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Mental Health Services PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT FOR TWELVE MONTHS ENDED MARCH 31ST… British Columbia. Legislative Assembly 1959

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 DEPARTMENT OF PROVINCIAL SECRETARY
Mental Health Services
PROVINCE OF BRITISH COLUMBIA
ANNUAL REPORT
FOR TWELVE MONTHS ENDED
MARCH 3 1st
1958
Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1959 I  To His Honour Frank Mackenzie Ross, C.M.G., M.C.,
Lieutenant-Governor of the Province of British Columbia.
May it please Your Honour:
The undersigned respectfully submits the Annual Report of the Director of Provincial
Mental Health Services for the fiscal year ended March 31st, 1958.
W. D. BLACK,
Provincial Secretary.
Provincial Secretary's Office,
December 4th, 1958. 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, 1958, being the Eighty-sixth Annual Report.
I have the honour to be,
Sir,
Your obedient servant,
R. A. PENNINGTON,
Deputy Provincial Secretary.
Deputy Provincial Secretary's Office,
December 3rd, 1958. o
TABLE OF CONTENTS
, Page
Officers and Staff, List of       7
PART I.—HEADQUARTERS
Report—Director of Mental Health Services       9
Report—Business Manager     22
Report—Personnel Officer  32
Report—Supervisor of Psychiatric Social Work  37
Report—School of Psychiatric Nursing  40
PART II.—CREASE CLINIC OF PSYCHOLOGICAL MEDICINE
AND PROVINCIAL MENTAL HOSPITAL
Report on Crease Clinic—Medical Superintendent  41
Report on Provincial Mental Hospital—Medical Superintendent  44
Statistical Tables, Crease Clinic  62
Statistical Tables, Provincial Mental Hospital    73
PART III.—THE WOODLANDS SCHOOL, NEW WESTMINSTER
Report—Medical Superintendent  87
Statistical Tables    94
PART IV.—PROVINCIAL MENTAL HOME, COLQUITZ
Report—Medical Superintendent _'_  100
Statistical Tables  102
PART V.—GERIATRIC DIVISION
Report—Medical Superintendent  106
Statistical Tables, Home for the Aged, Port Coquitlam  118
Statistical Tables, Home for the Aged, Vernon  121
Statistical Tables, Home for the Aged, Terrace  126
PART VI.—CHILD GUIDANCE CLINICS
Report—Director of Child Guidance Clinics  129
PART VII.—MENTAL HEALTH CENTRE
Report—Director of Mental Health Centre  140
Statistical Tables, Mental Health Centre  143  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.
Mrs. J. G. Lundahl, R.N., Acting 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.C.P. (Edin.), F.R.C.P(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.
R. C Arrowsmith, B.A., M.D.
E. Linnolt, M.D.
J. E. Boulding, B.A., M.D., CM.
G. O. Hallman, B.A., M.D.
K..J. Fisher, M.B., B.S., D.P.M.
A. M. Mandeville, M.D.
W. M. DesBrisay, B.A., M.D., CM.
K. W. Yue, M.D.
R. L. Newman, B.A., M.D.
E. Wong, B.A., M.D.
M. E. Murdoch, B.A., M.D., CM.
P. A. Barber, M.D.
D. G. Fryer, M.B., Ch.B.
A. D. Sleigh, B.A., M.D.
R. L. Kennedy, M.D.
P. W. Laundy, B.A., M.B., Ch.B.
W. W. Winslow, B.Sc, M.D.
J. G. Fraser, B.A., M.D.
J. R. Lewis, M.B., Ch.B., D.C.H.
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 Administration.
Miss O. M. Curtis, O.T.(Reg.), Supervisor,
Occupational Therapy.
R. Herring, Supervisor, Industrial Therapy.
T. F. Maunders, B.A., M.S.W., 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.CS.(C), F.A.C.S., Orthopadic Surgery.
Business:
.1. F. Anderson, Assistant Business Manager. W. Gueho, Cashier.
G. A. Grieve, Cost Accountant. R. Eoulter, Steward.
Miss N. Ihbe, Business Stenographer.
Rev. John F. O'Neil, Protestant.
Chaplains:
Rev. Father A. Frechette, Roman Catholic.
7 L 8 MENTAL HEALTH SERVICES REPORT,  1957/58
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
B. Tischler, M.D. Work.
T. Kamburoff, M.D. H. Mercer, Industrial Arts Instructor.
E. M. Tredger, M.D. J. Lynes, Recreational Instructor.
R. E. Manning, M.D. Miss N. J. E. Jessup, Occupational Therapist.
H. T. Davidson, D.D.S. Miss D. Dickinson, L.S.T., Speech Therapist.
Miss V. Sanders, R.N., Superintendent of J. Elliot, Chief Male Psychiatric Nurse.
Nurses. R. Nash, Instructor, Male Psychiatric Nurses.
Miss J. Ing, B.Sc(H.E.), Dietician. Miss E. Henshaw, Senior Clerk-Stenographer.
Mrs. H. M. Davy, School Principal.
Chaplains:
Rev. L. Hankinson, Protestant. Rev. Father J. R. Bernard, Roman Catholic.
PROVINCIAL MENTAL HOME, COLQUITZ
L. G. C. d'Easum, M.B., Medical Superintendent.
H. C. Yardley, Deputy Business Manager. E. F. Groome, 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. A. Clemons, LL.B., M.A., Speech Therapist.
W. L. Valens, M.D., CM., Psychiatrist. D. B. Ricketts, B.A., M.A., Supervisor, Social
Miss M. Munro, B.A., M.A., Supervisor, Psy- Work,
chology.
Mrs. M. Harvey, B.A.Sc, R.N., Supervisor, Public Health Nursing.
Mrs. E. LeRocque, 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. Mrs. B. G. Lipinski, B.A., M.A., Senior Psy
chologist.
Miss E. E. Jackson, Senior Stenographer. r-
REPORT OF MENTAL HEALTH SERVICES
For the Twelve Months Ended March 31st,  1958
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-sixth Annual
Report of the British Columbia Mental Health Services is submitted herewith.
INTRODUCTION
The Annual Report for the preceding year endeavoured to portray the three phases
of development which have governed our policy for the past ten years. It would, therefore, seem appropriate that some attention be devoted at this time to an evaluation of
the present situation and the possible trends of the future.
While much has been accomplished in the understanding and the treatment of mental and emotional illness, the fact still remains that the maintenance of good mental
health is our greatest single health problem. Public health has, for the most part, successfully dealt with environmental influences as they affect the physical well-being of
mankind in our country. Little progress has been made in attacking environmental
stresses as they affect the mental and emotional well-being of mankind.
Progress in psychiatry has always been cyclic in character. There have been years
in which great progress has been made, there have been years in which little progress
has been made, and, unfortunately, there have been years in which it has been difficult
to maintain the progress of former years. This has been due to public apathy fostered
by-isolation and shame, which heretofore have been closely associated with mental illness.
Through the efforts of the Canadian Mental Health Association and particularly the work
of the volunteers in our hospitals, the public is becoming better informed and the isolation and shame so long associated with the mentally ill is gradually disappearing. It is
hoped that public health will now be able to focus its attention on the mental health of
the individual with the same zeal and degree of success with which it attacked the physical environment as it affects the physical health and well-being of the individual.
Dr. Harry C. Solomon, president of the American Psychiatric Association, made
very definite statements in his recent presidential address regarding future trends in
psychiatry as they affect mental hospitals. "America's large mental hospitals," stated
Dr. Solomon, " are bankrupt beyond remedy and should be liquidated. The large mental hospital is antiquated and outmoded and rapidly becoming obsolete. We can still
build them but we cannot staff them and, therefore, we cannot make true hospitals of
them."
Dr. W. W. Maclay, Senior Commissioner, Board of Control, Ministry of Health,
London, England, summarized the trends in British psychiatry in the academic lecture
delivered to the First Canadian Mental Hospital Institute. Dr. Maclay stated present-
day trends as follows:— L  10 MENTAL HEALTH SERVICES REPORT,  1957/58
" 1. Mentally ill and mentally defective patients are, as far as possible, being put
on the same footing as patients with other forms of illness or disability.
" 2. The realization that mental hygiene and early treatment in the community can
promote good health, prevent or arrest illness, and in many instances avoid the need for
admission to hospital.
" 3. The realization that the community can care for many mentally ill and defective patients who are at present isolated in special hospitals.
" 4. The realization that big hospitals are apt to be bad hospitals and can be potent
factors in the creation of chronic patients.
" 5. The realization of the importance of a therapeutic community and of active
rehabilitation methods and the way in which these can be developed can be studied scientifically by suitably trained persons.
" 6. In the field of mental deficiency the extension of vocational training methods,
better supervision of defectives in the community, extension of day-hospital facilities,
and more intensive habit training will result in more defectives being cared for in the
community and an increased proportion of low-grade patients in the hospitals."
The Canadian Mental Health Association, in its second report on mental health
services in Canada, lays emphasis upon a " community orientation towards mental-health
services which would have the practice of psychiatry carried out as much as possible in
the patient's natural environment and everyday life situation. To be admitted to hospital is only one possible phase in the natural history of recovery from mental illness.
It is pointed out that the future developments in mental-health services will see increased
emphasis upon community mental-health services and facilities other than hospitalization."
As a result of these changes in orientation away from centralized large mental hospitals, several experiments are presently being carried out. In 1954 the State of New
York initiated a " new programme for community mental-health services " under the
" Community Mental Health Services Act." The Act is designed to " encourage the
development of preventive, rehabilitative, and treatment services through new community
mental-health programmes and the improvement and expansion of existing community
services."
The State of California initiated a similar programme in 1957 with the passage of
the " Community Mental Health Services Act." The Act recognizes that the responsibility for mental health is one which the State must share with all levels of government
and with the voluntary agencies that are actively interested in mental health. The
" Community Mental Health Services Act " is the legal instrument which authorizes and
facilitates optional action on the part of local governments who wish to establish local
mental-health services. The Act also provides State funds to match local funds appropriated to achieve broad mental-health goals.
From the above resume of present-day trends, it is obvious that the former idea of
isolating the mentally ill in a remote mental hospital where efforts were made to produce
a quiet restful existence is now outdated. Future treatment facilities should be located
in conjunction with medical centres and in the main streams of life, in small units and
close to the patient's home surroundings. If more up-to-date and more effective means
of dealing with mental-health problems can be put to use within the community, construction of mental hospitals will be a thing of the past.
Viewed against the background of these impending changes, it is fortunate that
mental hospitals across the country continue this year to show a reduction in patient
population. The Mental Hospital at Essondale reports a decrease in population of fifty-
one patients at the end of the fiscal year. This decrease has occurred in spite of an
increased admission rate and a diminishing death rate. If this process of gradual self-
elimination of our mental hospitals continues, there are three units which can be evacu- HEADQUARTERS
L 11
ated. I refer to the original Farm Cottage and Farm Annex at Essondale and the Mental
Hospital at Colquitz. In addition, the present overcrowded condition currently existing
in the various buildings of the Mental Hospital at Essondale will absorb a reduced
population for many years to come before the population of these buildings is reduced
to the normal standards for which they were built. Certainly there is no indication that
mental hospitals will be entirely unnecessary, but there is every indication that the numbers of patients in mental hospitals can be greatly reduced, and, further, that the majority
of future patients need not go to hospital if given early diagnosis and help in the community.
These new trends deserve very careful study, both in relation to the mental-health
needs of the Province and in relation to our critical staff situation. To this end, it has
been recommended that the services of the American Psychiatric Association be utilized
to conduct a survey of the mental-health needs and resources of the Province. Such
surveys have been carried out in many of the States and have resulted in the blue-printing
of mental-health programmes for 5-10-20-year goals. The survey report presents a
detailed and comprehensive analysis of a wide range of mental-health needs and services.
The recommendations presented represent current trends in professional thinking as they
may be applied to the needs of the Province. A re-evaluation at the present time would
be of great assistance in future planning.
STATISTICAL COMMENTS
The Division of Vital Statistics, Health Branch, Department of Health and Welfare,
has been responsible for the compilation of our statistical tables. No special studies
were undertaken during the year.
Table 1.—Showing Patients in Residence in the Various Institutions of the Provincial
Mental Health Services, April 1st, 1957, and March 31st, 1958, together with
Increase or Decrease.
Institution
In Residence, Apr
1, 1957
In Residence, Mar.
31, 1958
Increase (+)
Men
Women
Total
Men
Women
Total
Decrease (—)
95
1,814
285
735
143
105
286
131
1,645
506
405
129
226
3,459
285
1,241
548
234
286
101
1,862
287
776
141
101
285
151
1,546
541
401
125
252
3,408
287
1,317
542
226
285
+26
—51
+2
The Woodlands School	
4-76
—6
Home for the Aged, Vernon 	
—8
—1
3,463
2,816
6,279
3,553
2,764
6,317
+ 38
Table 2.—Showing in Summary the Admissions and Population Increase of the Provincial
Mental Health Services for the Ten-year Period April 1st, 1948, to March 31st,
1958.
Year
Total
Admissions
Admissions
65 Years
and Over
Admissions
15 Years
and Under
Voluntary
Admissions
Population
Increase
Index of
Increase1
1948/49..
1949/50..
1950/51-
1951/52..
1952/53-
1953/54..
1954/55-
1955/56..
1956/57..
1957/58-
Totals-
1,260
1,415
1,811
2,175
2,518
2,437
2,492
2,855
2,720
2,936
270
230
262
306
357
347
348
392
385
442
63
72
148
97
179
169
71
58
57
106
165
297
504
637
768
834
884
1,153
1,083
1,012
22,619
3,339
1,020
7,335
354
306
235
285
290
215
88
26
—78
38
1,759
28.09
21,62
12.98
13.05
11.54
8.82
3.53
0.91
—2.87
1.29
1 Percentage ratio of increase in population to admissions. L  12 MENTAL HEALTH SERVICES REPORT, 1957/58
Tables 1 and 2 should be studied together in order to gain a general idea of the
year's activities. It will be noted that a total of 2,936 admissions to all divisions is
recorded. This is an increase of 216 admissions as compared with last year. This
increase was forecast in last year's Report and is distributed as follows: Crease Clinic,
35; Provincial Mental Hospital, 76; The Woodlands School, 75; and Homes for
Aged, 30.
It will also be noted that there is a marked increase in the admission of patients
over 65 years of age and a marked increase in the admission of patients under 15 years
of age. In summary, the increase in patient admission has been in those divisions of
the service admitting and caring for the mentally retarded and the aged. Increased
admissions in these areas will continue as additional space becomes available for their
care and treatment. At the end of the year, 470 applications were still pending for
admission to The Woodlands School and fifty-eight applications were still pending for
admission to the Homes for the Aged. I am pleased to report that the number of patients
on the waiting-list for the Homes for the Aged has been greatly decreased during the
year, but there is a substantial increase in the number of patients awaiting admission to
The Woodlands School.
A study of the " in residence " table reflects a decreased separation rate in some
divisions as compared with last year's tables. However, in spite of many adversities
the large Mental Hospital at Essondale was able to conclude the year's treatment programme with a further decrease of fifty-one in the patient population. Similarly, the
Homes for the Aged report a decreased population of fifteen patients. The entire service
was thereby enabled to hold the total patient population increase to thirty-eight in spite
of the increased admission of 216 patients.
BUILDING PROGRAMME
No major construction was initiated this year, and none is in the planning stage.
It has been decided to defer indefinitely any additional construction of large buildings
in the Essondale area. Some further consideration was given to the advisability of proceeding with the plans for the development of a new mental hospital on Vancouver Island.
It has, however, been decided to defer further explorations in this regard due to the
changes in current treatment trends.
Construction of the Fraser View unit was completed late last year, and the first
patients moved into this building during the month of April, 1957.
The new Recreational Building at The Woodlands School was completed during the
month of December. The building presents a very handsome appearance and offers
facilities for a combined gymnasium and auditorium. A large play area is available in
the lower floor. The building also houses a full-sized swimming-pool. The building will
be a great asset to the School and fulfil the needs of the Recreational Department admirably.
The new nurses' home and School of Psychiatric Nursing Building was completed
in November, 1957. This combined unit provides single-room living accommodation
for 100 student-nurses, together with educational facilities sufficient to meet the needs
of the School for years to come.
Construction of the Admission and Infirmary Building at the Homes for the Aged,
Port Coquitlam, is 90 per cent complete. Occupancy of the building will be delayed
until early in 1959.
The maintenance and reconstruction work has been carried out by the Public Works
Department. A greater amount than usual has been accomplished during the year.
Details of this work will be found in the Business Manager's report. HEADQUARTERS L 13
GENERAL COMMENTS
Graduation activities in the School of Psychiatric Nursing were held during the
week of April 14th. The members of the graduating class and their parents and friends
were entertained at afternoon tea on Sunday afternoon. A very successful dinner-dance
was held at the Stanley Park Pavilion on the evening of April 15th. The graduates
greatly appreciated the fact that this evening was made possible through financial
assistance from the Department. The twenty-sixth graduation exercises were held on
the evening of April 17th. The function was held as usual in the New Westminster
Junior High School auditorium and was attended by a capacity audience. Mr. R. A.
Pennington acted as chairman. The Honourable Lyle Wicks represented the Government and brought official greetings to the graduates. Mr. Russell K. MacKenzie, Director
of the Vancouver School Board Training Programme for Senior Counsellors, was the
speaker of the evening. Sixty-eight women and seventeen men received diplomas and
pins.   Refreshments were served following the exercises.
Mental Health Week was observed during the week of April 29th. The week is
observed throughout the American Continent in an endeavour to focus the attention of
the public on matters pertaining to mental health. The mental-health facilities of the
Province were not featured this year, but a good many of the staff participated in the
various educational activities. All arrangements for the week were under the jurisdiction of the British Columbia Division of the Canadian Mental Health Association.
The Mental Health Centre and Child Guidance Clinic were officially opened on
May 1st, 1957. Mr. R. A. Pennington acted as chairman for the occasion. The building was received from the contractor by the Honourable William Chant, who in turn
officially presented the building to the Honourable W. D. Black. Mr. Black gave the
address. Following the official ceremony, the building was open for inspection throughout the afternoon and evening. Special exhibits had been prepared in the different
departments of both units, and members of the staff were on hand to explain the function of the different departments. Refreshments were served, and it was estimated that
700 people toured the building during the course of the day and evening.
I am pleased to report that the houses formerly occupied by the Child Guidance
Clinic have been renovated and refurnished and are now functioning as a men's rehabilitation centre. The buildings present a homelike atmosphere and will greatly augment
our rehabilitation programme. The centre has been named " Venture " and will offer
the same service to " prospective discharge " male patients as is currently provided for
female patients by the Vista rehabilitation centre. The centre will be operated by a
minimum of staff and will provide accommodation for nine or ten patients. The initial
group of men was admitted on July 16th. The administration of the centre comes under
the jurisdiction of the Clinical Director.
The Fraser View unit at The Woodlands School was opened for patient occupancy
on April 16th. The building presents a very pleasing example of modern architecture.
The staff express general satisfaction with the layout design and equipment of the building. The opening of these new wards involves a reclassification and proper segregation
of the patient-pupils. It has not been possible to open the entire building during the
course of the year. However, 124 new patients were admitted from the waiting-list.
Considerable apprehension is felt regarding the matter of obtaining suitably trained personnel to operate this large unit. The matter of recruitment of staff is proceeding as
rapidly as possible. The type of patient being admitted is one which demands a high
standard of nursing and pediatric care.
The Mental Health Services held a very successful two-day institute on October
24th and 25th. We were fortunate in obtaining Dr. Heinz E. Lehmann, Clinical Director
of Verdun Mental Hospital, Montreal, as a central figure in the institute. Dr. Lehmann
had recently returned from the World Congress in Mental Health held at Zurich.   Other L 14 MENTAL HEALTH SERVICES REPORT,  1957/58
participants in the institute were drawn from our staff. Dr. J. S. Tyhurst, Professor of
Psychiatry at the University of British Columbia, also participated. The institute was
well attended by our staff and many guest psychiatrists from the Vancouver area. The
institute was made possible through financial assistance from Federal Mental Health
Grants.
The School of Psychiatric Nursing was able, during the year, to provide refresher
courses for psychiatric nurses in all divisions. The purpose of these courses was to
keep the nursing staff well informed regarding recent advances in psychiatric nursing
and to assist in preparing them for the Civil Service eligibility examinations, which are
held annually.
The magnitude of the work done by the service can only be understood by a study
of the reports from the various divisions.
UNIVERSITY OF BRITISH COLUMBIA
The close affiliation with the University of British Columbia has continued. There
has been a free exchange of resources, which has greatly enhanced our service. The
appointment of Dr. James S. Tyhurst as Professor and Head of the Department of Psychiatry will greatly assist in the development of our graduate and undergraduate training
programmes.
It is hoped that during the forthcoming year our residency training programme will
be under the jurisdiction of the Department of Psychiatry in order to meet the full
requirements of the Royal College of Physicians and Surgeons of Canada. Preliminary
discussions to formulate this programme are under way. During the year one senior
resident in psychiatry was seconded to the University for a training period of one year.
In the meantime we have continued our former policy of sending one senior resident to
the University of Toronto and one to McGill University.
The work of the special sub-committee under the National Advisory Committee on
Mental Health (Ottawa) has continued its study with reference to the training of nurses
in mental hospitals. The work of the committee has been greatly hampered by the
resignations of several senior members, and I regret that a final report is not yet available.
VANCOUVER SCHOOL BOARD
The in-service training programme for special counsellors initiated by the Vancouver School Board has completed its third year of operation. This course of training
receives support from the Department of Education, the Vancouver School Board, and
Federal Mental Health Grants. During the three years in which the training course has
been available, eighteen teachers from the Vancouver schools, two from Richmond, and
one each from Surrey and Coquitlam districts have been given this training.
The in-service training programme has been designed as a directed experience in
group living, which includes lectures, discussions, visits, and other training procedures
in the principles of child development, with specific relation to the mental-health implications. Practical field experience is given in child and adult mental-hygiene clinics,
all mental-health facilities, and the various social agencies. On completion of the course
the teacher-counsellors return to their schools.
The programme is directed by Mr. Russell K. MacKenzie, who reports that during
the past three years there has been a very marked increase in the interest and acceptance
shown by all school personnel to the work of the special counsellor as a means of helping
children with problems.
The training of this group of teacher-counsellors is considered a very important
part of the preventive programme and one worthy of our continued support. The Vancouver School Board should be commended for its foresight in initiating this course of
instruction and for its generosity in including teachers from other school districts. HEADQUARTERS L 15
CANADIAN MENTAL HEALTH ASSOCIATION,
BRITISH COLUMBIA DIVISION
The British Columbia Division of the Canadian Mental Health Association has
completed five years of service. The growth of the organization since 1952 has been
phenomenal. The work as carried out by the Division has very greatly benefited the
Mental Health Services, indirectly through its general educational activities and directly
through the many ramifications of its volunteer activities. I am pleased to report that
the volunteer activities have increased during the year, and full data on these activities
may be found in the reports of the Medical Superintendents of the facilities in which
these services are utilized.
It is noteworthy to report that the volunteer group has now taken over the responsibility of the operation of the coffee-shop in Pennington Hall. The operation of this
concession has been very kindly relinquished by the Canadian National Institute for the
Blind in order that it may be utilized as a more active therapeutic agent by the volunteer
group. It is planned that the coffee-shop will provide a comfortable and congenial
meeting-place for patients and their relatives and friends during visiting hours and also
provide a further avenue of contact between patients and volunteers. It is hoped that
a select group of patients may be utilized in the operation of the coffee-shop to provide
a training experience prior to rehabilitation. Plans are under investigation regarding
the possibility of establishing a similar service in connection v/ith the Home for the Aged,
Port Coquitlam. Special commendation is due to Mrs. R. A. Pound, who has devoted
so much of her time and talents to ensure the successful operation of this new venture.
The scope for further developments of the volunteer programme in the various
divisions of our service is almost unlimited. The public response and interest is indeed
very gratifying.
The British Columbia Division of the Canadian Mental Health Association is a
Red Feather agency and receives an annual grant from the Department of the Provincial
Secretary on behalf of the Mental Health Services.
ASSOCIATION FOR RETARDED CHILDREN OF
BRITISH COLUMBIA
The Association for Retarded Children of British Columbia continued its rapid
expansion at the conclusion of its third year. A good many new chapters have been
organized throughout the Province, and several new schools for the retarded children
in these districts have been opened. The College of Education of the University of
British Columbia continues to assist in the preparation of teachers through a summer
course held each year. The enrolment last year numbered eighty. The Woodlands
School continues its close association with the organization, and senior staff members
have been loaned extensively for educational and orientation purposes. This service is
being given temporarily until an established travelling clinical team can be organized.
The executive of the association, together with the technical advisers, met with the
Honourable W. D. Black, Provincial Secretary, the Hon. Eric Martin, Minister of Health
and Welfare, and the Honourable L. R. Peterson, Minister of Education, together with
their respective deputies. A brief was presented by the association and was studied
during the meeting.
The Association is carrying out a very worthwhile programme and is worthy of
the assistance given by the Government.
An Act to amend the " Schools for Mental Defectives Act " was passed at the 1958
Session of the Legislative Assembly to meet two requests from the association. Under
the amendment, retarded children may now be admitted to The Woodlands School for
a thirty-day period. Application for this privilege is made in Form J. This provides
for temporary care during periods of family stress or would allow parents caring for a L 16 MENTAL HEALTH SERVICES REPORT,  1957/58
retarded child to have a holiday. It also provides a service for examination and assessment of a retarded child. The second provision of the amendment, under Form K,
allows for the admission of mentally retarded persons to The Woodlands School on a
non-resident basis for the purpose of attending day-school classes.
The association now has thirty-two chapters operating thirty-two schools providing
education for 348 children. This phenomenal growth has presented many organizational problems both to the individual chapters and to the Provincial association. It is
hoped that additional services within The Woodlands School which are needed to complement the work of the association may be developed as rapidly as possible in order
that these retarded children and many others may be integrated into community education and community living.
THE ALCOHOLISM FOUNDATION OF BRITISH COLUMBIA
The Alcoholism Foundation of British Columbia has summarized the fourth year
of operation in its fourth annual report. The foundation is concerned with education,
prevention, and rehabilitation. The chief focus of the foundation has been on the outpatient clinic service. A rehabilitation residence offers limited service to those male
patients who require a short-term controlled environment. The development of the
residential treatment programme and the out-patient and rehabilitation services have
been of assistance to the Mental Hospital in dealing with this type of patient. Dr. W. E.
Powles continues to represent the Mental Health Services on the board of directors.
THE NARCOTIC ADDICTION FOUNDATION OF BRITISH COLUMBIA
The second annual report of the Narcotic Addiction Foundation of British Columbia
reports a year of progress in spite of many frustrations. The foundation has, however,
succeeded in establishing a treatment centre and reports a total case load of 127 clients.
The programme is one of treatment and research of narcotic addiction on a plan of
voluntary referral. Dr. A. E. Davidson continues as a representative of the Mental
Health Services to the board of directors.
MENTAL HEALTH GRANT
The Government of Canada, through the 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 tenth year that the Mental Health Grant has been
available.
The grant provided for 1957/58 was $616,456. Projects totalling $603,679.14
or 97.9 per cent of the grant were submitted and approved. Expenditures made and
claims submitted to the Federal Treasury by March 31st totalled $582,358.01 or 94.4
per cent of the grant.
It is again a pleasure to acknowledge the helpful understanding and support of the
officials of the Department of National Health and Welfare.
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. M. O. Calverley completed a year of postgraduate study in psychiatry at McGill University
in August.
Mr. Alan M. Clark completed a year of postgraduate study in clinical psychology at McGill
University in April.
Miss A. E. Scott, Senior Research Assistant, Division of Vital Statistics, attended the Conference
of Mental Hospital Administrators and Statisticians in Washington, D.C., in May.
Mr. John Dowling, Personnel Officer, attended the Pacific Northwest Regional Laboratory on
Group Development in Seattle in June. HEADQUARTERS
L 17
Six clinical psychologists and two psychiatrists attended the Workshop on Research in Clinical
Psychology held at the University of British Columbia in June.
Mr. G. Glover and Mr. E. Elmore attended the annual Casework Institute of the Family Service
Association of America at Lake Wilderness, Maple Valley, Wash., in September.
Dr. T. G. Caunt attended the Ninth Mental Hospital Institute of the American Psychiatric
Association in Cleveland in October.
Dr. W. E. Powles attended the second annual institute and fifteenth annual conference of the
American Group Psychotherapy Association in New York in January.
Dr. A. M. Gee, Dr. I. S. Kenning, and Dr. N. L. Richardson attended the First Canadian Mental
Hospital Institute in Toronto in January.
Dr. L. A. Kerwood and Dr. G. M. Kirkpatrick attended an Institute on Current Trends in Child
Psychiatry at the University of Manitoba in March.
Dr. J. E. Boulding commenced a year of postgraduate study in psychiatry at McGill University
in September.
Dr. F. H. G. Mills commenced a year of postgraduate study at the University of Toronto in
September.
Bursaries were provided to eight social workers to attend the School of Social Work, University
of British Columbia, for one year commencing in September.
A two-day institute on schizophrenia was held at the Crease Clinic in October. Funds from the
Mental Health Grant were used to bring Dr. H. E. Lehmann, Clinical Director of Verdun Protestant
Hospital, Montreal, to the institute as lecturer and resource person.
Assistance was given to the British Columbia Psychological Association and the University of
British Columbia in bringing Dr. E. S. Shneidman from Los Angeles to lead the Workshop on
Research in Clinical Psychology held in June.
EQUIPMENT AND SUPPLIES
Provincial Mental Hospital, Essondale.—The following equipment has been provided: Six
resuscitators for use in electro-convulsive treatments.
The Woodlands School.—Equipment for the new gymnasium and swimming-pool to the value
of $12,000.
Home for the Aged, Vernon.—Four wheelchairs and a screen and portable loud-speaker for the
16-mm. projector.
School of Psychiatric Nursing, Essondale.—Teaching equipment for the classrooms and
demonstration-rooms, together with the technical equipment for an 11-bed student-nurses' infirmary.
Total approval, $14,500.
COMMUNITY MENTAL-HEALTH PROGRAMMES
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-health principles was continued by the
Vancouver School Board. Another group of eight teachers was enrolled, but one was forced to
withdraw from the course because of illness. The salary and mileage allowance of the training coordinator was provided by the grant.
PSYCHIATRIC SERVICES IN GENERAL HOSPITALS
The psychiatric services of the Vancouver General Hospital continued to receive support.
Salaries were provided for one additional social worker. The staff establishment supported by the
Mental Health Grant is now two social workers, one occupational therapist, one clinical psychologist,
and one medical stenographer.
The Royal Jubilee Hospital of Victoria was assisted by the provision of the salary of a full-time
physio-occupational therapist for the psychiatric service.
PERSONNEL FOR MENTAL HEALTH SERVICES
The stipends for consultants in the specialties of neurosurgery, general surgery, orthopaedic
surgery, and internal medicine are provided by a project.
The Rehabilitation Department has been assisted by the provision of the salary and mileage
allowance of the Rehabilitation Officer.
The various hospitals and clinics of the Mental Health Services continue to be assisted in the
provision of staff for the treatment of patients through the payment of salaries. L 18 MENTAL HEALTH SERVICES REPORT,  1957/58
RESEARCH PROJECTS
Several major research projects receive support from the Mental Health Grant. These studies
are conducted by the Department of Neurological Research of the University of British Columbia.
Projects this year include the following: Aromatic Metabolism in Schizophrenic Patients,
Aromatic Compounds in the Urine of Schizophrenic Patients, and The Biochemistry of Schizophrenia
(Animal Experiments).
The Department of Pharmacology of the Faculty of Medicine continued its studies on the Pharmacological Analysis of Pathways Leading to Diffuse Enhancement of Cortical Electrical Activity.
COUNCIL OF PSYCHIATRIC NURSES
The 1957 annual meeting of the Council of Psychiatric Nurses was held at Essondale on April 16th.
A report from the Bursary Policy Committee was received by the council, and a
motion to proceed with the implementation of the recommendations was passed.
The council appointed the following to the Bursary Selection Committee: Dr. L. E.
Ranta, Chairman; Mrs. H. Duke, Mr. G. Kenwood, Mr. R. H. Strong, and Dr. B. F.
Bryson, members.
The council was officially advised by the Deputy Provincial Secretary that the " Psychiatric Nurses Act " had been amended at the 1957 Session of the Legislative Assembly
to provide for the licensing of nurses in mental deficiency. Instructions to license such
nurses were issued to the registrar.
The council passed a resolution recommending that the Minister present a revised
set of regulations under section 9 of the Act to the Lieutenant-Governor in Council in
order that the regulations would pertain to nurses in mental deficiency as well as psychiatric nurses.
The registrar reports that on December 31st, 1957, there were 1,051 psychiatric
nurses and eleven nurses in mental deficiency licensed to practise in British Columbia.
STAFF CHANGES
General staff dissatisfaction and unrest, which seems to be characteristic of the
times, has been felt during the year. This situation finally culminated in the setting of
a strike date. Fortunately, a satisfactory agreement was reached between the employees'
association and the Cabinet, and the strike was averted. There was much evidence of
loyalty on the part of the staff in general, and it was clearly demonstrated that in the
event of strike action essential nursing and treatment services would be maintained.
I am pleased to report that we were able to initiate a five-day forty-hour week for
the nursing staff.    This change became effective on October 1st, 1957.
The report of the Personnel Officer indicates some improvement in the staff situation.
Table E of his report indicates that positions added to the establishment total 299. The
implementation of the five-day forty-hour week required seventy-seven new staff members. Two hundred and twenty-two positions were added to the establishment of The
Woodlands School to initiate the operation of the Fraser View unit.
A serious loss occurred in the resignation of Miss Edith M. Pullan as Director of
Nursing. Miss Pullan joined the service in 1940 and assumed the position of Director
of Nursing in 1951. She has handled a very difficult nursing situation in a most efficient
manner and has made a commendable contribution to psychiatric nursing in the Province.
Miss Pullan leaves to assume the position of Director of Nursing at the Royal Columbian
Hospital.
Dr. N. L. Mason Browne resigned from the senior medical staff to enter private
practice in the specialty of psychiatry. HEADQUARTERS
L 19
The following staff members terminated service by superannuation: T. Ryan,
charge psychiatric nurse, New Westminster; C. C. Scott, blacksmith, Essondale; W. Gallagher, chief psychiatric nurse, Essondale; R. R. Williamson, cook, Essondale; W. Stephens, charge psychiatric nurse, Essondale.
I regret to report the following deaths which occurred while in service: W. Jenkins,
cook, Colquitz; P. G. Landscrown, psychiatric nurse, Essondale; W. Stinson, building
service worker, Vista, Vancouver; R. A. Dier, psychiatric aide, New Westminster;
Mrs. E. M. Quinlan, psychiatric nurse, Essondale; Mrs. H. Lind, psychiatric aide,
Essondale; W. Keenan, psychiatric nurse, Essondale.
ACKNOWLEDGMENTS
In concluding this report I would like to express gratitude to the many community
agencies and associations who are engaged in working with us in the mental-health field.
I would like to express my appreciation of the fine degree of loyalty and co-operation
that has characterized our relationships with the various professional and employee
organizations. The relationships within our own service and other departments of
Government have been most congenial.
I am pleased to report that members of the Government are showing increasing
interest in our welfare, and that we have been visited by an increasing number of members of the Legislative Assembly during recent years. Our responsibility to the Provincial Secretary's Department has been maintained by a close association with our Deputy
Minister and the Minister. The friendly and personal nature of these relationships have
greatly assisted in the administration of the service.
I have the honour to be,
Sir,
Your obedient servant,
A. M. Gee, M.D., CM.,
Director of Mental Health Services. L 20
MENTAL HEALTH SERVICES REPORT,  1957/58
COMPARATIVE SUMMARY OF INCREASES AND DECREASES IN RESIDENT
POPULATION BY MAJOR DIVISIONS OF PROVINCIAL MENTAL
HEALTH SERVICES, 1952/53 TO 1957/58.
Institution
1952/53
1953/54
1954/55
1955/56
1956/57
1957/58
—64
+277
+49
+28
+62
+ 104
+ 50
— 1
+44
+ 19
o
+25
+2
+ 19
+ 15
-10
—70
+ 14
+9
—31
-49
+76
— 15
+26
+290
+215
+ 88
[_
+26
—78
+ 38
COMPARATIVE SUMMARY OF TOTAL PATIENTS UNDER CARE FOR MAJOR
DIVISIONS OF PROVINCIAL MENTAL HEALTH SERVICES BY FISCAL
YEARS, 1952/53 TO 1957/58.
Institution
1952/53
1953/54
1954/55
1955/56
1956/57
1957/58
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
5,408
The Woodlands School 	
1,373
1,349
1,714
8,995
9,072
9,212
9,749
9,618
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21 L 22 MENTAL HEALTH SERVICES REPORT,  1957/58
BUSINESS MANAGER'S REPORT
F. A. Matheson, Business Manager
Submitted herewith are the financial reports of the Provincial Mental Health Services
for the fiscal year ended March 31st, 1958.
The units of the Mental Health Services providing in-patient care comprise the
Crease Clinic and Provincial Mental Hospital at Essondale, The Woodlands School in
New Westminster, the Provincial Mental Home at Colquitz, and the Homes for the
Aged at Port Coquitlam, Vernon, and Terrace.
The daily average patient population in these units for the year was 6,256.60, this
being a decrease of 60.4 under the 1956/57 average of 6,316.60.
It might be worth while to note at this point that this is the second straight year
that there has been a decrease in patient population, a drop of 11.09 having been recorded
in 1956/57.
Gross operating costs amounted to $11,413,169.99, as compared to $11,125,468.64
for the fiscal year 1956/57, an increase of $287,701.35 or 2.6 per cent, with the result
that the daily per capita cost rose from $4.83 to $5, an increase of 17 cents.
This increase in operating costs is made up of an increase in salaries of $76,341.87
or 0.7 per cent and supplies and services of $211,359.48 or 1.9 per cent.
The salary portion of the increase can be attributed chiefly to expanded facilities
at The Woodlands School, and the increase in services and supplies is due mainly to
a greater outlay for pharmaceuticals in all units, together with a continual upward trend
in the price of foodstuffs, clothing, etc.
Perusal of the statements covering the various units of the Mental Health Services
will show increased costs as outlined above with the exception of the Home for the Aged,
Vernon. The decrease at this branch was caused substantially by a drop in the cost of
services performed there by the Department of Public Works.
Maintenance collections for the year totalled $1,724,046.70, as compared to the
1956/57 figure of $1,546,266.32, an increase of $177,780.38 or 11.5 per cent.
Dairy produce, meats, fruits, and vegetables to a value of over $460,000 were
purchased from the Colony Farm during the year.
The sum of $582,530.96 was expended for equipment, personnel, and staff-training
under projects approved by Federal Health Grants. Full particulars of these expenditures are covered by a statement included in this report.
The Department of Public Works let a contract in the amount of $281,765 for the
extension of the boiler-house at Essondale. During the last fiscal year a contract for
