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 co pq u > Pi m Vi X H >-} < a X hH < H z w o t/5 H OS H< CO «^< z2 < P O i—i _ >~ ___■ H g -i zd H < P a. 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'-g l n 3 c co +j C Eo w — c c 1 ■s c e 3 <- _. o ___ rt £ S-°2 .2 .H o _!_£___ i i«i C rt fl -S3 .2 b E c «t_ U'D r .ala §•£ IS & •a a t "5 o H U, it ,0 a ro ■a t c a h a h a ._ OS s t o o < H W H 2 Z 3 *- ° 3 > O *- m w V3 ■SrS S "3 c. a. 5 2 3 S ■S E 2 "a 21 o — 1.2 ■S ci TJ w. Ms ed TJ S cd ~t w .2 ft _." p cd ^_, 7s O u B S n. 33§ 2£'l s'S'l ■§-■§ u __ o > S d si § — cd *' cd +■> tH Ih -w O ° S C <u a" "13 H oj C w co o 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 tn BB H Z o > I-I w & o PS* w t- <M Z %\ H 05 W I- iS «n /^< ON J" R * U cn CA - a H t_. o H Z w w H < H 00 w Cfl Z o w S3 a CO 00 tr C e» r- vo cs o ___.*£ Cl rt_ rr, -rt SO Ci Ci CA Os OS Os 1ft w 8l a. ytciasrttn'ccosrnsomos ri R V3- CO •"-< CO O VD tS SO Tt -rf r. > rH On Tt 69 (w ° Cfl coOooooincoOmvoovON ^C a 5 o.2 C~V~t<Drt so tr- O so t~- Os rf o rtytso'-TfcATtciciOOOOrn to mtr-sortrttr-Citntmciso Ov u. coinOOsvoOOOmcSr- — Ih C3 01 3 a GO '—r-r-^-vo-^-'sD'^rcNr-'* VO <V5- m rt tr- tr- oo tn oo rt co ^T i-t tN co tt ts ri < «9- ts tN |S v__> Cfl CN 1 cN C>' d r- r- ! >0 O S-r1-1 ©^ (N 1 00 ri 01 ?^ - 1 >-J ra co oo ! in tn (/_- ', ,"H W- cn •5. ffi xl < >> o © 1 r. : ! 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E Crn ■*< raco a [_ c <_ u ■go II O cS " ft Xi Tt M flJ 3 +3 nn oJ^r oi-~ S z y s m s ° cotNr-ONOOrHtntNTtvo cofS'^-Ttm©fSrHCN|co 6Q- Tt CO rH rH r-OOONTtVOTtfNVDVOTt ©©fNcNrH^HCovor-m CNrnvom-^tcocovooNts Os so CO q^ r^ i> m" On" h ■ © 1 i CO On Tt TT ■n i «■ j r-avcoTto.oooovo.~- ONqooTtmm©ovrH r"ovo*ONr-.mr.vdcs" ©VOtNrHTtmcoVDVD tsovocoomcoqoN «-^rHco"corioor-*"co vo rH rH fN © CS 60- t-H rH ft 1) ! x 2 aj flj C Tt h. u re m ft u jd aj re u aj .y > o -a Sc£« ■S b -*a ra a 2 s i so ■ S .5i 2 I ra ' ZOSJU, HEADQUARTERS 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 u D tt Ci 3 b S3 g A £ « B J3 J3 0 2 a — ra |ow 01 VI OS 01 tt ca w H U u Q 01 £ ^^ U 01 O tf Percentage of Patients Recovered and Improved to Admissions Percentage of Discharges to Admissions (Deaths Excluded) Year It u > o a T) > •=2 si •a _» > o 6 ■a V > o a J B D 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 •a— 1 a g CS cn VD en C\ Tt S__ rt rn Tt oo cn Tt VO vo tn y-t rt cn Tt OH .-' O OO OC- o vo VC Tt Ov rH O cn oo (S o H p. cn on C- cs Ov £ es m I> VD e» m o" CS Tt cn tn Tt O Tf _, CN <S Tt •a 00 Tt OI CS j cs tF C-. Oh TH yt D O P. o 1 w o cn 00 s en cs W") cn i oo oo VC vo tn .-rt r- On to [ii rH r cs V. so so CN VO en Ov Tt vO s cs < 1 es en m o. r- vo rt r. 1 o fc CS yt cn T~, tn z 0 Ov Tt (N l> cs cs cn VD s 1-1 1-1 CS t> m r-i O Ov CT. ~rt" a. 1 fc CS ~H en rH VO vo t- Tt tH <o 00 Q < tn s rH (N cs en r- © r^ o. vo VD H< ■rt fc CO (N SO TH M OO O O r- t- en cs m CS tn s CS i-i eo Tt in en oo cs o~ Os fc" Tf en r- cs o H On W rt _H "> Tt Tt_ U tn s oo O oo (S VC 00 Tt r- s Ov en TT 1 fc tn on m cs *H Tt (N Tt VD VO cn cs CS r- 3 o CD ..j s cs cs Tf <n Tt Os m ov <n •rf- t*. a) a\ fc ■*t on 00 CS o z u _J <* ri < w 00 00 cn oT r~- © CO VC cn s (N CS Tt «#n m tn CO O T-H Tt On Tt ft tn ^ OV CS rH cn (S co o O Os en (N r- oo Wl P- W U in rn s m cs SO rH rr- l> (N as O en cn cs"~^ ov fN ft TT tj- 00 T"H r~' O "A (N as __ oo tn on Tt o2 ts s m cs VC r~ *n tn o Tt © Tt Tf -0 H Z W fc cn cn r- *"* *H 00 o CM cn tj t- vo bv cs g <-< s CN en wn 1-1 r- E. _) Tt 00 <N CM Tt _0 ** as li en a p. § 5. 9 < 1 o. -Ti cn -— r— CS tn *■« s es cn en < CS IT) t- rH — oo Tt A v^T i_3 t- F^ n^3 Z Q ° s < z CO < Z o cn CO § Q < H C o Pi 1 (■_ K ■2 Vj |E I < o .S3 s •2 S W ■a o •B *-. hJ 01 £ _: C 'S ft CQ < § H a 0 rt 0 a .2 rt o o E 0 c > 0 H > 0 H H * C « c vi T '■J = c u C u > U > U CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 107 X LU tn o z < On D O P2 O w 0 < CO i/) o z c-~ <f i/1 o. Q — j h < cn H «—i Z p. w 2 O a * < ca 5 ( ! u Z h J u VD l/~, w ON cn < -, W H Bi CO U i—i J H P. cn Z < 0 cn 1/1 <, q < Ph W H ca ^s TtOscsa\vo'-.fs<--(r- en en Tt nn cn es Tt CS Cn T-H T-H T-H OH esr-vovovDT-iTt ten rt j j es es cn t-h t- -<_ 0 B, T-H T-H ov CN rt »H cs es cs t-h ! l es vd cs co csesvoen© !»Ht Tt VD OO «T) T-4 Tt es H s cs Tt tn en ; t-h T-H T-H T-H Tf TH tn i I CS T-H ! Tt j 1 i i i 1 I1" go tt, II ! ! III i ! II Mill! s i i {*,-( 1 III 1 t-h | i ; | es ill | Mil | | I rt [ I 1 1 I ill '. ! II 1 T-H | | | | VO VD 1 A ji: ||!|l i 1 i III i 1 II i t-h i th | i cn VO s 1 ij i ill | i || Tt vo ! \ i cn \ \ -rt ; \ t-h cn tn Tt | rt ; rH ! ! ! ! ! ! 1 CS rt CS 1 1 Ov B< j j j [ j 1 I 1 ! 1 1 II A j j I | j 1 J I Tt t-i es i rt i i ^ VD s III 1 1 II 1 | ! CS ! 1 I j Tt III 1 T-H | j m fc Ml i M s i |rtH IJIII 1 It I | |- 1 [ iiii 1—1 i i i i th cs es i i w. I | | Tt in 1 © tt, ! 1 ill lllll | i ^ s ! | TH VO TH j j j TH cs es j i j t-h i I 1 | ^ i Ml i i cs Tt cn i [ oo I j Tt Tt rt 1 PC tn 1 s i : i cn yt j i i ,-H 'T-H ! ' | ! rt t i | !ii b D. 3 O Tt Tt I Tt 1 T-H I [ j i Tt © m i cn tt. i i *"" III | || 1 T-I | |(S s es t-h j t> es | t-h j th cn j | cs th j cn ill | | ! th es r- i | Tt DO t-h t-h en en cn 1 cn 1 t-h cn en ! th i j t-h Ill 1 | TH | i es © cs es i © 01 00 < PC *H ! i ! ! ! Ml i 1 1 | rt !CN cn ! ! co en i cn (t-h CS th ; ! ; i Tt III 1 1 CS 1 i i Tt cs i th r- en 2 j j (I IIII 1 II 1 1 ! l i | Tt ! cn oo Tt ! cn ! t-h tn • rt ■ rt en a, i "H ! j ill i 1 M y-t | | CS tn \ Tt tt | ; CS ! CS y-t ! i cs ! J CS ! T-H C^ T-H | j |> cn 2 ! ' ' 1 1 III | | ll ii . i , 7 cc Mi I : M | CN Tt j T-H TH Tt | CS ! CS rt j 1 1 r jM | rt 1 ! 1 ! ! i en r- i t-i i cn CS £ cn tt en © vo : j ! i cn th ; : i i j 1 II 1 1 | T-H T-H S B, *"* Mil fill 1 ill ; i | i 1 Ith t- t-h ov Tt oo i : i cn T-H T-H !! | 1 ! ill | | | | ! Tt Tt TH | Tt SO es 2 I 1 ! iiii! iii j | jj iiiii11 7 tt, iii i | ^t ( cn CS © ! ! Tt Tt rt [ j ) 1 | rt T-H 1 ! 1 ' ' T-H 2 *H ! ! III:! iii 1 1 II lllll Tt tti 1 i i ! i ! 1 i i 3 S H i i i i i i TJ cn j 0 PS y 00 3 rt tn 01 xi Tt „ o o fl C i j o Xi 00 3 01 O < cn 1 ll fc »_ oi cn ■1y » i Vh O tn 3 O a 3 O 9 » o o 41 6 Ih "to O 3 •-2 L DO 0 |.h| P. Ih *D ° n 3 3 01 -3 Is s> Hg 3 cj v- u •O rt 0 £ <U OJ 3 3 •a *a Ih t. o c >T > Ih 1- rt rt -a -a a 3 0 c U o 01 OJ CO CO rt a o cj rt '|1 fc w O «H cn o rt 5 I y !*> fi si tn it 01 •o tt o O >- *1 a fc 88 > t_ 5 l- 1 X OJ P > t P o « U s > 0 e ec « 0- B O t s 01 u L c 03 U JZ C o IE 5 U < a p a x 0 c _N U c c « h4 C C > C <L) _> u a> to K *£ ej tfl a p > xi o o -3 X c c c X D O N -C CO « t 01 p C 3 ■O c rt k- X 0 1 c p u oi s o >; *(» CO a. « T CJ 0 3 U _u X T c. c i a a D 01 0 a C c c _£ "a E 0 C 1 5 a B 0 '5 3 CC Ih rt Q *a c t o 3 0 'cc C rtt u > CM Q a "c c 4 t C t rt a T- 41 Ih 4 U * ! c J3 0 X o > a i. o 45 0 4) 03 s rt H cn 3 O B aj •3 Ii -3 0 0 cn o r 3 C E 3 C 'rt £ E G T. 01 3 g a cX Resulting from epilepsy and oth Secondary or due to infective or Secondary or due to allergic, 03 OS C ij fc _cn fl. jg | o w ■'-, > §2 H r o u H b'3 ll 01 to u rt 01 tH •3 o 4) 3 w ■a b , cc 0 £ H -U -3 3 3 § 0 u 41 1 cn U >, cn O. ■o 01 H o flj 1 fc 3 ■o 3 rt 0) 4) ^T .ii c x: "C "3 c d. a O i- •ES <- 'tn X 0 c J= -n ej c >. > CA tf a, p- °§ 3 33 0 3 'Tt (J g E ES +t o 3 -c P ■5 rt c U 4) J rt T, O UH . Ih CC! OJ ■Si 2 2 c t K a. i- fl. > c t > 'c? a d .2 s I-I OJ > 'tn 'I 1 4 1 4> Z CJ Cfl C5 > a. < >1 CM o 5 Q 108 MENTAL HEALTH SERVICES REPORT, 1956-57 X W tn a z < p o A O i w o <■« 2 a cn s O '« Z C e I m o z ►J u < - m no 2 m O ON o - o d 55 5 cn pl, < H cn gj w r-l •a--. th Tt CS Ov CN rt r^voTHT—incncN oo m run ho d_3 m es cn i-i t- OH m Mt- in ! OS O fc VO T-H j T- 1-1 i v ov i |Ttcs ies Ttm—HTt | v H £ en rH j | t-h j j T-H T- fc ! " Illl r-l 1 II II II II II II ill MM S 1 i illl T* | Illl j 1 *"* Ov in fc 1 1 Illl VD II II 1 II II II II 1 II Mil VD s Iiiii 1-1 II 1 II i'l Mill iii i i i Tt VO O fc 1 1 Ml en iiiii Iiiii: iii MM M ! If M Mill! i M MM |I|)1|| lllll III T-H | ! | § M II Ii 1 lllll Mi Iii Ov m in fc 1 I MM Tt 1 II 1 1 II MINI III INI tH 1 | | | | | lllll s 11 111 1 Mill iii i Tt un 1 1 1 III! \C j j || j 1 j |! |[ | fc i i iiii tr, 1 ! TH Tt Tt m T-H 1 1 1 1 I 1 1 1 1 1 | III rt | | j s w Hilll iiiii Ml iii Tt fc r^ cn 1 1 I'll Tt {II 1 1 1 T—1 rt Tt 5! i i MM n p, 3 O BB Tt fc cn t-h | t-h | : i | i | i | {{J MP 1 T-H T-H [ Tt • Tt | | | I 1 I t | Tt s m i iii iiiii Ov cn 1 tn oo < tt, i 1 1 o 1 ll ! ! i ! ill M T-H | Illl OS csiicsiii i t-i i es i 1 ! ! HIM Tt cn 1 O s i Mil cn i i III 1 1 ! iii iii >n 1 1 i N i I i fc 00 Mi! Ml 111 CN 1 iH TT en Os 7 tn s T* Iii Mi iii fc r- • Tt JIOT-H.T-. | |CS | j | 1 1 iiiii rH .