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Mental Health Services Branch PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT FOR TWELVE MONTHS ENDED MARCH… British Columbia. Legislative Assembly 1960

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 DEPARTMENT OF HEALTH SERVICES
AND HOSPITAL INSURANCE
Mental Health Services Branch
PROVINCE OF BRITISH COLUMBIA
ANNUAL REPORT
FOR TWELVE MONTHS ENDED
MARCH 31st
1959
Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1960   Department of Health Services and Hospital Insurance,
Mental Health Services Branch,
Essondale, B.C., December 6th, 1959.
The Honourable Eric Martin,
Minister of Health Services and Hospital Insurance,
Victoria, B.C.
Sir,—I have the honour to submit the Annual Report of the Mental Health Services
Branch for the twelve months ended March 31st, 1959.
I have the honour to be,
Sir,
Your obedient servant,
A. E. DAVIDSON, B.A., M.D., F.A.P.A.,
Deputy Minister of Mental Health Services. TABLE OF CONTENTS
Page
Officers and Staff, List of       7
PART I.—HEADQUARTERS
Report—Director of Mental Health Services       9
Report—Business Manager  18
Report—Personnel Officer  28
Report—Supervisor of Psychiatric Social Work  33
Report—Director of Nursing Services  36
PART IL—CREASE CLINIC OF PSYCHOLOGICAL MEDICINE
AND PROVINCIAL MENTAL HOSPITAL
Report on Crease Clinic—Medical Superintendent  38
Report on Provincial Mental Hospital—Medical Superintendent  41
Report on Treatment Services—Clinical Director  59
Statistical Tables—Crease Clinic  61
Statistical Tables—Provincial Mental Hospital  73
PART III.—THE WOODLANDS SCHOOL
Report—Medical Superintendent  88
Statistical Tables  94
PART IV.—PROVINCIAL MENTAL HOME
Report—Medical Superintendent  99
Statistical Tables  101
PART V.—GERIATRIC DIVISION
Report—Medical Superintendent  105
Statistical Tables—Home for the Aged, Port Coquitlam  117
Statistical Tables—Home for the Aged, Vernon  121
Statistical Tables—Home for the Aged, Terrace  124
PART VI.—MENTAL HEALTH CENTRE
Report—Director of Mental Health Centre  128
Statistical Tables  13 3
5   I 8
MENTAL  HEALTH SERVICES  REPORT,   1958/59
Business:
J. F. Anderson, Assistant Business Manager. W. Gueho, Cashier.
G. A. Grieve, Cost Accountant. R. Boulter, Steward.
Miss A. Potoma, Business Stenographer.
Rev. J. F. O'Neil, Protestant.
Chaplains:
Rev. Father A. Frechette, 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.
THE WOODLANDS SCHOOL, NEW WESTMINSTER
L. A. Kerwood, M.D., D.P.M., 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, Social Service.
B. Tischler, M.D. H. Mercer, Industrial Arts Instructor.
T. Kamburoff, M.D. J. Lynes, Recreational Instructor.
E. M. Tredger, M.D. J. Elliot, Chief Male Psychiatric Nurse.
R. E. Manning, M.D. R. Nash, Instructor, Male Psychiatric Nurses.
H. T. Davidson, D.D.S. J. Nuttall, B.A., B.Ed., Psychologist.
Miss V. Sanders, R.N., Superintendent of H. Kaine, Pharmacist.
Nurses. Miss E. Henshaw, Senior Clerk-Stenographer.
Mrs. H. M. Davy, School Principal.
Chaplains:
Rev. L. Hankinson, Protestant.
Rev. Father J. R. Bernard, Roman Catholic.
GERIATRIC DIVISION
B. F. Bryson, B.A., M.D., CM.,
Port Coquitlam Unit
A. I. Smith, Deputy Business Manager.
W. Lazorko, M.D.
Miss E. Johnstone, R.N., Superintendent of
Nurses.
Mrs. A. Frith, B.Sc.(H.Ec), Dietician.
Miss M. Jorgensen, Senior Clerk-Stenographer.
F.A.P.A., Medical Superintendent.
Vernon Unit
L. W. Fox, Supervisor.
Miss  M. O.  Lipsey,  R.N., Superintendent of
Nurses.
J. Smith, M.D., Visiting Physician.
Rev. C. E. Reeve, Protestant Chaplain.
Monsignor J. Miles, Roman Catholic Chaplain.
Terrace Unit
W. E. Skillicorn, Supervisor.
F. Stewart, Chief Psychiatric Nurse.
R. E. Lee, M.D., Visiting Physician.
Archdeacon C. A. Hinchliffe, Protestant Chaplain.
Rev. Father O. P. Mohan, O.M.I., Roman Catholic Chaplain.
MENTAL HEALTH CENTRE
ADULT CLINIC AND CHILDREN'S CLINIC
F. E. McNair, B.A., M.D., CM., Director.
T. L. Brown, B.Com., Unit Business Manager.
W. E. Powles, B.A., M.D., Senior Psychiatrist,
Adult Clinic.
G. M. Kirkpatrick, B.A., M.D., Senior Psychiatrist, Children's Clinic.
Mrs. M. Lae, R.N., B.S.N., Supervisor of
Nursing.
D. B. Ricketts, B.A., M.S.W., Supervisor,
Social Service.
Miss M. Munro, B.A., M.A., Supervisor, Psychology.
Miss A. Bailey, M.A.O.T., O.T.R., Supervisor,
Occupational Therapy.
Miss E. E. Jackson, Senior Stenographer.    I 12 MENTAL  HEALTH  SERVICES  REPORT,   1958/59
BUILDING PROGRAMME
No major construction was initiated or was under way this year. The only expansion
at the moment is in the Tranquille Sanatorium, where it is planned, as stated above, to
accommodate mentally retarded. There are several large buildings which may be used
to accommodate as many as 600 patients ultimately.
The Nurses' Home and Educational Centre was completed last year. The School of
Psychiatric Nursing moved into this centre in June, 1958, and began making use of these
facilities. The large classrooms and demonstration-rooms make it possible to increase
the size of the classes entering the School. The Nurses' Home portion of this building
was occupied by student-nurses in March, 1959.
The Admission and Infirmary Building at the Home for the Aged, Port Coquitlam,
was completed this year. This 328-bed building will serve as the administration centre
for the Home for the Aged. Provision is provided for the more intensive care of the
sick and infirm in this building. It is also planned that patients will be admitted directly
to the Home for the Aged in this unit.
The extension to the power-house was completed and officially opened by the
Honourable W. N. Chant on February 2nd, 1959. This expansion will permit the operation of the additional building facilities mentioned above.
STAFFING
Although the total number of staff recruited has increased, we still find considerable
difficulty in recruiting trained and professional personnel, particularly psychiatrists, psychologists, social workers, and nurses. Of our psychiatric staff, Dr. Gee and Dr. Byrne
have retired and Dr. Edwards, Dr. Mason Browne, and Dr. Halliday have resigned. We
have been unable to recruit additional psychiatrists, but three of our resident staff, Drs.
Boulding, Calverley, and Tischler, were successful in passing the examination to qualify
them as specialists in psychiatry.
The shortage of trained nursing personnel makes it extremely difficult to expand our
programme, let alone carry on with the effective day-to-day operation of present units.
We were able to open new wards in The Woodlands School in December, 1958, by
putting on an active recruitment campaign for psychiatric nurses, and also by employing
a number of psychiatric nurses on a part-time basis. The shortage of trained nurses will
undoubtedly present a problem in the opening of the unit at Tranquille and in the expansion of the facilities at the Home for the Aged, Port Coquitlam.
The following staff members terminated service by superannuation: C. G. Collins,
Assistant Charge Psychiatric Nurse; J. McBeth, Psychiatric Nurse; G. Mackenzie, Psychiatric Nurse; Dr. U. P. Byrne, Director, Child Guidance Clinic; Dr. A. M. Gee,
Director, Mental Health Services; J. Thompson, Building Service Worker; G. E.
Stoodley, Special Psychiatric Nurse; C. V. Godwin, Psychiatric Nurse; T. Gray, Building
Service Worker.
I regret to report the following deaths while in service: Dr. H. O. Johnsen, Dental
Officer; W. K. Olsen, Hospital Cleaner; J. Davidson, Psychiatric Nurse; H. G. Austin,
Assistant Charge Psychiatric Nurse; M. G. C. Dolbec, Psychiatric Nurse; J. E. Laking,
Psychiatric Nurse; G. L. McMillan, Gardener; W. J. Nelson, Assistant Charge Psychiatric Nurse; M. Horn, Psychiatric Nurse; R. C. Birch, Psychiatric Aide.
GENERAL COMMENTS
The annual graduation ceremony was held this year in the Vincent Massey Junior
High School on the evening of April 24th. Dean Neville Scarfe, of the Faculty and College of Education, University of British Columbia, was the guest speaker and gave a very
interesting address to the graduating nurses. There were ninety-three nurses graduated
on this occasion, sixteen of these being male nurses and seventy-seven being female
nurses.   Previous to the graduation a tea was held on Sunday, April 20th, at which the   HEADQUARTERS
I  15
Dr. W. P. Fister, Director of Neurology, attended a short course on " New Drugs "
at the University of Washington School of Medicine in March.
Special reports covering course content were prepared by all those attending short
courses.
Dr. R. W. Harrington commenced a year of postgraduate study in psychiatry at the
University of Toronto in September.
Dr. R. Parkinson commenced a year of postgraduate study in psychiatry at McGill
University in September.
Bursaries were provided to three social workers to attend the School of Social
Work, University of British Columbia, for one academic year commencing in September.
These rainees will serve a period with the Mental Health Services on the completion of
their training.
Two registered nurses were given bursaries to enter the School of Nursing, University of British Columbia, to take the diploma course in teaching and supervision. They
will give a return in service to the Provincial Mental Hospital on the completion of their
training in June, 1959.
A four-day institute on psychotherapy led by Dr. M. Prados and Dr. K. A. Yonge
was held in November. Mental Health Grant funds provided the honoraria and travelling expenses of the institute leaders.
EQUIPMENT AND SUPPLIES
Provincial Mental Hospital, Essondale.—A psychogalvanic apparatus with differential reaction timer was provided for the Psychology Department.
Six invalex walking aids and a multitone electric progressive treatment unit were
purchased for the Physiotherapy Department.
Twelve films on mental-health topics were approved for purchase for the film
library maintained for the Mental Health Services by the Provincial Mental Hospital.
Crease Clinic.—Three tape recorders for use in psychotherapy sessions were provided.
The laboratory was authorized to purchase a portable electro-cardiograph, an anaerobic incubator, an analytical balance, and a chromatogram attachment for the D.U.
spectrophotometer.
The operating-room was provided with the necessary instruments and supplies for
bronchoscopy, a supply of clamps, needles, and sutures for arterial surgery as well as
a skin-grafting knife for plastic surgery. An examination stretcher on wheels as well as
overbed frames for orthopaedic surgery were supplied.
The Woodlands School.—An electrophoresis apparatus and a complete set of chro-
matograph apparatus were supplied the laboratory for use in diagnostic investigations and
research studies on mental deficiency.
Home for the Aged, Port Coquitlam.—Equipment and supplies totalling $78,000
were approved for purchase to equip the 328-bed admission and infirmary unit. This
approval includes the equipment for the laboratory, X-ray department, ward surgeries
and examination rooms, dental suite, pharmacy, nursing stations, occupational therapy
and physiotherapy departments.
School of Psychiatric Nursing.—Approximately 125 books were approved for purchase for inclusion in the library of the School of Psychiatric Nursing.
COMMUNITY MENTAL-HEALTH PROGRAMMES
The programme of the Mental Hygiene Division of the Metropolitan Health Committee of Greater Vancouver received support similar to that granted in previous years.
The salaries of one psychiatrist, two clinical psychologists, two social workers, and one
stenographer were provided. I 16
MENTAL  HEALTH  SERVICES  REPORT,   1958/59
The course to train senior school counsellors in mental-health principles was again
offered by the Vancouver School Board. This year the enrolment was increased from
eight to ten teachers. The salary and mileage allowance of the training co-ordinator was
provided by the grant.
PSYCHIATRIC SERVICES IN GENERAL HOSPITALS
The out-patient psychiatric services of the Vancouver General Hospital continued
to receive support by means of salaries paid to a psychiatric social worker, a clinical
psychologist, and a medical stenographer. For the first three months of the year, provision was also made for the salaries of an occupational therapist and another medical
stenographer.
The psychiatric services of the Royal Jubilee Hospital in Victoria were assisted
through the provision of a salary for a physio-occupational therapist for three months
of the year.
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
travel allowance of the Rehabilitation Officer.
The hospitals and clinics of the Mental Health Services have again had assistance
in the provision of salaries for some of the treatment staff, including such specialists as
psychiatrists, nurses, technicians, clinical psychologists, and dieticians.
RESEARCH PROJECTS
Several major research projects were supported by the Mental Health Grant. The
studies are conducted at the University of British Columbia in the Departments of
Pharmacology and Neurological Research.
The Department of Pharmacology continued its studies into the pharmacological
analysis of pathways leading to diffuse enhancement of cortical electrical activity, while
the Department of Neurological Research maintained its emphasis on the biochemistry
of schizophrenia by conducting studies on the aromatic metabolism of schizophrenic
patients, the aromatic components in the urine of schizophrenic patients, as well as
animal experimental procedures on the biochemistry of schizophrenia.
COMPARATIVE SUMMARY OF INCREASES AND DECREASES IN RESIDENT
POPULATION BY MAJOR DIVISIONS OF PROVINCIAL MENTAL
HEALTH SERVICES,  1952/53 TO 1958/59.
Institution
1952/53
1953/54
1954/55
1955/56
1956/57
1957/58
1958/59
Provincial Mental Hospitals 	
The Woodlands School	
-64
+277
+49
+28
+62
+ 104
+50
— 1
+44
+ 19
o
+25
+2
+ 19
+15
— 10
-70
+ 14
+9
—31
-49
+76
—15
+26
-135
+86
-30
— 11
Homes for the Aged 	
Totals	
+ 290
+215
+ 88
+26
—78
+38
-90
COMPARATIVE SUMMARY OF TOTAL PATIENTS UNDER CARE FOR MAJOR
DIVISIONS OF PROVINCIAL MENTAL HEALTH SERVICES BY FISCAL
YEARS, 1952/53 TO 1958/59.
Institution
1952/53
1953/54
1954/55
1955/56
1956/57
1957/58
1958/59
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
1,373
1,349
1,714
5,377
1,481
1,373
1,744
Totals    .. .   -	
8,995
9,072
9,212
9,749
9,618
9,844
9,975  I 18 MENTAL HEALTH  SERVICES  REPORT,   1958/59
BUSINESS MANAGER'S REPORT
F. A. Matheson, Business Manager
Attached hereto are the financial reports for the year 1958/59 of the units of the
Provincial Mental Health Services providing in-patient care. The names and locations
of these units are as follows: Crease Clinic, Essondale; Provincial Mental Hospital,
Essondale; The Woodlands School, New Westminster; Provincial Mental Home, Colquitz; Home for the Aged, Port Coquitlam; Home for the Aged, Vernon; and Home
for the Aged, Terrace.
The daily average patient population in these units continues to show the downward
trend that became evident in 1955/56 and from Table A it can be noted that the decrease
from 1957/58 to 1958/59 is 8.80.
Gross operating costs for the year amounted to $12,453,445.32, an increase of
$1,040,275.33 over the 1957/58 total of $11,413,169.99, and the subsequent effect on
the over-all per capita cost was an increase from $5 to $5.46 or 9.2 per cent.
The increase in operating expenditure can be mainly attributed to salary increases.
Revenue for the year reached a gross of $1,838,158.33, an increase of $114,111.63
over the fiscal year 1957/58.
The Colony Farm continues to supply produce chiefly to the Lower Mainland units
of the Mental Health Services, and during 1958/59 dairy produce, meats, fruits, and
vegetables valued in excess of $425,000 were purchased from the Farm.
Assistance from the Federal Government in the form of projects approved under
Federal health grants permitted expenditure in the amount of $603,147.92 during the
year, a very valuable financial contribution used for the purchase of new equipment,
payment of personnel, and selected staff training courses.
Particulars of these expenditures are covered by a statement included with this
report.
I am pleased to be able to report that during the year a large number of improvements and additions to our plants and equipment were made. Some of the main items
of interest in this regard are as follows:—
The new substation located at the east end of the Essondale property was completed and a contract in the amount of $117,977 was let for a new 12-kv.
electrical distribution system.
All furniture and equipment for the Nurses' Home and Training Centre, Essondale,
were received, with the exception of the theatre-type seats for the two demonstration-rooms and the auditorium.    The training-school moved into its new
quarters in this building on June 3rd, 1958, and student-nurses moved into
the Nurses' Home section on January 19th, 1959.
Work in connection with the extension to the boiler-house and the installation of
the new boiler was completed.    The Honourable W. N. Chant, Minister of
Public Works, officially opened this extension on February 2nd, 1959.
A new fire-alarm system was installed in the Crease Clinic.
New sidewalks were installed at Essondale to assist in improving traffic conditions.
A contract in the amount of $21,938.88 was let for the installation of water-distribution mains.   This work was completed in March, 1959.
The 328-bed Valleyview Building at the Home for the Aged, Port Coquitlam, was
completed and turned over by the contractors on May 20th, 1958.
The auditorium and swimming-pool at The Woodlands School was put into operation during April, 1958.
The first patients were moved into the Fraserview Building at The Woodlands School
on November 26th, 1958. HEADQUARTERS I 19
Nurses' Home No. 1 at The Woodlands School was renovated and re-equipped for
a female rehabilitation centre.   This unit is now known as " The Lodge."
The Public Works Department called for tenders and a contract was let for a new
electrical distribution system for The Woodlands School.
A contract was let by the Public Works Department in the amount of $33,033 for
the renovation of the old kitchen at The Woodlands School.
Two automobiles were purchased for the use of the Social Service Department at
the Mental Health Centre.
Two new dish-washing machines—one for the main building and one for the annex
dining-room—were purchased and installed at the Home for the Aged, Vernon.
The outside of the buildings at the Home for the Aged, Vernon, were painted.
A new dish-washing machine and a pot-washing sink were installed at the Home
for the Aged, Terrace.
The exterior of the buildings at the Home for the Aged, Terrace, were painted.
A 16-mm. projection machine and screen were purchased for the Home for the
Aged, Terrace.
•-
■ '
— I 20
MENTAL HEALTH SERVICES REPORT,  1958/59
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, 1949/50 to 1958/59.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1949/50
Provincial Mental Hospital, New Westminster	
Provincial Mental Hospital, Essondale	
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
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  ,	
Crease Clinic  	
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	
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
Home for the Aged, Port Coquitlam	
3.62
3.91
Home for the Aged, Terrace 	
Crease Clinic— 	
3.47
9.95
Totals for the year	
5,562.54
$7,482,254.93
$1,345.11
$3.68
1952/53
Provincial Mental Hospital, New Westminster	
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
Provincial Mental Home, Colquitz    	
4.17
3.82
4.70
Home for the Aged, Terrace  	
Crease Clinic    	
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
3.45
4.05
3.99
4.54
3.09
Crease Clinic _	
9.18
Totals for the year	
6,152.93
$8,765,016.01
$1,424.53
$3.90
1954/55
The Woodlands School                         	
1,204.60
3,517.75
285.74
527.33
230.72
296.42
238.63
$1,811,848.81
4,685,444.76
426,786.04
739,859.92
368,726.10
328,553.97
860,673.73
$1,504.11
1,331.94
1,493.62
1,403.03
1,598.15
1,108.41
3,606.73
$4.12
3.65
4.09
3.84
4.38
3.04
Crease Clinic- -	
9.88
Totals for the year	
6,301.19
$9,221,893.33
$1,463.52
$4.01
1955/56
The Woodlands School                          	
1,219.45
3,508.79
285.30
539.27
229.62
287.30
257.96
$2,032,263.32
5,377,708.34
428,248.27
797,392.10
371,438.14
351,087.68
935,501.07
$1,666.54
1,532.64
1,501.05
1,478.65
1,617.62
1,222.02
3,626.54
$4.55
4.19
Provincial Mental Home, Colquitz	
Home for the Aged, Port Coquitlam	
4.10
4.04
4.42
3.34
9.91
6,327.69
$10,293,638.92
$1,626.76
$4.44  I 22 MENTAL HEALTH SERVICES  REPORT,  1958/59
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, 1959.
Gross operating costs—
Crease Clinic   $1,149,344.46
Provincial Mental Hospital, Essondale  6,08 8,091.20
The Woodlands School, New Westminster  2,968,725.50
Provincial Mental Home, Colquitz   488,028.69
Home for the Aged, Port Coquitlam  961,921.63
Home for the Aged, Vernon  410,529.00
Home for the Aged, Terrace  386,804.84
Gross cost for all institutions  $12,453,455.32
Less collections remitted to Treasury       1,838,158.33
$10,615,286.99
Daily average population   6,247.40
Gross per capita cost, one year  $1,993.38
Gross per capita cost, one day  5.46
Net per capita cost, one year  1,699.15
Net per capita cost, one day  4.66
Revenue (Patients' Maintenance Collections) of the Mental Health
Services for the Past Ten Years
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
1953/54  1,300,056.89 1958/59  1,838,158.33     HEADQUARTERS
Vancouver General Hospital	
Royal Jubilee Hospital, Victoria
Consultants in surgery
British Columbia Mental Health Services—Visiting lecturers
Personnel training—
Short courses in mental health	
  $2,052.08
Training in supervision in psychiatric nursing  2,467.00
Postgraduate training in social work  8,686.40
Postgraduate training in psychiatry  7,259.92
Metropolitan Health Committee of Greater Vancouver—
Training for senior school counsellors  8,640.00
I 27
$8,570.32
886.88
15,600.00
1,166.76
Total
29,105.40
$603,147.92    HEADQUARTERS
Table C.—Summary of Staff Turnover
1 31
1956/57 1957/58 1958/59 Change
Over all	
Student psychiatric nurses..
Male psychiatric nurses	
Female psychiatric nurses.-
Registered nurses	
Per Cent
35.60
32.20
14.67
35.63
52.38
Per Cent
28.45
24.73
13.44
35.63
59.70
Per Cent
22.5
35.22
9.1
24.8
33.8
Per Cent
-5.95
+ 10.49
—5.3
— 10.8
—25.9
Note.—Items 1 and 2 have been calculated against the monthly average and other items have been calculated
against the year-end staff count.
Statement of Separation and Recruitment by Division
Division
Recruited
Separated
Percentage
Turnover
Crease Clinic and Provincial Mental Hospital, Essondale..
Provincial Mental Home, Colquitz 	
The Woodlands School  	
Home for the Aged, Port Coquitlam 	
Home for the Aged, Vernon..
Home for the Aged, Terrace	
Mental Health Centre and Child Guidance Clinics..
301
14
199
37
30
11
21
303
14
156
35
32
13
28
21.7
17.3
21.6
18.8
41.6
22.0
28.9
Table D.—Comparison of Staff Totals by Unit with Totals for the
Preceding Fiscal Year
Fiscal Year 1957/58
Fiscal Year 1958/59
Division
Positions in
Establishment as of
Mar. 31,
1958
Positions
Filled as
of Mar. 31,
1958
Positions in
Establishment as of
Mar. 31,
1959
Positions
Filled as
of Mar. 31,
1959
52
7
50
8
52
8
52
8
59                       58                       60                      60
Headquarters  	
30        |             29        |              29        |             29
56                     51                     55                     49
297                   284
1,178        |        1,092
750        |            616
81         j              81
280
1,117
721
81
266
1,095
665
Provincial Mental Home, Colquitz  -
81
2,306                2,073                2,199
2,107
44        |              38                       41
39
196
79
59
185
80
55
188
77
59
193
77
55
334                   320        |           324
325
School of Psychiatric Nursing (Faculty) 	
12                     12                     17
15
2,841        |        2,581        |        2,725
2,624
Student-nurses (non-Civil Service)-	
225        |           222                   225
246
Totals  __	
3.066          1          9 803          1          7 950
2,870 I 32
MENTAL  HEALTH  SERVICES  REPORT,   1958/59
Table E.—Showing Composition of Nursing Staffs by Unit as of
March 31st, 1959
Registered
Nurses
Psychiatric
Nurses
Students
Psychiatric
Aides
Total
Number
Per
Cent
Number
Per
Cent
Number
Per
Cent
Number
Per
Cent
Female Division
Provincial Mental Hospital, Essondale-	
41
12
6
3
1
7
7.4
9.4
1.8
2.5
2.6
63.6
169
43
135
49
9
3
30.7
33.6
41.7
39.8
23.7
27.3
143
20
7
9
30.0
15.6
2.2
7.3
198
53
176
62
28
1
35.9
41.4
54.3
50.4
73.7
9.1
551
128
324
123
38
11
Totals  -
70
6.0
408
34.7
179
15.2
518
44.1
1,175
Male Division
1
	
