—First Admissions by Mental Diagnosis, Age-group, and Sex 206 TABLE OF CONTENTS
Q 9
Statistical Tables—Continued pA0E
Home for the Aged, Vernon—Continued
Table 5.—First Admissions by Mental Diagnosis, Marital Status, and Sex 206
Table 6.—First Admissions by Mental Diagnosis, Years of Schooling, and
Sex 206
Table 7.—First Admissions by Citizenship, Age-group, and Sex 206
Table 8.—First Admissions by Religion and Sex 206
Table 9.—First Admissions by Previous Occupation and Sex 206
Table 10.—Live Discharges by Mental Diagnosis, Condition on Discharge,
and Sex 206
Table 11.—Live Discharges and Deaths by Mental Diagnosis, Age-group,
and Sex 207
Table 12.—Live Discharges and Deaths by Mental Diagnosis, Length of
Stay, and Sex 208
Table 13.—Live Discharges by Condition on Discharge, Disposition to,
and Sex 209
Table 14.—Deaths by Cause of Death, Age-group, and Sex 209
Table 15.—Deaths by Cause of Death, Length of Stay, and Sex 210
Home for the Aged, Terrace—
Table 1.—Movement of Population 211
Table 2.—First Admissions by Health Unit and School District of Residence 211
Table 3.—First Admissions by Method of Admission and Age-group 211
Table 4.—First Admissions by Mental Diagnosis and Age-group 212
Table 5.—First Admissions by Mental Diagnosis and Marital Status 212
Table 6.—First Admissions by Mental Diagnosis and Years of Schooling 212
Table 7.—First Admissions by Citizenship and Age-group 212
Table 8.—First Admissions by Religion 212
Table 9.—First Admissions by Previous Occupation 212
Table 10.—Live Discharges and Deaths by Mental Diagnosis and Age-
group 213
Table 11.—Live Discharges and Deaths by Mental Diagnosis and Length
of Stay 213
Table 12.—Live Discharges by Mental Diagnosis and Condition on Discharge 213
Table 13.—Deaths by Cause of Death and Age-group 214
Table 14.—Deaths by Cause of Death and Length of Stay 214
PART VI.—CHILD GUIDANCE CLINICS
Report—Director 215
Report—Social Service Department 224
Report—Psychology Department 225
PART VII.—MENTAL HEALTH CENTRE
Report—Director 229
PART VIII.—COLONY FARM
Report—Business Manager 234 OFFICERS AND STAFF
PROVINCIAL MENTAL HEALTH SERVICES
Department of the Provincial Secretary
Hon. W. D. Black, Provincial Secretary.
R. A. Pennington, O.B.E., F.C.I.S., Deputy Provincial Secretary.
HEADQUARTERS STAFF
A. M. Gee, M.D., CM., F.A.P.A., Director of Mental Health Services.
A. E. Davidson, B.A., M.D., F.A.P.A., Deputy Director of Mental Health Services.
F. A. Matheson, Business Manager.
C. B. Watson, M.A., Administrative Assistant.
J. Dowling, Administrative Assistant (Personnel).
Miss A. K. Carroll, B.A., M.S.W., Provincial Supervisor, Psychiatric Social Work.
Miss E. M. Pullan, R.N., B.A.Sc, Director of Nursing.
PROVINCIAL MENTAL HOSPITAL AND CREASE CLINIC
OF PSYCHOLOGICAL MEDICINE, ESSONDALE
T. G. Caunt, M.D., F.A.P.A., Medical Superintendent.
J. Walsh, M.B., B.Ch., D.P.M., Deputy Medical Superintendent.
I. S. Kenning, B.Sc, M.D., CM., Clinical Director.
J. M. Jackson, M.D., Director of Radiology.
G. A. Nicolson, B.A., M.D., Director of Laboratories.
W. P. Fister, M.D., M.R.CP.(Edin.), F.R.CP.(C), Director of Neurology.
N. L. Richardson, M.D., CM., Assistant Clinical Director.
R. Halliday, M.B., B.Ch., D.P.M., Assistant Clinical Director.
F.G. Tucker, M.B., B.S., Assistant Clinical Director.
I. Tischler, M.D., Assistant Clinical Director.
P. McK. Middleton, M.B., B.S., Assistant Clinical Director.
F. J. Edwards, M.D., CM., Assistant Clinical Director.
M. O. Calverley, B.Sc, M.D.
F. H. G. Mills, M.D.
W. Lazorko, M.D.
E. J. Emanuels, M.D.
N. M. Thornton, B.A., M.D.
R. K. Karlsson, M.D.
R. C. Arrowsmith, B.A., M.D.
N. L. Mason-Browne, M.A., M.B.,
J. S. Petriw, M.D.
F. M. Richards, B.Sc, M.D.
H. S. Sexsmith, B.A., M.D., CM.
L. L. Scott, B.A., M.D.
E. Linnolt, M.D.
J. S. Daly, B.A., M.D., CM.
J. E. Boulding, B.A., M.D., CM.
G. O. Hallman, B.A., M.D.
J. K. Macdonell, M.D.
E. M. Gee, M.D.
Ch.B.
H. O. Johnsen, D.D.S.
G. D. Campbell, D.D.S.
J. W. Borthwick, B.A., Psychologist.
R. L. Ramsey, B.Sc, Director of Recreation.
K. Woolcock, Pharmacist.
G. H. Walker, Audio-Visual Department.
R. H. Strong, Chief Male Psychiatric Nurse.
Miss M. Kenny, B.S., R.N., Associate Director
of Nursing Education.
Mrs. M. Marr, B.Sc(H.Ec), Dietetics Administrator.
Miss D. M. Tayler, O.T.(Reg.), Supervisor,
Occupational Therapy.
R. Herring, Supervisor, Industrial Therapy.
J. D. Addison, Rehabilitation Officer (Men's
Division).
Miss H. Walsh, B.A., B.L.Sc, Librarian.
Consultant Staff:
F. A. Turnbull, B.A., M.D., Neurosurgery.
James W. Wilson, M.D., CM., F.R.CS.(Can.), M.S.(Minn.), General Surgery.
George T. Wilson, B.A., M.D., CM., General Surgery.
R. E. Outerbridge, M.D., F.R.S.C(C), F.A.C.S., Orthopedic Surgery.
E. F. Weir, M.D., Internal Medicine.
Business:
J. F. Anderson, Assistant Business Manager. W. Gueho, Cashier.
G. A. Grieve, Cost Accountant. R. Boulter, Steward.
Miss K. Schwarz, Business Stenographer.
11 Q 12 MENTAL HEALTH SERVICES REPORT, 1956-57
Chaplains:
Rev. John F. O'Neil, Protestant. Rev. Father A. Frechette, Roman Catholic.
Colony Farm:
W. B. Richardson, B.Sc. (Agriculture), Superintendent.
THE WOODLANDS SCHOOL, NEW WESTMINSTER
L. A. Kerwood, M.D., Medical Superintendent.
A. P. Hughes, B.Sc, M.D., Deputy Medical Superintendent.
W. O. Booth, Deputy Business Manager.
A. Gallinger, M.D., CM. Miss M. C. Hardy, Supervisor, Psychiatric Social
M. C Ellis, B.Sc, M.D., CM. Work.
B. Tischler, M.D. H. Mercer, Industrial Arts Instructor.
T. Kamburoff, M.D.
J. Lynes, Recreational Instructor.
C. S. Livingstone, M.D., M.R.C.P. ,
H T Davidson D D S Jessup, Occupational Therapist.
Miss V. Sanders', R.n!, Superintendent of Miss D- Dickinson, L.S.T., Speech Therapist.
Nurses. '• Elliot, Chief Male Psychiatric Nurse.
Miss J. Ing, B.Sc(H.Ec), Dietician. R- Nash, Instructor, Male Psychiatric Nurses.
Mrs. H. M. Davy, School Principal. Mrs. B. Powell, Clerk-Stenographer.
Chaplains:
Rev. P. C. McCrae, Protestant. Rev. Father D. J. McIntosh, Roman Catholic.
PROVINCIAL MENTAL HOME, COLQUITZ
L. G. C. d'Easum, M.B., Medical Superintendent.
H. C. Yardley, Deputy Business Manager. P. T. McLeod, Chief Male Psychiatric Nurse.
GERIATRIC DIVISION
B. F. Bryson, B.A., M.D., CM., F.A.P.A., Medical Superintendent.
L. W. Fox, Supervisor, Vernon. W. E. Skillicorn, Supervisor, Terrace.
CHILD GUIDANCE CLINICS
U. P. Byrne, M.D., D.P.H., D.I.H., M.R.S.H., F.A.P.H.A., F.A.P.A., Director.
T. L. Brown, B.Com., Unit Business Manager.
G. M. Kirkpatrick, B.A., M.D., Psychiatrist. Mrs. E. Chester, L.CS.T.(Eng.), Speech Ther-
W. L. Valens, M.D., CM., Psychiatrist. apist.
Miss M. Munro, B.A., M.A., Supervisor, Psy- D. B. Ricketts, B.A., M.A., Supervisor, Social
chology. Work.
Mrs. M. Harvey, B.A.Sc, R.N., Supervisor, Public Health Nursing.
Miss E. Hoskin, Senior Stenographer.
MENTAL HEALTH CENTRE
F. E. McNair, B.A., M.D., CM., Director.
T. L. Brown, B.Com., Unit Business Manager.
W. E. Powles, B.A., M.D. Miss B. Mitchell, R.N., B.S.N., Supervisor of
R. W. Harrington, B.A., M.D. Nursing.
R. Parkinson, B.A., M.D. Miss A. Bailey, M.A., O.T., Supervisor, Occu-
G. Glover, B.A., M.S.W., Supervisor, Social pational Therapy.
Service. Miss A. Elart, B.A., Senior Psychologist.
Miss E. E. Jackson, Senior Stenographer. REPORT OF MENTAL HEALTH SERVICES
For the Twelve Months Ended March 31st, 1957
PART I.—HEADQUARTERS
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-fifth Annual
Report of the British Columbia Mental Health Services is submitted herewith.
INTRODUCTION
The years following World War II have seen a tremendous development in the
psychiatric services of our Province. These developments have occurred both in reference
to services offered by Provincial agencies and community agencies. Probably the greatest
single development which has occurred has been the awakening of public interest in
matters pertaining to mental health and an increasing awareness of the part which the
community can play in maintaining good mental health for its citizens. Voluntary agencies such as the Canadian Mental Health Association and the Association for Retarded
Children are now working hand in hand with government agencies to bring about the
best possible solutions to our greatest single health problem.
As a service advances from a reasonably good grade of custodial care to an active
treatment and preventive programme, the former yardsticks of per capita per diem costs
and beds provided per 100,000 population become useless. The only yardstick that fits
present-day knowledge is the quality and the quantity of the service that can be rendered.
Psychiatry has in the past been too closely associated with beds provided in great numbers,
and placed too closely together. Present-day psychiatry recognizes that hospitalization
may be necessary during a serious mental illness but that other forms of treatment may
be utilized to better purpose. Is citizen John Doe only entitled to a reasonably good
grade of custodial care should mental illness overtake him? Is he entitled to the best
psychiatric treatment that present-day knowledge can give him? Are he and his family
entitled to any service which may prevent later hospitalization? These are the questions
which must be answered when future policy is being formulated.
The policy of the Provincial Mental Health Services as laid down over the past ten
or twelve years has been accomplished in three phases.
Phase I.—An effort was made to segregate into appropriate areas the mentally ill,
the aged mentally ill, and the mentally retarded. Prior to the initiation of this programme the Mental Hospital at Essondale housed large numbers of all three groups,
making treatment a secondary consideration. The hospital in New Westminster was designated as a school for the retarded, and special legislation governing its operation was
passed in 1953. A great deal of new construction has been carried out, bringing the
population up to 1,200 patient-pupils. A further new unit is under construction and
15 Q 16 MENTAL HEALTH SERVICES REPORT, 1956-57
will be ready for occupancy early in the new fiscal year. Unfortunately, the demands
for admission to The Woodlands School greatly exceed accommodation, and further
expansion of this service must receive early consideration. While a large number of
mentally retarded patients have been transferred from the Mental Hospital to the School,
there are over 300 retarded still in the Mental Hospital awaiting transfer.
Special provision for the care of the aged mentally ill was made in 1935 with the
passage of the " Homes for Aged Act." Facilities were first established at Port Coquitlam, adjacent to the Mental Hospital at Essondale. Later a smaller unit was established
at Vernon and a similar unit was opened at Terrace. The total capacity of these three
units is 1,100. A new admission and infirmary building is under construction at Port
Coquitlam which will provide accommodation for an additional 300 patients. Here
again the demands for admission exceed the available accommodation, and a waiting-list
has been established. While the advent of the Homes for the Aged has removed these
patients from the Mental Hospital, it does not take care to any extent of the ageing of
the population within the Mental Hospital.
As a result of these changes in the segregation of the retarded and the aged, great
improvements have been accomplished in the Mental Hospital, allowing for a more
active treatment programme and a higher discharge rate. I would refer you to the
Medical Superintendent's report for these details and would point out that for the first
time we are able to report a decrease in the Mental Hospital population.
The matter of the care of the mentally aged has not yet been fully met by any means.
It is felt, however, that an evaluation of the total facilities available for the care of the
senior citizens of the Province is indicated in order that the best use of our facilities may
be made. Under present-day concepts it is feasible to expect that a greater number of
our elderly patients might be returned to the community for care under less supervised
circumstances.
Phase 11.—The second phase of our policy has been to integrate more closely with
general medicine and where possible to provide treatment for early less severe forms of
illness on the same basis as that provided by general hospitals. To that end, the Crease
Clinic was opened in 1951. Special legislation governing the operation of the Clinic
simplified admission and discharge procedures and removed all legal implications.
Whereas maximum hospitalization was set at four months, in actual practice the average
hospitalization has been two months. Admission is by voluntary application or by medical certificates. During the year under review, 55 per cent of admissions were by voluntary application. The Crease Clinic has done much to gain the confidence of the public
over the past six years and has brought the treatment of mental illness into closer approximation with the treatment of physical illness. In addition, it has done much to improve
the standard of treatment in the Mental Hospital by its proximity and interrelated services.
It may be that the dictates of the future may indicate the fusion of the admitting service of
the Mental Hospital with that of the Clinic.
In reviewing the report of the year's activities, you will note that 1,465 patients
were admitted. Over 96 per cent of these patients were returned to the community after
an average hospitalization of two months, or less than 3 per cent were admitted to the
Mental Hospital for a more prolonged treatment than the four-month period permitted
in the Clinic.
Phase III.—-The third phase of our policy realization was achieved on January 2nd,
1957, with the opening of the Mental Health Centre. A spacious new building has been
constructed in Burnaby to bring together the Child Guidance Clinic and the Mental
Health Centre. The former service had operated since 1932 in very inadequate quarters.
The new building will allow for expansion of both services for years to come. The
successful operation of the Crease Clinic has paved the way for a closer integration of
a treatment service with the community. Formerly the psychiatric patient was a reject Platform party, official opening of Mental Health Centre and Child Guidance
Clinic, Burnaby, May 1st, 1957.
. :.;,':'.
Mental Health Centre (left) and Child Guidance Clinic, Burnaby. Q 18 MENTAL HEALTH SERVICES REPORT, 1956-57
from the community to the mental hospital. Little concern was felt for his return to the
communiy, and too frequently his return was opposed. Present-day psychiatry regards
the patient as a continuing member of the community and the mental illness merely
an incident of varying severity requiring treatment and return to the community.
The introduction of the services of the Mental Health Centre allows the patient to
preserve his community identity. It offers a new type of day service for persons whose
condition permits them to remain at home. Referrals are made by medical practitioners
and specialists, who have a continuing responsibility to the patient when the treatment
period has been concluded. In addition, the Centre offers out-patient follow-up service
to discharged patients from the Crease Clinic and the Mental Hospital. The Centre will
in the near future offer evening service to those who are able to continue in employment.
While a great deal has been accomplished in these three phases of our programme,
some deficiencies have been noted. It is felt that a year or two further consolidation of
this programme is required with an even closer integration with the community and other
community agencies at the three government levels. Some years of evaluation of the
work done at the Mental Health Centre will be required before its relationship to in-
residence treatment can be evaluated.
Certain changes in present-day trends can, however, be noted. There is a general
trend away from the further construction of large mental hospitals or large buildings of
the type with which we are presently familiar. The Canadian Mental Health Association
has recommended that hospital planning in the future will be around the provision of
small regional hospitals to be located in the areas in which they will serve and where
possible be closely associated with the already existing facilities in the community. Top
priority is given to the type of community care such as is being provided by our Mental
Health Centre.
It should be noted that there has been a slight decline in admissions to the various
branches of the Mental Health Services. In explanation of this it should be pointed out
that this is due to the restrictions placed upon admission of the mentally retarded and
the aged. With the opening of the Fraser View unit at The Woodlands School next year,
admission in this area will rise correspondingly. Similarly, with the opening of a new
unit at the Home for the Aged the following year, admissions in that area will also
increase. However, disregarding these two areas in which we have deficiencies in accommodation, there is every reason to believe that in the realm of mental illness the situation
is coming under control. It will be noted that for the first time there is a reduction in
the admissions to the Crease Clinic. Furthermore, the most hopeful indication of future
trends is the fact that there has for the first time been a reduction of seventy-four patients
in the population of the Mental Hospital. This is undoubedly the end result of our three-
phase policy and the newer treatment procedures. There is every indication that we are
now reaching a point where it is being demonstrated that the porblem of mental ill health
can be met, and that the further piling of psychiatric treatment failures into large storage
warehouses will be unnecessary. Certainly the most dramatic statistic in the mental-
health field at the moment is that in the United States the over-all population in mental
hospitals has been reduced by 1.3 per cent. We in British Columbia are pleased that our
mental hospital population has been reduced by 2 per cent. This decrease in population
is more spectacular when it is viewed against a continuing high but diminishing admission
rate. It is hoped that in future years it may be possible for financial provision to be
made for improvements and expansion of services so that the new skills and knowledge
which are rapidly being developed in the field of psychiatry may be used to their fullest
extent.
After a period of consolidation there will be a need for a re-evaluation of our services
in the light of present-day accomplishments and a clearly stated policy of service in
reference to the three goals of a mental-health service, which are: (1) The restoration of HEADQUARTERS Q 19
mental health to the mentally ill; (2) the prevention of mental illness; and (3) the
improvement of mental health in the mentally healthy.
Coincident with this need to evaluate services emerges the need to review all legislation with reference to the operation of our various divisions. It would be our hope to
consolidate many of our cumbersome Statutes into more simple procedures. It should
be our general aim to produce laws which would provide necessary treatment with the
same degree of facility and lack of restriction of liberty as is applied to the treatment of
the physically ill. Restriction and powers of compulsion should only be used in those
few cases where protection of the patient or the public is of paramount interest.
You will note during the reading of the reports of the various divisions that one
of the greatest problems encountered during the year has been the provision of trained
staff. There are great shortages of professional staff throughout the country. This is
particularly prevalent with reference to psychiatric social workers, who are so very
necessary if discharge rates are to be maintained. Psychologists and occupational therapists are also very difficult to recruit. The areas of service in which these categories are
employed have been greatly increased, and we have found ourselves not able to compete
in many instances with other agencies. The percentage of trained nursing staff to
untrained nursing aide staff has, unfortunately, shown further deterioration. At the
present time it is not possible for our School of Psychiatric Nursing to keep pace with
the attrition in the nursing departments. Top priority must be given to increasing the
faculty of the School as soon as the new building becomes available. It is hoped that
we may be allowed to increase the number of students to make provision for the expanding services of future years.
Great difficulty has been experienced in maintaining a staff of specialists in
psychiatry.
Dr. Kenning, the Clinical Director at the Crease Clinic and Mental Hospital, stresses
in his report the necessity of harmonious interpersonal relationships between staff members as they affect the patients under their care. This might well be summed up in the
following extract from the World Health Organization:—
The most important single factor in the efficacy of the treatment given in a mental hospital
appears to be an intangible element which can only be described as atmosphere. One of the
characteristic aspects of the psychiatric hospital is the type of relationship between people that
are to be found within it.
The percentage turnover for the entire staff was 35.6 per cent, giving some indication of the general staff unrest and dissatisfaction which, unfortunately, is present. The
highest attrition rate is in the women's nursing division. There has, in addition, been
a great increase in the resignation of graduate psychiatric nurses in the male division who
have left our employment for other more remunerative work. The Personnel Officer's
report indicates that recruitment has kept pace with the separation rate but does not
indicate the deterioration in staff quality which has resulted from the high separation rate
of trained staff.
STATISTICAL COMMENTS
The Division of Vital Statistics, Health Branch, Department of Health and Welfare,
has been responsible for the preparation of our statistical tables. Several interesting
comparative studies have also been carried out by the Division in collaboration with
statistics prepared by the Dominion Bureau of Statistics. The following is an example
of such a comparative table. Q 20 MENTAL HEALTH SERVICES REPORT, 1956-57
Table 1.—Rank of Most Frequent Diagnostic Classes on First Admissions
Rank
Canada
Provincial Mental Health Services
1
2
3
4
5
6
7
8
9
10
11
12
13
Schizophrenia _
Senile with cerebral arteriosclerosis..
Manic depressive
Mental deficiency-
Neurotic-depressive reaction
Alcoholism (without psychosis) —
Other with unspecified psychosis-
Anxiety reaction
Involutional melancholia-
Pathological personality-
Other unspecified psychoneurosis-
Alcoholic psychosis.. _
Paranoia with paranoid states
Schizophrenia.
Senile with cerebral arteriosclerosis.
Anxiety reaction.
Neurotic-depressive reaction.
Alcoholism (without psychosis).
Pathological personality.
Other with unspecified psychosis.
Manic depressive.
Mental deficiency.
Other with unspecified character behaviour with intelligence disorders.
Hysterical reaction.
Alcoholic psychosis.
Paranoia with paranoid states.
Reference to Table 1 indicates that schizophrenia continues to hold first place in the
diagnostic admission rank both in Canada and in our own Provincial service. A complete
statistical study of this diagnostic category was made in our Annual Report last year. It
is interesting to note that while in former years this diagnostic category carried an exceedingly poor prognosis and a low discharge rate, it now occupies first rank as the most
frequent diagnostic class of discharge. There is every likelihood that additional research
into the causative factors of this illness will further improve the general outlook.
It will be noted that senile psychosis with cerebral arteriosclerosis occupies second
rank both in Canada and British Columbia. This problem is one of greater proportions
in our Province, where we have a larger percentage of elderly citizens than the other
Provinces. Admission statistics in this category are distorted due to the fact that we have
had to set up waiting-lists with limitation of admissions to our Geriatric Division.
Manic-depressive psychosis, occupying third rank in Canada, falls to eighth rank in
British Columbia. This reflects the very fine work being carried out in the Crease Clinic,
which has resulted in the early treatment and shorter hospitalization of the less severe
reactions occupying third and fourth rank in our services. This improved treatment programme and improved public relations is further highlighted by the fact that our percentage of voluntary admissions is the highest in Canada.
Alcoholism without psychosis occupies a higher rank in British Columbia due to an
extension of services offered some years ago to this diagnostic category on a voluntary
basis. The needs for this service in the Mental Hospital may diminish with the recent
formation of the Alcoholism Foundation of British Columbia and the opening by the
Foundation of limited residence facilities in 1956.
Mental deficiency occupies a much lower rank in British Columbia, due to the
restrictions which have been placed on the admission of this category. A waiting-list of
several hundred applicants has been established due to lack of accommodation.
At the close of the fiscal year 6,279 patients were in residences in all divisions of
the Mental Health Services. Tables 2 and 3 provide comparative data. HEADQUARTERS
Q 21
Table 2.—Showing Patients in Residence in the Various Institutions of the Provincial
Mental Health Services, April 1st, 1956, and March 31st, 1957, together with
Increase or Decrease.
Institution
In Residence, Mar
31,1956
InResidence, Mar.
31, 1957
Increase (+)
Men
Women
Total
Men
Women
Total
Decrease (—)
Crease Clinic
110
1,846
281
719
144
102
289
147
1,687
508
396
128
257
3,533
281
1,227
540
230
289
95
1,814
285
735
143
105
286
131
1,645
506
405
129
226
3,459
285
1,241
548
234
286
—31
—74
+4
+ 14
The Woodlands School _
Home for the Aged, Port Coquitlam _.
+8
+4
—3
Totals...
3,491
2,866
6,357
3,463
2,816
6,279
—78
Table 3.—Showing in Summary the Admissions and Population Increase of the Provincial
Mental Health Services for the Ten-year Period April 1st, 1947, to March 31st,
1957.
Year
Total
Admissions
Admissions
65 Years
and Over
Admissions
under
15 Years
Voluntary
Admissions
Population
Increase
Index of
Increase1
1947-48 _
1948-49... _ _
1,111
1,260
1,415
1,811
2,175
2,518
2,437
2,492
2,855
2,720
225
270
230
262
306
357
347
348
392
385
69
63
72
148
97
179
169
71
58
57
91
165
297
504
637
768
834
884
1,153
1,083
316
354
306
235
285
290
215
88
26
-78
28.44
28.09
1949-50 — —
1950-51
1951-52 —
21.62
12.98
13.05
1952-53 ..
1953-54- -
1954-55
1955-56
11.54
8.82
3.53
0.91
1956-57
-2.87
Totals
20,794
3,122
983
6,414
2,037
1 Percentage ratio of increase in population to admissions.
Table 2 indicates at a glance the year's activities with reference to the various
divisions. It is with considerable interest and enthusiasm that we are able to report
a total decrease in population of seventy-eight patients. This is the first year that we
have been able to report a decrease in patient population. It will be noted also in
reference to Table 3 that there is a substantial reduction in the total admissions. Any
enthusiasm in this particular regard must be tempered with a word of caution that the
admission rate for mentally retarded patients will increase next year, when an additional
300 beds become available for this diagnostic category. The year following will see an
increase in the aged categories, when a further 300 beds will become available in the
Homes for the Aged. These at the moment are the two restricted areas. However, the
reassuring fact is that in the Mental Hospital, where there are no restrictions in effect,
the in-residence population has been reduced by seventy-four patients. It is hoped that
this is indicative of a new trend. Great credit is due to Dr. Caunt and his staff in making
it possible to present this favourable report.
BUILDING PROGRAMME
The contract for the construction of a new auditorium at The Woodlands School
was let to the Kennett Construction Company on April 6th, 1956. The contracted price
is $415,655. Construction at this time is well advanced, and the building should be ready
for use early in 1958. This building has been greatly needed for some years. The need School of Psychiatric Nursing and 100-bed nurses' home, Essondale.
The 300-bed Admission and Infirmary Building under construction,
Geriatric Division, Port Coquitlam. HEADQUARTERS
Q 23
becomes more acute as the population of the School increases and many of the former
recreational and garden areas have been used as building-sites. In addition to auditorium
and gymnasium facilities, the building will provide a swimming-pool.
The contract for the construction of a new nurses' home and School of Psychiatric
Nursing at the Mental Hospital at Essondale was let to E. H. Shockley & Company on
April 12th, 1956. The contract price is $985,667. Construction is well advanced at
this time, and the building should be ready for occupancy by the end of 1957. The
building presents a very imposing appearance and will give accommodation for 100
students. In addition, a nurses' infirmary is being provided. The educational centre
will provide classrooms and other facilities for the School of Psychiatric Nursing. Delay
in the construction of this unit has heretofore imposed severe limitations on our training
of psychiatric nurses and has greatly limited the training of affiliating nurses from the
general hospitals. It is hoped that with the completion of the building we will be able
to increase the teaching faculty and attract larger numbers of men and women to our
training programme. During recent years we have not been able to graduate sufficient
students to keep pace with the high attrition, and we have not been able to make provision
for the training of staff for the rapid expansion of services which has occurred during
recent years.
Construction of the Fraser View unit has been completed, and it will be ready for
occupancy shortly. The building is rated to house 300 patients. Two floors will be
devoted to the care of young patients occupying cribs. One floor will be used for
trainable children of an older age-group. Facilities have also been provided for the
treatment of the acutely ill and isolation segregation for children suffering from infectious
diseases.
Construction is well advanced for a new admission and infirmary building at the
Home for the Aged, Port Coquitlam. Completion of this unit is anticipated by the end
of'1957. It is hoped that the building will allow for direct admission to the Home for
the Aged without prior admission to the Mental Hospital.
A great deal of maintenance and reconstruction have been carried out by the Public
Works Department. The maintenance of a plant of this magnitude requires a great deal
of work and expenditure. Details of this work will be found in the Business Manager's
report.
GENERAL COMMENTS
Graduation activities in the School of Psychiatric Nursing began on April 17th with
a graduation dinner-dance which was held at the Stanley Park Pavilion. This event was
made possible through the financial assistance of the Department of the Provincial
Secretary. On Sunday afternoon, April 22nd, the School of Nursing entertained the
members of the graduating class, their parents and friends at a tea held in one of the
nurses' residences. This social gathering was well attended and afforded an opportunity
for the students and their parents to meet with the senior members of the service. In the
evening the students paraded to Queen's Avenue United Church, where special services
were held. The graduating exercises were held in the Vincent Massey lunior High School
auditorium on the evening of Thursday, April 26th. A class of sixty-one women and
twenty-three men received certificates. Mr. R. A. Pennington, Dputy Provincial Secretary, acted as chairman. The Honourable W. D. Black, Provincial Secretary, brought
greetings from the Government, and Dr. S. R. Laycock spoke to the graduating class.