the structural steel and one of the two additional high-pressure boilers to be installed
was let.    Construction work on this extension started on June 17th, 1957.
The Department of Public Works also let a contract in the amount of $27,174 for
a new ash-handling system for the boiler-house. Work in this connection was completed by the end of the fiscal year.
A contract in the amount of $28,291 was also let for the new substation and overhead circuits for Essondale.
I am pleased to advise that the new nurses' home and training centre was completed
during this fiscal year, and the building accepted by the Government from the general
contractor on October 21st, 1957. Requisitions for the furniture and equipment for
this new building have all been prepared and are in the hands of the Purchasing Commission, which is expected to place the orders early in the next fiscal year.
I am also pleased to advise that the new auditorium and swimming-pool at The
Woodlands School was completed by the contractor and turned over to the Government
in November, 1957. Requisitions covering furniture and equipment for this building
have been completed and forwarded to the Purchasing Commission for attention. HEADQUARTERS
L 23
The new 300-bed unit and auditorium at the Home for the Aged, Port Coquitlam,
is very nearly completed, and requisitions for the furniture and equipment for this building have also been forwarded to the Purchasing Commission for attention.
The official opening of the new Mental Health Centre building, Burnaby, was held
on May 1st, 1957. Approximately 250 people attended the official opening, and a further
500 inspected the building during the evening. The Honourable W. N. Chant, Minister
of Public Works, and the Honourable W. D. Black, Provincial Secretary, attended the
official opening.
The Venture, our new male rehabilitation centre in Vancouver, was opened on
July 16th, 1957.    Mr. S. R. Curtis has been appointed supervisor for this unit.
On August 1st the Federal Government Agricultural Prices Support Board discontinued its subsidy of 21 cents per pound on butter. This subsidy amounted to approximately $3,500 per month for all units of the Provincial Mental Health Services, and its
discontinuance has been reflected in the increase in food costs.
We were advised by the Deputy Minister of Public Works and the Chief Architect
that he did not consider the Colony Farm Cottage building was any longer suitable for
the care of patients, and that this building should be vacated as soon as possible.
The coffee-shop at Pennington Hall, Essondale, was taken over by the Canadian
Mental Health Association volunteers on February 3rd, 1958, and is now being operated
by this organization.
I am pleased to be able to again report that during the fiscal year under review
a large number of improvements and additions to our plants and equipment were made.
I regret to have to again report that during this year, in spite of the large number
of improvements to major additions made, a great deal of difficulty is still being experienced by our Public Works Department in keeping up with our maintenance demands.
During the first part of the year a considerable amount of progress was made in this
regard; unfortunately, in the last half of the year, work was curtailed.
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 Provincial Mental Health Services. L 24
MENTAL HEALTH SERVICES REPORT,  1957/58
FINANCIAL TABLES
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, 1948/49 to 1957/58.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1948/49
Provincial Mental Hospital, New Westminster....
631.75
3,394.08
287.76
372.03
119.68
$800,776.92
3,162,819.02
356,110.21
339,606.91
150,706.50
$1,267.55
931.86
1,237.52
912.85
1,259.24
$3.47
2.55
3.39
Home for the Aged, Port Coquitlam	
2.50
3.45
Totals for the year	
4,805.30
$4,810,019.56
$1,000.98
$2.74
1949/50
Provincial Mental Hospital, New Westminster	
650.83
3,556.78
287.02
380.15
202.57
$891,944.27
3,500,902.41
384,874.24
374,093.25
215,009.96
$1,370.55
984.29
1,340.93
984.07
1,061.41
$3.75
2.70
3.67
Home for the Aged, Port Coquitlam	
Home for the Aged, Vernon— -	
2.70
2.91
Totals for the year   	
5,077.35
$5,366,824.13
$1,057.01
$2.90
1950/51
Provincial Mental Hospital, New Westminster.—
Provincial Mental Hospital, Essondale	
763.81
3,425.98
286.82
384.74
231.42
74.07
192.52
$1,081,062.76
3,419,312.37
388,744.44
437,282.20
244,853.02
139,016.27
525,256.87
$1,415.35
998.05
1,355.36
1,136.56
1,058.05
1,876.82
2,728.32
$3.88
2.73
3.71
3.11
Home for the Aged, Vernon  	
Home for the Aged, Terrace  -
2.90
5.14
7.47
5,359.36
$6,235,527.93
$1,163.48
$3.19
1951/52
Provincial Mental Hospital, New Westminster	
Provincial Mental Hospital, Essondale . 	
799.47
3,485.14
282.68
381.03
216.43
208.97
188.82
$1,284,649.25
4,021,001.69
407,123.16
504,668.17
309,649.05
265,697.50
689,466.11
$1,606.88
1,153.75
1,440.23
1,324.48
1,430.71
1,271.46
3,640.85
$4.39
3.15
3.94
3.62
Home for the Aged, Vernon  	
Home for the Aged, Terrace  	
3.91
3.47
9.95
5,562.54
$7,482,254.93
$1,345.11
$3.68
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  	
949.24
3,440.34
284.79
442.94
224.18
292.07
230.77
$1,590,703.00
4,441,278.38
433,108.50
617,445.55
384,971.73
325,842.57
759,406.04
$1,675.76
1,290.94
1,520.80
1,393.97
1,717.24
1,115.63
3,290.75
$4.59
3.54
4.17
3.82
4.70
3.06
9.02
Totals for the year.	
5,864.33
$8,552,755.77
$1,458.44
$4.00
1953/54
1,150.76
3,491.15
285.28
469.13
228.26
293.19
235.16
$1,768,922.31
4,393,682.65
421,622.61
683,511.48
378,006.20
330,968.40
788,302.36
$1,537.18
1,258.52
1,477.93
1,456.98
1,656.03
1,128.85
3,352.20
$4.21
Provincial Mental Hospital, Essondale 	
3.45
4.05
Home for the Aged, Port Coquitlam 	
Home for the Aged, Vernon	
Home for the Aged, Terrace  	
3.99
4.54
3.09
9.18
Totals for the year	
6,152.93
$8,765,016.01
$1,424.53
$3.90
1954/55
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
Provincial Mental Hospital, Essondale	
3.65
4.09
3.84
4.38
Home for the Aged, Terrace.   	
Crease Clinic  -	
3.04
9.88
6.301.19
$9,221,893.33
$1,463.52
$4.01 HEADQUARTERS
L 25
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, 1948/49 to 1957/58—-Continued.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1955/56
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	
4.19
4.10
Home for the Aged, Port Coquitlam 	
4.04
4.42
Home for the Aged, Terrace.  	
3.34
9.91
6,327.69
$10,293,638.92
$1,626.76
$4.44
1956/57
The Woodlands 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
Home for the Aged, Port Coquitlam	
Home for the Aged, Vernon _    ,
Home for the Aged, Terrace  „	
4.20
4.75
3.33
11.72
6,316.60
$11,125,468.64
$1,761.31
$4.83
1957/58
1,266.21
3,410.79
285.36
538.56
231.34
288.63
235.31
$2,484,024.86
5,716,745.90
460,863.85
898,225.93
395,584.86
379,826.63
1,077,897.96
$1,961.78
1,676.08
1,615.03
1,667.83
1,709.97
1,315.96
4,580.76
$5.37
Provincial Mental Hospital, Essondale	
4.59
4.42
4.57
Hnmfl for the Aged, Vernon __.. 	
Home for the Aged, Terrace . 	
4.68
3.61
12.55
Totals for the year.	
6,256.20
$11,413,169.99
$1,824.30
$5.00 L 26 MENTAL HEALTH SERVICES REPORT,  1957/58
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, 1958.
Gross operating costs—
The Woodlands School, New Westminster______ $2,484,024.86
Provincial Mental Hospital, Essondale  5,716,745.90
Provincial Mental Home, Colquitz  460,863.85
Home for the Aged, Port Coquitlam  898,225.93
Home for the Aged, Vernon  395,584.86
Home for the Aged, Terrace  379,826.63
Crease Clinic  1,077,897.96
Gross cost for all institutions  $11,413,169.99
Less collections remitted to Treasury       1,724,046.70
Net cost for all institutions     $9,689,123.29
Daily average population  6,256.20
Gross per capita cost, one year  $1,824.30
Gross per capita cost, one day  $5.00
Net per capita cost, one year  $1,548.71
Net per capita cost, one day  $4.24
Revenue (Patients' Maintenance Collections) of the Mental Health
Services for the Past Ten Years
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
1952/53 _____ 1,147,831.65 1957/58______ 1,724,046.70 HEADQUARTERS
L 27
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MENTAL HEALTH SERVICES REPORT,  1957/58
Table I.—Expense Statement of the Crease Clinic of Psychological Medicine,
Essondale, for Twelve Months Ended March 31st, 1958
Salaries, Supplies, and Operating Expenses
Net
Vouchered
Expenditure
as Per
Public
Accounts
Service and Supplies from
Other Departments
Headquarters
Public
Works
Department
Actual
Cost of
Operations
Yearly
per Capita
Cost
Travelling expense _
Office expense	
Medical care 	
Nursing and ward supplies-
Dietary ._
Heat, light, water, and power-
Laundry-
Cars and trucking  	
Occupational and recreational therapy-
Incidentals and contingencies-
Buildings, grounds, and general maintenance-
Totals	
$681.65
6,157.62
184,010.74
586,582.41
186,352.32
24,000.00
9,600.00
5,477.12
12,723.13
17,705.90
$4,506.22
31.77
$40,069.08
$1,033,290.89 I    $4,537.99    I    $40,069.08
       I I	
$681.65
10,663.84
184,010.74
586,582.41
186,352.32
24,000.00
9,600.00
5,477.12
12,723.13
17,737.67
40,069.08
$1,077,897.96
$2.90
45.32
781.99
2,492.81
791.94
101.99
40.80
23.28
54.07
75.38
170.28
^$47580776"
Expenditures Made under Federal Health Grants for Province of
British Columbia, Year Ended March 31st, 1958
Crease Clinic—Staff and personnel training
Mental Hospital, Essondale—
Equipment	
Staff and personnel training	
$108,501.63
$468.16
197,057.00
The Woodlands School, NewWestminster—
Equipment  $11,149.19
Staff and personnel training     97,763.25
Mental Home, Colquitz—Staff and personnel training......
Child Guidance Clinic, Day-hospital, North Burnaby—
Equipment-
Staff and personnel training.
$2,789.41
9,375.00
Assistance to Mental Health Centre, Burnaby—Equipment	
Neurophysiological Research Unit at University of British Columbia—
Pharmacological Analysis of Pathways Leading to Diffuse Enhancement of Cortical Electrical Activity of
E.E.G. Activation     $7,385.66
Aromatic Metabolism in Schizophrenia     13,274.56
Study of the Biochemistry of Schizophrenia     16,393.18
Structural  Identification  of  Aromatic   Compounds   in
Schizophrenic Urine     10,682.56
Workshop in Clinical Psychology  403.00
Home for the Aged, Port Coquitlam—Staff and personnel training
Home for the Aged, Vernon—Equipment	
School of Psychiatric Nursing	
Medical Film Library	
Rehabilitation Department 	
City of Vancouver, mental-hygiene programme	
Vancouver General Hospital 	
197,525.16
108,912.44
9,375.00
12,164.41
243.97
48,138.96
2,760.00
356.24
8,306.90
1,015.51
4,351.40
21,415.00
12,688.32 HEADQUARTERS
L 31
Jubilee Hospital, Victoria
$2,615.69
Consultants in surgery        13,200.00
British Columbia Mental Health Services—Visiting lecturers	
General personnel training—
Short courses in mental health  $3,155.56
Postgraduate training in clinical psychology  419.30
Postgraduate training in social work  14,001.57
Postgraduate training in psychiatry  5,571.40
Mental Health Committee—Training for senior school
counsellors   7,365.00
447.50
30,512.83
Total
$582,530.96 L 32 MENTAL HEALTH SERVICES REPORT,  1957/58
PERSONNEL REPORT
J. Dowling, Personnel Officer
During the fiscal year the approved establishment of the Mental Health Services
increased by 162 positions, as set forth in Table E of this report.
The number of persons on staff as at March 31st, 1958, was 165 more than on
March 31st, 1957 (see Table A).
Table B appended to this report provides a breakdown of separation and recruitment
activity.
Table C shows a comparison of staff totals with the preceding fiscal year, and
Table D provides figures and percentages showing the composition of the staff of the
nursing services by unit. Changes in establishment by division are summarized in
Table E.
There has been a marked improvement in recruitment in several vital areas, including
social services, psychology, occupational therapy, laboratories, and nursing. On monthly
average the number of job vacancies was approximately forty-three less than in the
preceding fiscal year.
Over-all staff turnover declined by 7.15 per cent. In the vital registered nurse
classifications, however, turnover has risen by 7.32 per cent to the alarming figure of
59.7 per cent. Steps have been taken to correct this situation, but further investigation
is required.
The average monthly student enrolment in the School of Psychiatric Nursing has
been twenty-eight less than in the preceding year. While this is regarded as unsatisfactory, it is not serious since student enrolment as of March 31st, 1958, at 222, is above
the comparable figure in the two preceding years. The decline in the monthly average
enrolment reflects inadequate recruitment in the preceding fiscal year. Student separations due to resignations, failures, etc., have dropped by 7.47 per cent this year to
24.73 per cent.
Positive steps have been taken over the past two years to curb abuses of the sick-
leave regulations in the Essondale area. The test area involves approximately 1,900
employees. Unusually high absenteeism occurred during the month of October, 1957,
due to widespread incidence of Asiatic flu. Notwithstanding this, the average number
of days sick-leave per person per year declined from 8.34 days in 1956/57 to 6.64 days
in 1957/58. While the decline in the rate of absenteeism has been fairly steady throughout the year, it accelerated during the period November 1st, 1957, to March 31st, 1958.
This indicates that the introduction of the five-day work-week for psychiatric nursing
staffs has been a factor in the over-all reduction.
The Public Services Medical Plan became effective on November 1st, 1957. The
staff responded enthusiastically to this measure, and employee registration and payroll
implementation was carried through without difficulty.
The following matters of some importance were dealt with during the year:—
(1) A five-day forty-hour week for psychiatric nurses and aides was implemented, effective October 1st, 1957, with an increase in establishment of
seventy-seven positions.
(2) A detailed study of the Crease Clinic and the Mental Hospital, Essondale,
nursing staff organization was completed.
(3) A study was made of staff requirements for the 375-bed Fraser View
unit of The Woodlands School.
(4) A study of the entire staff organization of The Woodlands School was
started, but was incomplete at the close of the fiscal year.
Significant personnel figures are provided in the tables appended to this report. f
HEADQUARTERS L 33
Table A.—Summary Showing Over-all Staff Totals in Relation
to Separation and Recruitment
Staff recruited, excluding students      884
Staff separated, excluding students       723
Increase       161
Total staff, excluding students, as of March 31st, 1958  2,581
Total staff, excluding students, as of March 31st, 1957  2,420
Increase       161
Monthly staff average, excluding students, 1957/58   2,541
Monthly staff average, excluding students, 1956/57   2,336
Increase       205
Male        Female Total
Student enrolment as of March 31st, 1958  54        168 222
Student enrolment as of March 31st, 1957  46        172 218
Change    +8 —4 +4
Students, monthly average, 1957/58   186
Students, monthly average, 1956/57   214
Decrease         28
Panels held during the year were as follows:—
Appointments and promotions—
Number of interviews       300
Number of competitions         89
Disciplinary—■
Number of panels         17
Number of cases reviewed        49 L 34
MENTAL HEALTH SERVICES REPORT,  1957/58
Table B.—Showing a Breakdown by Classification of Recruitment and Separation Activity for All Branches of the Provincial Mental Health Services.
Excluding Student Psychiatric Nurses.
Recruited Separated
Physicians      17 17
Medical interns       5 4
Registered nurses     40 40
Female psychiatric nurses  171 134
Male psychiatric nurses     66 55
Female psychiatric aides  199 169
Male psychiatric aides  167 108
Teachers        1 1
Occupational therapists      12 5
Recreational therapists        1 	
Industrial therapists   	
Psychologists   11
Social workers  .__ 24
Dieticians  3
Cooks   6
Kitchen helpers  17
Clerks   17
Stenographers   36
Trades   1
Laundry-workers   8
Miscellaneous professional   10
Miscellaneous technical  7
Miscellaneous   58
Farm labour  7
1
11
13
5
6
9
17
34
4
6
8
8
60
8
884
723
Percentage Turnover
1955/56     1956/57 1957/58 Change
Overall  30.15        35.60 28.45 —7.15
Student psychiatric nurses ____ 27.18        32.20 24.73 —7.47
Male psychiatric nurses     9.50        14.67 13.44 —1.23
Female psychiatric nurses.___ 27.38        35.63 35.63 0.00
Registered nurses          52.38 59.70 +7.32
(Note.—Items 1 and 2 have been calculated against the monthly average and other
items have been calculated against the year-end staff count.) HEADQUARTERS
L 35
Table C.—Comparison of Staff Totals by Unit with Totals for the
Preceding Fiscal Year
Division
Fiscal Year 1956/57
Positions
in
Estimates
Positions
in
Establishment as of
Mar. 31,
1957
Positions
Filled as
of Mar. 31.
1957
Fiscal Year 1957/58
Positions
in
Estimates
Positions
in
Establishment as of
Mar. 31,
1958
Positions
Filled as
of Mar. 31,
1958
Colony Farm _
Colquitz Farm 	
Total of vote-
Headquarters	
Preventive Services	
Crease Clinic	
Provincial Mental Hospital, Essondale..
The Woodlands School. 	
Provincial Mental Home, Colquitz..	
Total of vote  - 	
Mental Health Centre   _ 	
Home for the Aged, Port Coquitlam..
Home for the Aged, Vernon 	
Home for the Aged, Terrace	
Total of vote  	
School of Psychiatric Nursing (Faculty)-
Totals (Civil Service positions)..
Student-Nurses (non-Civil Service)	
Totals   	
60
9
53
53
69
61      |
61
31
29
60
53
53
291
1,279
837
78
285
1,150
530
76
272
,068
513
77
2,485
2,041
1,930
34
37
31
217
80
63
189
77
59
187
75
54
360
325
316
.      |              |       	
3,039'
2,546
2,420
|         ....      |         218
3,039
2,638
I
53
7
52
7
60
60
61
56
286
1,154
750
77
297
1,178
750
81
2,267
I
190
77
60
196
79
59
225
3,034
58
51
284
1,092
616
81
2,306 2,073
185
80
55
327
334
320
12
12
12
2,80=1
2,842
2,581
222
2,803
1 Effective April 1st, 1957, the School of Psychiatric Nursing was transferred to a separate vote.
Table D.—Showing Composition of Nursing Staffs by Unit as of
March 31st, 1958
Registered
Nurses
Psychiatric
Nurses
Students
Psychiatric
Aides
Number
Per
Cent
Number
Per
Cent
Number
Per
Cent
Number
Per
Cent
Female Division
40
11
6
2
1
3
7.4
8.2
2.0
1.6
2.5
42.9
157
48
109
50
9
3
28.9
35.8
37.1
41.7
22.5
42.9
130
20
10
8
23.9
15.0
3.4
6.7
216
55
169
60
30
1
39.8
41.0
57.5
50.0
75.0
14.2
543
Crease Clinic    	
The Woodlands School	
134
294
120
Home for the Aged, Vernon  	
40
7
63
5.5
376
33.0
168
14.8
531     |    46.7
1,138
Male Division
1
2.4
188
45
85
41
33
7
9
1
53.1
48.4
36.8
65.0
55.9
35.0
22.0
100.0
27
14
7
6
7.6
15.1
3.0
10.2
139
34
139
22
20
13
31
39.3
36.5
60.2
35.0
33.9
65.0
75.6
354
Crease Clinic 	
The Woodlands School	
93
231
Provincial Mental Home, Colquitz	
Home for the Aged, Port Coquitlam.   „    .
63
59
Home for the Aged, Vernon   	
20
Home for the Aged, Terrace ...
41
Mental Health Centre	
1
Totals ,
1
0.1
409
47.4
54
6.3
398
46.2
862 L 36 MENTAL HEALTH SERVICES REPORT,  1957/58
Table E.—Summary of Establishment Changes During Fiscal Year 1957/58
Positions Positions
Division                                                                                                 Added Deleted
Headquarters   	
Provincial Mental Hospital, Essondale     42 65
Crease Clinic     10 16
The Woodlands School  222 38
Provincial Mental Home, Colquitz       5 	
Mental Health Centre       7 3
Child Guidance Clinics       4 2
Home for the Aged, Port Coquitlam       7 10
Home for the Aged, Vernon       2 2
Home for the Aged, Terrace  	
Farms staff    1
Totals  299 137
Net increase, 162.
Approved establishment as of April 1st, 1958  2,708
Approved establishment as of March 31st, 1957  2,546
1
Total      162 HEADQUARTERS L 37
REPORT OF THE PROVINCIAL SUPERVISOR
OF PSYCHIATRIC SOCIAL WORK
Miss A. K. Carroll, Provincial Supervisor
The past year has been one of challenge for social services throughout the various
units of the Mental Health Services. Staff shortages due to vacancies have continued to
restrict the social service programme in all units with the exception of one. In addition,
the approved establishment for social workers in institutional units has for some considerable time been insufficient to meet the need for expansion of services which has
been demonstrated in these units.
The need to increase social service coverage in the Provincial Mental Hospital and
Crease Clinic derives in large part from the response of patients to the new psycho-
pharmacological treatments, which enable greater numbers to be discharged, provided
sustaining help is available through social service. In The Woodlands School the
programmes of patient assessment and segregation and the expansion of facilities for
education and vocational training for high-grade mental retardates have resulted in
greater numbers being ready for discharge and rehabilitation, provided that continuing
help in procuring jobs, arranging accommodation, and extending support over the period
of adjustment is available from social service.
Although it is generally acknowledged that the community should assume the major
responsibility for social services to discharged mental patients, in reality this is rarely
possible.
Recent research undertaken by this officer, involving the rehabilitation of eight
female patients from the long-term treatment unit of hospital, amplifies the aforementioned situation. Four of the eight patients were readmitted to hospital or clinic
within six months of discharge largely because the specific social service resource they
needed was not available in the community.
Of the four patients who returned, one did so because of the lack of a resource for
the economic provision and continuing supervision of her medication. Another returned
because her need for a family-care type of boarding home was not available. A third
returned because of the lack of a vocational training resource, and a fourth patient
returned because there was no provision for a sheltered workshop or homework programme. Had such a resource as the latter existed, it would have met this patient's need
and resulted in a relatively stable adjustment to living in the community.
In all eight instances these patients were unable to locate work through use of the
established community employment service. Grave shortages in suitable accommodation
at rents which the patients could afford were very evident. In most instances these
patients were forced to take accommodation in premises which failed to meet criteria
designed to promote and sustain sound physical, emotional, and social health.
In six cases the living accommodation patients were forced to accept was at a much
lower social level than that to which they had been used prior to illness or during
hospitalization. In all instances of patients, referral to existing community resources for
counselling and social services could not be effected due to the facts of their being
individuals detached from a family group or because the residual of illness was such as
to preclude them from a casework helping relationship. For six patients there were no
outlets for recreation or friendship. In two cases, patients were able to find this through
their religious affiliation.
One of the most frequent causes of distress during the early stages of rehabilitation
was loneliness. However, more distressing was the lack of adequate financial assistance
for the patient over the initial period encompassing discharge from hospital to the receipt
of the first week's pay.   Next in stress came the need for varieties of accommodation, L 38 MENTAL HEALTH SERVICES REPORT,  1957/58
ranging from the subsidized family-care home, short-stay supervised midway homes for
small groups of patients, personal homes, and nursing and boarding homes.
Each case required on an average of 21V_v hours of social-work time from the point
of discharge from hospital to procuring accommodation. Each case required an average
of twenty hours twenty-five minutes of social-work time in locating employment. In the
four instances of patients completing the period of probation, an average of thirty-two
hours forty-five minutes of social-work time was required in patient counselling.
In all social service units of the Provincial Mental Health Services, consultation has
been requested on:—
(1) The supervisory and staff development processes.
(2) Family-centred social services to patients, content, method, and focus.
(3) Developing co-operative service policies with community agencies (the
community organizational aspects of the social-work job).
(4) The exploration and development of vocational training facilities for
patients.
(5) The management of cases at the point of intake and discharge of patients.
During the year there have been a number of meetings with community agencies
geared to exploring public welfare services and establishing procedures for co-operation
between the Mental Health Services and community social welfare resources in an
attempt to establish and extend more effective after-care services to patients discharged
from psychiatric institutions. Public health and welfare administrators particularly are
interested in effecting such co-operation. Out of a meeting with public welfare administrators, it was concluded generally that the extension of community services in the aftercare of mental patients did call for the appointment of additional social-work staff
either at the level of co-operating community agencies or within the Mental Health Services. Public welfare administrators indicated that patients on probation and former
patients already being served by co-operating community agencies were in need of additional services often beyond the functions of the agencies serving them, and that consideration needed to be given by the Mental Health Services and co-operating agencies
as to their provision.
The Family Service Agency of Greater Vancouver, an agency operating in the
field of voluntary effort, has given generously of its thinking and time in arriving at
criteria for referral of patients to this valuable community service.
During the year the recruitment of social-work staff in collaboration with the
Personnel Officer of the Civil Service Commission has continued to present difficulties
due to an inability to compete with social-work salaries offered by other agencies. In
some instances these difficulties have been temporarily surmounted by offering Federal
Mental Health bursaries for further study in the School of Social Work. These grants
on occasion have proven an incentive to accepting social-work positions despite irregularities in salary. During the year seven social workers on staff were granted Federal
Mental Health bursaries and will return to fill vacant positions in the social service units
early in the next fiscal year.
Eight students of social work had their field practice placement in the social service
units of the Mental Health Services. The close working collaborative relationship which
exists between student supervisors in the social service departments of the hospital and
clinics and the School of Social Work faculty has resulted in a sharpening of professional
skills and a further growth in professional competency on the part of staff, which has
been of signal benefit in improving social services to patients and relatives.
In on-going co-operation with the Faculty of Medicine, the School of Nursing, and
the School of Psychiatric Nursing in their programmes for student education, this officer
has contributed eleven one-hour sessions to fourth-year medical students, ten IVi-hour
sessions to psychiatric nursing students, and two three-hour sessions to affiliate nursing HEADQUARTERS L 39
students. These sessions were focused on the contribution of social work in the
multidisciplinary treatment setting of psychiatric hospitals and clinics.
The monthly reports of social-work supervisors and casework supervisors on
services to patients and relatives have continued to be of a very high order. Descriptively
and statistically, these reports give a definitive picture of case-flow, services, and functions in social service departments. The work of the supervisors' councils has been very
commendable, especially in regard to recommendations concerning essential content and
summarization of recording, the simplification of statistical method, and the essential
content of family-centred social services.
During the year this officer had the pleasure of serving as social worker with the
Child Guidance Travelling Clinic in clinical services to health and welfare agencies in
Trail, Vernon, Nelson, Prince George, and Dawson Creek. The cases presented had
been selected with care and skill and were largely representative of serious behaviour
disorder due to stressful parent-child relationships. In some instances the stresses in the
parent-child relationship were due to factors of mental retardation and concomitant poor
social and emotional development in the child. It would appear that the Child Guidance
Travelling Clinic service could give valuable assistance to many communities in exploring
their resources for diagnosis and treatment and bringing in additional service in support of
or in extension of those resources existing in community. Most community health and
welfare agencies expressed a need for the extension of treatment services. Some communities thought that treatment resources were available to some extent, but these could
benefit from periodic consultation from the travelling clinic.
During the year technical material has been written and submitted covering: —
(1) Co-operative Policy and Procedures between The Woodlands School,
Community, and Health and Welfare Agencies.
(2) Forms and Operational Procedures Current in a Care Programme for
Boarding-out Care of Mental Defectives.
(3) Form for Voluntary Admission of a Mentally Defective Person as a Nonresident Day Pupil to The Woodlands School.
(4) A Project to Develop Social Service Staff for Work in Rehabilitation
of the Mentally Retarded. L 40 MENTAL HEALTH SERVICES REPORT,  1957/58
REPORT OF SCHOOL OF PSYCHIATRIC NURSING
Miss M. Kenny, Associate Director of Nursing Education
This year 140 students enrolled in the School of Psychiatric Nursing; of these, 108
were women and thirty-two men. The total number of graduates was eighty-four; of
these sixty-seven were women and seventeen men. Although the number of women
graduates increased by five over last year, the number of men decreased by six, which
is regrettable considering the need for male nurses.
A recruiting committee was formed in conjunction with the Psychiatric Nurses'
Association.   It is presently compiling material to be used for publicity purposes.
The Association for Retarded Children contributed by sponsoring and planning
two recruiting tours, enabling our Nursing Counsellor, Mrs. E. Gibson, to speak to many
groups of high-school students in the Interior.
Mrs. Gibson also spoke to groups of high-school students and Future Nurses' Clubs
in Greater Vancouver and Fraser Valley areas.
A ten-hour refresher course in ward administration and supervision, in preparation
for the eligibility examinations conducted by the Civil Service Commission, was made
available to all graduate nurses at Essondale, The Woodlands School, Terrace, Vernon,
and Colquitz. Mr. Nash, a member of the teaching staff, conducted the course outside
the Essondale area.
Much work has been directed toward establishing a strong clinical teaching
programme which will give the students approximately two months of supervised clinical
experience in nine fields of learning.
The instructors have made further contributions in the preparation and grading
of eligibility examinations. Summer and holiday relief for the nursing service supervisory
staff has been supplied.
During the year 185 student-nurses from general hospitals and thirteen graduate
nurses received a two-month affiliation with this hospital. The student-nurses are from
seven schools of nursing in the Province and are represented in ratio to total student
population.
The graduate nurses, coming from areas as far east as Manitoba, have enrolled
primarily to correct a deficiency in their basic programme.
Twenty-six requests for postgraduate study were received from different areas of
Canada and the United States. Many requests for a one-month affiliation have been
received from nurses who, having had two months, feel that another month would be
invaluable because of additional experience, and desirable because three months is a
prerequisite to registration in the United States.   All of these requests had to be refused.
The expanding affiliation programme has necessitated a second instructor. The
number of students has greatly increased since 1935, and there has been an increase
in the following areas: (a) Hours of lectures; (b) tours and class projects; and
(c) clinical supervision.
The students now receive their clinical experience on fourteen wards. However,
there is need for strengthening of the supervision for these students.
The fact that the Hospital is not dependent on the affiliate students for nursing
service has placed this programme on a firm educational foundation. However, it is
recognized that educationally speaking this programme should be of three months'
duration.
The staff of instructors is grateful to the members of other departments who have
contributed so generously to the teaching programme of the students. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
L 41
PART II.—CREASE CLINIC OF PSYCHOLOGICAL MEDICINE
AND PROVINCIAL MENTAL HOSPITAL
REPORT OF THE CREASE CLINIC OF PSYCHOLOGICAL
MEDICINE
T. G. Caunt, Medical Superintendent
The Crease Clinic has now been in operation seven years. It continues to function
effectively and provides a valuable service for the treatment of the mentally ill of this
Province. The Clinic deals largely with short-term treatment, patients not being permitted to remain for a period longer than four months. Most remain for a much
shorter period.
The magnitude of the problem of maintaining mental health throughout our
Province must continue to be stressed. Examination of the following table, which is a
summary of the movement of population in the Crease Clinic for the fiscal year ended
March 31st, 1958, shows that the number of patients admitted increased by twenty-four
patients over the previous year. In the fiscal year ended 1952 the admission rate to
the Crease Clinic was 963, as compared to 1,488 admitted to the Clinic this year.
There appears to have been some slight levelling off of admissions to the Clinic since
the fiscal year ended 1956, when our admission rate was 1,627. The table shows the
number in residence at March 31st, 1957, as twenty-six less than those in residence
March 31st, 1958, due to a fairly heavy inflow of patients toward the end of the fiscal
year.
Male
Female
Total
Total in residence, March 31st, 1957	
Total admissions during year 1957/58-
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, 1958  	
95
597
453
144
295
247
48
588
533
55
3
101
131
891
643
248
468
378
90
867
823
44
4
151
226
1,488
1,096
392
763
625
138
1,455
1,356
99
7
252
There has continued to be screening of the patients admitted in order to provide
the services best suited to the patients' needs and to prevent the admission of unsuitable patients. Dr. Robert Halliday, Assistant Clinical Director, was in charge of this
procedure. He provided a very useful service to community physicians regarding the
suitability of patients for admission.
Voluntary admissions remained fairly high, 763 patients or 50 per cent of the total
admitted. This is a decrease over the previous year, when there were 798 or 54 per cent
of the admissions.
There are many more female patients admitted to the Crease Clinic than male
patients. The above table shows 597 male and 891 female patients were admitted to the
Clinic in the fiscal year—that is 294 or 19.7 per cent more female patients. This is the
reverse to what we find in the Provincial Mental Hospital, where more male than female
patients are admitted.
The fact that there are more female patients admitted to the Clinic provides many
problems in their treatment and management.    The female wards in the Clinic are L 42 MENTAL HEALTH SERVICES REPORT,  1957/58
usually taxed to their treatment capacity most of the time, and frequently there is overcrowding. Ninety-seven patients were admitted to the Provincial Mental Hospital from
the Crease Clinic or 6.7 per cent of Crease Clinic discharges. Patient separation from
the Clinic was very good—a total of 1,455 were discharged during the fiscal year.
The treatment programme is functioning very effectively under the direction of
Dr. Ian Kenning, Clinical Director. There have been difficulties experienced due to the
patient overload and shortages of senior specialist medical staff. Every department of
the treatment team has also experienced difficulties in securing trained personnel. This
was very noticeable in the supervisory levels of the nursing service.
We are pleased to report the appointment of Miss Olive Curtis as Occupational
Therapy Supervisor. This department is functioning well but will be more effective
when it is possible to consolidate the department in the West 1 area.
There continues to be considerable use made of the tranquillizing drugs in the
treatment of patients. Coma insulin continues to be used, but not to its former extent.
It was thus possible on June 28th, 1957, to close down the male and female coma
insulin wards in the Centre Lawn Building of the Provincial Mental Hospital and
transfer Provincial Mental Hospital patients to the Clinic for this type of treatment.
OPERATING-ROOM
Dr. Cave, the surgical resident this year, has organized the work very well. This
department is overcrowded and there is need for increased surgical ward space. During
the year there was a total of 581 operative procedures carried out in the operating-room.
This is twenty more than in the previous year. The operative procedures in summary
were:—
Major operations  108
Minor   operations     190
Or.hopa.dic operations     62
Applications of plaster      71
Neurosurgery operations       35
Genito-urinary operations     58
Eye, ear, nose, and throat procedures      33
Miscellaneous operative procedures      24
Total   581
The Clinical Director will give more details in his report following, touching on the
educational programme for the medical students, medical staff, and the programme
and needs of the treatment team.
DEPARTMENT OF NEUROLOGY
The Department of Neurology, under the direction of Dr. W. P. Fister, reports
an active year. This Department provides both a clinical and laboratory service for
the whole of the Provincial Mental Health Services. In addition, laboratory services
are offered to such Provincial and Federal institutions as the Girls' Industrial School,
Haney Correctional Institution, New Haven, Oakalla Prison Farm, and occasionally
to the British Columbia Penitentiary.
The clinical work is concerned with the investigations and treatment supervision of
psychiatric patients whose psychopathology rests in part or in whole on an organic background. A noticeable group amongst these is composed of patients with focal epileptic
seizures, who are ultimately treated by neurosurgical procedures. The steadily increasing
number of such patients is probably a reflection of the fact that the Provincial Mental
Health Services provide the only agency where surgery of epilepsy is at present carried
out in British Columbia. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
L 43
The extent of the laboratory work for the year  is  itemized  in the  following
tabulation:—
Total number of electro-encephalograms   1,379
Total number of pneumo-encephalograms
Operations 	
Lectures—
To medical students	
To nurses	
  189
  35
  24
  7
  1
  1
  1
The 1,379 electro-encephalograms were done for the following groups:—
Provincial Mental Hospital   444
Crease Clinic   668
To students of abnormal psychology
To physiology students 	
To Child Guidance Clinic	
Staff 	
Girls' Industrial School
Oakalla  	
British Columbia Penitentiary _.
New Haven 	
Haney Correctional Institution..
The Woodlands School 	
Out-patients 	
Child Guidance Clinic 	
13
45
29
1
3
3
144
27
2
Total
1,379
LIBRARY
The Crease Clinic library is under the direction of our librarian, Miss H. M. Walsh.
There has been a decrease in the circulation and service during this year due to a
shortage of staff. The library is now functioning five days a week instead of six, and
the hours during the day have been decreased considerably. Any patient in the Hospital
may obtain a library book and newspapers, and there are fifteen current magazine
subscriptions, which are particularly appreciated.
Approximately 3,000 books are on the library shelves or in circulation. This
figure is maintained fairly constantly, new books and donations being balanced by discards, losses, and books sent to the North Lawn tuberculosis wards. This year 201 new
books were bought (compared to 393 last year), 169 were donated, and 150 were sent
to North Lawn.   The circulation was 12,447, compared to 14,293 last year.
In the medical library very little progress was made in the recataloguing, which is
only about one-third completed. It is open from 8.30 a.m. to 4.30 p.m., except for the
lunch period, and closes alternate Mondays and Saturdays, so that the same group of
doctors will not be deprived of access to medical books one day each week. Some
outdated editions were removed from the shelves, leaving approximately 2,000 books
in the library, excluding sets of eighty-eight medical and psychiatric periodicals. There
was no drop in circulation in the medical library, with 881 books given out and 140 new
books ordered, including those for the laboratory. Eighty-seven books were received
from the University of British Columbia on interlibrary loan, and several books were
received from other universities. Since there is no staff for the medical libraries of
The Woodlands School, the Mental Health Centre, or the School of Psychiatric Nursing,
the librarian assisted them in such matters as ordering books. Visiting professional
people frequently remark on the excellence of the medical collection in the Crease
Clinic library. L 44 MENTAL HEALTH SERVICES REPORT,  1957/58
REPORT OF THE PROVINCIAL MENTAL
HOSPITAL, ESSONDALE
REPORT OF THE MEDICAL SUPERINTENDENT
T. G. Caunt, Medical Superintendent
The Provincial Mental Hospital continued to function very efficiently during this
fiscal year. The increasing patient admission rate may be taken as further evidence
of public awareness of mental illness in the community and of the facilities and services
provided by the Provincial Health Services for the purpose of treatment. The Hospital
facilities have operated at capacity, and occasionally there has been an overload of
patients on the admission wards, necessitating a very rapid movement of patients.
Some advances have been made in the housing and treatment of patients, but
further improvements are strongly recommended in patients' housing, especially in the
male and female continued-treatment areas, where the accommodation is overcrowded.
The treatment team would operate more efficiently with the addition of more
specialists in psychiatry and more supervisory personnel in both the male and female
nursing divisions.
The regularly accepted types of treatment are being routinely used. The various
types of ataractics are being used fairly extensively with satisfactory results. There has
been less demand for coma insulin, though this is still used in the Crease Clinic, where
we operate male and female coma insulin wards.
In treatment, the team approach continues to be emphasized with patient self-help.
Each division of the team has contributed a great deal, and every department's
assistance is vital to the patient's recovery.
The activation and mobilization of the patient population continues to increase.
More wards have been opened and an increasing number of patients have grounds
privileges.   Occasionally over 2,000 patients are enjoying this privilege on the grounds.
More visitors and groups visit the Hospital each year, and the volunteers of the
British Columbia Division of the Canadian Mental Health Association continue to grow
in numbers. They are doing excellent work on the wards and with the recreational and
occupational therapists. The volunteers are active in Pennington Hall, the apparel-shops,
and the Pennington Hall coffee-bar, which they are now operating.
. Each year there is a noticeable increase in the number of patients who leave the
Hospital with relatives or friends for short visits of a day, week-end, or several days in
the community. Visiting at the Hospital by relatives and friends any day of the week or
Tuesday evenings is also encouraged. Visiting is of great assistance in a patient's recovery
and successful rehabilitation.
There is still a considerable movement of staff in all departments. The Headquarters
Personnel Officer's report will show this movement in detail.
Movement of Population
The following table gives a summary of the movement of population of the Provincial Mental Hospital for this year:— CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
L 45
Men
Women
Total
1,814
782
1,645
586
3,459
1,368
640
89
617
54
1,257
143
729
671
1,400
In residence, March 31st, 1958.	
1,862
1,546
3,408
In residence, April 1st, 1957—
Men            	
1,814
1,645
273
Remaining on escape.-    	
5
Total on books, April 1st, 1957.	
Admissions from April 1st, 1957, to March 31st, 1958	
	
