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Mental Health Services Branch PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT FOR TWELVE MONTHS ENDED MARCH… British Columbia. Legislative Assembly 1961

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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
1960
Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1961
  To Major-General the Honourable George Randolph Pearkes,
V.C, P.C., C.B., D.S.O., M.C.,
Lieutenant-Governor of the Province of British Columbia.
May it please Your Honour:
The undersigned respectfully submits the Annual Report of the Mental Health
Services Branch, Department of Health Services and Hospital Insurance, for the
year ended March 31st, 1960.
ERIC MARTIN,
Minister of Health Services and Hospital Insurance.
Office of the Minister of Health Services and Hospital Insurance,
Victoria, B.C., January 12th, 1961.
 Department of Health Services and Hospital Insurance,
Mental Health Services Branch,
Vancouver, B.C., January 12th, 1961.
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, 1960.
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  11
Report—Business Manager  24
Report—Personnel Officer  35
Report—Supervisor of Psychiatric Social Work  40
Report—Director of Nursing Services  46
PART II.—CREASE CLINIC OF PSYCHOLOGICAL MEDICINE
AND PROVINCIAL MENTAL HOSPITAL
Report on Crease Clinic—Medical Superintendent  50
Report on Provincial Mental Hospital—Medical Superintendent  54
Report on Treatment Services—Clinical Director  75
Statistical Tables—Crease Clinic  77
Statistical Tables—Provincial Mental Hospital  89
PART III.—THE WOODLANDS SCHOOL
Report—Medical Superintendent  104
Statistical Tables  107
PART IV.—PROVINCIAL MENTAL HOME
Report—Medical Superintendent  114
Statistical Tables  116
PART V.—GERIATRIC DIVISION
Report—Medical Superintendent  121
Statistical Tables—Valley view Hospital, Essondale  135
Statistical Tables—Dellview Hospital, Vernon  140
Statistical Tables—Skeenaview Hospital, Terrace  143
PART VI.—MENTAL HEALTH CENTRE
Report—Director of Mental Health Centre  147
Statistical Tables  151
  OFFICERS AND STAFF
DEPARTMENT OF HEALTH SERVICES AND HOSPITAL INSURANCE
Mental Health Services Branch
The Honourable Eric Martin, Minister of Health Services and Hospital Insurance.
A. E. Davidson, B.A., M.D., F.A.P.A., Deputy Minister and Director of Mental Health Services.
HEADQUARTERS STAFF
F. A. Matheson, Business Manager.
C. B. Watson, M.A., Administrative Assistant.
J. Dowling, Personnel Officer.
Miss A. K. Carroll,, B.A., M.S.W., Provincial Supervisor, Psychiatric Social Work.
Miss B. Mitchell, R.N., B.S.N., Director of Nursing Services.
Miss M. Lonergan, R.N., B.Sc.N.Ed., Associate Director of Nursing Education.