The ceremony was attended by a capacity audience.
The Social Service Department, which heretofore was responsible to the Social
Welfare Branch of the Department of Welfare, has been transferred to the Department
of the Provincial Secretary and is now an integral part of our organization. This change,
which was recommended by the Central Inspection Board of the American Psychiatric Q 24 MENTAL HEALTH SERVICES REPORT, 1956-57
Association in 1951, was implemented on April 1st, 1956. It involved the transfer of
forty-three social work positions to our establishment. We are grateful to the Social
Welfare Branch for the high calibre of service which they have seconded to us over
the years.
As usual, Mental Health Week was held during the first week of May. This week
is observed throughout Canada and the United States as an opportunity to focus the
public attention on matters pertaining to mental health. The activities were organized
through the British Columbia Division of the Canadian Mental Health Association.
The week was a very great success from an educational point of view. The senior medical staff of all branches of our service co-operated with the Mental Health Association
in carrying out its programme. Open house at the Mental Hospital was held on the
afternoon and evening of May 3rd, when approximately 2,000 visitors toured the various
wards. An effort was made to feature the open-ward development, and Wards H 2,
F 2, A 2, and C 2 were open to the public, as well as Pennington Hall and the apparel-
shop. Suitable displays were arranged in each of these locations, and guided tours were
made in all of these areas. The guides were drawn from the volunteer group, the patient
group, and staff members. The displays set up by the various departments illustrated
their activities and interpreted pictorially the patients' daily routine.
During recent years senior members of the administrative staff have been privileged
to appear before the Select Committee on Education and Social Welfare of the Legislature. It is felt that these opportunities have been of great benefit in familiarizing the
members of the Legislature with the operation of the Mental Health Services. This year
Mr. F. A. Matheson and I had the opportunity of appearing before the committee on
March 5th. An effort was made to portray the magnitude of the operation of the Services, particularly in reference to the operation of the necessary auxiliary services required
to run the organization. A special film was prepared by Mr. Guy Walker, of the Audio-
Visual Department, showing all divisions of the Services and the various auxiliary services which are required to operate them. A running commentary was prepared to
accompany the film. The film and discussion were very well received by the members
of the Legislature.
As the organization continues to grow in size, changes have to be instituted to meet
changing situations. A great deal of internal reorganization has taken place during the
year along the lines of decentralization and a better delineation of headquarters' function.
The departmental Personnel Officer has contributed a great deal in the preparation of
charts of the various divisions and divisional departments. Headquarters conference
meetings have been initiated and scheduled on a monthly basis. An effort has been made
to keep the staff better informed with the publication of a " Mental Health Service News "
bulletin, which is to be published monthly with the exception of the months of July and
August. Mr. W. D. McFarland, Administrative Assistant to the Provincial Secretary,
has kindly consented to act as editor. The first issue appeared in March, 1957.
In the Mental Hospital and Crease Clinic a good many changes are taking place.
There has been an increased development of the open wards. The use of tranquillizing
drugs has opened up new therapeutic avenues. There has been a decrease in the use
of coma insulin therapy. As a result of these changes, an increasing number of patients
are now being treated in the Occupational and Recreational Therapy Departments.
Radical changes have been carried out in the reorganization of the Occupational
Therapy Department and the Dietary Department. Changes have been made in the
admission policy in the Crease Clinic, which allow for more selectivity in the type of
patient admitted and closer co-operation with the certifying physician. The increased
tempo of therapeutic activity in the Mental Hospital has resulted in an increased discharge rate and will ultimately reduce the number of long-term in-residence patient popu- HEADQUARTERS Q 25
lation. In the meantime this increased therapeutic activity and discharge rate in the
long-term patient group has very greatly reduced the working-class of patient, upon whom
mental hospitals have heretofore been dependent in their operation. Increased numbers
of personnel will therefore be required if we are to carry out our business of getting
people well and back home as quickly as possible.
The Essondale district has been designated as a Civil Defence area. I am pleased
to report that under the direction of the Medical Superintendent, who has been named
as Co-ordinator, Civil Defence planning is well organized in light of present-day knowledge.
Details of these and the many other activities of the Crease Clinic and Mental Hospital may be found in the report of the Medical Superintendent.
The branch mental hospital at Colquitz continues in its function of caring for a
group of treatment-resistant patients, many of whom have been certified by Order in
Council. A great deal of conversion work has been carried out with a better allocation
of space for increased patient activities. No definite decision has been reached with
reference to the future of this institution, but it is hoped that long-range planning may
provide for the accommodation of this group of patients elsewhere.
The most pressing need for increased and improved services over the past few years
has been in the area of mental retardation. While the opening of a large new unit at
The Woodlands School will improve this situation, it will not accommodate the number
of patients currently on the waiting-list. Due to greatly increased public interest and a
better community understanding of the problems of retardation, many of these children
are being cared for in private community schools. This very fine work of the Association
for Retarded Children is detailed elsewhere in this Report. However, in spite of this
present trend, the demand for in-residence tuition and care will continue to be a problem
within the jurisdiction of our service. The present site of The Woodlands School will
not allow for further expansion, and serious consideration must be given to the siting
of a new location if we are to meet the requirements of this very important division. The
Medical Superintendent in his report has made some very significant statistical studies
which are relevant to the problem. Many internal changes have taken place within the
School during the year. Open rehabilitation wards have been established, and the general orientation of the School has been greatly improved.
The Geriatric Division has operated to capacity during the year. Applications
for admission have stabilized over the past two years and average twenty-eight per month.
The opening of the new unit now under construction will bring the total number of beds
in this Division to 1,400, which will not, however, meet present demands for this type
of service.
It is felt that an evaluation of all services in the Province for the elderly citizen is
required before further expansion of this Division can be recommended.
The work of the Child Guidance Clinics is detailed in reports and tables covering
all phases of their activities. The teams are not able to handle the volume of work
referred to them, and it has not been possible to expand this service during the past few
years. There is ample work for additional teams, which should be developed as quickly
as is feasible.
The Mental Health Centre was opened for service on January 2nd, 1957, and has
operated for three months during the current fiscal year. It is operating a minimal service, but already is well integrated into the Mental Health Services and into the community agencies which it serves. Provisions have been made for the expansion as additional staff can be obtained. Present indications are that psychiatric treatment trends
will be to treat the patient in the community as close to his home as possible with early
rehabilitation. The Mental Health Centre is our first effort in this direction. Q 26 MENTAL HEALTH SERVICES REPORT, 1956-57
UNIVERSITY OF BRITISH COLUMBIA
Close association with the University of British Columbia has continued throughout
the year, particularly in the Faculty of Medicine, the School of Nursing, and the School
of Social Work. Numerous cross-appointments from our service and those of the University continue to enhance our work as well as our teaching programme. Small groups
of final-year medical students have spent two weeks as resident clinical clerks in the
Crease Clinic and Mental Hospital. The Professor of Surgery continues to supervise the
work of the Department of Surgery in the Crease Clinic. The resources of other departments in the faculty are used as necessity arises.
Several meetings have been held with reference to the development of a University-
sponsored graduate-training programme for our residents in psychiatry. Temporary
arrangements have been made whereby we have been able to draw freely from the University staff for lecturers, but the actual development of a full University-sponsored training
programme has been deferred until the appointment of a full-time professor in the Department of Psychiatry.
Former arrangements with the Department of Neurological Research under Professor
W. C. Gibson continue. This is assisted from a financial grant from the Department of
the Provincial Secretary. Individual research projects are financed under a Federal
Mental Health Grant.
The National Advisory Committee on Mental Health appointed a special sub-committee in 1955 to carry out a complete study with reference to the training of nurses in
mental hospitals. The sub-committee was asked " to explore a curriculum and study the
administrative arrangements which would be necessary to establish a combined programme." It was hoped that a satisfactory standard might be evolved for the dual training of registered nurses and psychiatric nurses which would be acceptable to all Provinces.
It was hoped that once such a curriculum was evolved a pilot training project might be
initiated in British Columbia. Miss Evelyn Mallory, Director of the School of Nursing
at the University of British Columbia, has chaired this committee. A great deal of work
has been done by this committee, and it is expected that the final results may be referred
to the National Advisory Committee soon.
VANCOUVER SCHOOL BOARD
The in-service training programme for special counsellors sponsored by the Vancouver School Board was established in 1955. It is supported by the Provincial Department of Education, the Vancouver School Board, and a grant from the Federal Mental
Health Grant. The course of training is limited to a select small group of senior teachers
who are experienced in counselling. It is designed to familiarize them with the principles of child development, with specific relation to mental-health implications. The
course covers one academic term and brings the student into close contact with all mental-
health disciplines. Practical field experience is given in all institutions and social agencies. On completion of the course, the teacher-counsellors return to their schools. This
is a very fine example of mental-health principles functioning at the community grass
roots in dealing with behaviour problems found in the school-child. It is also a very fine
example of three governmental levels co-operating in a very worth-while programme.
During the two years which this course has been operating, fifteen teachers have been
trained. Thirteen of these have been from Vancouver and one each from the Districts
of Richmond and Surrey. The training course is very capably directed by Mr. Russell
K. MacKenzie.
VOLUNTARY AGENCIES
The mental-health field was one of the later areas in which voluntary agencies were
developed. The role of the voluntary agencies is becoming more clearly defined and their HEADQUARTERS Q 27
contribution becoming greater with the passage of each year. Close liaison with all such
agencies is maintained, and much has been accomplished as a result of their efforts.
CANADIAN MENTAL HEALTH ASSOCIATION,
BRITISH COLUMBIA DIVISION
The fourth annual meeting of the above association was held on January 31st,
1957. The association has shown a phenomenal growth during the four years of its
operation. In addition to a strong Provincial division, the association has developed
branches in Vancouver, Victoria, Nanaimo, and Trail. The work of the division is
carried out by many committees. All departments and divisions of the Mental Health
Services participate actively in committee work, resulting in close co-operation between
the two organizations. The volunteer services continue to expand, and at the present
time over 100 volunteers are engaged in this work. One cannot speak too highly of the
work of this group and the great benefit which the patients receive as a result of their
activities. The volunteer programme is active in the Crease Clinic, the Mental Hospital,
and the Home for the Aged, Port Coquitlam. More specific details of the value of this
work will be found in the Medical Superintendents' reports.
The staff of the Provincial division is headed by Mr. James D. Ward, executive
director. The rapidly expanding day-to-day operations are under the direction of Mr.
Ward, and the Mental Health Services would like to commend him for the very efficient
job which he is doing. Mr. George W. Kenwood has recently been appointed executive
secretary to the Vancouver and Lower Mainland branch. Mr. Kenwood comes to the
position with many years of experience in the Mental Health Services, which will familiarize him with many aspects of his new position.
The British Columbia Division of the Canadian Mental Health Association receives
financial support from the Community Chest and Council for that portion of its programme devoted to the Greater Vancouver area, from membership fees, and from a
grant from the Provincial Secretary's Department.
ASSOCIATION FOR RETARDED CHILDREN OF
BRITISH COLUMBIA
The association has shown a remarkable expansion during the past year. There
are now twenty-two chapters covering twenty-six cities and caring for well over 300
retarded children. The schools are operated on a private-school basis. The Department of Education makes the same per pupil grant to the association as it makes to the
various School Boards. A meeting was held on April 9th, 1956, at which representatives from the association met with representatives of the Departments of Education and
the Provincial Secretary to draw up certain regulations necessary for the administration
of the 1956 amendment, section 138a, of the " Public Schools Act." A very satisfactory
meeting was held, and rules and regulations were drawn up which were satisfactory to
all concerned.
Two requests have been made for assistance from our department. First was a
request to establish a travelling screening team to assess retarded children for entrance
into the special community schools. Second was a request for advice in obtaining help
in establishing sheltered workshops and hostels for self-supporting older groups of
retarded. The first request is a responsibility which our department should carry, and
it is hoped that a travelling unit may be developed as staff becomes available. In the
meantime the services of the Medical Superintendent of The Woodlands School have
been used as a travelling consultant in the development of the community schools.
The School of Education of the University of British Columbia sponsored a week's
teacher-training course at the University during the summer for the teachers of the com- Q 28 MENTAL HEALTH SERVICES REPORT, 1956-57
munity retarded school. One full day was spent at The Woodlands School, and the staff
of the school participated in the instructional programme. A total of forty-five teachers
were registered, including practically all of the areas in which chapters of the association
have been formed. The Woodlands School continues to offer in-service experience in
teaching retarded children to the teachers of the various chapters.
The educational work of the association has done much to interpret the problem
of the retarded in the community as well as interpreting the function of The Woodlands
School. Our relationships with the association have been most congenial, and we believe
that its development heralds a new era for the retarded of the Province. Financial assistance to the headquarters of the association is provided by the Department of the Provincial Secretary in the nature of an annual grant.
Special mention should be made of the British Columbia Society for Handicapped
Children, an affiliated chapter of the Association for Retarded Children of British Columbia. This New Westminster branch has formed an auxiliary to The Woodlands
School and provides many personal services to the patient-pupils in the school. These
services range from personal visiting, letter-writing, and shopping to recreational outings
for larger groups. The chapter, with assistance from local merchants, has provided the
Tina Mowat Clubroom for use of patients of the school who have town privileges. In
addition, the auxiliary provides accommodation for out-of-town parents who are visiting
and counselling to parents during the early stages of adjustment, through which every
parent passes who has a retarded child. This is a volunteer service which we greatly
appreciate and would like to see extended.
THE ALCOHOLISM FOUNDATION OF BRITISH COLUMBIA
The foundation concluded its third year of operation and reports considerable progress during the year ended March 31st, 1957. The foundation offers treatment on both
an out-patient and residential care basis. The introduction of a residential rehabilitation
programme has to some extent reduced the number of voluntary applicants seeking
admission to the alcoholic service of the Mental Hospital. Dr. W. E. Powles continues
to represent the Mental Health Services on the board of directors.
THE NARCOTIC ADDICTION FOUNDATION OF BRITISH COLUMBIA
Although the foundation has not been able to realize its aim to become functional
during the current year, a great deal has been accomplished in developing a working
relationship with welfare agencies and other departments interested in the problem of
addiction. Dr. A. E. Davidson continues to represent the Mental Health Services on
the board of directors.
MENTAL HEALTH GRANT
The Government of Canada, through its Department of National Health and Welfare, made available to this Province a Mental Health Grant " to assist in an extended
programme for the prevention and treatment of mental illness, including rehabilitation
and free treatment." This is the ninth year that the Mental Health Grant has been
available.
The grant provided this year was set at $608,954, but this was found to be insufficient. The Federal officials agreed to transfer $70,000 from the Laboratory and Radiological Services Grant, thereby making a total of $678,954 available for mental-health
projects. Projects totalling $667,833.67 or 98.3 per cent of the grant were submitted
and approved. Expenditures made and claims submitted to the Federal Treasury by
March 31st totalled $598,600.46 or 88.1 per cent of the grant. HEADQUARTERS Q 29
The continued sympathetic understanding and support of the officials of the Department of National Health and Welfare are hereby gratefully acknowledged.
The major areas of expenditure this year are detailed hereunder.
PROFESSIONAL TRAINING
Bursaries for postgraduate training in the several specialties composing the psychiatric team were
provided, as follows:—
Dr. F. G. Tucker completed a year of postgraduate study in the Department of Psychiatry,
McGill University, Montreal, in August, 1956.
Mr. R. A. Baker completed his postgraduate studies in the Department of Biochemistry, University of British Columbia, in May, 1956.
Mrs. M. L. McKay completed the course in supervision in psychiatric nursing at the School of
Nursing, University of British Columbia, in lune, 1956.
Dr. A. E. Davidson, Mr. F. A. Matheson, and Mr. J. Dowling attended the Eighth Mental Hospital Institute of the American Psychiatric Association held in Denver, Colo., in October.
Miss F. MacDonald and Mrs. B. Lipinski, clinical psychologists from the Child Guidance Clinics,
attended the Institute on Protective Techniques sponsored by the Psychiatric Services Branch of the
Saskatchewan Department of Health in Saskatoon in May.
Mr. T. G. Dodsworth, Co-ordinator of Volunteers for the Provincial Mental Hospital and Crease
Clinic, attended the Laboratory on Group Development in Seattle in luly.
Mrs. A. J. Allan, social worker at the Victoria Child Guidance Clinic, attended the Case Work
Institute of the Family Service Association of America held at Lake Wilderness, Wash., in September.
Five senior registered nurses occupying administrative positions at the Crease Clinic and Provincial Mental Hospital attended an institute on " Interpersonal Relationships in Nursing Services "
sponsored by the School of Nursing, University of Washington, Seattle, in March.
Mr. Alan M. Clark commenced a year of graduate study in clinical psychology at McGill
University in October.
Dr. M. O. Calverley commenced a year of postgraduate study in psychiatry at McGill University
in September.
EQUIPMENT AND SUPPLIES
Provincial Mental Hospital, Essondale.—The following equipment has been provided:—
The complete equipment required to establish a dental clinic in the North Lawn Building.
A Gomco suction pump for an infirmary ward in the West Lawn Building.
An infra-red lamp, an ultra-violet lamp, and a paraffin arm and hand bath were supplied to
the West Lawn Building to assist in the establishment of a physiotherapy department to
serve the new neurological ward.
A Gomco suction pump for the Riverview Building at Colony Farm.
Crease Clinic of Psychological Medicine.—A Spencer rotary microtome was provided for the
laboratory.
The Woodlands School.—Technical equipment for examination, diagnosis, and treatment to be
used in the Fraser View unit to be opened in 1957. This equipment is valued at $28,000.
Provincial Mental Home, Colquitz, Vancouver Island.—An electric kiln for ceramic work in the
Occupational Therapy Department was provided.
Home for the Aged, Vernon.—A dental chair with panovision lamp and dental engine were
supplied to be used by the visiting dentist.
A hair drier was supplied to the women's ward.
Three wheelchairs were supplied.
COMMUNITY MENTAL-HEALTH PROGRAMMES
The grant providing assistance to the British Columbia Division of the Canadian Mental Health
Association was continued, but for only $1,250. This is the last year the Canadian Mental Health
Association will be assisted by the Mental Health Grant.
The programme of the Mental Hygiene Division of the Metropolitan Health Committee of
Greater Vancouver continued to receive support by the provision of salaries for one psychiatrist, two
psychologists, two social workers, and one stenographer.
The course to train senior school counsellors in mental hygiene was continued by the Vancouver
School Board. Another group of eight teachers was instructed. The project continued to provide
the salary of the training co-ordinator. Q 30 MENTAL HEALTH SERVICES REPORT, 1956-57
PSYCHIATRIC SERVICES IN GENERAL HOSPITALS
The psychiatric services of the Vancouver General Hospital continued to receive assistance.
This year the addition of a full-time clinical psychologist to the staff was approved, and the salaries
of the social worker, occupational therapist, and medical stenographer were also provided.
Equipment and supplies to establish a department of clinical psychology were provided by the
project.
The Royal lubilee Hospital, Victoria, was assisted by the provision of a full-time occupational
therapist for the psychiatric services.
PERSONNEL FOR MENTAL HEALTH SERVICES
The stipends for consultants in the specialties of neurosurgy, general surgery, orthopaedic surgery,
and internal medicine are provided by a project.
The Rehabilitation Department continues to be assisted by a project which provides the salary
and travel allowance for the Rehabilitation Officer.
The various hospitals and clinics of the Mental Health Services continue to be assisted in the
provision of personnel by the payment of salaries to staff as in previous years.
RESEARCH PROIECTS
Several major research projects receive support from the Mental Health Grant, and the Department of Neurological Research of the University of British Columbia continued as the agent of the
Mental Health Services in these studies.
Projects this year covered the following: Aromatic Metabolism in Schizophrenia, Structural
Factors in Mental Disease, Etiological Factors in Mental Deficiency, Animal Experiments in the
Biochemistry of Schizophrenia, and Structural Identification of Aromatic Compounds in Schizophrenic
Urine.
The Department of Pharmacology in the Faculty of Medicine has conducted studies on the
Pharmacological Analysis of Pathways Leading to Diffuse Enhancement of Cortical Electrical
Activity.
COUNCIL OF PSYCHIATRIC NURSES
The 1956 annual meeting of the Council of Psychiatric Nurses was held at Essondale on April 27th. The usual routine business was transacted. The British Columbia
Psychiatric Nurses' Association reported that its education committee had made a thorough study of the syllabus in mental nursing prescribed by the General Nursing Council
of England and Wales. They concluded that graduates of the English course had
attained an acceptable standard of proficiency in psychiatric nursing and recommended
that they be licensed to practise in British Columbia without further examination. The
council passed a motion to this effect.
The chairman requested the British Columbia Psychiatric Nurses' Association to
instruct its education committee to review the courses in psychiatric nursing offered in
the Provincial institutions of Manitoba and to make recommendations to the council at
its next meeting.
The annual surplus accruing in the administration of the Act was noted, and a
motion passed suggesting to the Minister that this surplus be utilized in furthering education for licensed psychiatric nurses.
The second meeting of the council was held on December 19th. The British Columbia Psychiatric Nurses' Association reported that they had reviewed courses in
psychiatric nursing prescribed for Manitoba, Alberta, Saskatchewan, England, Scotland,
Wales, and Northern Ireland. They found all to be of an acceptable standard and recommended that graduates of any of these courses be accepted for licensing in British Columbia without the need for further examination. The council passed a motion to this
effect.
It was reported to the council by the Deputy Provincial Secretary that the Minister
approved the suggestion of using the revenue surplus accruing in the administration of
the Act for furthering the education of licensed psychiatric nurses. The council passed HEADQUARTERS Q 31
a motion empowering the chairman to appoint a sub-committee on bursary policy to
report to the next meeting.
It was drawn to the attention of the council by the British Columbia Psychiatric
Nurses' Association that several mental-deficiency nurses had been licensed under the
" Psychiatric Nurses Act." A motion was passed requesting the Minister to amend the
Act in order that mental-deficiency nurses might come within its scope.
The registrar reported that on December 31st, 1956, there were 1,006 psychiatric
nurses licensed to practise in the Province.
STAFF CHANGES
As mentioned earlier in this Report, the total staff turnover was 35.6 per cent.
Many of these resignations have been in the professional-staff areas. The loss of highly
skilled employees greatly impedes our service. The usual changes occurring during the
year due to our psychiatric residency training programme are anticipated. Most of the
members of our resident staff remain with us for a two-year period, and we have had no
difficulty in replacing those who have completed their two-year training. We were, however, unfortunate in losing two senior residents from our permanent staff. In addition,
we had the misfortune to lose two specialists in psychiatry, Dr. E. E. Leyland and Dr.
R. L. Skwarok. The services of these two specialists could have been retained if salaries
had been adequate.
Dr. C. E. Benwell, Medical Superintendent at The Woodlands School, retired by
superannuation on October 31st, 1956. Dr. Benwell completed thirty-four years of
uninterrupted service, joining the staff on October 5th, 1922. The majority of Dr. Ben-
well's service was spent at the New Westminster branch, where he became Deputy Medical Superintendent when that institution was devoted to the care of the mentally retarded.
Dr. Benwell assumed the position of Medical Superintendent on the retirement of Dr.
L. E. Sauriol.
We were very fortunate in finding a successor for the position of Medical Superintendent at The Woodlands School in the person of Dr. L. A. Kerwood. Dr. Kerwood
received his medical education at Dublin University and holds a diploma in psychological
medicine from that university. He entered the field of mental deficiency in 1948, when
he served as Senior Medical Officer and later Acting Medical Superintendent at Heck-
ingham Institution, Norfolk. In 1951 Dr. Kerwood was appointed Deputy Medical
Superintendent of the Cell Barnes Hospital for Mental Defectives, Hertfordshire, which
position he held until coming to Canada in 1954. Prior to joining our services, Dr.
Kerwood was employed in the Ontario Hospital Services at the School for Mental Defectives at Smith Falls. Throughout his career Dr. Kerwood has maintained great interest
in clinical research and has undertaken several studies in the specialized field of mental
retardation.
The staff of the Vancouver Child Guidance Clinic was greatly strengthened with
the appointment of Dr. M. A. Menzies. Dr. Menzies is a graduate of Queen's University and has completed postgraduate studies at the University of Toronto. He is certified
in the specialty of psychiatry and has had several years of experience in child-guidance
work. Prior to joining our services on August 27th, 1956, Dr. Menzies was assistant
psychiatrist to the Division of Mental Hygiene, Metropolitan Health Committee, Vancouver. Dr. Menzies comes well trained in child-guidance work and is a welcome addition to our child-guidance staff.
Several promotions occurred in the senior medical staff. Dr. John Walsh was appointed as Deputy Medical Superintendent at the Mental Hospital and Crease Clinic.
Dr. I. S. Kenning was appointed Clinical Director in the Crease Clinic and Mental Hospital, replacing Dr. F. E. McNair, who took over the new position of Director of the
Mental Health Centre. Q 32 MENTAL HEALTH SERVICES REPORT, 1956-57
The following staff members terminated service by superannuation: Mr. G. Fitch,
assistant charge psychiatric nurse, Essondale; Mr. A. Buchanan, psychiatric nurse,
Essondale; Mr. R. Gibson, charge psychiatric nurse, New Westminster; Mr. J. Gill,
charge psychiatric nurse, New Westminster; Mr. A. G. Rikley, psychiatric nurse, Essondale; Mr. H. H. Sutton, upholsterer, Essondale; Mr. W. A. Wardle, chief cook, Essondale; Mr. E. Robinson, psychiatric nurse, Essondale.
I regret to report the following deaths which occurred while in service: Mr. P. J.
McLeod, chief psychiatric nurse, Colquitz, and Mr. R. G. Statton, charge psychiatric
nurse, Essondale.
ACKNOWLEDGMENTS
Sincere gratitude goes out to the many community and social agencies which have
been closely associated with us in the promotion of better mental health.
I would like to acknowledge the co-operation which we have had with all departments of government with whom our work has brought us into close association.
The administration of our large service has kept our headquarters staff in close
association with our own Minister and Deputy Minister, and we are grateful for the close
integration which we have had in the Department of the Provincial Secretary.
The relationships within our various facilities have been congenial. Our family of
services is growing and becoming more widespread, but every effort possible has been
made to keep all members of the family group integrated into a unit in which the individual institution has its own autonomy. As a result, the functions of the headquarters
staff are becoming more clearly defined.
In concluding I would like to express appreciation for the assistance and help rendered by the executives of the British Columbia Government Employees' Association
and the British Columbia Psychiatric Nurses' Association. The latter organization has
been particularly helpful in the Council of Psychiatric Nurses.
I have the honour to be,
Sir,
Your obedient servant,
A. M. Gee, M.D., CM.,
Director of Mental Health Services. HEADQUARTERS
Q 33
COMPARATIVE SUMMARY OF INCREASES AND DECREASES IN RESIDENT
POPULATION BY MAJOR DIVISIONS OF PROVINCIAL MENTAL
HEALTH SERVICES, 1952-53 TO 1956-57.
Institution
1952-53
1953-54
1954-55
1955-56
1956-57
—64
+277
+49
+28
+62
+ 104
+50
— 1
+44
+ 19
0
+25
+2
+ 19
+ 15
— 10
—70
The Woodlands School _ _
+ 14
+9
—31
+290
+215
+88
+26
—78
COMPARATIVE SUMMARY OF TOTAL PATIENTS UNDER CARE FOR MAJOR
DIVISIONS OF PROVINCIAL MENTAL HEALTH SERVICES BY FISCAL
YEARS, 1952-53 TO 1956-57.
Institution
1952-53
1953-54
1954-55
1955-56
1956-57
Provincial Mental Hospitals..
The Woodlands School
Homes for the Aged-
Crease Clinic _
Totals
5,227
1,130
1,202
1,436
5,040
1,278
1,255
1,499
5,051
1,263
1,292
1,606
5,247
1,278
1,330
1,894
5,335
1,275
1,287
1,721
8,995
9,072
9,212
9,749
9,618 Q 34
MENTAL HEALTH SERVICES REPORT, 1956-57
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H O HEADQUARTERS Q 35
BUSINESS MANAGER'S REPORT
F. A. Matheson, Business Manager
Herewith for your consideration is my report on the business operations of the
Provincial Mental Health Services for the fiscal year ended March 31st, 1957, together
with the financial tables and statements covering the operation of the various units for the
year under review.
As per Table A, the over-all daily average patient population was 6,316.60, a
decrease of 11.09 from the previous year.
Gross operating costs jumped from $10,293,638 to $11,125,468 and the daily per
capita cost from $4.44 to $4.83. This increase can be chiefly attributed to a stepped-up
treatment programme and a steady rise in food prices, particularly in meats and meat
products.
To return to the medical field, our operating-room in the Crease Clinic shows a total
of 650 surgical operations performed last year, as against 130 five years ago when the
theatre began to function. This increased service has an obvious effect on surgical supply
requirements and surgeons' fees, as reflected in our costs.