3,737
1,368
|                 5,105
Admissions—
520
9
155
6
78
4
2
8
461
13
102
1
8
1
981
22
Voluntary-   -	
257
Yukon  	
7
Order in Council—	
86
4
3
Transferred from Provincial Mental Home	
8
782
586
1,368
The admission services of the Provincial Mental Hospital continue to be extremely
busy dealing with a gradually increasing number of patients.
It is interesting to examine the total admissions to the Provincial Mental Hospital.
One thousand three hundred and sixty-eight patients were admitted, an increase of 109
patients over the previous fiscal year. It will be noted in the above table that the total
in residence on April 1st, 1957, was 3,459 patients, and that the total in residence on
March 31st, 1958, was 3,408 patients, a reduction of fifty-one patients. This indicates
that we separated 160 more patients than we did during the previous fiscal year. It is
interesting to note that the male admissions to the Provincial Mental Hospital continue
to lead, with a total of 782 patients as against 586 female patients. The average monthly
admission rate was 113 patients.
It would appear that these admission trends will continue. Since more female
patients are admitted to the Crease Clinic than can be handled adequately with the
accommodation available there, it will be necessary to transfer some of these patients to
the Provincial Mental Hospital for treatment. There were ninety-seven patients from the
Crease Clinic transferred to the Provincial Mental Hospital this year, an average of
eight per month.
The percentage of patients recovered or improved, as compared to admissions, was
68.9 per cent. This is a slight increase over the previous year, when the rate was 67.5
per cent. The percentage of deaths to the number under treatment remains unchanged
at 2.8 per cent. The percentage of discharges to admissions (exclusive of deaths) was
90.5 per cent, a slight increase over the previous year's figure of 89.2 per cent. The
daily average population was 3,404.7, a reduction of 98.9 from the previous fiscal year,
when the daily average population was 3,503.6.
It is interesting to note the total number of patients in residence on April 1st during
the past few years: In residence, April 1st, 1955, 3,524; in residence, April 1st, 1956,
3,533; in residence, April 1st, 1957, 3,459;   in residence, April 1st, 1958, 3,408.
During this year eighty-four Order in Council patients were admitted from the
Provincial gaols or Court. On March 31st, 1958, there were forty-two Order in Council
cases remaining in Hospital. L 46 MENTAL HEALTH SERVICES REPORT,  1957/58
On March 31st, 1958, we had in this Hospital the following Federal cases still
requiring treatment:—
British Columbia Penitentiary patients       4
Yukon Territory patients     23
Department of Indian Affairs patients     80
Department of Veterans' Affairs patients  253
Imperial veterans (D.V.A.)       1
Total Federal cases  361
This is a reduction of seventeen cases over the previous fiscal year, when this total
was 378 cases.
Clinical Services
The clinical services, under the direction of Dr. I. S. Kenning, Clinical Director,
have had an extremely active year. I would refer you to the Clinical Director's report
for fuller details.
All departments and personnel of the treatment team have co-operated and functioned extremely well in the treatment programme.
It is noticeable that fewer lobotomies are being done now—only four were performed during the fiscal year—and that electroconvulsive therapy is being used to a lesser
extent than formerly. Ataractics are used fairly extensively now. Psychotherapy,
individually and more commonly group therapy, is used whenever possible.
It is difficult for the Clinical Director to introduce any new projects which require
psychiatric or nursing staff. This shortage is felt, especially from June each year, when
many junior medical resident staff members leave the Hospital to continue their specialist
training at other medical centres.
The transfer of the Provincial Mental Hospital's male and female insulin treatment
wards to the Crease Clinic made it possible to convert the space vacated in the Centre
Lawn Building to another open ward, D 3 Annex, for men. This ward was completely
refurnished and is operating efficiently for male patients preparing for discharge.
The Venture, men's rehabilitation centre in Vancouver, was opened on July 16th,
1957, and has operated successfully. It is operated on similar lines to the Vista, women's
rehabilitation centre in Vancouver, which was opened several years ago. The Venture
accommodates an average of seven male patients, on visit to the city seeking employment,
and acts as a half-way home between the Hospital and the community. When employed
successfully and progressing satisfactorily, the patient is discharged from the Venture.
We are very fortunate in having an excellent husband and wife team operate the Venture,
which is supervised by the Clinical Director.
We regret the loss of one specialist in psychiatry this year, when Dr. N. Mason
Browne resigned to enter private practice.
Nursing Services
There have been many changes of personnel in both the women's division and men's
division of the Department of Nursing. The resignation of Miss E. M. Pullan, R.N.,
Director of Nursing, in January, 1958, has left a vacancy most difficult to fill. This has
added considerably to the problems of nursing administration in the women's division.
The shortage of qualified nursing staff for senior positions has been serious this past year.
In the women's division, ward manuals were completed and placed on all the wards.
They are proving to be valuable tools in ward administration. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
L 47
The nursing staff has focused its attention on the ward environment, trying to make
it as near normal as possible. Numerous changes have taken place in the East Lawn
Building, women's division, in reorganizing the patient-groups. The patients are
encouraged to regard assisting in the Hospital departments as desirable and important
in its relation to successful living. The importance of social activities is also stressed, as
well as the emphasis on development and independence where possible as an aid to
rehabilitation. Since December, when it became necessary to reduce the staff quota on
almost all the wards, it has become increasingly difficult to maintain this desired level of
nursing care, and on several occasions large groups of patients have been denied the
opportunities of taking part in activities away from the ward. Regrouping of patients
in the East Lawn Building has assisted the staff in organizing patient-care.
Further wards have been opened. Throughout the Hospital it is very noticeable
that every attempt is being made to eliminate the use of the locked door whenever
practical. It is now possible to travel between many wards without using a key to unlock
the once locked doors. The members of the nursing staff have been greatly encouraged
by these changes and are more enthusiastic, display more initiative, and are more ready
to try new ideas.   To maintain this standard requires more nursing care rather than less.
Some nursing staff members attended a University of British Columbia course in
group development. The Registered Nurses' Association of British Columbia offered
an institute on improving clinical experience, and this was attended by four members
of the Nursing Education Department and two members of the Nursing Service.
An attempt is being made to reduce the number of patients in some of the continued-
treatment areas. The Riverside Cottage has been reduced by one-third, and it is hoped
to gradually reduce this count and evacuate the building as soon as possible.
The Nursing Division interviews an average of 185 patients a month in regard to
extending grounds privileges. During the past year 2,219 patients were interviewed
and given grounds privileges. This function by the grounds supervisors of the Nursing
Division is very time-consuming. The Hospital grounds may now be thought of as the
largest ward of the Hospital. Owing to the increasing number of patients on the grounds,
more grounds supervisors will be required in order that they may be effective.
The patients' activities and freedom have been increased, and their appearance
has been improved by means of clothing supplied by the volunteers and by the work of
the hospital barbers and hairdressers. In the women's division the beauty-parlour reports
having given 38,690 beauty treatments, such as haircuts, sets, permanents, etc., during
the fiscal year.
In June the Canadian Council of Psychiatric Nurses' Association met at Essondale.
We were most fortunate in having Mrs. J. Lundahl, R.N., Assistant Director of
Nursing, take charge of the women's division of the Department of Nursing during the
absence through illness and following the resignation of the Director of Nursing. Mrs.
Lundahl has done a very good job during a period of some difficulty, and I am pleased
with the wonderful co-operation of the Nursing Division and that of other departments
during this period.
Psychological Services
The Department of Psychology, under the direction of Mr. J. W. Borthwick, is an
extremely important member of the treatment team and has been of great assistance,
though the department has operated for the year with only 70 per cent of its establishment of eight psychologists. For this reason it was impossible to meet all the demands
of the Hospital. The Department had only five to six staff members most of the time,
often one or two of these members being fairly new-comers. Altogether, 557 psychological reports were prepared. These were based on the administration of 1,473 separate
tests.   Group therapy was conducted for six hours weekly for both neurotic and psychotic L 48 MENTAL HEALTH SERVICES REPORT,  1957/58
patients. Numerous lectures on psychological topics were delivered to both intramural
and extramural groups. Research was limited to participation in one formal research
project, an evaluation of the behavioural effects of perphenazine. This department has
provided an excellent service, considering the staff shortage. With such shortages it is
not possible to satisfy all the demands of the Hospital and at the same time satisfy the
professional aspirations of the staff.
Social Services
Staff shortages restricted the programme of the Social Service Department, particularly in the Centre Lawn unit of the Provincial Mental Hospital. This need to
increase social service coverage derives in large part from the response of the patients
to the new psychopharmacological treatments, which enables greater numbers to be
discharged from the institutions and returned to the community provided continuing
help is available through the Social Service Department. The inability of the community
to assume responsibility for on-going help to a large proportion of discharged patients
places additional demands on the Social Service Department. Furthermore, the lack
of available resources points in many instances to the necessity for extending Hospital
services through the establishment of family-care homes in order to ensure adequate
supervision and after-care. However, despite the aforementioned difficulties, 1,189
patients received social services from the Department in the Crease Clinic during the
year. The provision of these services involved 4,383 casework interviews with patients
and their families, as well as 3,556 consultations and conferences with Hospital
disciplines and community resources. Similarly, the Department in the Provincial
Mental Hospital gave services to 1,026 patients, including 3,846 casework interviews
with patients and their families and 2,466 consultations and conferences with Hospital
disciplines and community resources.
The past fiscal year has been a most difficult one in terms of effecting suitable
employment for discharged patients due to the economic recession. Such a situation
has a most adverse effect on job placements for handicapped persons, particularly those
who, in addition to physical and emotional handicap, lack specific training for any type
of employment other than unskilled labour. As a result, despite increased activity on
the part of the Rehabilitation Officer, fewer patients were successfully rehabilitated.
Of 166 patients referred for employment and rehabilitation services, ninety were fully
rehabilitated, involving 2,189 interviews and consultations on the part of the Rehabilitation Officer.
Occupational Therapy
We were most fortunate in having the position of Supervisor of the Occupational
Therapy Department filled by Miss Olive Curtis. Her appointment took place in February, 1958. There have been few changes in the occupational-therapy programme.
Progress has been made in the West Lawn area since the industrial therapy (metal-work
section) was moved from the West Lawn Building to the North Lawn Building. This
has enabled the Department to expand, and it is now able to accommodate twenty-five
patients.
The Occupational Therapy Department is still short of trained workers. We are
hopeful that the percentage of professional staff will increase this coming year.
It was decided this year that the treatment of East and West Lawn Building
patients—that is, women and men patients—would be improved if their programmes were
integrated to a certain degree, and, therefore, a mixed gardening group was started, also
parties and other social functions which were run in conjunction with the Recreational
Therapy Department. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
L 49
The Centre Lawn male occupational-therapy programme was extended, and ward
classes were started on Wards D 2, D 3 and D 4, bringing a larger number of acutely ill
patients into treatment.
Lectures have been given throughout the year to the affiliate and student nurses.
Three occupational-therapy students from McGill University did their clinical interning
here during the summer months.
The Christmas sale of work realized $3,227.26. There was again a surplus of toys
made at the Riverside Occupational Therapy Department, and these were donated to
fourteen units of ex-servicemen's organizations for their children's Christmas parties.
Many of these organizations had donated materials to the Department throughout
the year.
Although progress was somewhat slowed down due to shortage of trained staff, a
tremendous amount of splendid work was done by this Department. There has never
been so much occupational-therapy activity in all the areas of the Hospital, and the total
number of treatments given during the year amounted to 106,482.
Recreational Therapy
The recreational-therapy programme followed a similar pattern to that of the
previous year, although it was not possible to reach all objectives. There was an extension of ward activation classes and more patient activation in concerts and other activities.
More patients were given the privilege of leaving the Hospital grounds on visits to industrial and cultural areas. More patients were enabled to take part in mystery bus trips.
Greater concentration was placed on swim therapy, whereby the achievement of the
patient is closely observed. Patients were encouraged to participate and assist the
recreational-therapy workers. More patient activities could have been arranged had the
number of recreational-therapy staff members been increased. With greater numbers of
patients being given increased freedom and grounds privileges, many more patients
become available for grounds programmes and more susceptible to activation techniques.
There was, however, no corresponding increase in the number of recreational-therapy
staff members. The number of patients with grounds privileges has vastly increased in the
past three years. On occasion there are now up to 2,000 patients on the grounds during
the course of a day.
It is not possible in this brief report to outline all the splendid activities in which this
Department is engaged. Conditioning and outside activities are being stressed for all
those patients able to participate, and indoor activation programmes are being stressed
for all those patients remaining indoors. There is a very active patient social programme
carried on throughout the various seasons of the year—dances, Sunday concerts, special
events in the community, the patients' annual sports day, etc. Bowling tends to be a
favourite at the Pennington Hall alleys, and during the warmer weather golfing and tennis
are very popular. Some of the facilities of this Department, when available, may be used
at times by staff for recreational and conditioning exercises. Swimming, both instructional and recreational, is very popular. The music therapist, Miss E. Swann, made a very
valuable contribution to the treatment team with her music appreciation programmes,
individual therapy, choir practices, glee club practices, and concerts. The activity programmes are constantly assuming greater importance.
Physiotherapy
We are pleased to report the appointment of Mr. A. Leach as head of the Physiotherapy Department. The Department at present has an establishment of five members,
with two members operating in the Crease Clinic, two members operating in the various L 50 MENTAL HEALTH SERVICES REPORT,  1957/58
divisions of the Provincial Mental Hospital, and one member attending the chiropody
service for the whole Hospital. There is no physiotherapist for the North Lawn Building
or the Home for the Aged, but visits are made twice weekly in an attempt to maintain
some services in these areas. There is evidence of an increasing tendency to use physiotherapy for the treatment of physical disabilities rather than as an additional approach
to the treatment of mental illness in the over-all treatment programme. This trend is
reflected in the statistics for hydrotherapy, which now constitutes less than 25 per cent
of the Crease Clinic treatments and only 4 per cent of the Provincial Mental Hospital
treatments. The corresponding increase in other physiotherapy methods is most noticeable in the field of remedial exercises, a most encouraging sign in so far as it represents
the transition from a passive to an active form of treatment. The person who can be
helped to help himself is in a better position that the person who is merely helped.
Patients are referred to the chiropody service from all parts of the Hospital, although
long-term patients requiring regular care are given priority. The Physiotherapy Department gave a total of 21,218 treatments during the fiscal year.
Hospital School
We regretted losing Mrs. R. Loland, school-teacher, through resignation in June.
The patients' school improved and developed from 53 to 107 patients under Mrs.
Loland's supervision. The part-time assistance of a psychiatric aide to this Department
helped considerably. Although the school was closed for several months before a replacement was secured, teaching of patients was continued on Ward H 1 by four patient-
teachers who were in the Hospital during this period, each caring for six to eight pupils.
Health of Patients
The health of the patients has been good and the number of notifiable diseases
small, considering the number of patients involved. There were a few cases of broncho
and lobar pneumonia, erysipelas, cancer, and pulmonary tuberculosis reported. A man
with a sore throat was admitted to the Hospital on May 13th, 1957, and we were
extremely fortunate in discovering immediately that it was a case of diphtheria. He was
isolated at once and treated, the ward was quarantined, and all contacts immunized. It
was well controlled and there was no spread of the infection. Considerable inconvenience was caused, since all movement of patients had to be stopped on the admitting ward
and temporary admitting arrangements made on Ward D3. Medical and nursing staff
who so rapidly detected this case of diphtheria and took appropriate action were commended. We were able to notify the Health Officer in the area from which this man was
received, thus preventing further spread of the disease, although there were other cases
discovered in the area. In August, Salk polio vaccine was given to all student-nurses and
patients under 18 years of age. In September, when the Asian influenza epidemic
occurred in Canada, vaccine was made available to all Hospital staff members. Eight
Hospital stations were set up and 1,060 c.c. of the influenza vaccine was used. It was
considered that this vaccine was of considerable assistance. However, many of the staff
were absent due to influenza, and 300 patients were affected in October and 700 in
November. They responded well to treatment. A few cases continued to occur until
December. The patients generally gain weight following admission, and their physical
health is well maintained and usually improved due to the medical and dietary attention
they receive. It is felt that the excellent weather this past year has also been a contributing factor. I would recommend the addition to our staff of a medical health officer, who
might be seconded to this Department from the Department of Public Health. There
would be sufficient work for such a doctor on a full-time basis in the Essondale area. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
L 51
Dr. J
Department of Radiology
M. Jackson, Director of the Department of Radiology, reports a busy year in
his Department, where almost 20,000 films of all types were taken and 13,848 patients
of the Provincial Mental Hospital were X-rayed. For some time the gradually increasing
scope of surgical procedures has made more urgent the need for X-ray equipment to be
installed in the operating-room of the Crease Clinic. A great deal of thought has been
given to present and future requirements, and it is hoped that the necessary equipment
may be available soon.
Department of Laboratories
Dr. G. A. Nicolson, Director of the Department of Laboratories, reports that the
total number of tests performed by this Department during the fiscal year was 49,113.
There has been a slight decrease in the number of procedures carried out by this Department due to the fact that the tuberculin testing and inoculating programme was taken
over by the tuberculosis specialist in the North Lawn Building. It is noticeable that with
the increased activity in the Surgical Department there is an increase in the procedures
pertaining to the diagnosis and treatment of patients undergoing surgical procedures.
There has been a significant increase in the number of autopsies performed, the total
being 171. This is the greatest number recorded here during a single year.
Pharmacy Department
The pharmacy is gradually expanding to meet the demands placed on it for products
and equipment used in the treatment of 6,300 patients. Twenty-four per cent of the
business of this Department was transacted in the purchase and supply of medicinal and
sundry surgical needs for The Woodlands School and the Homes for the Aged at Vernon,
Terrace, and Port Coquitlam. A growing need for greater reserve stocks increased the
inventory 3.9 per cent, pharmaceuticals increased 3.6 per cent, surgical equipment 8.8
per cent, and surgical sundries 2.94 per cent.
A therapeutic committee started in May has studied and advised on products of a
varying nature, primarily to determine the most feasible selection of medications for
general use. The principle adhered to allows a wide selection of good-quality items from
the thousands of products available and avoids duplications. Only products that have
proven efficient to the needs of the Hospital have been retained as standard stock items
in the pharmacy. Special medications are being purchased in limited quantity to serve
the need of the individual patient requiring a specialty item.
Clinical trials are still being handled by the pharmacy in co-operation with members
of the medical staff, and through these channels newer and better products are initiated
for more active therapeutic programmes.
Optical Department
The optical work done during the fiscal year was as follows: Refractions, 518;
major repairs, 217; minor repairs and adjustments, 125. This very useful service is
operated by the optometrist from his office in the Crease Clinic, where he sees patients
from the Provincial Mental Hospital, Crease Clinic, the Geriatric Division, and The
Woodlands School. These services very frequently assist in the discharge, rehabilitation,
and comfort of our patients.
Dental Department
Dr. H. O. Johnsen, Director of the Dental Department, reports an extremely busy
year in his Department. All unmarked dentures are now inscribed with the owner's
name, and the problem of dentures being lost has now been practically eliminated.
The majority of the work of this Department is done by Dr. H. O. Johnsen and
Dr. G. D. Campbell and their technician and dental assistants in the Dental Department L 52 MENTAL HEALTH SERVICES REPORT, 1957/58
in the West Lawn Building. Patients who are unable to attend the Dental Department
may be treated on their own ward or in the surgery when indicated. The North Lawn
dental office is functioning very well, and a much improved dental service is now being
provided for our tubercular patients.
During the past year, due to the illness of the dentist at The Woodlands School,
emergencies from The Woodlands School were treated at the Provincial Mental Hospital's Dental Department. Due to the number of patients and the pressure of work at the
Provincial Mental Hospital, only emergencies and work which is definitely considered
to be an asset from a rehabilitation point of view can now be done for the Crease Clinic
patients. During the year 1,379 dental examinations were made and 4,745 dental procedures were completed.
Chaplain
During the year, through the active co-operation of the staff members of the Provincial Mental Hospital, Crease Clinic, and Geriatric Division, much has been accomplished in providing opportunities for public worship for as many patients as possible.
Several major areas have remained untouched due to the shortage of trained personnel.
We are pleased to report the success the chaplain has had in directing the patients' magazine, " The Leader," which was taken over in September. An addition to the resident
chaplain's duties was made in December when he started conducting institutional funerals.
During the year the total number of church services provided was 345, with a total
attendance at the Protestant services of 31,413 patients. Our resident chaplain must
have a very real sense of satisfaction of a job well done. He receives many words of
appreciation from both the patients and staff. Services are held every week by the
Roman Catholic chaplain at the Hospital, the Rev. A. Frechette, O.F.M., who is the
rector of Our Lady of Lourdes, Maillardville, or by our resident Protestant chaplain,
the Rev. J. F. O'Neil, E.D., B.A., L.Th. Services are held in the North Lawn Building
and other wards of the Hospital for those patients unable to attend services at Pennington
Hall. The provision of flowers by the gardeners of the Hospital for the altars at the
Sunday services has been greatly appreciated by the patients and the chaplain. The
musical therapist, in directing the choir and providing the music for the Sunday services,
was of great assistance to the chaplain. The religious needs of our patients are well
taken care of by our resident chaplain and visiting Catholic priest.
Audio-visual Department
We regret to announce the Department has lost two long-service members through
resignation—Mr. G. H. Walker, supervisor, and Miss L. Archibald, stenographer. Mr.
W. E. Peters was appointed supervisor. Improvements have been made in this Department. The Hammond organ and speakers are now mounted off-stage in the Pennington
Hall auditorium. The entire area has recently been redecorated and is much improved.
The number of educational films loaned has increased over the past year by approximately 15 per cent. The number of registered borrowers has increased from 200 to
253, thus indicating the growing popularity of the library. The Canadian Mental Health
Association volunteers are now supplying two enthusiastic operators for the wired
music system. They play records continually on Tuesdays and Thursdays from 10 a.m.
until 3.30 p.m., and with the installation of the lawn speakers on June 20th, 1957, it
adds greatly to the patients' enjoyment. On March 1st, 1957, this Department undertook to photograph Provincial Mental Hospital patients. Considerable use is made of
the Department's 2x2 slide library, and much work has been put into it, adding new
slides and rephotographing obsolete slides. These are used extensively by doctors and
personnel lecturing throughout this Province and are occasionally loaned for use across
Canada and the United States. Much work is taken up in preoarine coloured and monochrome 16-mm. films of patients' activities and research for other divisions of the Mental CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL L 53
Health Services. The demand is now sufficient to warrant the services of a full-time
photographer by this Department. The Department has assisted throughout the year
with all Hospital activities, including the psychiatric nurses' graduation, the Recreational
Therapy Department's sports day, the volunteers' fashion show, the civil defence exercises, etc.   The following will give some indication of the activities of this Department:—
Number of Total
Recreational Motion Pictures Shows Attendance
35-mm. films at Pennington Hall  137 46,976
16-mm. films at Essondale, Riverside, and Home
for the Aged, Port Coquitlam  443 32,183
There were 240 16-mm. films shipped to other divisions of the Mental Health Services and other Provincial institutions. There were 869 educational films loaned from
the Department's library and 5,723 popular-music records were loaned within the Hospital during the year.
Industrial Therapy Department
The Industrial Therapy Department, under the supervision of Mr. R. Herring,
reports several changes that have taken place within the Department. Three shops of
the Industrial Therapy Department were moved to larger working areas in the North
Lawn Building. The area in the North Lawn Building required very little alteration,
the lighting and wiring being the main consideration. The machine-shop was moved
from the garage area to this new location, thus allowing more space for the upholstery-
shop in the garage. The metal-shop and the print-shop were moved from the West Lawn
occupational-therapy area to the North Lawn Building. This last move completed the
segregation of the Occupational and Industrial Therapy Departments.
In the three years which have elapsed since the loss of our main Industrial Therapy
Building, all but two of the departments have now been reorganized in fairly suitable
working areas. A tailor-shop is still located at the old Boys' Industrial School, and the
shoe-shop is located at The Woodlands School. These two departments remain under
cramped working conditions away from the central body. This arrangement is inconvenient in many ways, as is the travelling distance for patients working in the shops.
The changes incorporated this year have improved staff attitudes and working conditions.
The number of patients on the yearly roll totalled 2,234; 226 new patients were
started, seventy-seven patients from other employment; forty-three patients were re-
transferred to the wards; and eighty-four patients were discharged to the community.
An indication of the vast amount of work done by this Department may be gathered
from the following figures: The tailor-shop manufactured 1,748 items and repaired
14,228 tailored items; the uniform department manufactured 7,162 uniforms and repaired 10,563 uniforms; the furnishings department manufactured 45,510 pieces of
dry-goods furnishings; and the print-shop printed over VA million forms during the
fiscal year.
Fire Department
The Fire Department, under the direction of Fire Chief A. Lowry, has accomplished
a great deal this year. The Department has been constantly on the alert and answered
141 calls. The Department has been able to assist adjacent communities with its inha-
lator. The Department has conducted forty-eight lectures on fire prevention to the
various departments of the Hospital, and there were seven fire-drill evacuations for staff
and patients. The volunteer firemen have received seventy-seven hours of instruction,
and there were 166 practices. Each practice was from one to two hours and consisted