G. A. Grieve, Cost Accountant.
PROVINCIAL MENTAL HOSPITAL AND CREASE CLINIC OF
PSYCHOLOGICAL  MEDICINE,  ESSONDALE
T. G. Caunt, M.D., F.A.P.A., Medical Superintendent.
J. Walsh, M.B., B.Ch., D.P.M., Deputy Medical Superintendent.
J. E. Boulding, B.A., M.D., CM., Deputy Medical Superintendent.
F. G. Tucker, M.B., B.S., Clinical Director.
J. M. Jackson, M.D., Director of Radiology.
G. A. Nicolson, B.A., M.D., Director of Laboratories.
W. P. Fister, M.D., M.R.C.P.(Edin.), F.R.C.P.(C), Director of Neurology.
I. Tischler, M.D., Assistant Clinical Director.
M. O. Calverley, B.Sc., M.D., Assistant Clinical Director.
A. M. Creamer, M.B., Ch.B., B.A.O., Assistant Clinical Director.
T. J. Hennelly, M.D., D.P.M., Assistant Clinical Director.
G. O. Hallman, B.A., M.D.
M. E. Murdoch, B.A., M.D., CM.
A. D. Sleigh, B.A., M.D.
R. L. Kennedy, M.D.
A. Greiner, M.D.
A. J. LePage, B.A., M.D.
K. J. Davies, M.D.
R. W. Harrington, B.A., M.D.,
R. Parkinson, B.A., M.D.
N. R. McGregor, M.D.
H. J. Lewis, M.B., B.S.
A. Nnubia, B.Sc., M.D.
E. V. Mellor, M.B., Ch.B.
B. S. Koszegi, M.D.
C. J. Schwarz, M.B., Ch.B.
T. A. H. McCulloch, B.A. M.D.
P. R. D. Koch, B.A., M.D.
T. C. Feir, B.Sc., M.D.
I. M. Bus, M.D.
H. G. Adler, B.A., M.D.
D. H. Upton, M.D., CM.
R. N. Davis, B.A., M.B., B.S., D.P.M.
S. J. A. Vandrick, B.A., M.D., CM.
G. A. Batacan, M.D.
G. D. Campbell, D.D.S.
W. C Cusack, D.D.S.
J. W. Borthwick, B.A., Senior Psychologist.
G. G. Maxwell, Director of Recreation.
K. Woolcock, Pharmacist.
W. E. Peters, Audio-Visual Department.
Mrs. M. L. McKay, R.N., Superintendent of
Nurses.
R. H. Strong, Chief Male Psychiatric Nurse.
Miss D. R. Begg, M.S.W., Supervisor, Social
Service.
Mrs. M. Marr, B.Sc.(H.Ec), Dietetics Administrator.
Miss O. M. Curtis, OT.(Reg.), Supervisor,
Occupational Therapy.
R. Herring, Supervisor, Industrial Therapy.
Miss H. Walsh, B.A., B.L.S., Librarian.
Consultant Staff:
F. A. Turnbull, B.A., M.D., Neurosurgery.
James W. Wilson, M.D., CM., F.R.CS.(Can.), M.S.(Minn.), General Surgery.
R. E. Outerbridge, M.D., F.R.CS.(C), F.A.C.S., Orthopedic Surgery.
E. F. Weir, M.D., Internal Medicine.
Business:
W. Gueho, Cashier.
R. Boulter, Steward.
Miss A. Potoma, Business Stenographer.
Rev. J. F. O'Neil, E.D., B.A., L.Th., Chaplain, Protestant.
Rev. Father A. Frechette, O.F.M., Visiting
Clergy, Roman Catholic.
 J 8
MENTAL HEALTH SERVICES REPORT,  1959/60
PROVINCIAL MENTAL HOME, COLQUITZ
L. G. C. d'Easum, M.D., Medical Superintendent.
H. C. Yardley, Unit Business Manager. E. F. Groome, Chief Male Psychiatric Nurse.
SCHOOLS FOR MENTAL DEFECTIVES
L. A. Kerwood, M.D., D.P.M., Medical Superintendent.
The Woodlands School, New Westminster
A. O. Morrison, M.S.W., Supervisor, Social
Service.
H. Mercer, Industrial Arts Instructor.
J. Elliot, Chief Male Psychiatric Nurse.
J. Nuttall, B.A., B.Ed., Psychologist.
Mrs. H. M. Davy, School Principal.
Miss E. Henshaw, Senior Clerk-Stenographer.
W. O. Booth, Unit Business Manager.
A. Gallinger, M.D., CM.
B. Tischler, M.D.
T. Kamburoff, M.D.
E. M. Tredger, B.A., M.D.
R. E. Manning, M.D.
H. T. Davidson, D.D.S.
Miss V. Sanders, R.N., Superintendent
of Nurses.
Visiting Clergy:
Rev. L. D. Hankinson, B.A., Protestant.    Rev. Father J. R. Bernard, O.M.I., Roman Catholic.
Tranquille School, Tranquille
E. V. R. Merrick, Supervisor.
GERIATRIC DIVISION
B. F. Bryson, B.A., M.D., CM., F.A.P.A., Medical Superintendent.
Valleyview Hospital, Port Coquitlam
A. I. Smith, Unit Business Manager.
W. Lazorko, M.D.
K. C Greer, B.A., M.D.
Miss E. Johnstone, R.N., Superintendent of
Nurses.