-« | rn | rn | T—1 ■* l in 1 : *-, ii | irH | III CS rH ! Tf s [ [ J j | •«* III iii iii 1 a fc l l l >n i 1 i ! i III M r- Ttllllll h j ih |M 1 ^ 1 I j I 1 es s i i Mm M j If | || 1 1 i iiii l|l(NIII rt rt j rt 1 l> 7 fc i i MM III Ml i 1 iii 1 i i n VOIIICSIrt 1 | rH j | j 1 T-H 111 *"■ s CS M Iiii «"l 1 1 1 -1 1 1 1 f 1 1 1*" Tt fc — i i 1 M i Iiiii § 1 Illl ^ _ .—. . 1 G 3 o .2? U CJ o 01 4) <u u 3 3 3 2 o 1 T3 N N N u 03 CJ S c •a u OS i rt 1 OS a S c tt o Ut 00 uT CJ « 4) o o o tn s a Tfij *3 O ES "« s -_ — Si •S s S o €p t_> cc ?■§ _.. rt 'cn O 3 DO rt s G 01 2 tt o U i 0 Cj fc? A, •J! _- tn £ o S s w fc o i "_3 cc rt _? 1- M C 1! .ax 0 B tn g o s £ 5? 2 E i s s > o "" ^ 01 ,Sx ) o ^ u 3 tn g o ft i cn O « c _= p ll -3 cn 1! .2 o it 'oi Tt rt ft Is 01 1 G m u .-_, o 8 1 fl 1 o a _j "u rv c -S u .- » g —■ ■a o Tl 0 (_> a* 3 0 1 T3 G rt 3 •2 1 C O g S 8 I O « J rt ft q b — xs rt ra •- J3 CJ C y '___■ n ™2 > c c u i __ i > 1 c 1. 8 a 1 0 Z > c s 9 c 4. s c a 1 J 0 > C c 1- 4. c "r 'I $ C c 0 '> J: > 5 -2 rt % G ,£ O i2 B QJ 3 ft c t\ R F > u 3 4 t 3 4 C a •0 4. > 'S X 4 J3 4 3 1 ■0 c K 1 ! t- X c 1 C c t T a s 3 Xj It 0 #o ? Ih K C « 0 I X u L o '3 3: 2f 4. c 3 a. £ .1 4. » c a •_ c a_rE U 0) c iSjc .— — v '»_J. = C E 1> T3 cc •_: s ^ __ ^ £ 2 S.C s § 1 fc tH 3 O > rt .3 sc sz 11 S £ •0 ^ B C >. > B C cd cc ■0 0 s u CJ c 1 •a % fc- O 3 fl 3 C 3 M 3 R fc [_, flJcjflJCJ,"oflJ'0rt « omQ,Uh<<« rtp. _3 ■£ § Q-U3 1- O 4 CS E S rt cn .° .___ -o ,3 « -c rt .3 c<_ .3 5 a "Sfc £ <C l_ >. >t >. >, fc a .a 3 ,fi £ "S. Pt p. fc £hO CO Q u L L H CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 109 rf Tt in Q On On On «n Tt cn cn in 00 © t— T-CS | ON Tt 1 I 1 es i i ' m 11 III VD 1 i j M es 1 M OI cn 1 i i T-i ejv i r i i ^ es Tt i i i tn en CN I i i •d" © VD cs r- cn *H i 1 VD oo r- Tt oo CN Tt 1 (S Ov VD 00 VC r r i © cn 00 r i On ■* ** i i m oo On rH rH t- CS vo I i i t* OV 00 ON VD | " i CO © i i i O r- m I l 1 es cn £j cn en Ml i> 03 _rt O rt O G a 03 cn >, cn 3 O Ih CD G la 3 01 CJ 01 XI i+H y O <r C Sf. -3 flJ t. i p ^^ o <D Ih OS o ■^ rt ft "rt J T3 O aj a S3 lH 3 S o Xj cj S "^ ,3 QJ « cc H 'M •0 & qj rt M 5 B 6 p |I §■3 '-3 G rt 3 > „ Vh Ih OJ QJ ££ OO Cfl '3a o ,2 o >, E 3 0 0 H B c 3 « 0 Q 110 MENTAL HEALTH SERVICES REPORT, 1956-57 Xt^ 3 rt 00 1/ 1 © On If . t-h On CN , . __ ____, __ «n hc.mfl cn Nn 1 as OH t-H Tf VD OV CN voi-«ininvoT-.oovo Tt t> T- - r- TH TH TH T-HCSCSVOCSCnT-H (SItHCN OS O fc 1-1 tt cn m © CN cn Tt m Tt OV 1 t-H VD vo vo ,__, H s 1-1 1 OV 1 1 1 1 I I 1 1 1 T-H > Tt CS fc i i i t i \ I ', i i i go rS MM | | CS | | | I i 11 ii j i " Ij en e> fc II II I 1 II 1 cn | ^ j t-h Tt (s ! | | en 1 | | H in S ;!<!!!;; T-H — VD i 1 M i I II Tt VD fc MM|M| T-H T- ! j 1-1 1-1 1 t-h cs th 1 t-h m | rt m s i ._, i i j i T-H I 1 j lH ■ en vo> : 1 ■Mill ! i I On fc | | | CS | | j | t-h es T- * es 1 i | CN th | | ; 00 ; || Ov in s — I y-t in \ in fc | es 1 | j | j | l | T— CS ! t-h ; T-H ! m «n s I T-H A Tt fc es T-H I | Tt rt 4) a Tt £ Tt Tt fc T-H | T-H 00 T-H : es es 1 CS © | | i 00 ! ;| m en o Tt s 00 ■ Tt 1 ,_, Tf T-H ,-H 1 NO 1 1 I _ QJ 00 cn fc | \ 1 1 1 J 1 I | es < cn s | 1 i | | CN T-H j | TH j || Ov -(-J- . , t^-j ^h T-H T-H T-H r- fc cs A | ; i i cn i t-h i cn i | i CN cn a '"' CN 3 fc i 1 I T-H cn es ;d 1 i MM i 1 1 1-1 • 1 1 ,_, 1 1 Tt Tt es cs cn Tt 3 es o. •n fc III II M M I M *H s l cn i cn t-h | |t-h 1 j Mi 1-1 | I 1 1 CN 1 1 1 T-H j || M iii : i i cs fc 1 i M I i II -r s |rt 1 I 1 I 1 1 i | i | 1 1 1 II II 1 1 T-H 1 1 1 T-H I T-H Tt fc A s II M M II MM ^^ ^—v I QJ 3 G s CJ -tl _, B Ih 00 £2 3 O G O 3 Js rt N 4J OS 3 O 1 > cj rt 11 3 « O t-H cn o °§ 3 -^ 2 c _S CD 3 3 QJ fi G *J G 3 +j O S o B 0 O ■S2 O l- -H (J i o Cfl R CO fl QJ Ih _o o 5 QJ 3 X\ .1 .3. c S 1 a O -J a. o o rt 5 H 4J 3 O C cc u tH CC "5 c u X 0 i o CJ ed g 41 #> "oa Cfl QJ ft 4> T u 3 « *v. fl a fl _n c 1= ! a 3 0 Cl "e. c ra ra 0- Tt oi C QJ w -S « £ C H -E 4* tn ° tt G s rt O > i &- _Uc oo_ — C- _ S.8 *■ _. -B a. C .9 t ra E a E >. •a E fl > s cn ■a S E tn w j- <r *S « .2 c i oi H 3 3 £ QJ o C a. U >. cn Ph cn Ih QJ Xi 0 ■Ig o > § QJ _=! 833 -3 0 CO 3 > CJ 1 i X 3 I 4 | ft c o 0 0 4 D > IS c 3 a cc Ph 3 4 h D O (v x c CJ 3 U < 3 4 i- X 3 C N X Li 3 ft « HH > Cfl c > t ft ft rt 6 t> CO 1 3 3 3 ■3 c rt rn aj X 0 Tt 0 a 3 a c 3 a :> 4 cn flj u 3 flj 0 Z i c c 3 a 3 a ft) j; C c X •i ra o £ 0 3 O 5 O > c c u > C c 1 Cfl 'c? c •E t s p 1 X 4 4 C. -C .s: i/ _? > _/■ p- QJ c Ih Q. °4 og cn > o P o >. cn Ph ft s •" _ s * o & u ft a 5 a-si 3 C 11 a ; _. _l u __ 6 > < C fl ■c c c X C. , > P. | ,'l | t 0 X tt < 1 1 1] QJ -t- h 0 "rt a, CJ t- 81 _3 X 4. 1 B s 4. > 1 41 u ft) I 1 tl c 3 ft. 2 o « cn _ .— cc _S «- -.2 -5 0 « Ih 3 3 •£ SS y Jn On o H -a e >T Cfl 1 Ih Xi 3 O -3 u > c X 1 c C E- . X w cn Q Z < P o A O i w a < o r- 7 U-, o ON < , . Q h C/l ^ < m H z X w i) S p.: < >< S CO c; O H g H u ON. w _, _. H < _. BJ r—, C-C O -J 2 n Ph H < _-, z o C/1 1/1 S q < w w fcj ca < CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 111 CN T- m-cl m CN rH r- . t-h cn yt VD 1 as s Tt Tt tn Tt Tt Tt I Tt jCslT-HTt vo yt |cn |CS CNt-ht-h ItHth 1 es cn © cs m iiiii lillli: iiiii j | i : | 1 : 4 iiiii MM!!1 1 3 Iiiii 1 ! ! I ! 1 I Ov pin | || | | | | VD 1 1 *"' 1 1 1 i 1 1 1 ! ! Tt iiii iiiii On MMI 1 1 II 1 II iiiii iii!!!! m 1 1 cn ; | i i i i i j i ts vo es cn m Mill 1 M II II ts cs 1 1 1 Ith j 1 - iiiii i II I I! i in cn i 1 *"* i i 1"< irH • '< \ • CN 1 1 es 1 i i 1 i : 1 1 T- cn I i i ! ! i i 1 ii 1 Tt es MMI M 1 1 II 1 On rt|rtl| w |H j j Tt cn h iH H r 1 | 1 | | en in cn cn 1 1 1 "** 1 1 1 ii 1 m — 11111 ii m r i ^ Tt iii i iiiii cn .in iiiii H I I i iH i CS iCS iiiii 1 i | | | rH i '-' CN MMI MM! ^ Without Psychosis Disorders of character, behaviour, and intelligence— Pathological personality— > « B C or > 1 > C r- A > c e. e c t- c fc c c I •_ T— « I 5 V. c z X 4. e. p 3 0 1 3 0 0 QJ i CJ ft) . 0. '3 C X CJ > S T, S ft QJ U r_ ft *• ___ C a & t- E rt « hi +■» Zf c O QJ tr 0 41 ■0 ra 3 X 03 IT, OS £ ^ £ 0 Z ft 5 0 3 a c i, c 3 E rt U a 1 II ft?2 cj L ■a Se 8 « c_ — CO C *•§ e_ < Chronic brain syndrome Epilepsy—Other and uns Other, unknown, and un Total without p Q 112 MENTAL HEALTH SERVICES REPORT, 1956-57 X tt) <n a z. < r. 1/1 C/l 0 z 0 < p ►J < H z w 2 -, C/3 r^ -J co H on < H C/5 H ►J u. <. ' 1 (H c<> 2 X •^ <J s A < Sx 2 05 O u H z NO -j IT) U ON w _. H < C/l tt) A n fcJ A o o, H < 0. Z o I/. c/l S Q < H _. K OH o H fl es t> in ) ON OV T-H On VO T-H Tf l 00 t-c cn t-h Tt en © It-h r- oo vo I m en h rfvt l I I I I l T- rt T-H CS »-H | ! cs T-H I rt ! Tf rt i i es cs es Tt Tt i t-h r- in cs cs th ov Tt es i t-h oo Tt en cs Tt cs th t- On cn cn i t-h m cn cs ov oo i es es t-h i t-h Ut tt. fcJ « < I co cn £ E § S 5 Sg S _? 2 E E S °-_ » o .n B.2 ,11 ! § E E E E E ? to n oj tj .c : o »- c 3 « K M QJ rt Ih C/l (U ■tt > u « ° u .a I s^f£ 3 QJ „- ^ >. •■- §_.gsa* E »££ i ES E " a o tt cj co *a •3'«_ 5 O o rt ■S-S fc >W,_.C.fcJWr-C_J_ i * b ids J - O tj B • CJ QJ - k _ . •111 < S_ a. rt 4) E o I- w O U- (> V) cm tl) > V a 3 ■s Tj £ Tj O a a H (0 T-9 V (H is t/_ CJ 'J Eg rt CO EH rt It cn S3 "3 8 O o O n u o o Tl 3 ■=. 