Also, purchases of the tranquillizer drugs have increased during the year. For example, Largactil purchases increased from $63,375 in 1955—56 to $145,375 in 1956-57.
This increase, I might add, occurred despite a decrease in unit price of this drug.
During the year the Colony Farm supplied the Mental Health Services with dairy
products, meats, fruits, and vegetables with a value in excess of $475,000.
The Federal health grants continue to be of great assistance in providing personnel,
personnel training, and equipment to our mental hospitals. A total of $598,600.46
benefit was derived from this source during 1956—57, details of which are provided in a
statement included in this report.
A contract was let by the Public Works Department, in the amount of $985,667, for
a new nurses' home and training centre at Essondale in April. The contractor has made
excellent progress on this building during the year, and it is hoped that it will be completed about the middle of next year.
Plans have been completed for an extension to our boiler-house at Essondale, and a
contract in the amount of $543,035 was let for two additional high-pressure boilers, one
of which is to be installed next year. Although the main contract for this extension was
not let during this year, a contract to supply, fabricate, and erect the structural steel, in
the amount of $56,890, was let. This extension to the boiler-house will also provide for
the eventual installation of turbo-generators in order that we may generate our own electric
power. It is expected that work on this addition to our boiler-house will start early
next year.
Tenders were called and a contract let, in the amount of $415,655, for a new auditorium and swimming-pool at The Woodlands School. Owing to unforeseen difficulties,
the contractor got off to a poor start on this building; however, by the end of the year he
was making excellent progress.
I am pleased to advise that the new 300-bed Fraser View Building at The Woodlands
School was completed, furnished, and equipped by the end of the year, and plans have
been completed to transfer the first group of patients to this building on April 15th, 1957.
A new sewer system for the Essondale area was completed and placed in operation
on November 7th, 1956.
The Public Works Department completed the plans for the new Industrial Therapy
Building for Essondale, and it is hoped that construction on this building will start
next year.
The old Child Guidance Clinic buildings in Vancouver have been converted and
equipped for a Male Rehabilitation Centre. Q 36 MENTAL HEALTH SERVICES REPORT, 1956-57
Security patrols were started at both Essondale and The Woodlands School, and the
grounds at both institutions are now patrolled by members of the Commissionaire Corps
of British Columbia between the hours of 3.30 p.m. and 8 a.m.
The Mental Health Centre, located in the new Child Guidance Clinic and Mental
Health Centre building, Burnaby, was opened for the reception of patients on January
2nd, 1957. Dr. F. E. McNair was appointed Director of this new service.
A major change in the food service was started at Essondale during the year, and an
eight-week menu rotation was put in operation. A further change was also made, and
dinner is now the last meal of the day instead of the noon meal. It is felt that these
changes have made a great improvement in our food service to both patients and staff.
Our Audio-Visual Department completed a 16-mm. film showing all the auxiliary
services of the British Columbia Mental Health Services. This film will be used to
orientate new staff, especially new classes of student-nurses. The film was first shown to
the Select Committee on Education and Social Welfare of the Legislature on March 5th,
1957.
A monthly publication known as the " Mental Health Services News " was started in
March, 1957. This publication is distributed to all the staff in the Mental Health Services
and contains information of interest to our staff.
Monthly meetings of the headquarters staff with the superintendents of the various
units of the Mental Health Services was also started in March, 1957.
On December 9th, 1956, the Lower Mainland had some very heavy rain-storms.
Fortunately, at Essondale, we suffered no major damage, although nearly all basements
flooded, as did some ground-level areas. However, at The Woodlands School, on four
separate occasions, water flooded the boiler-house floor from 2 to 8 inches, and it was
only with a great deal of difficulty that we were able to keep the plant operating. Remedial
action has been taken by the Department of Public Works.
During the year four television sets for The Woodlands School and an electric range
for the J 3 cooking classes at Essondale were purchased from the Patients' Comfort Fund.
A complete reorganization separating the Industrial Therapy and the Occupational
Therapy Departments was made during the year.
STAFF
Mr. R. Lavigne was appointed head butcher on April 3rd, 1956.
Mrs. M. E. Marr was appointed Administrator of Dietetics on May 14th, 1956.
Dr. L. A. Kerwood was appointed Superintendent of The Woodlands School on
August 2nd, 1956.
Dr. C. E. Benwell, Superintendent of The Woodlands School, retired on superannuation on October 31st, 1956.
Miss O. Lipsey, Assistant Director of Nursing, Essondale, was appointed Superintendent of Nurses and Deputy Supervisor of the Home for the Aged, Vernon, on May
1st, 1956.
Mr. W. Wardle, Chief Cook, retired on superannuation on August 31st, 1956.
Dr. J. Walsh was appointed Deputy Medical Superintendent, Provincial Mental
Hospital and Crease Clinic, Essondale, on October 30th, 1956.
Mr. C. Doyle, Foreman of Works, The Woodlands School, retired on superannuation
on November 30th, 1956.
Dr. F. E. McNair was appointed Director of the Mental Health Centre, Burnaby,
on May 15th, 1956.
Dr. I. S. Kenning was appointed Clinical Director, Essondale, on November 1st,
1956.
Mr. A. Fraser, former steward at The Woodlands School, died on January 12th,
1957. HEADQUARTERS Q 37
Mr. P. T. McLeod, Chief Psychiatric Nurse, Provincial Mental Home, Colquitz, died
February 14th, 1957.
I am pleased to be able to again report that during this fiscal year under review a
large number of improvements and additions to our plants and equipment were made.
Some of the main items of interest in this regard are as follows:—
ESSONDALE
A new dental office was provided in the North Lawn Building.
New swill-houses were constructed at H.A. 6 and 7 and H.A. 8 and 9.
The dayrooms on Ward F 2 were completely refurnished.
New dining-room chairs were supplied to the Home for the Aged kitchen block.
Work was started to replace the floors on all wards in the West Lawn Building.
Alterations to North Lawn infectious wards were completed.
Installation of the new 12-inch water-main and 8-inch loop were completed.
A new fire-alarm system was installed in the West Lawn Building.
A new fence and playing-field were provided for the male airing-court.
New toilet facilities were provided at Hillside playing-field.
Work continued this year in improving and providing additional parking facilities.
Work continued on the new reservoir.
The ventilating system in the West Lawn Building was completely revamped.
The Crease Clinic building was redecorated throughout.
The Crease Clinic kitchen block was remodelled and redecorated.
A sprinkler system was installed in the mattress-shop, North Lawn Building.
A new floor was laid in the laboratory of East Lawn Building.
The four-channel central radio system was installed in all wards of the West Lawn Building,
Centre Lawn Building, East Lawn Building, and the west side of the Crease Clinic.
A new fence was provided for the female airing-court.
A start was made on alterations to the butcher-shop.
New airing-courts were provided for H.A. buildings 2, 3, 4, and 5.
The following is a list of major new equipment purchased during the year:—
1 tractor for the Gardening Department.
1 power wagon to be used as a utility truck and for snow-ploughing.
4 replacement trucks.
1 quintuplet 100-foot aerial-ladder fire-truck.
Laundry—
2 extractors.
3 washing-machines.
1 flat-work ironer and folder.
5 driers.
2 sets of sleevers.
2 garment driers.
1 set of steam puffers.
1 dry-cleaning drier.
1 pant shaper.
2 coat sleevers.
1 nurses' uniform sleever.
THE WOODLANDS SCHOOL
The Public Works Department is working on plans for a complete renovation of the main kitchen.
Work is continuing on the new playground.
The new equipment-shed and root-house were completed.
The lower section of the storm-sewer system was installed.
A new parking-lot to accommodate 125 cars was provided.
Work was started on converting Nurses' Home No. 1 into accommodation for patients.
Major improvements were made in the fire-alarm system.
PROVINCIAL MENTAL HOME, COLQUITZ
Major alterations were made in the basement section, part of which was formerly occupied by the
Stores Department. This general area now provides new and improved accommodation for the tailor-
shop, inside occupational-therapy shop, scullery, dining area, and patients' lounge. Q 38 MENTAL HEALTH SERVICES REPORT, 1956-57
A considerable amount of new furniture was purchased during the year.
The new sewage-disposal plant was completed.
HOME FOR THE AGED, VERNON
An evaporative cooling unit was installed in the annex building.
The interior of the annex and the dayrooms and corridors of the main building were redecorated.
The roofs of all the buildings were stained.
A new tractor was purchased.
A new battery of urns was installed in the kitchen.
The old concrete tennis-court was removed and replaced by lawn.
A new dental chair and necessary equipment was purchased under Federal health grants.
Major improvements and additions were made to the electrical-power distribution system.
A new commercial-type vacuum-cleaner and combination floor washing, waxing, and polishing
machine was purchased.
HOME FOR THE AGED. TERRACE
A reconditioned stoker was installed in the boiler-house.
The new well was completed and temporary pump installed.
Dictating equipment was purchased.
The paint-shop was completed.
Extensions to the garage were made.
CHILD GUIDANCE CLINIC AND MENTAL HEALTH CENTRE
A contract was let and work started on a number of additions and alterations to this unit, consisting of the following:—
Cupboards, etc., for the Occupational Therapy Department.
Changes in the kitchen. !'i
Provision made for staff change-rooms.
New garbage and dirty-linen house.
Building for storing outside equipment.
Additional parking facilities, etc.
I regret to have to again report that, in spite of the large number of improvements
and major additions to our plants made this year, a great deal of difficulty is still being
experienced by our Public Works Department in keeping up with our maintenance demands. However, toward the end of the year a number of casual employees, including
ten additional painters, were hired in an attempt to improve this situation.
A separate report has been prepared covering the operation of Colony Farm.
In closing, I would like to express my appreciation of the many courtesies shown
and the close co-operation that has been maintained between the various departments of
the Government and the Provincial Mental Health Services at all times. HEADQUARTERS
FINANCIAL TABLES
Q 39
Table A.—Showing the Average Number of Patients in Residence Each Year,
the Total Amounts Spent for Maintenance, and the Gross Yearly and
Daily per Capita Cost, 1947-48 to 1956-57.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1947-48
Provincial Mental Hospital, New Westminster-
Provincial Mental Hospital, Essondale
Provincial Mental Home, Colquitz
Home for the Aged, Port Coquitlam
Totals for the year
1948-49
Provincial Mental Hospital, New Westminster-
Provincial Mental Hospital, Essondale.
Provincial Mental Home, Colquitz...
Home for the Aged, Port Coquitlam... —
Home for the Aged, Vernon—
Totals for the year —
1949-50
Provincial Mental Hospital, New Westminster-
Provincial Mental Hospital, Essondale
Provincial Mental Home, Colquitz
Home for the Aged, Port Coquitlam
Home for the Aged, Vernon
Totals for the year
1950-51
Provincial Mental Hospital, New Westminster-
Provincial Mental Hospital, Essondale -
Provincial Mental Home, Colquitz
Home for the Aged, Port Coquitlam
Home lor the Aged, Vernon
Home for the Aged, Terrace
Crease Clinic
Totals for the year
1951-52
Provincial Mental Hospital, New Westminster-
Provincial Mental Hospital, Essondale
Provincial Mental Home, Colquitz
Home for the Aged, Port Coquitlam..
Home for the Aged, Vernon
Home for the Aged, Terrace
Crease Clinic
Totals for the year ,
1952-53
Provincial Mental Hospital, New Westminster-
Provincial Mental Hospital, Essondale
Provincial Mental Home, Colquitz
Home for the Aged, Port Coquitlam
Home for the Aged, Vernon
Home for the Aged, Terrace
Crease Clinic
Totals for the year..
1953-54
The Woodlands School
Provincial Mental Hospital, Essondale..
Provincial Mental Home, Colquitz
Home for the Aged, Port Coquitlam
Home for the Aged, Vernon
Home for the Aged, Terrace
Crease Clinic
Totals for the year-
628.00
3,275.41
290.31
326.75
631.75
3,394.08
287.76
372.03
119.68
4,805.30
650.83
3,556.78
287.02
380.15
202.57
5,077.35
763.81
3,425.98
286.82
384.74
231.42
74.07
192.52
799.^7
3,485.14
282.68
381.03
216.43
208.97
188.82
949.24
3,440.34
284.7i'
442.94
224.18
292.07
230.77
1,150.76
3,491.15
285.28
469.13
228.26
293.19
235.16
6,152.93
$662,357.80
2,622,349.15
298,773.55
243,861.27
4,520.47 $3,827,341.77
$800,776.92
3,162,819.02
356,110.21
339,606.91
150,706.50
$4,810,019.56
$891,944.27
3,500,902.41
384,874.24
374,093.25
215,009.96
$5,366,824.13
$1,081,062.76
3,419,312.37
388,744.44
437,282.20
244,853.02
139,016.27
525,256.87
5,359.36 $6,235,527.93
$1,284,649.25
4,021,001.69
407,123.16
504,668.17
309,649.05
265,697.50
689,466.11
5,562.54 $7,482,254.93
$1,590,703.00
4,441,278.38
433,108.50
617,445.55
384,971.73
325,842.57
759,406.04
5,864.33 | $8,552,755.77
$1,768,922.31
4,393,682.65
421,622.61
683,511.48
378,006.20
330,968.40
788,302.36
1,765,016.01
$1,054.70
800.62
1,029.15
746.33
$846.67
$1,267.55
931.86
1,237.52
912.85
1,259.24
$1,000.98
$1,370.55
984.29
1,340.93
984.07
1,061.41
$1,057.01
$1,415.35
998.05
1,355.36
1,136.56
1,058.05
1,876.82
.2,728.32
~$1,163.48~
$1,606.88
1,153.75
1,440.23
1,324.48
1,430.71
1,271.46
3,640.85
$1,345.11
$1,675.76
1,290.94
1,520.80
1,393.97
1,717.24
1,115.63
3,290.75
$1,424.53
$2.88
2.19
2.81
2.04
$2.31
$3.47
2.55
3.39
2.50
3.45
$2.74
$3.75
2.70
3.67
2.70
2.91
~$_-9CT
$3.88
2.73
3.71
3.11
2.90
5.14
_7L47_
$3.19
$4.39
3.15
3.94
3.62
3.91
3.47
9.95
$3.68
$4.59
3.54
4.17
3.82
4.70
3.06
9.02
$1,458.44
$4.00
$1,537.18
$4.21
1,258.52
3.45
1,477.93
4.05
1,456.98
3.99
1,656.03
4.54
1,128.85
3.09
3,352.20
9.18
$3.90 Q 40
MENTAL HEALTH SERVICES REPORT, 1956-57
Table A.—Showing the Average Number of Patients in Residence Each Year,
the Total Amounts Spent for Maintenance, and the Gross Yearly and
Daily per Capita Cost, 1947-48 to 1956-57—Continued
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1954-55
The Woodlands School. _ . .
1,204.60
3,517.75
285.74
527.33
230.72
296.42
238.63
$1,811,848.81
4,685,444.76
426,786.04
739,859.92
368,726.10
328,553.97
860,673.73
$1,504.11
1,331.94
1,493.62
1,403.03
1,598.15
1,108.41
3,606.73
$4.12
3.65
Provincial Mental Home, Colquitz
4.09
3.84
Home for the Aged, Vernon
Home for the Aged, Terrace
Crease Clinic _ _
4.38
3.04
9.88
Totals for the year —
6,301.19
$9,221,893.33
$1,463.52
$4.01
1955-56
The Woodlands School _
1,219.45
3,508.79
285.30
539.27
229.62
287.30
257.96
$2,032,263.32
5,377,708.34
428,248.27
797,392.10
371,438.14
351,087.68
935,501.07
$1,666.54
1,532.64
1,501.05
1,478.65
1,617.62
1,222.02
3,626.54
$4.55
Provincial Mental Hospital, Essondale
Provincial Mental Home, Colquitz —
4.19
4.10
4.04
4.42
Home for the Aged, Terrace — .
Crease Clinic _
3.34
9.91
Totals for the year.—
6,327.69
$10,293,638.92
$1,626.76
$4.44
1956-57
Th. WooHlands School
1,232.48
3,503.60
284.81
541.83
232.58
288.45
232.85
$2,246,193.06
5,851,370.53
446,497.91
831,370.73
402,867.14
350,880.96
996,288.31
$1,822.50
1,670.10
1,567.70
1,534.38
1,732.17
1,216.43
4,278.67
$4.99
Provincial Mental Hospital, Essondale
4.58
4.30
4.20
4.75
3.33
Crease Clinic —
11.72
Totals for the year
6,316.60
$11,125,468.64
$1,761.31
$4.83 HEADQUARTERS Q 41
Table B.—Summary Statement Showing the Gross and Net per Capita Cost
of Patients in All Mental Health Services Institutions for the Year
Ended March 31st, 1957.
Gross operating costs—
The Woodlands School $2,246,193.06
Provincial Mental Hospital, Essondale 5,851,370.53
Provincial Mental Home, Colquitz 446,497.91
Home for the Aged, Port Coquitlam 831,370.73
-Home for the Aged, Vernon 402,867.14
Home for the Aged, Terrace 350,880.96
Crease Clinic 996,288.31
Gross cost for all institutions $11,125,468.64
Less collections remitted to treasury 1,546,266.32
Net cost for all institutions $9,579,202.32
Daily average population 6,316.60
Gross per capita cost, one year $1,761.31
Gross per capita cost, one day $4.83
Net per capita cost, one year $1,516.51
Net per capita cost, one day $4.15
Revenue (Patients' Maintenance Collections) of the Mental Health
Services for the Past Ten Years
1947-48 $434,098.27 1952-53 $1,147,831.65
1948-49 613,710.03 1953-54 1,300,056.89
1949-50 730,442.02 1954-55 1,343,848.02
1950-51 763,884.12 1955-56 1,358,708.26
1951-52 928,398.83 1956-57 1,546,266.32 Q 42
MENTAL HEALTH SERVICES REPORT, 1956-57
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Q 45
Table I.—Expense Statement of the Crease Clinic of Psychological Medicine,
Essondale, for Twelve Months Ended March 31st, 1957
Salaries, Supplies, and Operating Expenses
Net
Vouchered
Expenditure
as Per
Public
Accounts
Service and Supplies from
Other Departments
Actual
Cost of
Operations
Yearly
per Capita
Cost
Headquarters
Public
Works
Department
i
t1 ??1. .7 !
$1,221.57 | $5.25
7,637.64
149,962.73
552,853.11
181,688.85
24,000.00
8,400.00
4,200.00
10,380.19
13,302.63
$4,402.50
17.040.14 1 51.70
.149,962.73
552,853.11
181,688.85
. 24,000.00
8,400.00
4,200.00
10,380.19
13,314.28
38,227.44
644.03
2,374.29
780.28
103.07
Laundry. _
36.07
18.05
11.65
44.58
57.18
Buildings, grounds, and general maintenance.-—
$38,227.44
164.17
Totals
$953,646.72
$4,414.15
$38,227.44
$996,288.31
$4,278.67
Expenditures Made under Federal Health Grants for Province
of British Columbia, Year Ended March 31st, 1957
Crease Clinic—
Equipment $ 1,304.33
Staff and personnel training 95,841.65
Mental Hospital, Essondale—
Equipment $5,967.94
Staff and personnel training 181,433.83
The Woodlands School, New Westminster—
Equipment
$16,734.14
Staff and personnel training 92,814.40
Mental Home, Colquitz-
Equipment
Staff and personnel training
Child Guidance Clinic, Day-hospital, North Burnaby-
Equipment
$149.18
8,700.00
$2,672.03
$97,145.98
187,401.77
109,548.54
8,849.18
Staff and personnel training 5,075.00
7,747.03
Assistance to Mental Health Centre, Burnaby—Equipment 56,957.20
Neurophysiological Research Unit at University of British Columbia—
Survey of factors contributing to narcotic addiction in
British Columbia $4,749.93
Pharmacological analysis of pathways leading to diffuse
enhancement of cortical electrical activity of E.E.G.
activation 4,074.69
Aromatic metabolism in schizophrenia 8,886.52
Structural factors in mental disease 10,531.05
Etiological factors in mental deficiency 5,433.38
Study of the biochemistry of schizophrenia 13,426.79
. Q 46 MENTAL HEALTH SERVICES REPORT, 1956-57
Neurophysiological Research Unit at University of British Columbia—Continued
Structural identification of aromatic compounds in schizophrenic urine $11,064.32
Metropolitan Health Committee mental-health training
for school counsellors 7,365.00
$65,531.68
Home for the Aged, Port Coquitlam — Staff and personnel
training 2,520.00
Home for the Aged, Vernon—Equipment 1,392.83
Medical Film Library 267.75
Rehabilitation Department 4,451.44
Vancouver General Hospital 12,266.52
City of Vancouver, mental-hygiene programme 20,352.00
Jubilee Hospital, Victoria 1,893.66
Consultants in surgery 12,900.00
Aid to Canadian Mental Health Association 1,250.00
British Columbia Mental Health Services—Visiting lecturers 200.00
General personnel training—
Postgraduate training in clinical psychology $1,565.63
Short courses in mental health 1,485.65
Training and supervision in psychiatric nursing 525.00
Postgraduate training in social work 475.00
Postgraduate training in psychiatry 3,373.60
Postgraduate training in laboratory 500.00
7,924i
Total $598,600.46 HEADQUARTERS Q 47
PERSONNEL REPORT
J. Dowling, Personnel Officer
During the fiscal year the approved establishment of the Mental Health Services
increased by 257 positions, as follows:—
Item Number of Positions
(1) Transfer of psychiatric social workers frorn the Department of Health and Welfare to the Mental Health Services,
effective April 1st, 1956 43
(2) Approval of full establishment for the North Lawn Tuberculosis Unit, which opened in May, 1955 105
(3) Increase in the Essondale laundry establishment 14
(4) Approval of the initial complement for the new Fraser
View unit of The Woodlands School 29
(5) Approval of the initial complement for the Mental Health
Centre, Burnaby, which opened January 2nd, 1957 37
(6) Miscellaneous 29
Total 257
The number of persons on staff as at March 31st, 1957, was 173 more than on
March 31st, 1956 (see Table A).
Table B appended to this report provides a breakdown of separation and recruitment activity. Over-all staff turnover increased from 30.15 per cent in the preceding
fiscal year to 35.6 per cent this year.
Table C of this report shows a comparison of staff totals with the preceding fiscal
year, while Table D provides figures and percentages showing the composition of the
staff of the nursing services by unit.
Several organizational studies of some importance have been concluded during the
year, including:—
(1) A study of the organization and establishment of the 275-bed North Lawn
Tuberculosis Unit has been finalized and a full complement of 139 has
been approved. The male and female nursing services in this building
have been consolidated into a single administration headed by a senior
superintendent of nurses. The North Lawn nursing staff has been separated from the central nursing administration and is presently operating
as a self-contained nursing unit. This is an experiment in unit organization, which is an accepted method in very large hospitals.
(2) A survey was made of organization and establishment for the Mental
Health Centre, Burnaby, which opened January 2nd, 1957. An initial
complement of thirty-seven has been approved, but additional staff will
be required as this new service develops. The business administration of
the Mental Health Centre and the Burnaby Child Guidance Clinic has
been consolidated under a unit business manager. Stenographic procedures have been adapted to dictating equipment which is used exclusively.
(3) A review was made of the methods and system in the Centre Lawn Medical Records Section. This area had been troubled with a heavy backlog
of stenographic work, and staff turnover was extremely high. As a result
of this survey, office accommodation was rearranged, dictating equipment
was installed, and new office procedures were implemented. The results
have been so encouraging that similar action in other medical-records
areas is being considered. Q 48 MENTAL HEALTH SERVICES REPORT, 1956-57
(4) A study of the organization, establishment, and classifications of the
School of Psychiatric Nursing was made by the survey committee
appointed by the Civil Service Commission in 1955. A report was
presented to the Chairman of the Civil Service Commission. All recommendations contained in it have been approved and implemented, or are
in the process of implementation.
Table A.—Summary Showing Over-all Staff Totals in Relation
to Separation and Recruitment
Staff recruited, including students 1,081
Staff separated, including students 908
173
Total staff, including students, as of March 31st, 1957 2,638
Total staff, including students, as of March 31st, 1956 2,465
Increase 173
Monthly staff average, excluding students 1956-57 2,336
Monthly staff average, excluding students 1955-56 2,205
Increase 131
Male Female Total
Student enrolment as of March 31st, 1957 46 172 218
Student enrolment as of March 31st, 1956 64 175 239
Decrease 18 3 21
Students, monthly average, 1956-57 214
Students, monthly average, 1955-56 206
Increase 8
Panels held during the year were as follows:—
Appointments and promotions—
Number of interviews 476
Number of competitions 103
Disciplinary—
Number of panels 13
Number of cases reviewed 47 HEADQUARTERS
Q 49
Table B.—Showing a Breakdown by Classification of Recruitment and Separation Activity for all Branches of the Provincial Mental Health
Services.
Recruited
Physicians 18
Medical interns 9
Registered nurses 32
Female psychiatric nurses 136
Male psychiatric nurses 40
Female student-nurses 116
Male student-nurses 22
Female psychiatric aides 206
Male psychiatric aides 177
Teachers
Occupational therapists 7
Recreational therapists
Industrial therapists
Psychologists
Dieticians
Cooks
Kitchen-helpers
Clerks
Stenographers
Trades
Laundry-workers
Miscellaneous professional
Miscellaneous technical _____
Miscellaneous
Farm labour
4
7
7
3
49
26
32
5
15
62i
12
58
38
1,081
Separated
11
9
33
134
60
53
16
172
161
2
13
2
3
5
6
8
37
20
30
5
11
21
9
55
32
908
1 Includes transfer of forty social workers to Provincial Mental Health Services.
Percentage Turnover
1955-56
30.15
9.5
27.38
Over all
Male psychiatric nurses
Female psychiatric nurses
Student psychiatric nurses 27.1.
(Note.—The over-all percentage has been calculated against the monthly staff
average and other items have been calculated against the year-end staff count.)
1956-57
35.6
14.67
35.63
32.2
Change
+5.45
+5.17
+ 8.25
+5.02 Q 50
MENTAL HEALTH SERVICES REPORT, 1956-57
Table C.—Comparison of Staff Totals by Unit with Totals for the
Preceding Fiscal Year
Fiscal Year 1955
-56
Fiscal Year 1956
-57
Division
Positions
in
Estimates
Positions
in
Establishment as of
Mar. 31,
1956
Positions
Filled as
of Mar.
31, 1956
Positions
in
Estimates
Positions
in
Establishment as of
Mar. 31,
1957
Positions
Filled as
of Mar.
31, 1957
64
9
56
8
52
8
60
9
53
8
53
8
73
64
60
69
61
61
31
29
27
31
29
29
Preventive Services
35
33
33
60
53
53
283
1,255
561
78
270
1,001
491
77
253
1,003
465
76
291
1,279
837
78
285
1,150
530
76
272
Provincial Mental Hospital, Essondale.
1,068
513
Provincial Mental Home, Colquitz
77
2,177
1,839
1,797
2,485
2,041
1,930
1
34
37
31
Home for the Aged, Port Coquitlam.. ,
205
78
63
189
76
59
180
77
52
217
80
63
189
77
59
187
75
54
346
324
309
360
325
316
239
218
Totals -
2,662
2,289
2,465
3,039
2,546
2,638
1 Prior to April 1st, 1957, student-nurses have been included in Estimates with psychiatric nurses and aides,
they are not Civil Servants, they are not included in establishment.
Since
Table D.—Showing Composition of Nursing Staff by Unit as of
March 31st, 1957
Registered Nurses
Psychiatric Nurses
Psychiatric Aides
Total
Number
Per Cent
Number
Per Cent
Number
Per Cent
Female Division
Provincial Mental Hospital, Essondale
43
7
7
2
1
2
10.7
6.2
3.1
1.7
2.7
40.0
144
50
87
47
8
3
35.7
44.2
38.0
40.2
21.6
60.0
216
56
135
68
28
53.6
49.6
58.9
58.1
75.7
403
113
229
Home for the Aged, Port Coquitlam
Home for the Aged, Vernon -
117
37
5
Totals-
62
6.9
339
37.5
503
55.6
904
Male Division
Provincial Mental Hospital, Essondale
1
2.5
181
49
83
38
32
5
11
1
59.7
65.3
41.3
64.4
62.7
27.8
27.5
100.0
122
26
118
21
19
13
28
40.3
34.7
58.7
35.6
37.3
72.2
70.0
303
75
201
Provincial Mental Home, Colquitz—
59
51
18
Mental Health Centre
1
Totals
1
0.01
400
53.5
347
46.5
748 HEADQUARTERS Q 51
REPORT OF THE PROVINCIAL SUPERVISOR
OF PSYCHIATRIC SOCIAL WORK
Miss A. K. Carroll, Provincial Supervisor
The past year has been an eventful one for social services throughout the various
units of the Mental Health Services. Despite vacancies in the staffs of all units, much
has been accomplished in the formulation and development of standards of social services as rendered in connection with the study and treatment of individuals. Consultation has been requested and advice given to social service departments in all units through
the year, and this has been focused on:—
(1) Criteria for the selection of the chronic patients for intensive casework.
(2) Criteria for the selection of the families of patients for intensive casework.