mostly of practical work, usina all types of fire-fighting equipment and involving both
the volunteers and the regular firemen.
The Fire Department has co-operated with Civil Defence groups from New Westminster regarding fire-fighting and gas-mask instructions.   Films and lectures have been L 54 MENTAL HEALTH SERVICES REPORT,  1957/58
given to various groups from near-by communities. Many meetings relating to Public
Works, Safety Committee, Blood Clinic Committee, etc., have been held in the fire-hall,
which is also the Civil Defence headquarters.
Fire-prevention inspections of all buildings and shops on the Hospital grounds
were carried out at intervals. Monthly inspections were made in conjunction with the
Tradesmen's Safety Committee. Quarterly checks and annual recharges were made of
700 fire-extinguishers at Essondale, The Woodlands School, and the Child Guidance
Clinic, and continuous maintenance work was done on fire-trucks, fire-fighting equipment, fire-hydrants, fire-alarm boxes, and the fire-hall itself.
Radio communication equipment was installed in the fire-hall, one fire-truck, and
the grounds patrol car. A new fire-alarm control was installed in the fire-hall and is
now in operation.
Civil Defence and Disaster Committee
The Essondale Civil Defence organization works very closely with the Essondale
Fire Department. It makes its headquarters at the fire-hall, where regular Civil Defence
meetings are held with the chiefs of services. The chiefs and senior officers of the Civil
Defence are usually the heads of the corresponding Hospital services. During the year
several staff members have received further training at the Civil Defence College at Arn-
prior, Ont., and many more received training locally in Vancouver and Victoria. This
type of planning is extremely valuable on account of the occasional flooding of the adjacent Coquitlam and Fraser Rivers. Our private radio station has been in operation since
August of 1957 and consists of a base station and two mobile stations. It has proven
extremely valuable in emergencies and would be invaluable in the case of a disaster or
major evacuation. It is essential that more communication equipment be procured
when this is possible.
A Civil Defence " paper evacuation " of the whole of the Essondale area was held
on October 4th. This exercise was mainly a testing of communications and reporting,
and much valuable information was gained. Dr. T. G. Caunt, Medical Superintendent,
attended the Civil Defence College at Arnprior, Ont., from November 18th to 22nd,
1957. We were pleased to have Group Capt. E. A. McNab, officer in charge of the
Vancouver Target Area Transportation Services, and C. W. MacDonald, Superintendent
of Police, in charge of the Vancouver Target Area Auxiliary Police Services, visit the
Hospital and give their advice on our evacuation planning. We appreciate the co-operation received from his department, from Air Vice-Marshal Heakes, Vancouver Civil
Defence Co-ordinator, and from all the other Civil Defence officials.
Medical Records
The Medical Records Department has been extremely active this year with the
increased patient admissions and the more rapid transfer and discharge of patients. The
preparation of adequate records in the various Hospital departments is an important
part of the total Hospital function. In addition to the records and the vast amount of
correspondence, there has been an increasing number of requests for information regarding our patients from Federal Government areas. The Department of Indian Affairs
has been supplied with reports on all the patients who are responsibilities of that Department. Reports relating to ex-service personnel have been forwarded to the Department
of Veterans' Affairs. The Medical Records Supervisor has operated her department
extremely well, especially so considering the large turnover of the more senior staff. In
many areas of the Department considerable experience and skill is necessary before the
position can be adequately filled.
I would recommend the installation of a fully modern recording system for the
Crease Clinic. This would greatly assist the medical staff and the Records in the keeping
of proper medical records and would be time-saving.   I would envision the installation CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL L 55
of a telephone recording system for the Crease Clinic and a system of stationary and
portable dictating units for the West Lawn Building similar to that presently in use in
the East Lawn Building.
Dietary Department
During the fiscal year of 1956/57 the prime dietary accomplishment was the initiation of a nutritionally improved general menu. The fiscal year of 1957/58 has afforded
the medical staff ample opportunity to evaluate the results of this improvement. The
dietary staff are greatly encouraged to learn that the general health of the mental patients
is the best it has been in the history of the Hospital, and this has been largely attributed
to the elevated feeding standard.
The total number of meals prepared by this Department during this past fiscal year
has been 4,730,224. Of this total, 4,557,362 meals were served to patients and 172,862
meals were served to staff.
Food prices have steadily risen since the fiscal year of 1954/55. This year the
prices of butter and meat have noticeably affected our food budget. Prior to July of
1957, butter was subsidized. With the loss of this subsidy, the additional cost of butter
to our Hospital up until March of 1958 was $18,000. The average price increase for
meat from June, 1956, to June, 1958, is 34.6 per cent. However, the actual increase
in cost to this Department has only been 22 per cent. This means that even though
there has been an increase in meat costs of 34.6 per cent, we have actually saved 14.4
per cent on meat expenditures, without any loss of meal standards. This saving in meat
expenditures is largely due to the excellent co-operation we have received from our
butcher-shop. The butchers have willingly and diligently butchered efficiently and economically in order to help hold down food expenses.
The average food price increase in 1955/56 over the preceding fiscal year was 3.31
per cent. The average food price increase in 1956/57 over 1955/56 was 3.91 per cent.
During this period the Hospital's meal costs rose considerably. The average food price
increase in 1957/58 was 11.52 per cent. This Department has worked most conscientiously to control waste and protect the food standard that we have. It is therefore with
some pride of accomplishment that this Department reports that even in consideration
of price increase of food of 11.52 per cent, during this fiscal year the Dietary Department
reduced the cost per meal at the Hospital by 7.4 per cent, Crease Clinic by 14.6 per cent,
and the Home for the Aged by 3 per cent below the meal costs of the previous year.
This was done without any sacrifice of established standards, but wholly by reducing
unnecessary use and waste. This Department has become more efficient during the past
fiscal year in maintaining food standards of the previous year at a cost of less than proportionate to average food price increase.
Stores Department
The Stores Department, serving an average daily patient population of 5,451 in
the Essondale area and at The Woodlands School, handled clothing, provisions, drugs,
fuel, etc., to a value of $3,175,000 during the year. This is at the rate of $8,700 for
each and every day of the year.
Laundry Department
The Laundry Department, one of the largest in British Columbia, handles over 12
tons of laundry each working-day. Dry cleaning, averaging 250 garments daily, is additional. Two trucks are required almost full time to care for the pick-up and delivery
of laundry alone.
Transportation Department
In an institution of this size, transportation is a major problem, and altogether forty-
five vehicles are used.   Included in this are two buses, an ambulance, and fire-fighting L 56 MENTAL HEALTH SERVICES REPORT, 1957/58
and snow-removal equipment. Groceries, meat, milk, bread, vegetables, etc., have to
be delivered to the kitchens daily. Laundry, drugs, furniture, films, laboratory supplies,
and specimens are among the other hundreds of items requiring delivery. Maintenance
of buildings, grounds, roadways, plant, and equipment also necessitates extensive trucking. Patients have to be transported to treatment centres and returned to their wards,
also to trains, boats, or airports upon discharge. Buses are required to transport patients
to movies, dances, outings, sporting events, and to church.
Patients' Accommodation and Hospital Maintenance
We started in May of 1957 to gradually evacuate the Riverside Cottage. This is a
very old building which had a total of 125 patients in residence. This number has been
reduced to eighty patients, and we are hopeful that we may continue to reduce the number of patients until this area is totally evacuated.
Patient accommodation in the acute-treatment areas is in fair condition. A tremendous amount of decorating and Public Works maintenance work has been done.
The continued treatment areas, however, are still considerably overcrowded and require
much maintenance work. Many floors have been replaced in the West Lawn Building,
Men's Division, and small surgeries have been completed on each ward. New furniture
has been placed on several wards, and it is hoped that Ward C 2 will be refurnished this
coming year. Patients have assisted in maintenance by painting beds. Many floors
have been retiled. There have been ward improvements in this regard in the East Lawn
Building, Women's Division. More details of Public Works maintenance and new projects will be observed in the report of the Business Manager.
All areas of the Crease Clinic and Provincial Mental Hospital have been surveyed
by the Medical Superintendent and the Business Manager with a view to maintenance
and alterations. Two rooms in the Centre Lawn Building were converted into doctors'
interviewing-rooms. Much work is being done about the Hospital grounds clearing
drains and installing new and larger drains. On April 12th, 1957, there was a serious
power outage from 1 to 2.30 p.m. This would again point out the need for a standby
plant for standby power to operate the entire Hospital with all its facilities, which would
include lighting, cooking, refrigeration, elevators, etc. We are pleased to report the
conversion of Nurses' Home No. 10 for male nursing staff who live on the Hospital property. There is need for the Hillside swimming-pool to be replaced, or most of the old
building in which it is located should be removed and the pool covered.
There is an urgent need now for enlarged public and staff parking areas. The Hospital grounds reflect considerable credit on the head gardener and his staff. I would
urge that the landscaping of the Hospital grounds be completed. Several areas have not
been landscaped, although the buildings have been in use for many years. The natural
beauty of the Hospital setting could be greatly enhanced if this work could be completed.
Visitors to the Hospital
In addition to all the usual volunteer activities of the British Columbia Division of
the Canadian Mental Health Association on the wards, there was great activity in the
volunteers' apparel-shops with preparations for the patients' annual fashion show, which
was held on May 8th and 9th. This fashion show was a tremendous success, and Pennington Hall was crowded each nieht with patients and the public. Mrs. Creiehton, of
the volunteers, arranged with the Canadian Broadcasting Corporation for tape recordings of the volunteer activities. Recordings were made by Mr. J. Ward, Director of the
British Columbia Division of the Canadian Mental Health Association, and Dr. T. G.
Caunt, Medical Superintendent, giving their views on the Canadian Mental Health Association hospital volunteers.
We were very pleased to have the Honourable Wesley D. Black, Provincial Secretary, and Mr. R. A. Pennington, Deputy Provincial Secretary, visit the Hospital from
time to time. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL L 57
On July 7th Dr. T. G. Caunt, Medical Superintendent, welcomed over 900 visitors
to the Provincial Mental Hospital on the occasion of the annual Fraser Valley Firemen's
Association picnic. The visitors enjoyed a very instructive and informative visit, and
much credit goes to Mr. McPhee, president of their organization, and Mr. A. Lowry,
Essondale Fire Chief. Demonstrations were given by the Essondale Fire Department
and visitors on fire-fighting methods and the handling of various types of equipment.
The Essondale grounds were toured, and the late afternoon was given over to a picnic.
The ladies' auxiliaries for the various ex-servicemen's organizations deserve great
credit for their thoughtfulness in visiting the ex-servicemen who are patients here.
We were happy to have Dr. J. E. Gilbert, of the Department of Health and Welfare,
Ottawa, visiting with us on November 1st to 12th at Essondale on his tour of all the
Provincial Mental Health Services of this Province.
Throughout the year many concert parties, bands, orchestras, entertainment groups,
and athletic groups visited. Our patients are also appreciative of the Vancouver Firemen's Band, which usually visits the Hospital on our annual field-day.
We are very grateful to the New Westminster and Kitsilano Kiwanis Clubs, whose
members visited the Hospital on Boxing Day and assisted the volunteers in personally
delivering 3,065 individual parcels to our patients from citizens throughout the Province.
Patients were very appreciative of the New Westminster Concert Band for its delightful
concert given at Pennington Hall in January and the B.C. Electric Ladies' Choral Society.
The Canadian Mental Health Association women volunteers took over the management of the Pennington Hall coffee-shop and opened for business on February 4th.
Their project is functioning extremely well. A very fine atmosphere prevails, the service
is improved, and many patients are gaining much help in assisting in this activity.
Gifts
Throughout the year the Hospital has received a large number of gifts from various
organizations in the Province, relatives, and interested friends. Many Provincial branches
of the Canadian Legion, British Empire Service League, have made donations of comforts to the patients, such as fruit, candy, smoking material, and small articles of clothing.
These donations are usually brought by the various women's auxiliaries of these units
and are greatly appreciated by our patients. At Christmas quite large amounts of comforts were received in this manner. The Canadian Mental Health Association volunteers
have distributed comforts, books, reading material, candy, and fruit, and on Boxing Day
they personally delivered parcels with the assistance of various Vancouver and New
Westminster service organizations to many wards in the Hospital. This was an especially
worth-while project in that these parcels had been donated to the Canadian Mental
Health Association by citizens from all parts of this Province, and a large group of public
minded citizens gave their time and effort in order that our patients might receive these
comforts. Much credit is due to Mr. J. Ward, Executive Director of the British Columbia
Division of the Canadian Mental Health Association; Mr. G. Dodsworth, who is in
charge of the local arrangements; the volunteers; and other participants. On numerous
occasions, gifts of tickets have been received in order that large groups of patients might
visit the Exhibition, Shriners' Circus, various fairs, and carnivals. Generous gifts have
been received from the Army, Navy, and Air Force ex-servicemen's organizations. Many
industrial organizations have been generous with gifts of materials for the use of patients
in the occupational-therapy areas.
General Comments
Reports were completed for the American Psychiatric Association Building Committee relating to open hospital wards, patient privileges, etc. Further reports were supplied to Dr. W. S. Barclay, Department of Indian Affairs, regarding Indian patients in
the Hospital. L 58 MENTAL HEALTH SERVICES REPORT,  1957/58
The Essondale branch of the British Columbia Government Employees' Association
held a successful blood donors' clinic at Pennington Hall on December 10th.
An innovation started this year was an information card showing Hospital visiting-
hours, telephone numbers, the doctor in charge of the patient, etc., which is given to
patients' relatives.    This was found to be a real convenience.
We have had excellent co-operation and assistance from the Royal Canadian
Mounted Police, and were fortunate in having Inspector Shanks, officer in charge of the
New Westminster R.C.M.P. detachment, visit this Hospital. He was able to give helpful
suggestions relating to the improvement of our Hospital police and commissionaire
services.
Recommendations
There is still a great demand for the admission of aged persons. There are usually
many more requests for admission than there is accommodation available in the Hospital.
The most suitable eases are admitted as soon as possible. Many of the aged, confused,
and senile who are committed to the Hospital are under 70 years of age. There is a
great need for further accommodation for the care of this type of patient in the community. It is anticipated that the aged patients accepted for care by the Provincial Mental Health Services will be admitted directly to the Geriatric Division when the new
building at Port Coquitlam is opened. This would take some of the pressure from the
male and female admitting wards at the Provincial Mental Hospital at Essondale.
There is a need for suitable facilities in the community to accept and treat alcoholic
patients who are presently being received in this Hospital. The expansion of the facilities of the Alcoholic Foundation would be an advantage in the treatment of these cases
and would be of assistance in cutting down the Provincial Mental Hospital admissions
and would help to relieve patient overcrowding on the wards here.
More requests are being received for the treatment of the emotionally disturbed
adolescent. There is a need for adequate accommodation and staff for the treatment of
disturbed children.
I would recommend that suitable facilities be provided elsewhere in the Mental
Health Services for the proper treatment and care of the male and female mentally
retarded patients of this Hospital. Their transfer would help to relieve the overcrowding
of patients in the continued-treatment areas of the Provincial Mental Hospital.
I would recommend that Order in Council cases and those cases referred to this
Hospital by the Court be accommodated and treated psychiatrically in a suitable hospital
in the prison setting. This type of patient is being admitted to this Hospital in increasing
numbers. They are treated and separated from the Hospital as soon as possible. They
do, however, present a considerable problem in a mental hospital where patients are
constantly being given more freedom in order to assist in their recovery and rehabilitation.
It is important that the standards of the treatment and care of the mentally ill in
this Province continue to advance, and I would urge that specialist staff shortages be
filled. It is not possible to stand still or mark time. Those services that do not advance
will regress.
Acknowledgments
I wish to express my appreciation of the co-operation received from all departments
of the Government; Dr. A. M. Gee, Director of Mental Health Services; and all members
of headquarters. I appreciate the assistance received from the Honourable Wesley D.
Black, Provincial Secretary, and Mr. R. A. Pennington, Deputy Provincial Secretary, in
matters relating to the Provincial Mental Hospital and the Crease Clinic. All departments of the Provincial Mental Health Services have been helpful, and I am most appreciative of their sincere co-operation. On behalf of our patients I am most appreciative of
all those organizations and visitors who have contributed to the well-being of our patients. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
TREATMENT SERVICES
I. S. Kenning, Clinical Director
l 59
This year has seen the Crease Clinic and Provincial Mental Hospital take on as large
a clinical load as ever. We have been able to carry on an active service to those admitted.
We have continued to use and rely on the recognized methods of treatment and, in
addition, find greater use for many of the newer drugs. In the long-term units of the
Provincial Mental Hospital, our discharge rate has been quite favourable, although our
readmission rate is continuing to increase because of the lack of follow-up facilities.
Reference may be made to the figures below:—
First admissions to the Provincial Mental Hospital:   1954, 653;   1955, 678;
1956, 617; 1957, 628; 1958, 695.
Readmissions to the Provincial Mental Hospital:  1954,388; 1955,461; 1956,
636; 1957, 631; 1958, 671.
Psychiatrists to-day realize we must plan for continuing case loads rather than only
the circumscribed treatment, admission, and discharge of patients with a mental illness.
If we had more services for supportive treatment, I have no doubt that our readmission
rate could be reduced. We have a need to carry our services closer to the community, to
the place where the patient needs our help to prevent these readmissions. Further development in this area is becoming urgent to the maintenance of our treatment programme.
We have continued to urge patients to take as active a role in the management of
their own affairs as their illness will permit. To this end, two more wards have been given
open-ward status during the year. The number of patients with grounds privileges averages 1,814, or approximately one-half of our total population. In this connection also,
we should note the report of the Royal Commission on the Law Relating to Mental Illness
and Mental Deficiency, 1954-57, which puts increasing emphasis on care and treatment
without compulsion and without the automatic loss of civil rights. As we continue to
integrate patients into a more active life within the Hospital, I believe we should give
thought to a possible future amendment allowing admission to the Provincial Mental
Hospital without automatic loss of civil rights. Although this would put an additional
burden on our administrative staff, it should be recognized that our primary purpose is to
serve the patient's needs.
During the year we have been able to improve our interviewing facilities, and this
has contributed greatly to the privacy of the doctor-patient relationship. Further improvements are still required. We have, on the other hand, done very little to improve the
privacy of patients on the wards, a fact that is not conducive to helping dislocated persons
assume their proper place in a hospital or any other society. Some of our wards remain
150 per cent overcrowded, and the Mental Hospital as a whole still operates between 40
and 50 per cent beyond its rated bed capacity. Crowding and lack of privacy do not
contribute to the personal worth of the individual.
Although increasingly short of specialized staff, we have for the first time assumed
the added burden of writing comprehensive discharge letters to all doctors who referred
patients to the Crease Clinic. This is another move planned to improve the continuity of
treatment between hospital and community. We hope to do the same thing in the Mental
Hospital in the near future. It should be noted, however, that we have lost some more of
our trained medical staff during the year, making this task increasingly difficult.
The Occupational Therapy Department is one which we have been able to improve
greatly during the year, so that now approximately one-half of the establishment is filled
by qualified occupational therapists. This means that the Department activities have
become much more meaningful for a greater number of patients. Group activities under
trained leaders have brought a more diversified approach to patient interaction. The
Recreational Therapy Department has also continued its splendid programme, but has L 60 MENTAL HEALTH SERVICES REPORT,  1957/58
been limited in its scope by the amount of transportation available and the supply of
nursing personnel. Not infrequently programmes had to be cancelled for the lack of a
driver or sufficient nursing staff to make the activity possible.
We have continued an active association with the University of British Columbia,
Department of Psychiatry, and hope that this may be developed further. In particular
we are tooking toward a time when the Hospital will be officially included in the University training scheme for psychiatrists. Such a scheme is essential to the welfare of the
Hospital and the calibre of treatment we will be able to offer in the future.
Last year, for the first time, we sponsored a two-day teaching institute with the help
of Federal Mental Health Grants. This was held at the Crease Clinic. The subject of the
institute was "Schizophrenia," and Dr. H. E, Lehmann, of Montreal, was the main
speaker, with Dr. J. S. Tyhurst also taking part in a panel discussion. This institute was
in addition to the usual weekly seminars and lectures that were continued by Hospital
staff in conjunction with and assistance from some members of the Department of Psychiatry of the University of British Columbia. Particular thanks are due to Dr. J. S. Tyhurst
and his staff for their co-operation in continuing this programme.
The volunteers under the Canadian Mental Health Association have continued to
play a vital role in the development of Hospital milieu. Their numbers have increased
greatly, and this year, in addition to all their other activities, they took over the operation
of the Pennington Hall coffee-shop and have, with their friendly interested attitude and
untiring efforts, made this fine facility into a real therapeutic asset. They now take part
in about twenty different activities throughout the Hospital. This is in keeping with the
general trend throughout the better hospitals in the United States and Canada, where
volunteers are playing an ever-increasing role in the life of the patient. Apart from the
direct benefit to the patients, these interested persons help to break down the artificial
barriers between us and the community.
The Department of Neurology, under Dr. W. P. Fister, has continued its great
service to the Hospital and the community. In this year a greater number of patients has
been dealt with neurosurgically than in any previous year. A total of thirty-three cases
were operated on for various conditions, the highest single category being that of focal
epilepsy, which accounted for fourteen of the operations. It may be noted that the Crease
Clinic is the only institution in the Province of British Columbia in which operations for
the relief of focal cortical seizures are at present undertaken. This service has been
extensively utilized by specialists in the Vancouver area as well as by the Indian Health
Service of the Federal Department of Citizenship and Immigration. All these cases
required the highest order of skill and equipment in the assessment and treatment of
their condition.
Our General Surgical Department has continued its high level of service. No longer
do we find the numbers of patients in Hospital who require a large amount of elective
surgery. The new system of rotation of a surgical resident in training from the University diploma course is highly satisfactory.
I should like to make note of the increasing age of our Mental Hospital population.
In the East Lawn Building the patient population has decreased from 1,388 to 1,297 in
the fiscal year, but the number of patients over 50 years has increased by 122. This is
typical of the changing conditions in the long-term areas of this and other mental hospitals. Whereas we are conducting an active and encouraging campaign against the major
psychoses such as schizophrenia, we have hardly begun to assess the problem of mental
disorders in the older age-groups, and, as yet, treatment resources are pitifully small both
here and elsewhere.
In 1951 the central inspection board of the American Psychiatric Association was
invited to assess, review, and make a report on the Provincial Mental Hospital facilities
in the Province of British Columbia. At that time they made many recommendations,
of which I am glad to say a great many have now been implemented.  These have all CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
L 61
added to better and increased welfare for the patient-group. There are, however, three
recommendations which remain outstanding and which, to my mind, are extremely
important.  These are:—
(1) The development of an in-patient children's  hospital for psychiatric
disabilities.
(2) The removal of the mental defectives from the Provincial Mental Hospital
to an institution primarily for the care of defectives.
(3) The employment of a full-time psychotherapist at the Hospital.
The need for a children's unit and the greater provisions for trained staff for psychotherapeutic treatment were outlined in my last report.   This situation has not changed.
We are receiving a large number of patients from the Courts and from gaols by
Order in Council. Reference may be made to the following figures: Admissions by
Order in Council to the Provincial Mental Hospital—1954, 30; 1955, 30; 1956, 32;
1957, 86. These patients represent a difficult treatment problem in the Hospital in that
we have a dual responsibility—one for security, the other for treatment. We still do not
have a clearly defined system or criteria for returning these people to the Courts. I should
like to recommend a committee be set up for the purpose of assessing Order in Council
patients along the lines suggested by the Royal Commission under the chairmanship of
the Honourable J. C. McRuer. I feel that all patients detained under Order in Council
should be reviewed at least once a year, and that those people making the recommendations should be well qualified and should assume a shared responsibility. L 62
MENTAL HEALTH SERVICES REPORT,  1957/58
STATISTICAL TABLES
CREASE CLINIC
Table 1,—Movement of Population, Crease Clinic, April 1st, 1957,
to March 3 1st, 1958
Male
Female
Total
95
453
40
104
131
643
73
175
226
Admissions—
First admissions— - _            .    .
Readmissions from a different institution of Mental Health Services 	
Readmissions from the same institution    -	
1,096
113
279
Total admissions 	
597
891
1,488
692
1,022
1,714
Separations—
588
3
867
4
1,455
Died          .   .
7
591
871
1,462
Net increase or decrease    -     	
In residence, March 31st, 1958-                	
+6
101
+20
151
+26
252
Table 2.—First Admissions to Crease Clinic by Health Unit and School
District of Residence and Sex, April 1st, 1957, to March 3 1st, 1958
Detailed information for the above table may be obtained on request. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
L 63
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L 65
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MENTAL HEALTH SERVICES REPORT,  1957/58
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MENTAL HEALTH SERVICES REPORT,  1957/58
Table 6.—First Admissions to Crease Clinic by Marital Status, Mental Diagnosis, and Sex, April 1st, 1957, to March 31st, 1958
Table 7.—Readmissions to Crease Clinic by Marital Status, Mental Diagnosis,
and Sex, April 1st, 1957, to March 31st, 1958
Table 8.—First Admissions to Crease Clinic by Mental Diagnosis, Years of
Schooling, and Sex, April 1st, 1957, to March 31st, 1958
Table 9. — Readmissions to Crease Clinic by Mental Diagnosis, Years of
Schooling, and Sex, April 1st, 1957, to March 31st, 1958
Table 10.—First Admissions to Crease Clinic by Citizenship, Age-group, and
Sex, April 1st, 1957, to March 31st, 1958
Table 11.—First Admissions to Crease Clinic by Religion and Sex, April 1st,
1957, to March 31st, 1958
Table 12.—First Admissions to Crease Clinic by Previous Occupation and Sex,
April 1st, 1957, to March 31st, 1958
Detailed information for the above tables may be obtained on request.
Table 13.—Live Discharges from Crease Clinic by Condition on Discharge,
Disposition to, and Sex, April 1st, 1957, to March 31st, 1958
Disposition to—
Condition
Home
Clinic
Agency
General
Hospital
Welfare
Institution
Other
Mental
Hospital
Other
Total
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Recovered	
Much improved—	
Improved	
Unimproved- 	
63
23
375
57
72
97
588
61
1
1
	