3 C o 3 O 4) 3 O ra 3 O M S_ L."0 ffl ° % ° 5- " J3 B * C JS K r= __ B T3 CC E u ■« CC tt S5 B T3 fc, c O..H.2 is B = B a 5". __o ■gz 4> QJ* E E o o B B Jtt CJ e| QJ -M rt -C £ ° 3 nJ . :o£S OZo, Uc CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 113 OO Tf Tt m o Ov in oo cn cs m Ov On OO © en Tf © yt es OV I 1 ! I i i t> Tf m 1 i M in CS rH , IrH es cn es ts CN "IM 1 1 ! »-H ! ! i es T* m III! 00 cs en es en © «n ts cn GO m Tt VD T$ r- VD Tt tn Tf rt Tt j V) 1 II * 1 " 1 m r-l N > < "c T3 QJ a '5 o oi o 3 E oj tn >. «_ 3 O Ih QJ 3 rt Ih 3 QJ (J „ o I tn X QJ ft co > rt j ft) C ■S3 -c ' w § QJ jij o >> co a rt ■a o> E Ih 4J ■£ tt 3 Ih O ttt Tt 01 03 a 3 o ■t ^3 I it o ^ I-I s « cfl o 0_ 3 .2 TJ 3 O -a a; 'o QJ a a> 3 3 •a 3 rt 1 0 3 § (■ CJ X 0 c ■g p s c £ 1 0 C H Cfl ra o -a s 0 Q 114 MENTAL HEALTH SERVICES REPORT, 1956-57 X a tn Q Z < cn O Z O < ►J < z W St- in co on D »H 5 H Is p. ■* Ss ^ o « r, NO o >--. z2 OH rH fN W. rH -C.tfcC.C.^ CS CS , « 0. CN ND CN C-i i ^t -H rH rH I r- CN 00 CN : rH : CN rH «C.- r,, -J u w co <c w 5 o H z O s tt. E 4> I CS I I vo It-h I cn cn It-h vo © cn rt | 3 Q < « Pi tt) r-l m < £ s'-ss CJ ra CO « T3 ■C ax ■» . °-s i ; S3 -SlB rn cn cj s_s : « o w i .3 E a i X)"a - co CJ CB 'tt *H Ih •-< aj cj 2 E E g S S, 5 E E R » CJ •S'b I e o * " o O B B.9 .SB 3 __! QJ 3 Eg b_2 o a •ST. ca B 1 g 0, u o c h3 « o " ! «3 .■a ■__•- £.= 3|« •B B CJ rB O CO >,_S „_ B co co 3 LL ° ° -j * js h CJ cj c. O S B cp B .9 a aj -_- ^ B K "b aj « c .£ -2 l?'c ° ■S £2 i 8 5? 5? s s _ ~ :■ J ' 3 A, Bl CC O < EC fl. O Z Ph fl, co E E S O fc. s S 33 S3 jb .2 -s? g e -s s ■a b o * J3 o aj cj tt tt V, js-a o n CJ .tt CJ i n u s oj y. $ SB * SB B -B * ^ '2? ""* 9 « t rt 5 rt .y QJ y QJ C ) (J P -3 0 1 3 60 03 fl T_) fl OS O </• B > 0 r3 -5 z •°flL Ih C S EC ra 3 0 ^ s-s rt C !. ? QJ Is "■3 ■sl g'J 2 0 ■0 .s LH B § u & 5 B ft 0 £ -.j-1 rt x •a ts Ih CL n **■ i< " AD, U u W 13b cot _HO CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL 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 "~10 3 2 1 9 3 25 14 1 3 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 OH innfH x W tn o z < 13 O A O i W o < fcj <: z w a o -J r) H vn w cn -r o\ w -^ c_! LL U H .0 0 -J s. A Ph Ph C/l < P-| (1 os 3 a u go rH rH CO CN rn rH rQ COCO M LD ICNVCfn rH rH ! rH CT, r- | CN O rH C-) I rH rH (N I *t rH _. rH cn ■ ^ ! r, cn CN ! I cn tj- ; cn cn CN CN rn ; cn CN fcn ! CN CN *-, :cnr-T_rH-a- i m von cn : rn r- cn j tN ! < W. NO CN rH •^ o\ cn : cn , CN mrH\_;coo\ !CN itN M-CN I rH \D r- CO 1 ** TT rH OO 0\ rH rH rH (N cn C- > NO W H CQ < ' ftS Qr £ e_= b § S B ? .9 " b b y B i»KU(.<r) ° S -b 2 -tt tt cj £ oj o >, -O CE • ~ r. ft S O CJ B 2 ° ft _! cj > CJ CO >h fc^ Sags; u 6 IS ,3 £ 3 ? a ra g « O O . rv U | | £ & c X X -3-3 3 &0 « O -| 2 u ■ rt 'tn ai 4) £ O 01 o o 5.E is! 3 M O § g-o a s g « 8 •a >,<£. on ss s o s Iq i 33 +h <u £_■ a§flifl3 " 13 O 3 O 3 O w o o CO ", 3 <° w 3 m o S? o * >> fi a 8 a £ -S c O O O I Vh ( b« b ; 3 O o a 3 o X ^J Ih 'S v-3 -c Cfl • i no-S- ■ B -B -. i B CJ ft ;fl_«.3._.23Sfc I *H , rt ~Z „_ . «■ h d © >. - rt aj u o_ ; Ph W Ph Ph -O X3 3 3 O O 3 cS 3 m 3 : i_; u .e -S x; o o 01 01 v v PS P_! &o co 1 s^ _.___! !S ) rt o £ ) o o » ) q) u *rt - 3 3 hi 1 Xj XI >£ J 6 O ci ? &&1 J rt rt 3 - -D *0 3 3 3 -o Q o 3 - y y c3 > o (U ™ a-5 g S o «a n E x: £ a ^ " 3 > 3 g> O "Jg O ftE S5 ? 1 •§ g .52 .SS £ +3 W CO H u O O O rt x: xi x fi U L> (1 Tt <n cn tn £? Ph Ph Ph .« , < Ph Q 118 MENTAL HEALTH SERVICES REPORT, 1956-57 X cu <n Q 2 < p< 3 0 A 0 w c. < -. -M Tfl 1/J o CU -i S o < r- Q 0 j < H r-~ 7 ir, w ON s —1 >- H cn M O cn — 2 a u -1 2S ( ) <: W 2 Cfl o H OS O N© § On. ,—1 o A H tt. -0 ,—1 c/l ttl o rJ A PL, < X < u > w ►J CQ < XtT-t 3 « OH Ov 0\ oo CS t- cn t-h Tt t-h \D CS o 00 csr-cscjNcnr-es nr >-H cs es e^ oc CS r- On t- C" "rt O H a. T-HNoir.cs i cn enOr-rH es tn i t-h CS ! es oo NOTtfCSCST-HNO ! T-H© fs) |t-HON t-H It-Ht-H CS T-H T-H S COcncnO t-h fsj rt rt OS Tt Tt SO es <n NOm jr-eST-Hcs cncn \dcs io !t-hcs i tn Ih rt b a 3 o Ih DO 1) M £ <u rt > a.' 1 j ; OS j j JH j | m s 1 "tf | ; ; cs ] zz MM 111! Illl o\ VO in NO (i II j OS J | | ! T-H Tt Os M M Ml II MM MM S : ! : tn \ : i i ; : j : j If o cs MM M III "tf VD 1 O TO ii es ! t-h o i t-i i i cn i cs tn "tf 1 I *"* ! i i ! ! ! ! ! ! ! i, t-h ; 1 vo j | j : i—i j I 1 iiiii O ON in 1 m tn » Tt i cs t-i ; : i : t-h i i ^ oc s n | j"n | 1 ; | t-h | ts i i iH j j iii iiii "tf In 1 o tt. es : i on i cs t-h rn i I IN ! ! "tf CO 1rt jrt I j j ™i Illl Illl S cn | j r- --H- j j j cS Tt oo en ^^ | | | | | | i III! Illl Os ■yt 1 tn Tf (i cn t-h ! cs ! CS | 1 cs 00 IrHjCSjIj || <N!t-<! III! S es ! yt cn j i ] i i cn H | !rt 1 1 | || N~ |j MM ■■tf tt es i ; oo ; \ Iiii j cn n hhhn j | j I j iiii iii: S ^ ! 1"° \ 1 1***^ ! m -tf ies|T-H[|: cs; '-'iii M | | Os cn 1 v. on tt,' "tf CS 1 CS ! t-h ! cn ! ! 1^1 ill o T-«!!Tj-il! !<N !!!! 111! 1 ! i ! i ! ilil iiii s "tf T-H | (- j T-H T-H | j j tn i i i i i i i HH "iii : :H i I i 1 i 1 i 1 iii i ! \ ^t cn o cn Ph ,_! cs t-h t-h ; i cn : : n [ 1 1 || Hrt [tJ |M I -htj 111! 1 |H 1 ij! IJII || j S cn cs 1 r- j : iiii 00 1 1 t j j j t-i >nes iiii iiii Os es cs (Jh cs t-h t-h oo : i :ii; cs \o T^H|!cn;cs: | *h :;:i i-h;:; i i 1 1 1 ! 1 i i 111 S j : ; "tf ; t-h | | Tt | In t-h j j cn | ; t-h es cs iiii iii! o cs ft cn : j O : t-h rt i { r NO vO cn) : linn-- i cscs Illl E 1 ! 1 ! I i i 1 I ! it i 1 s cs ; t-h tn ; j iiii SO tn, cs,[t-.*-h:i Tt tr- ::ies !!*-.: 1 1 1 i ill ill OS <n tt yt j i cn ; ! 111! ! i i i i i i i m | 1 IH |H 1 VOt-h ijj\C | ; ! j s i,—' *~' iii (N H 1 IHH 1 | t-4| .^h;wi I j j ! o li CS ! i i H i iii" 111^ iii i i I ! iii s MM 1 ' MM CS lit II [ j 1m 1 1 1 1 tn O 3 00 OS S rt H With Psychosis—Continued Hysterical reaction without mention of somatic symptoms Phobic reaction _ 3 O t a V « _> 3 D 3 0 o u > a :"J X 0 3 C cc aj tH 03 > y 0. Ih 3 a _6 c t- - oi z 3? O t> OS U tH a o 1 rt £ o tn e o ft e >> r. « g o £ ■ s e i o C 2 $ * ?1 H .ST o w tH C 3 .3 4) u 3 <u O (fc X rt >. Cfl Ph I? O u rt o tH 3 .2 rt N rt £ o £ o a £ B9 .H £ S 2 1 S O tn g w -H 3 3 r w l 3 U ott -fl Ph 9" o tj OS 01 Ih 3 O % N OS £ o tn cn £ o ft E >, u B 2 6 i 0 2 i cj .2 O S s tH 3 3 t; 01 C_J 3 -_i O tfc -5 a >. 01 a >> •a OJ s "u S a Cfl S = 3 C •a '■£ ?*| i-T c qj C 6-B tH OJ flj c •O 3 tH O <n Tl ■•3 g °1 ___ F 3* E o H o 3 rt 01 .9 o oo CO _>. rt a o3 03 a u 0 1 in CD 3 a- tu Cfl T3 rt -H a t/_ CO "co o xt u >. tn a 1 « o H Without Psychosis Disorders of character, behaviour, and intelligence— Pathological personality— Schizoid personality > 3 C V a 3 X c T c. t- a 3, > 1 o a tu D e. 1 > X c > 0 B 0 a 3 aj 1 a OJ X 3 T > c c i- g 'I a 3 < > 3 C T 3 0 x c V < 3 C 0 *> X B 3 R 0, w. A *r\ c. rt « c .5 9 Tt t\ « oi 3 a c So 2 I rt hJ > u c 4 X3 3 4 a <u ■a V > '_• e. Ph 1 c E'E .« c o J= ^° < a « i 3 3 O <j ■a bi 3 ■a t, o 0 -- V ■C u C X t- 3 C > -c <L X •c c c £ 3-. > rt E U a u — 11 rt 3 C s 2 - c c: 4 .- T, 5 4 e ! 1 j I >, CQ ft flj a & CJ /* i u CE 4) •tt B a 1 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 119 r- t-h cs cs cs t-h m t- cn es es m t-h cn ! t-h en th . I I ! ■t! ~< tj =__ .7 01 i £ A a- 1 £ £ 3 igg-a J "O T3 S ' j 3 3 * _ >. >. >- cn tn 01 ido.3 J rt rt O 4> a £§ I 2 5 •S ° 5 "a a S H O i .b .a vi • i B C ft ' o o » '- fc. . — ja -b d. uuw |1 3 ft i. tf o oo Q 120 MENTAL HEALTH SERVICES REPORT, 1956-57 X a-i cn Q Z < < H Cfl tt- O X H O S5 tt) 2 ON _-, ^H y g NO CO O W u_ o o »j « < Ut tn W o pri < u l> - ►J pa < Tj,- 3 rt OH Tf-«mT-H"tfTrHcsr-c-cnT-H-H o. a\ "tf vo *-< tn ■* t-h vo es vo oo Tt cs t-h cs vo tn cn cs on rt rt "tf *-< cs 0 00 CN es <n © tth 0. \o rt VO ^J- Tt Tt Tt rt 0 H "rt £ u cA y-> os oo rt iT-HTtfesOes T-H\omes : cn cn © r- t-h VO VO CS t-h T-."tfONCST-H"tf rH cs : cs i 00 CS cc tt Tt ci Tt o\ cn r- -<t es u 73 on "tf es vo leSNOmT-H^H^ oo cn on "tf rt es t-h ,-h ^ ,-h oncSt-h Tt Tt ci vi Tt m CS "tf t-h Tt 00 : © cn ires es ] T-H OS CO <+H o 00 3 4> h5 Cfl Xj 3 O S "tf 4) > o rt £ 4> Ph w 1 1 I 1 1 1 1 1 1 1 1 ! !N 1 1 i Ml 1 1 1 1 1 1 1 1 1 1 Iii i i i iii fi 1 i I 1 i 1 1 j i i { j I i i 1 | i ; | j : ; | ! iii i i i i i i i i i i i iiii i i i iii 1 i i i 1 ] i Cfl ^3 a o "tf a> "rt E OJ Ph cs ! tn es I | ! I | j (D m.