(3) Criteria for the selection of patients for after-care services.
In all units, consultation has been sought on the development of techniques and
approved content for summarized recording of social-work activity in the treatment of
patients. Another area in which consultation has been given concerns the development
of a uniform system of social service statistical reports—one which would indicate the
range of direct services as well as the responsibilities of the psychiatric social worker in
the institutions and the clinics. As a result, forms of statistical reporting have been
devised which more nearly reflect the aforementioned and simplify the statistical process.
The Social Service Departments have continued to ask for consultation on departmental organization. All departments seek to provide more effective service in the study
of patients at the point of intake and in the assessment of the social and emotional problems inherent. These careful assessments result in social services more valid and effective therapeutically because they are related to the patient's needs and to the specific
conditions surrounding his difficulty or illness. An analysis of the social-work job at all
levels, followed by written descriptions of the same, as well as the setting-up of procedural
manuals for social workers, has further aided the departments in developing an organization and structure which utilizes to the full present staffing patterns.
The monthly reports of casework and administrative supervisors concerning the
progress of programmes have been of a very high order. Analysis has frequently
resulted in the introduction of changes in structure or the innovation of new procedures
which have permitted improvement and expansion in social services in all units, despite
the grave shortage of staffs.
During the year instructive material has been prepared on the methods of procurement and selection of social service personnel. Toward the end of the year, sixteen
trained social workers available for employment were contacted and interviewed. The
majority were interested in working in the Provincial Mental Health Services, and the
thirteen staff vacancies existing could have been filled if the salaries offered had more
nearly equalled those prevailing in local agencies. Information regarding the procurement of social-work personnel has been submitted to the Personnel Officer of the Civil
Service Commission from time to time.
Teaching is a responsibility of the progressive social service programme. Three
distinct kinds of teaching are done by social workers in psychiatric hospitals and clinics—
development of the social-work staff, field training of social-work students, and participation in the training of other professional and non-professional groups in the hospitals
and clinics.
A programme has been developed in collaboration with the School of Social Work
for the instruction of social-work students in field practice in the Mental Health Services.
A close working relationship between the students' supervisors and the School has Q 52 MENTAL HEALTH SERVICES REPORT, 1956-57
resulted in better integration of class-work and field-work practice. These students continue to provide a valuable source of social-work recruitment to the Mental Health
Services.
In co-operation with the Faculty of Medicine, the School of Nursing, and the School
of Psychiatric Nursing, an educational programme whereby students are acquainted with
the contribution of social work in multidisciplinary settings has been set up. Eleven
sessions were given to fourth-year medical students, fourteen to affiliate nurses and
psychiatric nurses, and two sessions to graduate nurses in the School of Nursing.
The social service departments all have programmes for the development of the
social-work staff. Their primary purpose is to provide better service to patients and
their families by increasing the competency of the staff. Supervision, orientations, staff
meetings, seminars, extensive use of library facilities, consultation, staff committee work,
research activity, and institutes are some of the media which are being used in staff
development. During the year selected social workers from various units have attended
institutes on family casework services, co-ordination of community services, group work,
Canadian Conference on Social Work, problems of juvenile delinquency, the American
Orthopsychiatric Institute, and Civil Defence. The inclusion of social workers in the
medical staffs' development programme, clinics, ward planning conferences, and the
wide use of educational films have greatly contributed to the development of social-work
competency and to the extension of effective social services.
Frequent conferences with Provincial and municipal welfare and health agencies
as well as voluntary agencies have resulted in the exploration of community services and
the formulation of co-operative social service policies to the benefit of patients and their
families. Patients often need services both from the community and from the hospital,
and these services must comprise a network planned for the benefit of the patient. When
a patient leaves the hospital, the hospital social worker has responsibility for referring
him, with his co-operation, to an appropriate agency. Knowledge of community resources and adequate referrals are basic to the mobilization of the community in the
achievement of maximum rehabilitation for the patient. Co-operative social service
policies have been effected between the Mental Health Services and the Family Service
Agency, the National Employment Service, the Borstal Association, Social Welfare
Branch, Child Welfare Division, the Official Committee, the Division of Vital Statistics,
and the Young Women's Christian Association. Of urgent necessity in the coming year
is the development of a co-operative service policy in regard to after-care services for
patients, particularly in the areas of family care, boarding- and nursing-home services.
Through such co-operative efforts, many States in the United States and some Provinces
in Canada have developed valuable family-care programmes, which, as a stage or extension of hospital treatment, have proven of signal benefit in the treatment and rehabilitation of patients.
In the treatment of patients there are many services of a technical nature. Some
of these as they concern job finding, job selection, job placement, and habilitation services, such as the procurement of social security and social welfare assistance, can be
ably done by rehabilitation officers working within a social rehabilitation section of a
social service department. During the past year, on the instruction of Administration
and the request of the Rehabilitation Officer, the social rehabilitation programme, to date
a one-man service, was incorporated into the Social Service Department. With the
increasing response of patients to newer treatment programmes, the services offered by
rehabilitation officers are more frequently needed by patients and more frequently in
demand as the discharge rates of patients continue to increase. The extension of social
rehabilitation, through a more adequate staffing of this section, is an urgent necessity if
we are to meet the rehabilitation needs of patients on discharge and reserve hospital
facilities for those patients in need of active treatment services. HEADQUARTERS Q 53
During the year technical material has been written and submitted covering:—
(1) A Comprehensive After-care Programme for Mental Patients.
(2) A Scheme to Provide Social Rehabilitation and Habilitation Services for
Mental Patients.
(3) Suggested Changes in Psychiatric Social Work Job Classifications and Job
Descriptions.
(4) Foster Home Care Programme for the Mentally Retarded with Suggested
Regulations for the Boarding Out of This Group of Patients in Care.
(5) A Description of the Organization, Structure, Functions, and Services
of a Social Service Department in a Training School for the Mentally
Defective.
(6) A Description of the Social Services in Provincial Mental Hospital with
an Analysis of Intake and Case Flow and Suggestions regarding Useful
Staff Patterns and Staff Needs. Q 54 MENTAL HEALTH SERVICES REPORT, 1956-57
REPORT OF SCHOOL OF PSYCHIATRIC NURSING
Miss M. Kenny, Associate Director of Nursing Education
Graduation exercises for the School of Psychiatric Nursing were held, as formerly,
at Lester Pearson Junior High School, New Westminster. A class of eighty-five student-
nurses, consisting of sixty-two women and twenty-three men, was graduated.
A reorganization of the School is planned, which will establish positions for three
Grade II Instructors. It is hoped that this will in some measure ease the chronic shortage
and rapid turnover of teaching staff which has plagued the School this year. At one time
the programme for students affiliating from the general hospitals was nearly discontinued,
and only a temporary appointment at the last moment saved it.
The usual large fall class was enrolled this year, as far as women were concerned.
However, the spring class was small, and the enrolment of men continues to be
disappointing.
The customary talks to the high-school students for recruiting purposes were made
by our Nursing Counsellor. In addition, she attended the annual recruiting drive held
by the National Employment Service.
In order to decrease the number of withdrawals from the School, a Selection
Committee was set up in an effort to screen applicants more closely.
Along with the usual programme for our own students and the affiliate students, the
School was also responsible for conducting tours of the Hospital for students from the
Vancouver General and St. Paul's Hospitals.
Members of the teaching staff, in addition to their teaching duties, were also busy
on the various committees operating throughout the year.
Once again the School of Psychiatric Nursing is indebted to members of other
departments, without whose splendid co-operation its programme could not function.
Much credit is deserved by the staff of the School of Psychiatric Nursing, who from
time to time throughout the year shouldered heavy teaching burdens, often at very short
notice. _-
CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
Q 55
PART II.—CREASE CLINIC OF PSYCHOLOGICAL MEDICINE
AND PROVINCIAL MENTAL HOSPITAL
REPORT OF THE CREASE CLINIC OF PSYCHOLOGICAL
MEDICINE
A. E. Davidson, Deputy Director of Mental Health Services
The Crease Clinic of Psychological Medicine continued to function effectively during
the year and has offered a valuable service to a large segment of the community.
The following table gives a summary of the movement of population for the year:—
Male
Female
Total
Total in residence, March 31st, 1956. _ —
Total admissions during year 1956-57
First admissions
Readmissions .
Number of voluntary admissions
First admissions —
Readmissions-
Discharges during year
To community
To Provincial Mental Hospital and other institutions-
Deaths during year.. _ _ —
In residence, March 31st, 1957
110
540
405
135
278
222
56
548
515
34
7
95
147
924
649
275
520
390
130
935
896
41
5
131
257
1,464
1,054
410
798
612
186
1,483
1,411
75
12
226
The admission rate has dropped somewhat when compared with last year—some
1,464 patients were admitted to the Crease Clinic this year, compared with 1,627
admitted during the fiscal year 1955-56. Thus a peak was reached last year. Whether
this trend of declining admissions will persist remains to be seen. The proportion of
voluntary admissions, however, remains constant—798 patients or 54 per cent of total
admissions were admitted on a voluntary basis this year, compared with 876 or 53 per
cent of admissions last year. An attempt has been made this year to screen admissions
to the Crease Clinic. This has been done with a view of trying to prevent the admission
of unsuitable patients. One of the members of the medical staff was appointed as
admission officer. Physicians in the community may consult with him or refer cases
with a view to determining suitability for admission.
Separations from the Clinic continue to be in excess of admissions. A total of
1,483 patients were discharged during the fiscal year. Of this total, it was only necessary
to readmit some seventy-five patients or 4.9 per cent to the Provincial Mental Hospital;
this compared very favourably with the 7.2 per cent patients discharged who were
readmitted to the Provincial Mental Hospital during the fiscal year 1955-56.
The treatment programme under the new Clinical Director, Dr. Ian Kenning, has
continued to be effective. There has been an increased use of the tranquillizing drugs
in the treatment of various mental disturbances. This has reflected itself in a decrease
in the use of coma insulin therapy. In view of this, arrangements are being made for the
transfer of patients in the Mental Hospital requiring coma insulin therapy to the Crease
Clinic. It will thus be possible to give the coma insulin portion of this therapeutic
programme in the Crease Clinic and then return these patients to the Provincial Mental
Hospital if further treatment is required.
Occupational therapy has continued to play an important part in the total therapeutic
programme. During the year there has been a reorganization of these departments. Q 56 MENTAL HEALTH SERVICES REPORT, 1956-57
The male and female sections of the Crease Clinic Occupational Therapy Department
have been united under one supervisor. Both male and female patients attend the
Occupational Therapy Department together. During the coming year it is hoped to
further consolidate the Department by uniting both shops in the West 1 area.
The recreational-therapy functions have been increased during the year. A male
and female therapist have been assigned to the Clinic, and these individuals are able to
produce a much better organized programme of recreation for the patients.
There is an ever-increasing amount of work carried out in the operating-room and
surgical suite. During the year there was a total of 561 operative procedures carried
out in the operating-room. The following summary gives the details: 65 major operations, 173 minor operations, 60 orthopaedic operations, 84 applications of plaster,
33 neurosurgery operations, 65 genito-urinary operations, 41 eye, ear, nose, and throat
procedures, and 40 miscellaneous operative procedures. Dr. Gelpke, our surgical
resident, has organized the programme in this department very efficiently. The increasing work in this area stresses the need for the expansion of surgical-ward facilities, which
have been planned now for some considerable time.
The educational programme for our medical staff has continued to function quite
actively. During the year we have had a number of the teaching staff of the University
give lectures or conduct courses of instruction to our medical group. In addition to
this, senior members of our own medical staff take an active part in this educational
programme. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 57
REPORT OF THE PROVINCIAL MENTAL
HOSPITAL, ESSONDALE
REPORT OF THE MEDICAL SUPERINTENDENT
T. G. Caunt, Medical Superintendent
This fiscal year has been an extremely active one for the staff and the patients of
the Provincial Mental Hospital and Crease Clinic. The departmental reports will show
this in detail. Much progress and many improvements have been made this year in the
treating and housing of our patients. Each year we find there is not only a greater
public awareness of mental illness, but that the public realizes now that something can
be done about it in the way of prevention or treatment. Many times it has been stated
that " the Mental Hospital isolation from the community is being gradually broken down
by the work of our gradually increasing numbers of volunteers." There are now over
100 men and women volunteers visiting the Provincial Mental Health Services at Essondale. This creates an exchange of ideas, which is valuable to all patients, staff, and
volunteers, especially when we realize that mental illness now strikes as many as one
family in five in the community.
This past year there has been a generally increased activation and mobilization of
our patients. It is not possible in such a brief report as this to mention all the splendid
work being done by the departments that make up the total hospital team—the nursing
division, psychology, social service, medical, the public works, and all the other departments that take part in our total hospital programme. The contribution of each department is vital to the hospital. The team approach continues to be emphasized, with patient
self-help. There is a greater general movement of patients and staff, a greater state of
flux or fluidity. There tends to be less permanency. This is a trend that is desirable in
the case of the patients, perhaps, providing they do not leave the hospital before the
completion of their treatment. However, there are inherent disadvantages in the case
of too rapid staff turnover. While those trained personnel who leave our services are
a gain to other areas of British Columbia or Canada, they are a distinct loss to our
hospital services, since personnel must be on our staff here for many months, in some
cases before they reach their maximum efficiency and usefulness to the services. Q 58
MENTAL HEALTH SERVICES REPORT, 1956-57
Movement of Population
The following table gives a summary of the movement of population of the Provincial Mental Hospital for the past fiscal year:—
Men
Women
Total
1,846
700
1,687
559
3,533
1,259
638
73
510
71
1,148
144
711
581
1,292
In residence, March 31st, 1957 _
In residence, April 1st, 1956—
1,814
1,645
3,459
1,846
1,687
232
5
Total on books, April 1st, 1956
3,770
Admissions from April 1st, 1956, to March 31st, 1957
1,259
5,029
Admissions—
441
19
194
8
27
2
2
7
457
10
87
4
1
898
29
281
8
31
2
3
7
700
559
1,259
The admission services of the Provincial Mental Hospital continue to be extremely
busy dealing with a gradually increasing number of patients requiring treatment.
The percentage of patients recovered or improved, as compared to admissions, was
67.5 per cent. The percentage of deaths to the number under treatment was 2.8 per cent;
the percentage of discharges to admissions (exclusive of deaths) was 89.2 per cent. The
daily average population was 3,503.6.
On March 31st, 1957, we had in this Hospital the following Federal cases still
requiring treatment:—
British Columbia Penitentiary patients 4
Yukon Territory patients 27
Department of Indian Affairs patients 74
Department of Veterans' Affairs patients 272
Imperial veterans (D.V.A.) 1
Total Federal cases.
378
Clinical Services
There have been important changes in our clinical services. We are very happy
to report the appointment of Dr. J. Walsh as Deputy Medical Superintendent. Dr. F. E.
McNair, who has been our Clinical Director since October, 1952, transferred in December, 1956, to assume the directorship of the Mental Health Centre. Dr. McNair was a
most valuable member of the staff here, and we are certain he will continue to be so in
his new appointment, where we wish him every success. We have been most fortunate
in the appointment of Dr. I. S. Kenning, who is now the Clinical Director. Dr. Kenning's
report shows in considerable detail the changes taking place within the clinical services,
with the team treatment approach continuing, the lessening of electroconvulsive therapy
and lobotomies, and the increasing use of tranquillizers. Dr. Kenning clearly points out CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 59
the need for increased specialists in the whole treatment team, with suitable accommodation in which to operate.
We regret the loss through death this year of Dr. W. Morris. Dr. Morris, the specialist in tuberculosis, was seconded to the Mental Health Services and was doing an
extremely splendid job in caring for the patients here until the time of his sudden death.
All treatment facilities have continued throughout the year, though with difficulty
on occasion, due to shortage of medical or nursing staff. These shortages have been
pronounced on occasion, in both the male and female nursing divisions, especially in
senior supervisory positions.
Five members of the medical staff successfully wrote their specialty in psychiatry;
however, two of these specialists have now left our staff to engage in private practice.
The constant medical-staff change creates problems in adequately treating patients, especially in the continued-treatment areas of the Hospital. Owing to the staff shortage in
the Psychology Department, our services have been further reduced this year. This is
a distinct loss to the Hospital, where psychologists are urgently required for rehabilitation of new and old patients.
The report of Dr. W. P. Fister, Director of the Department of Neurology, shows
there is a constant demand in his Department for clinical consultations and electroencephalograms. Many neurological cases showed gratifying results following surgery.
We are pleased to report the appointment of Dr. E. V. Mellor, neurologist and electro-
encephalographer, who joined this department in March, 1957. He will spend part of
his time at the Mental Health Centre in Burnaby.
Social Service
The report of the Social Service Department describes that Department's activities
for the past year very well. Miss D. Begg, Supervisor of Social Service, shows the difficulties in securing adequate numbers of professional personnel. This staff shortage has
reduced the services the Social Service Department is able to provide. It has been necessary to curtail the area of coverage, and in some areas there has been complete withdrawal of services, in order to maintain an adequate standard of services for a smaller
number of patients elsewhere.
Health of Patients
The general health of the patients has been very good. There have been very few
cases of notifiable infections among either patients or staff. There have been no serious
epidemics of gastro-intestinal or upper respiratory infections. There have been occasional cases of erysipelas, cancer, and pulmonary tuberculosis. During the winter months
a few cases of broncho and lobar pneumonia were reported. With the advent of Salk
polio vaccine, immunization of all patients under 18 years of age was completed.
Activities
The Director of Recreational Therapy has succeeded in his aims of providing more
opportunities for patient recreational activities and in encouraging nursing staff to feel
free to foster recreational interests for and with their patients. There has been increased
recreational-therapy activity in all areas of the Hospital. There has been hiking, walking
parties, picnics, regular swimming parties, mystery tours by bus in the surrounding
countryside and to Stanley Park.
There has been great activity surrounding patients' fashion shows arranged by the
men and women volunteers from the British Columbia Division of the Canadian Mental
Health Association. In the fashion show held on May 26th, 1956, thirty-two patients
participated, modelling clothes and accessories from the apparel-shop, which is managed Q 60 MENTAL HEALTH SERVICES REPORT, 1956-57
by the lady volunteers. The arrangements were made by the volunteers with the officials
of the Hairdressers' Association of British Columbia to provide six hair stylists to demonstrate hair styling during this fashion show. This show was a tremendous success
and was held the second day to accommodate the crowds interested.
Many patients are interested in gardening at the Riverside, North Lawn, and in the
Hillside areas.
The annual sports day was held on August 14th, with over 2,000 patients out on
the grounds. Sports events of all types were arranged by the Recreational Director and
his staff. Volunteers staffed numerous booths about the grounds, and meals were provided for all patients and visitors. Our patients greatly appreciated the Vancouver Firemen's Band visiting the Hospital on sports day.
More patients each year are interested in the Pacific National Exhibition, and
many bus loads of patients each year are able to visit the exhibition. Courtesy tickets
are supplied by service groups.
The Leader, the hospital patients' publication, has greatly increased in content and
shows much improvement. There is greater patient participation. On December 14th,
1956, the first issue of the new monthly Leader was published. It is a very good publication and reflects considerable credit on all patients and staff connected with its publication. The weekly patients' bulletin continues as usual, and it will now largely consist
of day-to-day occupational, recreational, and religious activities in the Hospital.
More patients each year are permitted freedom of the grounds. These patients are
from both open and closed wards. Many hundreds of patients now have free access to
the grounds any time during the day. More patients are visiting their homes and families
on week-ends and holidays. This is assisting in their mental improvement and recovery
and subsequent rehabilitation.
Occupational Therapy
There has been a great change and progress made in the Occupational Therapy
Department this year, and we regret Miss D. M. Tayler, Supervisor of Occupational
Therapy, has completed her exchange year and has returned to England. Occupational
Therapy is now established in all wards of the East Lawn Building. Our reorganization
of the industrial therapy and occupational therapy occurred on September 1st, 1956,
and all divisions of the occupational therapy, male and female, come under Miss Tayler's
direction, and all departments of male and female industrial therapy come under the
direction of Mr. J. Herring. Many hundreds more patients benefit in the East Lawn
Building through occupational therapy since it has been established on all wards. There
is still considerable shortage of trained occupational-therapy staff. The reorganization
of the Occupational and Industrial Therapy Departments is an improvement and is functioning very well.
Visiting Groups
" Open house " tours were held on April 24th, 1956, in Pennington Hall and East
and West Lawn Buildings. Members of the men and women volunteers group assisted
at the time, with large numbers of the public and press visiting these buildings. Very
informative and instructive booths were prepared and staffed by members of the treatment teams. Great interest in these exhibits and displays was shown by over 2,000
visitors, who toured the Hospital in groups of fifteen with guides supplied by the patients,
nursing staff, and volunteers.
On May 1st, 1956, the Fraser Valley Firemen's Association of over 100 members
visited the Hospital on its annual visit. These visits are a valuable means of exchanging
information relating to fire prevention. The visitors examined the new 100-foot fire-
ladder, which was demonstrated by the staff of our fire department. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
Q 61
On February 1st, 1957, the board of directors of the Canadian Mental Health
Association, British Columbia Division, with Dr. J. D. Griffin, medical director of the
Canadian Mental Health Association, Toronto, Dr. Ranton Mcintosh, president of the
British Columbia Division, and twenty-five members visited the Provincial Mental Hospital and Crease Clinic. Following a luncheon here the party toured the Crease Clinic,
the apparel-shop, Ward F 2 in the East Lawn Building, a typical open ward, and then
the Audio-Visual Department and the Recreational Centre in Pennington Hall.
Regularly throughout the year large numbers of our men and women volunteers
visit the wards at the Hospital, taking part in many activities. The Women's Auxiliaries
of the Canadian Legion, Empire Service League, the Army, Navy and Air Force Veterans' Association, and other such organizations visit the Hospital throughout the year.
The patients greatly appreciate groups of entertainers who visit the Hospital from time
to time, especially the visits of bands and orchestras, such as the visit on May 6th of the
Vancouver Ladies' Orchestra. They gave a concert in Pennington Hall.
The 100-foot aerial-ladder truck in front of the Essondale Fire Hall.
Fire Hall
On November 14th, 1956, the Fire Department of the Provincial Mental Hospital
took delivery of its new fire-ladder truck. The truck is equipped with a 100-foot extension
ladder. The Hospital is extremely fortunate in securing this powerful pumping equipment,
which has electrical generating equipment to provide its own lighting. It is now possible,
with this new piece of equipment, to reach directly to the roof of any of our buildings.
Mr. Lowry, Chief of the Essondale Fire Department, periodically visits the various
Hospital buildings in order to advise and instruct staff so that they may be aware of the
equipment we have and its correct use. His instructions are being continued in order to
strengthen fire-prevention regulations. We feel such instructions are extremely important
at all times, but especially during periods when movement of equipment may become
difficult owing to ground conditions or fog. Q 62 MENTAL HEALTH SERVICES REPORT, 1956-57
Gifts
Throughout the year large numbers of gifts have been received by the Hospital from
interested relatives, friends, or organizations. A large amount of clothing is received by
the men and women volunteers for the apparel-shop. Many articles are received from
the Canadian Mental Health Association, British Columbia Division, who receive donations from the Lower Mainland and Interior of British Columbia. On May 28th, 1956,
Mrs. Bingham, president of the Fraser Valley Ladies' Council of the Women's Auxiliaries
to the Canadian Legion, British Empire Service League, donated a Le Clerc standard
loom to the occupational-therapy shop at Riverside. We appreciate also the parcels of
candy, fruit, cigarettes, and other extras donated to our ex-service personnel by Branch
No. 2, Canadian Legion, New Westminster, and the Army, Navy and Air Force Veterans'
Association. The Women's Auxiliaries of the Canadian Legion of the Lower Fraser
Valley visit patients regularly with gifts. Our patients greatly appreciated the donation
on October 30th, 1956, of seven television sets by the Hoo Hoo Fraternal Organization
of Vancouver. During the Christmas season, hundreds of presents were received for ex-
service personnel. The volunteers of the British Columbia Division of the Canadian
Mental Health Association delivered over 4,500 parcels. They were received through
their organization from all over the Province and were specially wrapped and addressed
to individual patients in the Hospital.
Patients' Accommodation
The general condition of patients' accommodation has improved this year. A great
deal of painting and decorating has been completed, and new floors are being laid. There
is, however, still much overcrowding and the need for further renovation and improvement. Plans are under way for the gradual evacuation of patients from the Colony Farm
Cottage. There is still a shortage of storage space for patients' clothing, and with the
increased treatment and greater patient mobility, there is an increasing shortage of
patients' activity areas. In the older buildings there is a shortage of conference and
therapy rooms, doctors' interview rooms, and doctors' office space. Many improvisations have been made to overcome these inconveniences. Considerable difficulty is presented, however, since the functions of the older buildings have changed considerably
since their construction.
Dietary
During the past year there has been much improvement in the appearance and
content of our patients' meals. Mrs. Marr, Dietetics Administrator, has made many
improvements and worth-while suggestions to further improve the efficiency and modernization of this department. Much still requires to be done, especially in the East Lawn
Building main kitchen and J 3 dietary areas.
A change was made in the patients' diet by Mrs. Marr on October 1st, 1956, and
their meals were altered whereby the protein and mineral content of breakfast was
increased, the midday meal was made lighter than formerly, and the evening dinner was
made the heaviest meal of the day. This change proved generally satisfactory. Patients'
evening snacks continue as formerly. On October 16th, 1956, Miss Black and Mrs.
McFarlane, of the Department of Dietetics at the University of British Columbia, visited
the Hospital and discussed with Mrs. Marr and Mrs. Cowley the setting-up of cooking
classes for our women patients in the East Lawn Building. Women patients have shown
a very great interest in the cooking classes. In addition to the modernization of the East
Lawn dietary areas, there needs to be improvement in the garbage collecting, holding,
and disposal.
Stenographic Staff
There has been considerable shortage this year of trained stenographic personnel.
In May, 1956, the situation was particularly acute in the Centre Lawn Provincial Mental CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 63
Hospital admitting and clinical areas. This situation was reviewed, and in February of
1957 the clinical offices were transferred to the fourth floor and dictaphone and transcribing machines were installed. This change has resulted in considerable improvement. The
Provincial Mental Hospital admitting centre is now located on the main floor of the Centre
Lawn Building. Further changes are recommended in other areas of the Hospital, especially in the East Lawn Building. The services of a fully qualified medical-record librarian
could be used to advantage now.
Civil Defence and Disaster Committee
Dr. T. G. Caunt is Co-ordinator of the Essondale Civil Defence, with Dr. J. Walsh,
Dr. B. F. Bryson, and Mr. F. A. Matheson acting as Deputy Co-ordinators. Meetings of
the Civil Defence Vancouver target area have been attended by senior Hospital officials
relating to flood evacuation policy and principles. The Essondale Civil Defence organization has co-operated in the various Civil Defence exercises. Civil Defence meetings have
been held at Essondale, and reports have been presented by members of our nursing,
social service, and medical staff, who have attended Civil Defence courses in Washington,
Victoria, and Arnprior. Brig. J. A. McCarter, Assistant Provincial Civil Defence Coordinator, visited the Hospital with Mr. G. Raley, executive assistant to Air Vice-Marshal
Heakes, Vancouver Civil Defence Co-ordinator, and Dr. S. Murray, Vancouver Public
Health Officer, attended a Civil Defence meeting held here on November 7th, 1956.
Senior Essondale officials attended meetings at New Westminster which were addressed
by Gen. G. S. Hatton, Deputy Federal Civil Defence Co-ordinator, and Gen. C. R. Stein,
Provincial Civil Defence Co-ordinator. These discussions were related to the Provincial
Civil Defence pattern.
New and Maintenance Public Works
A great deal of work has been done by the Public Works Department in this area.
In the East Lawn Building there has been much decorating and painting, new floors were
laid, and furniture was supplied for the sun-porches. In the West Lawn Building, wooden
floors have been completely removed on the C-side and replaced with concrete and tile.
This has made a marked improvement in this building. The building has been redecorated and is now bright and airy. Considerable inconvenience was experienced by the
patients and staff during these alterations, but was cheerfully accepted while this much-
needed work went forward.
New car-parking areas have been completed and surfaced adjacent to the new post
office. New curbing has been placed in front of the Centre Lawn. There are many new
sidewalks, gardens, and flower-beds being built, and they add greatly to the appearance
of the Hospital grounds.
There was a great increase in the Public Works maintenance work in October, 1956,
due to flash floods and heavy rains experienced at that time. We are pleased to report the
installation of new water-mains. This has greatly increased the water-pressure and the
safety of the patients in event of fire. On December 8th and 9th, 1956, over 5 inches of
rain fell at Essondale. The hillside was flooded, but the main floor of the West Lawn
Building was protected by sand-bagging. All surface water-drains were put out of action
due to blocking by rocks and earth. The Public Works Department deserves considerable
credit for their work in this emergency. A vast amount of plumbing has been replaced
in the West and East Lawn Buildings. This has all been made possible by the increased
water-pressure. Thousands of feet of flooring has been tiled this year throughout the
Hospital.