Mrs. A. Frith, B.Sc.(H.Ec), Dietician.
Miss M. Jorgensen, Senior Clerk-Stenographer.
G. Kelly, Pharmacist.
Miss K. Piro, B.Sc, Laboratory Technician.
Miss G. Fuller, X-ray Technician.
Mrs. M. Franklin, Recreational Instructor.
Miss A. Anderson, M.A.O.T., Occupational
Therapist.
Dell view Hospital, Vernon
L. W. Fox, Supervisor.
Miss H. O. Lipsey, R.N., Superintendent of
Nurses.
J. Smith, M.D., Visiting Physician.
Rev.  C  E.  Reeve,  B.A.,   Visiting Clergy,
Protestant.
Monsignor J. Miles, Visiting Clergy, Roman
Catholic.
Skeenaview Hospital, Terrace
W. E. Skillicorn, Supervisor.
F. Stewart, Chief Psychiatric Nurse.
J. Nicholson, M.D., Visiting Physician.
Ven. Archdeacon C A. Hinchliffe, Visiting
Clergy, Protestant.
Rev. Father O. P. Mohan, O.M.I., Visiting
Clergy, Roman Catholic.
MENTAL HEALTH CENTRE, BURNABY
ADULT CLINIC AND CHILDREN'S CLINICS
F. E. McNair, B.A.,
T. L. Brown, B.Com.,
G. M. Kirkpatrick, B.A., M.D., Senior Psychiatrist, Children's Clinic, Burnaby.
W. E. Valens, M.D., CM., Senior Psychiatrist, Children's Clinic, Victoria.
F. H. G. Mills, M.D.
M. A. Menzies, M.D., CM.
A. A. Cashmore, M.D.
Miss E. E. Jackson,
M.D., CM., Director.
Unit Business Manager.
Miss D. I. Arneson,
visor of Nursing.
D. B. Ricketts, B.A
Social Work.
Miss A. Bailey, M.A.O.T., O.T.R
visor, Occupational Therapy.
Miss M. Munro, B.A., M.A., Chief Psychol
ogist.
Senior Stenographer.
R.N., B.S.N., Super-
M.S.W., Supervisor,
Super-
-
 ^ggSSS*-
Official party at the formal opening and dedication of the Valleyview Building, Essondale,
May 22nd, 1959. From left to right: The Right Rev. G. P. Gower, Lord Bishop of New
Westminster; Mr. L. J. Christmas, Reeve, District of Cbquitlam; Honourable Lyle Wicks,
Minister of Labour and Minister of Commercial Transport; Honourable W. N. Chant, Minister
of Public Works; Dr. B. F. Bryson, Medical Superintendent; Dr. A. E. Davidson, Deputy
Minister, Mental Health Services; Miss E. Johnstone, Superintendent of Nurses; Honourable
Eric Martin, Minister of Health Services and Hospital Insurance; Honourable W. D. Black,
Provincial Secretary, Minister of Municipal Affairs and Minister of Social Welfare.
The Valleyview Building for admission and infirmary care, Geriatric Division, Essondale.
 J  10
MENTAL HEALTH SERVICES REPORT,  1959/60
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 Report of Mental Health Services Branch
For the Twelve Months Ended March 31st, 1960
PART I.—HEADQUARTERS
REPORT OF DIRECTOR OF MENTAL HEALTH SERVICES
A. E. Davidson, M.D., Deputy Minister of Mental Health Services
and Director of Mental Health Services
A most significant development affecting Mental Health Services occurred
this year with the Departmental reorganization resulting in the transfer of the
Mental Health Services from the Provincial Secretary's Department to the newly
formed Department of Health Services and Hospital Insurance. In the reorganization, mental health forms one of the three branches of the new Department. The
three branches are the Health Branch, the Hospital Insurance Branch, and the
Mental Health Services Branch. As each of the branches is headed by a Deputy
Minister, this has resulted in the combining of the position of Deputy Minister of
Mental Health Services with that of the Director of Mental Health Services. These
changes are reflected in the accompanying chart, which depicts the relationship of
the Mental Health Services Branch to the other branches and also the general
organization of the various operating parts of the Mental Health Services.