2.5
189
46
87
39
35
7
52.4
50.5
36.3
61.9
60.3
35.0
26.8
100.0
34
19
7
7
9.4
20.9
2.9
12.1
138
26
146
24
16
13
29
38.2
28.6
60.8
38.1
27.6
65.0
70.7
361
91
The Woodlands School  _
240
63
58
20
41
2
Totals	
1
0.1
416
47.5
67
7.7
392
44.7
876
Table F.—Summary of Establishment Changes during Fiscal Year 1958/59
Positions
Division Added
Headquarters  	
School of Psychiatric Nursing       4
Provincial Mental Hospital, Essondale       8
Crease Clinic	
The Woodlands School       7
Provincial Mental Home, Colquitz  	
Mental Health Centre	
Child Guidance Clinics  	
Home for the Aged, Port Coquitlam       2
Home for the Aged, Vernon  	
Home for the Aged, Terrace  	
Farms staff  	
Positions
Deleted
2
1
Totals
21
Increase, 17.
Approved establishment as of March 31st, 1959  2,725
Approved establishment as of April 1st, 1958  2,708 HEADQUARTERS I 33
REPORT OF THE PROVINCIAL SUPERVISOR OF
PSYCHIATRIC SOCIAL WORK
Miss A. K. Carroll, Provincial Supervisor
During the year 1958/59 the social service departments throughout the units of
the Provincial Mental Health Services have been very active in studies of structure,
functions, and services in order to meet more effectively the needs of patients, to cover
more adequately the increased intake of patients in some units, and to relate more entirely
to the treatment goals in the various units. The effectiveness and value of the contribution of any one discipline is dependent to a large degree on the clarity of agency goals,
purposes, administrative and therapeutic structure, organization, policies, functions, and
procedures. Much positive effort must continually be spent in the formulation and communication of these if the valuable contribution of disciplines is to be fully utilized to
the benefit of administrative and therapeutic programmes. One of the outstanding
developments of this year has been the purposeful attempt to bring about this clarification
at all levels of the administrative and therapeutic structure.
Toward the goal of greater patient coverage and of remotivation of patients to healthy
living, the social workers have continued to equip themselves, through the institution of
a special staff development programme, with more knowledge of group processes,
dynamics, motivation, and structure. Through the study of this medium, social workers
in all units have obtained some ability in group leadership and some skill in group motivation as well as an understanding of group interaction and response. In the institutions
this skill is very important in helping patients to learn or relearn more adequate social
behaviour and also in affording patients emotional support and assistance in dealing with
the reality situations which they face in the hospital and in the community. The contribution of social work in this particular area has been very commendable in The Woodlands School, the pre-convalescent services in the Provincial Mental Hospital, and in the
group treatment programme in the children's and adult clinics of the Mental Health
Centre.
The planning and work of the supervisors in all units in developing a staff education
programme focused on the understanding and acquiring of group skills has been an outstanding feature of the social service programme during the fiscal year. Together with
this specific programme has proceeded one of refining individual treatment skills and another of revision of departmental organization in order to support more adequately the
extension and improvement of treatment services. Out of these efforts has resulted a
therapeutic programme more patient-centred, as well as the knowledge of a need for an
increase of such educational supports as institutes, seminars, and research projects
focused on acquiring more administrative and therapeutic skills. Work in psychiatric
settings is extremely demanding, and without the stimulation of adequate staff education
and development programmes it can become depleting to the degree that staff for its own
preservation must seek a change of work setting. Extraordinary mobility of staff in
psychiatric hospitals and clinics often reflects the lack of such programmes.
The primary purpose of a staff development programme is to provide better services
to patients and their families by increasing the competency of the staff. Supervision,
orientation sessions, staff meetings, institutes, seminars, extension of library facilities,
consultation, staff committees, and some research activity are the media which have been
developed and used to this end by the social service staff throughout the Provincial Mental
Health Services. Much of this effort has involved staff in willingly extended overtime.
Selected social workers from the various units have had, during the fiscal year, the following opportunities for educational advancement: Attendance at a four-day institute on
family services; a one-day institute at the School of Social Work, University of British
Columbia, on teaching responsibilities and techniques in field instruction of student social I 34 MENTAL  HEALTH  SERVICES  REPORT,   1958/59
workers; summer session courses at the School of Social Work on social group work practice and techniques of administrative management; the annual spring institute of the
British Columbia Corrections Association; six weekly seminars for advanced and beginning student supervisors at the School of Social Work; a one-day seminar on staff relationships and social structure in a mental hospital, in Provincial Mental Health Services,
Crease Clinic; a four-day institute on psychotherapy in Provincial Mental Health Services,
Crease Clinic; the National Conference of Social Work. Perusal of the aforementioned
educational opportunities afforded by Administration is indicative of a belief in the importance of opportunities for the continuing development of staff on the job and a
realization that such are of utmost importance in the attainment of adequate treatment
skills. This officer attended the International Study Conference on Child Welfare and
the International Conference on Social Work in Tokyo at the request of the Children's
Bureau of the Ministry of Health and Welfare, Japan.
During the year, recruitment of social-work staff (a responsibility this officer undertakes in collaboration with the Personnel Officer of the Civil Service Commission) has
continued to present difficulties, and many vacancies have remained unfilled. Many of
the recruitment difficulties relate to the need for an all-out recruitment drive, co-operatively undertaken at national and local levels by schools of social work, health and welfare
agencies, and the professional organization for social workers. Too few university graduates are enrolling in social-work postgraduate studies, a fact which poses a serious problem in the manning of Canada's expanding social welfare programme. However, because
social work in psychiatric hospitals and clinics stands high as a preference work setting,
many more social workers could be recruited to the service if a recruitment programme
utilizing all possible media was to be put into operation. In all units of the Povincial
Mental Health Services the contribution of social work is accepted, and the opportunities
for the valid practice of social work are rich and numerous. In addition, the needs of
patients for social services and their ability to use social service on the way back to health
are very great. Finally, psychiatric hospitals and clinics have the means to be great
centres of learning. All these factors have signal value and attraction in the recruitment
of social-work personnel.
The training of social-work students is an asset to the whole psychiatric hospital
and clinic programme. The assumption of such teaching responsibilities provides stimulation to all staff and also helps in recruitment. The contact with the School of Social
Work has been generally mutually advantageous in that it provides a meeting point for
new thinking, methods, and techniques, and their testing in valid practice. During the
fiscal year twelve student social workers had a field-work practice placement in the Provincial Mental Health Services.
In co-operation with the Faculties of Medicine, Nursing, and the School of Psychiatric Nursing, a contribution of twelve 1-hour sessions to fourth-year medical students,
twelve IVi-hour sessions to psychiatric nurses, and three 3-hour sessions to affiliate nursing students has been rendered. These sessions were focused on the contribution of social
work in the multi-disciplinary settings of hospitals and clinics as well as on the social
factors in emotional and mental illness.
The education of the public has not been overlooked as patients need the understanding and services of both the hospital and the community. Further, the responsibility
of hospital and clinic in the interpretation of mental illness and the concept and principles
of mental health are of prime importance. Social workers throughout the Mental Health
Services have undertaken to meet this responsibility through orientations, public addresses,
discussion groups, and panel presentations to Parent-Teacher Associations, service clubs,
professional organizations, and church groups. Adequate representation on and participation in the voluntary health and welfare planning organizations in community is important because of the opportunities it affords for interpreting the Provincial mental-health
programme and contributing to the community's plan for adequate health and welfare HEADQUARTERS
I 35
services for its citizens. Social work has participated in the programme of the following
divisions: Guidance of the Handicapped, Family and Child Welfare, Health Services,
Care of the Aged, all of which are divisions in the Community Chest and Council, as well
as in the scientific planning section of the Canadian Mental Health Association and the
British Columbia Association for Retarded Children.
In all social service units in the Provincial Mental Health Services, consultation has
been requested and given on:—
(1) Content and basic services of social service departments.
(2) Supervisory and staff development services.
(3) Criteria for selection of patients for service.
(4) Responsibilities  and  content  of  social  services  during  the  admission
(diagnosis) and discharge of patients.
(5) The intake process, its definition, content, and purpose.
(6) The development of the casework supervisory skill.
(7) The understanding, development, and use of group supervision.
(8) The social-work job in social rehabilitation.
(9) Work-flow, case loads, and staffing patterns.
During this year there has been additional and urgent evidence of the need for the
development of a family care programme of both a therapeutic and a custodial nature
for some patients in the psychiatric institutions of the Provincial Mental Hospital and The
Woodlands School. The family care home programme is now generally recognized as a
service of outstanding importance for the convalescent and elderly infirm or multiple-
handicapped patient. It is also of value in the rehabilitation of patients for whom no
helping resource exists in the community.
During the year the contribution of the supervisors and casework supervisors has
continued to maintain its traditional high standard. This group of senior social workers
have high qualifications, and their outstanding skills have been enhanced and augmented
by years of responsible and evaluative practice. Their monthly reports, special studies,
and practical research submissions have been of a high order and a vital force in the
advancement of standards of practice and services. This officer gratefully acknowledges
the contributions of all levels of the social-work staffs throughout the units of the Provincial Mental Health Services, as well as the acceptance and support of the Directors
and Medical Superintendents of the consultant's usefulness and contribution. It has
indeed been a year of challenge, stimulation, and fruitful effort.  HEADQUARTERS I 37
Shortage of instructors continued to hamper the School's programmes. Study and
reorganization of the School of Psychiatric Nursing was begun in March, 1959, and it
is hoped that with the increased appropriation for nursing educational functions it will be
possible to recruit several well-prepared instructors so that the educational programmes
may be expanded and improved. One of the greatest single needs of the Mental Health
Services Branch is for more trained nursing personnel.
It is appropriate at this point to mention that in December, 1958, Miss Margaret
Prowse joined the staff of the School of Nursing at the University of British Columbia
as lecturer in psychiatric nursing. She spent two weeks in January becoming acquainted
with the Mental Health Services. This enthusiastic and dedicated exponent of psychiatric
nursing will stimulate the interest of many nurses in psychiatric nursing. Miss Prowse will
also be supervising the field-work experience of the University students in the Mental
Health Services, and her influnce will have a beneficial effect on nursing care. We look
forward to greater liaison with the School of Nursing at the Universiy of British Columbia.
With the completion of the new nurses' residence and the anticipated expansion of
student programmes, I was asked to make a study of the residences' organization, function, and staffing. The major change in policy which resulted from the study was that
students would be given priority for accommodation and that only temporary accommodation would be provided for all new staff. As the rooms were required, residence
privileges would be withdrawn from staff members who had been in residence the longest.
The residences for students are to be the responsibility of the School of Psychiatric Nursing, while the residences for all staff are to be the responsibility of the Home Supervisor
under the direction of the Business Manager. Considerable working out of the reorganization remains to be done. On January 19th the first two floors of the new residence
were occupied, and by February 28th all rooms were in use. This move left Nurses'
Home No. 6 empty, and in March the men students moved from the inadequate facilities
of West Lawn attic to Nurses' Home No. 6. The recreation room in the new residence
provided a centre for student activities and, under the sponsorship of the Students' Council
and the Nursing Counsellor, the students organized weekly dances, recreational activities,
a students' paper, and a fund-raising tea.
The 11 -bed nurses' infirmary, located on the ground floor of the new residence, was
fortunately opened when the increased need for more adequate facilities was acutely felt.
Under the expert and sympathetic guidance of Dr. A. Greiner, it is now possible to provide excellent medical and nursing care for students. The total health service for students,
however, needs more thorough study.
On March 20th, 1959, the British Columbia Registered Nurses' Association and
the School of Psychiatric Nursing co-sponsored a Schools of Nursing Conference at the
Education Centre. Some thirty-two nurses attended, and the group included the directors
of nursing and educational directors of the seven schools of nursing, as well as the educational directors from the Victorian Order of Nurses and the Metropolitan Health Committee.   The purpose of the conference was twofold:—
(1) To acquaint those attending with the current trends in the psychiatric
field:
(2) To review and discuss the past, present, and future plans for an affiliation
programme in psychiatric nursing.
The programme was received enthusiastically, and the stimulating and helpful discussion revealed the desire the participants had for increasing the number of nursing
students who were able to take the affiliation programme. The Provincial Mental Health
Services reaffirmed its intention of expanding the programme when qualified instructors
were available.
The year was a busy and productive one, with many encouraging signs for future
developments. I wish to thank all those who contributed to the nursing educational
programmes and to the welfare of the students. A special note of appreciation is extended
to all who contributed to my own orientation. I 38
MENTAL  HEALTH  SERVICES  REPORT,   1958/59
PART II.—CREASE CLINIC OF PSYCHOLOGICAL MEDICINE
AND PROVINCIAL MENTAL HOSPITAL
REPORT OF THE CREASE CLINIC OF PSYCHOLOGICAL
MEDICINE
REPORT OF THE MEDICAL SUPERINTENDENT
T. G. Caunt, Medical Superintendent
The Crease Clinic of Psychological Medicine completed its eighth year of service to
the mentally ill of this Province with the fiscal year ended March 31st, 1959.
The Crease Clinic is designed to treat patients who will only require a brief period
of hospitalization of less than four months' duration. Those patients who have an illness
requiring more prolonged treatment are referred to the Provincial Mental Hospital.
A senior medical staff member, in addition to the admitting duty doctor in charge,
provides a very helpful service to doctors in the community regarding the suitability of
patients for admission to the Clinic.
It is important to note that the same treatment facilities are available to the patients,
whether they are admitted to the Crease Clinic or the Provincial Mental Hospital. The
Crease Clinic has functioned very effectively during this past fiscal year. There have been
occasional instances when non-urgent admissions have been briefly deferred because of
the pressure of admissions and then later admitted. Suitable patients that urgently require
treatment are always accepted at once either at the Crease Clinic or Provincial Mental
Hospital.
Examination of the following table, which is a summary of the movement of population in the Crease Clinic for the year ended March 31st, 1959, shows that the number
of patients admitted (1,492) increased by only four patients over the previous year. This
slight levelling-off of admissions since the year ended March 31st, 1956, when the admission rate was 1,627, was suggested in my previous Annual Report.
Total
Total in residence, April 1st, 1958-	
Total admissions during year 1958/59..
First admissions   -.
Readmissions 	
Number of voluntary admissions	
First admissions 	
Readmissions  —
Discharges during year	
To community— 	
To other units	
Deaths during year	
Total in residence, March 31st, 1959	
The voluntary admission rate to the Crease Clinic has increased from 763 patients
or 50 per cent in the previous fiscal year to 834 or 56 per cent of the total patient admissions to the Clinic for the fiscal year ended March 31st, 1959. The table shows 616
male and 876 female patients were admitted to the Clinic in the fiscal year just ended;
that is, 260 or 29.6 per cent more female patients. This is the usual trend of admissions
to the Crease Clinic and compares with 19.75 per cent more female admissions the
previous year.
Eighty-five patients were admitted to the Provincial Mental Hospital for continued
treatment from the Crease Clinic, or 5.7 per cent of Crease Clinic discharges. This also
is average and was 6.7 per cent in the previous year.    I 42
MENTAL  HEALTH  SERVICES  REPORT,   1958/59
Movement of Population
The following table gives a summary of the movement of population of the Provincial Mental Hospital for the year ended March 31st, 1959:—
Men
Women
Total
1,862
771
1,546
596
3,408
1,367
Discharges during the year —	
744
96
626
57
1,370
153
840
683
1,523
1,822
1,457
3,279
In residence, April 1st, 1958—
	