-HiiiiT-HT-HcscS'-H- Tt Tt ] Tt i \ : : i : CS | ! -tf r 1 r 1 i _fl fl O s cn 4) 73 £ 03 © V") I cn I I 1 I i-H "tf CQ It-h©! | j 1 ii; '■lllll 1 "1 1 1 1 III cS © * ! i i i | i iiiii i 4) rt r-cnT-Hiii-tirH»-..-Hoo cn i vo i i t-h i ; cn TtJ- SO cn vo t-h 1 cs j tph 3 O CS 03 'oS £ u Ph ©cn"tf»n|!|iTrHOes mn :n i <s hmh t> Tt Tt Tt j Tt © 0 tn Tt | 1 1 t-h | iii i OJ rt h-^thCt !iH(fj ithicico eST-Hcnm l i l ! th i SO Tt Tt On •n m ! ' en —i | xj 3 o u 73 £ OJ Ph r- co t> m : ithhidoo^ oo *-h cn m cs t-h vo Tt t^. cs t-h nn t-h GO es cn Tt Tt Tt j m t-h rn 73 1 TtesoeS!i*H--<esc?\Ti- o. —< ! © Tt Tt ; Tt i-< Tt t-h t-h o* 1 cn | T1 •rj o\ 1 j en es ; E O s u •a 3 D 4) I o\csoocnT-H!!cn<ni>TO r^cncso t-h i cn th j t-ht-h cn r- II III 0 ON. OS SO Tt Tt Tt T—1 vo JJ T-Hi-H!cs[!T-HOin"tftn cniioo t-h ,-h ,-h ; cs ; ; t-h t-h r- 00 cn r- j t-h | vo cfl Cfl o 3 bl) rt 5 73 3 flj S -S3 --_ 0 Cj X tH c x CJ c 4 tH X 0, 0 _N X u 3 t a OJ 03 t> *« 4 Ih D 4 V c '3 cc -2 0 X 4 3 a *flj E a c 0 x *c > 3 0 g 0 B -3 O 3 rt t> a O •O 3 ec rt O p rt Ih « P- </ O -3 C > ca * 3 4! -/_! "5 O j: c > « 3 a c 4 a: B "5 c Ih * Cfl C 'C * rt fl Ih X OJ aj e -3 1 '_? c X u >» CO Ph R O -C O > CO 0 C_ O O 2 < > c c a 0 rt k U" 3 C £ -3 O O 'a O X u >. Cfl a i 0 a C 0 > c ■0 4 s '0 4 a « c 3 ■0 3 rt 03 x 0 i 6- 1 £ a 0 2'-5 Cfl g .H n 0 Cfl OS „_, So Sb «*H O O ■.£ Ii B C flj r- i b s-S 0 '5 * 0 11 * a OS 01 rt tn cS tr £?| £ •5 a 5 3 >. 3 O t K O -C O X a 3 c t a oj Ih > 3 3 £ 0 L) «_> >■ C rC 0 3 C t Cl 01 Ih 41 > "5 f> a a ■3 6 c u 3 s z s 0 rt N rt £ 0 CA O CT Kg: S > >> tc c_ C ♦! c B CJ E-- al ._. c *«_ cfl B *33 ^-> 0 a S.2 S. Is 0 >-, [fl a a 0 rt H rt £ 0 CO CO h ftS E g > .2 * 1 0 1=3 (A & 1 s S!B PS S.2 B 8 rfl B Ji £ O >T P^ fl O rt N rt E 0 co V) e 0 rr cfl & E E S B| .2 _, "S fl- I* 8 ° cfl ex -B-S .b; u 3: __ S1B .a M 0 e S-B a 0 _§ e u >. (£ •a 01 cfl '0 <u a CO S 3 •a c rt •a" 4> 1 <3 0 Cfl 0 •0 O Is CJ >, Ph c t 0 4 U C t- 3 4 3 1 £ 0 Ih X c > ca 3 g X O '£ 0 u M Tj 3 o* 4) GO ■3 d rt CO 3 a >. a c X u > Cfl 3 ■5 B 0 H Without Psychosis Disorders of character, behaviour, and intelligence— Pathological nf.rsnnalitv > "a 3 O tn flJ C 03 a E | | c c c < 3 .2 Z X X rt b 3 Tt -O OJ X 0 ca 01 ■d Ih O '•3 Ih 3 O > rt X3 01 Xl "§> J?S =o.H S CJ Jtt CE CJ - >,' h *3 rt « £ A .3 a fl t3 c rt 3 O rt jq u XJ V rt rt X3 •O 5J Cfl CO "0 4) OJ *o &g 3 J2 c 2 rt 3 S3 m a 5 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 121 Tt Tt Tt t- (N *n cn cn cs O 00 CS Tt 1-1 —i es es es t-h m r- m © m Tt Os VO 00 en es es m t-h ON Tt MM II 1 m l iii j i es | ! 1 Tt t- II lil cn Tt 00 cn ! j en j j | r- on o " ~ , 77 <n t-h 1 ill T-I Ov m cn I 1 en | | | Tt 00 1-1 ; i cs t-h ij r- vo t-h m Tt Tt Tf Tt || r- «n cn vo en es j cn cs l| vo oo es r- 1 t-h t-h t-h m VO vo Tf cn es Tt m T-H T-H lO tH T-H ; m © T3 .' 4> A cs c 'o 0 5 a u rt ra 73 CJ o 3 rt 'a 0! c 3 £ E .2 .2 "K 4> ■fl ►3 > rt co 3 O -g a u *« 3 O T3 flJ Cfl S^ > tH 03 fl Ih O cfl O xi *% •d 4) U a En 3 « £ _= £ 8 fl 73 4) 4) 3 ft _y fl 3 <-j c 4) U „ 0 c 1 a ill * ^3 3 2 S « C o it la rt '3 -°x « f Cfl > rt cc 1 £ a u flj C ■t _E ■3 5 °-_.a H ° ssJjti^S'Stf Ih i_h 35 jr. <n r- X\ X aa X 9 UL w o O O Q 122 MENTAL HEALTH SERVICES REPORT, 1956-57 T-J^H "Or-H OH OH t-h rt CS t-h m ,-H -H T-H Tt ' • 'T-H ' rt 0 Ut 73 ft CS CS | 1 t-H rH Tt t> ! ; ; i rn CS t-h t-h ,-H t-H % H S Ut I 1 1 1 i II i ■St-. 5 w ft _=V 2 s° § 1 1 I 1 1 1 1 I 1 1 1 ON VO 1 in ft MINI i 1 ft | | | || | | | | | | mosis, Age-group, 2 ! i i | I j 1 i ft O es O i ft) 0 < X H <: VO £ i ! ! 1 i 1 i i 1 1 1 Tt vo 1 o vo as in in in ft i r i i i i t-H Tt VO I vo ft r111111mi ^ S T-H T-H | | ! 1 y-t cn £' | | | j jHH j IrH | cn ft i *** i i i i i •H ON m 1 m m ft i i iH 1 I i j ! 1 ! 1 i 1 1 i 1 1 I ^ s i *■* j [ i j i *H S ; | | j |H j | I 1 j rt "tf m <_> in ft iiiii1! Tt in <± in ft i iiii 1 I 1 II 1 s s Mil f_t 1 1 ! 1 1 ! 1 It. 1 1 rH O c~~ g as Q Tt Q Tt ft 1 1 MM M co tt, °^ CO Tt ft i i i 1 i i 1 1 '■ ! rt 01 tn Tt s i i i i iiH i *" rt u Tt § 111 i.i i r rt Mental ch 3 1st, Qt 3 "tf ft ill i ft) H a Tt ft j j 1111 ii 1 1 i i i i i i t i CO 00 i i OJ) Tt s i i t i i i i ; tt. rH < CO >- U 00 Tt s [ i r i 1 I I I u OJ) < Ov cn m ft M Mm 6 0D < Os cn 1 ft 1 11 1 1 1 1 1 | | 1 1 1 ! 1 1 1 1 1 I!!!!!!! JH A cn £ 1 i 1 II 1 1 m « cn s ! 1 ! 1 I 1 ! 1 O A cn 1 © ft Illl Tt cn 1 ft 1 i II i II ! 1 z o Ovo w tn tn On < H s 3 ° u „ tt) ^ < On tt) rH § Iiii iii Os °? in es ft Os CS 1 m es ft MMM j j i i s *■** j | j 1 j j <H s 11111111 i T-H tt) -. 5j es ft la. - 3 CS ft | | © es s ! 1 1 1 1 1 I 1 1 1 1 1 1 1 j s"' CO Z rt 1-1 H s O. ft MM o\ ft i i i i i | i i i | Z a- 1 m z s £ ft >A § 1 II 1 1 1 1 | s MMM! ! i ! 2 < Tt | | | j | j rH 3 < i i t-h i i i : i T-H A -. D X O ft) Tt 7 © ft iiiii! Op 7 o ft. s r 111111 ii M M U GO O Q tn Z 22 Z a < ffi < H H < < W ft) Q j o Q oo 1—1 o ra 03 tH ON E 4 4 Cfl c. OJ ABLE "cfl o fl u C > 0- c 5 73 Ih 3 ft) -J « < rt OJ Q Tt o 01 3 5? U5 3 O x) Tt ra H rt s 73 a 4 z tn C 4 4) W H ,3 v OS C jb x ra X Xj H > Ih 03 fl "ra tn X, 03 > ra f/ 8.E s T 4 X rebral arl r demons ified psyc drome w U cc s Q 01 ■S «4H O 3 w S"S •a S ■9 » c c izophrenic di chosis with c chosis of oth er and unspe onic brain sy lepsy 3 0 ra > 03 _ c o H a 1 a o 03 fl fl ■£ os a 3 C 00 £ Cfl 3 .2 "cfl 03 _, u 'rt oS o 5 3 o « '■_!_ H o ra III N aS 5 4) flj ? IE c B 3 u X> o n ? 3 o V C c •5 E? fe x tt & •£ WPhPhOUWO - 4 H « %> ra « <0pt (5tS« CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 123 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 _ 144 273 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 Cfl C .2 'cfl Cfl 1 Discharges OJ C 01 Xf 03 w r% >. Tt 01 J* 3J o 0J c_ c. CJ CJ u •O B 3 *T. 03 Zl O rt X oi o3 ill 3 ° -fl 111 ;rcentage of scharges to dmissions (Deaths .eluded) aj Year •tt u OJ > O CJ 13 CJ fc- ti > w O O cj 2 * tZ-tt «J «J^ tt _ Jo»5 C- *H u -j i_ oc 8*1? < A Zp. Q Zt.'S Q £h e_,f-S< _l,c<u_ o,QZh 1872 — 18 1 1 16 18 5.55 5.55 5.55 1873 15 10 2 5 14 2 31 66.66 80.00 16.12 1874 1875 1876 12 29 22 4 3 11 3 3 3 10 5 19 32 35 5 13 3 — 26 48 54 33.33 10.34 50.00 33.33 26.89 63.63 11.53 20.83 9.35 1877 14 4 4 3 38 3 49 28.57 78.57 6.12 1878 16 7 3 8 36 2 54 43.75 62.50 16.16 1879 18 4 1 8 41 5 54 22.22 27.77 14.81 1880 17 5 5 48 7 58 29.41 29.41 8.62 1881 13 5 3 5 48 61 38.46 61.54 8.19 1882 1883 1884 7 8 10 20 3 4 2 5 1 1 4 2 3 2 5 49 49 51 61 1 2 10 55 57 59 71 42.85 50.00 20.00 25.00 57.14 62.50 60.00 25.00 3.63 5.26 3.33 1885 — _ 6.94 1886 27 36 26 41 52 49 52 44 10 15 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 O cc 1 •tt < Discharges c. Si a 0J D tt OJ 1 « A >- ■els. Z cd O tt c. u 0 Cfl OS 01 Ih CJ 03 O Whole Number Treated Percentage of Recoveries to Admissions Percentage of Discharges to Admissions (Deaths Excluded) o> Year ■tt OJ 0J o o o A •tt « OJ 0 o_ •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 tt 1 < Discharges Cfl X rt u Q c V r3 'co A 0 cd fc- o> CJ «J £>H __ _j cd ZnW o VI cd CJ CJ C OJ 0% 01 tH CJ 03 a W 03 Xi B 3 01 QJ O rt xi 01 Percentage of Patients Recovered and Improved to Admissions Percentage of Discharges to Admissions (Deaths Excluded) to Year •0 g 01 > 0 0 01 A •0 QJ > *2 •0 0J > 0 0, s •a QJ > 0 a 1 0 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 TJ — C « 2S t- 00 t- rH rH 00 rt r- Ci g g SO © t> i«n Tt VO JS T-H (S cn z" OH cs i cs r- i J-) t- Tf in CS 00 O "c3 tt-' \o in © (S CS i cn i t T-H r-j 0. o H s tn oo tn 'ct rt m m cs tn m * r- tn CS Tt -t rt © C- T-H © Ov § Q < Tt CO T3 go tt,' cn i r^ cn i ! 