2
1
1
2
1
17
37
12
32
3
1
4
2
1
1
66
24
401
97
73
97
603
94
139
121
1,004
191
Totals 	
518
818
2 | --
1
2 |      2
1
2 |      1
1
54 |    44
I
10
2
588  | 867  |  1,455
1           1 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
L 69
Table 14.—Live Discharges from Crease Clinic by Mental Diagnosis, Condition
on Discharge, and Sex, April 1st, 1957, to March 31st, 1958
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
25
8
1
1
8
5
2
2
9
22
6
2
......
1
2
4
1
5
25
12
1
1
2
1
3
33
8
1
1
3
16
5
2
24
149
24
6
9
" 1
14
13
12
31
6
3
40
2
1
1
174
44
9
13
.
1
1
11
33
31
12
5
3
193
1
1
3
5
29
1
1
1
10
1
5
1
4
2
2
33
4
1
1
2
4
3
3
1
8
1
1
1
215
33
8
11
2
22
23
19
40
9
4
56
4
1
3
262
62
12
14
1
2
2
2
18
57
40
22
5
4
250
2
2
3
6
477
95
20
Paranoia and paranoid states	
25
1
2
4
24
41
76
Anxiety reaction without mention of somatic symp-
80
Hysterical  reaction  without  mention  of  somatic
31
5
8
306
Psychoneurosis with somatic symptoms (somatiza-
4
Psychoneurosis with somatic symptoms (somatization reaction) affecting digestive system	
Psychoneurosis with somatic symptoms (somatiza-
2
2
Psychoneurotic disorders, other, mixed, and unspe-
4
Chronic brain syndrome with neurotic reaction	
9
61
68
20
93
312 | 542
57
63
450
766
1,216
Without Psychosis
Disorders of character, behaviour, and intelligence-
1
1
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1
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1
1
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1
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1
2
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1
49
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1
24
18
5
2
8
1
13
5
20
4
1
73
45
10
3
17
5
Other and unspecified character, behaviour,  and
27
Chronic brain syndrome with behavioural reaction-
2
15
29
Other diseases of central nervous system not associated with psychosis 	
Observation without need for further medical (psychiatric) care   	
Other, unknown, and unspecified conditions- 	
8
3
2
5
5
4
4
89 |    61
40
31
138
101
239
Grand totals    _	
66
11
24 |    97
1
401  | 603
1
97
94
588
867
1,455 L 70
MENTAL HEALTH SERVICES REPORT,  1957/58
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PROVINCIAL MENTAL HOSPITAL
L 73
Table 1.—Movement of Population, Provincial Mental Hospital, Essondale,
April 1st, 1957, to March 31st, 1958
Male
Female
Total
1,814
105
2
1,645
168
3
3,459
273
5
Totals as at April 1st, 1957     	
1,921
1,816
3,737
Admissions—
454
128
200
241
136
209
695
Readmissions from a different institution of Mental Health Services	
Readmissions from the same institution- -	
264
409
782
586
1,368
2,703
2,402
5,105
Separations—
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108
4
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54
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3
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Died                   	
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290
7
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856
1,697
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—99
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In residence, March 31st, 1958	
1,862
1,546
3,408
Table 2.—First Admissions to Provincial Mental Hospital, Essondale, by
Health Unit and School District of Residence and Sex, April 1st, 1957,
to March 31st, 1958.
Detailed information for the above table may be obtained on request. L 74
MENTAL HEALTH SERVICES REPORT, 1957/58
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L 79
Table 6.—First Admissions to Provincial Mental Hospital, Essondale, by
Mental Diagnosis, Marital Status, and Sex, April 1st, 1957, to March
31st, 1958.
Table 7.—Readmissions to Provincial Mental Hospital, Essondale, by Mental
Diagnosis, Marital Status, and Sex, April 1st, 1957, to March 31st, 1958
Table 8.—First Admissions to Provincial Mental Hospital, Essondale, by
Mental Diagnosis, Years of Schooling, and Sex, April 1st, 1957, to March
31st, 1958.
Table 9.—Readmissions to Provincial Mental Hospital, Essondale, by Mental
Diagnosis, Years of Schooling, and Sex, April 1st, 1957, to March 31st,
1958.
Table 10.—First Admissions to Provincial Mental Hospital, Essondale, by
Citizenship, Age-group, and Sex, April 1st, 1957, to March 31st, 1958
Table 11.—First Admissions to Provincial Mental Hospital, Essondale, by
Religion and Sex, April 1st, 1957, to March 31st, 1958
Table 12.—First Admissions to Provincial Mental Hospital, Essondale, by
Previous Occupation and Sex, April 1st, 1957, to March 31st, 1958
Detailed information for above tables may be obtained on request. L 80
MENTAL HEALTH SERVICES REPORT,  1957/58
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L 81
Table 14.—Resident Population of Provincial Mental Hospital, Essondale,
by Mental Diagnosis, Number of Previous Admissions, and Sex, December
31st, 1957.
Table 15.—Resident Population of Provincial Mental Hospital, Essondale,
25 Years of Age and under, by Mental Diagnosis, Length of Stay, and Sex,
December 31st, 1957.
Table 16.—Resident Population of Provincial Mental Hospital, Essondale,
26 to 49 Years of Age, by Mental Diagnosis, Length of Stay, and Sex,
December 31st, 1957.
Table 17.—Resident Population of Provincial Mental Hospital, Essondale,
50 Years of Age and over, by Mental Diagnosis, Length of Stay, and Sex,
December 31st, 1957.
Detailed information for the above tables may be obtained on request.
Table 18.—Live Discharges from Provincial Mental Hospital, Essondale, by
Condition on Discharge, Disposition to, and Sex, April 1st, 1957, to March
31st, 1958.
Condition
Recovered _
Much improved-
Improved 	
Unimproved	
Totals-
Disposition to—
Home
M.
44
28
352
58
21
26
400
34
482 | 481
Clinic
Agency
M.
Welfare
Institution
Other
Mental
Hospital
Other
Total
M.
7
103
110
F.
1
4
______
115
M.  I   F.
I
M.
6 |      2       50
1  |         30
30 j    13 | 390
23
27
417
Grand
Total
9 |      6 |  170 | 150 |
73
57
807
320
46 |    21  | 640 | 617 | 1,257 L 82
MENTAL HEALTH SERVICES REPORT,  1957/58
Table 19.—Live Discharges from Provincial Mental Hospital, Essondale, by
Mental Diagnosis, Condition on Discharge, and Sex, April 1st, 1957, to
March 31st, 1958.
Mental Diagnosis
Condition on Discharge
Recovered
M.
Much
Improved
M.
Improved
M.      F.
Unimproved
M.
Total
M.
F.
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 .
Psychosis of other demonstrable etiology-
Other and unspecified psychoses-
Anxiety reaction without mention of somatic symptoms     	
Hysterical  reaction  without  mention   of  somatic
symptoms
Obsessive-compulsive reaction-
Neurotic-depressive reaction .
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.—	
154
9
5
3
1
5
40
9
2 I
1 I
1  I
233
27
5
2
4
5
15
3
12
13
1
1
7
1
1
I
21
28
25
243
2
2
2
21
6
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2
3
3
1
4
	