	
1,862
1,546
290
7
Total on books, April 1st, 1958.  ■ ' 	
Admissions from April 1st, 1958, to March 31st, 1959  	
3,705
1,367
	
5,072
Admissions—
514
6
117
5
55
5
1
8
472
1
107
4
10
2
986
7
Voluntary _          	
384
9
Order in Council    	
65
5
3
8
771
5.96
1,367
The admission services have again been very busy.
It is noted 1,367 patients were admitted during the year. The average monthly
admission rate was 113.9 patients. The total admissions for the year show a decrease of
one patient over the preceding year.
It has again been possible to reduce the number of patients in residence. The total
in residence April 1st, 1958, was 3,408, and the total in residence March 31st, 1959,
was 3,279, a reduction of 129. This is a very creditable achievement and reflects the
intensive programme of treatment. Male admissions and separations are noticeably
greater than female admissions. This is usually the case at the Provincial Mental Hospital and the reverse to what occurs at the Crease Clinic.
Only eighty-five patients, thirty-seven men and forty-eight women, were transferred
from the Crease Clinic to the Provincial Mental Hospital this year, an average of seven
patients per month. During the previous year this averaged eight patients per month.
These patients were transferred since they required more than four months' treatment,
the period of residence permitted in the Crease Clinic.
The percentage of patients recovered or improved, as compared to admissions, was
75.1 per cent. This compares with 68.9 per cent the previous year. The percentage of
deaths to the number under treatment was 3.2 per cent. The percentage of discharges to
admissions (exclusive of deaths) was 100.2 per cent. This is an increase over the previous year's figure of 90.5 per cent. The daily average patient population was 3,301.84.
This is a reduction of 108.95 from the previous year, when the daily average population
was 3,410.79.
During this year sixty-five Order in Council patients were admitted from the Provincial gaols or Court. On March 31st, 1959, there were thirty Order in Council cases in
Hospital.   CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL I 45
swimming, and other activities.    Many more patients leave the Hospital for brief or
extended visits in the community with relations or friends.
Mrs. M. L. McKay and Mr. R. Strong are appreciative of the splendid co-operation
of their staff and also the assistance willingly given by other departments, which aided in
the smooth functioning of their departments.
Psychological Services
The Department of Psychology, under the direction of Mr. J. W. Borthwick, reports
a year in which diversification of staff duties has continued to increase. Psychological
appraisal of patients remains the main function, but there has been a greater demand for
service in therapeutic interviewing, group therapy, clinical research, and staff development and education.
During the year 621 psychological reports have been prepared, based on interviews,
and the administration of 1,635 separate tests. The great majority of these reports are
concerned with psychodiagnosis and prognosis of newly admitted patients. A small
number deal with re-evaluations following treatment, assessment for discharge, and rehabilitation planning. Psychologists examined and reported on fifteen applicants to the
School of Nursing. As a guide to the School, an estimate of the educational level of
applicants who cannot produce proof of formal education is made. As part of a project
to develop selection norms for psychiatric nursing students, 104 new students have been
given tests. By following their careers for the next couple of years, it is hoped to develop
appropriate test standards for screening new applicants.
Approximately 300 hours were spent in conducting group therapy, chiefly in the
East Lawn and West Lawn Buildings. Another 150 hours were spent in seeing patients
referred for individual counselling and psychotherapy.
In the field of research, clinical psychologists have taken part in two current studies
evaluating the therapeutic effect of two new drugs. This department received two new
items of research equipment which will be useful in future research projects. One is a
polygraph for measuring various psychophysiological changes and the other is a tape
recorder.   Federal Mental Health Grant funds supplied this equipment.
Participation in staff training has increased. Eighty hours of lectures were delivered
to various groups. The majority of these were lectures in pshychology to the students
of psychiatric nursing. Considerable time was spent in the East Lawn and West Lawn
Buildings in consultation with ward staff in regards to programming and group procedures.
The major new undertaking in staff training has been the development of a programme of group therapy to be conducted by the nursing staff. At the request of the
Clinical Director, we examined ward programmes reported in use at other hospitals. One
such programme has been developed at the Philadelphia State Hospital and was called
" remotivation technique." This technique was tried and found to be relatively simple
in method and teachable. After having gained some experience, a set of notes was
prepared for instructional purposes. A library of materials for use with the method was
collected. Supervisors and charge nurses throughout the Hospital were then contacted
in order to give them a background in the technique and to work out administrative
details. Two courses of twelve hours each have been conducted for a total of twenty-
four nurses. Where possible there has been follow-up of the formal course with on-the-
ward supervision. It is believed that this technique is both therapeutic for the patients
and rewarding for the nursing staff. Many of the nurses have shown remarkable ability
and initiative in using this method. A satisfactory means of continuing supervision and
administration has not yet been reached, but co-operation from the nursing staff has been
good, and a solution is expected soon. Remotivation technique is one approach for
nursing staff to participate more in therapeutic programmes. It is hoped that it will soon
become the complete responsibility of nursing.   I 48 MENTAL HEALTH SERVICES  REPORT,   1958/59
pitches, croquet, and especially the ever-popular bowling-alleys were the scene of extensive activity. Steps were also taken to increase programme and staff coverage to provide
for more active use of gymnasium and recreation facilities on Saturdays when working
patients were free to participate.
Such recent innovations as the Stanley Park outings, mystery bus trips, expeditions
to community events, concerts, etc., continued to grow in popularity. Changes made in
staffing in certain areas made possible more extensive activation programmes, particularly
in the East Lawn Building and the Crease Clinic. Alteration of the days and time during
which supervisory staff was available resulted in much greater opportunity for the patient
group to avail themselves of the splendid billiard-room facilities.
Extensive staff changes during the year saw Mr. Richard Ramsay, the Director,
Miss Eileen Swan, music therapist, and Mrs. Doreen Weston, instructor, resign to
continue university studies, while Mr. Gordon Maxwell joined the department in January
and was appointed as Director on November 1st, 1958. Mr. Frank Knight was appointed
music therapist in July, and three instructors' vacancies were successfully filled as of
February 1st.
Altogether, this has been a year which has brough notable changes in the emphasis
and direction of clinical leadership as related to the care and management of patients.
Additional wards have been opened and many more patients are enjoying ground
privileges, with all that this implies in regard both to the voluntary basis of their
participation and the nature of the activities in which and to which they may be expected
to respond. Keeping abreast of these developments and being willing and able to adapt
and change as new interests and needs are revealed promise to offer a stimulating and
challenging role for the department in the weeks and months to come.
The very encouraging statistical reports of the activities of the department are also
indicated in the fact that 3,086 department sessions were held with a total attendance of
116,376, made Up as follows:  Group Sessions Attendance
Crease Clinic   642 18,261
Provincial Mental Hospital  1,972 90,903
Special events   6 2,722
Music theraby  466 4,490
Totals  3,086 116,376
Physiotherapy
Mr. Craig Stewart, physiotherapist in charge of this department, reports a busy
year. The increasing tendency to use physiotherapy for treatment of physical disabilities
is again evident, and particularly noticeable in the declining use of hydrotherapy as an
agent in the care of mental illness. Most of the hydrotherapy administered is in the
form of whirpool baths, used as an aid in assisting local peripheral circulation.
When the patient's condition permits, every effort is made to encourage attendance
at the department for treatment rather than be recipients of a more passive treatment
in bed, and in this way attempt to encourage self-motivation and the reactivation of the
patient.
Full use is made of all the equipment. A total of 19,803 treatments were given to
2,859 patients. The chiropody section, which is in this department, is functioning to
full capacity.
Patients' School
Mr. Robert E. Dalby, school-teacher in charge of this department, reports that
while the school is chiefly concerned with education along the lines of the regular school
system up to Grade XII, it should be regarded as an adjunct of the other therapeutic
services. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL I 49
For those patients possessed of high intelligence, the Hospital school is a natural
haven. It offers possibilities for self-expression and personal development, which will
assist them to adjust more adequately to life. Less bright individuals, often underprivileged educationally, frequently progress very well toward a state of literacy and
general competency. New Canadians form another group of patients who profit
educationally and socially from the school.
The teacher has noted a marked desire, even need, of some patients to help others
—that is, to teach. Even if these people were not particularly competent, their assistance
was certainly valuable.
Since the average attendance of a patient was only two months, emphasis has been
on basic mathematics and English. The correspondence courses supplied by the Department of Education best meet the needs of patients who cannot leave their wards.
Eighteen per cent of the patients have requested commercial training, usually a refresher type of course. Clerical training seems to be the most immediately useful training
that an academic school can offer.
During the year the teacher had occasion to visit most of the wards, the male ones
several times. The charge nurses were helpful in giving information about patients attending the school, as well as prospective students. The following will give the statistics of
this department for the period May 12th, 1958, to March 31st, 1959: —
Total enrolment (male, 43; female, 31)    74 students
Average daily attendance   (including those  attending
mornings or afternoons only)     19 students
Average period of attendance per patient  8.7 weeks
New Canadians learning English    11 students
Commercial subjects     13 students
Health of Patients
The health of the patients has again been very good and the number of notifiable
diseases small. Because of the threat of smallpox, all staff members were revaccinated.
Those under the age of 40 received Salk polio vaccine.
A diphtheroid-like infection developed but was rapidly controlled by appropriate
precautionary measures combined with isolation techniques.
Infectious hepatitis has been endemic in the community. As a result, in January,
1959, the local Public Health Officer was consulted. Gamma globulin was given to all
patients and staff contacts, student-nurses, food-handlers, patients receiving surgery, and
all others indicated. Every department co-operated completely. The infection was confined. No male patients were infected, and only fifteen female patients plus a few nurses
who had been exposed prior to returning to Essondale were infected. Altogether over
1,100 patients and staff received gamma globulin, and by February 16th, 1959, free
movement of patients and staff was permitted.
The continuous screening and testing of our patients by our specialist in tuberculosis
continues to yield results and is a very valuable service. The Tuberculosis Control X-ray
survey provided by the mobile unit at Riverside units, Colony Farm, and the East Lawn
Building in January, 1959, was extremely helpful to the Hospital.
The greatest care is taken to detect and treat at once infections found in patients being
admitted to Hospital or patients returning from visits in the community.
Department of Radiology
Dr. J. M. Jackson, Director of the Department of Radiology, reports great activity.
An increase of 591 examinations over 1957/58 is reported. This increase reflects the
trend throughout the Hospital toward a more thorough work-up and diagnosis on more
patients.   As an example of this, the number of pneumo-encephalograms studied totalled I 50 MENTAL  HEALTH  SERVICES  REPORT,   1958/59
289, an increase of 104 over the previous year. The general surgical service and that
of internal medicine has also been more aggressive, tending toward a more extensive
use of this service as an aid in diagnosis. The year's work in total consisted of 16,531
examinations.
Department of Laboratories
Dr. G. A. Nicolson, Director of the Department of Laboratories, reports that a high
standard of service has been maintained. There is an increasing demand for laboratory
service.
From a summary of the total number of tests performed by the laboratories of the
Provincial Mental Hospital and the Crease Clinic during the year, some significant observations can be made as follows: The total number of procedures carried out was 50,980
(representing 124,091 units in the Dominion Bureau of Statistics system of reporting).
This indicates an increase of 1,867 in the total number of procedures performed as compared with the previous year. Complex chemical analyses have been requested more
frequently. Blood electrolyte determinations and blood cross-matching procedures have
increased in accordance with the increase in surgical procedures carried out in the Surgery
Department. An increase in spinal-fluid determinations reflects increased activity in the
Neurology Department. A total of 202 autopsies was performed, an all-time high for
the Mental Health Services. With the increased volume of work, the resources of both
technical and clerical laboratory staff have been used to capacity.
Pharmacy Department
Mr. K. Woolcock, Chief Pharmacist, reports that there have been increased demands
for service. The pharmacy at Essondale serves the entire Mental Health Services. Every
effort is made to purchase and to have ready at all times the most effective pharmaceutical
agents known to science in the treatment of the mentally ill.
The pharmacist and the medical staff who comprise the Pharmacy Therapeutics
Committee have set out on a programme of improvement in the selection of medication
available to the doctor.
In order to assist in the selection of the most suitable of many products, the
Committee is preparing a formulary or directory of medicines best suited to the patients'
needs. The preface of the manual states: "The proliferation of proprietary names
has reached such proportions that the ordering of medicines is becoming less and less
subject to rational and scientific principles and more and more subject to non-rational
considerations and advertising pressure."
If and when this pocket volume is accepted by the Hospital, the medical staff can
be well assured that every effort has been put forth to offer the ultimate in compounds
whose therapeutic usefulness is clearly established.
Optical Department
Mr. H. H. Woodbridge, optometrist in charge of the Optical Department, reports
on the completion of another active year of service to our patients.
A total of 518 refractions were completed. A total of 232 major repairs and 150
minor repairs and adjustments were made, thus making a total of 900 procedures carried
out to improve the health, efficiency, and comfort of our patients.
Dental Department
The Dental Department, under the direction of Dr. G. D. Campbell, reports a very
busy year. We regret the loss of our previous dentist, Dr. H. O. Johnsen, who died
July 7th, 1958. Many improvements were achieved in this department through Dr.
Johnsen's efforts. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
I 51
The department was fortunate in having Dr. W. C. Cusack, formerly of Tranquille,
join our staff on August 25th, 1958, and Mrs. Milan, a dental assistant, join our staff
in May, 1958.
Dental patients are received on referral from the ward doctors. The dentists, by
discontinuing routine examination of new patients, use this time to better advantage
for routine dental treatment. However, the dental technicians continue to mark the
names of all new patients on their respective dentures. Duplication of records is reduced
by keeping the dental charts of all patients on file in the dental office rather than with
the patient's medical files.
The department is constantly busy with the relief of pain and discomfort in the
mouth, in addition to restorative work.
During the year, 5,218 dental procedures were completed.
Chaplain
The full, willing, and ready co-operation of the staff of all departments of the
Provincial Mental Health Services, without which the work of the chaplains could not
be accomplished, continued throughout the year. A new venture this year was the
conducting of regular church services on two infirmary wards, similar to those on the
wards in the Home for the Aged, Colony Farm, and North Lawn, and which were continued. There are also services both morning and evening every Sunday in Pennington
Hall auditorium for all patients of the Crease Clinic, the Provincial Mental Hospital,
and the Home for the Aged who wish to come and are able to either walk or be brought
by transportation.
" The Leader," the patients' monthly magazine, and " The Weekly Bulletin," the
schedule of events, have continued to be published under the supervision of the resident
chaplain, through the loyal efforts of many of the patients assisted by certain of the staff.
During May our resident chaplain, the Rev. J. F. O'Neil, was elected as regional
representative of the Association of Mental Hospital Chaplains, an affiliate organization
of the American Psychiatric Association. The resident chaplain also continued to be
active throughout the year in the formulation of a national policy for the Anglican Church
of Canada, and indirectly for the Canadian Council of Churches, regarding the training,
qualifications, and provisions of chaplains in penal and mental institutions.
In close co-operation with the Clinical Director, the main emphasis has been on
the provision of opportunities for worship. There have been 439 services during the
year, of which 80 were funerals and 26 were Roman Catholic mass. There was a total
attendance of 36,934 patients. The Roman Catholic services and funerals were conducted by the Rev. Father A. Frechette, O.F.M., of Our Lady of Lourdes, Maillardville,
together with his two assistants, the Rev. Father Antonio Dion, O.F.M., and the Rev.
Father Dureau Bonaventure, O.F.M.
Audio-Visual Department
Mr. W. E. Peters, supervisor of the Audio-Visual Department, reports that during
the past year there has been considerable installation work. The Home for the Aged
auditorium and the nurses' training-school required combination motion-picture and
public-address sound systems. The Woodlands School auditorium required a public-
address and music system for the recreations-therapy staff; also installation of the 35-mm.
projection equipment was started but, unfortunately, an outbreak of hepatitis caused
considerable delay on this project.
The photographic section is turning out very excellent work. A special project
has been the taking of pre- and post-operative photographs for the Department of
Surgery in the Crease Clinic. Besides providing an accurate record of the patient's
condition, they have been used for several clinics and are now always available for
teaching and educational purposes. I 52 MENTAL HEALTH  SERVICES  REPORT,   1958/59
A photographic display showing how the facilities of this department are used in
the Mental Health Services was prepared for the Mental Hospital Institute of the
American Psychiatric Association at Kansas City, Mo. They also used six of the key
photographs for a two-page spread in their March, 1959, journal.
Two hundred prints were made for the Canadian Mental Health Association.
These were used to promote the association and also thank the various organizations
throughout British Columbia for their contribution of Christmas gifts.
Lectures by Dr. Yonge, Dr. Prados, and Dr. Colbeck were taped and then cut on
disks.    These will make an invaluable addition to our clinical library.
This department assisted with the regular events connected with the Hospital, such
as the psychiatric nurses' graduation, sports day, the Canadian Mental Health Association
volunteers' fashion show, and civil defence exercises.
The following will give an indication of the regular activities of this department:—
Number of Total
Shows Attendance
35-mm. films at Pennington Hall  143 45,933
16-mm. films at Essondale, Riverside, and Home
for the Aged, Port Coquitlam  481 28,332
There were 292 16-mm. films shipped to other institutions. The educational film
library now has 277 registered borrowers (a 10-per-cent increase over the previous year),
who used 942 films.
The overall production in photography shows an average of 10 per cent increase
over the previous year, with a marked increase of 300 per cent of 2 x 2 colour transparencies, which are used extensively for lecturing by the clinical and other departments in the
Hospital.
The music-record library loaned 4,308 records. Recorded music through sound
system totalled 672 hours to the Hospital wards and grounds.
Industrial Therapy Department
Mr. R. Herring, supervisor of the Industrial Therapy Department, reports an active
year. Records show high-quality production and repair schedules. A tremendous job of
serving the Hospital was maintained, and great credit is due to the staff and patients who
took part in this work. An indication of the vast amount of work done by this department may be gathered from the following figures:—
Mattress and Canvas Section	
Upholstery Section	
Tailoring Section	
Cabinet Section	
Shoe Section	
Machine Section
Printing Section ._._ _ 2,098,278
Metal Section	
Uniform Section
Dry-good Section
Manufactured
Items
Repaired
Items
8,757
2,985
779
1,030
3,891
13,925
528
2,207
4,620
250
818