Department of Nursing Service
Full reports by the Director of Nursing, Women's Division, and the Chief Male
Psychiatric Nurse, Men's Division, will show the major staff changes and activities being Q 64 MENTAL HEALTH SERVICES REPORT, 1956-57
carried forward in these two divisions. Various committees have been formed for dealing
with the problems of this division and the desire to change from central administration to
individual unit administration with unit administrators in charge. Ths plan has much
merit; however, it will be necessary to have adequate numbers of trained nursing personnel before such a plan can be placed in operation generally.
There is a shortage of qualified nursing staff, especially in the senior supervisory
categories. The Director of Nursing reports that qualified staff are available, but they do
not apply or remain on staff because of the poor salary structure offered qualified personnel. The staff of the Men's Division is especially short of trained supervisors in the
senior supervisory positions. The Director of Nursing shows in her report that there is a
gradually increasing percentage of staff in the aide category. On July 8th, 1956, Mrs. J.
Lundahl joined our staff as Assistant Director of Nursing. On August 13th, 1956, Miss
Morna Kenny was appointed Associate Director of Nursing Education, replacing Miss O.
Smith, who resigned.
During the course of the year several of our older members have left our services
through superannuation. Mr. F. Salmon retired on September 28th, 1956, following
thirty-two years of service in the Men's Nursing Division, having joined the staff in 1924.
A refresher course for all charge nurses of the Men's and Women's Nursing Division
was held from December 3rd to 14th, 1956. This is very valuable and proved quite
helpful to the nursing staff.
General Comments
The Neuro-Psychiatric Section of the Vancouver Medical Association held a meeting
at the Crease Clinic on April 23rd, 1956, and forty-four doctors attended. A very interesting and informative presentation was given by the medical staff of the Provincial
Mental Health Services.
On May 23rd, 1956, the Fraser and Coquitlam Rivers flooded, but by May 29th
the danger was over. Constant inspection of the dykes was made by the Public Works
Department. The Disaster Committee of the Hospital held several meetings, and the
assistance of the Civil Defence was available if required. Several hundred acres were
flooded, with some of the fields being flooded up to a depth of 12 feet. However, it was
not necessary to evacuate patients from Riverside or Colony Farm Cottage and Annex.
Great interest was shown on the occasion of Dr. Karl Menninger's visit on June 6th,
when he spoke at Pennington Hall to a large group of our staff. Dr. Menninger, who is
from Topeka, Kans., later gave a very interesting lecture to our medical staff during
a case presentation made by our medical officers.
In July Mr. G. Walker, Director of the Audio-Visual Department, installed amplifiers about the grounds and airing-courts. In addition to the music enjoyed by the
patients, this hook-up is of considerable assistance when contact is necessary with the
grounds staff. The Audio-Visual Department reports increasing activity with the installation of the new 35-mm. cinemascope equipment.
The laundry and dry-cleaning department is now functioning quite well. The type
and quality of laundry is showing constant improvement.
The religious needs of our patients are being cared for through the Rev. J. F. O'Neil,
our resident chaplain. Services are held every week by our resident chaplain and our
visiting Roman Catholic priest, Rev. Father A. Frechette, as well as additional services
and music broadcast on our radio on Remembrance Day and special religious days. The
Rev. Msgr. J. P. Kane, D.P., who faithfully visited this Hospital for many years, found
he was too busy to continue this service and resigned on November 21st, 1956.
There are now eight open letter-boxes on wards of the Hospital where patients may
post uncensored letters at will. This has, on the whole, worked out very well, though
there is still the occasional time when we receive inquiries from relatives or friends regarding letters they have received. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 65
Many of the Hospital staff have now been supplied with name-bars to be worn on
their lapels. These have proven to be helpful to the staff.
The Mental Health Services News Bulletin, the first issue of which appeared in
March, 1957, is serving a useful purpose in supplying all the divisions with information
as to what is taking place in the various divisions.
Recommendations
There is a continuing request for hospital accommodation for ageing persons. It is
not possible nor desirable for the Mental Hospital to care for larger numbers than they
are now doing with their present facilities. I would consider that only those most suitable
cases should be admitted to this service, and that provision of suitable facilities in the
community be provided for proper care of senile cases. This would take a considerable
pressure off the Provincial Mental Health Services and would leave them better able to
care for those patients requiring psychiatric treatment. The provision of community
facilities, as suggested, would enable many patients to be transferred directly from the
Provincial Mental Health Services back to the community, where they could be cared for
in such an environment. There are approximately 350 male and female mentally retarded
patients in this Hospital. I would recommend that suitable facilities be provided elsewhere in the Services for them, in order that they might receive care more appropriate to
their needs. This transfer would help to relieve the overcrowding of patients in the Provincial Mental Hospital area. The addition of further social service staff is required in
order to further reactivate the rehabilitation of patients back to the community.
There is a great need for an increased number of trained men and women nurses,
especially in the supervisory areas. I would recommend that appropriate inducement be
offered in order to secure adequate numbers of specialist senior medical staff, social service workers, psychologists, registered nurses, and psychiatric graduates.
Acknowledgments
I would like to express my appreciation of the co-operation received from all departments of the Government. I am appreciative of the co-operation of all members
of the Provincial Mental Health Services who have made this such a successful year.
I am especially appreciative of the assistance received from the Honourable Wesley D.
Black, Provincial Secretary, and Mr. R. A. Pennington, Deputy Provincial Secretary, in
dealing with questions concerned with the Provincial Mental Hospital and the Crease
Clinic.
TREATMENT SERVICES
I. S. Kenning, Clinical Director
The Crease Clinic and Provincial Mental Hospital at Essondale have for years been
in the forefront of psychiatric treatment. This year, as always, we have endeavoured to
maintain that position and, where possible, to improve our treatment services. That
there has been a good deal of success is reflected in our discharge rate and over-all separations reported elsewhere; however, a high discharge rate is not accomplished without
a good deal of effort on the part of all the staff—it means a greater number of patients
being assessed, treated, and discharged. Each step of this operation makes use of the
clinical services of the Hospital.
To assess a person who has broken down in the community, we must have a knowledge of the community stresses, the individual's reaction to those stresses, and the reasons for this type of reaction. The collecting of this information depends in part on the
Social Service and the Psychology Departments as well as the doctors. The institution Q 66 MENTAL HEALTH SERVICES REPORT, 1956-57
of proper treatment procedure depends upon the skill of the physician and the resources
of the Hospital. This latter element has been spoken about in previous years in this
Report as the problem of creating a therapeutic community—a community in which the
withdrawn are encouraged closer to reality, hostility is absorbed rather than reflected,
and some therapeutic activity or experience in living is provided for all patients. It is
easily seen then that the treatment philosophy of the Hospital has continued to be one
of a team approach in which all members may contribute from their discipline for the
good of the patient. Our success has been due to the efforts of the staff as a whole and
to many of the recent advances in the field of psychiatry.
Electro-convulsive therapy now finds its proper place in the treatment of the acutely
depressed and some acutely disturbed individuals. In the control of overactivity we
now rely more heavily on the tranquillizers, so that electro-convulsive therapy and lobot-
omy have had to be used less for this purpose, but find their rightful place in the treatment of certain conditions for which they are particularly suited. This is reflected in
the fact that forty-eight lobotomies were done in 1950, whereas in 1956 only eleven were
done. The latter figure probably represents the correct number of those individuals who
have conditions which particularly respond to this operation, whereas the 1950 figure
represented a more desperate staff using radical procedures to control chronically disturbed people when there was less in the way of treatment resources. Let us not return
to that former state.
The ataractics or tranquillizers recently assumed a larger place in therapeutics and
are probably responsible in part for the recent reduction shown in the number of lobotomies necessary. There is no doubt that they are contributing to the over-all milieu,
making it possible for more patients to be on the grounds and to be accessible to all the
treatment services. These drugs, however, do not cure in themselves, but make the
patient more accessible to the resources of the Hospital.
One resource of any good psychiatric hospital is psychotherapy—the individual
work between a physician skilled in interpersonal relationships and his patient. We
have endeavoured wherever possible to offer psychotherapeutic help to patients who can
make use of it, but much of the time our medical staff, let alone psychiatrists, is so short
that if the doctors in the continued services saw every patient once a year, each patient
would have only one hour of time once a year, assuming that the doctor had no other
duties—in fact, he has many other calls on his time. In the admission areas and in the
Crease Clinic more time is, of course, available, but still the scope of what is done remains
short of what could be done. In so far as possible, we are using group therapy because
it is more economical of time, and yet nothing can ever replace the individual attention
between a physician and his patient. To further conserve the physician's time, we have
this year consolidated our insulin treatment on two services rather than three. For a
time we have had to discontinue our adolescent treatment group, which further aggravates a situation in which there are no specialized in-patient treatment resources for disturbed children and adolescents in the Province. This is a continued cause of difficulty
and results in our being called upon to treat people for whom we have no resources.
The volunteers from the Canadian Mental Health Association have continued to be
very active in the Hospital, and have done a great deal to help in properly clothing the
patients and in improving their feeling of worth through social activities and contact with
the outside world.
As in other years, the senior clinical staff has continued with the teaching of medical
students. For our resident physicians we have continued and expanded our evening
teaching programme, so that last year, for the first time, we offered two hours of lectures
and seminars once a week for both a junior and an advanced postgraduate group. In
this programme we were helped by the generosity of numerous members of the staff of
the University of British Columbia, who gave to us their time and knowledge. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
Q 67
Since January of this year we have had the benefit of the Mental Health Centre,
which has in many cases carried on the treatment of discharged patients, enabling us to
discharge those who might not otherwise be out of hospital. It is still too early to say
if the Mental Health Centre will relieve the load on the Crease Clinic, which for some
time has been under a great deal of pressure on the women's side.
This year, for the first time, we have begun the immunization of patients with polio
vaccine. To date all those of 18 years and younger are in the process of immunization.
In summary I should like to refer to the recent work of Stanton & Schwartz, published in the book " The Mental Hospital." These authors conducted a controlled study
of interpersonal relationships as they affected the patients in a mental hospital in the
United States. Some of their findings are as follows:—
(1) That where there was confusion among the staff in regard to role, this was
reflected in confusion among the patients.
(2) If two staff members in contact with one patient were in covert disagreement, this was reflected in pathological excitement on the patient's part.
(3) Where there were poor decisions, this reflected itself in poorer performance of personnel.
(4) Changing the social context of the hospital and ward for the better resulted
in improved behaviour; in this way, incontinence, for example, could be
checked.
(5) Low morale among the nurses due to failure, anger, resentment, guilt, or
blame resulted in withdrawal on their part from the patients, resulting in
greater patient withdrawal. Raising the morale reversed this.
The first three points refer to the necessity for close harmony among the members
of the treatment team. The last two relate to the provision of adequate physical facilities
and the correct attitude of staff. A nurse or any other clinical-staff member who feels
deprived of an adequate living wage may carry resentment into his relations with patients,
and, as noted above, an unhappy or resentful staff member creates a disturbed or withdrawn patient—one more who may remain in the confines of the hospital for a longer
period of time. In these days when more treatment facilities are available than ever
before, it is unfortunate that a few dollars should stand in the way of even greater
progress.
Similarly, we must think in the future of improving our treatment plant in keeping
with current clinical practices. It is not enough that maintenance only be done. A proper
room for interviewing, a place to do occupational and industrial work—a recreational
area—all these and many more are the tools of the psychiatrist, just as a scalpel is the
tool of the surgeon. From time to time these tools must be adjusted to meet current
clinical concepts and needs, or else we shall find ourselves operating with a blunt scalpel. Q 68 MENTAL HEALTH SERVICES REPORT, 1956-57
Table 1.—Cases Treated by Coma Insulin, by Sex, Diagnosis, Result, and Disposal,
Provincial Mental Hospital
(a) females
0
ZQt
Result
Disposal
Diagnosis
•a
01
01
>
o
tl
01
tA
-a
01
>
o
M
|
A
o
3
T3
O
|
•a
u
O
E
5
o
T_ __■
aoc
ii
!l
56
"9
— V,
MO
.Sffi
c«
'3 2
Ij
■p
CJ
s
Affective Disorders
2
2
2
Schizophrenia
3
2
2
13
2
5
4
1
...
2
2
1
2
9
1
4
3
1
1
1
2
1
1
1
1
1
10
1
2
3
2
1
2
3
1
3
1
1
Hebeph renic ,
—
Schizoaffective
—
Totals
32
2
23
7
18
14
34
2
25
7
20
14
(6) MALES
Schizophrenia
5
6
20
2
4
2
1
2
3
3
2
13
1
2
1
2
2
1
2
1
5
12
3
4
1
8
2
1
37
2
6
21
8
21
16
1
1
1
1
1
1
Totals
2
—
2
2
39
2
6
21
10
21
18 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 69
Table 2.—Cases Treated by Coma Insulin, by Sex, Diagnosis, Result, and Disposal,
Crease Clinic of Psychological Medicine
(a) FEMALES
Diagnosis
o
j- tt
ll
Result
Disposal
u
CJ
>
O
o
Oi
■a
>
o
,-t
tt,
e
__
u
3
■a
0)
>
o
IH
a
1
•a
CJ
>
o
fi,
6
I
o
•a £?
o .
00 tt
Ii
S3
a
_0
q
|
c3 o
ii
US
OS
0 .+_;
** Ot
X) •£
01 t—r O
01 (->_
w_ C rt
fiVc
rt p 5
•a
o
3
Affective Disorders
i
1
i
Schizophrenia
Simple
4
3
1
4
Hebephrenic
2
1
1
1
i
14
1
3
8
2
11
3
69
22
2
1
3
3
50
15
14
3
56
18
5
2
8
2
9
4
5
5
1
3
Schizoaffective
9
1
1
7
7
1
1
Childhood. _
1
1
1
1
1
1
Totals- -
132
5
10
89
27
104 | 9 | 19
—
1
1
1 I . ...
1
1
1
4
4
4
3
3
3
%
1
1
1
Chronic brain syndrome with psychotic re-
1 1 1
1
Totals . ,.
11 | 1 | — | 10 | —
11 I 1 ----- 1 -
143
6
10
100
27
115 1 9 1 19 I
1 1 1
(6) MALES
Schizophrenia
9
1
7
1
7
2
1
1
1
9
1
2
4
2
6
1
2
41
7
6
24
4
34
2
5
24
4
4
14
2
20
2
2
10
9
1
8
2
9
2
7
9
103 | 13 | 14 | 66 | 10
84 1 5 | 14 |
1
1
1
1
1
1
1
1
1
1
1
1
Chronic brain syndrome with psychotic re-
1
1
1
—
Totals
5 | — | — | 4 | 1
5 | — | — | —
Grand totals
108
13
14
70
11
89
5 | 14
1
—
: Q 70
MENTAL HEALTH SERVICES REPORT, 1956-57
Table 3.—Cases Treated by Electro-convulsive Therapy, by Sex, Diagnosis, Result,
and Disposal, Provincial Mental Hospital
(a) FEMALES
*o
1. _,
.OB
ll
Result
Disposal
Diagnosis
T3
V
i.
>
O
->
A
u
>
o
h
Q.
S
J3
3
s
T3
CJ
>
o
u
tt,
1
•tt
CJ
>
O
o.
£
S
5
o
ID ."3
MS
ss
'rt
.S'S.
_D O
.s a
c
'S3
11
■o
Hi
5
Affective Disorders
14
21
6
4
1
2
-----
1
3
1
10
15
5
3
2
1
1
2
6
5
4
12
15
1
Totals . . .
45
3
5
33
4
17
28
Schizophrenia
18
9
14
57
5
19
9
2
1
6
1
3
16
8
12
37
3
13
7
2
1
2
12
3
2
9
4
6
33
2
10
4
9
5
8
24
3
9
5
Catatonic -
Paranoid _
—
Schizo-affective , _
—
Totals _._ _
131
3
10
96
22
68
63
1
1
3
2
2
10
3
1
1
1
1
1
1
1
2
1
4
2
1
1
5
1
1
3
1
1
1
7
2
Mental deficiency with psychosis
—
Totals ~ . ~ .
23
2
2
12
7
11
12
199
8
17
141
33
96
103 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
Q 71
Table 3.—Cases Treated by Electro-convulsive Therapy, by Sex, Diagnosis, Result,
and Disposal, Provincial Mental Hospital—Continued
(6) MALES
o
.o n
S.J
'a
Result
Disposal
Diagnosis
•tt
u
u
u
>
o
CJ
->
•a
<_
>
o
fi
|
o
3
s
■tt
V
>
o
h
O,
|
■a
a)
>
O
Q
E
5
o
•a |j
u ■_.
Cl, 3
t! 3
Is
bliO
.saa
3^.
'rt rt
u
s
Affective Disorders
13
9
6
2
2
1
1
1
10
8
3
1
3
7
3
1
1
6
6
5
1
Totals _
30
4
1
22
3
12
18
Schizophrenia
35
2
29
65
11
19
8
1
1
3
4
3
3
1
22
17
51
8
11
3
9
2
8
11
3
5
3
8
5
18
4
3
27
2
24
47
11
15
5
Catatonic .
Totals- _ _
169
2
14 | 112
41
38
131
1
1
1
5
6
1
3
1
1
1
4
4
1
1
1
1
1
2
2
2
1
1
3
5
1
3
1
Neurotic depressive reaction
1
Acute brain syndrome with psychotic reaction.-
Mental deficiency with psychosis —
1
Totals .
19
1 | 12
6
2
15
2
218
6
16
146
50
52
164
2 Q 72 MENTAL HEALTH SERVICES REPORT, 1956-57
Table 4.—Cases Treated by Electro-convulsive Therapy, by Sex, Diagnosis, Result,
and Disposal, Crease Clinic of Psychological Medicine
(a) FEMALES
Diagnosis
Res
S3
o
eel
to
>
o
Q.
u
a
g
3
>
O
o
3
fc
^
a
Disposal
SB
25
rt y
o __
b;u
S.2W
« o_
tjj-i s
Hf-,2
Affective Disorders
Manic-
Depressed. - -
Psychotic depressive—
Involutional psychotic-
Totals
Schizophrenia
Simple
Hebephrenic
Catatonic- __
Paranoid— _
Acute undifferentiated-— - _
Chronic undifferentiated
Schizoaffective - —
Residual -
Totals-
Paranoid state
Anxiety reaction
Neurotic depressive reaction. -
Dissociative reaction _
Conversion reaction
Obsessive compulsive reaction
Phobic reaction- — _
Schizoid personality -
Emotionally unstable personality
Passive aggressive personality -
Inadequate personality
Cyclothymic personality
Chronic brain syndrome with neurotic reaction
Chronic brain syndrome with psychotic reaction
Totals
Grand totals
12
30
23
24
7
2
18
64
16
19
23
1
150
6
18
135
1
3
5
1
1
1
5
3
1
2
5
426
1
2
6
3
3
1
1
89 |
21
18
22
6
2
11
51
11
12
16
1
13I 110
6
15
114
1
3
4
1
1
1
4
2
1
187 |
12 | 155
26
31
334
69 |
20
2
12
35
12
29
21
23
85
6
2
15
58
13
16
19
6
18
133
1
3
4
1
1
1
5
3
1
2
4
397
1
1
2
1
5
1
2
1
2
2
2
1
129 |
14
183 | 2 | 2 |
10
19 CREASE CLINIC AND ]
PROVINCIAL
. MENTAL HOSPITAL
Q 73
Table 4.—Cases Treated by Electro-convulsive Therapy, by Sex, Diagnosis, Result,
and Disposal, Crease Clinic of Psychological Medicine—Continued
(b) MALES
Diagnosis
Cfl
s
V
a
0*
o
u
V
XJ
6
tt
%
Result
Disposal
n
u
CJ
>
O
u
•tt
u
>
o
u
J
■s
1
•o
>
o
Ih
a
s
•o
V
>
0
c
a
1
o
*o £?
CJ- —
MB
a 3
ll
Q E
.iSo
OU
.3
M
.3
.3
« o
11
o 1
S o.
.3 to
&.2S.
u u__
"m 3 rt
Bb b
« p u
,H HW
Ha.2
•a
u
a
Affective Disorders
6
1
5
6
10
4
2
4
10
16
4
3
9
16
9
2
2
5
—
9
—
Totals.. -
41 | 10 | 8 | 23 | -
41
— | —
—
Schizophrenia
7
5
2
6
1
2
1
1
Catatonic
16
3
6
4
3
13
2
i
38
7
7
21
3
32
6
18
1
3
11
3
14
4
Chronic undifferentiated
11
11
9
2
. 11
10
1
11 | — | —
—
Totals
103 | 11 | 16 | 63
13
95 | 1 | 16
i
1 1 1 I 1
7 1
7 I I I 7 I
7
19
2
5
11
1
19
Acute brain syndrome with psychotic reac-
3
2
1
2
1
Chronic brain syndrome with neurotic re-
2
2
2
Chronic brain syndrome with psychotic re-
3
4
5
2
Passive aggressive personality — __._
-----
Psychophysiological gastrointestinal reaction
Totals
—
—
45
5 | 5 | 30 | 5
42 1 -- 1 3
Grand totals.
189
26 1 29 | 116
1 1
18
178
1 | 19
1
i
Table 5.—Cases Treated by Electronarcosis, by Diagnosis, Result, and Dispose
il,
Crease Clinic and Provincial Mental Hospital
•o
QJ
rt
Result
Disposal
•o
u
>
o
•o
3
Diagnosis
oh
cjiS
.O 3
g.3
■fa
V
u
>
O
o
CJ
PS
Bi
|
3
3
•3
V
>
o
Ci
a
E
>
o
Ih
Pi
I
s
5
T3
u
5)
u
s
-0
.S-H
1 S
o O
01
a
1
3 1
1 1
-.1 2
1
3 1
32 1 8
—
Schizophrenic
40
1
3
24
12
Miscellaneous _
8
4
4
7 1 1
Totals
51
2
3
30
16
42
9
—
1 Q 74 MENTAL HEALTH SERVICES REPORT, 1956-57
DEPARTMENT OF LABORATORIES
G. A. Nicolson, Director
The total number of tests carried out in the laboratories of the Mental Hospital
and Crease Clinic during the fiscal year was 47,896. This is a decrease of 5,293 from
the previous year, caused by a shortage of trained laboratory personnel, which necessitated curtailment of some laboratory services.
Analysis of the following detailed figures reveals several points of general interest.
The incidence of syphilis in new admissions remains at the low level of 1.5 per cent.
During the year the standard Kahn test for syphilis was discontinued, and the more
specific V.D.R.L. test instituted in its place.
The number of liver function tests carried out remains high. These are complicated, time-consuming procedures, used to protect patients from undesirable complications which might otherwise arise in their treatment with tranquillizing drugs.
There has been a marked increase in the number of bacteriological procedures
performed, including smears, cultures, and antibiotic sensitivity tests. This is the result
of the increased use of antibiotics in treating various infections among the patient population.
The rapid turnover in hospital staff still continues to necessitate carrying out many
more preventive inoculations and vaccinations than were required in previous years.
More autopsies were performed than in any year previously, the total number being
148.
Enumerated below are the laboratory tests carried out this year:—
Blood tests—
Kahn, negative 2,095
Kahn, positive 39
Kahn, quantitative 23
V.D.R.L., negative 1,070
V.D.R.L., positive 8
Red-blood cells and haemoglobin 1,142
Haemoglobin 3,411
Hematocrit (M.C.V., M.C.H., and M.C.H.C.) 64
White-blood cells and differential 4,112
Sedimentation rate 1,481
Eosinophile count 6
Thorn test 1
Lupus erythematosus cells 1
Grouping 173
Cross-matching 520
Indirect Coombs test 181
Sternal marrow 4
Bleeding time 79
Coagulation time 78
Prothrombin activity 123
Platelet count 26
Capillary fragility 1
Reticulocyte count 64
Red-cell fragility 3
Culture 46
Widal 10
Agglutination for B. abortus 4
Paul Bunnell test 2 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 75
Blood tests—Continued
Glucose 644
Glucose tolerance test 31
Insulin sensitivity test 3
Amylase 12
Non-protein nitrogen 333
Urea nitrogen 13
Urea clearance 3
Uric acid 11
Creatinine 9
C02 combining power 26
Cholesterol 114
Barbiturate 5
Bromide 12
Chloride 58
Sodium 5 7
Potassium 57
Iron 3
Copper 1
Calcium 13
Phosphorus 6
Alkaline phosphatase 894
Acid phosphatase 37
Icterus index 46
Van den Bergh 156
Total protein 37
Albumin-globulin ratio 66
Albumin 1
Hanger flocculation 212
Thymol turbidity 78
Congo red 1
Alcohol 9
Cerebrospinal fluid—
Kahn, negative 93
Kahn, positive 2
Colloidal gold 94
Cell count 576
Total protein 579
Glucose 8
Chloride 7
Bromide 1
M. tuberculosis 1
Urine—
Routine general 8,466
Acetone 2,239
Quantitative sugar 272
Fructose 1
Benzidene 618
Bromide 2,739
Quantitative albumin 244
Mosenthal 6
Concentration and dilution test 1 Q 76 MENTAL HEALTH SERVICES REPORT, 1956-57
Urine—Continued
Friedman 5 9
Bence-Jones protein 2
Chyle 8
Bile 222
Urobilinogen 50
Porphyrins 5
Melanin 1
Phenylpyruvic acid 1
Phenolsulphonephthalein 3
Calcium 2
Copper 188
Amino acids 14
Sulphonamides 2
Arsenic 1 2
Tin 1
Lead 2
Cystoscopic specimens 15
Chromatograms 717
17-ketosteroids 20
M. tuberculosis (24-hour specimen) 4
Smears—
Miscellaneous 552
Gonococcus 57
M. tuberculosis 71
Vincent's organisms 2
Malaria 2
Trichomonas 41
Diphtheria 2
Fungus 5
Sputum—
M. tuberculosis 369
Occult blood 1
Cultures—
Miscellaneous 812
Antibiotic sensitivity 1,038
Diphtheria 2
Typhoid 518
Dysentery 518
Salmonella 12
M. tuberculosis 459
Gonococcus 3 8
Fungus 27
Water for bacterial count 1
Milk for bacterial count 89
Faeces for bacterial count 19
Gastric contents—
Analysis 6
Occult blood 9
M. tuberculosis 106 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 77
Fasces—
Parasites 58
Occult blood 235
Stercobilin 2
M. tuberculosis 4
Injections—
Typhoid vaccine 651
Diphtheria toxoid 59
Pollen antigen 25
Skin tests—
Tuberculin 2,589
Schick 171
Dick 5
Smallpox vaccinations 134
Basal metabolic rate 251
Electrocardiograph 318
Biopsies 147
Fluid for cancer cells 2
Autopsies 148
Animal autopsies 24
Sections 3,327
Rush sections 6
Ascitic fluid routine 1
Water for copper 3
Total 47,896
DEPARTMENT OF NEUROLOGY
W. P. Fister, Director
The neurological services have enjoyed a very active year. There was a constant
demand for clinical consultations. The E.E.G. facilities were fully employed in examining 1,520 patients, eighty-five more than in the previous year. There were also 336
pneumograms performed, twenty fewer than last year.
The number of neurosurgical cases investigated and subsequently operated showed
a substantial increase compared with the previous year. Eleven of the twenty-nine cases
dealt with were suffering from epileptogenic lesions. These were removed surgically
under electrocorticographic guidance with gratifying results.
A clinical survey was carried out of all the patients (twenty-five in number) suffering from Parkinson's disease with a view of making surgical therapies available to them.
The Woodlands School has made greater demands for consultative examinations
than before. In addition, the research project on oligophrenia phenylpyruvica carried
out in The Woodlands School was supported by serial E.E.G. studies. Graphs of the
electronic frequency analysis were submitted for intended publication.
The opening of the Mental Health Centre in Burnaby has also augmented the scope
and duties of this Department. A full-time E.E.G. technician is employed there. The
neurologist is at present on a part-time basis and gives one day a week to the day centre.
Such Provincial and Federal institutions as the Girls' Industrial School, the Boys'
Industrial School, the Boys' Detention Home, Oakalla Prison Farm, New Haven, the Q 78 MENTAL HEALTH SERVICES REPORT, 1956-57
British Columbia Penitentiary, and the Child Guidance Clinic have made frequent calls
on our laboratory facilities.
Lectures on neurological and neurophysiological topics were arranged for the
medical and nursing staffs.
Clinical demonstrations were given to the first- and third-year students of medicine
and applied psychology of the University of British Columbia.
In the latter part of March, 1957, we welcomed Dr. E. V. Mellor to our staff in the
dual capacity of clinical neurologist and electroencephalographer.