The advantages gained by this reorganization are considerable. In the first
place, this move brings mental health rightfully into the area of health along with
the various other health facilities of the Province. This should result in greater
ease of a co-ordinated effort among the three branches, which should facilitate the
over-all mental-health programme. The Mental Health Services Branch should
also be able to contribute more effectively to the programmes of the other branches.
Moreover, through the Deputy Minister's office it should be possible to more adequately give expression to the many needs and requirements of the service and
thereby interpret the development of new mental-health facilities.
Because of the reorganization and resultant change in function, it was considered desirable that the Deputy Minister and his administrative staff should be
removed from the Essondale area. Over the years, as the mental-health services
have developed, the general administration has been managed through the offices
of the Director of Mental Health Services located at Essondale. It is felt that if
full attention is to be devoted to the problems involved in the over-all mental-health
programme, the central office should be divorced from the local operation of any
one unit and should be situated at some distance from it.
After reviewing various possibilities and with the helpful co-operation of the
Health Branch, a decision was made to locate the central administrative offices of
the Mental Health Services Branch in the unfinished seventh floor of the Provincial
Health Building at 828 West Tenth Avenue in Vancouver. Plans for these offices
have been prepared by the Public Works Department and the necessary construction has been started. It is hoped that it will be possible to occupy the new quarters early in the coming fiscal year. The location of the central office close to the
major health facilities in Vancouver should assist in the most effective development
of the Mental Health Services.
11
 J  12 MENTAL HEALTH SERVICES REPORT,  1959/60
During the fiscal year 1959/60 the survey of the Mental Health Services being
conducted by the American Psychiatric Association has proceeded satisfactorily.
As reported previously, this study is concerned with the mental-health needs and
resources of the Province. Studies were commenced early last year and have been
proceeding throughout the entire year. It is anticipated that the report will be
ready for presentation sometime during the fiscal year 1960/61. Considerable
extra work has been assigned to several members of the Mental Health Services
staff who have compiled special reports for the survey team.
Reports and briefs have been forwarded from many organizations throughout
the Province who have a concern or interest in some special aspect of mental health.
Reports from several Government departments whose activities are closely related
to the Mental Health Services have been contributed.
Dr. Mathew Ross, medical director of the American Psychiatric Association,
in addition to the professional consultants, has visited the Province on different
occasions this year for the purpose of making detailed studies of specific areas of
the mental-health programme. During the summer months public hearings were
held in a number of centres throughout the Province. At these hearings interested
individuals or groups were invited to present a brief and give expression to their
views of the mental-health needs in their particular community or field. Centres
visited included Vancouver, Victoria, Nanaimo, Nelson, Kelowna, Kamloops, and
Prince George. The Deputy Minister was able to attend the public hearings, and
in this way secured an intimate picture of the problems and needs as seen by the
local communities of the Province.
In addition, the central inspection board of the American Psychiatric Association has made a thoroush inspection of all the existing units of the Mental Health
Services.   The result of these inspections will be included in the final survey report.
The studies made by the survey team have been exhaustive. It is anticipated
that the report will serve as a guide for planning and development for many years.
MAIOR EVENTS AND TRENDS
Considerable expansion has taken place in the areas dealing with the aged.
These units of the service have been organized separate from the Mental Hospital
at Essondale and now function with their own staff under a Medical Superintendent
who is directly responsible for all three units.
The new admission and infirmary unit, which is known as Valleyview Building, has been occupied. The infirmary wards are all in use, and the admission
wards are in the process of being activated.
To improve the efficiency of the Geriatric Division, the Homes for the Aged
Act has been repealed, and these units now operate under the Mental Hospitals Act.
They are now specialized mental hospitals for geriatric patients. At the same time,
these three units have been renamed—Valleyview Hospital at Port Coquitlam, Dell-
view Hospital at Vernon, and Skeenaview Hospital at Terrace.
Last year's Report noted that the Tranquille Sanatorium had been transferred
from the Health Branch to the Mental Health Services Branch. It has been decided
to use this plant as a school for mentally retarded patients. The institution has been
designated the Tranquille School.