2,098,278
1,390
218
8,796
11,515
36,182
Mending Section  83,617
The following special services were given during the year: Clothing alteration service
for patients on request; staff uniform service—measurements and fittings; interior
decorator colours—aid in selection, colours, fabrics and drapes; wrapping and mailing
service; eye-glasses—the marking and cataloguing of patients' names on all glasses,
including The Woodlands School and the Home for the Aged; plastic name-bars issued
to all staff and services maintained, including The Woodlands School, Home for the Aged,
and Mental Health Centre and Child Guidance Clinic. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
I 53
The number of patients on the yearly roll totalled 2,396; 230 new patients were
started; 82 patients were transferred to other employment; 19 patients were returned to
the wards; and 82 patients were discharged to the community.
Fire Department
Mr. A. P. Lowry, Fire Chief, reports that the Essondale Fire Department answered
forty-seven calls during the year, eight of these being fires in buildings housing patients,
eighteen were grass and brush fires, seven rubbish fires, two automobile fires, and twelve
false alarms. There were twenty-eight fires in couches, mattresses, garbage-cans, etc.,
which were extinguished by the nursing staff without the aid of the department. Thirty
smoke calls were investigated.
The department has conducted thirty-seven one-hour lectures and twenty-six four-
hour lectures and demonstrations to the various departments of the Hospital, and there
were seven fire-drill evacuations for staff and patients. The volunteer firemen have
received ninety-two hours of instruction and there were ninety-six practices. Each practice
was from one to two hours and consisted mostly of practical work, using all types of fire-
fighting equipment and involving both the volunteers and 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
given to Cubs and Boy Scouts from near-by communities and children from The Woodlands School. Many meetings relating to safety committees, civil defence, and blood
clinics have been held in the fire-hall.
The department made fifty-nine miscellaneous calls on Hospital business, which
included assisting various trades with pumper and aerial ladder, helping to recover
bodies of several drowning victims, and transporting equipment. They made twenty
courtesy calls, giving assistance to people not connected with the Hospital.
Three barn dances were held in the fire-hall garage by student-nurses under the
supervision of Mrs. Gibson, nursing counsellor.
On June 4th, 1958, a patient was rescued when trapped by high water in the swamp
between Colony Farm and the Fraser River. On June 5th a large-scale civil defence
exercise was carried out, with headquarters at the fire-hall.
On June 17th No. 2 truck and five men were sent to assist the Port Coquitlam Fire
Department to fight a large bush fire.
During the latter part of 1958, 208 members of the nursing staff attended the four-
hour lectures at the fire-hall, and the results have been most encouraging.
The normal routine duties carried out are as follows: Inspections of all buildings
and shops connected with the Hospital; monthly inspections in conjunction with the
safety committee; quarterly check and annual recharge of 700 fire-extinguishers at
Essondale, The Woodlands School, and Mental Health Centre and Child Guidance
Clinic. All fire-fighting equipment was continuously maintained—hydrants, alarm-
boxes, etc.—and the chimney-cleaning contractor was supervised.
Civil Defence and Disaster Committee
This Committee has been active during the year, and regular monthly meetings have
been held. A short course of instruction in civil defence and disaster was given to the
nursing staff. Arrangements have been completed with the School of Psychiatric Nursing
to add three hours to the curriculum to be devoted to instruction in civil defence. The
first series were given in September to the classes. This arrangement will be continued
as a regular lecture.
Three members of the staff have attended courses at the Civil Defence College at
Arnprior, Ont. These courses included Emergency Feeding, Fire and Rescue, and
Physicians' Indoctrination. I 54 MENTAL  HEALTH  SERVICES  REPORT,   1958/59
An evacuation exercise was held in June, and much valuable information was
obtained from this exercise. At his request, a report on this exercise was forwarded
to the Co-ordinator, Greater Vancouver Target Area, who commented very favourably
on it and expressed the opinion that it might well form the basis for planning for similar
institutions across the country.
Four members of the social service staff attended a one-day institute on " Personnel
Services in Civil Defence " at Vancouver.
Instruction in civil defence and disaster planning has been enhanced by a continuing
series of demonstrations in fire-fighting given to the nursing staff by our Fire Department.
These lectures and demonstrations enhance the skill of our nursing staff in the face of
any emergencies which are likely to arise in a hospital of this kind.
Close contact has been maintained with the Co-ordinator, Greater Vancouver Target
Area.
Medical Records Department
Miss A. Dingle, supervisor, is in charge of this extremely busy department and
reports that during the past year the Medical Records Department has continued its
efforts to keep abreast of the changing concepts in psychiatry. The reactivation programmes in the various units reflect in increased activity of the records, and this activity
has been particularly in evidence in the East Lawn Building.
In the Crease Clinic, changes have been made in the recording routine so that more
information regarding the condition of each patient on admission is made available to
the treatment team by the Assistant Clinical Directors. This change has been made in
conjunction with a reorganization of the records office staff to provide more supervision
and a closer check on the contents of the files and to release one stenographer for secretarial duties for the Clinical Director and his assistants. Plans have been finalized for
the installation of dictating equipment, and it is expected that this will ease the pressure
on both the medical and stenographic staff. Dictation equipment has also been requested
for West Lawn Building.
In the past year, 2,804 records were requested from the "stack room," compared
with 1,814 in 1956/57 (not including records used on research projects). This is an
increasingly time-consuming work as most of these records have to be returned to their
place within a short time. It has been felt for some time that this should be done bv a
filing clerk, and it would be a full-time task to draw and return files required for answering
inquiries, readmitted patients, and research projects, and to do the filing on the closed
records.
Samples have been requested of all forms used in the various offices in order to have
these catalogued and numbered. This would be in conjunction with the catalogue of
forms used on the wards and would assist in the plan to have stationery issued directly to
the ward from stores, with only the office stationery handled by the clinical office staff.
Dietary Department
The patients' meals and service generally in this department have shown further
improvement under the direction of Mrs. M. E. Marr, dietetics administrator. This is
a great achievement when considering the tremendous number of meals served, over
4,000,000, as indicated in the statistical report following:—
Number of meals served to patients      3,983,205
Percentage of total meals, diet therapy  6.4%
Number of meals served to staff        151,388
Total meals served     4,134,593
Total cost of raw food  $1,736,110.00
Average price increase of meat per pound  11.07%
Cost increase of meat used 1958/59   10.26%
Percentage of total food cost that is meat  35.00% CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
I 55
Average price increase of other foods _7 i  1.30%
Percentage increase in total costs ,  3.86%
Average cost per meal of raw food served  $0.4199
Total cost, crockery, linen, salaries, silver, and
miscellaneous         $88,426.00
Total cost per meal, excluding heat, light, and
power  $0.5112
Prices have risen during 1958/59, and inevitably food costs have risen. However,
our food costs have risen less than proportionately to price increases. Meat costs are
approximately 35 per cent of total dietary costs; therefore, considerable study has been
given to meat consumption. Increased efficiency in the handling of meat during this year
has saved the institution $14,241. This was made possible by the utilization of means
enabling us to reduce the quantity of meat handled whilst still maintaining our menu
standard. In 1957/58, the amount of meat handled was 1,336,837 pounds, at a cost of
$467,148 (average cost per pound $0.3506). In 1958/59 the amount of meat handled
was 1,331,762 pounds, which is a decrease over the preceding year of 5,075 pounds, but
an increase in cost of 10.26 per cent or an increase of $47,934 or a total cost of $515,082
(average cost per pound $0,388). Had 1957/58 quantities been processed in 1958/59,
meat costs would have been $530,333. This efficiency and resultant saving has been
attributable to:—
(1) Greater efficiency in portion control:
(2) More discrimination in purchasing:
(3) Reduction of waste resultant from:—
(a) Better management:
(b) The acquisition of a quick freeze and other equipment:
(c) More efficient utilization of by-products.
Satisfactory progress in dietary services was made in 1958/59 by the improvement in
the service of therapeutic diets. Three special-diet service areas have been established,
wherein control and supervision of special-diet service has been made possible.
Plans were completed for the renovation of the East Lawn kitchen during this period,
also for the opening of the new kitchen of the Valleyview unit of the Home for the Aged,
Port Coquitlam.
Demands upon the Dietary Department are steadily increasing. Additional to our
menu preparations are the frequent and regular preparation for numerous recreational
activities which require dietary items to complete their sociability.
Stores Department
Mr. R. A. Boulter, supervisor of the Stores Department, reports that this department,
being constantly aware of the value of time and the necessity of accurate portion control
in the preparation and serving of meals, has provided this type of service in the past twelve
months.
There is available to-day an ever-increasing variety of prepared foods (fresh, dried,
and frozen), all of which lend themselves most effectively to Hospital usage and at a
comparatively economical rate, considering labour saved and minimized wastage.
We have also incorporated these ideas into our Hospital manufacturing of beef and
pork by-products through the innovation of freezing.
This type of supply presents a challenge to the tradesman. It is the answer for many
supply problems and offers unlimited advantages to the dietary personnel.
Provisions, clothing, drugs, and other supplies to a value of $3,269,799 passed
through the Stores Department during the year. This cared for an average daily patient
population of 5,455 and covered patients in the Crease Clinic and the Provincial Mental
Hospital, Essondale; The Woodlands School, New Westminster; and the Home for the
Aged, Port Coquitlam. I 56 MENTAL HEALTH  SERVICES  REPORT,   1958/59
Laundry Department
Mr. D. Anderson, supervisor, reports a gradually increasing volume of work. The
Essondale laundry processes all the maerial from the Home for the Aged, Port Coquitlam,
and The Woodlands School, New Westminster, in addition to that received from the Provincial Mental Hospital and the Crease Clinic. The expansion in the first two areas is
reflected in the demands made on this department.
It is difficult to visualize the magnitude of the job this department does. It means
handling 13 tons each working-day, usually over 135,000 pounds per week. Three hundred and fifty garments are dry-cleaned per day.
There has been an increase in the volume of material processed, both in the Laundry
and the Dry Cleaning Departments:—
Laundry  lb.    7,038,445
Increase  lb.       192,445
Dry cleaning lb.       110,720
Increase lb. 7,660
Mattresses sterilized  1,823
Pillows sterilized  310
Transportation Department
Mr. G. Nolan, transportation supervisor, reports the Transport Department, with its
headquarters located at the Provincial Mental Hospital garage, Essondale, has two main
functions: (1) To maintain and repair a fleet of approximately fifty units, consisting of
buses, light and heavy trucks, station wagons, passenger-vehicles, plus other miscellaneous
equipment, and (2) to formulate and maintain schedules of varied types of transportation
to meet the requirements of other departments within the Services. The services are provided on a twenty-four-hour basis as required. A very active year was experienced, but
the load was considerably lightened due to the splendid co-operation of all departments
concerned and the teamwork of the transport staff.
Patients' Accomodation and Hospital Maintenance
All areas of the Crease Clinic and the Provincial Mental Hospital have been surveyed
by the Medical Superintendent and Business Manager with a view to maintenance and
alterations. The Public Works Department has completed a great amount of decorating,
painting, and alterations, both inside the various buildings and about the Hospital
grounds. Maintenance is carried on constantly in addition to the emergency coverage and
service provided on a twenty-four-hour basis by many of the Public Works departments.
The West Lawn Men's Building has been much improved with further floor replacements, painting, and storage space provided in surgeries. Many new plumbing fixtures
were installed. Ward C 2 was provided with new furniture in the dayroom. New office
space was provided for medical and psychology staff.
Pennington Hall, the recreational building, was painted and decorated throughout
and the gymnasium floor refinished.
The Riverside Cottage patient count has been reduced to 56. It was formerly 125.
The situation is further improved by vacating the top floor and operating the building on
an open-ward basis.
All wards are now provided with television sets, and many areas are provided with
outlets to select desired radio programmes.
The East Lawn Women's Building is much improved, with the wards painted in
pastel colours, which are selected by the nursing staff.
The new dish-washing equipment installed at Riverside annex is a great improvement.  I 58 MENTAL  HEALTH  SERVICES  REPORT,   1958/59
Twenty-five branch delegates of the Canadian Mental Health Association, British
Columbia Division, representing many widely scattered districts in the Province, held
their annual meeting on March 20th at the Crease Clinic.
On March 29th Dr. Mathew Ross, medical director of the American Psychiatric
Association, visited the Hospital.
Gifts
The Provincial Mental Hospital and Crease Clinic have again received very large
numbers of gifts for our patients from relatives, interested friends, and organizations. We
wish now to thank everyone who has contributed to the welfare of our patients in any
way, since it is not possible to report everyone here.
Many valuable gifts were received during the year; possibly the most valuable gift
that anyone can give is his time and talent, and our patients and staff are appreciative
of the many thousands of hours cheerfully given this past year.
We are appreciative of the thousands of gifts received through Mr. J. Ward,
executive director of the British Columbia Division of the Canadian Mental Health
Association, from all over British Columbia. These gifts are used to stock the men's and
women's apparel-shops, or may be distributed directly to our patients on December 26th
(Boxing Day) by Hospital volunteers and Kiwanis Club members.
Many gifts were received in connection with our patients' fashion show in May—
make-up, hair styling, clothing, costume accessories. Miss Marie Moreau, fashion editor,
with a staff of specialists, assisted by many more, was in charge of make-up for our
models.
Many generous gifts of tickets have been received which have enabled large numbers
of patients to visit the Pacific National Exhibition, Shrine Circus, fairs, concerts, and
sports events.
The Canadian Legion and Army, Navy, and Air Force ex-servicemen's organizations
gave many gifts, not only at Christmas, but during the year, when the members of their
women's auxiliaries visited the Hospital. Large quantities of fruit, smokes, candies,
and other comforts were provided.
Reading material and comforts were received from the 48th Battalion organization
and Hycroft veterans.
Patients in North Lawn Infectious Diseases Building were most appreciative of
twenty table lamps they received from Branch No. 44, Tubercular Veterans Section
of the Canadian Legion.
Many industrial organizations have been generous with gifts of materials for the
use of patients in occupational and recreational areas.
Many periodicals, soft drinks, small items of clothing, and comforts are received
every month.
Two patients' wards and the volunteers' coffee-shop were decorated at Christmas
through the generosity of a private firm.
General Comments
During the year many acts of courage and devotion to duty are noted among our
staff and patients. I wish to commend Mr. Jack Stewart, Men's Nursing Division, who,
during April, was instrumental in saving a woman patient from drowning.
The members of the Essondale Fire Department are to be commended in their
splendid work in rescuing a male patient who was marooned on the flooding Fraser River
last June.
These two incidents resulted in the saving of lives. Many praiseworthy acts, no
doubt, occur daily in the various Hospital departments and are not reported. I wish to
commend the staff concerned.  I 60
MENTAL  HEALTH  SERVICES  REPORT,   1958/59
reduction in the numbers of patients is making it increasingly possible to come closer to
adequate care for those who are here. Last year I noted the increasing number of
patients 50 years of age and over, and this trend is continuing.
The fall teaching institute for physicians, primarily, was held again this year for
four days. Two visiting professors led the programme. They were Dr. Keith Yonge,
Professor and Director of the Department of Psychiatry, University of Alberta, and Dr.
M. Prados, retired Associate Professor of Psychiatry at McGill. The institute was
focused on psychotherapy in all its aspects. It was a very successful undertaking. The
weekly teaching seminars throughout the winter were held again this year. The resident
staff did a great deal of the work in preparation, although this was supervised and added
to by the senior clinical staff.
There have been many useful changes of internal organization, of which I can
mention only a few. The Occupational Therapy Department has been strengthened by
the addition of more qualified therapists, and so we have been able to continue with the
trend of having qualified persons in each area. This has made for much greater efficiency
in working, and its effect has been felt throughout the Hospital. In the medical area of
the Hospital, ward rounds have been changed so that they are more functional, and better
unite the treatment facilities as a team and are more effective in supervising and teaching.
This year a number of staff have taken on the task of compiling a Hospital formulary by
the end of the year. This is nearly ready for release. It is a most ambitious task and
will improve the functioning of this department.
Two research projects have been completed during the year. The first had to do
with the investigation of a drug which was found to be highly effective in certain kinds
of depression. The second project concerned the investigation of a drug used in activating of long withdrawn patients. The institution of remotivation group therapy within
the Hospital has been another excellent addition. This year the role of volunteers working at Essondale has increased to 200 in number. They continue to make an excellent
contribution in many areas of the Hospital.
In conclusion I may say there have been some improvements in the over-all level
of operation in which we use more specific methods of treatment. All of the usual treatment methods have continued to be employed effectively throughout the year. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
STATISTICAL TABLES
I 61
CREASE CLINIC
Table 1.—Movement of Population, Crease Clinic, April 1st, 1958,
to March 31st, 1959
Male
Female
Total
In residence, April 1st, 1958    	
101
438
37
141
151
577
42
257
252
Admissions—
1,015
79
398
Readmissions to a different institution of Mental Health Services 	
616
876
1,492
717
1,027
1,744
Separations—
606
4
889
4
1,495
8
Died    	
Total separations     -   . ..
610
893
1,503
Net increase or decrease.   ..      ... 	
+6
107
— 17
134
—11
241 I 62
MENTAL  HEALTH  SERVICES  REPORT,   1958/59
Table 2.—First Admissions to Crease Clinic by Health Unit and School
District of Residence and Sex, April 1st, 1958, to March 31st, 1959
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
Metropolitan Health Committee,
School District No. 1 	
2
2
4
„         „   2...	
1
1
2
School District No. 45  ..
6
6
12
 ,   3	
6
4
10
Simon Fraser, New Westminster—
„   fZ.	
2
4
2
2
6
14
14
41
18
55
 5 _..
„   43	
32
„   18-	
1
1
North Fraser Valley, Mission—
Selkirk, Nelson—
School District No. 42    	
7
10
17
School District No. 7   	
2
3
5
„   75       ...
6
8
14
„   8.   -	
1
1
,   76
1
4
5
„   10	
2
2
Upper Island, Courtenay—
School District No. 47 	
West Kootenay, Trail—
2
1
3
School District No. 9  _..
1
2
3
 ,   71	
5
5
„   11*   	
5
12
17
„   72	
3
1
4
„   12	
3
1
4
Skeena, Prince Rupert—
School District No. 50 	
South Okanagan, Kelowna—
1
1
2
School District No. 14         	
2
3
2
8
4
11
, 52   	
 ,   53 	
7
4
5
3
12
 ,   15	
7
„   16	
1
1
„   54
1
2
3
 17.	
2
2
Peace River, Dawson Creek—
 23	
12
11
23
School District No. 59	
4
4
 77 	
2
2
4
 60    	
3
3
North Okanagan, Vernon—
Victoria-Esquimalt Union Board
School District No. 19 	
1
1
2
of Health—
 20	
2
3
5
School District No. 61 (part1) —
11
12
23
„   22	
2
7
9
Saanich and South Vancouver
South Central, Kamloops—
Island—
School District No. 24	
8
8
16
School District No. 61 (part2)—
6
7
13
„   26 	
4
2
2
4
„   62
1
3
3
3
„   29	
„   63  	
4
„   30	
1
3
4
 64 	
1
1
 31	
1
1
2
Cariboo, Prince George—■
Nanaimo—
School District No. 27-	
4
3
7
School District No. 65	
2
3
5
„   28 	
3
5
1
8
1
„   66         	
2
3
1
5
 56	
 67 	
1
„         „   57      ...
12
2
15
2
27
4
„   68         	
3
3
9
12
 58-	
 ,   69 	
3
„   70          	
10
7
17
School District No. 32	
5
1
6
School districts not covered by
„   33	
6
11
17
health units—
„   34-	
10
9
19
School District No. 46	
2    1
1
3
Boundary, Cloverdale—
, 48 	
1
1
School District No. 35	
9
10
19
 ,   49	
4
4
„   36	
19
38
57
„   61 (part3) —
1
2
3
„   37	
3
6
9
„   73 -.     ...
	