00 m 1 ( vo OS | | vO s rH ; On n ! ! ** m t-h : so tt, O Q O X H W cn ! On t-h : -n i : oo 00 NC fc i M •n j | >T) rt rH rf ! ! _r\ rn : m so SO s cn ! | ♦_ cn | t- ; ; 3s v. i in © rt SO tt 1—1 ^ / s vo s cn i r- cs i cs cs rn cn t-H m r- >H CS JITIH -» cs | as tA m in tt I rH i Tt ^ l tn so cn oo j ; r- r- i so , cn w tn s ■n Tt Q CT) Z On cn ! vo j i as h rn SO •St tn 1 o tt, 1 *"* i ! t-H j T-H 1-1 oo t-h tn i ; Tt cn rH 0O rH m O rH tn tn . * tn s yt a \ i t rH cs t> ! vo I 1 -n rf ! r- rH r, T-H Cfl Ih rt 01 Os Tf tn ft | CS j j ■n 1 rt CS s cn yt cn i i o cs ts as Tt rt rJ CO < rr, ■Tf cs cn ; i un 1-t t-H on o : © i i © cn ! © i cn "tf tt t-h [ cn ! ! <J J T-H ! J o a 3 O H C-0 <_> 00 < 2 ; Os" Tt \OSTt j tt t* iir Tt s ■n t-h | rn ! rs OS m tn cn ft Os ! SO ! ! ! CS ! I -n cs cs cn t-h -n cs 00 (S cn m r- cn ! o tn M- rt rn H „ Z NO s cs cs ! n t-h rH [ cn Tf tt t-h ! cn 1 ! o in ; c* Tt cn cs W IT) -J r. 1 © cn s tviONr. | © SO CS SO 1 Ct T-H rt (S "tf [P1H » cn cS r- CS Os Ci tt i ^ i N rH o « 1 vc rn r- cn rt x cn t-h t-- cs m cs s cs -n ^^ ■Ties ct ft 0O If lH ! Tt : ■n CS ! rt I S 1 lT l"rH "rt 1 SO rt CS OS : 1 tn CN s Tt j { s 1 I 1 r | O j 1 => | jf ; rt o\ tt tt] cs th cs i : n rt : cs i rn Cfl C/_ Z __, 2 1 s < _. s CS ! 1 N t tt i ! ** i 1 * lllj 1 1 s 1 1 SO ! | o : i ; i § & Q 5 < o M »5 ffj 9 B o Cfl z o fl cn o Cfl S3 C &5 § 1 •2 •2 Q -a ^ 5 < < tt i H Cfl 0 xt o X 1 ^ A -fl 2 K fe ■*_ ■<t w a V. I-I « > _. 3 _) c c 5 c _- H a c > p r3 CJ tl c R (C c c n (fl fl C a QJ s 1) S (H PJ XS M w « >?nJ^O >^OP Q 128 MENTAL HEALTH SERVICES REPORT, 1956-57 X w cn o z < ft o A O i w o < tn O z o < Q H Z w s r-~ rH in « UN M ■L 5! H Cfl Q rH z C) o Cfl u w 5 fc-T £ < H 0 H ft Cfl n NO w CTn fcj c—1 5 r. H H Z ft Cfl § ►J « fc-4 Cl- < < z > 0 Ph Ph O H Cfl Z 0 1/1 C/l 3 Q < H C/l ca OH cs > SO i CO \OCT\t~-rtcSt^rH rH cn rH rH cn ! i j tn ; cs | «n ; t^ Tt 11— 11 i r ! : cs I cs m vo m j rH CS CS Tt Tt ciTt \ Tt : cs i CS V, rt rH I II I | rH rH I fS CS O j I ! : Oh im \ t~~ Tt yt « Tt yt r- cn : t-h i xr~ r i' rj" rH CN CO | rH CN t I CN rn T. rH TJ" VO rH I CN I Cn Tr CN ffc *C CN rH | I |<N i i" I I I I I i I ! ! I »n cs cn cs cs ih j co rH cs co cs cs &H W ►J pa 00 CO 6 j .2 cj : tt g? s s a 3 3 a I tt, > ■tt ° £_o •a c -H „ a s cs *a u & J> g a as 1 S Q SOZ -H s > £■2 8 o 9 52 ^ OS OS XJ rf, 03 fl ■§ W rt c^ §3 S3 fl U J5 Vh tj t3 *0 rt Q ooo a ° „ C C •- .2 .2 ___ * hh"0 |. 3 2 2 -ll-assa-aa 4n rt l » rt _ C ■!•§§■ (►j« .S 03 03 fl 4= £ X* rt K 8 fc- S o,MS oi 53 --> 0O2 o .S.E^.ss.S. .55 S a S j' U' Ih -~ *0 "O *D 3) u o <u >. o o u u j3.O-.P-l- I CO Uj; -Li SS r- tj e 2 S co 3 f &s e till <U Cl (U -rH ITS ^'5 a ? t o fl o o rt •o -c T-i £ S u u N « £ S?£? vh Ph Ph fi 03 ri o 3 3.1°. O rt —' - ■5 S ? s a-a 1° 9 P. i|U c- 5 Q. O figs1 13 B ■ :, ._! .5; •- a . s .a ) Ph C-, < ft IKOZci, CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 129 00 -. vo rH CS OS f- rH SO tn Tt rH OO CO rH CS OS CO r HrHrnrH Tt M On O fSCSOl J Tt ISO r . Os tn H m rH Tt rH CS CS rH rH |rH rH CS OS Tt Q\ rl Tl ' rH : CO rt cn t as rH CS CS SO Tt VO rH f rH j IrH ! CO VO © SO cn rH n ■ cn m 1 T-H tn cs I ! © | 00 MMM 1 i lllll!) i i nn ; co:c II II II 1 II ! 1 ' . m - Os i 7 ! S | MM 1! i1_l 1 i 1 j i i rn ro tn 1 cS | r ) cn ** j T H OS CS i i i r i 1 1 1 1 1 1 1 t!CS! r-c|ri 1 II 1 1 II II ! 1 - cn CO 1 1-1 | CS 1 cn | || || | ! 1 r i i ! ! ! 1M | II1 rNi i r ■ Os CO *"* | |S Iiiii: 1 i i 1 i ! I | MM ii 111 ii in M" Os 1-1 : cs | cs | «n | i |«M | | I | 1 .--.CS p . | c CS CO t 1 I 1 1 1 oo l ! i 1 ! ! 1 i ! 1 1 1 1 1 1 1 H 1 ! T-H : so ! ! . r- 1 i H | 1 1 lllll ill! I - co *-1 VO MMM ! i ; cs t : 1 1 1 ii ii ii i rn i r Os rH 1 1 ! rH J I ii if] ii i i t-h t-h :ioc 5 ! cs III ! 1 ! 1 ! 1 1 1 II II 1 11 II- ; m i ; CO ; M | CO Tt r- : " l! i I CS | ! tn © : C^ | i | 1 ■^t r^ 1 1 1 Tt 1 1 ,_, i CS I 1 T-H ! *~' i i MMM! MM 1 !" CO 1 © ■ lllll in j ! t en MMM I i 1 ! i 1 1 1 1 1 1 1 1 1 II m 1 1 ! I m i i i W l ■ ! ': Iiii ^ m : O ! ! ; m Ml ! rH rt ! M i *""" 1 ! iiii i I ! ! 1 *~ rt i rH 1 1 . cs ; i cs I 1 ! 1 CS r- I rH , rH 1 tn yt "N II M 1 || 1 1 Ml= oo CO I i M 1 1 m 1 : r II M i 1 1 1 MM MM ! ! ** 1 o |CN ii r r 1-1 i i \m~ ! u ii ii mm i r tn CS 1 * MMM *"* i 1 j 1« I 1 1 m i ii ii ii r ii* O ID ! rH rH rH ! Tt ! rH 1 1 | ! CS rH ! O tn *"* 1 1 Mill i | 1 ,~l CS i i j i i j *H i 1 1 M rt *■* i i ** ^ | IT) VO V 00 CJ a> C rt •■H *-• 1 O fl c rt O 6 c o 03 00 fl o u t, rt .!>_ u c TJ G rt tn >H u Cfl Cfl fl .2 c 0 01 tH .2 tn > CO fl 0 , CJ •0 rH c •a rt __! «H _D ^3 •" OJ — CJ cj o rt J? Jr. C CJ *fl C 73 OS 01 u cc 5 I! OJ T3 T3 c b rt s H 3 O 3 o > 3 03 C rC ^ \ Wi o <u Ut 3 •O CT C <U >. w GO (/j c •" 'rt T3 R 3 .O CQ u cn 'fl S • > Ih O 01 C C CQ _ e K '£ c o g .-2-rH II i- 13 rt ,c fl. Q TT >1 rt m •-1 Ih 2 S 03 t_ OO 3 cfl 0 'w •£? o 4; ■s t* >. Cfl X % o H orders of character, behaviour Pathological personality— Schizoid personalitv c o tn Tt OJ 5 3 c c rt ra Ph > 'i c o Cfl u 0. 0 rt 3 a L •c rt P > fl C o Cfl u ! « t < > « c o r-. O 0 T o CO < fl O .1 ™ fl 3 >< OJ Vj .- cc « 1 a .5 o ^ a 5 o a a o Si o 3 E ntt) E £ > U C CJ X c 01 D OJ X m > V OS Ch L tn w ■x fl 1< CJ < c 'c c H 0 c c t X X rt 01 E X Tt OJ X 0 3 O *> rt X 01 o >■ tJ-5 .■A <j ^^ &2 •h "-3 rt ™ |g > '5 £ -O 1 n o O 2 U c ID 6 1 o C OJ ■a o Ph "o c O Mental deficiency acquir Mental deficiency with e J30 03 0. B B o o tH U Xt XI C C >. > Cfl Cfl C C 'rt -S t- — .O .O CJ o c c o o X £ u <u D C 3 •o C rt S j: 0 1 > Cfl C GJ fl "rt u C s 03 O '5 c 03 T cn ^ O r _cfl M TJ ■£ H '| 1} " 13 « rS « to o 5 rfl 0) CJ 6 s? Cfl «? c a 3 *j a £ a" '5 ll a o ^H 3 Cfl rt o xt c oi Ih 0 U CO a 0 u U w 0 o Q 130 MENTAL HEALTH SERVICES REPORT, 1956-57 ' rH rH f- CN CN X el cn a z < D o A O w o < tn O Z O < < H Z w O m ON >t n Ui H •J -_2 D M 2 a O rj cn « w^ ►Jo < 2 Ph no" .8g z ca _J z i Ph O H Cfl z o Q < m NO w rH p. < OH vo oo © 01 -h cjn r~ oo cc cn :^t ! ro ro CN cn ; I -3- cn r-r-r-m i co oo _■* C- ! rH CO rH In CN 5 5 CO > oO A. p. ft s_ ft ___!_ tt _s_ ft ___L ft _s_ tt rS so ! cs m ! CS rH CS CS rH t CS CS T-H I rH I rH Tt rH CS rH CS r-C ' ill ! CS rH Tt rH CS rH t-h rH rH CO t-h cs cs : i cs Ph IE A 2 •3 S." 'fl rC C ' o « ao » ft.£ 1 a o ~ ■ >> N IS § L cj cj _3 U rt 3 <_) oS -° Cfl w oj .S3 o 3 ft .a s few CJ CJ 'tt •5 7 co =3 S w o > > ___3 <_> fl C 1 «_£ 60 U O h «" •2 O O •2 5 «, «° i CJ T3 ccj S § 8 2 >,'5 Sao O Ji Ji ° -a a _3 o o •a a { O 00 b > «w C rt _ «. *r_ fl P E? ° o rt i.H S ill's. 'fl2 I 111- 1 cfl JH C —h *2 a - 2 R 2 « a b OJ 1_l Eg o IS ' 2 a 5 J | J ° 1 2 ci _ i fc. cd oj , CJ -o I fc- iz c ._ u O ■tt tt o O O ccj £ 2 u_„CJ-n«T^-*- c o o o C .3 CJ O CJ : cj >, u >, j £ ft < Ph : >> >> - C0 V, ■A A n fc- co cj _-.-_.CJIh £ £>■£ cj Ph » " 'cj a >>.S < Xp, 3 -S '■6 |8.2 1 &a i. V tt Si g I o 9 a-o £ _3 H ■y £ cfl fl y -O 93 %}, OZM CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 131 T-H \C V * cn -rt Tt ci yt m Tt ci Os o cs i <n m 1 rHmcn icscn rn i i Tt ; rt tn oo ! t-h CS lO ICnCSrHrHrH j (^ ,_, (sj ,1 ^t OO OS r- 0\ il!!!i iiii! w SO t- MMM MM! i GO MMM II II 1 1 1 VO iiiii! 1 1 1 *"* i ■ iiii!! fi! ' i o i 1 j i i ts iiiii i cs o\ r^ iiiii' iiii r 3 i t-h : : i oo | t j i j m "Mill MMI 1 © so MM!2 lllll 1 cn CS ) ! : | | rt j j 1 | | | rt cs j rn | j j \o i i : : i i i 1 i n iiiii i rt CO r 11 r iiiii i CO o~ cs CO j j I j 1 00 llrHrH! ! ' 1 r i i i i as cs |"H |N* IIMI i oo oo cs j j j j j SO j rH j j j | _> cn cn (S Ov cs cn cs ii— r imm" rt CS i iH I iH iiiii j CS cn 1-1 1 i i ! 'iiii ! * so |*"* j |' 1 .*"*.!! i cs «n riii iiiii i •" ■Ti 1-1 I "■* 1 j j i j rH 1 m en j Without Psychosis Disorders of character, behaviour, and intelligence— Pathological personality— Schizoid personalitv ■ _.. > re B 5 CA tn <U 0 a 0 3 a a X re fl c o tfl tH i fl I < 3 #C 1 > 03 Xi fl 3 X a i 1 1 1 >i u c 03 -a c 03 ft 01 Xi 03 > 'cn oS 1 b 2 __ tt a c §•= S | a, i 2 v 3 3 cd J- s ° h L CJ c o qj 5 o ;_: * '_ Ji « « E a OJ s c 0 s fl c t D u - *re V- 3 C V OS X 03 X X 1 a s o T fl > T fl £ C o u K c z a, E c •a a > c '5 h rfl c o -fl U X OJ S l CU C ca C 3 •3 C Cl 0 I cn 0 £ bi 'o O CO rt O fl 6 03 >. Cfl Cfl 3 O > tH 03 fl "rt Ih fl 01 CJ 4) -m y 0 '_? c !f_ T- 01 u £ o •a £ tn % 01 ^ rfl o o ,3 a >. Cfl ft 3 O rfl o H « B C ■a G re Ih 0 Q 132 MENTAL HEALTH SERVICES REPORT, 1956-57 O z o < r-l < H Z tt. Cfl < H C/_ rJ < H I—I A < So OH OCfcC.MrfcCOCOIOCfcOOC.r, lli. rH CO CO OOCO-rJ-rH-J-OO r, M Ol ^ fl\ r, 00 CO V. CN t~ O C.CDOIO CO, cn £h t-1 p. pa" & Z o cfl Cfl a •i o S no" cfl 10 •__ _S < _2 h rt Z r-l rJ< < <- o a Z t/, Ph o H cfl z o < H Cfl A W « 11 III CS CS I I CO ! rH rH OS Tt ; rts Tt Ci Tt Ci I T-H i i o : i i cs i i I E u tl. t-CSrHCSOOm-rtT-HcnCSrHrHrHCn I CS rH j T-H rH | m OssociTtv-iTttrsl'ytrt-OD\nTt | O I rt |(S os cs !csv_cscscssocnT-HrH (N t-H rH rH I CS m rH ; eld' Iff: HJ CO £ i: 4> cj 2 5 CO o) cd *3 .