The first group of patients has been transferred to the Tranquille School from
The Woodlands School. This group is composed of mentally retarded boys between
the ages of 20 and 40 who have received the full benefit of training in The Woodlands School and who now require minimal care in an institution. Approximately
130 boys have been transferred this year—enough to occupy one building formerly
 HEADQUARTERS
J  13
Valleyview Auditorium, opened on May 22nd, 1959.
The Education Centre, Essondale, opened in 1958.   The classroom unit is on the right,
while the students' residence is on the left.
 J  14 MENTAL HEALTH SERVICES REPORT,  1959/60
known as the infirmary.   Plans are being made for further groups to be transferred
to the Tranquille School this year.
Specific mention should be made of the treatment programme at the Provincial
Mental Hospital at Essondale. In common with other progressive mental hospitals,
efforts are being directed toward the opening-up of the hospital. Whereas a few
years ago mental hospitals were largely closed with doors locked and only a few
patients having freedom to get outside, to-day the reverse is true. At Essondale
now approximately 70 per cent of the patients reside in open wards, with freedom
to come and go from the ward as part of their treatment programme. This change
has been made possible in part by new drugs and new methods of treatment, but
also in large part by the altered attitudes toward mental illness on the part of the
staff and the general public. The increase in freedom gives the patient an opportunity to live in a more normal way, assuming more responsibilities for his own
affairs. This change in treatment philosophy is largely responsible for the increase
in the number of patients being released from hospital and in the decrease of patient
population in the Provincial Mental Hospital.
PERSONNEL
The number of personnel employed within the Mental Health Services has
continued to expand. During the past year there has been an increase of 270 in
the number of staff employed. At the end of the fiscal year there were 2,927 positions filled in our service. It should be noted that this represents approximately
one-third of the total Civil Service.
Through persistent effort it has been possible to increase the numbers of professionally trained personnel on staff. The use of Mental Health Grant bursaries
to assist in training has assisted in the recruitment of the professional groups.
During the year three qualified psychiatrists joined the service. One of these
took his training in Canada and obtained his certification in psychiatry from the
Royal College of Physicians and Surgeons of Canada. Two others were trained in
Great Britain and had considerable experience in the psychiatric branch of medicine.
This helped to improve the situation in regard to this aspect of the staffing situation.
It was also possible to participate in the training programme for psychiatrists
which has been initiated by the Department of Psychiatry at the University of
British Columbia Medical School. Five candidates admitted to this training were
supported by Mental Health Grant bursaries. It is hoped that the training programme will continue, and that it will expand, thereby increasing the number of
trained psychiatrists available to provide for the mental-health needs of the Province.
There has also been a concerted effort to improve the staffing of the social
service departments in the various institutions. During the year the number of
positions has been increased from forty-eight to sixty-three. In order to assist in
the provision of suitably trained social workers, use has been made of Mental Health
Grants to aid in their training at the School of Social Work, University of British
Columbia. During the year ten social workers were being assisted through Mental
Health Grant bursaries.
A similar effort has been made in regard to nursing. This year six nurses were
supported under Mental Health Grant bursaries. These individuals have been
enrolled in the course in clinical teaching and supervision at the School of Nursing,
University of British Columbia. This increased number of trained personnel should
assist considerably in the development of the nursing programme.
During the year there has also been a great deal of study preliminary to the
reorganization of the Department of Nursing Education.   The establishment of this
 HEADQUARTERS J 15
department has been increased by the addition of three positions for instructors,
which should result in a much more effective teaching programme.
This year the number of students in the School of Nursing has been markedly
increased. Whereas previously student enrolment was limited to 225, this has now
been increased to 325. The increase has permitted us to enlarge the size of the
classes which have been taken into the school, and in due course will be reflected
by an increased number of graduating psychiatric nurses each year.
The Department of Business Management has been closely studied with a view
to a reorganization paralleling the changes that have taken place in the medical
administration. The business management for all units is centralized at Essondale
under the Business Manager of the Provincial Mental Health Services, but at the
beginning of the fiscal year 1960/61 a professional hospital administrator responsible to the Medical Superintendent of the Crease Clinic and Provincial Mental
Hospital will commence duty. This employee will administer all services except
those directly involving the practice of medicine and closely allied professional
activities.