2
2
Metropolitan Health Committee,
 80	
4
4
Vancouver—
Unorganized	
1
1
School District No. 38 	
10
19
29
Unknown  	
3
3
„         „   39
145
193
338
5
5
 41	
„        „   44
38
25
1
75
41
16
Totals	
475
619
1,094
1 Includes Victoria and Esquimalt only.
2 Excludes Victoria, Esquimalt, and Oak Bay.
3 Includes Oak Bay only. CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
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I 69
Table 14.—Separations from Crease Clinic by Mental Diagnosis, Condition
on Discharge, and Sex, April 1st, 1958, to March 31st, 1959
Mental Diagnosis
Condition on Discharge
Recovered
M
F.
Much
Improved
M.
F.
Improved
M.
Unimproved
Total
M.
F.      M.
Grand
Total
With Psychosis
Schizophrenic disorders	
Manic-depressive reaction	
Involutional melancholia	
Paranoia and paranoid states..
Senile psychosis	
Presenile psychosis-
Psychosis with cerebral arteriosclerosis..
Alcoholic psychosis-
Psychosis of other demonstrable etiology—
Other and unspecified psychoses-
Anxiety reaction without mention of somatic symptoms	
Hysterical  reaction  without  mention  of  somatic
symptoms
Phobic reaction  	
Obsessive-compulsive reaction _
Neurotic-depressive reaction-
Psychoneurosis with somatic symptoms (somatization reaction) affecting digestive system.
Psychoneurosis with somatic symptoms (somatization reaction) affecting other systems	
Psychoneurotic disorders, other, mixed, and unspecified types.
Chronic brain syndrome with neurotic reaction
Syphilis and its sequelae	
Total with psychosis..
Without Psychosis
Disorders of character, behaviour, and intelligence—
Pathological personality	
Immature personality	
Alcoholism-   	
Other drug addiction-
Primary childhood behaviour disorders..
Mental deficiency-
Other and unspecified character, behaviour,  and
intelligence disorders.
Chronic brain syndrome with behavioural reaction..
Chronic brain syndrome, N.O.S	
Epilepsy-
Other diseases of central nervous system not associated with psychosis  	
Observation without need for further medical (psychiatric care).
Other, unknown, and unspecified conditions-
Total without psychosis 	
Grand totals	
16
189
29
17
6
1
4
12
8
12
36
11
2
64
222
44
16
14
2
4
6
9
42
66
20
3
4
200
27 |    42 |    14 |    20 | 397 | 660
1
19
30
—
	
15
2
4
	
1
2
1
1
1
1
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3
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2
5
1
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10
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22
228
40
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6
1
1
5
14
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15
43
16
3
71
273
50
20
15
2
2
7
7
11
49
25
4
6
236
501
90
41
21
3
3
12
21
22
64
124
41
4
9
307
2
2
4
10
2
45 I    78 I 483
800 | 1,283
1
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5
2
1
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1
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35
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90 I    64
89
212
28 |    44
I
22  | 487
I	
724
77 |    99     606 | 889
I I
1,495 I 70
MENTAL HEALTH SERVICES  REPORT,   1958/59
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MENTAL HEALTH  SERVICES  REPORT,   1958/59
Table 14.—Resident Population of Provincial Mental Hospital, Essondale,
by Mental Diagnosis, Number of Previous Admissions, and Sex, December
31st, 1958.
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, 1958.
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, 1958.
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, 1958.
Detailed information for the above tables may be obtained on request.
Table 18. — Separations from Provincial Mental Hospital, Essondale, by
Condition on Discharge, Disposition to, and Sex, April 1st, 1958, to March
31st, 1959.
Disposition to—
■" i a
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.
18
19
461
57
16
25
432
23
—
	
3
	
	
	
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1
115
1
"~2         1
42  1      7
19 1      6
18
21
506
199
16
26
440
144
34
47
946
Unimproved —  ...
343
Totals 	
555
496
__
	
3
	
	
	
123
116
63 |    14
1
744
626
1,370
J CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
I 83
Table 19. — Separations from Provincial Mental Hospital, Essondale, by
Mental Diagnosis, Condition on Discharge, and Sex, April 1st, 1958, to
March 31st, 1959.
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
3
1
1
7
5
1
2
3
1
1
1
1
12
1
2
1
16
2
1
1
1
1
2
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14
3
6
9
30
6
5
7
2
3
11
1
254
26
11
1
3
1
5
22
9
13
5
1
15
2
2
1
54
1
11
3
299
16
4
8
5
7h>
40
12
8
8
2
4
11
4
283
34
13
1
24
1
47
26
13
18
8
2
2
19
2
3
1
582
50
17
1  | ......
5 |    21
__ | ......
41   1    42
9
29
1
97
2
1
1
3
2
2
3
3
1
66
Psychosfs of other demonstrable etiology—	
25
26
Anxiety reaction without mention of somatic symp-
1
16
Hysterical   reaction   without  mention   of   somatic
2
1
2
4
6
30
Psychoneurotic   disorders,   other,  mixed,   and un-
2
3
Syphilis and its sequeke    -	
5
Total with psychosis 	
18  |    14
17
24
327 | 371
109  |    88
471
497
968
Without Psychosis
I
1
i
2
1
1
1
1
33
7
107
3
3
3
4
3
9
6
1
16
6
27
2
1
10
4
3
25
2
14
1
1
10
5
18
14
9
2
1
2
5
......
5
1
13
16
1
1
60
.9
121
4
4
14
5
8
9
24
15
25
9
29
4
1
15
1
5
5
17
16
1
1
85
18
—
1
1
150
8
Primary childhood behaviour disorders	
5
29
Other and unspecified character behaviour and in-
6
13
14
41
Chronic brain syndrome with behavioural reaction...
Chronic brain syndrome with convulsive disorder..	
Other diseases of central nervous system not asso-
31
Observatlon without need for further medical (psy-
1
Other, unknown, and unspecified conditions. _.
1
_ |     2
4
2
179 |    69
90 |    56
273
129
402
18
16
21
26
506
440
199  I   144
744
1
626
1,370 I 84
MENTAL  HEALTH SERVICES  REPORT,   1958/59
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P I 88 MENTAL  HEALTH SERVICES  REPORT,   1958/59
PART III.—THE WOODLANDS SCHOOL, NEW WESTMINSTER
REPORT OF THE MEDICAL SUPERINTENDENT
L. A. Kerwood, Medical Superintendent.
Patient Population
Herewith the annual report for The Woodlands School for the year April 1st, 1958,
to March 31st, 1959, including a summary of the annual reports from the various departments.
On March 31st, 1959, total cases on register, including cases on probation, was
1,419, an increase of 102 over last year.   There were 1,403 patients in residence.
Population Analysis
(a) Sex Ratio.—In the year 1957/58, 57 per cent of cases were male. This year
the percentage is 59 per cent. This means that there are more male patients being cared
for on the crib wards. These children will ultimately grow too large for the cribs, and
will need transfer into male nursing areas. We are greatly in need of specific mortality
figures related to diagnosis for planning the sequence in regards to male patients; that is,
from cribs under female nursing care, to beds under female nursing care, to beds under
male nursing care. Over-all mortality figures are available but not based on diagnostic
entities. Until such time as these are available, accurate planning and programming will
be extremely difficult.
(b) Distribution by Grade and Age.—Approximately one-quarter of our case load
is composed of low-grade cases; that is, idiots with I.Q.'s less than 25. Approximately
one-third of our total case load is below the age of 9. These two factors are, of course,
interrelated. The need for early admission is practically confined to the low-grade case.
Where community facilities for training and residential care are not developed, the
greatest social pressure is for the admission of the low-grade multiple-handicapped
individual. In meeting our obligations toward the persons on the waiting-list, this
group has been awarded high priority, and our admission programme reflects this. This
tendency toward the inclusion of more multiple-handicapped low-grade cases who require
nursing care is a feature of all residential schools, and one which will undoubtedly reflect
itself in the need ultimately for specialized physical plant and increased nursing facilities.
Admissions
There were 155 cases admitted to permanent care at The Woodlands School during
the last fiscal year (see table).
It will be noted that there were large numbers of cases under the age of 5, and
under the age of 10 there was a total of 84 cases.
Admissions by Diagnosis
During the last year the provisional classificatory system of the American Association
on Mental Deficiency has been utilized, and under this classification the following major
groups were admitted— THE WOODLANDS SCHOOL
I 89
Diagnosis
Male
Female
Total
Cerebral birth trauma-
Cerebral infection, postnatal (specify)	
Congenital cerebral maldevelopment due to prenatal infections (specify)-
Congenital cerebral maldevelopment—non-specific-
Congenital cerebral maldevelopment—other forms (specify)-
Congenital cerebral maldevelopment with cerebral palsy-
Congenital cerebral maldevelopment with cranial anomalies (specify)..
Congenital cerebral maldevelopment with Mongolism..
Congenital cerebral maldevelopment with phenylketonuria-
Familial  	
Kernicterus (isoimmunization, other).
Other postnatal forms  	
Progressive neuronal degeneration	
Psychogenic	
Unclassified  	
Unknown	
Totals..
3
1
16
1
5
2
8
4
1
1
4
62
7
4
1
25
10
5
11
2
4
1
1
2
10
83
15
7
2
41
1
15
7
19
6
5
2
4
1
2
16
2
145
The significant feature of this list is the number of cases under " congenital cerebral
maldevelopment—non-specific " and " unclassified ". This reflects the lack of basic
knowledge regarding etiology that exists in this field, and points to the need for increased
research efforts to further elucidate many of these problems. It is obvious that a logical
system of prevention or cure cannot be initiated until basic diagnosis and etiology can
be established. A further point which I wish to mention is that the processing of all
admissions through an adequate diagnostic and planning clinic is a very worth-while
but time-consuming process. Each case has a complete history protocol, and securing
information for this frequently leads to considerable correspondence with public health
authorities, physicians, hospitals, and schools. All necessary investigations involving
laboratory work and psychometric evaluation are carried out prior to the clinic, and
we are hopeful that the state of affairs which was in existence three years ago, when a
large percentage of our patient population was undiagnosed and without any psychometric
investigation, will not occur again. However, this does mean that the staff are adding
considerably to their duties, and should high admission rates continue in the future, it
will certainly be necessary to increase the staff in medicine and psychology to ensure that
all patients do have an adequate diagnostic service before the training programme is
started.
Temporary Admissions (Thirty-day)
Twenty-one persons were given temporary thirty-day care during the year. Four
of these cases were admitted more than once. Sex distribution was made up of twelve
females and thirteen males.
Reasons for admissions were as follows:—
(a) Two children suffering from phenylketonuria were admitted. One of
these cases was admitted twice for stabilization and special dietary treatment.
(b) Home emergencies—five admissions. Two of these cases remained as
permanent admissions.
(c) Parents in need of holiday—nine cases.
(d) Medical care required by parents—five admissions. Two of these were
readmissions. Confinement of the mother, admission to enable parent to
attend summer-school course, admission to enable parents to secure further documentation, and medical investigation rated one case each.
It is to be hoped that this programme will be considerably expanded in the future, as
it has given service to parents who otherwise would receive nothing.
This programme involves staff in more work relating to the physical examination,
admission procedure, clerical work, control of clothing, and so forth.   Should this pro- I 90 MENTAL  HEALTH  SERVICES  REPORT,   1958/59
gramme be much enlarged, this will also have to be reflected in the staff who will be
available to give this additional service.
Waiting-list
At March 31st, 1959, the total number of cases on the waiting-list was 510, of which
356 were over 6 years and 154 were under 6 years. As long-term planning is dependent
upon accurate statistical material, we are currently undertaking a large-scale investigation
of all cases, and it is hoped that within a few months the waiting-list will be broken down
by sex, age, provisional diagnosis, and concomitant physical defects. It is also intended
that a card indexing system be developed for quick reference to these cases.
Physical Facilities
During the year two further facilities became available to us. One, " The Lodge,"
was the old Nurses' Home No. 1, which has been converted into a hostel-type accommodation for senior rehabilitation female pupils, from which they can carry out day work
in the community and in which they can learn more about housekeeping at a domestic
rather than ward level. The second facility which became available, was the full
utilization of the new auditorium and swimming-pool.
These have both proved of great benefit to the pupils, and I think particular
reference should be made to the swimming-pool. We have been surprised at the degree
of skill which has been shown in swimming by pupils of relatively low mental endowment.
The pool is also beneficial physically, and we have found that many cerebral palsy cases
who suffer from marked circulatory problems have shown physical improvement after
using the pool. Swimming has also been found to be of benefit for the rather lower-grade
disturbed and hyperactive patients and appears to exert a definitive sedative effect upon
them. They also look forward to their swimming very much, and this provides motivation
and thus helps in ward management. The pool is used to the capacity of the plant. It is
under the direct control of the chief engineer and is supervised by the Public Health
Inspector of the local public health unit. We have had excellent co-operation from both
these areas, and I would like to thank Dr. E. Wylde and his staff for their interest and
efficient service.   We are fortunate also in having a most enthusiastic instructor.
Physical Care and Therapeutic Programme
(a) Physical Health.—During the early part of the year an epidemic of infectious
hepatitis was experienced which continued during the year. Very large numbers of staff
and pupils were affected in spite of prophylactic inoculation of staff with gamma globulin,
as follows:—
Patients Staff
January   113 43
February      36 17
March      17 20*
Totals  166 80
1 Approximate.
We were fortunate in having the advice and help of the local Medical Health Officer,
Dr. E. Wylde, and his staff in investigating the epidemology and instituting procedures
to control this epidemic. The epidemic brought sharply to our notice the inadequacies
relating to fly protection, garbage disposal, laundry facilities, and hygiene relating to food
utensils. I wish to stress again that where there are large concentrations of incontinent
children living in overcrowded conditions, the possibility of explosive outbreaks of dysentery and other infectious diseases is always present.   In order to protect our patients it  I 92 MENTAL  HEALTH  SERVICES  REPORT,   1958/59
(b) Clinics.—One hundred and thirty-nine cases were seen at diagnostic clinics
during the year, and 146 cases at rehabilitation clinics. There were forty-nine group
psychotherapy sessions, twenty-two individual psychotherapy sessions, and thirty staff
clinics, which included interpretation to staff of department's work, showing of movies,
speakers from other areas, etc.
(c) Publication.—An article was published by Dr. B. Tischler in the June 15th
number of the Canadian Medical Association journal reporting on work done here on the
pyrodoxine requirements in phenylketonuria.
(d) Nursing.—The basis of all good physical care is adequately-trained personnel.
As the patient population has tended toward the admission of more severely and younger
pupils, the need for trained staff increases. Scarcity of trained staff is virtually a universal
problem. During the year considerable thought has been given to the best utilization of
trained nursing staff and reports such as the Manchester Survey; the Bethlem and
Maudsley Survey; the 1958 Nursing-staffing Survey of the Department of Mental
Hygiene, State of California, have been studied with a view to analyzing the work done
and seeing how the trained staff can be used most effectively.
It would seem essential that housekeeping aspects should be separated from nursing
care. It is also very important that a reduction be sought in the amount of time which
nursing staff devote to purely clerical activities; this should start at the nursing administrative offices and be continued down to the ward level.
(e) Dietary.—It should be noted that we have not been able to fill either of the
vacancies for dieticians during the year. This is a serious state of affairs, particularly
when we are dealing with a large child population. In order to meet, in some degree,
this lack, a dietary committee has been established under the chairmanship of Dr. A.
Gallinger, and has already made valuable recommendations.
(/) Laboratory.—Continual difficulty has been experienced in securing adequate
numbers of trained staff.
The need for an adequate laboratory does need to be stressed as it is obvious that
in a hospital containing large numbers of physically debilitated children, and subject to
infectious disorders which are characteristic of this group, we must have adequate
laboratory facilities for diagnosis and treatment. It should further be realized that as
the study of mental defect continues, more diseases of obscure biochemical etiology are
being discovered; in many cases the diagnosis depends entirely on laboratory work
(for example, phenylketonuria galactosaemia), and we can certainly look forward to
requiring more biochemistry as time goes on.
(g) Occupational Therapy Department.—We have been without the senior position
for five months, and it is to be hoped that in the area of occupational therapy and
physiotherapy the time will come when we are able to secure staff. Both these facilities
play a very large part in the training and care programme.
(h) Community Activities.—The staff at The Woodlands School have been involved
with many agencies on a consultative basis and have given many orientations and lectures
to groups both inside and outside the School. The Woodlands School is represented
on the executive of the British Columbia Association for Retarded Children; the Medical
Superintendent is on the board of directors of the Canadian association; the Deputy
Medical Superintendent is past president of the North West Pacific Region of the
American Association on Mental Deficiency; and many public lectures and talks have
been given by both of these persons, as well as other staff members—social service,
psychology, etc. There was a total of twenty-eight talks or lectures given to community
groups outside the School in the past year, attended by approximately 1,000 persons
and involving five staff members. There were thirty-eight visiting groups of an attendance
of approximately 700; of these, about half were University students.
(i) Psychology.—It should be noted that the year 1958/59 is the first time in
five years that the appointment of psychologist has been filled for the whole year, and THE WOODLANDS SCHOOL
I 93
the first time since the establishment of the School that there have been two psychologists
on staff. I would suggest that there is need to explore the use of psychometricians in
order that the clinical psychology team would be able to utilize more of their time
in interpretation and consultations. It should be noted that there are still approximately
200 cases that have not received adequate intellectual assessment. The adequacy of the
Psychology Department is fundamental to the operation of the training-school, as are
continual consultative consultation and evaluation studies. There is no doubt that many
tragedies have occurred in the past because pupils who have speech, hearing, and other
defects have been clinically assessed as having much lower potential than they in fact
possessed; only painstaking and skilled psychological testing of all pupils will avert these
costly mistakes.
Total number of tests given, 474.
(/) Recreational Department.—During the past year this department has been
able to double pupil attendance and also offer a greater variety of activities in the programme work. This has been made possible by the facilities offered by the new
gymnasium-auditorium and swimming pool. There were 1,004 pupils attending
recreation classes, with a weekly attendance of 2,070. Swimming classes, with a weekly
attendance of 162, were started on October 18th, 1958. The new playing-field was
used extensively during the year.
(k) Social Service Department.—This department has been very actively engaged
in pre-admission and admission services, rehabilitation, and case work. A fully
recognized and adequately demonstrated method of reducing the number of pupil
residents in the institutions for mentally retarded is the use of the family care and placement programme.
(/) Educational Department.—The School was involved in orientation to community groups, and twenty-one people observed in the classrooms during the year. Number of pupils attending academic school was 284. The following classes were available:
Opportunity, senior academic, junior academic, intermediate, primary academic, kindergarten, pre-school, and industrial arts; craft and socialization, speech correction, lip-
reading and braille, cerebral palsy, needlework and dressmaking, domestic science; other
activities being in regards to pupils' orchestra, boys' choir, and rhythm band. I 94
MENTAL  HEALTH  SERVICES  REPORT,   1958/59
STATISTICAL TABLES
Table 1.—Movement of Population, The Woodlands School,
April 1st, 1958, to March 31st, 1959
Male
Female
Total
In residence, April 1st, 1958- 	
On probation, carried forward from 1957/58-
Totals as at April 1st, 1958	
Admissions—
First admissions  	
Readmissions to a different institution of Mental Health Services..
Readmissions to 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, 1959	
776
541
5
+59
600
1,317
13
784
546
1,330
62
83
145
4
4
1
1
2
63
88
151
847
634
1,481
17
17
34
19
9
28
8
8
16
44
34
78
+ 86
1,403
Table 2.—First Admissions to The Woodlands School by Health Unit and
School District of Residence and Sex, April 1st, 1958, to March 31st, 1959
1 Includes Victoria and Esquimalt only.
2 Excludes Victoria, Esquimalt, and Oak Bay.
3 Includes Oak Bay only.
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
School District No. 3	
Selkirk, Nelson—
School District No. 8    ..
1
1
1
1
1
1
1
1
3
1
3
16
1
5
2
4
3
1
1
1
1
1
2
1
2
1
2
2
3
2
2
25
4
3
5
3
1
1
2
1
1
1
1
2
1
1
1
3
1
3
1
2
6
3
5
41
5
8
2
9
6
North Fraser Valley, Mission—
School District No. 42. 	
„   75 	
Upper Island, Courtenay—
School District No. 47 	
„   71..    	
„   72	
1
1
2
3
1
2
2
1
1
1
1
1
2
1
1
2
1
1
4
1
1
4
1
1
3
1
2
2
2
West Kootenay, Trail—
SchoolDistrictNo.il	
2
School District No. 15	
„   16 	
„   17	
Skeena, Prince Rupert—
School District No. 50  _
„   52	
 54	
Peace River, Dawson Creek—
School District No. 59 	
Victoria-Esquimalt Union Board
of Health-
School District No. 61 (part1)-.
Saanich and South Vancouver
Island—
School District No. 61 (part2)-.
, 62	
Central Vancouver Island,
Nanaimo—■
School District No. 65 	
,            „         „   68         	
„   23.. 	
„   77	
North Okanagan, Vernon—
School District No. 22	
South Central, Kamloops—
6
Cariboo, Prince George—
School District No. 56	
„   57	
„   82	
Upper Fraser Valley, Chilliwack—
School District No. 33	
 34  ,
Boundary, Cloverdale—
School District No. 35	
,    36
3
2
2
3
„   70	
„   79         	
3
1
„   37	
Metropolitan Health Committee,
Vancouver—
School districts not covered by
health units—
School District No. 46	
„   48           ..   ..
1
1
 39	
„   41
„   61 (part3) —
„   80.  	
1
3
„   44
1
Simon Fraser, New Westminster—
School District No. 40        .   	
63
88
151
„   43	    I 98
MENTAL HEALTH  SERVICES  REPORT,   1958/59
Table 14.—Deaths Occurring in The Woodlands School by Cause of Death,
Age-group, and Sex, April 1st, 1958, to March 31st, 1959
Age-group (Years)
Cause of Death
Under
1
1-3
+6
7-9
10-14
15-19
20-29
30-39
40 and
Over
Total
Grand
Total
M.
F.
M.
F.
1      1      1
M. 1 F. IM. 1 F.
1      1      1
M.
F.
M.
F.
1
M.IF.
1
1
M IF.
1
M.
F.
M.
F.
	