"
DEPARTMENT OF RADIOLOGY
J. M. Jackson, Director
The following is a tabulation of the work performed in this Department for the
twelve-month perior ended March 31st, 1957:—
Crease Clinic of Psychological Medicine
Number of films taken 5,085
Number of patients X-rayed 2,081
Films Patients
Chests 1,664 1,631
Extremities 217 71
Spines 328 92
Skulls 56 23
Pneumoencephalograms 1,929 140
Barium enemas 104 10
Barium meals 483 33
Barium swallows 5 1
Pyelograms 79 13
Gall-bladders 32 7
Abdomens 39 28
Ribs 18 6
Pelvis 5 4
Jaws 29 6
Noses 3 1
Sinuses 23 5
Mastoids 15 3
Heart fluoroscopies 16 3
Ventriculargrams 38 3
Angiogram 2 1
Totals 5,085 2,081 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 79
Provincial Mental Hospital
Number of films taken 21,586
Number of patients X-rayed 13,422
Films Patients
Chests 11,604 11,440
Extremities 2,410 794
Spines 743 209
Skulls 215 78
Pneumoencephalograms 2,547 186
Barium enemas 683 74
Barium meals 1,523 126
Barium swallows 128 17
Pyelograms 534 103
Gall-bladders 159 34
Abdomens 211 122
Ribs 163 64
Pelvis 45 32
Jaws 139 36
Sinuses 133 32
Noses 65 20
Mastoids 40 10
Facial bones 24 7
Planograms 155 29
Heart fluoroscopies 17 3
Bronchograms 16 2
Cholangiograms 8 2
Ventriculargrams 24 2
Totals 21,586 13,422
DEPARTMENT OF PHYSICAL MEDICINE
I. S. Kenning, Clinical Director
The staffing of this Department has improved a great deal since last year's report,
so that we have been able to offer the services of a qualified physiotherapist in all areas
of the Hospital and Clinic.
Treatments have been carried out as in previous years; details of procedures can
be seen from the accompanying tables. In addition, a total of 1,968 treatments were
given by the chiropodist attached to the Department.
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, 1956, to March 31st, 1957:— Q 80
MENTAL HEALTH SERVICES REPORT, 1956-57
Provincial Mental Hospital
Galvano and faradic stimulation
Hydrotherapy
Infra-red
Number of
Treatments
19
_ 115
_ 127
_ 1,013
Massage and manipulation
Remedial exercises 2,621
Short-wave diathermy 346
Ultra-violet lights 96
Wax baths 45
Total number of treatments.
Total number of patients treated
4,382
190
Crease Clinic of Psychological Medicine
Male
Female
Total
20
2,171
138
341
153
104
493
1,485
55
56
4
24
109
27
1,870
747
8
719
583
314
29
754
763
3
80
195
146
510
47
4,041
885
Galvanic and faradic stimulation..
8
1,060
583
467
133
1,247
2,248
58
136
199
170
619
5,153
333
6,748
512
11,901
845
PHARMACY REPORT
K. Woolcock, Chief Pharmacist
Noticeable advancement has been made in the pharmaceutical field. We are proud
that this Department has played an important part in the mental-health programme,
whose services have kept pace in the expanding application of modern medicine.
Our use of the ataractics, or, as they are more commonly called, the tranquillizers, is
second to none, and several medical projects to determine the efficacy of treatment
through these specialized medications have been successfully accomplished by the
Pharmacy working in conjunction with the medical staff.
The Department has recently expanded its activities to include the supply of
pharmaceuticals and surgical requisites to the Mental Health Centre, the eighth on the
list of institutions which utilize this Department for their supplies.
The efficiency of our services is somewhat curtailed since (a) our output to the
institutions has risen tremendously, and (ft) it requires an average of six weeks for the
British Columbia Purchasing Commission to service our orders before we obtain the
necessary commodities.
The facilities of the new Pharmacy have aided in the dispensing both of basket and
prescription items, and the system we are employing allows for an almost uninterrupted
flow of hospital necessities with a bare minimum of staff. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 81
We have undertaken to aid in the training of a pharmaceutical student. The
programme of specialized hospital training is absolutely essential since the number of
available hospital pharmacists is at an all-time low.
DENTAL DEPARTMENT
H. O. Johnsen, Director
During the past year a fully equipped, modern, and very attractive dental clinic has
been established in the North Lawn Building. All active tuberculosis patients requiring
dental treatment are now taken care of at this clinic.
A noticeable increase in the number of dentures lost, often shortly after a patient
is admitted, has become evident. This has made it necessary for both dentists and dental
technician to spend a great deal of time replacing such lost dentures, time that should
have been used to fill the ever-increasing demand for new dentures developing as patients
are getting well and once more start to take an interest in their personal appearance.
During the fiscal year, ninety-three dentures were reported lost. Of these, thirteen
were subsequently returned to their owners, thanks to our system of marking all
dentures. But eighty dentures had to be replaced. This situation is being given special
study in order to develop a remedy.
Summary of Work
Examinations 2,462 Extractions 1,126
Fillings 1,170 Prophylaxis 195
X-rays 746 Treatments 395
Dentures made 214 Dentures repaired 257
Dentures relined 43 Bridges made 1
Bridges repaired 6 Plastic crowns 5
General anaesthetic __ 7
OPTICAL DEPARTMENT
H. H. Woodbridge, Optometrist
The following is the report of the optical work done for the fiscal year April 1st,
1956, to March 31st, 1957, for the Provincial Mental Hospital and the Crease Clinic
of Psychological Medicine:—
Refractions 625
Major repairs 257 Q 82 MENTAL HEALTH SERVICES REPORT, 1956-57
DIETARY REPORT
Mrs. M. E. Marr, Dietetics Administrator
During the year the Dietary Department embarked upon a programme to reorganize
its operations, with prime emphasis on better meals for the patients at a cost that is
within our budget limitations. Such an objective has required considerable menu
revision, and from this revision our achievements have been as follows:—
(1) The menu has been improved both nutritionally and attractively.
(2) The dinner has been changed from midday to evening in order that the
patients might have more sustenance during the long period from dinner
to breakfast.
(3) An eight-week rotating menu has been implemented throughout all
kitchens. This rotation ensures that each patient shares equally with
every other patient and staff in the institution.
(4) As the rotating menu affords us a good basis for accurate cost computation per patient meal, we have commenced cost accounting in each
kitchen.
We could not have succeeded to the extent that we have in this objective had we
not had splendid co-operation from the nursing department, the stores, butcher-shop, and
bakery. We are very grateful for their assistance.
As well as having filled prescriptions for special diets common to all hospitals, we
have conducted two unusual and noteworthy diet-therapy projects. Miss Richards,
dietician, directed a project for the Department of Neurological Research, University of
British Columbia. This project was designed to determine the effects of phenylalanine
on schizophrenic patients. Since then, Miss Donna Smith, dietician for West Lawn and
Centre Lawn, has administered a minimum copper diet to a patient with Wilson's disease.
Great success in the treatment programme for this patient has been achieved.
During the year we contributed to the Essondale School of Psychiatric Nursing by
lecturing in normal nutrition and diet therapy.
In addition to our regular duties, we have done considerable catering during the
year. Some of the functions for which we have catered were the staff dance, the
CM.H.A. dinner, the graduation tea, the graduation reception, and the Mental Health
Centre opening tea.
There have been nine promotions on our staff during 1956-57. Four kitchen-
helpers were promoted to Cooks—Grade 1, three Cooks—Grade 1 were promoted to
Cooks—Grade 2, two Cooks—Grade 2 were promoted to Cooks—Grade 3, and one
Cook—Grade 3 has been promoted to Cook—Grade 4.
Staff dining facilities have been brightened by the decoration and renovation of the
Crease Clinic dining-rooms. The decor and colour were chosen co-operatively by the
Industrial Therapy and Occupational Therapy Departments. The drapes made by
the industrial therapists make a refreshing change from the old lambrequins. The
occupational therapists did a lot of research to obtain the authentic West Coast Indian
designs that they block-printed on to the drapes, and incorporated into the totem-poles
which adorn the structural pillars. We are very appreciative of the thought, time, and
effort expended by these two departments.
Plans are now finished for the renovation of East Lawn kitchen and dining-rooms.
When this renovation is completed, this building will have an excellent kitchen, which
will enable us to improve upon the menu and meal service for the patients in that building.
The Dietary Department is greatly encouraged by its progress during 1956-57, and
we are enthusiastic in our anticipation of greater progress in the year to come. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 83
DEPARTMENT OF NURSING, WOMEN'S DIVISION
Miss E. M. Pullan, Director of Nursing
During the early part of the year the position of Assistant Director of Nursing
became vacant when Miss H. O. Lipsey, R.N., transferred to the position of Superintendent of Nursing at the Home for the Aged, Vernon, and the position of Senior
Instructor in the School of Psychiatric Nursing became vacant when Miss O. J. Smith,
R.N., resigned. These positions remained vacant for several months and were then filled
when Mrs. J. Lundahl, R.N., was appointed as Assistant Director of Nursing and Miss
M. Kenny, B.Sc, R.N., was appointed as Associate Director of Nursing Education
(a new title given to the position held by the person who is responsible for the School of
Psychiatric Nursing).
With the increase in the scope of activity in the Department of Nursing, we found
that problems which arose had many more facets than formerly, thus making the
administrative process of problem-solving very difficult. To aid in the solution of
problems, a committee on nursing was organized, as follows:—
Committee on Nursing
!
I I I
Committee on Nursing Service Committee on Nursing Education Nurses' Residences
I I I
Task Committees Task Committees Task Committees
Nursing Service Policy. Nursing Education Policy. Nurses' Residence Policy.
Nursing Procedures. Selection, Academic Progress, Clinical Progress,
Nursing Records. and General Conduct of Students.
Nursing Curriculum Committee.
Psychiatric Nursing.
Affiliate Programme.
Postgraduate Programme.
In-service Education
Refresher Courses.
The committee is composed of the chairmen of the sub-committees, with the
Director of Nursing as chairman. The chairmen of the sub-committees are the heads
of the Department of Nursing section—for example, Nursing Service, Nursing Education,
Nurses' Residences. The Task Committees are made up of members of staff chosen
because of their familiarity with the problems. This committee structure has been most
valuable in solving many problems. It has also been valuable in bringing the ward staff
into closer relationship in solving the problems which are vital to the wards.
In an effort to standarize the administrative procedures, ward manuals were planned
for each ward. This was a tremendous task. It was well on its way to completion by the
end of the year.
The interest in new plans and projects for nursing care of patients has been very
promising. There has been considerable competition between the different units. The
patients are definitely benefiting from the keen interest of the staff. Socializing activities
are much better understood and are being used in a very beneficial way.
Considerable thought has been given to the desirability of changing the plan of
organization of the Department of Nursing, Women's Division, from being controlled
through a central administration to individual unit administration. This was done in the
North Lawn Building, and unit organization was started December 3rd, 1956, with
Miss M. Howells, R.N., appointed as Unit Nursing Administrator. This has been quite
successful, and better care has been the result. Plans are being made to continue the
unitization process for all the units if supervisory staff is available. It is very obvious
that when supervision is more direct, as found in the unit plan, the dividends are high
in better patient care. Qualified staff are available, but they do not remain because of
the poor salary structure offered qualified persons. Q 84 MENTAL HEALTH SERVICES REPORT, 1956-57
Two instructors from the School of Psychiatric Nursing were transferred to the
Mental Health Centre in December—namely, Miss B. Mitchell, R.N., and Mrs. K. Lae,
R.N. Mr. G. Kenwood, psychiatric nurse instructor, resigned to join the staff of the
Canadian Mental Health Association.
A forty-hour refresher course was given to all charge nurses at Essondale and The
Woodlands School in December. A course in administration and supervision was given
to supervisory staff (men and women). This course was given throughout the year.
I should like to take this opportunity of thanking the nursing staff for their splendid
service in the past year, often under very trying circumstances; all members of other
services of the Hospital for their co-operation; and those members of the medical
profession who gave so freely of their time for the benefit of nursing.
DEPARTMENT OF NURSING, MEN'S DIVISION
R. H. Strong, Chief Male Psychiatric Nurse
This year saw the start of a much-needed renovation of the West Lawn Building.
New floors had been laid in two complete wards on the east side by Christmas time and
the wards redecorated. At the time of this report, three wards on the west side are
simultaneously undergoing similar changes. West 2 surgery also had new floors laid in
the single rooms by Christmas and clinic wards repainted. All of this has resulted in
a considerable amount of readjustment to different schedules which had to be adopted
by patients and staff and caused considerable temporary inconvenience. However, by a
close liaison with the Public Works Department, complete co-operation has been enjoyed
between the two departments.
The large male airing-court underwent some changes also, a badly needed wire
fence was erected, and one section was levelled to provide a playing-field. We now have
a loud-speaker hooked up to the wired music system for the enjoyment of the patients
in the airing-court. We are now able to borrow an amplifier and microphone from the
Audio-Visual Department, which assists the staff greatly when calling patients out to
receive visitors.
Another section which has expanded considerably is a park-like area being shaped
by patients alone as a therapy project to the west and north of the court. Much credit
is due to Mr. Finnie, a psychiatric nurse, for his untiring efforts in initiating and guiding
the clearing and landscaping of this hillside area over several years with patients.
Ward A 2 was refurnished this past year, and furnishings are now more in keeping
with the surroundings of an open ward.
Male staff were required to escort eight male patients to other parts of Canada
during the past year in addition to many escort services to other areas within the
Province, including twelve patients to the Provincial Mental Home at Colquitz.
The number of patients who now enjoy grounds privileges number approximately
1,400. On May 1st, 1956, the male services were assigned the responsibility of supervising female patients with grounds privileges, as well as the male patients. I therefore
increased the grounds patrol from two to four staff. The total number of patients that
had to be interviewed by the Grounds Supervisors prior to the patients receiving privileges
was 1,848 in the twelve-month period, or an average of 154 per month. This is a very
time-consuming effort, and the large area of grounds to be covered, plus the many CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 85
problems they must cope with, again indicates that the staff may have to be further
increased to do an effective job.
The School of Psychiatric Nursing last winter gave a refresher course for charge
psychiatric nurses, which I feel was more effective because the nurses were taken off the
ward for one week to attend this course, thus they could concentrate on the lectures
without being bothered at the same time with ward problems. Further to this, male
supervisors were invited to attend refresher lectures for supervisor staff. Attendance
was rather sporadic because other duties often were more urgent. This again indicates
the need for sufficient supervisory staff in the male services to give adequate service and
provide relief.
Staffing of male wards with trained personnel presents an ever-increasing problem.
Demands on nursing staff have increased over the previous year again, and much credit
is due them for meeting these demands so admirably.
PSYCHOLOGY DEPARTMENT
J. W. Borthwick, Senior Psychologist
The Psychology Department has continued to have difficulty in recruiting staff.
During this year we have, on the average, been operating at less than two-thirds of our
establishment. We have also been providing a part-time service to The Woodlands
School, which has had no psychologist on staff during the year. In October, however,
the Civil Service Commission recommended salary increases to take effect at the beginning of the forthcoming fiscal year. It is hoped that these will make our salaries more
competitive with other employers of psychologists across Canada and thus help to relieve
these shortages.
The duties of the psychologists during the year consisted chiefly of diagnostic evaluations, therapy, and educational activities. Most of the 454 psychological reports completed were aimed at providing diagnostic evaluations of new admissions. A smaller
number were aimed at evaluating certain patients as part of their discharge planning.
This latter service, it is believed, is a worth-while one which should be recognized as an
essential step in rehabilitation, especially of the long-term patient.
The Department has been active in group therapy, participating in 167 sessions
during the year. The group technique has ranged from the interpretive-integrative sort
with neurotics to socializing-reality testing with chronically disturbed psychotics. Complete records have been kept on all these groups both for evaluating the progress of the
patients and to serve as a way of increasing our knowledge about this therapeutic method.
A small number of patients from the West Lawn and East Lawn Buildings have been
seen individually in intensive therapy for a total of 119 sessions.
In the realm of education, we have given forty lectures to psychiatric nurses in
training, plus eleven lectures to psychiatric residents. Numerous lectures and talks have
been given to extramural groups, such as students in psychology, medicine, and public
health nursing, as well as to community groups, such as Parent-Teacher Associations and
community centre members.
Unfortunately the above service functions of the Department leave little time for
research. Research in human behaviour is one of the major fields in which the psychologist is trained. It is hoped that as our staff is built up, we can begin to perform this
important function for a modern mental hospital. Q 86 MENTAL HEALTH SERVICES REPORT, 1956-57
The following is a tabulation of tests administered:—
Arthur Point Scale 2
Bell Adjustment Inventory 3
Bender Gestalt 157
Benjamin Proverbs 10
Bernreuter Personality Inventory 1
Blackie Pictures 1
California Test of Personality 1
Differential Aptitude 3
Draw-a-Person 154
Goldstein Scheerer 29
House-Tree-Person 2
Kuder Preference Record 14
Lee-Thorpe Occupational Interest Inventory 6
Minnesota Multiphasic Personality Inventory 27
Porteus Mazes 15
Progressive Matrices 5
Rorschach Inkblots 318
Rosenzweig Picture Frustration 2
Sentence Completion 44
Shipley Hartford __—____—__ 54
Stanford-Binet, Forms L and M 6
Strong Vocational Interest Blank 1
Symonds Picture Story 6
Thematic Apperception Test 49
Vernon-Allport Study of Values 4
Wechsler Adult Intelligence Scale 3
Wechsler-Bellevue, Forms I and II 361
Wechsler Intelligence Scale for Children 10
Wechsler Memory Scale 15
Wide Range Achievement 9
Word Association 1
Total 1,313
SOCIAL SERVICE DEPARTMENT
Miss D. R. Begg, Supervisor
A. Social Service
During the year the Social Service Department has experienced serious reverses in
the recruitment of professional personnel to the point where it is now operating with
approximately 47 per cent of the normal complement of staff. Vacancies resulting from
resignations to take more lucrative positions in community social agencies and from
transfers to other units of the Provincial Mental Health Services have remained unfilled.
The units which have been most severely affected by these depletions in social-work
personnel are those in the Provincial Mental Hospital. In order to maintain an adequate
standard of services for the smaller number of patients which can be accommodated
by a reduced social service staff, it has been necessary to curtail markedly the area of CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 87
coverage, even to the extent of complete withdrawal of services from the West Lawn,
Riverside, and Colony Farm Buildings. To date it has never been possible to offer social
service to patients hospitalized in the North Lawn unit and the Home for the Aged,
although the necessity for such services has been demonstrated. Due to the rapid turnover of the patient group in the Crease Clinic and the frequent need for emergency social
services, an attempt has been made to maintain a fairly consistent number of social
workers in that establishment. However, this has been done at the expense of the other
units and at a level below the basic minimum. A further loss to the Department was
experienced through the resignation of the social group worker and the able contribution
which she made to programmes involving the adolescent treatment group, activities on
open wards, and nursing education. Pilot projects which she initiated on two of the
open wards have, since her resignation, received very limited consultative help from
Social Service.
Efforts to recruit available social workers have been largely unsuccessful due to low
salaries and consequent inability to compete with community social and welfare agencies.
It is hoped that the salary increases proposed for April, 1957, will ameliorate this situation to some degree.
The operational structure of the Social Service Department has continued to be on
a sectional basis, and includes Admissions and Brief Services Sections and Continued
Services Sections. The former are situated in the Crease Clinic and in the Centre Lawn
Building of the Provincial Mental Hospital and provide intake and brief services to
patients and their families usually, although not necessarily, during the early periods of
hospitalization. Continued Services Sections are located in the Crease Clinic and in the
Centre Lawn and East Lawn Buildings of the Provincial Mental Hospital. Social
workers employed in these sections offer sustained social services to a selected group of
patients and their families at any point during hospitalization and in certain instances
following discharge. However, it has not been possible to meet adequately the needs of
all the patients and their families for whom, on assessment, social services have been
indicated. In the Crease Clinic approximately 50 per cent of the patient intake was
carried on either a brief or sustained basis. Similarly, in the Centre Lawn Building
social services were extended to approximately 25 per cent of the patient load and in the
East Lawn Building to approximately 18 per cent.
With a view to further integration and uniformity of services and procedures
throughout the Social Service Departments, the responsibilites of the Assistant Chief of
Social Work (Supervisor—Grade I) were, in September, 1956, extended to include the
Social Service Department at the Crease Clinic. In all units, developments have pointed
to greatly improved methods of communication with medical staff. This has been largely
due to the institution of weekly meetings arranged between medical and social service
personnel, and geared to the sharing of information relevant to treatment and rehabilitation of patients. Such effective means of interdisciplinary communication are of particular importance to the social workers since the increased use of drug therapies has resulted
in a significant increase in the rate of patient discharges, and a corresponding need for
greater and generally more accelerated social services in the area of rehabilitation.
Meeting with community and social welfare agencies for the purpose of delineating
functions and formulating policies of referral have continued during the year. As a
result, mutually satisfactory policies have been developed with the veterans' welfare
officers of the Department of Veterans' Affairs with respect to rehabilitation services for
selected groups of veteran patients, and with the Borstal Association in relation to patients
in whom that agency maintains a continuing interest during hospitalization and subsequent to it.
Two students (one first year and one second year) from the School of Social Work
have received their field-work training in the Provincial Mental Hospital. Such place- Q 88 MENTAL HEALTH SERVICES REPORT, 1956-57
ments provide an opportunity for the recruitment of potential staff, and in this instance
both students are considering employment in some branch of the Provincial Mental Health
Services. The student who is completing her first year of training has made application to
take summer employment with the Provincial Mental Hospital, following which she hopes
to enrol for further training leading to the Master's degree under a Federal Mental Health
Grant.
The work of the Departments during the year is reflected in the statistical summaries.
Crease Clinic statistics show a reduction in casework interviews with and regarding
patients as compared with the number for the previous year. This would appear to be
related to staff shortages in the Clinic during the late spring and summer months when
vacancies occurred and were not immediately filled. In some instances, replacements
were obtained later in the year. In other instances, vacancies remained unfilled. On the
other hand, the statistics for this specific service as provided by the Social Service Department in the Provincial Mental Hospital remains essentially unchanged, despite the present
critical staff situation. In explanation it is to be noted that the monthly reports for
the Provincial Mental Hospital Social Service Department indicate a very high level of
productivity during the early months of the year when numbers of staff were relatively
consistent and then show a marked drop in the number of interviews as of December,
1956. This drop corresponds with the heavy reduction in staff due to transfers and resignations and the resulting inability to fill them. As previously mentioned in the report,
there has been a sharp increase in the number of consultations with members of other
disciplines, which is true of the Social Service Departments in all units of the Provincial
Mental Hospital and Crease Clinic.
In addition to direct services to patients and their families, social workers participated in the orientation of seventy persons with respect to the functions and services
offered by social workers in the Hospital and Clinic settings. This group included twenty-
five in-service-trained social workers from the Social Welfare Branch as well as thirty-five
first-year graduates from the School of Social Work. In addition, ten individuals received
orientation at various times during the year to the services offered in these institutions.
The Department also participated with other disciplines in orientation lectures to Canadian Mental Health Association volunteers who were working in the Hospital and Clinic.
The staff recognizes the need for and the benefits to be attained from community interpretation, and during the year have been active in talking to high-school and other interested
groups. It is hoped that with additional personnel there will be increasing activity in this
particular area.
The social workers would like to express appreciation of the support and cooperation received from the Administration of the Provincial Mental Health Services,
from other disciplines and departments within the Hospital and Clinic, and from community agencies and resources. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 89
Statistical Summary of Patients Receiving Service from the Social Service Department,
April 1st, 1956, to March 31st, 1957, Crease Clinic of Psychological Medicine
I. Admissions Section
Incoming—
Cases brought forward from previous fiscal year 17
New cases 543
Cases reopened, either during the year or from previous years 22
Cases transferred in during the year (either from another service or
between social workers) 20
Total intake into case loads 602
Outgoing—
Cases transferred out during the year (either to another service or
between social workers) 302
Cases closed during year 267
Total disposition 569
Cases carried forward to next fiscal year 33
II. Continuing Casework Services Section
A. Services to Patients during the Treatment Period
Incoming—
Cases brought forward from previous fiscal year 50
New cases 127
Cases reopened, either during the year or from previous years 3
Cases transferred in during the year (either from another service or
between social workers) 245
Total intake into case loads 425
Outgoing—
Cases transferred out during the year (either to another service or
between social workers) 113
Cases closed during year 255
Total disposition 368
Cases carried forward to next fiscal year 57
B. Services to Patients during the Periods of Pre-discharge and Post-discharge
Incoming—
Cases brought forward from previous fiscal year 32
New cases 27
Cases reopened, either during the year or from previous years 8
Cases transferred in during the year (either from another service or
between social workers) 92
Total intake into case loads 159
Outgoing—
Cases transferred out during the year (either to another service or
between social workers) 14
Cases closed during the year 141
Total disposition 155
Cases carried forward to next fiscal year 4 Q 90 MENTAL HEALTH SERVICES REPORT, 1956-57
III. Summary of Professional Activities
1955-56 1956-57
Case-work interviews with patients 3,663 3,093
Case-work interviews with relatives 1,197 897
Total case-work interviews with and regarding patients 4,860 3,990
Consultation with other disciplines 1,639 3,797
Consultation with welfare agencies and employment resources 570 573
Total conferences and consultations concerning patients 2,209 4,370
Periods of ward rounds attended by one or more members of Social Service
staff 90
Medical clinics attended by one or more members of Social Service staff 12
Supervisory consultations (hours) 410
Programme development and staff meetings (hours) 80
Orientation to Clinic of outside personnel 70
Correspondence sent out regarding patients 450
Statistical Summary of Patients Receiving Service from the Social Service Department,
April 1st, 1956, to March 31st, 1957, Provincial Mental Hospital
I. Admissions Section
Incoming—
Cases brought forward from previous fiscal year 42
New cases 525
Cases reopened, either during the year or from previous years 326
Cases transferred in during the year (either from another service or
between social workers) 10
Total intake into case loads 903
Outgoing—
Cases transferred out during the year (either to another service or
between social workers) 123
Cases closed during year 730
Total disposition 853
Cases carried forward to next fiscal year 50
II. Continuing Casework Services Section
A. Services to Patients during the Treatment Period
Incoming—
Cases brought forward from previous fiscal year 75
New cases 115
Cases reopened, either during the year or from previous years 20
Cases transferred in during the year (either from another service or
between social workers) 13
Total intake into case loads 223
Outgoing—
Cases transferred out during the year (either to another service or
between social workers) 64
Cases closed during year 135
Total disposition 199
Cases carried forward to next fiscal year 24 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 91
B. Service to Patients during the periods of Pre-discharge and Post-discharge
Incoming—
Cases brought forward from previous fiscal year 103
New cases 66
Cases reopened, either during the year or from previous years 11
Cases transferred in during the year (either from another service or
between social workers) 86
Total intake into case loads 266
Outgoing—
Cases transferred out during the year (either to another service or
between social workers) 60
Cases closed during year 183
Total disposition 243
Cases carried forward to next fiscal year 23
III. Summary of Professional Activities
1955-56 1956-57
Case-work interviews with patients 3,548 3,279
Case-work interviews with relatives 877 1,198
Total case-work interviews with and regarding patients 4,425 4,477
Consultation with other disciplines 2,529 3,439
Consultation with welfare agencies and employment resources 715 1,099
Total conferences and consultations concerning patients 3,244 4,538
Periods of ward rounds attended by one or more members of Social Service
staff 155
Medical clinics attended by one or more members of Social Service staff 24
Supervisory consultations (hours) 585
Programme development and staff meetings (hours) 60
Orientation to Hospital of outside personnel 70
Correspondence sent out regarding patients 1,163
B. Social Rehabilitation (for Male Patients)
This is the seventh annual report of the Rehabilitation Section, together with statistical figures covering the fiscal year April 1st, 1956, to March 31st, 1957.
As of February 1st, 1957, the Department lost the services of Mr. J. D. Addison,
who had started the Rehabilitation Section in February, 1950, and continued as a " one-
man section " since that time. Mr. Addison took a position of considerable importance
and responsibility with the Federal Department of Indian Affairs in Vancouver. The
steady growth and development of the Rehabilitation Section had been largely a result
of Mr. Addison's efforts and energies. His contacts with employer groups in the community and with the National Employment Services officers have built a firm base for
the further work and development of the Rehabilitation Section. The Mental Health
Services have indeed lost a most valuable employee in losing Mr. Addison. Following
Mr. Addison's departure, the work of the Rehabilitation Section came to a standstill.
The Social Service Section was able to carry a very limited number of emergency rehabilitation cases. As of the end of the fiscal year, no replacement had been obtained. It was
hoped that a replacement would be obtained early in the new year in order that services Q 92 MENTAL HEALTH SERVICES REPORT, 1956-57
to patients could be resumed and in order that the contacts and liaison built up could be
maintained.
The employment situation was excellent in April, 1956, and continued at a peak
until well into late fall. Consequently, job opportunities for discharged patients were
also very good. As a result, more patients were fully rehabilitated than in any previous
year.
Substantial progress was made toward setting up an in-town Rehabilitation Centre
for male patients. The buildings have been procured and renovated and suitable staff
obtained. We now only await the equipping of the Rehabilitation Centre to be able to
put it into operation.
In the Greater Vancouver area there are a considerable number of personnel in
various fields engaged in rehabilitation-type work. In view of the fact that job opportunities are limited, there is therefore increasing competition among those engaged in
rehabilitation work for the jobs available. If our patients are to be given a fair chance
at the jobs available, there is need for more staff in the Rehabilitation Section in order
that more contacts and closer liaison may be made and maintained with community
groups.