£ cj tt vie Hi Ifl O cj 3 N "fl -3 't fl O -fl rt > cS-SrS ■9 _! g fc! ed m O CJ a'i."-=" a J3 asi cd ."a 5; cj cd 8 K _? ft- cfl cc- 0- "3 E B s 2-1 ft- 8 e_ -_ M 5. o « E E ° iS§| •a e __• ill w 3! O .-.^ ^£ | S'S fi' O _ O u C-_ ft O cj v, :p cd fi o OJ 3 Cd Ih _- « r, y fc- cd S > a cd >x, U OJ OJ E K & •- •* o o a & « & ft o CJ cn < ft. " fc- >> o<x 3 cn fcJ §g o Hi cj g o OZft, §5 •3 "o C -3. i rt TJ fl. c S,.a.s 3 nE __._« •L- OJ _C rt CJ OJ o «.' 1-5-3 -a P o «J g a 5_ a cj jtt .tt oj ■3 _, Oft, oj a So .gco -O 03 03 B B o o 3 on -S _____ j K *fl *0 J " C C 1^ >> >> <_ t; co co i .§.5.5 "t3 rt rt I rt 3 E CJ O _?T3 - 8>'b a ft fc-' J °° O O J> OJ fc- fc- — j_; J= JS ft* OUWO ft CA B H O I o CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 133 m O Z 0 «5j Q ►J < H f? HI s -, Cfl p H ■< H c/_ J «! H A r^ < CO rS On c—i r» H Cfl A rH r-l ro r-l K Q U 7, PS 8 tn £ w 0 „ H HH 3 NO H cn l-H Oh Cfl On ,—i rt r. X H Cfl rj < ri H PS Z 0- < X i-4 p. 3 v. o n z 7, > < 0 pS Ph o H Cfl Z o w W -J ca H "O-H »<n m cs t- cc m in so rt r- t- CS Cs m cn cn rj c •- c^- r- cs Q <n C rt rt CO rH os CS »<n ss es " to OH 01 *rt rtt^CS |rt ICOCOCOCSrtCS 1 It- *- rH cn !> CS cn rH ! rH j Tt <n oo E 00 T-H CO cs 11 II 1 ! rt 03 Ut 03 rHSO iMCOrH-nCSCSCOCSCSrHrH 1 V cs SOr-rHCSrHCSrH rH tn t-- NO T-H 1 o 00 Os OS 1 1 S o *rt i t-h [ [ i | i j i i j i | 1 : 01 E 1 I I1 I 1 1 ii 1 i Ill 1 II II 1 1 I 03 « CQ O Ut ™ Tt i | ! I I I I : i i ! i : i i ,..,.,. w £ rt a i M i i i i i i i i i i i i i Ii M II 03 "c3 Osrt!l!!|rH!|l!||rH m i i cs i i i : i Cl l> T3 B lllll 1 I 1 1 1 I 1—1 ii iiii i rH « tH rt TT ft 0 Tt Wrt ! ! ! ! |H In 1 1 1 1 1 rH 00 i : t-h i i i i : rH OS Is iiii! i lilil ! iM 1 CS <s a II Illl ! u OS CO | [ ! ! illl IrHCSIII 1 SO 1 1 rH ! 1 | | | l> •q B 1 1 1 1 1 1 1 1 1 iii | i i iiii 1 u 01 co 3 CJ Ih o > 5 Ut £ cnCSll|lrH|||l|||! SO ; | rt i ; ; i : ^ o 'a f lilil rt CQ a 1 I f 1 i ! i i i i i i 1 1 1 iiii i a la t- CS rH |CS |HHH IrH 1 | j CO Os i i i i i i i i Os rt a •o 03 s i 1 iiii j i i i i i i i i "^ O -a fc P 0 Is a NiN |nn j j | | j j | | j | 1 i 1 i 1 1 i 1 1 I i NO i r i r i i CS GO ii | i i i rt loan ItN IMHM IH 1 1 IH r- rH f*. hJ rH 0\ 1 1 rH | rH CO 'CO Ih fc II 1 1 1 1 <n 1 i 1 r- rt § aj t- t- 1 IrHCO IrlH IrH [ 1 1 r- | cs CS 1 CS 1 1 ri 1 1 tn t^ "rt a "III i Illl 1 CO r i i i i cn SO © OSrHllllllltSrHlllCS in cn rt yt -rt i : j j NO rt ^ ill I 1 i cn ■* .9 a 1 ! i 1 1 1 1 111 iii i V CO « VO CO I ICS MHrtrl^rtHH o Tt rH (0 (S rH 1 rH 1 CS cs S cn | 1 tn CS CO oo fc 1 2 13 •o 9 a a s u cfl 4> .3 2K "3 u Si ft fl o a & 5? o c 3 c o Cfl OS o '—* TJ .2 oi o > « S S 9 ■ o ° s c.2 || s a v fl SB C rt o rt 01 M 'oi fl B eg co O a rt s « a u a ,«o_ S3 0 CJ 1 « in. I X T. c fl .9 t rt S fl "o X u B tl. \ % tf 1 I U _0 tf C t- 4 X tf c T a s a o X 4 0 Jh CO rj OJ t cn 2 o II O co E° 4) -a *o OJ __E c c CJ re QJ Ih U 9 c c 1 V Ih OJ _> •a o X 1 lH w o tH •a Ih i Ih CJ O Ih 3 aj fl X ,g 'S o * fit B % o & fi _M •fl « ■2 E5 0 rC s3 § a o « 5 > t c 0 cC w ct c 1) 1 E | 3 O V rt M _s« fa <U 4 S E se •o -a 03 cn >. cn 3 o > it 03 c *rt Ih fl 8 Cfl '_o o •s >. Cfl & 3 O ■B cr 0 If T o '\ CJ l- X T o [• X CJ tfl 03 > tr tr 93 i OJ "V t c Cl H> re CD E c c E o > c im « c •0 c A _rt o fl re Ih re Ch tr C -fl (. > CO O * C OJ CO \5 c -fl u •> Cfl p £ c 4 Cfl CD Ih Ch OJ u X I 5 O X CJ > 0 j= u > co 0 t, C a CJ < a -C 0 0 "5 0 -fl u > Cfl Ph U a D CO C 3 ■a c a u -fl 0 Q 03 -C in "rt a & 'C u ._. fi X < DC a, 3 C £ 0 CJ CJ > a tn 03 cn X O tf tf oi Lc C | t c h 3 a. -3 o .-3 O Ih 03 V it CJ >. c > IT c "5 u rC o c c r- X D 1 "rt 0 H cc I- 9, c 5 (, '5 c c X ft. e a O -fl c t 5 > U c 1 4 X fl OJ a i or c a X u c o rfl o c > tr c ■fl t. X c c c Ih X 0 > Cfl fl * 'S o| CO -A 03 O tn >, OS Vi 03 ft ■S3 -E- «1 o 1 0 H c ■a [ e Q 134 MENTAL HEALTH SERVICES REPORT, 1956-57 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 Q 135 X ui cn a z «: cC o A O i W O < o z a < < H Z >H « w" r-l < a z O NO w2 Ph O tn O « o ►J < rH u z > o PS A. Ph o z o H < fc-l p rH o Ph H Z w Q 55 w W r-l « < IEJOX PUEJO 6? Z3 cd > CO O 00 CN rn , ICNCN i-CfCN CN CO 00 nf CO rHl/lfcOCNCDr^C-CNOOCN rH 00 ON l^rHrHCnr-CnCN rH rH rH rj- (N cd on ~a\ ic. CN CT) rH rH CN i rH rH 00 00 C. 00 CN rH CN rH | rH fS) . rH rH H f) , rH rH , rH C_) , I rH ; ! ON -ll- I/. m 00 CN ; VO rH rH I I' I m t-h j I I-" -4 v. So: a Jtt c o a ss_d Ih CO oj a „ o u a'_i £ a ■a o £f §1 a* ■r2 V £ Xi > 01 o % 8 'fl U T-H §B.g £ « O _ _ o . o.'V-B-g ass 8 •-- 3 § 8 S - •w c o °- *a w •fl rt > b fl w . g i-. c rt o> tn co r< >-h Ph m Ph e n, o fl rt CO Ed 0 fl o ca *W o C fl o s X « i- O X. fl ffi C c fl a •c i- V -fl t c ft 3 O 9 C -fl u > f_ u •d Nfl 'S <u & C fl *d fl rt tH 5 1 c ts rt « ■H y- 3 2 fl 0 o rt tH "c_ £ c d i > o rt V o X co 0 rfl p C--B-5 6 « S P CJ w ».Sf H T_ CJ .2 c *3 oo £ 1.1 sa °. Mt.Ec.!. & S3 .£ .-ess f, y .. -h 5 fe CJ hQ rt O (U lH £ .a fl ZA *_' n <c-,o< Zo. co ^C ;t_, EJS 5 -*H — --j •a o co o x ___= n n >> 1 -* •_*. rt r? x -x ____; «-b CS' <u (h I § &! is: *Ij co O c fc, __ e _: »a ca go, CO •tt tt a o CO rt u xa O X) o Vh 3 O OJ rt XI rt ._.« c .2 X X rt > rt XI 03 Xi "§> J2ri S3 cj J= cc rt xa o tr ■d a <u *d tfl (h E3 o CO J2 cj j=C CJ CJ p o -H r- *o X c c ^ > cn cn fl H •d aj C C | Ih Ih ■ p a a. IhI OhhS- O O CJ .9 I S § 2 co O CJ 7. co CO «? LH :«i !•- S .22 u M *" _o O £ «J Q 136 MENTAL HEALTH SERVICES REPORT, 1956-57 o z n < Q -j < H Z w s NO -" l/-> m ON _. H w fcj H < C/l Q ,—i Z co o C/1 OS v> w w CQ i. fcj w «: u H w ft- p c/i O X K w 00 < Q Z Z <c w s z CJ 3 tn tn z s a > o < OS CO Ph -J n Ph o > Z o A Ph HH H u- <f O r-1 Oh o Ph Oc, M cq 2 p H Z Z- H Q m w Pf! in « i-i la m vo c ,_ CO rr, rt- VO 00 *n ^ rf ___-. Tl- o Tf rH nn Ht O MnmcnNOmHintmH CN CN Cn rH Tf m CS tn rH CN cn m OH tN m cn tar.'-mHTtH^tNH rn rH 00 vo cn Ph *"* nn rH (N 00 rt o TtOOOOTH^ifiOOfO'tCN t \ \ Os fh tncNcs. |TftN a tn oo cn vo r- s CiSOTtTtcnTtsO^tOOyt m •P CN ; sD *-■ CN o\ ^ " " U , , __ i ,_, i ,,,.., 00 Ut i ii! ; o I , . i I i ii. i c rt vo ^ : I : i : : t-h ! I 1 , , , __, • 1 rH 1 ' ' m Tf CJ > a i ! I : ! 1 T-H 1 1 1 ! 1 7-1 Uh 1 rH 1 •n Tt Tt • • ' rH cn 00 1 1 1 ! A ! i i i i ! 1 i ! 1 i i i Tt 3 O cn Ov oo vo ; 1 rH 1 : IrH 1 VD rH tN | ; Ml i CA fl o a i j i ; Ml 1 rt Tt • ■ • • m __, P. ! 1 i VO ; i p co 1 ■a o 03 Ih & i , i Tf VOVO ! i Tf 1 1 CS IrH |r- , , , , 1 t TT-t 1 I 1 Tf <: a m j i >n j j 1 i ! ! 1 tt o oo cs Tf Ihhh ; y± Tt tn 1 rH tn ts cn ts i | un a III ! Tf 00 ci rt vo £ Ph - j ,_H ! i ■ 1-1 o f. H inOHmcS n rn \o cn : vr; »o ! cn CN oc 00 rH 1 i e a ! ! i " z t~-<omtn\ocici-*tooo\-*tT- m Tt rH m rn j m cn VO ___-. Ph cn 1 1 Tf I Tf 0 c O t^OThc-cnmr-vorHtNc^^. ■ rH rH EN Tt Ci 1 CN VO en cn a m cn (N cn i ! ! tnciosG>cctnsoci*tc-itn ! ! rH CN m rH Cn. 1- rH 1 Tf cs tn tn O r- O Ph so CO 1 *"* to tt o Z H Ci-rttncnciTttnTtt^itr~ci 1 T-H y~t ! ! r~ vn CS 00 a r- o CN ^-s d- xs O t£ CJ rt 03 ft u o c ■d 03 P OS co p. 2 a _ 1 fl o N O m "5 fi ft I u c 13 C •a E C CJ 0 co OS s?._ i S S 0> on 1 E fl eg o a rt 5 "rt fl* QJ a _*2 0 c-c tl j. »H tf 1 *C C c Z 0 X c c ts 1 t cc £ a. > a, _ .^ o ■p c c X c c < E c - c c 1 Cf a c tf 7- _ - ■e I fl 1 a '''5 c 1 -c- I ^0 'o c X $ a C * c . fl: t c/ *E C g 1 V C 'C a t- a 7 X <L 4 c c f j i C c c f > b c c "cL c X fl k c. c c E 4 fl X C+. ll c 0. J S Or c X_ | C cc '- - C X 1 H S o <*. co c o_ C T .2 e S- S _ •S 5 !i c x u O c 'Z3 ct G a OS ' 03 a J z t t . « I I- t 2 fl -S t s 4 1- 4 ,> "_- I T \ C __> fl c .- I 4 t "J j c j < 2 o CO s o 0, E CO o E 0 > co £ .2 . s > fc- 8 2 E 1 S> 0 (L i I i i X b z t i CC 03 .