The position of Business Manager, Provincial Mental Health Services, will
remain in the headquarters organization, where the incumbent will serve as consultant in business management to the Deputy Minister.
It is planned to decentralize business-management functions in the other units
in a similar fashion.
This form of organization will make each Medical Superintendent responsible
for all aspects of the operation of his unit. It is considered that this change is a
major development in the Mental Health Services, and that it will contribute greatly
to the efficiency of the operations.
GENERAL COMMENTS
Several functions were held in connection with the graduation ceremonies of
the School of Psychiatric Nursing. The annual dinner-dance in honour of the
graduating class was held on April 14th. On Sunday, April 12th, a graduation tea
was held, and later in the evening the graduating class attended church services at
the Olivet Baptist Church in New Westminster. The graduation exercises were held
in the Vincent Massey Junior High School on the evening of April 16th. Professor
William Dixon, Director of the School of Social Work of the University of British
Columbia, the guest speaker, gave a stimulating and timely address to the graduating
class. Sixty-three students graduated this year—fourteen male nurses and forty-
nine female nurses.
The contribution of the British Columbia Division of the Canadian Mental
Health Association to the Mental Health Services of the Province has been considerable. The work of the dedicated volunteers who have visited and worked with
large groups of patients helps to convey to these people the interest that the community has in them. Through their daily contact with the patients and particularly
through their apparel-shop activities, the volunteers play an important part in the
therapeutic programme. At Christmas-time again this year the Canadian Mental
Health Association was responsible for seeing that every patient in hospital received
an appropriate gift.
The Association for Retarded Children has continued efforts to obtain better
conditions for the mentally retarded and their efforts have benefited the total
resident population of both the schools for retarded children. Members of this
association have contributed individually to the patients in the school. There has
been considerable study and work preliminary to the establishment of an organiza-
 J  16 MENTAL HEALTH SERVICES REPORT,  1959/60
tion to co-ordinate the volunteer activities to both The Woodlands School and
Tranquille School. This volunteer organization should be ready for active operation
this coming year.
The boards of directors of the Alcoholism Foundation and the Narcotic
Addiction Foundation have had representation from the Mental Health Services
Branch. Dr. F. G. Tucker continues to represent the Mental Health Services on
the board of directors of the Alcoholism Foundation and Dr. A. E. Davidson has
served in a similar capacity with the Narcotic Addiction Foundation. In this way
the Mental Health Services Branch has been able to assist and collaborate in the
planning of these services, both of which have important relationships with the
Mental Health Services.
We have again been pleased to participate in the in-service training programme
for senior school counsellors, which is presented by the Vancouver School Board.
The purpose of this programme is to provide senior teachers with an insight into
mental-health principles as they relate to the school-child. A group of ten senior
teachers took the training course this year. The course has been financed under
Mental Health Grants. Many staff members of the Mental Health Services Branch
have contributed lectures, clinics, and demonstrations to these people.
The 1959 annual meeting of the Council of Psychiatric Nurses was held on
April 30th, 1959. Mr. T. G. Dodsworth was appointed as a representative to the
Council by the British Columbia Psychiatric Nurses' Association, replacing Mr. J.
Longstaff, whose term had expired. The Bursary Selection Committee presented
the annual report and selected the first candidate for a bursary to take postgraduate
training in psychiatric nursing. The Council accepted with extreme regret the
resignation of Mr. William Cross, who had served as registrar of the Council of
Psychiatric Nurses since its formation in 1951. Mr. J. A. Markley, psychiatric
nurse, was appointed to the position of registrar.
A special meeting of the Council of Psychiatric Nurses was held on January 29th, 1960, in response to a request by the Council members appointed by the
British Columbia Psychiatric Nurses' Association. The purpose of this meeting
was to consider amendments to the Psychiatric Nurses Act proposed by the British
Columbia Psychiatric Nurses' Association. A committee of the Council was
appointed to study the suggested changes in the Act. This committee will submit
a report with recommendations at the next annual meeting.