	
	
	
1
1
2
	
1
1
	
1
1
1
1
1
1
1
	
	
1
~~I
1
1
1
1
1
1
1
	
1
1
1
1
2
1
1
1
5
1
2
1
1
1
2
3
1
2
1
Infectious hepatitis-       	
1
1
	
	
	
1
1
Late  effects  of intercranial
1
Cerebral    spastic    infantile
paralysis  	
	
	
4
1
Hypertensive heart disease
	
	
1
1
1
1
1
8
Diseases of digestive system	
Congenital malformations	
Progressive muscular dystro-
1
2
4
1
Accidents    -   —
	
	
	
	
1
Totals	
11    2
2
4
—
1
1
2
3
2
	
4
1
5
	
19
9
28
Table 15.—Deaths Occurring in The Woodlands School by Cause of Death,
Length of Stay, and Sex, April 1st, 1958, to March 31st, 1959
Detailed information for the above table may be obtained on request.   PROVINCIAL MENTAL HOME
STATISTICAL TABLES
I 101
Table 1.—Movement of Population, Provincial Mental Home,
Colquitz,1 April 1st, 1958, to March 31st, 1959
Number
In residence, April 1st, 1958  287
On probation, carried forward from 1957/58       2
On escape, carried forward from 1957/58       1
Total as at April 1st, 1958,
  290
Transfers     15
Total under care
Separations—
Discharged in full
Died 	
On probation and still out _
Escaped but not discharged
Total separations	
Net increase or decrease	
In residence, March 31st, 1959_
305
12
10
1
1
24
-6
281
1 This institution cares for male patients only.
Table 2.—Transfers to Provincial Mental Home, Colquitz, by Health Unit
and School District of Residence and Sex, April 1st, 1958, to March 31st,
1959.
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, 1958, to March 31st, 1959
Method of Admission
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
Warrant 	
1
	
i
l
1
1
1
1
2
1
1
1
1
1
1
4
Certification	
9
— | —
2
Totals 	
1
2
1
2
3
1
1
1
1
2
15 I 102
MENTAL HEALTH SERVICES REPORT,  1958/59
Table 4.—Transfers to Provincial Mental Home, Colquitz, by Mental
Diagnosis and Age-group, April 1st, 1958, to March 31st, 1959
Mental Diagnosis
Age-group (Years)
20-24
25-29
30-34
35-39
40-44
45^19
50-54
55-59
60-64165-69
70 and
Over
Total
With Psychosis
Schizophrenic disorders 	
Psychosis with cerebral arteriosclerosis	
1
	
1
2
	
3
1
1
1
1
1
10
1
1
Psychosis of other demonstrable etiology	
  1      - 1 -----
1
1  1   1      1
2 | --  |      4 |      1
1  |      1   |       1  |         1  |    13
Without Psychosis
1
	
—  1 „-
„- | —-
1
1
-   1  -----
1
Total without psychosis 	
-.. | ..- | —
__ |      1
  1 	
-- | -. | — |        1  |      2
1  1 	
1
2  1       1
4 1      1
1
1
1
2
15
Table 5.—Transfers to Provincial Mental Home, Colquitz, by Mental Diagnosis and Marital Status, April 1st, 1958, to March 31st, 1959
Table 6.—Transfers to Provincial Mental Home, Colquitz, by Mental Diagnosis and Years of Schooling, April 1st, 1958, to March 31st, 1959
Table 7.—Transfers to Provincial Mental Home, Colquitz, by Citizenship and
Age-group, April 1st, 1958, to March 31st, 1959
Table 8.—Transfers to Provincial Mental Home, Colquitz, by Religion, April
1st, 1958, to March 31st, 1959
Table 9.—Transfers to Provincial Mental Home, Colquitz, by Previous Occupation, April 1st, 1958, to March 31st, 1959
Detailed information for the above tables may be obtained on request. PROVINCIAL MENTAL HOME
I 103
Table 10.—Resident Population of Provincial Mental Home, Colquitz, by
Mental Diagnosis and Age-group, December 31st, 1958
Mental Diagnosis
Age-group (Years)
Total
15-19
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
2
7
11
18
18
23
1
1
29
1
1
1
1
35
1
1
4
21
1
1
1
25
2
2
38
3
3
228
Manic-depressive reaction 	
Paranoia and paranoid states-	
6
5
3
Psychosis   of   other   demonstrable
2
Other and unspecified psychosis _.
.-. | —
3
6
1  |      2
7
U
18
18 |    25 |    33
41
24
29
44
253
Without Psychosis
Disorders of character, behaviour,
and intelligence—■
Pathological personality-	
1
1
1
1
—
3
1
1
2
1
1
4
2
4
4
1
1
1
2
1
1
4
20
Chronic brain syndrome, N.O.S	
Epilepsy _ 	
2
4
Total without psychosis	
	
1
1
2
4
4 |      5 |      6
5
2
—
2
32
1
3
8
13
22
22 1    30
39
46
26
29
46
285
Table 11.—Resident Population of Provincial Mental Home, Colquitz, by
Mental Diagnosis and Number of Previous Admissions, December 31st, 1958
Table 12.—Resident Population of Provincial Mental Home, Colquitz, by
Mental Diagnosis and Length of Stay, December 31st, 1958
Detailed information for the above tables may be obtained on request.
Table 13.—Separations from Provincial Mental Home, Colquitz, by Mental
Diagnosis and Condition on Discharge, April 1st, 1958, to March 31st, 1959
Mental Diagnosis
Condition on Discharge
Recovered
Much
Improved
Improved
Unimproved
Total
Schizophrenic disorders 	
Psychosis with cerebral arteriosclerosis..
Mental deficiency-
Chronic brain syndrome, N.O.S...
Totals	
12 I 104
MENTAL HEALTH SERVICES REPORT,  1958/59
Table 14. — Separations from and Deaths Occurring in Provincial Mental
Hospital, Colquitz, by Mental Diagnosis and Age-group, April 1st, 1958,
to March 31st, 1959.
Mental Diagnosis
Age-group (Years)
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70 and
Over
Total
Separations
Schizophrenic disorders  	
Psychosis with cerebral arteriosclerosis...
Mental deficiency  	
Chronic brain syndrome, N.O.S 	
1
2
Z
-
_
1
1
2
1
2
1
1
9
1
1
1
Totals   -	
-    |    -    |      1
2    |    —
2    |      2
1
....    |      4
12
Deaths
Schizophrenic disorders —
	
—
„
1    1    —
Z i z
1
1
....    1      1
5
1
1
8
1
Psychosis with cerebral arteriosclerosis ...
--
	