<• X H- Er S3 5 fi* fc, a. U c ■H _ fc. C S-. ,'■3 $ o o -■: H _ OJ rL C _ |'l 1 o- 01 ■d fl n M rS (0 *M o -fl o >l ft X % o H •_3 Q t«: § Q 1 xt c rt fl 0 1> xs .- __! ■_; *. fc." c S " O 0. fc- r. s« oi o_ C tH X CJ *■ T3 C. S0- 1 C J r- e £ ■ "E 1 a z 1 X C c < t c X X p \ * C CO it 03 Xi tH o co '•3 Ih 3 O > rt XS 03 ^* _. 8? IS J 3 flj t. J 3 4 5 & ■_; - rt ? )l! )Ph2 Ih 3 .2 '? rt XS OJ -fl t-T CJ "S rt Ih rt XS CJ ,x\ 03 cfl '5 CJ ft i ■d I C 4 rt *c t-1 c CJ 03 Tt "a H 3 O "> rt xs £y xC %* 03 0. B T o c Ih t- *a x c - >. > co u C ,C rt S Ih 1- *-: .2 i a c o c a 4) CO >. CO CQ 3 O > Ih O fl "rt Ih fl CJ u o Cfl OJ V 11 1 -H C CO io 0 x; u >, CO G. H 0 I o H rt O ■a c at -H 0 X c CC 5 > t Cl a i 4 L a > fc — •< > ,x C < 1 ?s i * co Ch > p. £ ft a o £ c p. ^5 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 137 fc-l < H Z H 2 >H « W PS P-l Q Z P Q Z < P. cs < ft o NO en l/"> « C7N <! ,—1 W JH H C/l CO ,—i c^ CO P 5 0. ca o a Z u o U _. pj pq Q j" X <r i-i H 00 0- u __ Z o HI tn >H r-l ■m < H H CO Z P. ft s <J CO I-I r-, < o 0 z z w > I-I n r. C. Ph CO O ft z 0 C. z <j o P H <u fc-l p ft o Ph H Z w Q i/i P. S NO a i-i M < Xirt CntSCSTtVOrHrHrH O CN m rH in O rH o cn th OH p. VO CN \ ci tn -rt yt yt \o oo m Tt : cs i cn oo o H a t- ! CS cn ! 1 j Tf Tf (N * cs d\ e s rH rH | ] j j | 1 ts h cn rt > p. i 1 1 1 2 a rH -J t\ h ;h i | i | j ts 1 1 ! Iw ! i j ' h cn I I 1 1 T cs 1 CO Ut CN S I- i . i I 1 • ' iiii" h m rH a * 1 1 II 1 1 i * ", 1 1 lN 1 1 j c ■i r- co t. rt 1 1 1 II 1 1 rH j j Ct j j | c ■I cn rt Tf a N 1 1 ; j 1 i 1 M ! 1 I i I i I 1 i N co 1 M , ,__, ' 1 rH * I rt CO H rt OJ >- pc< 1 1 II II a : oo 0 XS en c OJ OS 03 > Ci ft 1 ' 1 1 ! i i S tj- j : | j ; | Tf 1 1 jrHrH , | i c i 1 vo ft , ____, ! a > o\ ! ! ! 03 >t a « 1- r | | 1 Tf ! rH j 1 *H i M I T] 00 ft o 1 1 ] i i i O ____, , 1 I ! ! CS cn -nfi V B -1 1-1 Mil 1-1 a P- 1 1 1 rH 1 | __1HHH 1 V£ Tf rH | 1 1 || CS CO XS ft *" | |' 1 1 1 o [*" I T-I 1 j 1 1 r cs 21 cn O 2 a 2 i r~ ii V. ** ! rH tN 1 rH rH V£ rH CS co XJ ft CN 1 IHHH 1 ) 1 nn CS rH ! ! 1^ 1 * ON 21 S3 * 1 1 1 II 1 «n j rH rH rH J j j : p* 00 fl # •a o cd ft fl 1 c o CJ O Cfl 0 fl rt O c 0 oa o d a S CJ cc CJ Ih S 'cn O i oS 3 I frt 1 cj * i V 4 *fl Ih O B X c c t o: 03 Tt 01 > 0 1 a v. X o c rt f. a C c ft £ cS « c o E 01 -a rH <D XS a O ■S > o X CJ (fl "5 CJ o tn O a o a fl Hb I" £ cc . - 03 ii G g.a .fl co H CO OJ lH CJ o fl CJ c X 1 o rH •d G CO with psychosis. .. Without Psychosis .5 •d fl rt Ih s o if •d -fl __> "5 si o t rt Q Ih _ 2 ^ > a fl o CO lH CJ ft F 4» *fl O CO '•B u 3 O i "9 ^ §1 €.1 A3 v\> XS« rt Ih 3 O > rt XS 03 X X $ o I B ■tt B >, CO CO fl o 03 c rt g G CJ 0 03 »4H 0 '_? 0 X a > co a c o X 1 O 2 izophrenic nic-depress anoia and chosis of o er and uns terical rea irotic-depr onic brain rt H orders of c Pathologi Immature Alcoholis Primary c Mental de onic brain eosv CJ OS 03 € Ih co cc ll o >. co ft Ih 0 Vj OS a rt Oh >. Cfl ft xs 0 fi CJ z -fl u co 5 fc- Jtt u '5 w 5 Q 138 MENTAL HEALTH SERVICES REPORT, 1956-57 >t n a o < ft o tn A < B S s__ 'HtcNrCfSr-rHrJ-oOcrir-HtOOCN, ICP j CN rH |rH-J-r_O0VDCN--,CN0OCNrHrs| VIOIHN —, c. rn rn r~- \D CN - I CN I I I OO O NO in O C7N H h NO CN W cn ►J < 0H u ft 7, m O CO c/i a w fcj p < H X ft 01 w co o X Q 7, <-> < < H >t z w < H 00 ft -1 O < m u H z c. > Z o — Ph ^ ft O tn O z Z o 0 -Ji H < --I 0 -J p ft < n H Ph Z w H Z 2 w 9 tn w * _2° I^T_ S-> "fl ^g cn O a tS J rH rH t V~t Tt ! rH ! cn cn cn cs | CS CS T-H T-H I m ! t-h i ) cn : rn rH ! Cn CS W t-i 5 ■o rt * t- «J o 8 -" c .2 aj ca ■a ^ o I e, S £■ CJ T-H OOP n "fl rj 2 S g o^SSc 1 __ si al I a Q, C £ co co -fl O ~c\s i i ts CO O c- co O . .2 a ! g S I 6 S a a _ O cj S ■5 cd 2 '■ aj a tt s i "g SI o ,*i»o»;»s B £ oj J5 * . I fc.g I < ft o r- B K.§ < EG ft 11 0 H fl * lis? 8 2 " o ,, i, J» j II g >h B o « .& aj o ±j a co > v, -tt CT ■ •tt •— __ E OJ ■ & ss a " s . b -, -j B -rt 8 & § 1 -s i T3 3 b C I r .X C U M 1 o 2 a fl § = " Sfl 5 £ « J= >. OZftOw rr, -a "■9 s a) o fl "3 o rt A3 CJ a fl u ■d Ih F. fl o ■■B >. fl > 3 eo) 0 X "? C Xi QJ xs. C 03 %«■ ____, CJ rflC u c Ih rt C > XS u C -I DS - c C >'d u cfl fl1 s o o £ § T_3 T3 1> 5 X co 1 .fl o fl C o CO U CO rt gl 2c cfl a 4) co co co .5.5 rt rt C X 5 • S 2 5 xi e -0 tr * H 0 t < £ 5 fl ft rt X S3 = '£ c > - - VH o X no CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 139 >t p. „ A ft > 0 Q Z < w e < ft o NO rtf cn <i On w c—1 >H ft o tn CO CO ft A fc-l H < Ph y z o C/l a w u c/. p-l WQ -HH CCJ H on 0- C/l Q n Z ffi < j r« ■< < H H Z c/_ w ft O ►J EC g H o z 0 z ftl > _, CJ A Ph tn ft O o z z < Ho S3 ? h n z ^§ z w Q 55 a p. m c5h rt > -SO its I —5 7S 51 cn O a O Os Tt m t-h ; : cs » T-H-c-j-cn i t-h im tHin i h ' rH | CS Tj- ! Cn rH CS OS Tt Tt | lH rH Tf ^ff) cn cn t-~ oo t-h rn cn cs i CS II ! Tj" t-h rn Tt tn ©ti- i cn t- cs Tj* tj- cn i Tt i tn !>_nTti_nrHcncn t v. lrHrHrnoocnvr.cn vOcn : cn Tf Tt vo ,' cs cn cn voo\t-Hi-n«<n lOTtcn : t-h r- vo cs ! r- cn un : cn t-h cs iOriHHinmHfi.ro t*-ooi-c |Tt | n h ri m h Mi! £ "3 2 V os xs fe 03 U £ K c I CJ _a *• X. xt > "u .2 8 B § s. s fc- a a ■tt £ tt ft? -5 iii •fl C P XS rt > ..Sfl Xi cn oS O -H XS ■s .a ■« * « co S -n. to O cj M 2 U XI fl _fl (« > rt u ft * rt 3? oi .S3 - O ft:T " I E 8 _.._! cj rt « s ll II g s § C *■» +3 fl 3 O -M o rt 3 X) a OS fi -S S g 111 ■fl 'h5 1 £ rt S* 65 I a ca i u 8 I co -* i flJ -a Sea §1* QJ CO 0) * flj fl B ' ._|S; co r» _q - "3 .' 60 ' fl -C SI CJ r.1 s ii 3g«.£iB 2 X. CD h ■ rt & co 0 j- fl cj x rt QJ In CO ' A. -/_) Ph Ph ' Ph O fl >,X ■ fc- V, , a* fc- _, -33 '._! g 8 0-1*5 3 g Zft R c_ g B -"B rt s ji S 3 ^ C L aj & rt c-h C o co o "B BC r; C5 ' U O J= >. t! ft ,S° eg 5 Oh U CO ■fl ed .5 rt 1 4) •d a o fl c rt o fl 01 fl ft) Ih «3 Ih 3 O 41 .fl T3 C rt o > rt xs 4> X) CA 3 O Ih Ih fl o Ih 4> rt XS > xO |^ fl 0 xs -t u "fl > fl rt Ih rt i Ih fl U o 0 ■5 > 0 1-" 0 & I o ft rt P b t-H rt ff XS U Si rt c o CO lH CJ O CJ § E c/ <_ X X « CJ fl Ih > u c _4 'o tfl aj OJ tfl "S QJ ft co 1c CJ fcs fl o o Ih Ih ■fl Xt C C K >> co co fl a CJ rC ■4H C/ 0 5 C co _n ft» T co c « ro - o fl 9 a f. CC 0 ■o a cd os X E ° fl o Ih CJ X Xi T3 C _H _D X3 o u fe co M ■3 ^ H O ■a rt fc < O a s^ c ■fl D CJ uj*S O UUWO Q 140 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 26" 6 377 17 133 510 432 54 1 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 X P. cn § < E- o o i O o z o < < H Z W >- r-- « !£ ON rJ „ s H Q cn Z rt o «n cn _ cn pq Oh cn O a ►J < H Z P-l O H no" m On -j u z tM a, Ph o A Ut tn P-l CS P. a u cn P. > n < H-jox PUBJQ O B ZS ca j go cs cN cn cn r- t r- voMHTt cs t-h cs cs cs cn Tt es i cn Mill! CS I I ! m It I ! I i SO j rH rH cn rn cn ■>* cs I : : i i t-h t-h tn ics cn m cs tn vo : vo oo : cn cn -ft CS tJ- 00 cs rn rH m as rt cn vo I I I rH i I CO i i (S rH tr, rH | rH rH rH MH j CO | rH CO i i illl I I I _- V. ft • isi' I u 61 ig-a-'i I g £ 11 iSftf i &_§ CJ .2 cd cfl c- O fc- J- •d C5 o£h o c_> £ 03 CO rt |s| §g'S ■fl tJ' ifl? Bug 1 cj ca 3 o i. a .a aj cj a __ "9 § .2 c* .2 -a 3 a 1 5 ca ca fc, » r. .c fc-f1" "fl Cfl llifll r. Oft ca , £ u _, •§ .a « B •a h « f. o » OJ iii* ft B QJ fi : .a '31 g.. S "0 ca b ! ' o-h S 3 ' . ° ca H if 1 g1 : . fe1 -a a j . It ■ S -3 ° ! , «S° III aJS.2.2 «B _ n inc-cacacJT-cfcj t « U„r q _.a!uPH<:-.o.siSoo2| fl O OS si t-H 0H ii s.fl -fl _fl CJ fl » tn W Oh Ph bJ_ Tt fcfl-H a o ft o S-S .9 .2 3 o o S o CJ £ _? ■<<£ tH U ca a ■o o SrO % B t. cfl i O fc- - ■Sja 0 fi CJ O CJ o cj ca >. >> >, >, O cfl cfl cfl cfl - cn fc- ft, Ph B, Oh . s .2 a n o i'l U 03 01 U - 03 I > i *w ig|l ' S a § p. O u o a> Tt H ei V *d i'Sl-sil WH MrO O ^ « o __? fl >> ^ _o o W fc.OZ 3 o 3 o a i CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 143 rn cs cn cs cn rn cs ■■* cn cn t Tt os tr~ Os tn\o cSOCJvt ■*4t VC CTn "* t-H rH OS VO VO t-h ir-vocncnrH i> cn oo tn "rt tn cn <n Tt Os 00 f* cn CN VO I I cn 7cs th"' ; t-h cS rH rn CS rH Tfr I Ci Tt Tt I ! I IN I m. o o a & c3 3 oj fi Jtt "I s : 2 8- 43 tt_ J qj ca * c _.-_> ; 'ij cfl C ."fl ! 2 ftf-g igSrSg I fi ■tt CJ co O OJ -tt BC '•§* !