Mr. W. H. Lacey and Mr. B. Muise were present at the special meeting as
new members appointed by the British Columbia Psychiatric Nurses' Association
to replace Mr. W. R. Butcher and Mr. G. Kenwood who had resigned their seats.
STATISTICAL COMMENTS
Information pertaining to the movement of patient population in the several
institutions of the Mental Health Services Branch is contained in Tables 1 and 2.
The total in residence as of April 1st, 1959, was 6,227 patients. During the year
3,293 persons were admitted to the various units of this service. This means that
a total of 9,520 individuals received care and treatment from the in-patient units
of the Mental Health Services. An additional 1,603 patients received services at
the Mental Health Centre on an out-patient basis. This makes a total of 11,123
patients who have received some form of psychiatric treatment from the Mental
Health Services Branch during this year. In addition, many of the relatives and
friends of the patients have received consultative and supportive service from the
staff.
 HEADQUARTERS
J  17
It will be noted that there has been a considerable increase in admissions—
3,293 in 1959/60 compared with 2,993 in 1958/59. The increase has been
reflected in all units.
Table 1.—Showing Patients in Residence in the Various Institutions of the Provincial Mental Health Services, April 1st, 1959, and March 31st, 1960,
Together with Increase or Decrease.
Institution
In Residence, Apr
. 1, 1959
In Residence, Mar
31, 1960
Increase (+)
Men
Women
Total
Men
Women
Total
Decrease (—)
107
1,822
281
803
136
93
277
134
1,457
600
392
125
241
3,279
281
1,403
528
218
277
120
1,608
288
752
109
206
106
288
145
1,411
635
451
128
-      -
265
3,019
288
1,387
109
657
234
288
+24
—260
+7
— 16
Mental Hospital, Essondale	
The Woodlands School -	
+ 109
+ 129
+ 16
+ 11
Valleyview Hospital, Port Coquitlam	
Dellview Hospital, Vernon	
Skeenaview Hospital, Terrace 	
Totals  	
3,519
2,708
6,227
3,477
2,770
6,247
+20
Table 2.—Showing in Summary the Admissions and Population Increase of the
Provincial Mental Health Services for the Twelve-year Period April 1st, 1948,
to March 31st, 1960.
Year
Total
Admissions
Admissions
65 Years
and Over
Admissions
15 Years
and Under
Voluntary
Admissions
Population
Increase
Index of
Increase1
1948/49 	
1,260
1,415
1,811
2,175
2,518
2,437
2,492
2,855
2,720
2,936
2,993
3,293
270
230
262
306
357
347
348
392
385
442
425
506
63
72
148
97
179
169
71
58
57
106
135
182
165
297
504
637
768
834
884
1,153
1,083
1,012
1,118
1,316
354
306
235
285
290
215
88
26
—78
38
—90
20
28 09
1949/50 	
21 62
1950/51 	
12 98
1951/52	
1952/53—  	
1953/54... _	
1954/55 — __	
1955/56 	
1956/57	
13.05
11.54
8.82
3.53
0.91
1957/58._ _	
1 29
1958/59 	
3.00
1959/60 	
0.61
Totals	
28,905
4,243
1,337
9,771
1,689
i Percentage ratio of increase in population to admissions.
The total resident population of the in-patient units increased by only twenty
during the year. The increase stems largely from the opening of the new institution
for mentally retarded at Tranquille and the opening of the Valleyview Building at
Valleyview Hospital, Port Coquitlam. The population increases in the schools for
retarded and the geriatric units were considerable, whereas there was a sizeable
decrease in the resident population of the Provincial Mental Hospital at Essondale.
Another gratifying figure to note is the number of patients seeking admission
to hospital on a voluntary basis. During the year 1,316 individuals were admitted
to hospital in this manner—a much larger proportion than in any previous year.
MENTAL HEALTH GRANT
The Government of Canada, through the Department of National Health and
Welfare, made available to this Province a Mental Health Grant " to assist in an
extended programme for the prevention and treatment of mental illness, including
 J  18 MENTAL HEALTH SERVICES REPORT,  1959/60
rehabilitation and free treatment." This is the twelfth year that the Mental Health
Grant has been available.