Statistical Summary, April 1st, 1956, to January 31st, 1957
Total number of cases referred for rehabilitation 239
Minus cases unsuitable for rehabilitation 5
Total number of active rehabilitation cases 234
Cases fully rehabilitated 154
Cases assisted by referral and casework 80
Total number of interviews (with patients, prospective employers, doctors, nurses, etc.) 1,627
Monthly average of interviews 163
OCCUPATIONAL THERAPY DEPARTMENT
Miss D. M. Tayler, Supervisor
During this year there have been great changes and progress made in this field of
work.
Starting in chronological order, in April, 1956, the North Lawn Department opened
for both men and women working together.
On September 1st the whole Occupational Therapy Department was reorganized,
and the Industrial units were separated and run under the guidance of Mr. Herring. The
women's Occupational Therapy Departments amalgamated with the men's Occupational
Therapy Departments, and all came under the supervision of an occupational therapist.
With this change, during October, the Crease Clinic Departments became a combined
department for men and women working together.
By February, 1957, an additional room was loaned to the North Lawn Department
for craft work, and that necessitated the Department to become an open one, the first
in the Essondale area.
Great progress has been achieved in our geriatric unit at the Homes for the Aged.
With a change of staff in October, ward groups were started in the women's day-rooms,
and with this increased activity the Christmas decorations were made and put up by the
patients in their own wards. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 93
The East Lawn unit has had a major change. In the Department the number of
the patients has been reduced to about ninety, and occupational therapy is now carried
on daily on the wards with nursing staff under the supervision of the Occupational Therapy staff, thus 185 to 200 more patients are now able to benefit. This latter figure is not
included in the summary of statistics.
There was a great shortage of staff for the first six months of this year. Four occupational-therapy students came for clinical affiliation from the University of Toronto and
one student from McGill for two months. All these students came during the summer
months and were of assistance to the staff.
Since November the staff members were gradually increased to twenty-three, allowing just one vacancy. Unfortunately, few of the staff are qualified, but with able handicraft instructors the work in the varying departments has been increased and a reasonable standard of work achieved.
In July the Grade 2 positions were created for the therapists taking charge of workshops in East, Centre, and North Lawn. Apart from that, no salary increase has been
received, so there is still much discontent among the staff.
The Department again arranged the floral decorations for the nurses' graduation
in April. An exhibition of crafts was arranged for the " open house " at East Lawn in
May and at the Coquitlam Women's Institute Flower Show in August.
The Christmas sale was held on December 5th, when $2,448.20 was realized. Toys,
made by Riverside Department, were distributed again to The Woodlands School.
Assistance was given in the judging of the ward decoration competitions at Christmas
time.
Rugs and drapes have been supplied to the stores at Essondale for issue as required.
The Woodlands School has received all cotton garments for patients in that unit.
Lectures were given to the various nurses' classes with demonstrations of patients'
craft work and art therapy.
The Art Therapy Departments at the Crease Clinic and East Lawn are assisting
with the redecoration in the Crease Clinic dining-room. This project will extend into
next year.
It was planned and agreed that the East 1 Occupational Therapy Section in Crease
Clinic should be amalgamated with the West 1 unit, incorporating the room used by the
Recreational Department. This change has not yet come about, but tremendous advantages will result when this move is completed.
Number of patients registered for treatment at beginning of
months 9,141
Number of patients admitted for treatment during months.. 2,231
Number of patients transferred or discontinued from treatment during months 949
Number of patients discharged from treatment during year 1,403
Number of patients registered for treatment at end of
months 9,025
Total number of treatments given during year 131,446
Total number of hours workshop facilities available to
patients during year 10,705
On the whole, this year has seen many improvements to the various departments and
a more static staff during the latter six months. Q 94 MENTAL HEALTH SERVICES REPORT, 1956-57
INDUSTRIAL THERAPY DEPARTMENT
R. Herring, Supervisor
A reorganization, effective September 1st, 1956, placed occupational therapy and
industrial therapy under separate supervision—occupational therapy directly responsible
to the Clinical Director, and industrial therapy directly responsible to the Business
Manager.
Occupational Therapy Men's Division previously paralleled a programme with the
Women's Division. Both Departments carried and supervised Industrial sections, occupational therapy dominating the Women's Division, whereas industrial therapy dominated
the Men's Division.
The Industrial Therapy section has been operating as an independent unit since
September 1st, 1956, under adverse conditions due to inadequate working space and
facilities, making it difficult to cope with the increasing service demands. Plans, however,
are complete for a new Industrial Building, and it is hoped that present difficulties will
be overcome in the near future.
As shown under (a) and (b), and although the Departments are under separate
supervision and directorship, they have similar aims but use different mediums to attain
the goal.
(a) Occupational Therapy goal: Rehabilitation by a therapeutic programme,
under medical direction, using a craft medium.
(..) Industrial Therapy goal: Rehabilitation and trade training, operating on
a treatment level through the medium of trade shops, functioning as
a manufacturing centre, giving the Hospital a manufacture and repair
service.
The various shops of the Industrial Therapy Department are scattered in several
buildings, which does little for efficiency of operation. The locations are as follows:—
Cabinet-shop: Garage at Essondale.
Upholstery-shop: Garage at Essondale.
Machine-shop: Garage at Essondale.
Mattress, Canvas Department: Basement, North Lawn Building.
Tailor-shop: Hillside.
Shoe-shop: The Woodlands School.
Print-shop: West Lawn, B 1.
Metal-shop: West Lawn, B 1.
Uniform Department: East Lawn attic.
Furnishings Department: East Lawn attic.
Mending Department: East Lawn attic.
Sorting Department: East Lawn attic.
A staff of twenty conduct the present programme.
The Cabinet-shop repaired 2,202 pieces of furnishings and manufactured 375
cabinet pieces.
The Upholstery-shop repaired 540 pieces of furniture and manufactured 670 items.
The Mattress Section of the Canvas Department repaired 3,244 items and manufactured 7,485 items.
The Tailor-shop repaired 14,120 tailored items and manufactured 1,455 tailored
items.
The Shoe-shop repaired 5,531 pairs of shoes. Present facilities are not adequate for
manufacture.
The Print-shop printed 891,292 forms in a ten-month period.
The Metal-shop manufactured 350 items in a four-month period.
The Uniform Department manufactured 5,004 nurses' uniforms and repaired 8,475
uniforms. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 95
The Furnishings Department manufactured 49,893 pieces of dry-goods furnishings.
The Mending Department repaired 67,890 pieces of light clothing and furnishings.
The East Lawn Women's Industrial section, recently incorporated in the main Industrial body, operates four units, giving employment to patients in the East Lawn Building.
To further familiarize, I would like to report the activities of the Dry-goods Furnishings
Department. This section manufactures over 4,000 articles of dry-goods monthly,
namely: Print dresses, jackets, drapes, curtains, table-cloths, sheets, pillow-cases, slips,
bloomers, panties, vests, nightgowns, towels, laundry-bags, sterile wrappers, bibs, etc.
All articles manufactured are invoiced to stores weekly.
The average number of patients given employment monthly was 176; the yearly roll
totalled 2,104 patients; 138 new patients were started; 69 patients were discharged; and
43 patients transferred to other employment.
CHAPLAIN'S REPORT
J. F. O'Neil, Chaplain
The role of a chaplain in a mental hospital can be considered from several different
points of view, and, in accordance with the view that one takes, the method of his work
is thereby determined. On one side his training, abilities, and experience, which are
required before he can be a chaplain, as a moral guide and counsellor may be considered
as of prime importance. On another side it may be his position as an official representative of a recognized organization in the community, and so it is his traditional role as a
member of the community coming within the hospital walls and his link with the community that is considered. On a third side it may be his training as a religious teacher
that is needed. In all three cases his work must of necessity be mainly, in fact almost
entirely, with individuals and small groups, and so the numbers that one man can affect
are very limited, but although very limited, nevertheless very essential. On another side,
he can be seen as mainly a spiritual leader either in a prophetic or a priestly role. In these
two cases his main efforts will lie in the field of far larger assemblies of patients, either
for a mass dissemination of religious knowledge or as a leader in the art of worship and
of seeking and obtaining necessary help spiritually in time of need.
These are only five of a number of ways of viewing the work of a chaplain. All are
necessary, and all are essential. But with the chaplain staff so limited as it is, only one
can be selected, and the rest left to go by default, and the patients be so much the poorer
and slower of complete recovery. At Essondale, in all three units, the last one is the one
that has been selected. A real effort has been made as far as time permits to provide
opportunities for worship for all who are physically and mentally well enough to be
brought together to worship on a voluntary basis.
At this point, appreciation must be expressed for the ready co-operation of all
departments and personnel in the Hospital, without which this programme could not have
been carried forward to anywhere near as adequate an extent. The nursing services and
the transport have been untiring every week in getting the patients to church, and the
Recreational Department in getting the auditorium at Pennington Hall ready. The Audio-
Visual Department has not failed to keep the wired-music system open for the thrice-
weekly broadcasts. Special mention should be made of the nursery, which supplied
flowers weekly throughout the growing season to help beautify the altar and try to make
a multi-purpose hall more church-like.
During the year, through the efforts of the Industrial Therapy Department, a real
contribution was made in the making of robes for the choir. Their appearance now comes Q 96 MENTAL HEALTH SERVICES REPORT, 1956-57
much nearer that of a choir in any church in an ordinary community. Also, through the
efforts of the two musical therapists that we have had during the year, their standard in
performance is comparable to that of any small church.
Two events of special interest took place during the year. In November Msgr.
Joseph P. Kane, the rector of Port Coquitlam, who for a number of years has been the
Roman Catholic Chaplain at the Hospital, was replaced by the rector of Our Lady of
Lourdes, Maillardville, the Rev. A. Frechette, O.F.M., as the Roman Catholic Chaplain.
The second event was in February, when the experience and service of the Resident
Chaplain were recognized by the Chaplains' Association of the American Protestant Hospital Association as a professional hospital chaplain. There are now three such accredited
hospital chaplains in the Province—our own Resident Chaplain and two under the
Department of Veterans' Affairs at Shaughnessy Hospital in Vancouver.
During the year our Resident Chaplain has been a very active member of a national
committee on the Anglican Church reviewing the whole field of chaplaincy services in
mental and penal institutions. It is hoped that, from this, plans will be laid that will bear
real fruit in a few years.
Also, during the year another step was taken in the field of relations with the community when, through the efforts of Dr. W. E. Powles, of the Mental Health Centre, and
the Rev. Professor F. Peake, of Anglican Theological College, a tour of the Crease
Clinic was arranged, together with a lecture and discussion by the Resident Chaplain for
the senior students of the Anglican Theological College of the University of British
Columbia.
During the past few years the Province of British Columbia has been the leader for
Canada in the field of chaplain services for its Mental Health Services. It was the first
to recognize our obligations to the patients under our care and provide a full-time chaplain as a member of the staff. Now he has not only been provided for in the establishment, but is also accredited. But we have now reached a critical point, and the work
must be extended or this leadership relinquished. This expansion must come in several
areas, such as the organization of all the chaplaincy work of the Mental Health Services
as a department with ability for training and consultation as well as individual effort; the
relations with the various churches in the community, that an educational programme be
built up, that the establishment be increased to provide a sufficient number of chaplains,
and, most important of all, that adequate facilities in the form of permanent chapels be
provided.
The following statistics are for the Resident Chaplain only, and do not include the
services of the Roman Catholic Chaplain, who celebrated mass in Pennington Hall on
the first and third Sundays of each month and on Christmas Day.
Number of public services 293
Number of broadcasts (wired-music system) 116
Total 409
Total attendance, excluding broadcasts 33,606
Services in Pennington Hall 100
Attendance in Pennington Hall 25,742
Services on the wards—
Riverside 17
North Lawn 42
Homes for the Aged 134
Total 193 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 97
Attendance on the wards 5,864
Services of holy communion 25
Number of communicants 2,403
Average attendance—
Pennington Hall, morning 447
Pennington Hall, evening 300
Riverside 3 2
North Lawn 31
Homes for the Aged 30
Communicants 9 6
Average weekly attendance 700
Average weekly number of services 8Vi
RECREATIONAL THERAPY DEPARTMENT
R. L. Ramsay, Director
During the past year the Recreational Therapy Department concerned itself with
two main objectives: Firstly, it tried to provide more opportunities for patients in recreation; and, secondly, it made an attempt to encourage members of the nursing staff
to feel free to foster recreational interests with their own patients at times most suitable
for the patients and for ward routine.
In addition to our regular Hillside Park picnics and " cook-outs," we were able to
make arrangements to transport patients to Stanley Park on all-day picnics three times
a week during the summer. This type of programme was designed to give the patients
as much freedom and relaxation as possible in a setting away from the institutional way
of life. They enjoyed hikes around the park, and they were made very welcome by Dr.
Newman at the Stanley Park aquarium.
We feel that giving patients the opportunity to enjoy programmes off the Hospital
grounds is very important. Therefore, our " mystery trips " up and down the Valley
and around the Lower Mainland were increased from one per week to five.
Last winter a group of five U.B.C. students in physical education developed programmes with patients on Wards H 3, A 4, C 3, R 3, and H 4. These programmes, which
were held weekly and continued for three months, were considered part of the students'
field-work training. The programme planning, organization material, and evaluation
proved to be of great value in establishing stronger contact with the patients and providing
them with good recreation. The excellent co-operation of Dr. H. D. Whittle, of the University of British Columbia, greatly contributed to the success of the work.
The responsibilities of the Recreational Therapy staff members were confined to
certain areas throughout the Hospital. We felt that we would develop greater identification with certain groups and also be in a better position to work more closely with the
nursing staff in helping them to encourage greater participation in recreation on the wards.
It was interesting to observe the enthusiasm and interest shown by them in this respect.
In many cases they provided not only regular activities and special events for the patients,
but they also took an active part in working with the patients in encouraging them to plan
their own programmes, which, of course, is the very essence of a sound recreational
programme.
Our entire programme in recreation has a long way to go before it reaches its objectives completely. We have to be more aware of the importance of group planning and
programming besides mass entertainments; we have to recognize quality over quantity in
4 Q 98
MENTAL HEALTH SERVICES REPORT, 1956-57
evaluating programme developments; and we must be very much aware of the necessity
to attract professionally trained personnel to our Department.
Although the present Recreational Therapy staff is very capable, we must be realistic
about the number of our staff members. Under existing circumstances we need a very
definite increase in staff in order to adequately meet the needs of our patients.
A statistical summary of the year's activities is appended.
Patients' Recreation
Programme
Adolescent group
Badminton
Bingo parties
Bowling
Bus trips ("mystery rides")
Card parties, Crease Clinic ___
Concerts (outside talent)
Concerts (patient talent)
Number of
Programmes
44
_ 108
11
_ 508
77
26
9
3
Conditioning classes 198
Cook-outs
Dance instruction
Dances
14
49
104
48
35
34
19
64
34
33
213
117
1
Ward programmes _. 1,002
Golf (daily during summer)
Tennis (daily during summer)
U.B.C. student ward programmes 60
Gymnasium classes
Parties
Picnics
Pre-adolescent groups ____.
Socials
Softball
Stanley Park trips
Swimming (recreational)
Swimming (therapy) __
Sports day
Totals _
2,811
Music Therapy (Part-time Therapist)
Programme
Music therapy
Choir practices
Variety programmes
Totals
Number of
Programmes
55
15
14
84
Attendance
Total
426
974
1,700
9,653
2,273
1,161
3,391
900
2,146
470
2,512
24,392
1,810
5,113
1,338
91
6,646
6,800
781
4,757
1,589
1,500
31,296
3,255
525
480
115,979
Attendance
Total
2,405
348
1,270
4,023 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 99
Staff Recreation
Number of Attendance
Programme Programmes Total
Badminton 36 662
Bowling 43 472
Dances 1 750
Swimming instruction 77 2,894
Swimming (recreational) 77 1,582
Totals 234 6,410
The following staff activities were held in the auditorium:—
April 4th, 1956: Student-body dance.
May 26th, 1956: Fashion show, C.M.H.A. volunteers.
May 30th, 1956: Fashion show, C.M.H.A. volunteers.
June 1st, 1956: Nurses' softball dance.
October 25th, 1956: Blood clinic, B.C.G.E.A.
December 14th, 1956: Student-body dance.
December 15th, 1956: Children's Christmas party, B.C.G.E.A.
AUDIO-VISUAL DEPARTMENT
G. H. Walker, Supervisor
With the arrival of the 35-mm. Cinemascope equipment in late November, a new
25-foot-wide screen was installed in Pennington Hall auditorium. After some readjustment to the projectors and the anamorphic lenses, Cinemascope motion pictures were
in operation by December 18th. At the time the screen was installed, a number of
changes were made to the valances on the ceiling of the stage, which greatly improved
the over-all lighting for stage presentations. The wide screen decreased the amount of
storage space on the stage, and it was necessary to recommend that the Hammond organ
loud-speakers be installed on suitable shelves in front and on each side of the stage.
The supplying of 16-mm. recreational films to the Girls' Industrial School was terminated in March, 1956, and films of the same type sent to the Provincial Mental Home,
Colquitz, were terminated on March 31st, 1957. Both institutions will secure their own
films in the future.
Due to sagging television interest, and after a lapse of one year, 16-mm. recreational
movies were resumed in the Riverside Building in December. The pressure of other
work and delay in replacing staff who had resigned was largely the reason for cancelling
sixty 16-mm. recreational shows throughout the Mental Hospital during the year.
The 16-mm. educational film library continues to expand, with more new films,
borrowers, and films loaned. The work involved in the shipping, receiving, and revising
of the films, including the recreational films, plus the compiling and assembly of catalogues, now requires one staff member full time.
Over a period of time, with the use of the Department's colour camera, a new library
has been gradually forming, and is composed at the present time, of 235 colour slides,
size 2x2, depicting activities and treatments in the Mental Hospital and Crease Clinic.
During the past year, groups of slides have been loaned sixteen times.
During the summer a twenty-five-minute 16-mm. motion-picture film was made of
general activities at The Woodlands School. At the same time, throughout the year and
still being continued, is a 16-mm. colour film made in connection with phenylpyruvic Q 100 MENTAL HEALTH SERVICES REPORT, 1956-57
oligophrenia treatments being given there. Further, in early 1957 a thirty-two-minute
film, requiring three weeks of shooting, was made at the Mental Hospital, Essondale.
Approximately one week was required for editing this film.
On March 1st the Department began to photograph patients on admission to the
Mental Hospital. This amounts to approximately thirty-five photos per week, fifty-two
weeks per year. The pressure of this work has necessitated the cancellation of 16-mm.
recreational shows for the patients, as previously mentioned.
The wired-music master control was relocated in what was originally the office, and
the office staff combined in one area. The advantages of the control being in a separate
room are many—the quietness necessary in its operation, less disturbance to others, and
the convenience of having the wired-music records filed adjacent to the control. During
the year the West Lawn and Centre Lawn Buildings were rewired by the Public Works
Department for four-channel operation. Some assistance from the Canadian Mental
Health Association volunteers is welcomed in the operation of the wired-music system.
On " open house " day, May 3rd, the Department was visited by a large number of
people, and wherever possible demonstrations of equipment were made.
In conjunction with the architects, assistance and recommendations were given in
the layout of the audio-visual rooms in the proposed Crease Clinic addition. Also, tentative fists of equipment were drawn up in connection with the requirements of the auditorium now under construction at The Woodlands School.
Not included in the list of basic activities are many other services rendered, such
as hearing-aid repairs for patients, maintenance and improvements in projectors and
sound equipment supplied to the Recreation Therapy and miscellaneous departments,
ward record-players, and the Audio-Visual Department's own host of audio-visual
equipment.
Summary of Activities
Recreational Motion Pictures
Number Total
of Shows Attendance
35-mm. films at Pennington Hall 141 48,848
16-mm. films at Essondale, Colony Farm, and
Home for the Aged, Port Coquitlam 478 37,772
16-mm. films shipped to—
The Woodlands School 143
Mental Home, Colquitz 98
Home for the Aged, Vernon 46
AUco Infirmary, Haney 46
Provincial Home, Kamloops 46
Educational 16-mm. Film Library
Number of registered borrowers 200
Films loaned 796
Total attendance, 31,815.
Films projected at Essondale and Crease Clinic 73
Total attendance, 1,377. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 101
Summary of Activities—Continued
Photography
4x5 monochrome negative exposed 510
7.Vi x 4 monochrome negatives exposed (admittance, March,
1957, only) 96
3V4 x 4 colour transparencies produced 176
2x2 colour transparencies produced 86
8x10 monochrome prints produced 796
5x7 monochrome prints produced 197
2Vi x 4 prints produced, monochrome (admittance, March,
1957, only) 96
Miscellaneous monochrome prints produced 98
16-mm. motion-picture film exposed feet 3,805
Music Record Library
Popular 78 r.p.m. records loaned 8,290
Long-play 33VS records loaned 21
Record-players (two) loaned 258
Recorded music through sound system hours 432VS_
Educational Record Library
Tape recordings minutes 312
Disk recordings minutes 612
Records loaned 80
LIBRARY
Miss H. M. Walsh, Librarian
The patients' library was closed for a few days in December for redecorating, the
result of which caused much appreciative comment. The pleasing two-tone decor, the
shelves colourful with plastic-covered books, and the whole bright, quiet atmosphere
makes the library a popular and well-used place. Books and magazines circulate to all
wards and patients directly, by inter-hospital mail, or by the volunteers of the Canadian
Mental Health Association. The George Derby Health and Occupational Centre kindly
donated a considerable number of magazines.
Following the example of the University and Vancouver Medical Association medical
libraries, it was decided to recatalogue the medical books from Library of Congress classification to the much more extensive and detailed National Library of Medicine system.
This necessitated temporarily shelving the books by title. Such a project is very time
consuming, and it will be some time before this undertaking will be completed. Q 102 MENTAL HEALTH SERVICES REPORT, 1956-57
Patients' Library
Book collection
5,424
New books added
393
Donations
381
Total
6,198
Less—
Discards _
3
146
489
Losses _
To North Lawn
638
Total
5,560
Current magazine subscriptions
15
Number of books circulated
14,293
Medical Library
Book collection
2,283
New books added
94
Total
2,377
Journals, medical and psychiatric
88
Books received on inter-library loan
88
Number of books circulated
890
REHABILITATION SERVICE, WOMEN'S DIVISION
N. L. Richardson, Assistant Clinical Director
The Vista has continued to provide a very necessary service toward the rehabilitation
of patients from both the Crease Clinic and the Provincial Mental Hospital. Greater
emphasis has been placed, however, on rehabilitation for the Mental Hospital patient.
In general this group, with longer periods of hospitalization and subsequent loss of relative
contacts, is a group with greater needs around the area of return to the community.
Following Dr. McNair's appointment to the Mental Health Centre, Dr. Richardson has
continued the previous policy of weekly visits to The Vista. These visits have been for
the purpose of supervision and to see a small group of patients for out-patient psychotherapy. It is anticipated the need for this latter form of treatment will diminish now
that the Out-patient Department at the Menal Healh Cenre is funcioning.
For some time, patients at The Vista were without social service help because of the
depletion of social service ranks. Fortunately, the Provincial Supervisor of Psychiatric
Social Work has herself provided this vital service as a temporary measure. An additional
problem arose in connection with housekeeper services. The Vista was without a housekeeper for the period from November 8th, 1956, to January 26th, 1957. This necessarily
placed extra responsibilities on the supervisor at The Vista during the above-mentioned
period.
Intake
Remaining in residence, March 31st, 1956 4
Number admitted to The Vista from the Crease Clinic 35
Number admitted to The Vista from the Provincial Mental
Hospital 25
— 64 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 103
Separations
Number returned to the Crease Clinic 2
Number returned to the Provincial Mental Hospital 3
— 5
Rehabilitated to the community 9
Rehabilitated to own home 7
Rehabilitated to job and lodging 38
Total rehabilitated 54
Remaining in residence, March 31st, 1957 5
REPORT OF SCHOOL-TEACHER
Mrs. E. R. Loland, Teacher
During the second year of a more formal programme of education at the Provincial
Mental Hospital, much was accomplished. The variety of subjects studied by patients,
the number of patients receiving instruction, and the interest shown by patients and staff
have all shown a marked increase. Total school attendance rose from 53 to 107 patients
during the fiscal year 1956-57. Thirty-seven adolescent patients carried on with their
regular school curriculum. Forty-four adults studied courses for self-improvement.
Thirty-one of these studied business courses, and the remaining thirteen studied courses
such as social studies, French, or mathematics. Nine patients furthered their study of the
English language while attending school. Seventeen mental defectives continued elementary education in reading, writing, and arithmetic.
The adolescent class toured the Vancouver Sun Publishing Company, the Vancouver
Museum, and visited the bus depot. Closer to " home," we toured the Essondale Fire
Hall, Mattress-shop, and Bakery.
During the summer of 1956 a course of nature study was offered to open-ward
patients. Classes were held out-of-doors weekly and were attended by thirty to fifty
patients each week. Some of the many varieties of trees found on the grounds were
studied. Interesting scrap-books were made by some of the patients attending. The
patients expressed much interest in this course and the wish that the same course, or one
similar to it, be offered each summer.
In September, 1956, due to the unpredictable behaviour of some of the adolescents,
it was thought advisable by the Clinical Director to have an additional staff member in
attendance in the schoolroom during their class. Because it was impossible to assign an
aide to the school immediately, due to staff shortage, the adolescents received schooling
on their respective wards from September to December, 1956. The addition of Mr. Bruce
McLaren, psychiatric aide, to the school constituted the greatest single improvement of
the year. Q 104
MENTAL HEALTH SERVICES REPORT, 1956-57
STATISTICAL TABLES
CREASE CLINIC
Table 1.—Movement of Population, Crease Clinic, April 1st, 1956,
to March 31st, 1957
Male
Female
Total
In residence, April 1st, 1956— __
110
147
257
Admissions—
405
32
103
649
59
216
1,054
91
319
540
924
1,464
650
1,071
1,721
Separations—
548
7
935
5
1,483
Died _
12
555
940
1,495
— 15
95
-16
131
-31
In residence, March 31st, 1957 _
226
Table 2.—Showing in Summary Form the Operation of the Crease Clinic
since Its Inception
cn
tt
O
E.
I
<
Discharges
01
jtt
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a — ra
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01
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Percentage of
Patients Recovered
and Improved to
Admissions
Percentage of
Discharges to
Admissions
(Deaths Excluded)
Year
It
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Percentage of
Deaths to
Whole Numbe
under Treatme
January, February, and
March, 19511
1951 521 ..
264
963
1,221
1,256
1,364
1,627
1,464
26
158
96
85
147
265
117
121
38
496
727
814
901
1,144
1,019
23
155
201
213
284
223
225
12
21
14
7
5
12
170
215
243
242
267
257
226
45
28
25
1
10
31
264
1,133
1,436
1,499
1,606
1,894
1,721
24.24
67.91
67.39
71.58
76.09
86.60
85.18
35.61
94.19
94.35
98.96
97.65
100.31
101.30
1.06
1952-531 —
1953-541
1.46
0.93
1954-55-
0.44
1955-56 __
0.26
1956-57-
0.13
1 Discharged "Without Psychosis," 1951, 7; 1951-52,97; 1952-53,148; 1953-54,131. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
Q 105
Table 3.—First Admissions to Crease Clinic by Health Unit and School
District of Residence and Sex, April 1st, 1956, to March 31st, 1957
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
School District No. 1 _
1
3
4
1
1
5
1
4
2
4
2
2
9
3
2
6
8
2
1
1
3
3
1
2
15
1
1
6
3
3
19
1
6
167
17
1
1
3
~3
4
1
5
21
1
1
10
1
23
2
2
3
2
7
1
' 12
1
1
1
2
4
4
1
3
7
2
3
20
12
14
31
4
17
242
35
2
4
7
1
4
9
1
6
25
1
3
14
2
3
32
2
5
5
2
13
1
20
1
3
2
3
7
7
2
5
22
3
4
26
15
17
50
5
23
409
52
Metropolitan Health Committee,
Vancouver—Continued
School District No. 44.
„ 45
12
2
16
4
3
5
1
3
5
2
1
2
12
5
1
2
5
3
1
4
1
9
1
4
2
5
4
6
6
22
9
17
18
9
6
4
10
2
4
2
1
3
16
5
1
5
1
3
6
1
9
4
10
3
4
2
5
4
4
5
5
„ „ 2
34
„ 3
11
„ 4
Simon Fraser, New Westminster—
School District No. 40
„ „ „ 43
33
22
North Fraser Valley, Mission—
School District No. 42
„ 75
» „ 76 -
„ 8 _
12
West Kootenay, Trail—
School District No. 9.
11
1
„ 11
, 12
Upper Island, Courtenay—
7
South Okanagan, Kelowna—
„ 71
15
„ 72-
2
, 15...
16
Skeena, Prince Rupert—
School District No. 52
„ 53
6
„ „ „ 17
3
„ 23
54
Peace River, Dawson Creek—
1
„ 77—
North Okanagan, Vernon—
School District No. 19
5
Victoria-Esquimalt Union Board
of Health—
School District No. 61 (part1) —
Saanich and South Vancouver
Island—
School District No. 61 (part2) —
, 62
„ „ , 63
„ 20.