1
Totals-     -	
—
—
—
1
1
1
7
10
Table 15.—Separations from and Deaths Occurring in Provincial Mental
Home, Colquitz, by Mental Diagnosis and Length of Stay, April 1st, 1958,
to March 31st, 1959.
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, 1958, to March 31st, 1959
Length of Stay
Cause of Death
4-7
Months
8-11
Months
1
Year
2
Years
3-5
Years
6-9
Years
10 Years
and
Over
Total
Arteriosclerotic and degenerative heart disease
1
1
1
3
4
5
4
Suicide .    — —	
1
Totals      —
1
1
1
7
10
Table 17.—Deaths Occurring in Provincial Mental Home, Colquitz, by Cause
of Death and Age-group, April 1st, 1958, to March 31st, 1959
Detailed information for the above table may be obtained on request. GERIATRIC DIVISION I 105
PART V.—GERIATRIC DIVISION
REPORT OF MEDICAL SUPERINTENDENT
B. F. Bryson, Medical Superintendent
The Geriatric Division of the Provincial Mental Health Services has continued to
serve to the best of its ability the needs of the Province in providing special medical and
psychiatric care for over 1,300 elderly men and women during the year 1958/59.
The increasing need for more adequate accommodation and treatment sources for
the aged population in the Province is reflected in the very marked increase in the number
of applications for admission to the Geriatric Division during the year. A total of 336
new applications was received for the admission of patients 70 years of age or over suffering from varying degrees of senile and arteriosclerotic brain changes associated with
emotional or behavioural reactions which made it impossible for them to be adequately
managed or cared for in the community. Of this total, 162 were for men and 174 for
women. This is an increase of 79 per cent over the number of applications received the
previous year. The greatest increase came from the Lower Mainland and Vancouver
Island areas, with a total of 251 applications, an increase of sixty-three over the number
received during the previous year. Applications from the northern portion of the
Province for the admission of men to the Terrace unit remained unchanged with a total
of twelve. Requests for admission to the Vernon unit, from the Okanagan and Kootenay
areas, totalled seventy-three, an increase of only seven. The average number of applications received per month was twenty-eight, or nearly one per day throughout the year.
Of the total number of applications received, 152 were considered of sufficient urgency
to be accepted immediately although other applications were on hand. In all such
instances, especially in those for admission to the Port Coquitlam unit, the patients were
actually disturbed or were in situations where their behaviour and symptoms made their
management impossible. This was an increase of forty-one over the total of immediate
admissions for the previous year.
Vacancies created by deaths and discharges made it possible to accept a total of 305
patients from the community. This total included 151 men and 154 women; an increase
of fifty-three over the previous year. It was possible to admit all applicants for admission
to the Vernon and Terrace units, so that at the end of the fiscal year 1958/59 there were
no names on the waiting-list for these units. The greatest need for additional accommodation exists, therefore, in the Lower Mainland and Vancouver Island areas. The
completion and full operation of the Admitting and Infirmary Building at the Port Coquitlam unit during the coming year will appreciably improve the problem in this area.
As in past years, all patients accepted for admission from the community did not
actually arrive on the wards of the Homes for the Aged, especially at the Port Coquitlam
unit, where all patients are admitted through the Mental Hospital admitting service. In
a small number of instances, death occurred shortly after admission, or arrangements
were made for alternative methods of care, before they were transferred to the Home for
the Aged.
As will be noted in the accompanying statistical tables, the number of aged patients
in residence in the three units of the Homes for the Aged at the end of the fiscal year
totalled 1,033, including 528 at Port Coquitlam, 218 at Vernon, and 277 at Terrace. Of
this total, 516 were elderly men and 517 aged women. Vacancies created during the
year by deaths and discharges totalled 332, of which 313 were due to death of feeble and
debilitated patients, equally distributed between men and women. This is an increase
of thirty-two over the preceding year, and is felt to be a result of the increasing feebleness
and debility of many patients who have been in hospital for many years, as well as the   I 108 MENTAL HEALTH SERVICES REPORT,  1958/59
all positive reactions, which numbered 296. No active cases were revealed in this survey
of patients, whose ages ranged from 68 to 97 years.
Skin infections due to staphylococcus aureus have been a minor problem because
of their resistance to most antibiotics, and particularly because of the difficulties encountered in providing adequate isolation due to lack of suitable space and shortage of
staff. Although this infection has not been eradicated, it is felt that it is being held to
a minimum.
The tranquillizing medications continue to be of great assistance in the treatment of
many emotionally or psychologically disturbed patients, who are great problems in
management because of restless, agitated, or destructive behaviour. During February a
survey of the patient-group showed that a total of 208 elderly patients required this form
of medication, and included 164 women (37.7 per cent) and 44 men (20.1 per cent).
Most patients have benefited greatly by relief from their anxiety and restlessness, and have
become more content and able to participate to their maximum in the activities of the
hospital.
The geographical situation of this unit in relation to the Crease Clinic and the
Mental Hospital has been a continuing problem because of the limited transportation
facilities and the shortage of nursing saff who must escort patients going to the X-ray,
surgical, and dental departments at the Crease Clinic. The medical and nursing staffs
are looking forward to the opening of the new building at this unit, which will provide
X-ray, laboratory, pharmacy, and dental services, which will greatly reduce this burden
on the nursing and transportation departments.
Routine medical care at the Port Coquitlam unit has been largely the responsibility
of Dr. W. Lazorko, who has been most diligent. The duty doctors at Essondale have
provided service on an emergency basis in the absense of Dr. Lazorko, and the Medical
Superintendent has assisted by giving clinical medical service when required. However,
he has found that most of his time has been needed to attend to the increasing medical
administrative duties of the Geriatric Division, especially during the latter part of the year
when plans were being formulated for operation of the Admitting and Infirmary Building
and for reorganizing administration of the Port Coquitlam Home for the Aged so the
nursing, business, and various therapeutic services could function separately from the
corresponding departments at Essondale, which have heretofore provided these services.
This organizational planning has been in accordance with the policy outlined by
the Director of Mental Health Services, and a great deal of time and thought has been
spent on the part of the personnel department, headquarters staff, the various department
heads at Essondale, and the Medical Superintendent in detailing the requirements in terms
of establishment, organizational structure, and equipment that is needed to place this area
on a unit basis. At the end of the year the new building was structurally complete and
most of the equipment and furnishings in place.
On January 19th Mr. A. I. Smith began duty as the Port Coquitlam unit Business
Manager and comes well equipped in Civil Service training and experience to assist in
the development and expansion of this unit. At the end of the year Mr. Smith had made
much progress in the organization of the business section and has contributed greatly to
the Medical Superintendent.
Nursing service to the patients has been maintained at a very satisfactory standard,
although at times this was accomplished with difficulty owing to shortage of personnel
through sicknes, absences from the ward for escort duty, and lack of holiday relief. On
several occasions important nursing procedures were delayed or discontinued temporarily
because of the lack of sufficient staff. The day-to-day care of geriatric patients is time-
consuming and requires a great deal of patience and tact on the part of the staff, as the
aged confused person moves and thinks at a slower tempo and requires a slower pace of
life. Haste, impatience, and frequent changes in daily routine increase confusion and
insecurity in the geriatric patient, thereby increasing the nursing attention required. GERIATRIC DIVISION I 109
Wherever possible, instruction has been given to the nursing staff regarding geriatric
nursing as information becomes available in this newer field of nursing and medical care.
In July Mrs. K. Warrender was able to attend the Work Conference in Geriatric Nursing,
held at the University of Washington, and brought back knowledge which has helped
to improve the standard of nursing services. At the end of the year several psychiatric
nurses from this unit were undertaking training at Essondale in the remotivation technique, and will soon be available to form groups among the patients at the Home for the
Aged. Dr. Lazorko has also given several talks to the nursing staff regarding nursing
and medical problems peculiar to the aged. 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.
The most significant change in the nursing service during the year occurred on
February 1st, when Miss E. Johnstone was appointed Superintendent of Nursing Services, with jurisdiction over both male and female nursing staffs. By the end of the
year, recruitment of additional supervisory staff and transfer of other nursing personnel
from the Essondale establishment had progressed so that the nursing department at this
unit could begin to function on April 15th, 1959, as a separate entity directly responsible
to the Medical Superintendent of the Geriatric Division. Miss Johnstone has had
extensive training and experience both in administrative and instructional nursing and
has been most assiduous in carrying out her new duties.
Occupational and recreational therapy have continued to play a major role in our
efforts to assist many elderly patients in regaining interest and satisfaction in their
daily life. The occupational programme at this unit was without daily guidance because
of the shortage of therapists until June, when Miss A. Anderson was assigned to full-time
duty. Since then she has conducted an active programme of handicraft instruction on
both the men's and women's wards as well as instruction to special mixed groups of the
more capable patients in a weekly afternoon programme. Miss Anderson has been
limited in the number of patients she could keep occupied, but throughout most of the
year has had an average of 150 men and women engaged in a variety of handicraft
activities. It is felt that many more patients will benefit from this form of activity when
the generous facilities in the new building are available and additional therapists can
be recruited.
The recreational programme under the part-time leadership of Mr. Harrison Smith
continued to be an important feature in the total-treatment programme. Throughout the
year many patients have benefited from the regular programme of weekly social gatherings, picnics in the summer, bus trips to Stanley Park, and " mystery rides " in the hospital buses through the co-operation of the transportation department. The patient-
group has also benefited and enjoyed the interest of a number of community groups who
have voluntarily given of their time and talents to entertain our patients. The New
Westminster Camera Club especially has been very generous and has entertained the
elderly men and women on several occasions with programmes of beautiful colour slides.
On August 19th ninety elderly men and women were guests at the P.N.E. Shrine Circus
in Vancouver through the courtesy of the directors of the Pacific National Exhibition
and the Gizeh Temple in Vancouver. This yearly event has been most appreciated by
the many patients who have been able to attend.
Due to difficult weather conditions at Christmas it was impossible for entertainment
groups and choirs to visit the hospital as in former years, but a few of the men and
women of this unit formed a small choir to sing carols to their bedridden friends. Under
the guidance of Mr. Smith, this group has expanded and now meets regularly each week
as the Happy Gang Club and the H.A. Choir, and through them many ideas for programmes suitable for elderly people are obtained. The music therapist at Essondale has also
contributed greatly in developing the H.A. Choir, who sing in the weekly church services. I 110 MENTAL HEALTH SERVICES REPORT,  1958/59
On March 23rd the beautiful new auditorium and chapel became available for
patient use, and immediately became the centre for the recreational programme. As
unitization of the Homes for the Aged progresses during the new year, it is expected
that a full-time recreational therapist will be appointed, and that this important phase
of patient care and treatment will be expanded to reach many more of our patients with
more on-the-ward activities.
The volunteer workers of the Canadian Mental Health Association 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
many other ways. The successful efforts of the Canadian Mental Health Association in
providing all patients with a suitable gift at Christmas was again most appreciated, and no
one was forgotten on that very special day.
Other auxiliary therapeutic services, including ward movies by the Audio-Visual
Department, beautician and barbering service, and chiropody services from the central
departments at Essondale have been supplied regularly to the Home for the Aged patients
throughout the year. Too often such services are taken for granted because they are so
regularly supplied, but they are recognized and appreciated as a very important part of
the services available for our patients.
The religious needs of the patients have been faithfully and fully met by Rev. John
O'Neil, resident chaplain, and Father Frechette, who have conducted regular services
in Pennington Hall, which are attended by many of the Home for the Aged patients.
In addition, Reverend O'Neil has held regular weekly services on the wards for those
patients who are unable to attend the Sunday services at Essondale. Early in the new
year regular Sunday afternoon services will begin in the new chapel for the patients of
this unit.
Dietary services have been satisfactory and without much change in staff or service
facilities throughout most of the year. On April 15th Mrs. Frith, dietician, became available to the Port Coquitlam Home for the Aged on a full-time basis in charge of the
dietary department. Mrs. Frith has been most conscientious in her efforts and interest
toward improving the dietary welfare of our elderly patients and in planning for the
occupation of the kitchen in the new building. In co-operation with Mrs. Marr, Director
of Dietetics at Essondale, a special " geriatric menu " was devised and instituted for our
patients in September. This diet is served to all elderly patients and contains ratios of
proteins, fats, and carbohydrates, and is rich in certain vitamin-containing foods which
authorities believe are most suitable for aged persons, in whom the digestion and assimilation of ordinary diets is often faulty or deficient. The major change in the dietary service,
of course, occurred on March 24th, when the dietary staff moved from the very inadequate quarters in the old H.A.K. building and began operations in the spacious and well-
equipped kitchen in the new building. At the same time the Home for the Aged dietary
department was placed on a unit basis, with Mrs. Frith as dietician in charge, the separate
department now being organized under the Home for the Aged Unit Business Manager.
It will now be possible to give improved service to patients and staff, but especially to
improve the special-diet service, which has been quite inadequate.
The many and varied duties of the medical records office and the Medical Superintendent's office have been ably carried out by Miss Marlynn Jorgensen, assisted by Miss
Alberta Burns. Increased clerical staff is urgently needed and will likely be available
early in April. On March 21st these offices were moved from the cramped quarters in
the old Administration Building to the spacious accommodation in the new building.
The well-appointed offices and Medical Records Section are thoroughly appreciated by
all concerned. Adequate office accommodation for the nursing supervisors was also
made available at this time. GERIATRIC DIVISION I 111
The Public Works Department has attended to all general repairs and maintenance
required, and there has been no interference in patient care and treatment through breakdowns or utility failures. In addition, several projects have been completed, including
the replacement of deteriorated flooring in the basement dormitory of H.A.K. and the
removal of the large pillars at the two entrances to the Home for the Aged grounds. The
gardeners have also progressed during the past few months in regrading and seeding the
lawn areas around the new buildings.
The major activities of the Public Works Department at the Home for the Aged,
however, have centred around the completion and furnishing of the 328-bed Admitting
and Infirmary Building and the auditorium. At the end of the year, several areas of the
new buildings were occupied and in operation, as noted in other portions of this report,
and progress was well advanced with the equipping and furnishing of the ward areas.
There remain, however, a number of urgently needed projects, which have been
requistioned for some time. Among these are the additional fire-escapes for H.A. 1, 2,
and 3, which will not only provide improved fire-escape exits from these older buildings,
but will allow reorganization of the dormitory and dayroom spaces to provide two day-
room areas in the place of the single crowded area which now exists. A swill-house for
H.A. 4 and 5 and proper screening of the kitchens and dining-rooms in the older buildings are also needed, completion of which would improve considerably the sanitary and
nursing facilities in the wards of this unit.
Vernon
The Vernon unit has operated efficiently and without any major changes during the
year under the able and conscientious administration and guidance of Mr. L. W. Fox,
the unit supervisor, and his deputy and superintendent of nurses, Miss O. Lipsey, R.N.
New admissions to this unit increased appreciably during the year, with a total of
ninety-four, which included seventy-two directly from the community and twenty-two
from the Provincial Mental Hospital, Essondale. This represents an increase of sixteen
over the total admissions for the previous year. Separations numbered 102, including
ninety deaths, seven discharges, and five transfers to the Port Coquitlam unit for special
treatment.   In all, 320 patients were provided with care and treatment during the year.
The medical care and supervision of this patient-group has continued under the
capable direction of Dr. J. Smith, assisted by his associate, Dr. A. D. Dale, both practising
physicians in the City of Vernon. In September Dr. Dale left the Vernon area, and for
the remainder of the year Dr. Smith has been without assistance. Daily visits by Dr.
Smith have not been possible during the past few monthss, but he has readily responded to
all calls for his services, and has visited the wards several times weekly. Although some
routine medical work has been delayed, all patients have received prompt medical attention when necessary, and adequate medical supervision has been provided.
There have been no major medical problems or illnesses of an epidemic nature, and
seasonal increases of upper respiratory infections during the spring and fall have not been
out of proportion to that experienced in the Vernon community. Several patients required surgical procedures, including one in which a colostomy was carried out, and in
another a gastrectomy was required for carcinoma. Eight patients suffered fractures as
a result of accidental falls. All surgical procedures were done by Dr. Smith at the adjacent Vernon Jubilee Hospital, whose staff have continued to be most helpful and cooperative at all times.
Auxiliary medical care has been supplied as required, and several patients have
received special eye examinations, in addition to others who have been provided with eyeglasses by local optometrists as required. Dental care has also been provided by a local
dentist who visits the unit regularly for examination and treatment, using the dental
equipment provided at this hospital. Several full sets of dentures have been made for
those patients who could benefit from their use. I 112 MENTAL HEALTH SERVICES REPORT,  1958/59
The nursing services at the Vernon unit have been maintained at a very satisfactory
level under the devoted and conscientious supervision of Miss Lipsey, and the loyal cooperation of all members of the nursing staff. It is felt that the nursing establishment
provided for this unit is minimal, but sufficient to provide the basic nursing needs of
this patient-group when all staff are available. However, during periods when absences
due to illness and vacations deplete the ward quotas, it is most difficult to maintain ward
routines.
During the year Miss Lipsey has continued her efforts to standardize and unify nursing techniques and procedures on the female and male wards so that the total nursing
staff are able to function as an efficient team.   Ward manuals are being compiled.
A very welcome additional service was provided for the elderly women for five
months during the year when a local beauty-parlour, during its slack season, supplied
operators who visited the unit one afternoon each week to give haircuts, finger-waves, and
permanents to many very appreciative elderly ladies. This voluntary service from the
community was highly appreciated by the nursing staff, who were thus able to devote
their time to other duties.
A recent development has been the formation of an Accident Prevention Committee
in conjunction with the Workmen's Compensation Board. Although designed primarily
for the protection of hospital staff, the patient population also benefits, since hazardous
conditions are a threat to both patients and staff.
The auxiliary therapeutic services of occupational and recreational therapy have
continued to flourish and benefit this patient-group under the conscientious leadership
of Mrs. Sherlock. All patients showing any degree of aptitude have been encouraged
to engage in handicraft activities. Many men and women have shown an improvement
in attitude and have found interest and pleasure in again being creative and occupied.
A full and varied programme of entertainment has been maintained, including such
summer activities as lawn bowling, horseshoe pitching, garden parties, and picnics.
Winter activities consisted of weekly picture shows, bingo parties, and special mixed
gatherings to celebrate birthdays, Easter, Hallowe'en, and, of course, the Yuletide season.
Mrs. Sherlock has been assisted in these activities by the nursing staff and the volunteer
ladies' group who visit the wards regularly.
During the year a second television set was provided through the Patients' Comfort
Fund.
Religious services have been regularly provided by Monsignor Miles and Reverend
Reeve. They have been most sincere and conscientious in their attention to the religious
needs of our patients in conducting formal services, visiting patients, and in conducting
funeral services as required.
Dietary service at this unit has continued to be very satisfactory. Mr. Owen, chief
cook, and his able staff have shown sincere interest in the dietary needs of this patient-
group and have provided appetizing menus of high quality throughout the year. Special
efforts have been made to provide appropriate menus and special treats for occasions
such as the Christmas and Easter festivities, and for the monthly birthday parties. During
March a new stainless-steel dish-washing machine, with pre-wash unit, feed and take-away
tables, was installed to replace the old unit. This equipment, including a smaller unit
for the annex, which will be installed shortly, will measurably improve the efficiency
and sanitation in the washing of dishes.
The Laundry Department, under the direction of Mr. Todd, has maintained a laundry service of high output and quality, and throughout the year processed a monthly
poundage of over 41,500. At regular intervals throughout the year, test bundles from
the laundry have been submitted to the Canadian Institute for Launderers and Cleaners
for impartial checking on laundry efficiency. On each occasion the test reports for
samples from the Vernon Home for the Aged were returned with a rating of excellent. GERIATRIC DIVISION I 113
The many and varied duties in the clinical office have been carried out satisfactorily
by Miss Lystang. Adequate medical records and other necessary administrative stenographic duties have been maintained, but only with great difficulty, and on many occasions considerable delays have occurred. There is definite need for additional clinical
office help at this unit in order to maintain satisfactory records and administrative service
for our patients.
The Stores Department has continued to function efficiently throughout the year
under the supervision of Mr. Baron. Although adequate stocks of foodstuffs and other
materials have been maintained with no depletion in quality or quantity of service to
the wards, the costs have been kept at the same level as the previous year, in spite of
recorded increases in the cost-of-living index.
Public Works staff at the Vernon Home for the Aged under the direction of
Mr. Baker, chief engineer, and Mr. Hornell, maintenance foreman, have been most
co-operative, and have maintained the buildings and equipment in very good order.
There were no major interruptions in the essential utility services, and no interferences
in the comfort and safety of this patient-group.
In addition to routine maintenance and repair, the Public Works staff were able to
install five water-temperature regulators to provide control of maximum water temperature, thereby removing the hazard of scalding. The installation of concrete floors under
two wings of the main building has been completed and will provide much-needed
additional storage space.
A considerable amount of interior and exterior painting has been carried out during
the year by the employment of casual help.
Two important projects, however, were not completed during the year. A second
high-pressure boiler is needed to prevent interruption in the heating of the wards in the
event of severe winter weather, and air-cooling equipment is needed for proper temperature-control and ventilation of the dayrooms and dormitories. It is hoped the funds
will be allotted to complete these projects.
It is with regret that we report the misfortune of Mr. Legg, the unit gardener, who
was severely injured in an accident in June while on duty. He suffered fractures of both
legs, and although he has made much progress toward recovery, he had not returned to
work at the end of the year. His assistant, Mr. Malowany, has carried on his work,
so that the usual beautiful appearance of the hospital grounds has been maintained.
The hothouse facilities have been utilized to the full, and fresh-cut flowers or potted
plants have been available for patients' enjoyment on the wards during most of the year.
The interest and goodwill of the residents of Vernon toward our hospital have again
been demonstrated in many ways. Many local organizations have been very generous
in devoting their time, effort, and material articles for the benefit of our patients. Groups
such as the Boy Scouts, Girl Guides, C.G.I.T., and church members visited the Home
at Christmas to sing carols, and the ladies of the Royal Purple Lodge and men of the
Independent Order of Oddfellows have been generous in providing car-ride outings for
many patients during fine weather. Square-dance clubs, the local Teen Town group,
and others have supplied enjoyable entertainment on a number of occasions. The
Canadian Mental Health Association also provided gifts for patients at Christmas as in
former years.
Terrace
The Terrace Home for the Aged, under the able direction of Mr. W. E. Skillicorn,
supervisor, and his deputy, Mr. F. Stewart, Chief Psychiatric Nurse, has completed
another successful year of operation, and has provided care and treatment for 323 elderly
men. A total of thirteen patients were admitted directly from ten different communities
in the northern portion of the Province during the year, compared to seventeen for the I 114 MENTAL HEALTH SERVICES REPORT,  1958/59
previous year, and twenty patients were transferred from the Essondale Hospital, to give
a total of thirty-three new patients. Thirty-four vacancies were created by deaths, five
by transfers to the Mental Hospital, and two discharges to the community.
Throughout the year the general health and welfare of this patient-group has been
maintained at a satisfactory level, although it is noted that there is an increasing number
of patients at this unit who are becoming feeble. This is a result of the advancing age
of the patients who were originally transferred to this unit, and the fact that many new
admissions have been men who were in advanced stages of senility and physical debility.
There are now few patients who are able to assist the nursing staff in the routine activities
on the wards or elsewhere in the hospital.
During October a few cases of staphylococcus skin infection developed and were
cause for concern for a short while, but prompt isolation, careful treatment, and preventive measures soon controlled the spread and all patients cleared up well. In January
several patients developed shigella dysentery, but this was also brought under control
quickly.
Four patients suffered hip fractures as a result of accidental falls. Three patients
required major surgical procedures, which were carried out by Dr. Lee at the Terrace
General Hospital, whose staff have been very co-operative and helpful in giving assistance
to the Terrace unit whenever required.
General medical care and supervision throughout the year have been provided by
Drs. Dukelow, Lee, and Nicholson, who are associated in general practice in Terrace,
and they have been most conscientious in their attendance and treatment of the medical
needs of our Terrace patients.
During September the annual chest X-ray survey of patients and staff was carried
out by the travelling clinic of the Division of Tuberculosis Control, and in January
a recheck of seventy-five patients and staff was completed at the Terrace General Hospital. As a result of these surveys, one patient was found to have an active lesion and
was discharged to the Provincial Mental Hospital for treatment in North Lawn Building.
Judicious use of the several types of tranquillizing medications has continued to be
of assistance in the treatment of patients who otherwise would be difficult problems
in management.
Nursing services for this patient-group have been carried out conscientiously and
devotedly by the nursing staff under the direction of Mr. F. Stewart, Chief Psychiatric
Nurse, and they are to be commended for the high standard they have maintained in
spite of many difficulties resulting from lack of patient help. In addition to routine
nursing care, the staff have also made considerable progress in developing a recreation
programme for their elderly charges. Organized bingo parties, checker and crokinole
tournaments have brought amazing results in the stimulation of interest in patients who
previously appeared to have no interest in their surroundings. In addition to the regular
weekly movies, the recent acquisition of a 16-mm. sound projector through the courtesy
of the Patients' Comfort Fund makes it now possible to show special entertainment and
travelogue films more frequently and to more patients.
Through the efforts of Mr. Clifford, Assistant Charge Psychiatric Nurse, a small
library for patients has been started, and plans have been laid for the construction of
a small library and reading-room by conversion of one of the porches. The library cart
tours each ward weekly, and patients are able to make their own selections.
During the year it has been possible to maintain a nearly complete establishment
of nursing staff, and there have been relatively few changes. This improvement in stability of nursing staff is offset, however, by the rapidly decreasing source of help from
the patient population. Because of their increasing debility, fewer patients are able to
care for themselves. Considerably more time is being spent by the nursing staff in individual feeding, changing clothes, and bathing. The nursing staff are required to do more
of the general housekeeping on the wards, which was previously done by patient help. GERIATRIC DIVISION I 115
A similar situation exists in the dining areas, where responsibility for cleanliness and
sanitation has previously fallen to capable patients under the supervision of a staff member. As patient care is of primary importance, the housekeeping needs of the hospital
are often delayed or dispensed with, so that the general standard of cleanliness and sanitation is gradually deteriorating. Increased help both for nursing personnel and building
service workers is an urgent requirement.
The religious needs of the men at this unit have been met by the sincere and devoted
interest of Archdeacon Hinchcliffe and Father Mohan, who have conducted church
services on the wards and visited patients regularly through the year.
Dietary service has continued to be of a high standard, and the cooking staff, under
the direction of Mr. H. F. Piffer, chief cook, have provided appetizing and diversified
meals. Holidays and other special occasions have been marked by special menus and
additional treats. At the close of this year, a new dish-washing machine and vegetable-
peeler arrived and will be installed early in April. With the installation of this new
equipment, it is anticipated that the need for patient help in the kitchen will be practically
negligible.
The Stores Department, under Mr. Morgan, has operated satisfactorily. Supplies
generally have been of good quality, with no undue delays in delivery.
The laundry, under the direction of Mr. Norton, has been able to maintain satisfactory service, but only with increasing difficulties due to the lack of adequate patient
help. During most of the year it was necessary to take a psychiatric aide from ward
duties to assist Mr. Norton in maintaining a steady flow of linen to the wards. Two staff
laundry-workers are urgently needed to replace the five elderly patients now trying to
assist the laundryman.
The Public Works staff at the Terrace unit have continued to be most diligent and
co-operative in carrying out general maintenance and repair of the buildings and equipment, and there have been no serious interferences in the comfort and welfare of this
patient-group. Several special projects were completed, including renewal of the floor
and joists in the boiler-house workshop and under one wing of the hospital building, as
well as rewiring of the paint-shop and reroofing of the hospital, single men's quarters,
and a section of the recreation hall.
In spite of an exceptionally dry period in the Terrace district during the summer
months, the water-supply remained very good, which indicates that the new well and
supply system completed the previous year have satisfactorily overcome the worrying
problem of water shortage that has existed at this unit since its inception.
The staff painter has been exceedingly busy all year redecorating the interior of the
hospital buildings, much of the ward and dayroom furniture, as well as doing some
exterior painting.
The care of the grounds has also been an increasing problem due to lack of patients
capable of doing this kind of work. Only three aged men are available, and they have
only been able to cut the grass and keep the flower-beds free of weeds. No flowers
were grown, and the garden area has been reduced to one very small plot. In order to
maintain the appearance of the grounds and to provide outdoor interests for the patients,
there is a definite need for a full-time gardener at this unit.
The problem of maintaining adequate functioning of the various departments in
all three of our geriatric units by relying on patient help is becoming increasingly greater.
Although it is therapeutically important for elderly patients to be occupied and busy
to the extent that their physical and mental condition allows them, it must be recognized
that the patients admitted to the Geriatric Division are elderly and the large majority are
well past the accepted age of retirement. It is felt, therefore, that the time has passed
when patient labour in the Geriatric Division should be counted in determining the
personnel required for adequate full-time operation of any department or service. i 116 mental health services report, 1958/59
Acknowledgment
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 patients to the care
of this Division. The loyalty and co-operation of the members of the staff of each unit,
as well as the wilhng co-operation and assistance received from all departments of the
Mental Hospital, the Crease Clinic, and headquarters personnel, throughout the year
are sincerely appreciated. GERIATRIC DIVISION
STATISTICAL TABLES
I 117
HOME FOR THE AGED, PORT COQUITLAM
Table 1.—Movement of Population, Home for the Aged, Port Coquitlam,
April 1st, 1958, to March 31st, 1959
Male
Female
Total
141
71
1
6
401
108
4
3
342
Admissions—
179
5
9
78
115                    193
219
516
735
Separations—
7
69
7
3
120
1
10
Died                    _ 	
189
8
83                  124          |         207
Net increase or decrease                               ,   .
In residence, March 31st, 1959	
-5        |          -9
136                  392
1
-14
528
Table 2.—First Admissions to Home for the Aged, Port Coquitlam, by Health
Unit and School District of Residence and Sex, April 1st, 1958, to March
31st, 1959.
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
South Okanagan, Kelowna—
School District No. 14  ..
1
1
1
1
1
1
3
4
1
30
5
3
2
2
2
1
1
2
1
1
1
2
1
4
8
2
56
5
8
7
3
2
2
2
1
1
1
1
2
2
1
7
12
3
86
10
11
2
9
2
4
Upper Island, Courtenay—
School District No. 71 	
1
1
1
4
1
3
1
2
1
4
1
1
3
1
1
1
1
1
1
2
1
„   15	
Skeena, Prince Rupert—
School District No. 52	
„   53  .    ....
„       „   23 —
1
„   77 	
1
South Central, Kamloops—
School District No. 24	
 54	
Peace River, Dawson Creek—
School District No. 59	
1
„   26 	
1
Cariboo, Prince George—
School District No. 57—	
Upper Fraser Valley, Chilliwack—
School District No. 32	
33
Victoria-Esquimalt Union Board
of Health—
School District No. 61 (part1)
Saanich   and   South   Vancouver
Island—
School District No. 64
7
„   34	
Boundary, Cloverdale—
School District No. 35     	
Central Vancouver Island, Nanaimo—
School District No. 65 	
 36 	
1
>■           „       ,i   67-   .
4
Vancouver—
School District No. 38	
 68 	
„   70	
School districts not covered by
health units—
1
2
2
1
1
4
2
 39	
 41	
 44.	
„   45- -	
Simon Fraser, New Westminster—
School District No. 40 	
„   43. 	
, 48 .—
 ,   49	
„   61 (part2)	
North Fraser Valley, Mission—
School District No. 42	
Totals
78
115
193
Includes Victoria and Esquimalt only.
; Includes Oak Bay only.  GERIATRIC DIVISION
I 119
Table 10.—Separations from Home for the Aged, Port Coquitlam, by Mental
Diagnosis, Condition on Discharge, and Sex, April 1st, 1958, to March
31st, 1959.
Condition on
Discharge
Total
Mental Diagnosis
Recovered
Much
Improved
Improved
Unimproved
Grand
Total
M.
F.
M.
F.
1
M.   1    F.
!
M.
F.
M.
F.
-
—
1
1
-
1
1
T
1
1
1
1
1
1
2
3
1
1
—
1
3
5
1
1
2
1
i
i
i
l
1
4
Psychosis with cerebral arteriosclerosis
Psychosis of other demonstrable etiology-
6
1
1
Chronic brain syndrome with behavioural
2
2
1
Totals
—
2    1       -
4
4
8
—
14
4
18
Table 11.—Separations from and Deaths Occurring in Home for the Aged,
Port Coquitlam, by Mental Diagnosis, Age-group, and Sex, April 1st, 1958,
to March 31st, 1959.
Mental Diagnosis
Age-group (Years)
60-69        70-79        80-89        90-99
)        I        I
M.     F. I M.     F.
I        I        I
M.
F.
M.
F.
Not
Stated
M.     F.
I I
Total
M. | F.
Grand
Total
Separations
Schizophrenic disorders—	
Senile psychosis-
Psychosis with cerebral arteriosclerosis—_
Psychosis of other demonstrable etiology-
Other drug addiction-
Chronic brain syndrome with behavioural reaction-
Chronic brain syndrome, N.O.S.	
Senility   	
Totals-
Deaths
Schizophrenic disorders	
Manic-depressive reaction-
Senile psychosis-
Psychosis with cerebral arteriosclerosis-
Alcoholic psychosis .
Psychosis of other demonstrable etiology-
Other and unspecified psychoses	
Syphilis and its sequelae-
Chronic brain syndrome with behavioural reaction-
Chronic brain syndrome, N.O.S.	
Senility—   	
Totals..
1
1
1
2
2
1
2
1
_
1
—
2
—
1
1
7  |    3
6 |    1 |    1 |
|    1  | 33  | 46
I        I        I
31  | 56
4 I
1  I    1
I
| - | 14 |    4 |     18
2
1
66
79
1
1
1
1
9
16
12
69 |120 |
I        I
189 I 120
MENTAL HEALTH SERVICES REPORT,  1958/59
Table 12.—Separations from and Deaths Occurring in Home for the Aged,
Port Coquitlam, by Mental Diagnosis, Length of Stay, and Sex, April 1st,
1958, to March 31st, 1959.
Detailed information for the above table may be obtained on request.
Table 13.—Separations from Home for the Aged, Port Coquitlam, by Condition on Discharge, Disposition to, and Sex, April 1st, 1958, to March 31st,
1959.
Disposition to—
Condition on Discharge
Home
Other Mental
Hospital
Other
Total
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
1
4
1
2
7
1
1
1
2
4
8
4
2
8
8
Totals
6
2
7
1
1
1
14
4
18
Table 14.—Deaths Occurring in Home for the Aged, Port Coquitlam, by Cause
of Death, Age-group, and Sex, April 1st, 1958, to March 31st, 1959
Age-group (Years)
Total
Cause of Death
60-69
70-79
80-89
90-99
Not
Stated
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
-
1
2
1
5
18
1
1
2
1
1
1
3
1
5
23
1
4
5
3
1
1
1
2
20
1
1
2
1
2
4
~3
5
23
1
1
2
9
2
1
1
1
2
1
1
2
1
1
7
1
5
2
1
1
4
2
9
39
2
1
1
4
2
2
3
7
1
4
10
54
2
3
11
16
5
1
2
1
2
1
11
1
6
19
Arteriosclerotic and degenerative heart disease	
93
4
4
12
20
Diseases of stomach, intestines, and peritoneum	
7
3
2
1
2
4
Totals           	
1
33
46
31
56
4
16
1
1 1 69
120
189
Table 15.—Deaths Occurring in Home for the Aged, Port Coquitlam, by Cause
of Death, Length of Stay, and Sex, April 1st, 1958, to March 31st, 1959
Detailed information for the above table may be obtained on request. GERIATRIC DIVISION
HOME FOR THE AGED, VERNON
Table 1.—Movement of Population, Home for the Aged, Vernon,
April 1st, 1958, to March 31st, 1959
I 121
Male
Female
Total
101
34
10
5
7
125
36
226
Admissions—
70
10
1
1
6
8
56
38
94
Total under care	
157
163
320
Separations—
Discharged in full      	
riierl
6
56
2
1
34
3
7
90
5
64
38
102
-8
93
125
—8
In residence, March 31st, 1959 - -	
218
Table 2.—First Admissions to Home for the Aged, Vernon, by Health Unit
and School District of Residence and Sex, April 1st, 1958, to March
31st, 1959
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
Boundary, Cloverdale—
School District No.   1  	
1
1
School District No. 37 ..	
1
1
„     2	
1
2
Metropolitan  Health  Committee
 5.,	
2
Vancouver—
Selkirk, Nelson—
School District No. 39-	
7
7
School District No.   8	
1
„   41	
1
1
„           „       „   10	
1
„   44
2
	