2
	
	
16
6
40
1
2
10
1
1
2 | 147 |    86
23  |    30
27 | 390 | 417
44
237
16
5
5
9
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40
65
14
10
276
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3
32
40
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17
13
2
1
11
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1
21
2
14
1
8
45
28
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8
6
119
46
1
3
2
3
2
7
11
17
2
1
5
4
6
10
23
10
1
2
10
17
5
17
73
57 | 225 I 147
513
51
14
8
41
1
80
87
19
27
14
5
1
15
5
2
2
97 |    93 | 415  | 470 |     885
73
16
165
5
5
28
3
10
33
12
22
372
170     150     640  | 617 |  1,257
I I CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
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Q THE WOODLANDS SCHOOL
L 87
PART III.—THE WOODLANDS  SCHOOL, NEW WESTMINSTER
REPORT OF THE MEDICAL SUPERINTENDENT
L. A. Kerwood, Medical Superintendent
On March 31st, 1958, the population of The Woodlands School was 1,330, an
increase of eighty-nine over March 31st, 1957. There were 784 male and 546 female
cases. Last year the distribution of cases was shown by age-groups. This year the
Psychology Department has prepared an analysis of the population by age-group, grade
of mental defect, sex, presence or absence of physical handicap (locomotor difficulties,
blindness, deafness, etc.), and intelligence quotient (known as the result of tests, based
on clinical estimate or unknown). This information is summarized in the Tables 1 and
2 below. It should be noted that the total figures do not correspond to those at March
31st, 1958. This is due to the fact that these figures became available later on in the year.
There will not, however, be any large difference in distribution.
Table 1.—Female Population by Age-groups, Intellectual Status,
and Physical Handicap
Age-group (Years)
Total
I.Q.'s
Physical
Handicapped
Percentage of
Total by
Grade
I.Q. Grade
6 and
Under
7-13
14-21
22-31
32-41
42 and
Over
Low average (90-f-)	
Dull normal (80-89).	
1
14
22
17
2
17
60
68
6
2
4
37
73
34
6
1
2
1
20
59
21
3
1
2
1
14
30
7
1
2
2
16
37
4
1
2
8
10
105
273
156
34
2
2
15
48
68
5
0.3
1.4
Border line (70-79) —-	
1.7
Moron (50-69)        	
17.8
Imbecile (25-49)
46.4
Idiot (0-25)              	
26.5
Untestable or untested _	
5.8
54
9.2
153
26.0
156
26.5
107
18.2
56
9.5
62
10.5
588
140
23.0i
Percentage of total by age-groups...
Percentage of total handicapped.
Table 2.—Male Population by Age-groups, Intellectual Status,
and Physical Handicap
I.Q. Grade
Age-group (Years)
6 and
Under
7-13
14-21
22-31
32-41
42 and
Over
Total
I.Q.'s
Physical
Handicapped
Percentage of
Total by
Grade
Low average (90+) —
Dull normal (80-89)-
Borderline (70-79)....
Moron (50-69) ___.
Imbecile (25-49)	
Idiot (0-25)_
Untestable or untested-
Total by age-group. —
Percentage of total by age-groups-
5
14
24
38
34
65
67
12
2
2
11
52
107
59
3
81
10.2
182
22.9
236
29.7
2
5
30
61
34
2
1
2
6
11
39
10
1
3
2
5
24
38
15
4
134
16.8
70
91
11.4
31
156
324
209
60
2
6
27
86
98
12
0.7
1.0
3.9
19.6
40.9
26.0
7.5
794
231
29.01
1 Percentage of total handicapped.
It should be noted that there are approximately 110 male patients nursed by the
female staff. L 88 MENTAL HEALTH SERVICES REPORT,  1957/58
During the year the patients cared for on the male side of the hospital were segregated; that is to say, units were established in which patients of similar needs and similar
chronological and mental age were placed. Wards are now grouped as follows: There
are three wards for patients who are mildly retarded, the age ranges of these wards being
from 15 to 30 years, from 16 to 42 years, and from 29 to 68 years. There is one intermediate ward midway between the mildly and moderately severe; this houses seventy-two
patients with an age range of 6 to 17 years. There are four imbecile wards, the age ranges
being from 7 to 16 years, from 16 to 20 years, from 20 to 29 years, and from 29 to 50
years. There are three wards for severely retarded cases, age ranges being from 6 to 13
years, from 13 to 20 years, and from 20 to 40 years. There is one adjustment ward for
disturbed and problem behaviour patients (mainly those at the upper end of the imbecile
scale and some morons). This ward has a population of forty-six and an age range of
15 to 40 years. There is one ward for cerebral palsy cases of all ages. This also houses
certain imbeciles with additional physical handicaps such as blindness and deafness. The
ward population is forty-seven and covers all age ranges. There is one ward for senior
residents with a mean age of approximately 50 years. There is one ward for infirmary
cases and new admissions. The admission programme on the male side is now tied in
with bed availability in these segregated wards. This reshuffling of patients employed a
great deal of time and study and was very capably handled by Dr. Pauline Hughes in
co-operation with the male nursing division.
I would like to thank all staff concerned for the energetic way in which they cooperated in bringing about this change.
The segregation plans are completed for the female side but need the opening-up of
new wards to make the physical movement of patients possible. At the moment all crib
cases have been centralized in the Fraser View unit, which was opened early in the year.
Adult spastics now occupy Ward 1. It is to be hoped that segregation will be completed
on the female side during 1958/59. One of the effects of the segregation programme is
to throw up sharply the needs of the various groups which tend to be overshadowed when
the wards contain a heterogeneous collection of patients. One thing clearly demonstrated
is the degree of overcrowding which exists in all wards, particularly in the dayrooms, and
the inadequacy of existing toilet facilities and clothes storage to provide a well-organized
training programme for the moderately retarded group.
It will be apparent from Tables 1 and 2 and the distribution of segregated wards that
The Woodlands School has to provide care, treatment, training, and recreational facilities
to a remarkably heterogeneous clientele, ranging all the way from pediatric infant care
to long-term residential living conditions for elderly moderately affected individuals.
It will be noticed that the largest single group in the School is comprised of young
adult moderately retarded (imbeciles) of both sexes. The next largest is a group of
younger and more severely retarded cases (idiots), followed by mildly retarded young
adults, and lastly by a small and older group of elderly patients whose formal psychometric evaluation places them in the dull normal and border-line groups of general
intelligence.
Each individual patient-pupil may have special needs (psychiatric, medical, educational, psychological, recreational, physiotherapeutic, and so on), as well as having basic
needs for adequate housing, clothing, dietary, etc.
By and large, however, we may consider that the three major groups (mild, moderate, and severe) have preponderant needs which are distributed in the following way:—
Severely Retarded Group.—This group is mainly composed of children, and many
of these have multiple handicaps (motor defects, sensory defects, congenital malformations, etc.). They require a maximum of medical and nursing care and a minimum of
educational and psychiatric treatment. Such cases are usually admitted because then
parents are unable to meet the demands on their time and energy that the constant care
of these patients necessitates.    Although many of them are suffering from a chronic THE WOODLANDS SCHOOL
L 89
physical disease, hydrocephaly, etc., they cannot be maintained in general-hospital beds
owing to the demands for acute admissions and the high costs of prolonged care in the
general-hospital setting.
Staffing in the areas devoted to their care should reflect the accepted standards
currently in use in pediatric hospitals, and the nursing staff must have available for their
use adequate housekeeping, food delivery, janitorial services, etc., since this work poses
a very considerable strain on staff both physically and mentally. It should be realized
that not a few of these children may require anything up to one hour per feed and may
have to be changed very frequently during both day and night, as well as needing skilled
nursing care for physical illness.
I wish to report that the standard of physical care given to these children at The
Woodlands School is good. I would like to thank the nursing staff for their unceasing
efforts and devotion in caring for these children. It is exceedingly important for the
mental health of their parents and siblings that these children should be well cared for
and given the benefits of modern therapeutic knowledge.
The opening of the crib ward in Fraser View unit has been most helpful to the staff
in this regard. There is adequate space between the cribs, the air circulation is good,
and the spacious surroundings, although making for extra housekeeping work, impart
more dignified and quieter working conditions, which are most necessary to the staff's
well-being and efficiency. Some difficulty has been experienced in this building owing
to wide fluctuations in temperature (mainly due to solar heating), which have been very
difficult to control, but on the whole the building is a great asset to The Woodlands
School and one which has received much favourable comment from visitors and relatives.
The adult severely retarded group is not so adequately housed, and these patients
present a very difficult nursing problem, mainly on account of their weight and the fact
that many are completely helpless; some are also quite unco-operative. There is need
for the development of more efficient equipment in the way of portable baths, special
toilets, and chairs to help the staff in the sheer mechanical difficulties of handling this
group.
Moderately Retarded Group.—This is the largest hospital group and requires a
moderate investment of medical attention and skill and a maximum investment of training. These pupils can be taught self-care (to dress, feed, and attend to their toilet needs)
and can contribute a great deal toward their day-to-day management. When fully trained
they are capable of residing in areas of low staff concentration, and, although unable to
contribute in a positive sense by earning, they are, with training, able to live their lives
at less cost to the community owing to the reduction in staff necessary for their care.
For these objectives to be reached, there must be adequate toilet and clothing-storage
facilities available and sufficient school, occupational-therapy, and recreational staff.
Overcrowding with inadequate toilet and storage facilities makes the potential training
of these persons difficult, if not impossible, to achieve.
Many well-trained moderately retarded individuals should be able to spend their
adult lives either at home or in small residential units with less staff supervision than is
required in the large hospital school. There is need for the future development of such
types of care. Financial assistance to parents and the provision of small residential-care
homes would enable many of this group to leave the hospital school when it has played
its part in training, socializing, and developing them to the limit of their ability, thus
freeing hospital beds for the acceptance of other individuals into the active training
programme.
Mildly Retarded Group.—The cases in this group are nearly all placed in The
Woodlands School because of social failure of one kind or another. Many are emotionally disturbed and immature; some suffer from mild mental illness. This group does
not make heavy demands on physical, medical, and nursing care as they do not suffer
in the main from any physical impairments.   The School aims at developing their social L 90 MENTAL HEALTH SERVICES REPORT,  1957/58
skills by working with the patients in a psychotherapeutic relationship and instituting a
psychiatrically orientated programme involving academic school, vocational training,
occupational therapy, and recreational therapy. A large percentage of these individuals
are potentially capable of self-support (providing that openings exist in the community
for their acceptance and employment). The greatest unmet need for this group is in
the area of vocational training. It is vitally important for the training-school to be able
to assist in rehabilitation of these potentially self-directing individuals by offering a variety
of training experiences. They should assist in hospital maintenance work as helpers
and labourers. They must learn to use simple tools and develop manual skills. Traditionally, the maintenance departments of the training-school are used for this purpose,
and the artisan staff are selected both for their ability to train and instruct the patients
in good work habits.
These patients' contacts with society must be continued in every way possible, and
the tendency to institutionalization must be actively combatted by maintaining contact
with the community at all times during their training and rehabiliation period. All those
who work in the training-schools see the need for early ascertainment followed by adequate planning and realistic training for such children, and that as things stand at present
many of our cases come to us after years of neglect, frustration, and rejection. Many
have developed personality defects and antisocial behaviour patterns which take years
to modify and sometimes are beyond alteration.
The major problem during the last year has been a shortage of adequate training
staff and the exceptional staff turnover. There is need for the establishment of a course
of training both to further develop the psychiatric nurses in their special skills required
in caring for the retarded and for the aides so that all staff may take a fuller and more
dynamic share in meeting the special needs of the retarded person in the residential
training-school.
I am summarizing reports from the major departments below.
Crib cases were moved into the Fraser View unit in April. The training-ward for
the younger moderately affected girls was also established in this building. This has
been an unqualified success and provides one of the best units of its kind that I have
seen. Two wards (A and B) were turned over to the male side and are currently in
operation.
The auditorium and swimming-pool are nearing completion. The adult working
girls' rehabilitation unit (Nurses' Home No. 1) is progressing slowly. There is great need
for the administration to be centrally located, and plans are tentatively under consideration in this regard.
Medical care is good. Mortality rates are running at approximately 1 per cent per
annum.  There have been no major outbreaks of illness during the year.
Dental Department
There were 1,480 cases seen during the year, in comparison with 1,450 cases in the
year 1957. Dental care is good. The Department is, however, quite inadequately housed
and the equipment is out of date; chairs were manufactured at some date prior to 1913.
Mention has been made of this need previously.
Laboratory
Tests carried out numbered 5,822, compared with 6,155 in 1957. The reason for
this reduction in work is that we were without a laboratory technician for a good part
of the year and much of the work had to be done at the Provincial Mental Hospital.
Chromatography apparatus has been ordered but has not yet arrived. There is no doubt
that more staff will be needed as the population increases. THE WOODLANDS SCHOOL
L 91
Beautician's Department
A total of 6,805 treatments were given during the year, compared with 6,547 in
1956/57. The Beautician's Department is poorly situated. Plans are being considered
for a change in location.
X-ray Department
There were 4,488 cases seen during the year, compared with 4,520 in 1956/57.
Here there is need for a waiting-room, changing-room, and toilet facilities. The patients
at the moment are lined up in the corridor outside the door of the administration offices
whilst awaiting X-ray.
Nursing Services
Women's Division
In 1957/58 trained staff numbered 97; aides, 160; ratio of trained staff to aides,
.60:1, compared with 1956/57—96, 133, ratio of .72:1. This is a continuation of the
reduction in numbers of trained to untrained staff which has been taking place over the
past few years.
It should be noted that this has taken place in a situation where larger numbers of
maximum-care patients are being admitted.
Male Division
In 1957/58 trained staff numbered 84; aides, 153; ratio, .55:1. In 1956/57
trained staff numbered 80; aides, 115; ratio, .70:1. Once again a state of decline is to
be noted. It is imperative that the decline in numbers of trained staff be stopped in
order to maintain adequate standards of care and to develop better services to the patient-
pupils. This problem of reduction of trained staff is the single greatest area of concern
to the medical administration.
Department of Education
Twelve teachers from special schools for the retarded in the community came for
observation at the School. There have been no staff changes, although one addition to
the staff is on the estimates and this position will soon be filled. There has been, therefore, a further drop in the ratio of teachers to pupils. Three hundred and twenty-five
patients are presently attending school, 138 of these have an I.Q. of 50 and 187 have an
I.Q. below 50. Only thirty pupils attend school for the full five-hour day. If all the
pupils of The Woodlands School are to receive comparable education and training to
that of special schools in auxiliary classes, the following staff would be required: —
Analysis of Academic Teaching Programme
Group
Number
of
Pupils
Hours
per
Week
Total
Pupil-
hours
per Week
Number
in Class
Weekly
Pupil-
hours
per
Teacher1
Number
of
Teachers
Required
Above 50 I.Q., ages 7 to 12-
Above 50 I.Q., ages 13 to 30 ..
Above 50 I.Q., ages 31 to 40...
I.Q. 35-49, ages 7 to 30-
Handicapped I.Q. 35 and above, ages 7 to 30..
Totals— — — 	
40
135
25
225
100
25
25
10
10
5
1,000
3,375
250
2,250
500
10
15
10
10
5
250
375
250
250
125
525
7,375
1 Based on 25-hour teaching-week.
The figures given above are based on Kirk and Johnson " Educating the Retarded
Child," from data supplied by the Ministry of Education in the United Kingdom and
recommendations by the Vancouver School Board relating to auxiliary classes.    It is. L 92 MENTAL HEALTH SERVICES REPORT,  1957/58
obvious from these that in order to meet pupils' needs there must be a large expansion
in teachers.
Physiotherapy Department
Treatments given in 1957/58 were 2,972, compared with 3,281 in 1956/57. It
should be noted that we had only two physiotherapists during part of the year. One
aide was seconded to this Department in October.
Speech Therapy Department
This Department commenced full time in October, and since then sixty-seven cases
have been seen and thirty-eight have received therapy.
Psychology Department
There was no full-time psychologist in The Woodlands School until July 3rd, when
Mr. Nuttall entered the staff and was joined by Miss Helen Walter on March 10th. The
background work for Tables 1 and 2 occupied a great deal of time in this Department
during the year.
Total number of tests given was 341. Both members of the Department have been
actively engaged in diagnostic and rehabilitation clinics, daily conferences, staff clinics,
and orientations of various community groups.
Audiology Department
Mrs. Gysin attended from the Health Centre for Children, made fifty-four visits,
took part in five conferences, and carried out 491 tests.
Our grateful thanks are due Mrs. Gysin and to the Health Centre for Children for
this extremely valuable service, which is in need of further development.
Social Service Department
This Department has been very actively engaged in preadmission and admission
services, rehabilitation, and casework. There is probably need for further development
in this Department if an all-out programme for rehabilitation and non-institutional care
is to be carried out.
Dietary Department
The Woodlands School dietary is good and the food has been both palatable and
nutritious. The old kitchen is in need of complete renovation and overhaul, and this,
I understand, is to be completed during the coming year.
Recreational Department
The auditorium and gymnasium became available to the Department toward the
end of March, and there is no doubt that this is one of the most beautifully decorated
and well-equipped facilities possessed by the training-school. The Department of Public
Works is to be congratulated on the striking but harmonious colour scheme which it
selected for this building. The games area below the auditorium is invaluable for play
activities, as is the black-topped area outside. Mrs. Lindo joined the staff early in the
year, and the Department is at present functioning with four instructors and carrying on
a full programme both during the week and on week-ends.
There are now four equipped playgrounds for the population, and the new play-
fields will soon be put to use. The social club, comprising forty-two boys and girls, has
been developed, and they plan and arrange their socials and recreational programmes
during the week. THE WOODLANDS SCHOOL
L 93
There is a lunch-time recreation class for the boys of Fraser Glen and Riverdale,
and recently a start has been made in cleaning up the ravine to make a camp-site for
the children. The usual annual gym display was well attended. Over 200 boys and
girls attended picnics in Stanley Park, and 180 attended the Pacific National Exhibition.
Two sports days in July and August at Willow playgrounds were attended at The Woodlands School.
The waiting-list still remains rather large and currently stands at 470. L 94
MENTAL HEALTH SERVICES REPORT,  1957/58
STATISTICAL TABLES
Table 1.—Movement of Population, The Woodlands School,
April 1st, 1957, to March 31st, 1958
Male
Female
Total
In residence, April 1st, 1957  	
On probation, carried forward from 1956/57..
Totals as at April 1st, 1957. 	
Admissions—
First admissions. 	
Readmissions from a different institution of Mental Health Services..
Readmissions from the same institution  	
Total admissions	
Total under care   	
Separations—
Discharged in full  -  	
Died      	
On probation and still out-
Total separations.	
Net increase or decrease 	
In residence, March 31st, 1958...
735
2
+41
776
506
6
+35
541
1,241
8
737
512
1,249
63
6
1
53
1
116
7
1
70
54
124
807
566
1,373
10
13
8
10
10
5
20
23
13
31
25
56
+76
1,317
Table 2. — First Admissions to The Woodlands School by Health Unit and
School District of Residence and Sex, April 1st, 1957, to March 31st, 1958
Detailed information for the above table may be obtained on request.
Table 3.—First Admissions to The Woodlands School by Method of Admission,
Age-group, and Sex, April 1st, 1957, to March 31st, 1958
Age-group (Years)
Total
Method of Admission
Under
1
1-3
4-6
7-9
10-14
15-19
20-29
30-39
40 and
Over
Grand
Total
1      1      1
M.lFJM.IF.
1      1      1
1      1       1
M.I F. IM.I F.
1      1      1
M.
1
F. IM.
1
F.
1      1       1
M. 1 F. 1 M. 1 F.
1      1       1
1       1       1
M. 1 F. IM. 1 F.
1      1      1
Certification  —
1      I      1
1|    1]  131    8
1       1       1
13   10
1
121    9
12
1
9|    7
I
9
1
4|     4
I
51     1
'   I   !
2     3| 69| 54
1      1       1
123 THE WOODLANDS SCHOOL
L 95
Table 4.—First Admissions to The Woodlands School by Mental Diagnosis,
Age-group, and Sex, April 1st, 1957, to March 31st, 1958
Age-group (Years)
Mental Diagnosis
Under
1
1-3
4-6
7-9
10-14
15-19
20-29
30-39
40 and
Over
Total
Grand
Total
I
M.I F.
M
F.
M.
F. IM.
1
F.
1      1      1
M. 1 F. IM. 1 F.
1      1      1
M.
F. IM.
1
F.
M.
1
F. IM.
1
F.
Neurotic-depressive reaction-
Mental deficiency—
Idiocy      .
Imbecility.. 	
1
1
4
2
1
3
3
1
1
2
1
3
_
4
4
1
2
2
3
1
1
5
1
5
1
2
1
2
2
1
1
2
3
1
1
5
2
1
2
5
2
2
1
1
5
1
1
5
1
" 1
1
2
1
3
1
1
1
1
1
1
1
1
1
3
13
15
15
6
9
11
1
7
9
16
3
4
13
1
1
20
24
31
Border-line intelligence	
9
13
Mental deficiency with epilepsy  	
Epilepsy     	
24
1
Totals — -
1
1
13
8
13
10
12
9
12
9
7
9
4
4
5
1
21    31 691 541   123
llll
Table 5.—First Admissions to The Woodlands School by Mental Diagnosis,
Years of Schooling, and Sex, April 1st, 1957, to March 3 1st, 1958
Table 6.—First Admissions to The Woodlands School by Citizenship, Age-
group, and Sex, April 1st, 1957, to March 31st, 1958
Table 7.—First Admissions to The Woodlands School by Religion and Sex,
April 1st, 1957, to March 31st, 1958
Table 8.—First Admissions to The Woodlands School by Previous Occupation
and Sex, April 1st, 1957, to March 31st, 1958
Detailed information for the above tables may be obtained on request. L 96
MENTAL HEALTH SERVICES REPORT,  1957/58
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p. THE WOODLANDS SCHOOL
L 97
Table 10.—Resident Population of The Woodlands School by Mental Diagnosis,
Length of Stay, and Sex, December 3 1st, 1957
Detailed information for the above table may be obtained on request.
Table 11.—Live Discharges from The Woodlands School by Mental Diagnosis,
Condition on Discharge, and Sex, April 1st, 1957, to March 31st, 1958
Condition on Discharge
Mental Diagnosis
Recovered
Much
Improved
Improved
Unimproved
Total
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Schizophrenic disorders	
1
1
2
1
1
3
1
2
1
1
1
3
1
1
1
1
2
3
1
2
3
1
1
3
1
1
4
1
Mental deficiency—
Imbecility   	
Moron.—- -	
3
4
4
Mongolism 	
2
1
Epilepsy.. _ 	
1
Totals
1
1
4
4
fi    1      s
10
10
20 L 98
MENTAL HEALTH SERVICES REPORT,  1957/58
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L 99
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P L 100 MENTAL HEALTH SERVICES REPORT,  1957/58
PART IV.—PROVINCIAL MENTAL HOME, COLQUITZ
MEDICAL SUPERINTENDENT'S REPORT
L. G. C. d'Easum, Medical Superintendent
I am pleased to report the appointment of Mr. E. F. Groome as Chief Psychiatric
Nurse—Grade 2. The appointment became effective on July 1st, 1957. Mr. Groome
was formerly Chief Psychiatric Nurse at the Home for the Aged, Terrace.
Other changes occurring among the staff during the year were nine psychiatric aides
who left the service, two of whom were permanent appointees. The remainder were
probationers or casual employees. Three psychiatric nurses joined the staff. Two of
these were from England and one was a transfer from the Provincial Mental Hospital,
Essondale. The remainder of vacancies were filled by psychiatric aides. The percentage
of psychiatric aides to the total nursing staff remains at about 33 per cent. With the
implementation of the forty-hour five-day week on October 1st, 1957, our staff was
increased by five, bringing the total to sixty-three, plus one holiday relief for summer
months. Mr. R. P. Nash, nursing instructor from the School of Psychiatric Nursing,
was at the institution during November, 1957, and conducted a course in ward and personnel management. This course proved quite popular with the psychiatric nurses
attending.
Our patient population on April 1st, 1957, was 285, and on March 31st, 1958, was
287. During the year seventeen patients were received at this institution from the
Provincial Mental Hospital, Essondale, and eight patients were transferred from this
institution to the Provincial Mental Hospital. Five of these latter were cases of pulmonary
tuberculosis being transferred to the North Lawn Building. The other three were referred
for further diagnostic investigation and treatment if necessary. Two patients were discharged in full during the year and one patient was discharged on probation. Sixteen
patients were seen by the Appeal Board. The general health of the patients was good
throughout the year. The greatest trouble we had was with a minor outbreak of boils,
which proved very resistant to therapy. There were five patient deaths during the year,
all of them occurring in the elderly group, and in most instances the cause of death was
due to circulatory failure.
As always, the Victoria Chest Clinic has been most co-operative and made regular
monthly visits to this institution with a portable X-ray unit.
Industrial and Occupational Therapy Departments
In a building as old as this institution there is much maintenance work to be done.
Most of this is done with the supervised patient help and is considered industrial therapy.
Our decorating is going on constantly, and the paint gang is kept busy throughout the year.
Extensive alterations and repair work were done during the year. The new lower east
dining-room was finished, as well as a new kitchen attached to it, and the old dining area
and kitchen were converted into a patient lounge and poolroom. New lighting was
installed, ventilation was provided, and this new lounge has proved very popular. The
top east ward was completely redecorated in bright new colours, and the appearance of
the dormitory has been enhanced by chipping off the old white paint from about 100 beds
and doing them over in a light-green colour. Both occupational-therapy shops were well
utilized throughout the year, and as many patients as possible were given instruction in
wood and metal turning, ship model work, copper-tooling, cabinetwork, etc. Before
Christmas many of the toys which had been collected by the Optimist Club in Victoria
were repaired and returned to the group for distribution among the needy. During the
year we put on two very fine displays of articles made in the Occupational Therapy
Department.   One was in the Hudson's Bay Company store during Mental Health Week. PROVINCIAL MENTAL HOME
L  101
Recreation
Weather permitting, the recreation court was in daily use during the summer months,
and during the winter months the more active patients were allowed out to exercise on
the paved sidewalks on the inside of the enclosure. In addition to the regular entertainment programme of bingo, radio, and television, a total of twelve concerts were presented
by various groups. We are very grateful to these concert parties, who have been so
generous with their time and talent. At Christmas time we were remembered again by
the Salvation Army, the Canadian Mental Health Association, and the combined Women's
Institutes. The Red Cross Society and the Britannia Branch of the Canadian Legion
provided comforts for the ex-servicemen monthly. These were all very much appreciated.
Regular church services were held throughout the year.
Regular visits were made during the year by Dr. S. S. Avren and Dr. W. G. Dempsey
to care for the physical and dental needs of the patients respectively. L  102
MENTAL HEALTH SERVICES REPORT,  1957/58
STATISTICAL TABLES
Table 1.—Movement of Population, Provincial Mental Home,
Colquitz,1 April 1st, 1957, to March 31st, 1958
Number
In residence, April 1st, 1957  285
On probation, carried forward from 1956/57       2
On escape, carried forward from 1956/57       1
Transfers
Totals as at April 1st, 1957
288
17
Total under care
305
Separations—
Discharged in full
Died 	
On probation and still out __
Escaped but not discharged
Total separations
Net increase or decrease	
10
5
2
1
18
+2
In residence, March 31st, 1958  287
1 This institution cares (or male patients only.
Table 2.—Transfers to the Provincial Mental Home, Colquitz, by Health
Unit and School District of Residence and Sex, April 1st, 1957, to March
31st, 1958.
Detailed information for the above table may be obtained on request.
Table 3.—Transfers to Provincial Mental Home, Colquitz, by Method of
Admission and Age-group, April 1st, 1957, to March 31st, 1958
Method of Admission
Age-group (Years)
Total
20-24
25-29
30-34
35-39
40-44
45^19
50-54
55-59
60-64
65-69
70 and
Over
Warrant—   	
Certification   	
Other	
1
1
..._.
2
1
1
1
1
1
1
1
1
1
9
3
1
Totals-	
1
1
2
2
1
1
1
1
2
1     I    13 PROVINCIAL MENTAL HOME
L 103
Table 4.—Transfers to Provincial Mental Home, Colquitz, by Mental
Diagnosis and Age-group, April 1st, 1957, to March 31st, 1958
Mental Diagnosis
Age-group (Years)
Total
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70 and
Over
With Psychosis
1
1
1
2
1
1
1
1
2
7
2
Other and unspecified psychoses	
2
Total with psychosis	
1
1 | _
1 |      2 |      1 |      1
1
1
2
11
Without Psychosis
Mental deficiency—moderate	
Chronic brain syndrome, N.O.S	
—
	