„ 21 —
28
„ „ 22
„ „ „ 78-
South Central, Kamloops—
School District No. 24
10
1
„ 26
6
„ 29— -
64
3
„ 30
Central Vancouver Island,
Nanaimo—
School District No. 65—
„ 66
31-
Cariboo, Prince George—
School District No. 27
8
9
28
67
„ 68 _
2
„ „ , 55
13
„ „ „ 56
„ 69
5
, 57
„ 58—
Upper Fraser Valley, Chilliwack—
School District No. 32
, 70
School districts not covered by
health units—
School District No. 46
19
4
33
„ 34
„ 48
, 49
„ 61 (part»)
73—
„ 80
4
2
Boundary, Cloverdale—
School District No. 35._
„ 36
„ 37 .
9
6
9
9
Metropolitan Health Committee,
Unknown _
6
11
School District No. 38
„ 39
Totals
437
708
1,145
„ 41
1 Includes Victoria and Esquimalt only.
2 Excludes Victoria, Esquimalt, and Oak Bay
3 Includes Oak Bay only. Q 106
MENTAL HEALTH SERVICES REPORT, 1956-57
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Disorders of character, behaviour, and intelligence—
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Q 115
Table 9.—First Admissions to Crease Clinic by Years of Schooling, Mental
Diagnosis, and Sex, April 1st, 1956, to March 31st, 1957
Table 10. — Readmissions to Crease Clinic by Years of Schooling, Mental
Diagnosis, and Sex, April 1st, 1956, to March 31st, 1957
Table 11.—First Admissions to Crease Clinic by Citizenship, Age-group, and
Sex, April 1st, 1956, to March 31st, 1957
Table 12.—First Admissions to Crease Clinic by Religion and Sex, April 1st,
1956, to March 31st, 1957
Table 13.—First Admissions to Crease Clinic by Previous Occupation and Sex,
April 1st, 1956, to March 31st, 1957
Detailed information for the above tables may be obtained on request.
Table 14.—Live Discharges from Crease Clinic by Condition on Discharge,
Disposition to, and Sex, April 1st, 1956, to March 31st, 1957
E
isposition to-
Condition
Home
Clinic
Agency
General
Hospital
Other
Mental
Hospital
Other
Total
Grand
Total
M.
F.
M.
F.
M. 1 F.
1
M. 1 F.
1
M.
F.
M.
F.
Recovered ,
Much improved
Improved
61
62
316
58
50
56
654
110
1
—
~2
__
1 |
3 |
. | 1
1
13
20
11
30
9 1 11
2 j 4
64
62
342
80
53
59
678
145
117
121
1,020
225
~41
Totals
497
870
1
2
4 | 1
34
12
21
548
935
1,483 Q 116
MENTAL HEALTH SERVICES REPORT, 1956-57
Table 15.—Live Discharges from Crease Clinic by Mental Diagnosis, Condition
on Discharge, and Sex, April 1st, 1956, to March 31st, 1957
Condition on Discharge
Total
Mental Diagnosis
Recovered
Much
Improved
Improved
Unimproved
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
With Psychosis
18
7
3
2
10
3
3
3
8
13
8
1
1
2
6
3
14
1
30
4
4
1
4
1
1
14
1
1
23
7
1
1
3
4
16
1
124
13
5
4
2
2
7
13
50
13
1
3
35
1
2
1
5
178
44
27
17
1
1
2
6
26
78
18
6
4
201
2
2
7
5
26
2
4
1
1
5
5
1
3
3
1
48
2
1
1
4
14
1
21
1
3
2
198
24
12
6
2
6
13
11
21
59
18
3
3
60
1
2
1
1
9
1
262
61
29
18
1
1
4
12
40
92
21
6
5
252
3
3
10
7
1
4611
85
41
24
1
2
7
Alcoholic psychosis
Phychosis of other demonstrable etiology
17
23
61
Anxiety reaction without mention of somatic symp-
151
Hysterical reaction Nvithout mention of somatic
39
9
Obsessive-compulsive reaction
8
312
Psychoneurosis with somatic symptoms (somatiza-
zation reaction) affecting circulatory system
Psychoneurosis with somatic symptoms (somatization reaction) affecting digestive system
Psychoneurosis with somatic symptoms (somatiza-
1
5
4
Psychoneurotic disorders, other, mixed, and un-
11
Chronic brain syndrome with neurotic reaction
16
2
Total with psychosis _ ,
57
49
61 | 56
281
625
52
98
451
828
1,280
Without Psychosis
Disorders of character, behaviour, and intelligence—
1
2
1
3
3
1
1
2
1
11
17
4
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3
2
1
9
3
25
14
1
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1
4
1
3
1
10
6
2
2
1
1
3
2
1
16
7
1
1
6
2
1
1
6
1
5
21
24
8
10
3
7
3
2
12
5
1
41
21
2
1
9
3
7
1
2
12
2
1
5
62
45
10
1
19
6
Other and unspecified character, behaviour, and
14
Chronic brain syndrome with behavioural reaction-
4
4
24
Other diseases of central nervous system not asso-
7
Observation without need for further medical (psy-
2
Other, unknown, and unspecified conditions.
5
Total without psychosis _
V
4
1 | 3
60 | 53
28
47
96
107
203
64
53
62 1 59
341 1 678
80
145
547
935
1,483
Includes one male schizophrenic, condition not stated. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
Q 117
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MENTAL HEALTH SERVICES REPORT, 1956-57
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PROVINCIAL MENTAL HOSPITAL
Table 1.—Movement of Population, Provincial Mental Hospital,
Essondale, April 1st, 1956, to March 31st, 1957
Male
Female
Total
1,846
86
1,687
146
5
3,533
232
5
Totals as at April 1st, 1956
1,932
1,838
3,770
Admissions—
379
124
197
249
152
158
628
276
355
Total admissions - -
700
559
1,259
2,632
2,397
5,029
Separations—
638
73
105
2
510
71
168
3
1,148
Died _
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273
5
818
752
1,570
Net increase or decrease „
-32
-42
-74
In residence, March 31st, 1957 _
1,814
1,645
3,459 Q 124
MENTAL HEALTH SERVICES REPORT, 1956-57
Table 2.—Showing in Summary Form the Operations of the Mental
Hospitals since Inception
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12
14
17
19
17
14
6
5
6
5
6
4
10
18
6
5
3
4
12
20
13
14
66
77
82
100
117
123
135
133
5
11
5
18
17
6
12
2
88
102
103
123
152
166
175
179
37.03
41.66
46.15
34.15
32.69
38.77
32.69
31.81
59.25
55.55
69.23
46.34
44.23
46.94
51.92
72.72
6.81
1887
4.80
1888
2.87
1889
1890
1891
1892
1893
3.25
7.64
11.69
6.95
7.60
1894
1895
1896
1897
1898
1899
80
62
64
74
81
101
113
115
121
139
115
123
150
221
13
29
23
20
27
31
38
40
30
38
46
43
36l
48
19
11
25
8
13
32
27
20
31
37
26
33
43
43
19
20
9
14
19
21
29
25
25
26
26
27
28
39
162
164
171
203
221
234
258
284
311
349
321
348
388
461
29
2
t
32
18
13
24
26
27
38
27
43
73
28
213
224
228
246
285
327
356
377
413
466
480
505
552
666
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
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
8.92
8.92
3.94
5.69
6.66
6.42
1900
8.14
1901
6.63
1902
6.06
1903
5.57
1904
5.42
1905
5.34
1906
5.04
1907.
5.08
1908
230
232
280
332
681
732
84
67 3
56
77
82
114
57
40
41
60
507
536
595
690
46
29
48
105
765
816
896
1,034
1,065
28.30
31.00
30.00
19.57
53.90
64.60
59.28
54.42
7.44
1909
6.40
1910
4.57
1911
5.83
191?
375
74 !
128
76
752
62
18.90
53.80
7.02
1913
380
90*
146
67
919
167
1,264
22.63
62.10
5.30
1914
402
58
126
74
1,027
108
1,364
14.43
45.77
5.43
1915 _
332
83
91
89
1,090
61 1
1.437
•>5.00
52.41
6.19
1916
353
732
96
80
1,205
1,301
115 I I 1 S.7
20.68
47.87
5.24
1917
371
88
78
106
96
1,650
23.72
44.74
6.42
1918
375
75
95
132
1,347
46
1,753
20.00
45.33
7.47
Jan. 1, 1919, to
March 31, 1920
574
116
221
132
1,458
111
2,025
20.20
.58.71
6.51
1920-1921
489
88
173
122
1,566
108
2,043
14.17
72.60
5.97
1921-1922
478
96
178
114
1,649
83
2,137
20.08
57.32
5.33
1922-1923 _
438
91
167
133
1,697
48
2,180
20.77
59.36
6.10
1923-
1924-
-1924
447
461
842
63
121
242
163
138
1,784
1,884
87
100
2,234
2,327
18.56
13.66
64.20
66.16
7.25
-1925
5.93
1925-1926
475
57=
240
142
1,995
111
2,434
12.00
62.53
5.83
1926-1927
494
761
171
161
2,125
130 1 .
2,565
15.38
50.00
6.27
1927-1928
542
751
252
147
2,269
144
2,743
13.28
60.33
5.36
1928-1929
543
92-
294
181
2,347
78
2,914
16.76
71.07
6.21
1929-1930
602
1181
311
223
2,411
64
3,063
19.10
71.26
7.28
1930-1931 —
632
70i
235
191
2,550
139
3,148
10.60
64.24
6.06
1931-
1937-
-1932
562
635
58"
44*
299
323
181
195
2,676
2,824
126
148
3,214
3,390
10.32
6.92
63.52
58.42
5.63
-1933..
5.75
1933-1934. -
610
613
309
200
2,960
136
3,530
10.00
60.65
5.66
1934 1935
653
679
711
631
349
304
321
291
3,080
3,180
120 1
3,721
3,838
10.87
9.27
64.32
54.05
5.94
1935-1936
100
—
7.58
i Three not insane.
6 Five not insane.
2 One not insane.
3 Two not insane.
4 Four not insane.
B Six not insane. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
Q 125
Table 2.—Showing in Summary Form the Operations of the Mental
Hospitals since Inception—Continued
Cfl
tt
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Discharges
c.
Si
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Z cd O
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03
O
Whole Number
Treated
Percentage of
Recoveries to
Admissions
Percentage of
Discharges to
Admissions (Deaths
Excluded)
o>
Year
■tt
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o
o
A
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0
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•ZA
Percentage of
Deaths to Who
Number under
Treatment
1936-1937...
793
78s
300
268
3,301
121
4,067
9.96
63.60
6.59
1937-1938..-
834
827
74
72 3
330
345
207
208
3,487
3,612
186
4,255
4,471
8.87
8.71
67.30
78.72
4.86
1938-1939
125
4.65
1939-1940
869
1117
455
230
3,710
98
4,713
11.39
88.50
4.88
1940-1941
864
834
1078
71s
410
400
254
255
3,836
3,902
126
66
4,781
4,843
12.38
8.51
79.97
56.46
5.31
1941-1942
6.54
1942-1943
803
91.
443
260
3,925
23
4,919
11.32
66.50
5.31
1943-1944
840
87
423
309
3,960
35
4,965
10.36
61.66
6.02
1944-1945
822
96i°
377
300
4,019
59
4,960
10.46
58.39
6.04
1945-1946
834
117s
352
240
4,110
91
5,014
14.02
57.43
5.84
1946-1947
880
9710
496
238
4,151
41
5,174
11.02
68.18
4.59
1947-1948
1,111
124"
560
240
4,269
118
5,447
11.34
63.64
4.40
1948-1949
1,260
137i2
748
209
4,355
86 |
5,758
10.87
76.59
3.63
1949-1950
1,415
195
787
202
4,602
7.47 1
5,999
13.78
69.40
3.37
n
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Discharges
Cfl
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a
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Xi
B
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Percentage of
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and Improved to
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Percentage of
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Admissions
(Deaths Excluded)
to
Year
•0
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A
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•0
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>
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Percentage of
Deaths to Who
Number under
Treatment
1950-511=-.
1,499
169
421
414
223
4,538
64
6,314
39.35
67.04
3.53
1951-5213
1,217
138
301
438
188
4,578
40
6,020
36.07
92.77
3.12
1952-5313
1,332
53
240
350
183
4,791
213
6,035
21.99
67.64
3.03
1953-5413*...
1,041
23
395
374
161
3,768
62
5,040
35.45
94.64
3.38
1954-55...
1,139
26
589
313
145
3,812
44
5,051 |
54.08 |
81.47
2.88
1955-56
1,253
33
705
308
144
3,814
2
5,245
58.90
83.48
2.75
1956-57 _
1,259
42
44
778
295
151
3,744
70
5,314
68.62
91.90
2.84
3 Two not insane. 6 Five not insane. '• Twelve not insane. 8 Ten not insane. 9 Eight not insane.
10 Seven not insane. 1X Three not insane; 196 without psychosis. :2Two not insane; seventy-eight without
psychosis. 13 Discharged "Without Psychosis," 1950-51, 284; 1951-52, 252; 1952-53, 258; 1953-54, 188.
* For The Woodlands School, see separate tables. Q 126
MENTAL HEALTH SERVICES REPORT, 1956-57
Table 3. — First Admissions to Provincial Mental Hospital, Essondale, by
Health Unit and School District of Residence and Sex, April 1st, 1956,
to March 31st, 1957.
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
School District No. 1
1
2
1
1
1
4
1
2
2
7
5
1
1
1
4
3
1
3
1
9
1
3
3
2
1
3
5
2
2
5
3
6
1
4
19
2
5
210
1
1
1
1
1
1
1
1
1
2
2
1
2
2
5
1
1
4
9
1
4
3
1
8
3
2
11
2
7
179
2
1
3
2
2
1
2
5
1
3
4
9
6
3
3
1
9
1
4
1
7
1
18
1
3
3
2
1
4
9
2
2
8
4
14
4
6
30
4
12
389
Metropolitan Health Committee,
Vancouver—Continued
School District No. 41
„ 44-. - .
24
13
3
17
6
5
3
2
10
1
3
2
2
19
9
2
2
2
2
1
5
6
2
1
3
1
1
4
1
9
14
18
14
2
29
8
5
7
1
1
3
3
2
2
2
10
4
1
2
2
2
5
7
2
1
1
3
1
1
2
1
„ 2
„ 3
42
27
„ 4
45—
Simon Fraser, NeNv Westminster—
School District No. 40- _
„ 43 —
5
„ 5—
„ 18
46
14
North Fraser Valley, Mission—
School District No. 42—
„ 7
10
„ 8
„ 75
7
, 10
West Kootenay, Trail—
School District No. 9
11
Upper Island, Courtenay—
School District No. 47.
„ 71--
1
4
„ 72... -
5
South Okanagan, KelONvna—
School District No. 14
„ „ 15
Skeena, Prince Rupert—
School District No. 52
„ 53
13
3
„ 16
„ 54
5
17
Peace River, Dawson Creek—
School District No. 59
23
4
„ 77
60
Victoria-Esquimalt Union Board
of Health-
School District No. 61 (part1)....
Saanich and South Vancouver
Island—
School District No. 61 (part2) —
„ 62
, 63
„ 64
2
North Okanagan, Vernon—
School District No. 20
„ 21
20
„ 22
„ „ 78
South Central, Kamloops—
School District No. 24
„ 25
13
3
4
2
„ 29
Central Vancouver Island,
Nanaimo—
School District No. 65-
„ 67
„ „ 68
„ 30
„ 31
4
Cariboo, Prince George—
School District No. 27
3
10
70
13
, 55
„ 56.
„ „ 57
„ 79
2
School districts not covered by
health units—
School District No. 46
48
„ 49.
„ 61 (part3)
„ 73
Upper Fraser Valley, Chilliwack—
School District No. 32
33
„ 34
3
4
2
3
Boundary, Cloverdale—
School District No. 35
„ 36
2
„ 74—
1
„ 80 -
4
37
1
Metropolitan Health Committee,
Vancouver—
School District No. 38
„ 39
11
15
Totals
503
401
904
1 Includes Victoria and Esquimalt only.
2 Excludes Victoria, Esquimalt, and Oak Bay
3 Includes Oak Bay only. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 127
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MENTAL HEALTH SERVICES REPORT, 1956-57
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Q 129
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Table 9.—First Admissions to Provincial Mental Hospital, Essondale, by Years
of Schooling, Mental Diagnosis, and Sex, April 1st, 1956, to March 31st,
1957.
Table 10.—Readmissions to Provincial Mental Hospital, Essondale, by Years
of Schooling, Mental Diagnosis, and Sex, April 1st, 1956, to March 31st,
1957.
Table 11. — First Admissions to Provincial Mental Hospital, Essondale, by
Citizenship, Age-group, and Sex, April 1st, 1956, to March 31st, 1957
Table 12. — First Admissions to Provincial Mental Hospital, Essondale, by
Religion and Sex, April 1st, 1956, to March 31st, 1957
Table 13. — First Admissions to Provincial Mental Hospital, Essondale, by
Previous Occupation and Sex, April 1st, 1956, to March 31st, 1957
Detailed information for the above tables may be obtained on request. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
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MENTAL HEALTH SERVICES REPORT, 1956-57
Table 19.—Live Discharges from Provincial Mental Hospital, Essondale, by
Condition on Separation, Disposition to, and Sex, April 1st, 1956, to
March 31st, 1957.
Disposition to—
Condition
Home
General
Hospital
Other
Mental
Hospital
Other
Total
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
32
33
382
41
5
8
342
40
3
1
13
100
1
91
4
2
14
13
1
~20
2
36
36
412
154
6
8
363
133
42
44
775
287
Totals _ _
488
395
3
114
92
33
23
638
510
1,148 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
Q 141
Table 20.—Live Discharges from Provincial Mental Hospital, Essondale, by
Mental Diagnosis, Condition on Discharge, and Sex, April 1st, 1956, to
March 3 1st, 1957.
Mental Diagnosis
Condition on Discharge
Recovered
Much
Improved
M.
F.
M.
13
1
25
7
4
1
11
1
2
1
1
2
1
1
1
F.
Improved
M.
F.
Unimproved
Total
M. I F.
M.
Grand
Total
With Psychosis
Schizophrenic disorders
Manic-depressive reaction .
Involutional melancholia
Paranoia and paranoid states
Senile psychosis..
Presenile psychosis
Psychosis with cerebral arteriosclerosis-
Alcoholic psychosis..
Phychosis of other demonstrable etiology-
Other and unspecified psychoses-
Anxiety reaction without mention of somatic symptoms ...
Hysterical reaction without mention of somatic
symptoms.
Phobic reaction
Obsessive-compulsive reaction..
Neurotic-depressive reaction..
Psychoneurosis with somatic symptoms (somatization reaction) affecting other systems
Psychoneurotic disorders, other, mixed, and unspecified types.
Chronic brain syndrome with neurotic reaction .
Syphilis and its sequelae
Total with psychosis..
Without Psychosis
Disorders of character, behaviour, and intelligence—
Pathological personality
Immature personality
Alcoholism...
Other drug addiction
Primary childhood behaviour disorders-
Mental deficiency-
Other and unspecified character, behaviour, and
intelligence disorders
Chronic brain syndrome with behavioural reaction-
Chronic brain syndrome, N.O.S
Epilepsy
Other diseases of central nervous system not associated with psychosis
Total without psychosis-
Grand totals
34
5 | 33 | 8
2 |1|3|
36
36
133
12
1
4
2
11
7
2
8
7
187
1
3
7
1
1
10
4
188
27
1
4
6
6
6
3
2
1
18
183 I 267
10
9
52
5
229 | 96
412 363
52
1
25
1
23
1
2
1
109
45
154
55
22
223
24
29
1
26
23
9
6
97
359
12
20
10
203
4
5
11
1
2
16
5
36
279
133
638
209
30
1
57
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6
377
17
133
510
432
54
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1
86
1
52
29
17
12
6
2
1
24
1
2
3
5
736
34
20
266
3
6
22
2
2
25
11
19
412
1,148 Q 142
MENTAL HEALTH SERVICES REPORT, 1956-57
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MENTAL HEALTH SERVICES REPORT, 1956-57
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B3<« Physician examining a patient at The Woodlands School. Q 150 MENTAL HEALTH SERVICES REPORT, 1956-57
PART III.—THE WOODLANDS SCHOOL, NEW WESTMINSTER
REPORT OF THE MEDICAL SUPERINTENDENT
L. A. Kerwood, Medical Superintendent
On March 31st, 1957, our population was 1,241, consisting of 735 males and 506
females. These figures become more meaningful if broken down into five-year age-
groups. The approximate distribution of the patients cared for on the male side of the
hospital was as follows:—
Age-group
54 years and over
47-51 years
42-46 „
37-41 „
32-36 „
27-31 „
22-26 „
17-21 „
12-16 „
8-11 „
3- 7 „
Number of Approximate Percentage
of Total Population
Patients
40
17
22
33
33
50
69
110
145
74
3
7.0
3.0
3.0
5.0
5.0
8.0
10.0
18.0
24.0
12.0
0.5
Patients cared for on the female side are distributed as follows:-
Age-group
54 years and over
47-51 years
42-46 „
37-41 „
32-36 „
27-31 „
22-26 „
17-21 „
12-161 t>
8-11 „
3- 7 ,; ___.-_-_.
Less than 3 years .
Male
Patients
3
37
80
3
Female
Patients
24
19
11
17
32
41
55
60
86
94
59
6
Approximate Percentage
of Total Population
4.6
3.0
1.6
2.6
5.0
6.4
8.6
9.4 '
14.0
20.6
21.8
1.4
1 Below age-group 12-16, both male and female cases are nursed by the female staff.
These tables show that there are considerable numbers of children, of whom many
require pediatric nursing care. They also demonstrate that there are more than 100 male
crib cases who will, when they become too large for cribs, require beds, and who will
ultimately need to be transferred to the male side of the hospital.
It has been found that a height of 44 inches determines the size at which the child
requires a bed, and an analysis of patients reveals that the average age for males at this
height is 7.5 years, and for females 8.5 years. Thus, in 1958 there will be sixteen male
and sixteen female crib patients requiring beds. In 1959 there will again be sixteen
of each sex, and in 1960 there will be twenty-three male patients and eleven females;
in 1961 there will be fourteen males and twelve females. These facts will have to be
considered when new crib cases are admitted and will affect the admission programme.
There are approximately 450 cases on the waiting-list, and the following table shows
cases awaiting admission by year of application:— THE WOODLANDS SCHOOL
Q 151
Year of Application
1953
Number of Cases
17
Year of Application
1956
Number of Cases
157
1954
97
1957
77
1955
121
There are approximately 151 under the age of 6 and 300 cases over the age of 6.
The following table is inserted to show the growth of the waiting-list and the number
of admissions yearly to The Woodlands School. There are no figures available in respect
of the numbers on the waiting-list for the years 1951, 1952, 1953, and 1954.
Year
1951.
1952.
1953
1954.
1955-
1956_
1957_.
It can be seen from the foregoing figures that the opening of the Fraser View Building
will leave large numbers of patients on the waiting-list. Judging by the Provincial birth
rate, it would appear likely that there will be a need for approximately 20 more beds
per annum for new cases born. This figure may, of course, be somewhat modified by
facilities which may be brought into existence elsewhere. It would seem important,
therefore, that consideration be given for the provision of more beds for the mentally
retarded in the future. I do not recommend that the population of The Woodlands
School be increased much more, as this is not generally felt to be in the best interests of
the patient-pupils. Also, we are utilizing to capacity the sources of heating, dietary,
dentistry, and radiology.
Waiting-list
Admissions
159
74
»
322
.
178
> 211
57
309
151
469
14
Reception-room, Fraser View Building, The Woodlands School. Q 152 MENTAL HEALTH SERVICES REPORT, 1956-57
It is obvious that the waiting-list is going to constitute a continuing problem, and
probably the best way that the School can be helpful to both parents and applicants in
the immediate future is by the provision of some further specialist services.
First, the establishment of a travelling clinic, which could give advice and help to
parents who reside at a distance from The Woodlands School, would undoubtedly help
to relieve some of their problems and anxieties and might result in some parents keeping
their children at home.
Second, it has been found helpful in other communities faced with a similar problem to permit children who are on the waiting-list to be admitted to the Hospital-School
on a temporary basis, thereby giving the parents a chance for a holiday. This often has
the effect of making it possible for parents to keep charge of a child whom otherwise
they would be forced to admit because of the stress and strain of continual home care.
Third, the provision of a diagnostic and parent service out-patient department would
be helpful to those parents not covered by the travelling clinic. These suggestions would
not, I think, be a permanent answer to the problem of an increasing population and the
resultant increase of retarded individuals, but they would relieve this problem somewhat
and be extremely helpful to parents of such children.
In order to maintain a high standard of medical staff and medical interest in the
problem of retardation, it is vitally important that the Hospital-School be in a position
to offer adequate service of the kind mentioned, so that the medical profession of the
Province may regard The Woodlands School as providing specialized service both in
an out-patient capacity as well as providing residential in-patient facilities. The logical
place for long-term investigation of basic problems of mental retardation is at the
Hospital-School, where there is the greatest selection of clinical material. This is even
more important than in the case of general physical disease, because many of the syndromes which are associated with retardation are extremely rare and sufficient numbers
of cases can only be seen where the case concentration is high.
There is, at the moment, a very wide interest in the problem of retardation and
investigations at present taking place in the direction of biochemical and metabolic
studies. In order for these to be carried out adequately at the School, there must be
well equipped and staffed laboratory facilities. We have a small laboratory and are faced
with chronic difficulties in getting an adequate supply of staff. It is generally known that
where an active research programme is being carried out, the problem of staffing becomes
less difficult as people are interested in such programmes.
Taking into account the arguments outlined above, it would seem that provision
should be made for a further building at The Woodlands School. This building would
house Administration, the Social Service Department, specialized services—that is, dental,
X-ray, and laboratory—and also should be the headquarters of the travelling and diagnostic clinics. Short-term temporary care cases and patients undergoing special investigation would be located therein as well. It would become an active teaching centre for
the medical profession, medical students, and provide in-service training for medical
and other professional staff, as well as being a location where casework for parents with
children on the waiting-list could be carried out. The building itself should be designed
with these areas in mind, and provision should be made so that units functioning therein
could be reasonably flexible. I have in mind the type of building with the internal
non-weight-bearing walls which are formed of movable light-weight partitioning. There
is no doubt that a need exists for such a building, both in order to more efficiently utilize
the existing hospital facilities and also to provide better community service, as well as
to make The Woodlands School into an active area for training and research. Otherwise,
one will be faced with the continual problem of expanding residential facilities for the
retarded as the size of the community increases. THE WOODLANDS SCHOOL
Q 153
During the year a census has been taken of the patient-pupil population, which has
been helpful in pointing out the educational needs of the patients and in giving us a background upon which a properly segregated stratification of patients in the wards by both
chronological and mental age can be arranged. These two factors will have the effect
of helping us to place our nursing staff more advantageously and will be much better
from the patients' point of view. It is obvious from this preliminary survey that there
will be need for an increased number of teachers, particularly for those patients whose
endowments lie within the imbecile range and who require training rather than academic
tuition. We have been much hampered in this work by the lack of adequate psychological investigation, and attention is directed toward reports from the Department of
Psychology.
The following figures will be of interest:—
Year
Psychological
Tests
Administered
Remarks
1951-52
1952-53
170
508
258
316
477
87
This total included 81 staff psychometrics.
1953-54
1954-55
1955-56 -
1956-57
psychological staff of Provincial Mental Hospital.
During this year we had a psychologist on our staff for only four months.
During this year we had a psychologist on our staff for only nine months.
During this year we had a psychologist on our staff for only eight months.
No psychologist on staff here, but had intermittent service from Essondale.
These figures demonstrate that no more than a fraction of our pupils have had
psychological testing, and it is vitally important that there should be adequate psychological staff attached to the Hospital-School. A minimum of three psychologists is
required.
The physical health of the patients remained satisfactory during the year. There
were eleven deaths, details of which will be found in the statistical tables. It may be of
interest at this point to consider the death rate for the past few years:—
Year
1950
Percentage of Total
Population Dying
per Annum
4.9
Year
1954
Percentage of Total
Population Dying
per Annum
1.8
1951
2.7
1955
1.5
1952
2.2
3.4
1956
0.9
1953
There are, therefore, approximately fifteen patients dying per year, and these are
mainly in the lower age-groups.
There were twenty-nine male patients and eight female patients admitted during the
year. We are, at the moment, overcrowded on all wards, which makes the work of the
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Mental Health Services PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT FOR TWELVE MONTHS ENDED MARCH 31ST… British Columbia. Legislative Assembly [1958]
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| Title | Mental Health Services PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT FOR TWELVE MONTHS ENDED MARCH 31ST 1957 |
| Alternate Title | MENTAL HEALTH SERVICES REPORT, 1956-57 |
| Creator |
British Columbia. Legislative Assembly |
| Publisher | Victoria, BC : Government Printer |
| Date Issued | [1958] |
| Genre |
Legislative proceedings |
| Type |
Text |
| FileFormat | application/pdf |
| Language | English |
| Identifier | J110.L5 S7 1958_V02_11_Q1_Q240 |
| Collection |
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 | 2017-08-04 |
| 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 | 10.14288/1.0354201 |
| AggregatedSourceRepository | CONTENTdm |
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