2
West Kootenay, Trail—
Simon Fraser, New Westminster—
School District No. 11	
1
School District No. 40- 	
1
1
„   12 	
1
2
North Fraser Valley, Mission—
School District No. 42	
1
1
2
School District No. 14     	
1
3
2
5
„           „        „   75   	
1
1
„   15	
Skeena, Prince Rupert—
„   16... —
2
2
School District No. 52	
3
3
 17	
2
2
Victoria-Esquimau. Union Board
 23	
5
5
10
of Health-
 77	
3
3
School District No. 61 (para
1
1
North Okanagan, Vernon—
central  Vancouver   Island,   Na
School District No. 20	
4
4
8
naimo—
 22	
3
8
11
School District No. 65	
1
1
South Central, Kamloops—
School districts not  covered by
School District No. 24	
6
5
11
health units—
„   30 —
1
2
3
School District No. 49-	
1
1
„   31- - -
1
1
„           „        „   61 (part2)....
1
1
Cariboo, Prince George—
Ex-Province „	
1
1
School District No. 57 	
2
2
Upper Fraser Valley, Chilliwack—
Totals	
56
38
94
School District No. 32	
1
1
1 Includes Victoria and Esquimalt only.
2 Includes Oak Bay only.  GERIATRIC DIVISION
I 123
Table 10.—Separations from Home for the Aged, Vernon, by Mental Diagnosis,
Condition on Discharge, and Sex, April 1st, 1958, to March 31st, 1959
Condition on Discharge
Mental Diagnosis
Improved
Unimproved
Grand
Total
Male
Female
Male
Female
Male
Female
1
3
1
4
~2
1
1
7
2
2
1
2
9
Totals       -                     -	
4
1
4
3
8
4
12
Table 11.—Separations from and Deaths Occurring in Home for the Aged,
Vernon, by Mental Diagnosis, Length of Stay, and Sex, April 1st, 1958, to
March 31st, 1959.
Length of Stay
Mental Diagnosis
Under
1
Month
1-3
Months
4-7
Months
8-11
Months
1
Year
2
Years
3-5
Years
6-9
Years
10
Years
and
Over
Total
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Separations
Manic-depressive reaction—
Senile psychosis	
Chronic    brain    syndrome,
N.O.S	
3
1
—
—
-
1
—
2
1
—
-
2
—
—
-
-
2
1
7
2
2
1
2
9
Totals 	
3
1
—
- | __ | __
1|-|   2|   1|_
—
2 | - | -
	
-|   2|   8 I   4|    12
Deaths
Schizophrenic disorders	
Psychosis with cerebral ar-
8
2
1
8
7
9
5
1
1
.... | -
1
3 1   1
8
4
3
2
8
3
1
3
8
4
2
1
1
54
34
1
1
Chronic    brain    syndrome,
N.O.S    —
88
Totals	
8
2
9
7
9
5
31   11   8
1      1
4
3
2
8 |   3
1
4
8
4 |   2 | 56
1      1
34
90
Table 12.—Separations from and Deaths Occurring in Home for the Aged,
Vernon, by Mental Diagnosis, Age-group, and Sex, April 1st, 1958, to
March 31st, 1959.
Detailed information for the above table may be obtained on request.
Table 13.—Separations from Home for the Aged, Vernon, by Condition on
Discharge, Disposition to, and Sex, April 1st, 1958, to March 31st, 1959
Disposition to—
Condition on Discharge
Home
Other Mental
Hospital
Other
Total
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
Improved  _	
Unimproved- 	
3
2
1
2
3
1
4
4
1
'       3
5
7
Totals	
5
1
2
3
1
	
8
4
12 I 124
MENTAL HEALTH SERVICES REPORT, 1958/59
Table 14.—Deaths Occurring in Home for the Aged, Vernon, by Cause of
Death, Age-group, and Sex, April 1st, 1958, to March 31st, 1959
Age-group (Years)
Cause of Death
60-69
70-79
80-89
90-99
Grand
Total
M.
F.
M.
F.
1
M.   I   F.
1
M.
F.
M.
F.
Malignant neoplasms 	
Cerebrovascular lesions—	
Arteriosclerotic and degenerative heart disease	
3
1
1
	
1
3
15
1
1
1
1
6
1
1
3
20
2
17
3
~ 1
1
2
1
4
1
7
40
5
1
27
1
3
2
7
67
1
8
1
1
1
2
3
1
Totals  	
5
22
9
25
21
4
4
56
34
90
Table 15.—Deaths Occurring in Home for the Aged, Vernon, by Cause of
Death, Length of Stay, and Sex, April 1st, 1958, to March 31st, 1959
Detailed information for the above table may be obtained on request.
HOME FOR THE AGED, TERRACE1
Table 1.—Movement of Population, Home for the Aged, Terrace,
April 1st, 1958, to March 31st, 1959
Number
In residence, April 1st, 1958  285
Admissions—
First admissions
13
Readmissions to a different institution of Mental Health
Services      20
Total admissions
Total under care
Separations—
Discharged in full	
Died 	
Transfers to other geriatric units
Total separations 	
Net increase or decrease	
In residence, March 31st, 1959_
33
318
3
34
4
41
-8
277
1 This institution cares for male patients only.  I 126
MENTAL HEALTH SERVICES REPORT,  1958/59
Table 5.—First Admissions to Home for the Aged, Terrace, by Mental Diagnosis and Marital Status, April 1st, 1958, to March 31st, 1959
Table 6.—First Admissions to Home for the Aged, Terrace, by Mental Diagnosis and Years of Schooling, April 1st, 1958, to March 31st, 1959
Table 7.—First Admissions to Home for the Aged, Terrace, by Citizenship and
Age-group, April 1st, 1958, to March 31st, 1959
Table 8.—First Admissions to Home for the Aged, Terrace, by Religion, April
1st, 1958, to March 31st, 1959
Table 9.—First Admissions to Home for the Aged, Terrace, by Previous Occupation, April 1st, 1958, to March 31st, 1959
Detailed information for the above tables may be obtained on request.
Table 10.—Separations from and Deaths Occurring in Home for the Aged,
Terrace, by Mental Diagnosis and Age-group, April 1st, 1958, to March
31st, 1959.
Mental Diagnosis
Age-group (Years)
Total
60-69
70-79
80-89
90-99
Separations
3
1
1
1
1
—
3
Senile psychosis 	
1
I
1
1
Totals   _	
5        |          2
-
7
Deaths
2
1
1
7
6
5
6
3
1
1
1
10
14
9
Senility -      -
1
4
18          I          10
2
34
Table 11.—Separations from and Deaths Occurring in Home for the Aged,
Terrace, by Mental Diagnosis and Length of Stay, April 1st, 1958, to
March 31st, 1959.
Detailed information for the above table may be obtained on request.
Table 12.—Separations from Home for the Aged, Terrace, by Mental Diagnosis
and Condition on Discharge, April 1st, 1958, to March 31st, 1959
Mental Diagnosis
Condition on Discharge
Total
Recovered
Unimproved
Schizophrenic disorders - — -	
1
3
1
1
3
1
1               |                 1
|                 1
Totals                            	
1
6               1                7    I 130 MENTAL HEALTH SERVICES REPORT, 1958/59
Since increasing demands are made on nursing staff to participate in patient-care,
nurses have in turn made demands for additional supervision and in-service education,
which has been provided both for psychiatric nurses and registered nurses. This has
been provided in part by our own staff through individual supervision and also
by Miss Anne Furness, social group worker from the School of Social Work, University
of British Columbia.
The School of Social Work's interest in the development of a therapeutic group
work programme for student placements enabled us to obtain the services of Miss Sweeny,
a- social group worker. Accordingly, a beginning has been made for the use of groups
in treatment in the Children's Clinic. Two parent counselling groups and an 8- to 10-
year-old children's group have been meeting regularly. In the establishment of the group
worker's position, we have lost the unit supervision of social-work students who are placed
with us each year for practical experience.
Training Programme
We have enjoyed good relationships with various departments of the University.
The student programme in social work was a large one. There were six casework students
in the Children's Clinic and two in the Adult Clinic. In addition, there was a group-work
student in each of the Clinics. Liaison has continued with the School of Nursing at the
University of British Columbia, and two public health nursing students spent one month
of field work at the Adult Clinic. During the year one resident in psychiatry has been
given a year's supervised experience, and four residents have been given six months'
supervised experience. It is important that such training programmes be continued and
enlarged. We are needing a closer relationship with the Department of Psychiatry,
University of British Columbia, so that this Centre may be developed as an "approved
training centre for psychiatrists. Students who are trained in this Centre provide a reservoir from which permanent staff are often appointed. In maintaining a good staff it is
also important to provide for additional training of permanent staff and for a suitable
recruitment programme. We are pleased that one psychiatrist and one social worker
were away from their duties during the year for additional training. Unfortunately, we
do not have a satisfactory recruitment programme to fill vacancies when they occur.
Administration
Changes in administration have been effected in order to carry out the integration
of the Children's and Adult Clinics. The building and grounds, on the whole, are
well kept up. The development of the I.B.M. punch-card system has progressed favourably, and for the Adult Clinic the 1958/59 period will be the first complete report using
this card system. In the Children's Clinic, development of the I.B.M. statistical method
is under way, and plans are to record only basic information during the 1959/60 period
and to develop this into a comprehensive system for the following year.
Public Relations
Many staff members serve as committee members and advisers to other community organizations. Some have contributed in planning and participation to specific
educational programmes such as the Child Welfare League Conference in Vancouver.
Several have attended professional conventions.
Orientation to the Centre has been offered to affiliate nurses and psychiatric nurses
for some time. Further demands have been made from non-affiliate nurses from the
Vancouver General Hospital and also from graduate staff nurses. In an effort to meet
rhese demands and also to be economical of staff time, one half-day interpretation of the
Children's Clinic and Adult Clinic has been offered.   Groups visit once every two months,   MENTAL HEALTH CENTRE
STATISTICAL TABLES
I 133
Table 1.—Summary of Operations, Mental Health Centre, Adult Clinic,
April 1st, 1958, to March 31st, 1959
Male
Female
Total
Total number pending at March 31st, 1958	
Plus assessments—
Provincial Mental Health Services hospital services...
Children's Clinic, Mental Health Centre	
From other institutions	
From in-town general practitioners and other specialists-
From out-of-town general practitioners	
From in-town psychiatrists	
Totals-
Disposition of assessments—
Hospitalization recommended-
Social agency recommended-
Other medical care recommended-
No case made—
Advice, assessment only	
Patient withdrew	
Admissions 	
Total pending at March 31st, 1959..
Patient load—
Brought forward-
Total O.P.D. admissions.
Less O.P.D. discharges-
Total number under treatment, March 31st, 1959-
39
3
108
19
29
198
200
54
90
144
85
59
29
3
200
35
62
329
10
120
170
290
159
131
18
68
3
3
308
54
91
527
|      328        |      528
17
174
260
434
244.
190
Family members under treatment at March 31st, 1959:   Parents, 2;   Spouses, 18;   Other, 1;   Total, 21.
Table 2.—Movement of Population, Out-patient Department, Mental Health
Centre, Adult Clinic, April 1st, 1958, to March 31st, 1959
Male
Female
Total
Caseload as at March 31st, 1958 -	
Total admissions  	
First admissions	
Readmissions..
54
90
82
8
85
59
120
170
138
32
159
131
174
260
220
40
244
Caseload as at March 31st, 1959       	
190
Table 3.—First Admissions to Mental Health Centre, Adult Clinic, by Health
Unit and School District of Residence, April 1st, 1958, to March 31st, 1959
Detailed information for the above table may be obtained on request.  MENTAL HEALTH CENTRE
I 135
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Chro   i-XyS&J       MENTAL HEALTH CENTRE I 139
Summary of Children's Clinics' Activities, April 1st, 1958, to March 31st, 1959
Stationary Clinics
Vancouver      Victoria
Mainland
Travelling
Clinics
Vancouver
Island
Travelling
Clinics
Totals
Number of days clinics held_
Tptal number of children referred-
Total number of children given full examination-
Other agency diagnostic cases given full examination
(social, health, etc.)
Clinic direct-service cases given full examination-
Other agency consultative cases	
Clinic direct-service cases referred (private)—
New  	
Repeat—
Number of persons oriented at clinic.
Number of community education functions.
247
469
294 '
224
70
11
193
41
253
96
247
121
140
41
99
1
71
8
7
3
134
431
325
325
106
19
9
19
17
17
2
637
1,040
7~78
607
169
120
264
49
260
118
Sources of All Cases Referred to Children's Clinics Showing Service Given,
April 1st, 1958, to March 31st, 1959
Number
of Cases
Type of Service Given
Agency or Source ■■  ■■"
Diagnostic
Study Only
Consultative Study
Only
Clinic
Direct
Service
46
12
4
161
17
1
44
12
3
133
17
1
2
1
28
Sub-total     	
241        |                 |        -	
25
38
73
8
79
25
6
33
21
5
26
16
11
10
3
6
6
25
37
39
8
69
20
5
20
11
5
24
15
10
9
5
5
1
33
4
5
1
13
10
2
1
1
1
3
1
1
3. Medical and health services—
1
6
North Frasey Valley Health Unit   '          	
Selkirk Health Unit                    	
South Central Health Unit   	
Sub-total                	
391
	
4. Schools—
15
3
2
27
6
1
2
26
6
1
4
1
11
3
Girls' Industrial School ...
Sub-total-	
54
	
30
11
28
7
■ 2.
-_■■■.
Probation Officer
;          2
'■         Sub-total	
41
6. Adult Court—
Family Court ;,        -
1
1
	
„„,..	
 .__!_..„	   IiJ.42
MENTAL HEALTH SERVICES REPORT, 1958/59
Diagnoses of All Cases Examined by Children's Clinics, April 1st, 1958,
to March 31st, 1959—Continued
    ■■■-"--   =-■=■ "
Children
Adults
Total
,                   .                                                            .       ....
Male
Female
Male
Female
321.5                   .                      	
13
88
7
10
37
27
2
24
1
6
1
1
1
1
33
5
34
1
3
5
26
14
2
1
5
1
2
20
1
.6
2
2
1
1
10
1
2
' 1
2
20
324                       .   -             	
138
324.4       	
1
325            	
11
325.1  	
15
325.2                   . .
67
325.3	
43
325.5 	
325.4                                                     	
2
2
326                       .   -             	
26
326.1	
1
326.2   	
326.3	
11
2
Other—
QcK 1
1
351    -	
353                                                                    	
1
2
353 1                                                                     	
2
793    . . 	
55
Total examinations completed  _
374                169
20
33
596
Printed by DON McDjy_u_ro, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
 „     .I960
560-1159-938 ■I   

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