1
	
	
1
1
1
Total without psychosis _	
—
1
	
_J_ | __ -| __ | .._..
--. | -.
■—I        1 1      2
1
1
	
•.1       0   1       11       1
1   I      1
Table 5.—Transfers to Provincial Mental Home, Colquitz, by Mental Diagnosis and Marital Status, April 1st, 1957, to March 31st, 1958
Table 6.—Transfers to Provincial Mental Home, Colquitz, by Mental Diagnosis and Years of Schooling, April 1st, 1957, to March 31st, 1958
Table 7.—Transfers to Provincial Mental Home, Colquitz, by Citizenship and
Age-group, April 1st, 1957, to March 31st, 1958
Table 8.—Transfers to Provincial Mental Home, Colquitz, by Religion, April
1st, 1957, to March 31st, 1958
Table 9.—Transfers to Provincial Mental Home, Colquitz, by Previous Occupation, April 1st, 1957, to March 31st, 1958
Detailed information for the above tables may be obtained on request. L  104
MENTAL HEALTH SERVICES REPORT,  1957/58
Table  10.—Resident Population of Provincial Mental Home, Colquitz, by
Mental Diagnosis and Age-group, December 31st, 1957
Mental Diagnosis
Age-group (Years)
15-19
1
20-24125-29
1
30-34
35-39
40-44
45^19
50-54
55-59
60-64
65-«9
70 and
Over
With Psychosis
1
2
9
12
17
21
20
1
1
34
1
1
1
1
34
1
4
22
1
1
27
2
2
39
4
3
238
7
5
Psychosis with cerebral arterioscle-
2
Psychosis   of   other   demonstrable
etiology	
Other and unspecified psychoses
1
3
6
Total with psychosis	
1 |      2 |      9
12
17
21  |    22 |    38
39
24
31
46
262
Without Psychosis
Alcoholism — - 	
1
1
~~1
4
1
2
1
1
5
2
2
" i
4
1
1
4
4
20
Chronic brain syndrome, N.O.S	
Epilepsy	
4
4
Total without psychosis	
...... |      1  |      1 |      1
5
3
6
5
4
2 | .__.
4
32
1
3
10 I     13
22
24
28
43
43
ie. I   31
50
294
Table 11.—Resident Population of Provincial Mental Home, Colquitz, by
Mental Diagnosis and Number of Previous Admissions, December 31st, 1957
Table 12.—Resident Population of Provincial Mental Home, Colquitz, by
Mental Diagnosis and Length of Stay, December 31st, 1957
Detailed information for the above tables may be obtained on request.
Table 13.—Live Discharges from Provincial Mental Home, Colquitz, by Mental Diagnosis and Condition on Discharge, April 1st, 1957, to March 31st,
1958.
Condition on Discharge
Mental Diagnosis
Recovered
Much
Improved
Improved
Unimproved
Total
2
1
6
1
8
1
1
3
7
10 PROVINCIAL MENTAL HOME
L 105
Table 14.—Live Discharges from and Deaths Occurring in Provincial Mental
Home, Colquitz, by Mental Diagnosis and Age-group, April 1st, 1957, to
March 31st, 1958.
Mental Diagnosis
Age-group (Years)
Total
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70 and
Over
Live Discharges
1
1
—
—
2
1
1
1
1
2
8
1
Mental deficiency _ —
1
Totals	
1    |      1    |    ....
-    1      2    |      1    |      2
1
2
10
Deaths
—
....
—
1
1
3
4
1
Totals	
....
1
1
3
5
Table 15.—Live Discharges from and Deaths Occurring in Provincial Mental
Home, Colquitz, by Mental Diagnosis and Length of Stay, April 1st, 1957,
to March 31st, 1958.
Detailed information for the above table may be obtained on request.
Table 16.—Deaths Occurring in Provincial Mental Home, Colquitz, by Cause
of Death and Length of Stay, April 1st, 1957, to March 31st, 1958
Length of Stay
Cause of Death
1
Year
2
Years
3-5
Years
6-9
Years
10 Years
and Over
Total
3
2
3
2
Totals	
_        1       _
1
—
5
5
Table 17.—Deaths Occurring in Provincial Mental Home, Colquitz, by Cause
of Death and Age-group, April 1st, 1957, to March 31st, 1958
Detailed information for the above table may be obtained on request. L  106 MENTAL HEALTH SERVICES REPORT,  1957/58
PART V—GERIATRIC DIVISION
REPORT OF MEDICAL SUPERINTENDENT
B. F. Bryson, Medical Superintendent
The Geriatric Division has continued to operate to capacity during the year
providing special medical and psychiatric care to a large number of elderly men and
women of the Province who, because of senile or arteriosclerotic mental changes,
exhibited symptoms or behaviour which could not be adequately treated or cared for
elsewhere.
Although there has been some decrease in the number of requests for admission
to the Geriatric Division, it is still evident that the existing facilities within the Mental
Health Services are inadequate to provide for the many elderly disturbed patients who
require the special care available in the three units of the Division.
It is felt that the decrease in the number of requests for admission to the Homes
for the Aged is a reflection of the increasing interest on the part of physicians in the
community in the welfare of the aged and the judicious use by them of the new tranquillizing medications in preventing many elderly people from becoming acutely disturbed
to the point of requiring urgent committal. It is felt that the various welfare agencies,
too, have become more interested and aware of the problem of accommodation for the
aged in our population and have submitted requests for admission only for those who
have been most difficult and where other modes of care at the community level have
been exhausted.
In addition, the Medical Superintendent has spent many hours during the year
interviewing relatives and others, by telephone, by mail, or in person, who have been
burdened or intimately concerned in the problem of caring for confused disturbed elderly
relatives or patients. Wherever possible, advice and encouragement have been given to
maintain these patients in the community as long as possible. In many cases, suitable
accommodation or medical treatment has been worked out so that admission to the
Home for the Aged could be delayed or was no longer required. In many instances the
cost of maintaining an elderly relative in a nursing home, plus the cost of medical care,
has imposed an intolerable financial burden on the patient's estate or on the patient's
family to the point that admission to the Home for the Aged became imperative.
The lack of nursing-home accommodation at the community level, as well as the
financial problem, has again been a major factor in preventing the discharge of many
patients from the Geriatric Division who have shown improvement and could now be
maintained near their family in a nursing-home situation. Many such patients require
a minimum of skilled nursing care, but because of their confusion, loss of memory, and
disorientation do need a homelike atmosphere and protection from wandering and
becoming lost.
The treatment and management of the large number of senile and arteriosclerotic
patients who require continued care in hospital is time-consuming and demands much
patience and understanding on the part of the nursing staff, who must be sympathetic
and accepting of the handicaps imposed on their patients by the process of age or
arteriosclerosis. Patience and tact are required in great measure to overcome the
resistance and lack of co-operation engendered by physical debility, mental confusion,
loss of memory, disorientation, or delusional thinking. Authorities are becoming increasingly aware that a relatively higher ratio of nursing staff to patient population is required
to give adequate care to the geriatric mental-hospital patient compared to the ratios
required in other areas of mental-hospital care.
During the past year 266 applications were receiving requesting admission of
elderly disturbed men and women over the age of 70 years to the Geriatric Division. GERIATRIC DIVISION L 107
This represents a decrease of seventy-four or 21 per cent over the previous year, when
340 applications were processed. In addition, it was possible to accept 252 patients
for admission, which represents a slight increase of nine over the 243 accepted from
the community during the fiscal year 1956/57. The number of applications received
averaged twenty-two per month, while the average for the previous year was twenty-eight.
The number of applications received which were considered urgent and for whom admission could not be delayed numbered 111 or 42 per cent of the total number received,
which represents very little change from the past few years. Although the number of
names on the waiting-list has decreased during the year, due to death or the provision
of alternative methods of care, the number of new cases developing continues to be
steady, and there is a constant pressure for accommodation beyond the scope of the
present facilities of the Geriatric Division.
Applications for the admission of patients 70 years of age or over from the Lower
Mainland area of the Province numbered 188. It was possible to accept 157 from this
area. In the Okanagan and Kootenay areas, seventy-four applications were received,
all of which were accepted for admission to the Vernon unit. In the northern part of
the Province, only twelve elderly patients required care of this type and were admitted
directly to the Terrace unit.
Total admissions to the three units of the Geriatric Division, including direct
admissions from the community and transfers, numbered 281, an increase of fifty-three
over the previous year. Of these, 150 were men and 131 women. The Port Coquitlam
unit received 166, an increase of thirteen; the Vernon unit seventy-eight, an increase
of thirty-one; the Terrace unit 37, an increase of nine compared to the previous year.
During the year it was possible to discharge in full to the community fourteen men
and four women who returned to their families for continued care or for whom nursing-
home accommodation was provided. This number represents an increase of eight over
the number discharged during the previous year. It is still felt that many more patients
could be discharged if social service workers were available on the staff of the Geriatric
Division. This service would provide better liaison with community agencies and families
of improved patients whereby suitable arrangements could be worked out to find
accommodation away from the hospital. This would in turn provide more vacancies
for the early admission of acutely disturbed patients who create severe problems in
management to families and communities in all parts of the Province.
Most vacancies are created by deaths, which totalled 271 in the three units, an
increase of sixty-eight over the previous year, and included 137 men and 134 women.
This ratio in the death rate of 1:1 is a change from the experience of the past years, when
the ratio of male to female deaths has been consistently 2:1.
Total separations from the Geriatric Division, including deaths and discharges,
totalled 289, compared to 219 for the previous fiscal year. The total number of patients
in residence at the end of the fiscal year was 1,053, including 542 at Port Coquitlam,
226 at Vernon, and 285 at the Terrace unit. Of the thirty-seven vacancies available
for new patients in the three units at the year's end, twenty-eight were at the Vernon
and Terrace hospitals, and there were no patients from these areas awaiting admission.
However, plans are being formulated to fill these vacancies from the Essondale area.
The remaining nine vacancies at the Port Coquitlam unit have already been allocated
to the most urgent cases on the waiting-list and will shortly be filled.
It will be noted, therefore, the greatest problem in providing accommodation and
treatment for mentally ill elderly men and women exists in the Lower Mainland and
Vancouver Island areas of the Province. The new Admitting and Infirmary Building
now nearing completion at the Port Coquitlam unit will appreciably improve the situation,
and it is hoped that these facilities will be made available for use at an early date. L 108 MENTAL HEALTH SERVICES REPORT,  1957/58
At the Vernon unit all vacancies on the women's wards during the year were filled
by direct admissions from that area of the Province. However, the number of applications for the admission of elderly men to both the Vernon and Terrace units did not utilize
all the vacancies which occurred during the year, so that it was possible to transfer thirty
male patients from the Essondale area to these units, thereby releasing this number of
beds for the acceptance of patients from the Lower Mainland area. However, only five
patients were suitable for transfer from the Port Coquitlam unit, so that the remaining
twenty-five were taken from the Mental Hospital population at Essondale.
On May 8th, 1957, twenty patients were taken to the Terrace unit, and on February
4th, 1958, ten men were escorted to the Vernon unit. In each instance, transportation
was provided by C.N.R. special coach, and the patients were escorted by a suitable
number of psychiatric male nurses and Dr. Bryson. As on previous occasions, the
highest degree of co-operation and assistance was provided by the C.N.R. authorities
and train crews, so that our patients were comfortable en route and arrived safely and
happily at their destination.
In addition to visits at the time of patient transfers, the Medical Superintendent
visited the Terrace unit on December 9th and the Vernon unit on May 29th and October
8th. He was accompanied in May by Mr. J. Dowling, Administrative Assistant for
Personnel of the Provincial Mental Health Services, and in October by Dr. J. Gilbert,
Consultant in Psychiatry, Department of National Health and Welfare, Ottawa. On
each occasion Dr. Bryson spent a day or so visiting the patients, discussing problems of
medical care and administration with the supervisor, and on several occasions had the
opportunity to speak to the nursing staff on the subject of geriatric medicine and nursing.
Every opportunity has been taken to encourage a high standard of medical and nursing
service for our patients, and the nursing staffs in each unit are to be commended for their
loyalty and devotion to the welfare of their patients in spite of the many frustrations and
difficulties with which they have had to cope.
Port Coquitlam
Throughout the past year the Port Coquitlam Home for the Aged has functioned
to capacity, with no appreciable change in the various departments. There have been
no major medical problems, and, generally speaking, the health and comfort of the
patient population has been maintained at a very satisfactory level. This has been
accomplished, however, only by the devotion and interest of the nursing staff, who have
had to put forth even greater efforts to maintain the standard of nursing service, especially
during the latter part of the year, when staff reductions became necessary. The lack of
sufficient supervisory staff for our nursing services, which has been a problem at this
unit for many years, was felt even more keenly during the past year.
Every effort has been made to continue the policy of keeping the elderly patients
as physically and as mentally active as their condition warrants for as long as possible
rather than to allow them to become bedridden and mentally deteriorated any sooner
than absolutely necessary. This policy not only serves to preserve the integrity and
independence of the older person and to give some meaning and pleasure to their later
years, but reduces to a minimum the burden of bed care, which is so time-consuming
to an already limited nursing staff. However, this also increases the need for constant
supervision of the many unsteady feeble patients on our wards, who are prone to
accidental falls and other mishaps which lead to fractures and other injuries.
A very welcome addition to the medical staff of the Port Coquitlam unit occurred
on July 1st, 1957, when Dr. Walter Lazorko was assigned to full-time duty as assistant
to the Medical Superintendent. Dr. Lazorko has applied himself assiduously to his
duties, and his skilled medical service and constant interest in his patients have
measurably improved the general health and welfare of this patient-group.   His presence GERIATRIC DIVISION L  109
not only provides greater medical coverage and early attention to illnesses which might
rapidly become chronic or serious, but also allows the Medical Superintendent to devote
more time to the increasing problems of administration in the Geriatric Division.
During the fall and winter months the usual increase in upper respiratory infections
occurred, with an unusually high incidence of influenza-like conditions during November
and December, when similar infections became so prevalent in the general population.
However, secondary complications such as bronchopneumonia were kept to a minimum
by prophylactic treatment and early use of antibiotic medication. Although many very
feeble and debilitated patients succumbed to these infections, only two deaths were
considered to be due directly to influenza. There were relatively very few reportable illnesses and no infections of an epidemic degree.
Skin infections due to staphylococcus aureus have been a minor problem because
of their resistance to most antibiotics, and particularly because the difficulties encountered
in providing adequate isolation of cases due to lack of suitable space and shortage of
staff. Although this infection has not been eradicated, it is felt that the problem is under
control.
The tranquillizing medictations continue to be of great assistance in the treatment
of many psychotically disturbed patients, who are great problems in management because
of restless, agitated, or destructive behaviour. An average of 150 patients have been
receiving this form of therapy with marked benefit to their own contentment and welfare,
as well as reducing the amount of nursing care and supervision which they would
otherwise require.
As in past years, the surgical service at the Crease Clinic, the specialist consultant
staff, and the Departments of Neurology, Pathology, and Radiology have contributed
greatly to the maintenance of a high standard of medical care for this patient-group.
Many elderly patients have been referred for special investigation and treatment throughout the year. The geographical situation of this unit in relation to the Crease Clinic
and Mental Hospital has been a continuing problem due to the limited transportation
facilities and the shortage of staff for escort duty with patients, but these special departments have co-operated to the full to keep this problem to a minimum. The facilities in
the new building, however, will improve this situation considerably.
During the year twenty-seven patients, including twenty-three women and four men,
were referred for orthopedic care for hip and other more minor fractures received in
accidental falls. This is a marked improvement compared to the previous year, when
thirty-one women and eleven men suffered similar injuries. In addition, twenty-one
patients received major surgical treatment at the Crease Clinic, the most common surgical
procedures being repairs for hernia, prostatic hypertrophy, and, in female patients,
vaginal hysterectomy and repairs for rectal prolapse. One elderly lady was transferred
from the Vernon unit in order to attend the British Columbia Cancer Institute in Vancouver for radium implantation of a cervical carcinoma. She progressed well and has
been returned to her ward at Vernon. One man was similarly transferred from the
Terrace unit for treatment of a carcinomatous condition of his ear. A number of patients
from the Port Coquitlam unit have also been referred to the British Columbia Cancer
Institute for special treatment, and in all instances the Institute staff have been most
co-operative and helpful. Many other patients have been referred to the consultant
staff at Essondale for advice and treatment for a wide variety of medical conditions.
Routine nursing and ward services have been maintained satisfactorily throughout
the past twelve months, and there have been no major staff changes or additions to
services. Wherever possible, minor changes in nursing routines have been made where
the comfort and welfare of the patients could be improved, or where such changes
could lessen the burden on the nursing staff. Staff reductions during the latter part of
the year have further increased the difficulties of maintaining a high standard of nursing L  110 MENTAL HEALTH SERVICES REPORT,  1957/58
care. In December the physiotherapists who previously visited our wards regularly were
withdrawn due to reduction of staff in the Physiotherapy Department at Essondale.
There has been no replacement, and many patients who cannot be transported to the
main department at the Crease Clinic have been denied this service, which is a necessary
part of geriatric medical care.
Mrs. K. Warrender, R.N., Superintendent of Nurses in this area, has been devoted
in her efforts to provide supervision, advice, and co-ordination of the nursing services
on the women's wards, but has been hampered by the lack of continuity which exists
when on-the-spot supervision is not available during the afternoon and night duty
periods. To a greater extent has the lack of supervision been noticeable on the men's
wards. Trained nursing supervisors who are familiar with the total patient population and
are available on the wards during each shift period are necessary to ensure co-ordination
and continuity of ward routines and to provide instruction and guidance to ward charge
nurses when required.
The general health and care of our elderly ladies, both physically and mentally,
has been enhanced by the continued service of the small and cramped but efficiently
operated beauty-parlour on H.A. 4. The one beautician assigned to this area has been
steadily occupied during the year and has been the recipient of many smiles of gratification for a new "hairdo." Her services have been of great assistance in helping the
elderly ladies regain and retain a fading interest in personal care and appearance. So, too,
on the men's ward have the hospital barbers stimulated a waning interest in personal
appearance by a well-trimmed haircut. Special foot care, supplied when required by
Mr. Bradford, chiropodist at Essondale, has also been an important factor in providing
comfort to many of our elderly patients.
The occupational- and recreational-therapy programmes have continued to flourish
throughout the year and have played a major role in our efforts to assist patients in
regaining a new and satisfying interest in life, to recall and enjoy old skills, and to revive
and strengthen a lost sense of security and the satisfaction of accomplishment, as well
as to enjoy again the pleasure of mixing with others and making new friends. Mrs.
Shefley continued her programme of handicraft instruction on both the men's and
women's wards, as well as conducting special mixed groups of the more capable patients
in a weekly afternoon programme on H.A. 4. Mr. Harrison Smith has similarly conducted a regular programme of weekly social activities for both men and women
throughout the winter months. During the summer months his programme consisted
of picnic outings at the Hillside picnic-grounds, trips to Stanley Park, and, in co-operation
with the garage staff, the organization of mystery rides in the hospital buses. Both Mrs.
Shefley and Mr. Smith have shown exceptional interest and enthusiam as well as skill
in devising activities particularly suitable for the patients in this area. Of particular
importance has been the combination of their programme for special events, the success
of which, especially in this area, has indicated that co-operation and unification of these
two forms of therapy can produce beneficial results not easily possible by either discipline
working independently. During the Christmas period the beautiful ward decorations
and party favours were in large part the work of patients themselves, and Mr. Smith
and Mrs. Shefley combined their efforts to conduct ward parties, which were highly
successful and in keeping with the Christmas season. Their combined efforts produced
a most enjoyable Valentine party in February, and on other occasions such activities
as the music- and art-appreciation programme and the nature-study projects were
received and participated in with enthusiasm by a large number of elderly men and
women. An Easter tea and puppet show held on March 27th was the highlight of the
year's activities, with several elderly patients narrating the parts in the puppet show and
acting in a small skit. The refreshments at the tea were made and served by a number
of the elderly ladies. During the same afternoon a display of patients' handicraft work
was on view and brought many comments of surprise concerning the quality and variety GERIATRIC DIVISION
L 111
of projects produced by this patient-group. Approximately 150 patients from the Home
for the Aged wards enjoyed this afternoon, as well as many staff members from Essondale
and the Crease Clinic.
The volunteer workers of the Canadian Mental Health Association have also
continued to contribute greatly to the health and happiness of our patients by their
regular visits to the wards, the sing-songs conducted with patients, their assistance at ward
socials, and in the many other ways that they have shown their interest in our patients.
Their twice-weekly visits have been highly appreciated by patients and staff alike. The
successful efforts of the Canadian Mental Health Association in providing all patients
with a suitable gift at Christmas was greatly appreciated, and no one was forgotten on that
very special day.
The Audio-Visual Department at Essondale, too, has continued to bring many
hours of enjoyment to our patients through the medium of their 16-mm. ward movies,
which are shown regularly and are popular with a large number of patients.
Reverend O'Neil has held regular religious services on the wards each week
throughout the year for the many patients who are unable to attend the regular Sunday
church services at Pennington Hall. Father Frechette has also given freely of his time
to visit patients of his faith whenever requested. The religious needs of our patients
are being well served at present, but the opening of the new Chapel-Auditorium Building
will provide welcome space and more suitable environment for this important aspect
of patient-care.
Throughout the past year the dietary service has continued to be very satisfactory
both in respect to the quality and service of the general diets supplied to the wards daily,
although at times under difficulty due to the cramped quarters and antiquated facilities
in the main kitchen and the lack of adequate help in the ward kitchens. Miss E.
Thompson, dietician in charge of the Home for the Aged area, continued supervision
of this department until the end of September, when she transferred to Jericho Hill
School in Vancouver. By the end of the year no replacement had been provided. Due
to improved medical care in this area, there has been a considerable increase in the
number of patients receiving special diets, which has increased the demands on the main
kitchen as well as on the nursing staff on H.A. 4, H.A. 7 and H.A. 6, where patients
are congregated who require special dietary service. During the last five months Mrs.
Marr, Chief Dietician, Provincial Mental Hospital, has attempted to supervise the dietary
service in this area as well as her busy schedule permitted.
The Home for the Aged clinical office has also continued to function efficiently
during the past year under the able direction of Miss Marlynn Jorgensen, assisted by
Miss Alberta Burns. The many and varied secretarial and clerical duties of this office
have been gradually increasing as medical, nursing, and other allied patient programmes
have expanded.
The Public Works Department has carried out general repairs and maintenance
as required throughout the year and, in addition, has completed several important projects. In June three console television sets, generously donated by the Hoo Hoo Club
of Vancouver, were installed on wards H.A. 2, H.A. 3, and H. A. 8, as well as another
set provided by the Hospital to H.A. 9. All wards, with the exception of H.A. 4, H.A. 6
and H.A. 7, have now been supplied with this popular form of diversion. The painting
programme which started in February of 1957 continued steadily through to the end of
September, by which time all buildings, except the interior of H.A. 1, had been tastefully
redecorated both inside and out. This work has given the wards a bright and cheerful
appearance and has been highly appreciated by patients and staff alike. It is hoped
that work in H.A. 1 will be completed in the very near future. During the year the
maintenance staff have completed other welcome projects, including new tiled flooring in
the east dormitory and nurses' office of H.A. 2, single rooms and corridor in H.A. 1, the L  112 MENTAL HEALTH SERVICES REPORT,  1957/58
basement dormitory of H.A. K; sodding of the new ward-airing courts; provision of
spring locks on the main entrance doors of H.A. 3 and H. A. 2.
In September, by contract labour, the unused chimneys were removed from the
roofs of H.A. 1, H.A. 2, H.A. 3, H.A. K, and the Administration Building. During
December a basement-floor washroom was remodelled to provide much needed storage
space for patients' clothing and luggage on H.A. 3.
In addition to the television sets, new equipment received included seven vacuum
cleaners for the wards and replacement of approximately sixty dayroom chairs with
colourful chrome-tubing armchairs, which are much more practical and suitable for the
elderly patients than the older-type dayroom seats.
Whenever possible, the Medical Superintendent has taken the opportunity to
encourage and stimulate interest in the community in the problems of adjustment that
beset the increasing numbers of elderly people in our population, especially with reference
to the preventive aspects of geriatric medicine and the importance of proper preparation
of the older person for retirement. During Mental Health Week in May, Dr. Bryson
participated on two occasions in the Film Festival programme arranged in Vancouver
by the Canadian Mental Health Association. On each occasion the geriatric film " Retire
to Life " was shown, with a brief introductory talk by the Medical Superintendent of the
Geriatric Division. On May 14th and 17th Dr. Bryson attended the first British Columbia
conference on " The Needs and Problems of the Aged," held at the University of British
Columbia. This conference was exceptionally well attended by over 100 delegates,
representing a variety of agencies and groups in the Province who are interested and
aware of the growing problem of providing for the needs of our elderly citizens. Dr.
Bryson has also continued to be a member of the sub-committee of the Committee on
Health and Welfare of the Aged of the Vancouver Chest and Council, with special interest
in the mental-health problems of the aged people in the Greater Vancouver area.
Vernon
The Vernon unit has continued to function efficiently and to capacity during the
past year under the able and devoted supervision of Mr. L. W. Fox, the unit Supervisor,
and his deputy and Superintendent of Nurses, Miss H. O. Lipsey, R.N.
As in past years, a high standard of nursing care and attention has been maintained,
and all departments and personnel of this unit are to be commended for their interest
and co-operation in maintaining this standard under, at times, very trying circumstances.
Dr. J. Smith and his associates have continued their high standard of medical service
to this patient-group. Drs. Sleigh and Wilson left the Vernon area during the summer
months, and in September Dr. A. D. Dale replaced them in association with Dr. Smith.
Dr. Dale calls daily and alternates with Dr. Smith on week-ends, so that twenty-four-hour
expert medical service is available for our patients at this unit.
There have been no major medical problems and no epidemic illnesses during the
year, and the seasonal increases of upper respiratory infections during the winter months
have not been out of proportion to that experienced in the Vernon community. Staphylococcal skin infections have been at a minimum, with but two or three cases during the
year.   Two patients developed hepatitis, but neither proved to be of the infectious type.
Only four patients—one elderly man and three ladies—suffered hip fractures as a
result of accidental falls, which is an improvement over previous years in spite of the
increasing age and feebleness of the patients at this unit. Where indicated, pinning
operations were performed by Dr. Smith at the Vernon Jubilee Hospital, with postoperative care being continued at the Home for the Aged.
Although there have always been a few patients confined to bed throughout the year
on both male and female wards for a variety of reasons and often because of general
weakness and debility of age, it is considered that the general health of this patient-group
has been maintained at a high level. GERIATRIC DIVISION L 113
The diagnostic facilities of the Vernon Jubilee Hospital have been used to a greater
extent during the past year, including the laboratory and X-ray departments. The administrative and technical staff of this hospital have continued to be most co-operative and
helpful in providing special care for our patients whenever their assistance has been
required.
The dental chair and equipment provided for this unit has been used regularly by
the dentist during his weekly or semi-monthly visits, and all patients requiring dental
service have received prompt care, whether for extractions, fillings, or new dentures.
Optical needs have also been provided by a local optician, and a number of patients have
received refractions and new spectacles as required.
General nursing and ward services have been maintained at a satisfactory level
throughout the year, and there have been no changes in senior nursing personnel. The
introduction of the forty-hour week and subsequent staff reductions have placed a marked
burden on the existing staff in attempting to maintain former standards. In addition, as
there has been no relief allowed for illness of staff, there are frequent occasions, especially
during the winter months when patient morbidity is at its peak, that wards have to
operate with insufficient personnel. The lack of sufficient numbers of nursing personnel
on the wards at all times not only reduces the quality of patient-care, but produces a
hazard in the event of fire, an ever-present threat in wooden-frame buildings.
As in past years, an in-service educational programme has been conducted for the
nursing staff during the winter months in the form of instructive films. In October Mr.
R. Nash, instructor in the School of Psychiatric Nursing at Essondale, visited the Vernon
unit and conducted a three-day refresher course for psychiatric nurses preparing for
eligibility examinations. Miss M. L. Jayne, registered physiotherapist employed in the
Vernon area, also gave a short course in body mechanics and basic physiotherapy
principles to both nurses and aides. The time and effort donated freely by Miss Jayne
has been sincerely appreciated.
In addition to annual chest X-rays for patients by the travelling clinic of the Division
of Tuberculosis Control, the nursing staff have been X-rayed every six months. During
November the North Okanagan Health Unit made available to the Vernon community
Asian influenza vaccine, and a large number of the Home for the Aged staff took advantage of this offer.
Throughout the year senior nursing-staff meetings have been held frequently for
the discussion of nursing procedures and routines, and minor changes have been made
where it was felt that an improvement could be made which would better patient-care or
render nursing routines more efficient.
The Dietary Department has continued to operate efficiently, and all the dietary
personnel have shown a sincere interest in the dietary needs of the elderly patients,
Throughout the year regular meals have been ample and appetizing, and on special
occasions, such as Christmas, New Year's, and Easter time, special menus have been
prepared to suit the occasion. The kitchen staff have also been most willing to prepare
cakes and other tasty treats for special ward parties. One important need in kitchen
equipment is replacement of the present dish-washing machine, which is inadequate and
does not meet the standards required by the district Health Officer. At the end of the
year this long-standing requisition had not been implemented.
The Laundry Department also has continued to maintain a steady output of an
average of 40,000 pounds a month in spite of a reduction in patient-help and limited
staff. In November Mr. Boyer, Laundry Manager, returned to the Essondale area and
was replaced by Mr. L. Todd, who has been most co-operative and efficient. As a member of the Canadian Institute for Launderers and Cleaners, the laundry is permitted to
submit test bundles at periodic intervals for testing and report. All samples submitted
during the past year have been rated as excellent for whiteness retention, minimum
strength-loss, detergency, and chemical damage value. L  114 MENTAL HEALTH SERVICES REPORT,  1957/58
In May a very capable and enthusiastic handicraft instructor, Mrs. J. Sherlock,
joined the staff of the Vernon unit. Under her guidance numerous handicrafts have been
introduced and taught to many patients, bringing to light unsuspected talents. The
mental conditions and attitudes of a large number of patients have been improved by this
diversional programme, helping, as it does, to give them a feeling of accomplishment,
aiding them to retain some degree of independence and achievement, while at the same
time diverting their thoughts from the more unfortunate aspects of their lives.
In addition to the handicraft instruction, Mrs. Sherlock has developed a full and
varied programme of entertainment, including, during the summer, such activities as
lawn bowling, horseshoes, outdoor checkers, and garden parties. Weekly picture shows
on the wards and special ward socials occupy the winter months. During the fall a
group of volunteer ladies from Vernon began regular visits to the unit and have been
most helpful in assisting Mrs. Sherlock in her entertainment programme. In the Annex,
patient entertainment facilities were augmented by delivery of a television set, which has
given many hours of enjoyment to the ladies there.
The clinical and administrative offices were able to maintain and fulfil the many
and varied demands placed on them while the services of two clerk-stenographers were
available. Since the first of the calendar year, when general staff reductions allowed only
for the retention of one stenographer, the administrative and clerical duties, which are
heavier now than ever, have been maintained only by overtime work on the part of Miss
Lystang, Miss Lipsey, and Mr. Fox. The completion of patients' files and records have
frequently been long delayed, and other services dependent on clerical assistance have
suffered.
In the Stores Department, Mr. T. S. Groves, who has been in charge of this Department for a number of years, resigned to enter private business. After some delay, this
position was filled by Mr. P. W. Baron. In spite of rising prices of food and materials
during the past year, the Vernon unit has managed to keep the per capita cost in food-
supplies from increasing proportionately.
The Public Works Department has been active in keeping up with general maintenance and repair and in the completion of several major projects. A combined shed
to house the tractor and to provide extra working space for the gardener was built adjacent to the greenhouse by and under the supervision of Mr. Hornell, the foreman carpenter. Major repairs to the Annex roof, renovation of the boiler-room office, and
painting of several indoor and outdoor sections of the hospital were also completed.
In addition, two new air-cooling units were installed by contract in Dormitories M 2
and F 2.
Fire Chief Little, of the Vernon Fire Department, has continued to give advice with
respect to fire-prevention measures at the unit, and in February conducted the annual
inspection of the premises.   The report of this inspection was very satisfactory.
Mr. Legg, the hospital gardener, has continued his devoted and conscientious service in keeping the lawns and flower-beds in excellent condition, and his efforts have
brought many comments of admiration from the Vernon residents. In addition, he has
kept the wards supplied throughout the year with seasonal cut flowers from the greenhouse.
The interest of the community of Vernon in the presence and operation of the
Home is evident by the continued generosity and desire of various organizations in donating time, effort, and articles for the benefit of our patients. At Christmas the patients
enjoyed several visits from choral groups, including groups of Girl Guides, C.G.I.T.,
Boy Scouts and Cubs, Pioneer Girls, and from two church groups. The ladies of the
Royal Purple Lodge have provided automobile rides for some of the ladies, and often
donations of candy, fruit, and magazines are received from fraternal societies and individuals. The Canadian Mental Health Association was again very generous this past
Christmas in supplying suitable gifts for all patients.
L GERIATRIC DIVISION L 115
Devotional services have been held regularly by Father Miles and Reverend Reeve.
Both have been conscientious in the performance of duty, in the conducting of services,
visits to patients, and attendance at funerals.
In light of the above, therefore, the Medical Superintendent feels that the residents
of the Vernon Home for the Aged have received during the past fiscal year the best
medical and nursing care and attention that is possible with the limited personnel and
facilities available at this unit.
Terrace
The Terrace unit, too, has completed a successful year of activity under the very
capable supervision of Mr. W. E. Skillicorn, unit supervisor, and his deputy and Chief
Psychiatric Nurse, Mr. F. Stewart.
No major medical problems were encountered during the year, and the general
physical health of the patients has been satisfactory, although there has been a gradually
increasing degree of morbidity amongst this patient-group and a higher rate of mortality.
It is felt that this is a reflection of the increasing age and general debility of these patients,
especially those patients who were originally transferred to this unit from Essondale.
It has been very difficult to replace working-patients in the laundry, dining-rooms, and
kitchen, as well as for grounds maintenance. Most patients admitted directly from the
community have been too feeble to be considered for sustained activity in any of these
areas, and it has been exceedingly difficult to find patients in the Essondale area suitable
for transfer who could replace the working-patients at this unit. In order to maintain
existing services, not only at the Terrace unit, but at all three Home for the Aged units,
it will be necessary in the future to make provision for more paid staff, as reliable patient-
help is gradually becoming less available.
During the year Dr. J. R. Nicholson became associated with Dr. Dukelow and
Dr. Lee, and the care of our patients at this unit is shared on a month-about rotation
system by these busy physicians. All three doctors have shown a devoted interest in the
health and general welfare of the patients and have given conscientious service to their
medical needs.
The need for an increased amount of surgical care has been evident throughout the
year, with a total of nine patients requiring major surgical procedures and several minor
operations. With the exception of one man who suffered a fractured hip and was transferred to Prince Rupert for pinning operation, all cases were treated at the Terrace
General Hospital, where the attending doctors carried out the surgery. The major procedures included a colostomy, one prostatectomy, one appendectomy, two amputations
for gangrene, two hernias, removal of a large lipoma, and the relief of a bowel obstruction. One patient was transferred to the Port Coquitlam unit for treatment of a cancerous
growth on his neck.
The staff of the Terrace General Hospital have been most co-operative and helpful
during the year, not only with respect to those of our patients hospitalized there for
surgery, but in providing special X-ray or laboratory examinations on other patients as
required.
As is customary during September, all patients and staff received their annual chest
X-ray through the courtesy of the travelling clinic of the Division of Tuberculosis Control.
A recheck of seventy-five patients and staff was performed in January. No active cases
of tuberculosis were found during the past year.
The use of the tranquillizing medications has continued in selected cases and has
produced benefits to the patients concerned by reducing their anxiety and restlessness to
a feeling of contentment, with increased interest in their environment and greater ability
to co-operate and thus reduce the amount of nursing care they required. L 116 MENTAL HEALTH SERVICES REPORT,  1957/58
The nursing staff of the Terrace unit, under the supervision and guidance of Mr.
Groome and later Mr. Stewart as Chief Psychiatric Nurses, as well as the special contribution of Mrs. M. Skillicorn, R.N., have continued their very capable and conscientious
efforts in providing the maximum standard of care and comfort possible for this patient-
group. During the past year the recruitment of suitable nursing aides has improved
considerably, so that the nursing staff, both numerically and qualitatively, has been at the
highest level since the opening of this unit in 1951.
Two major changes in senior nursing staff occurred during the year, when Mr. R. A.
Jones, Charge Nurse, was transferred to the Essondale area and Mr. E. F. Groome, Chief
Psychiatric Nurse, left the unit to take up a similar position at Colquitz. Mr. F. W.
Stewart received the appointment as Chief Psychiatric Nurse and has been fulfilling his
new responsibilities very ably. The Charge Nurse positions were filled on an acting basis
by two of the senior psychiatric nurses, and at the end of the fiscal year replacements
were expected momentarily from Essondale to complete the complement of trained
nursing staff.
During the early part of November Mr. R. Nash, from the School of Psychiatric
Nursing, visited this unit and conducted a two-day refresher course for the psychiatric
nurses applying to take eligibility examinations. This visit was stimulating and instructive
to the nursing staff, and it is hoped that further similar visits will be arranged by the
School. It is most important both for the morale and the efficiency of nursing personnel
in outlying units that they be kept in touch with up-to-date methods and nursing procedures which are available to their colleagues in the larger centre at Essondale.
Weekly motion-picture shows have continued to be the favourite form of patient recreation, followed by radio, card games, and reading. More active recreational activities
or occupational pursuits suitable for elderly men have been lacking at this unit because
of staff shortage and the lack of any one person who could be spared from essential ward
duties to organize a recreational or occupational programme, although such a programme
would reap great benefits in general patient welfare and would also reduce the burden of
nursing care and supervision which is inherent with large numbers of sedentary, disinterested, and deteriorating elderly patients.
Church services and visits with the patients have been carried out regularly through
the year by Father Turgeon, Father Mohan, and Archdeacon Hinchcliffe, who succeeded
Rev. M. O'Connell as Protestant chaplain. In addition to the regular Sunday services, two
mixed choirs—one from the Gospel Mission and one from the Pentecostal Tabernacle—
have presented twice-monthly concerts on the wards. The interest of these community
organizations in the welfare of our patients is greatly appreciated.
The dietary staff, under the direction of Mr. H. F. Peffer, chief cook, have provided
the unit with a wholesome and diversified menu throughout the year. Their extra efforts
by working various holidays and other special occasions to add treats and special dishes
has been cause for much favourable comment by all the patients. This department has enjoyed an improved stability of staff during the year, with consequent smoother functioning.
The Stores Department, under the supervision of Mr. Morgan, has continued to
function efficiently throughout the year and has maintained a constant and ready supply
of the many items required for the smooth operation of all departments.
The laundry, under the direction of Mr. Norton, has continued to maintain an
adequate supply of clean linen, although at times with considerable difficulty and occasional delays due to the decreasing availability of patient-help for this department. The
addition of two paid laundry-workers is required in order to maintain this service as
patient-help can no longer be counted on.
The engineering staff, under the direction of Mr. F. T. MacLachlan, have been most
co-operative and helpful in the general maintenance of the heating system as well as the
electrical and plumbing equipment. GERIATRIC DIVISION L 117
The Public Works Department has also been able to complete several major projects,
including the construction of a new pump-house over the new well, the installation of a
proper pump and new water-line from the new well to the boiler-room, the construction
of a pole-line and remote-control system for the new well, all of which will now assure an
adequate and ready supply of water at all times. Other projects included installation of
a reconditioned stoker for the third boiler, reconstruction of the walk-in cooler in
the hospital kitchen, and construction of a new overhead power distribution system.
The staff painter has completed redecoration of the interior of the hospital building and
has also completed several areas of the exterior of the buildings.
Difficulty was again experienced during the early part of the year with the sewage-
disposal system. In order to overcome the problem of a periodically inactive septic tank,
a new laundry effluent-disposal line was constructed to by-pass the septic tank and prevent inactivity apparently produced by the detergents from the laundry. At the end of
the year, no further problems of this nature have occurred. The previous difficulties of
snow-removal during the winter months have been removed by the provision of a snow-
blade which can be attached to the large truck.
In summary, the Medical Superintendent feels that the standard of service provided
for the patients at the Terrace unit is at the maximum possible with the numbers of staff
and facilities available, and that all departments have co-operated whole-heartedly and
with sincere interest in the welfare of the patients entrusted to their care.
ACKNOWLEDGM ENT
In concluding this report of the Geriatric Division, the Medical Superintendent again
wishes to express appreciation for the understanding and co-operation received from the
many agencies and individuals in the Province whose problems may have been magnified
by the necessary delays encountered in the admission of elderly patients to the care of this
Division, also for the willing co-operation received from all departments of the Provincial
Mental Hospital, the Crease Clinic, and the three units comprising this Division of the
Mental Health Services, as well as for the advice and guidance frequently received from
headquarters personnel. L 118
MENTAL HEALTH SERVICES REPORT,  1957/58
STATISTICAL TABLES
HOME FOR THE AGED, PORT COQUITLAM
Table 1.—Movement of Population, Home for the Aged, Port Coquitlam,
April 1st, 1957, to March 31st, 1958
Male
Female
Total
In residence, April 1st, 1957  	
143
19
40
405
36
71
548
Admissions—
55
Readmissions from a diffeient institution of Mental Health Services	
111
59
107
166
202
512
714
Separations—
13
48
3
108
16
Died                                   	
156
61
111
172
—2
141
—4
401
6
In residence, March 31st, 1958 _	
542
Table 2.—First Admissions to Home for the Aged, Port Coquitlam, by Health
Unit and School District of Residence and Sex, April 1st, 1957, to March
31st, 1958.
Detailed information for the above table may be obtained on request.
Table 3.—First Admissions to Home for the Aged, Port Coquitlam, by Method
of Admission, Age-group, and Sex, April 1st, 1957, to March 31st, 1958
Age-group (Years)
Method of Admission
60-69
70-79
80-89
90-99
Total
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Certification 	
Urgency 	
1
6
43
61
1
15
37
1      2
59
106
1
165
1
Totals	
1
6
43 |    62
1
15 |    37  |           |      2
I           1           1
59
107
166 GERIATRIC DIVISION
L 119
Table 4.—First Admissions to Home for the Aged, Port Coquitlam, by Mental
Diagnosis, Age-group, and Sex, April 1st, 1957, to March 31st, 1958
Age-group (Years)
Total
Mental Diagnosis
60-69
70-79
80-89
90-99
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
With Psychosis
Schizophrenic disorders—■
Simple type  	
—
1
1
1
2
26
1
1
3
1
1
1
19
20
2
1
3
4
1
10
12
1
	
1
1
1
5
30
1
1
4
1
1
1
31
33
3
1
5
Schizo-affective 	
1
1
Involutional psychotic reaction   	
Paranoia and paranoid states	
1
1
36
63
1
Other and unspecified psychoses  	
3
Total with psychosis	
— |      2
30 |    48
8 |    24 | _ |      1
38
75
113
Without Psychosis
1
1
2
1
1
1
8
3
2
3
9
1
6
2
4
7
1
1
3
14
3
5
10
17
1
Chronic brain syndrome with behavioural reaction
8
24
Other diseases of the central nervous system	
20
Total without psychosis. 	
1  |      4
13 |    14
7 |    13 | _ |      1
21
32
53
1   I       6
43 1    62
15
37  1
2
59
107
166
Table 5.—First Admissions to Home for the Aged, Port Coquitlam, by Mental
Diagnosis, Marital Status, and Sex, April 1st, 1957, to March 31st, 1958
Table 6.—First Admissions to Home for the Aged, Port Coquitlam, by Mental
Diagnosis, Years of Schooling, and Sex, April 1st, 1957, to March 31st, 1958
Table 7.—First Admissions to Home for the Aged, Port Coquitlam, by Citizenship, Age-group, and Sex, April 1st, 1957, to March 31st, 1958
Table 8.—First Admissions to Home for the Aged, Port Coquitlam, by Religion
and Sex, April 1st, 1957, to March 31st, 1958
Table 9.—First Admissions to Home for the Aged, Port Coquitlam, by Previous
Occupation and Sex, April 1st, 1957, to March 31st, 1958
Detailed information for the above tables may be obtained on request. L 120
MENTAL HEALTH SERVICES REPORT,  1957/58
Table 10.—Live Discharges from Home for the Aged, Port Coquitlam, by
Mental Diagnosis, Condition on Discharge, and Sex, April 1st, 1957, to
March 31st, 1958.
Condition on
Discharge
Total
Mental Diagnosis
Recovered
Much
Improved
Improved
Unimproved
Grand
Total
M.
F.
M.
F.
1
M.   I    F.
1
M.   1    F.
1
M.
F.
1
—
1
—
1
2
1
1
1
1
2
2
1
1
1
4
4
1
1
1
2
2
1
6
Psychosis with cerebral arteriosclerosis—
Other character  behaviour and intelligence disorders 	
Chronic   brain   syndrome   with   behav-
5
1
1
Chronic brain syndrome, N.O.S 	
Other diseases of central nervous system-
1
2
Totals	
1
....
1
-    1      5
2
6
1
13
3
16
Table 11.—Live Discharges from and Deaths Occurring in Home for the Aged,
Port Coquitlam, by Mental Diagnosis, Age-group, and Sex, April 1st, 1957,
to March 31st, 1958.
Age-group (Years)
Total
Mental Diagnosis
60-69
70-79
80-89
90-99
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Live Discharges
	
	
2
3
1
1
1
2
1
2
1
1
1
	
	
	
4
4
1
1
1
2
2
1
6
Other   and   unspecified   character   behaviour   and
Chronic brain syndrome with behavioural reaction—
1
Other diseases of the central nervous system :.	
2
Totals              	
_  |      8
3
5
	
13
3
16
Deaths
	
2
8
~16
2
1
3
15
1
16
1
2
2
6
1
26
1
2
6
4
2
15
27
5
1
4
47
1
46
1
6
1
2
4
62
1
Psychosis with cerebral arteriosclerosis  _	
Psychoneurotic disorders, other 	
9
—
3
24
2
73
1
11
......  |       1
_  |      ...
1
3
Totals
2
27
40
18
54
3
12
48
108
156
Table 12.—Live Discharges from and Deaths Occurring in Home for the Aged,
Port Coquitlam, by Mental Diagnosis, Length of Stay, and Sex, April 1st,
1957, to March 31st, 1958.
Detailed information for the above table may be obtained on request. GERIATRIC DIVISION
L 121
Table 13.—Deaths Occurring in Home for the Aged, Port Coquitlam, by Cause
of Death, Age-group, and Sex, April 1st, 1957, to March 31st, 1958
Age-group (Years)
Total
Cause of Death
60-69
70-79
80-89
90-99
Grand
Total
M.
F.
1
M.  1   F.
M.
F.
M.
F.
M.
F.
	