__ & _= & Cfl rt r. ft, O cn ca si ft & r- C. c £ QJ 53 OO til & tt I I S g o o h S .S ■c tn •-" rv cn rt 1 & «= -H CD > ■*_" rt g tX£ 3 H 3'oh^ j o 5T o ca rn - n W w *rt eg !? -fl *d -S o 3 *d S lis- iff rg i£ ca co c 1 c .5 S 3 O " ft "O i_ ca .a ca e, o qj c •h _> a ._: S •h i a > a h<<oiO «BA,i S ° rt rfl IS J tj o >. I qj TJ _- C ! CB 12 TJ J ■ o '3 « fi . '-. C qj &c 3 CC 'cj fi O ft 3 CJ Qj qj O C v, tn ._ T3 j5 fc; J3 B-O &-, E O U p fc- ca 3 __. § qj S j:.5_ o£S O £ rt fl •- i- 03 > « hfi »*■ (H rC fl .a 03 fi (J qn __> <?.■__. ■a .2 g cc ISPS' cn ii -h qSjs •s'5z.|l. U O O 73 © Hcjijc.=!_?_?S3 as3?sc£»' i ca ■ S.3 ft "bo •b ca .b 2 s * -ft 1.52 a s ;xu a 2? ^ ° ° (o a '§ & I- a u H _S "h rB Jh J- JB ft$ 2 H 0 UUBO Q 144 MENTAL HEALTH SERVICES REPORT, 1956-57 < H Cfl Ut o X H O z u) ri tn O z cs < fcj < z Bh t-- IT) CTn pq ttf H i-l cn < th Q CO cn y cn P. no < ►J __; ° a- ~ cn no o tn X% -3 H H cn Z -1 W _) r«-. 3 _J °_ OH t_ QJ QJO rn£ 75 •g o £S PCS' tt, s . cs cn «n vo i vo vo oo vo tj- m j *-« *-. i"N l s i i i ii i r OO rH j | rH tn | j j rH Tf O cn HHVO rHrH s - ! °n NO CO rH o o CN T-H m O CN Tf tn s - CN CO U. CN 1 1 I i i i r ! i ! i i I I IH I ] |H ] I |"| | I"" I ! t-h ! rH ! rn j CS cs cn t-h ; r-n-t CS rH VO j CS ir-rn I I 00 I 00 rH rH j h _- CT) in rH | rH rH -c.r;r,M. I rH rH I> j fs] o z X pel > tn o A Ph § O A Ut tn w o A < X U cn a > cs w rJ M 3 o •ca i B _1 . _> I a ■ lali o fc- a _v> u co -5 > "qj . cj cfl £ .a cA — H £ ■» £ Bo B "O o 6 3 ; N ■_- -H ■ ■-: a o . J_ ca > ' cn 2 r3 C l-Sl'Sft'SS Is II o. fl E S O tLH i a s H§a i 'a fi i * o b a ■2_5 o S ■ 0J -H ! S fi ! ** 2 81 a b QJ|£ 3 ft p _, &_ .» eg o.»*2 8 *t3 u u a « J o o o i x xi j- Tt I U O cj 03 ) >1 U >.rC n fen fes <ffift,OZ ft, | K S i _: qj i-g.fi I tn 03 11!•;_ i e o « O i 3 cfl T3 O- . w _B fi QJ .' QJ O Cfl - S3 S* ca f Iiii >. £ ft ft. 0 cn S 5 __ s •a B B CJ ca ca S3-3 S_ u .3 P. n CB *_ g E ,° '51b i o5i fc- ft rH <, I g£ I* B TJ : " i B.§!"2 2 "5 3 -h n fl : Illl la- 3-o £.-. 3 ca "a gas* S -a | S .2 OA-Sj-g rt §1 es 03 -fl ■ s >. o Cfl CJ a *d fl u ■ 0 tr* > -fl u U . 03 03 c a Tt M 03 O cn r- rt ou c d* i_ n" O JH 03 03 -H "H _C (H UWOO 3 a H O CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 145 x w Cfl Q Z < A 0 o A O i P. O < cn O Z o ►J < H Z w >- t-- m "-. r "^ ttf rt 3 H Q "5 z fl O w CW fcr- to t Ah H cn r2 VO _j °^ H H* W " d rt o< z > o ft. PL, o z 5 A D o o O cn X H < P. Q cn p. rJ CQ < ■d.-- oo tn T- ■'CTsmcnrHcscncS'-cm m ■* cn ov cn t-h Or ■^ OH 1 tt. CN Tt \ vo r- p OOTt | O CS >n rH In rH t-h !(S On »* CS VO CS 1 ■* cn H s rH j rH rn <o rH _..*d Ph Mill!!! MM i i -7 rt s I ! | 11 | | j | | |'| *H 1 J I j 1-1 1-1 Is rt > vn 1 rH 1 rH fN oo ft rt Cj CN s tO rH 100 IVO |CN j j IrH T* CS | rH CN | | OS vo I 1 rH ! ! t-H V) Bh : i : Tt : ill 1 1 ! ! II 1 i 1-1 Tt — S lllll ! lllll! ^ M 1 1 "t Ov Ov tt 1 1 1 Tt T-H tt, cn rHrH IrH ; -d- rt j t—i t— | o cn s 1 ^ ! j | 1-1 OS tn tn tt- «" ; i I i ; i ! j j- T» . r i i >n s in rH ! j | VO III! iiiii; ■«* tn o Ph m i-i 111 r" 111 tn iiii i | m 1 1 1 1 1 ! 1 rH 1 1 1 1 Tt | | Tt Tt »_n S MINI! 1 i i i Cfl Ih rt u b CJ. in Ph *" 111111 ** i 11 CN | cs s "H 1 1 i 1 1 ! 1 1 1 M CN *^ i | | j *H cn o tJ- tt 1 I ! Ill Illl iii! \ on I So < s M 1 1 1 1 1 1 1 1 1 I I | ; i 1 ! 1 1 j j.| | CN 1 1 1w | cn ii<i i cn 1 Ph' i 1 1 1 1 1 MM 1111 \ | rH ! ! I i ; i T-H ! cs cn s j ! ! ! ! 1 Illl | cn tt MM 1 rH ] | ! ! I ! rH ! ' ! ; ; cs tn s iii!!! MM Mil j 4 Os 2 tt I i t j i i i i i t i i | ! j 1 ! 1 1 1 1 ! ! ! MM i cs s i M II M ! 1 ! M I 1 ! \ 2 tt | | | | | | | || | | | 1 mi*"1 i " ^ CN s i Illl i 4 Ov Ph 11111111111 | MM i s 1 M II 1 | | | | | 1 T pi j | ] | i i i i i i MM i 3 s || II II j| MM ' i 1 0 03 on fl CJ o o j c c 03 £ y rt 4> Tt rt o ! fl i cn y r O o rt 6 M CJ *d OS tH 3 O V rt 1- fie oi a II II •tt T- B B .S.S rt a tt r- ^^ CJ c. C C o c B 03 tn i i O a cd 5 1 s to O -=; t_> Oh 1 V tt V X u O y X c fl OJ t- X C 0 N C c t 0 03 j-> QJ J V tr 03 U Q 03 V CJ i s c i C 0 "Z e 0 c fl o X o > D 01 y C X t_ > -C C V 1 Oj 01 « •2 "tH 03 g rt "rt Vh ■O JO .!_. U tf fl _« c. s ""__: 0 c 4 ■£ ■-a OJ <D CC 3 S rt c h x w U c > -31 ■dec _c ! I '•-' fl 0 s Cfl t 'cfl c O n | tl . R t e a t £ a j 1 rZ Ih 3 03 fl XS % Sj II T3 CT fi QJ >, cfl Cfl cfl ca -a B B S ca O cfl a 3 P J3 y 'v O JB U >t Cfl ft I "ca 0 H o rC CJ I 3 1 3 O '> rt rfl 03 x> u 03 Is 2 tt J3 - CJ CC a o^ CC Cfl — IJ c cn § > Ih 63 c Ih c u ^.« o *| Cfl H. «J CJ rt « OJ ri cn O rC u ft fl tf ii s o t h a 3 CO > c V. OJ u P- > p- t < > V p- £ j_ 0 CO cfl s -fl X c ■6 Q 146 MENTAL HEALTH SERVICES REPORT, 1956-57 X •d — ooir)T-HO\ir)cnT-HcScncNrH>n in On ^ Ui ss cn t-h cn ri CN t-h tn a OH z tt Oh H^nx ir-CNrHrHcn VO ! ! cn t-H rH m < "rt o >t H S 00 <rt 1 O CN in rH m rH rH |CS rt~. TT CS VO CS TT cn < t-H ! rH rH cn 1-1 tr- cn Ph O X Cfl t-< Ih l> rt > tt cN jt-h | |t-h jhh | irn ON j as 2 fl s Ov CS j j | j | T-H T-H j j rH -cf CS t-H rH rH ! «n Ov H O z p. 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A Xi rt (J Cfl 'c 3 p ja Cfl 'cfl o O 09 ft «i o H Without Psych eases of character, behaviour, and inte onic brain syndrome with behavioural > 03 e 4 c»* 3 C •fl E V- o H X CJ rt *7 > c c V 03 >> CJ Ih cfl T-t „SSi8 --SrE'SS CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL Q 147 "d-H ■"TfOrHTfcnrHCScnrHTfCS * X OH w Cfl "rt O PP rH rH j (S o Q H s Z < *d ttl MM M M M Oh ►3 s 1 1 1 1 I j j 1 j 1 I I I 1 { 1 1 j T-H O "1 S3 rt > A O i P-l tt *""• s |rH jCS 1 |«n | .O j 1 ; CS CS j IrH j jrH jcn c- CN o 1 i-Ih icni.vo iilTf!lj;lirHi vn < VD tt Ml l ' II ! i ! ! i ! i ! ! 1 1 r* rs X VO s "^ H C7\ < tt. VO tt T-H | i <^|H 'H 'HH 1-Hcn T-H1 rH 1 *H 0 VO s ii! i i III iiiii 1-1 tt, rH I i 1 1 1 *H I 1 rH, | | 1 i Tt , | 1 ! J rH i | o wn ttl iiiii II MM lllll 1 Ml w cn 03 Ih rt b s 1 I ! 1 1 1 1 1 rH CS rH j 1 j ! CS 1 1 j 1 ; 1 j j VO 5 < U tn A tn tt j MH j 1 JH |H j | , ,H , j j j | j j jHllfi s cn __; t- 3 O Ov Tf tt CN « ON W r-l fc-l 60 00 < Tf s i | | | i j iH | i H : j I i I ! 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Q Bh o ttl cn P" < o >H « ttf ►J < Q Z o W a 8 "H r. gNO 3. Os $~ 2 H Z £ p-l ^ 5 rJ Ph z 5 Ph O Z H s Ph P CJ u O cn H < Ut Q NO CM w -J < OH fc- oj -a > «JO -•a 2g ** "3 o DS cn cs cS cn rn t i i> vo cn vo cn t (TfOrHT^fcnrHCScnrHTfCS I t-h O cn rH OO I rH I rH rH I CS rH I rH I rt OO rH r- cn cs oo cn irncno iTfcs rH rH j (N I Cn ! rH t-h i I M ! rH ! 00 Q -t o ttcnO 2 £ c_ , a 5 ' B ___! 0i s 5 e —i 5 ca H co 3 c fl o - op onx rfl 'fl cj £ 8 & 3 *rt c. i- o § fc. - 5-> JJ fcg U B S 5«.3 (h -a bO -fl c fl ■___ o " o 4) 93 j- C— +J B ° g III —< OJ -fl o Xi rt ' 00 *_> 03 03 tt xi ■° Sg' ■S1 ? O B B hoo o s 8.8 03 B Cfl (H t-i >, E ■B H o? T3 o E v, O b a 2 B c- l3 .3 > C_ MH rB ; b b . i _. 11 r s B >, >. mtj id 03 O -Tt ~ 03_r% S I Ih rt S "' s 3 a. '* 2 C_! - O CS n i ^3 .8 .2 S « tt > o 6 < m a o o S, o .OQfiOO n §i 03 O 53 IH t*t C O rj 8 S S Si rt rt "d 2 w s_'3 .a 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
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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 |
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British Columbia. Legislative Assembly |
Publisher | Victoria, BC : Government Printer |
Date Issued | [1958] |
Genre |
Legislative proceedings |
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Text |
File Format | application/pdf |
Language | English |
Identifier | J110.L5 S7 1958_Q1_Q240 |
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Sessional Papers of the Province of British Columbia |
Source | Original Format: Legislative Assembly of British Columbia. Library. Sessional Papers of the Province of British Columbia |
Date Available | 2017-08-04 |
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 |
Catalogue Record | http://resolve.library.ubc.ca/cgi-bin/catsearch?bid=1198198 |
DOI | 10.14288/1.0354201 |
Aggregated Source Repository | CONTENTdm |
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