2
8
11
~2
3
1
1
1
2
1
7
16
1
2
2
3
1
1
2
2
4
7
1
2
1
1
7
1
3
32
2
2
3
1
1
2
1
2
9
1
2
2
13
20
2
4
1
3
2
1
9
2
10
59
1
4
5
8
1
2
3
4
11
2
Vascular lesions of the central nervous system	
Arteriosclerotic and degenerative heart disease    .
23
79
1
Diseases of the arteries and veins  —	
6
9
8
1
2
6
2
...... |      2
5
2
27  1    40
18
54
3
12
48
108
156
Table 14.—Deaths Occurring in Home for the Aged, Port Coquitlam, by Cause
of Death, Length of Stay, and Sex, April 1st, 1957, to March 31st, 1958
Detailed information for the above table may be obtained on request.
HOME FOR THE AGED, VERNON
Table 1.—Movement of Population, Home for the Aged, Vernon,
April 1st, 1957, to March 31st, 1958
Male
Female
Total
105
51
3
129
24
234
Admissions—
75
3
54
24
78
159
153
312
Separations—
5
53
2
26
7
Died                                                                                   	
79
Total separations	
58
28
86
—4
101
—4
125
—8
226
Table 2.—First Admissions to Home for the Aged, Vernon, by Health Unit
and School District of Residence and Sex, April 1st, 1957, to March 31st,
1958.
Detailed information for the above table may be obtained on request. L 122
MENTAL HEALTH SERVICES REPORT,  1957/58
Table 3.—First Admissions to Home for the Aged, Vernon, by Method of
Admission, Age-group, and Sex, April 1st, 1957, to March 31st, 1958
Age-group (Years)
Method of Admission
60-69
70-79
80-89
90-99
Total
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
5
25
8
22
15
2
1
54          24
78
Table 4.—First Admissions to Home for the Aged, Vernon, by Mental Diagnosis, Age-group, and Sex, April 1st, 1957, to March 31st, 1958
Age-group (Years)
Mental Diagnosis
70-79
80-89
90-99
Total
Grand
Total
1
M. 1   F.
!
M.
F.
M.
F.
M.
F.
M.
F.
With Psychosis
Schizophrenic disorders—
.._. | —
1 1 ......
2 1 .	
2
2
—
2
1
4
2
1
Psychosis with cerebral arteriosclerosis	
4
Total with psychosis. 	
3 I ---- 1      4 |	
_ | _ ||
7 | —
7
Without Psychosis
Chronic brain syndrome with behavioural reac-
2
	
1
20
8
22 |    15
...... |
2 |      1
1
46
24
1
Chronic brain syndrome, N.O.S.— —	
70
Total without psychosis.—	
2 |   |    21  |      8
22 |    15
2 |      1
47 |    24
71
5 1 .... 1    25 1      8
22 1    15
2 1      1
54 1    24
78
1
1
1
Table 5.—First Admissions to Home for the Aged, Vernon, by Mental Diagnosis, Marital Status, and Sex, April 1st, 1957, to March 31st, 1958
Table 6.—First Admissions to Home for the Aged, Vernon, by Mental Diagnosis, Years of Schooling, and Sex, April 1st, 1957, to March 31st, 1958
Table 7.—First Admissions to Home for the Aged, Vernon; by Citizenship,
Age-group, and Sex, April 1st, 1957, to March 31st, 1958
Table 8.—First Admissions to Home for the Aged, Vernon, by Religion and
Sex, April 1st, 1957, to March 31st, 1958
Table 9.—First Admissions to Home for the Aged, Vernon, by Previous Occupation and Sex, April 1st, 1957, to March 31st, 1958
Detailed information for the above tables may be obtained on request. GERIATRIC DIVISION
L 123
Table 10.—Live Discharges from Home for the Aged, Vernon, by Mental Diagnosis, Condition on Discharge, and Sex, April 1st, 1957, to March 31st, 1958
Condition on Discharge
Mental Diagnosis
Improved
Unimproved
Grand
Total
Male
|
Female
Male
Female
Male
Female
1
1
1
3
1
1
4
1
1
6
Totals	
1
1
4
1
5
2
7 L 124
MENTAL HEALTH SERVICES REPORT,  1957/58
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L 125
Table 12.—Live Discharges from and Deaths Occurring in Home for the Aged,
Vernon, by Medical Diagnosis, Age-group, and Sex, April 1st, 1957, to
March 31st, 1958.
Detailed information for the above table may be obtained on request.
Table 13.—Live Discharges from Home for the Aged, Vernon, by Condition on
Discharge, Disposition to, and Sex, April 1st, 1957, to March 31st, 1958
Disposition to—
Condition on Discharge
Home
Other Mental
Hospital
Other
Total
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
1
4
1
1
1
4
1
1
2
5
Totals	
5
1
1
....      |      5
1
2
7
Table 14.—Deaths Occurring in Home for the Aged, Vernon, by Cause of
Death, Age-group, and Sex, April 1st, 1957, to March 31st, 1958
Age-group (Years)
Cause of Death
60-69
70-79
80-89
90-99
Grand
Total
M.
F.
M.
F.
1
M.       F.
1
M.
F.
M.
F.
Malignant neoplasms  	
1
1
	
8
2
11
1
1
1
1
1
1
2
1
7
2
3
1
1
1
1
1
1
1
20
2
25
1
2
1
2
1
3
12
3
4
1
3
2
■>
10
23
—-
—.
12
1
2
Arteriosclerotic and degenerative heart disease	
37
4
fi
1
1
Totals	
2
24
8
25
16
2
2
53
26
79
Table 15.—Deaths Occurring in Home for the Aged, Vernon, by Cause of
Death, Length of Stay, and Sex, April 1st, 1957, to March 3 1st, 1958
Detailed information for the above table may be obtained on request. L 126 MENTAL HEALTH SERVICES REPORT,  1957/58
HOME FOR THE AGED, TERRACE1
Table 1.—Movement of Population, Home for the Aged, Terrace,
April 1st, 1957, to March 31st, 1958
Number
In residence, April 1st, 1957  286
Admissions—
First admissions     17
Readmissions from a different institution of Mental Health
Services      20
Total admissions
Total under care
Separations—
Discharged in full	
Died 	
_-. 37
___ 323
..__ 2
___ 36
Total separations	
Net increase or decrease	
In residence, March 31st, 1958
1 This institution cares for male patients only.
38
-1
285
Table 2.—First Admissions to Home for the Aged, Terrace, by Health Unit and
School District of Residence and Sex, April 1st, 1957, to March 31st, 1958
Detailed information for the above table may be obtained on request.
Table 3.—First Admissions to Home for the Aged, Terrace, by Method of
Admission and Age-group, April 1st, 1957, to March 31st, 1958
Method of Admission
Age-group (Years)
Total
60-69
70-79
80-89
90-99
!          I          1
14         1         10         1         13
37 GERIATRIC DIVISION
L 127
Table 4.—First Admissions to Home for the Aged, Terrace, by Mental
Diagnosis and Age-group, April 1st, 1957, to March 31st, 1958
Age-group (Years)
Total
60-69
70-79
80-89
90-99
With Psychosis
Schizophrenic disorders—
1
1
6
3
3
1
2
3
1
4
4
—
2
1
7
9
Psychosis with cerebral arteriosclerosis	
10
Total with psychosis	
14
6
9        1        .-.
29
Without Psychosis
4
1
1
2
—
1
5
2
4
4        |        _
8
14
10
13
---
37
Table 5.—First Admissions to Home for the Aged, Terrace, by Mental
Diagnosis and Marital Status, April 1st, 1957, to March 31st, 1958
Table 6.—First Admissions to Home for the Aged, Terrace, by Mental
Diagnosis and Years of Schooling, April 1st, 1957, to March 31st, 1958
Table 7.—First Admissions to Home for the Aged, Terrace, by Citizenship
and Age-group, April 1st, 1957, to March 31st, 1958
Table 8.—First Admissions to Home for the Aged, Terrace, by Religion,
April 1st, 1957, to March 31st, 1958
Table 9.—First Admissions to Home for the Aged, Terrace, by Previous
Occupation, April 1st, 1957, to March 31st, 1958
Detailed information for the above tables may be obtained on request.
Table 10.—Live Discharges from and Deaths Occurring in Home for the Aged,
Terrace, by Mental Diagnosis and Age-group, April 1st, 1957, to March
31st, 1958.
Mental Diagnosis
Age-group (Years)
Total
60-69
70-79           80-89
90-99
Live Discharges
1
:::   1   1
-
1
1
Totals.           	
1
_   i    i
—
2
Deaths
1
2
1
1
2
4
1
5
5
1
1
~9
1
2
2
6
1
1
17
7
1
1
Totals
7
16
11
2
36 L  128
MENTAL HEALTH SERVICES REPORT,  1957/58
Table 11.—Live Discharges from and Deaths Occurring in Home for the Aged,
Terrace, by Mental Diagnosis and Length of Stay, April 1st, 1957, to
March 31st, 1958.
Detailed information for the above table may be obtained on request.
Table 12.—Live Discharges from Home for the Aged, Terrace, by Mental
Diagnosis and Condition on Discharge, April 1st, 1957, to March 31st, 1958
Mental Diagnosis
Condition on Discharge
Total
Much
Improved
Unimproved
1
1
1
1
Totals           	
1
1
2
Table 13.—Deaths Occurring in Home for the Aged, Terrace, by Cause of
Death and Age-group, April 1st, 1957, to March 3 1st, 1958
Cause of Death
Age-group (Years)
60-69
70-79
80-89
90-99
Total
Malignant neoplasms.   	
Benign neoplasms.- 	
Vascular lesions of the central nervous system.
Other diseases of the central nervous system.—
Arteriosclerotic and degenerative heart disease
Pneumonia  	
Influenza 	
Diseases of the uninary system-
Diseases of the blood and blood-forming organs-
Totals  _ 	
16
11
1
1
2
19
2
6
36
Table 14.—Deaths Occurring in Home for the Aged, Terrace, by Cause of
Death and Length of Stay, April 1st, 1957, to March 31st, 1958
Detailed information for the above table may be obtained on request. CHILD GUIDANCE CLINICS L 129
PART VI.—CHILD GUIDANCE CLINICS
DIRECTOR'S REPORT
U. P. Byrne, Director
During the year the Child Guidance Clinic had its twenty-fifth anniversary, an
occasion celebrated by a reunion attended by members, some of whom had worked in
the original house on Hornby Street as well as Thirteenth Avenue. On May 1st, 1957,
the Mental Health Centre and Child Guidance Clinic in Burnaby was formally opened.
A review of the monthly reports shows that the need for an increased staff for a
day-school for emotionally disturbed children and an observation and treatment centre
for disturbed pre-adolescents has been emphasized month after month. The long interval
between a parent's application for help and continued treatment has been referred to time
after time, as well as the need for an extension of the travelling clinic services, the
appointments for which have had to be made more than a year and a half ahead.
Travelling clinics to Penticton, Kelowna, Cranbrook, and Creston were cancelled due to
staff shortages in September, 1957, and instead of the Burnaby and Mainland travelling
clinic seeing eighty-one new cases a month, it was possible to see only thirty-four.
During the year four of the most experienced in their field left the Clinic to do work
which offered them wider scope and considerably higher salaries. Mrs. E. Chave, who
for a long time had been a devoted worker here, more recently in charge of University
students attached to the Clinic for field work or postgraduate studies, left to spend a year
with her husband in England. We were also sorry to lose Mrs. P. Coyle, Mrs. McLeod,
Mrs. E. Chester, Mrs. B. Lipinski, and Miss M. Speirs. Dr. R. Harrington returned to
the Mental Health Centre after completing six months, during which he gave excellent
service to the challenging cases seen throughout the Province, with the travelling clinic.
As the year ended, the number of social workers for the first time in several years
was almost that of the established positions, due in part to improved salary scales, in part
to the Federal Mental Health Grants having stimulated recruitment, and in part to a
smaller staff turnover than in recent years.
During the summer we were pleased to have two students from Burma placed with
us under the Colombo Plan.
It would appear in the last few years there has been a levelling-off of the demand for
"direct service" at the Clinic, and it is likely that an additional team would markedly
cut down the present waiting-list. A review of patients' addresses shows that when the
Clinic was near the Vancouver City Hall 80 per cent came from Vancouver and 5 per
cent from Burnaby, whereas now 53 per cent come from Vancouver, 20 per cent from
Burnaby and 27 per cent from other suburban areas. Thought has been given to more
effective ways of helping private cases who come to us for help, and during the past year
the whole intake procedure has been made more flexible in the hope of meeting immediate
needs. The value of a social worker schooled in dealing with a group of parents or
children is apparent, and sessions with parents have been shown to have definitely cut
down the individual treatment time needed for a family and to have helped young people
who respond better when associated with others of their own age-group.
The senior psychologist reported that the past year has seen the fulfilment of the
unhappy prediction of the last annual report, and qualitative as well as the quantitative
losses are apparent from an examination of the monthly reports. During the year there
were three resignations—one of the Grade 3 level, one Grade 2, and one Grade 1—so
that only one psychologist above the B.A. level remains. There is a definite scarcity of
psychologists locally, and the recent salary increases have made no change. It has been
impossible to fill the present vacancies, which means that the present psychologist's time
is devoted almost solely to diagnostic demands, leaving no time for treatment, research, L 130 MENTAL HEALTH SERVICES REPORT,  1957/58
or education, an aspect which would deter those who might accept a lower salary if the
work here offered more opportunities. The demands for the orientation of psychology
students from the University of British Columbia have been met fairly well, but there has
been no progress in expanding the programme, which would require a greater percentage
of well-trained personnel here.
In November, 1957, Mr. A. Clemons, who has had wide experience in North
America and South Africa as a speech therapist, joined the staff. As well as giving
children and parents help in the Burnaby Clinic and Children's Hospital, Mr. Clemons
takes an active part in the committee governing the cerebral palsy school and in the
orientation of medical students. He has more recently started a service in which out-of-
town parents can get advice by correspondence.
In March, 1958, Mr. A. O. Morrison was transferred to us from the Social Welfare
Branch, New Westminster, and with his wide experience in social work and knowledge
of local resources we are fortunate in having such a man for the travelling clinic.
Miss M. Munro, our senior psychologist, was chosen as one of sixty Canadians to
take part in the Canadian Conference on the Needs of Children, which met in Toronto
and will continue to plan for a larger conference to be held in 1960. During the year
Mrs. M. Harvey, the senior public health nurse, was elected to the Royal Society of
Health. Mr. D. Ricketts was appointed local representative of the Child Welfare League
of America and a member of the planning committee for the next national conference.
A study of statistical tables for the year shows that:—
(1) There has been an appreciable decrease in the total number of cases given
a full examination, an over-all loss of 12 per cent.
(2) There has been an increase in the number of private cases, those referred
by parents and doctors and in which the Clinic invests the most in time
and effort, somewhat over 8 per cent more than in the previous year.
(3) Interviews by social workers, in spite of staff shortages, have increased
from 6,832 to 7,604, an increase of almost 12 per cent.
(4) There has been no marked change in the percentage of cases from the
various sources which refer children to our clinics, a smaller decrease in
those coming from the schools, including the Industrial Schools, and a
slight increase in those referred by private doctors.
(5) Of the children seen, more are diagnosed as varying types of emotional
immaturity than all varieties of mental retardation.
(6) The need for residential and day treatment for emotionally disturbed
children has constantly been brought to our attention as an unavailable
resource in British Columbia. CHILD GUIDANCE CLINICS
L 131
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L 133 L  134
MENTAL HEALTH SERVICES REPORT,  1957/58
Table 3.—Sources of All Cases Referred to Child Guidance Clinics, Showing Service
Given, April 1st, 1957, to March 31st, 1958
Number
of
Cases
Percentage of
Distribution
Type of Service Given
Agency or Source
Diagnostic Study
Only
Consultative
Conference Only
Clinic
Direct
Service
I. Social agencies—
144
114
13
9
29
1
128
93
13
5
24
1
16
21
4
2
Family and Children's Service    	
City Social Service Department  —
3
Sub-total                              	
310
24.20
—
......
2. Medical and health agencies—
Public health nurse 	
80
22
37
148
1
1
10
18
9
6
11
12
12
4
26
9
12
25
4
67
19
37
47
1
1
10
17
8
5
11
10
9
4
25
7
12
15
4
3
3
94
1
1
1
2
3
1
2
10
10
7
Selkirk Health TTMt
Central Vancouver Island Health Unit 	
	
West Kootenay Health Unit... 	
447
34.90
	
3. Schools—
Public —    .
13
3
28
16
17
26
16
17
2
13
Other --   - -	
3
Sub-total   -
77
6.01
	
--        1         -
4. Juvenile Court.        — -
28
6
23
4
5
2
-
34
2.65
.   .
5. Adult Court—Family Court 	
1
0.08
1
___
72
5.62
72
7. Parents, relatives, self, friends ~
305
23.81
|        305
8. Others—
C.N.I.B        .   .__ _ _
9
4
2
1
10
1
1
1
3
2
1
9
4
2
1
8
1
1
1
2
1
1
Indian Health Services 	
R.C.A.F.                              	
	
1
1
Provincial Guidance Clinic (Calgary) —
1
1
35
2.73
	
	
Totals                            	
1,281
100.00
685
179
417 CHILD GUIDANCE CLINICS
L 135
Table 4.—Presenting Problems and Disorders of All New Cases Given Full Examination
by Child Guidance Clinics, April 1st, 1957, to March 31st, 1958
Children
M.
Adults
M.
F.
Total
1. Primary behaviour disorders—
(a) Habit disorders—
Thumb-sucking	
Enuresis 	
Masturbation-
Tantrums	
Soiling..
(b) Personality disorders—
Seclusive states 	
Depressed states...	
Day-dreaming..
Feelings of inadequacy..
Sensitiveness	
Phantasy  	
Aggressiveness.	
Negativism	
Other	
(c) Neurotic disorders—
Tics and habit spasms-
Overactivity	
Fears	
W)
Nervousness	
Anxiety	
Nightmares	
Other	
Conduct disorders—
Truancy	
Fighting and quarreling-
Untruthfulness	
Stealing-
Destruction of property-
Use of alcohol	
Cruelty-
Disobedience..
Setting fires	
Sex offences....
Vagrancy-
Running away	
Breaking and entering-
Assault	
Other	
Educational disability—
(a) Associated with dull-normal or border-line intelligence..
(6) Special mental disability—
Writing-
Reading	
Arithmetic-
Other	
(c) Social adjustment-
3. Mental deficiencies—
(a) Familial 	
(_>) Mongolism-
(c) With developmental cranial anomalies..
(_D With congenital spastics 	
(e) Post-infectional 	
(/ ) Post-traumatic	
(g) With epilepsy...
(h) With other organic disorders..
(t) Undifferentiated	
Mental retardation	
1
15
1
12
7
6
2
5
10
2
2
16
4
3
4
11
11
4
1
6
26
2
1
23
9
3
6
1
1
2
1
10
1
1
6
33
6
6
5
5
3
13
14
16
1
3
1
17
19
1
4
1
1
2
2
4
11
4
23
2
17
11
4
6
14
6
5
22
10
12
6
12
14
18
4
2
7
1
15
39
6
2
1
34
9
22
1
10
1
1
4
1
13
1
1
12
55
1
10
7
1
5
7
5
17
25 L  136
MENTAL HEALTH SERVICES REPORT,  1957/58
Table 4.—Presenting Problems and Disorders of All New Cases Given Full Examination
by Child Guidance Clinics, April 1st, 1957, to March 31st, 1958—Continued
Children
M.
Adults
M.
Total
5. No ascertained mental deviation—
(a) Problem of physical health and development..
(6) Spastics..
(c) Speech problems	
(d) Hearing problems..
(e) School problems	
(/) Social problems-
Placement	
Adoption _
Other _	
(g) Normal personality..
(/.) Sight problem _
Totals	
8
3
11
5
5
2
14
6
6
12
12
8
400
244
12
1
11
16
8
20
18
20
1
5
15
668 CHILD GUIDANCE CLINICS
L 137
Table 5.—Diagnoses of All Cases Examined by Child Guidance Clinics, April 1st, 1957,
to March 31st, 1958
Children
Adults
Total
M.
F.
M.
F.
Psychoses—■
300                                                            .          - -	
1
1
1
17
1
1
1
2
1
2
2
1
5
5
5
1
1
35
11
17
7
8
17
68
7
7
16
40
29
1
1
13
3
4
2
1
1
1
1
3
1
1
1
56
1
1
9
1
11
1
1
1
2
1
3
24
4
11
7
5
1
43
2
1
11
21
25
1
1
12
3
2
1
1
1
1
1
1
1
31
1
5
2
3
-
1
2
2
1
4
1
__-
1
3
1
300 8                                                    	
2
Psychoneurotic disorders—
310                        ...      _.  _	
26
311	
2
312 	
1
314  	
11
315                                                    _	
1
317	
2
317 3   	
1
318                           	
1
318 2                                    	
1
318.4                                                                      	
2
318 5                                              	
3
319 9                                                                             —
1
Disorders of character, behaviour, and intelligence—
320                                                                 	
5
320 3                                  -           	
7
320.4...                     	
6
320 5                       .   -            -	
4
320.7                                                  _	
1
61
321.1           _ 	
17
321 2                       ....        -  	
29
321.3                                                            	
14
321 4  .    _.	
13
321.5                                              _             	
18
324                       .	
120
324.1  — —     -	
7
324.2 —                          -	
2
325
8
325.1                          ._	
27
325 2                                                   ..... —
63
325.3      	
325 4                                                  .                                     	
58
2
325.5                   _      -    	
1
325.6	
1
326     -	
25
326 1                                                  ...          - -
3
326.2-                     —	
7
326 3                                      - 	
4
326.4-
1
327          .-        	
2
327.3	
1
327 4                 _                   	
1
327.9—	
1
328.3           	
2
Other—
083.1 —	
1
351       —	
3
353	
1
353.1 _	
2
353.3	
2
353.8 _	
1
793  —	
89
400
244
12
12
668 L 138 MENTAL HEALTH SERVICES REPORT,  1957/58
Table 6.—Chart Comparing Ages with Intelligence Quotients of All New Cases Seen at
Child Guidance Clinics, April 1st, 1957, to March 31st, 1958
MALES
Intelligence Quotient
Age-group (Years)
Total
1-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40+
0- 19                -
2
12
14
7
15
8
16
6
1
10
22
27
22
38
26
19
3
3
16
12
19
32
25
20
1
4
1
3
13
8
5
	
1
—
......
—
1
......
	
3
20- 49     . .                 	
26
50- 69 ..      	
70- 79 _
56
48
80- 89                     ....	
59
90- 99 	
91
100-109 	
110-129 	
75
50
130-139. 	
140+ 	
1
3
Totals     	
80
168
128
34
	
1
i
	
	
412
FEMALES
0- 19	
20- 49—	
4
5
3
5
5
5
4
1
4
16
18
20
18
17
12
2
1
1
1
4
6
18
22
13
10
5
9
9
6
8
4
	
_.
	
2
9
50- 69 	
30
70- 79  	
80- 89	
90- 99  	
36
52
51
100-109	
110-129  	
43
30
130-139..	
......    |    ......
—    |    ..   .
2
140+- 	
1
Totals 	
31
109
75
41
... .    |    ..
1
—
     |    256
1
Table 7.—Summary of Professional Activities in Social Service Department,
April 1st, 1957, to March 31st, 1958
Vancouver    Victoria
Total
Total interviews with and regarding clients...
With adults 	
With children-
Team conferences attended on direct-service cases-
Internal  	
Including other agencies 	
Casework conferences—
Internal  	
Including other agencies-
Consultations with other team members-
Supervisory consultations-
Programme development and staff meetings	
Orientations to clinic of outside professional personnel-
Talks, lectures, film showings, etc..
Participation in community committees, etc..
5,474
1,977
7,451
4,100
1,347
5,447
1,374
630
2,004
496
60
556
224
79
303
249
4
253
317
4
321
589
52
641
696
72
768
803
95
898
125
5
130
45
45
41
41 CHILD GUIDANCE CLINICS
L 139
Table 8.—Summary of Cases Given Services by Social Service Department,
April 1st, 1957, to March 31st, 1958
Vancouver
Victoria
Totals
Direct Service
239
67
306
392
48
31
151
4
32
543
Cases reopened during the year 	
52
63
423
183
606
662
353
250
187
912
540
309
63
372
Services to Agencies
279
285
34
55
313
340
1,226
339
1,565 L 140 MENTAL HEALTH SERVICES REPORT,  1957/58
PART VII.—MENTAL HEALTH CENTRE
DIRECTOR'S REPORT
F. E. McNair, Director
The Mental Health Centre is now making its first annual report of one full year's
service to the community as an adult out-patient psychiatric treatment centre. It serves
two main functions—namely, consultative and treatment. Two treatment services are
offered—a day-hospital service for a capacity of twenty-eight patients with current staff
and an out-patient treatment service for a capacity of 130 patients in addition to the
day-hospital group. The consultative service is valuable both as a method of assessing
patients for treatment and as a general service to the community, where many agencies
look for consultation and collaboration with respect to the management of sick people
who do not come within the scope of the Centre. In the organization of the treatment
service, a conscientious effort has been made to assign the amount of staff time available
to any given patient according to the severity of the illness shown rather than according
to expediency. It is felt that if enough time is given to cases taken under treatment,
then some expectation of progress can be expected. By adequate assessment, we can
reject from service here those cases that are not expected to make any progress on the
methods of management we have to offer. The foremost well-defined categories of
patient service can be defined as follows:—
(1) Intensive service—two hours or more of staff time each week.
(2) Brief regular service—one hour a week for a period of not longer than
two months.
(3) Prolonged regular service—one to three hours a month for a period in
excess of two months.
(4) Minimal service—brief contact of once monthly with the addition of
first aid in time of crisis.
Nearly one-third of our patients have been given the intensive service, about
a quarter have been given minimal service, about one-third have been given a regular
service, but there has been a high proportion of cases requiring more than two months'
service, so that our case load in this regard has tended to pile up. It needs to be emphasized that the burden of patient treatment cannot be reduced just by crossing people
off the rolls. If patients remain sick, they continue to require service. If we do not
give enough service, it hardly seems worth while to give service at all in any given case
as change in some resistant cases cannot be effected in a brief period of time or with
any haphazard use of empirical procedures. We are endeavouring to avoid the establishment of a waiting-list either for assessment or for treatment as we feel this, in the
long run, will defeat our efforts and create ill will in the community.
We will now look more closely at the unique contributions of the various professional disciplines which offer consultation and treatment. First, it should be noted that
it is because the persons concerned have adequate training and experience that they are
able to function in a large measure independently and to co-ordinate their working
together in such a way that effectiveness rather than redundancy is achieved.
We find that the realm in which most patients are requiring help regardless of
predominant symptoms is in the area of relationships to other people. If one of our
staff can provide a trusting supportive relationship out of which the patient can grow
into more self-confidence and be more socially adept, then the patient will be making
progress. We refer to the staff member who is most directly involved with the patient
as the principal therapist, though the psychiatrist will also be available as a consultant MENTAL HEALTH CENTRE L 141
to him. In addition to his role as consultant, the psychiatrist is the person who has the
comprehensive medical training and who, therefore, assumes responsibility for treatment
given at the Centre. He also is required to have familiarity with all the techniques and
resources which can be brought to bear on the patient's problem. In the field of interview treatment or psychotherapy, the psychiatrist is expected to deal with the deep inner
mental conflicts, if the patient is ready. Patients may be treated by social workers when
.the treatment plan indicates a predominance of social tensions in the illness. As the
doctor on the team, the psychiatrist also provides a liaison with the family doctor, who
is the other doctor sharing responsibility for the patient's treatment in the community.
All staff are involved in the diagnostic process, which may involve several interviews
both with the patient and collaterals. The establishment of a therapeutic milieu also
requires a close understanding among all staff members so that consistent approaches
can be made to troubled people whose tendency is both to seek and to create inconsistency in others. The formal group psychotherapy sessions may be conducted by
psychiatrist, senior social worker, or psychologist. All staff members contribute to the
day-to-day recording from which social research projects can be developed.
The psychologist's specific contribution comes through techniques of measuring
the patient's assets of intellect, achievement, and personality and the determination of
his ability to use his potential. Special areas of interest and special capabilities may also
come out in aptitude tests. Personality assessment by psychological techniques can
be of most use when the patient, through defensiveness and evasiveness, is resistive to
disclosing many inner feelings and attitudes in the interview situation. Since psychological tests are designed to be a short cut to personality knowledge, they must constantly
be under review and evaluation.
The social workers have been particularly skilful in the long-range therapy of
patients with considerable residue of schizophrenic symptoms after hospitalization. The
social worker contributes to the team a specialized knowledge of community resources
and their use on behalf of the patient. When the family setting must be modified, it is
the social worker who works with the family to help them become a positive emotional
support in the patient's recovery.
The occupational therapist has a comprehensive occupational and recreational
programme by which she helps the patient mix with other men and women in both
a social and work setting, thereby building up anxiety tolerance in both fields. She
plans a programme for the individual, aimed to improve motivation and concentration,
and can evaluate his capacity to work with others at a job. By coming to know the
patient well while working and playing along with him, she can encourage initiative and
help him to become a productive and acceptable member of a group.
The demands on both the registered nurse with psychiatric training and the
psychiatric nurse in this setting are quite extensive and vary according to the preparation
of each. In keeping with our philosophy that the patient remain a citizen in the community, the nurse orients the patient how best to use services, serving more as a guide
than as a nursemaid. She gives hospital-type services but also is closely involved with
the occupational and recreational programme. The nurse co-ordinates the various staff
services to the patient. In day-to-day relationship with patient, the nurse is the person
in closest contact and carries responsibility both to carry out conference recommendations and to report changes in the patient's condition. She is alert to identify the patient's
emotional needs and to anticipate crises, and, where possible, assisting the patient to get
the most out of supportive friendly relationships with staff and other patients and at
other times providing time for the patient to be alone. For the out-patient, the public
health nurse is the person the patient can appeal to for emotional first aid, and in some
instances a specializing service is required. She is also the person on the spot to provide
brief contact with the many family members who call at the Centre. L  142 MENTAL HEALTH SERVICES REPORT,  1957/58
In addition to treatment services, we have sponsored the organization of a social
club. The social club provides a relaxed atmosphere for patients and ex-patients who
are not fully comfortable in community social groups. Planning for the activities of the
club is undertaken by a committee of patients with the guidance of staff and with the
assistance of the Canadian Mental Health Association, who have provided us with
a group of seven volunteers. There has been considerable support and enthusiasm for
the club, which has met every second Tuesday evening in the occupational and recreational rooms of the Centre. An evaluation of the club's function has been carried out
with the help of Miss Anne Furness, of the University School of Social Work. It has
been noted that to date the programme has emphasized variety and has not provided
a continuity of interest, and hence there has not been too much opportunity for a
deepening of personal relationships or for the encouragement of leadership from the
patient-group. We will shortly be developing a more extensive programme in which
small interest groups will meet for part of each evening so there may be a better recognition of individual personalities within the social club, a chance for each of them to
make a larger contribution to the group, and also to gain a greater feeling of personal
achievement.
Throughout the year a comprehensive medical-record keeping system has been
developed and will be introduced in its complete form for a year's trial on April 1st.
Information will be kept for all patients admitted to service but not for those seen for
assessment only. As well as basic administrative information, special information will
be kept in the field of medical data, social background information, and treatment information. A multi-disciplinary committee has worked out the format for the new record
system and has had the expert assistance of Miss A. E. Scott, of the Vital Statistics
Division of the Provincial Health Branch. All the data collected can be listed on
check-off sheets for transfer to punch-cards in Victoria. A protocol has been worked
out for the guidance of those taking the information in various professional departments.
The statistical tables show the actual volume of work undertaken during the year.
It is noted that women outnumber men for treatment in the proportion of approximately
two to one. It is also noted that the number of patients receiving day-hospial care at any
one time is approximately one-sixth of the total patient-load. The average length of stay
in day-hospital for those discharged is twenty-five days. The treatment service has
been heavily weighted toward personal interviews. The fraction of time involved in
giving physical treatment is significantly small in comparison, and those patients
receiving tranquillizing medication represent only about one-third of the total patient-
group at any one time. Although only about one-fifth of the patients under treatment
are received on direct referral from Crease Clinic and Mental Hospital, the patients
under treatment who have previously had admissions to Crease Clinic and Mental
Hospital within a short period is closer to one-half. The patients who have required
the longest service are those who continue to have a psychiatric impairment after they
are discharged from hospital, and these, for the most part, are those with the diagnosis
of schizophrenic reaction. Some of this group of patients make enough gains over
many months that they can finally get along without further assistance, others can return
to their family doctor for aid, but some continue to require supportive care in the Centre
to keep them from returning to hospital. We are finding that there is a considerable
public relations job to do in building up public awareness that many people can share
in assisting the psychiatric patient, particularly the family doctor, who can in many
cases look after patients with a psychiatric diagnoses if he has a consultative service.
We are doing our best to build up this resource. In addition, we are pleased that we
enjoy the confidence of the specialists who are practising psychiatry privately, and about
one-fifth of our referrals are actually made from this group of medical specialists. MENTAL HEALTH CENTRE
STATISTICAL TABLES
L 143
Table 1.-
-SUMMARY OF OPERATIONS, MENTAL HEALTH CENTRE, BURNABY,
April 1st, 1957, to March 31st, 1958
Male
Female
Total
9
34
3
126
60
9
11
78
4
1
213
91
17
20
Plus assessments—
112
4
4
339
151
26
232
404
636
Totals   	
241
415
656
Disposition of assessments—
16
1
17
70
22
106
32
14
21
89
18
232
48
15
38
No case made—
159
40
338
232
406
638
Total pending at March 31st, 1958.  	
9
9
18
Patient-load—
30
106
56
232
86
Total O.P.D. admissions
388
136
82
288
168
424
250
54
120
174
Table 2.—Movement of Population, O.P.D. Mental Health Centre, Burnaby,
April 1st, 1957, to March 31st, 1958
Male
Female
Total
Case load as at March 31st, 1957-
Total admissions	
First admissions	
Readmissions	
Discharges-
Case load as at March 31st, 1958-
30
106
102
4
82
54
56
232
215
17
168
120
86
338
317
21
250
174
Table 3.—First Admissions to Mental Health Centre by Health Unit and
School District of Residence, April 1st, 1957, to March 31st, 1958
Detailed information for the above table may be obtained on request. L  144
MENTAL HEALTH SERVICES REPORT,  1957/58
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W
S MENTAL HEALTH CENTRE
L 147
Tabl? 7.—First Admissions to Mental Health Centre by Marital Status, Sex,
and Diagnosis, April 1st, 1957, to March 31st, 1958
Detailed information for the above table may be obtained on request.
Table 8.-
-Movement of Population, Day-hospital Unit, Mental Health Centre,
Burnaby, April 1st, 1957, to March 31st, 1958
Male
Female
Total
In day-h<J_pital, March 31st, 1957	
6
51
12
121
18
Admissions. 	
172
57
53
133
114
190
167
111 day-hospital, March 31st, 1958. 	
4
19
23
4,558
167
Average stay in day-hospital.	
27.3
Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1959
540-1258-6771 

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