The grant provided for 1959/60 was $714,322. Projects totalling $698,-
426.63 or 97.7 per cent of the grant were submitted to and approved by the Department of National Health and Welfare. Expenditures made and claims submitted
to the Federal Treasury by March 31st totalled $642,086.17 or 89.8 per cent of
the grant. This is a small increase over last year, when expenditures were 88.5
per cent of the grant.
The major areas of expenditure are detailed hereunder.
Professional Training
Dr. R. W. Harrington completed a year of postgraduate study in psychiatry
at the University of Toronto in August. Dr. R. Parkinson completed a year of
postgraduate study in psychiatry at McGill University in August.
Four nurses attended a two-day institute on " Supervision on Evening and
Night Duty " at the School of Nursing, University of Washington, in April.
Three charge nurses from the Valleyview Hospital attended an Institute on
" Geriatric Nursing " at the School of Nursing, University of Washington, in May.
The Occupational Therapist, Mental Health Centre; the Chief Male Psychiatric Nurse, Provincial Mental Hospital; and the Nursing Counsellor of the School
of Psychiatric Nursing attended the Sixth Pacific Northwest Laboratory in Group
Development in Seattle for two weeks in June.
A charge nurse from The Woodlands School attended a two-day institute on
" The Nurse and Cerebral Palsy " given by the School of Nursing, University of
Washington, in June.
Two nursing supervisors responsible for in-service training programmes at
the Provincial Mental Hospital and The Woodlands School respectively attended a
four-day institute on " In-service Training in Nursing " at the School of Nursing,
University of Washington, in July.
Dr. Pauline Hughes, Deputy Medical Superintendent of The Woodlands
School, and Dr. Bruce F. Bryson, Medical Superintendent of the Valleyview Hospital, attended the Eleventh Annual Mental Hospital Institute of the American
Psychiatric Association held in Buffalo in October.
A five-day institute on " Mental Health In-service Education " was jointly
sponsored by the Mental Health Services Branch and the Health Branch in October.
Mental Health Grant funds made it possible for fifty-eight public health nurses and
one public health educator to attend this institute.
A head nurse from the Crease Clinic, a charge nurse from the Provincial Mental Hospital, a charge nurse from The Woodlands School, a deputy chief nurse from
Valleyview Hospital, and an instructor from the School of Psychiatric Nursing
attended a two-day institute on " Staphylococcus Infection and Aseptic Technique "
at the School of Nursing, University of Washington, in January.
Miss Kay Baba, physio-occupational therapist employed at the Trail-Tadanac
Hospital, was sponsored for a three-month period of supervised training with psychiatric patients at the Mental Health Centre, Burnaby, commencing in November.
Special reports covering course content were prepared by all those attending
short courses.
Ten social workers were provided with bursaries to permit them to enrol in
the School of Social Work, University of British Columbia, for the academic year
beginning in September.
 HEADQUARTERS J  19
Three clinical psychologists were granted bursaries to permit them to enrol
for an academic year of postgraduate study commencing in September. One chose
to attend the University of Western Ontario and two enrolled at the University of
British Columbia.
Five registered nurses were granted bursaries tenable for one academic year
in the School of Nursing, University of British Columbia. One registered nurse was
given a bursary to permit her to enrol for two quarters in the advanced programme
of the School of Nursing, University of Washington.
Five physicians were granted bursaries to enable them to enrol for graduate
specialist training in psychiatry in the Department of Psychiatry, Faculty of Medicine, University of British Columbia. These bursaries, tenable for one year, commenced in July.
Dr. M. Albert Menzies, of the Children's Clinic, Mental Health Centre, was
granted a bursary to permit him to take a year of post-specialist training in child
psychiatry at Johns Hopkins University, Baltimore.
All the persons granted bursaries have signed agreements to give a return in
service to the Mental Health Services Branch at the conclusion of their training
periods.
Equipment and Supplies
Provincial Mental Hospital, Essondale.—Five films on mental-health topics
were approved for purchase for the film library maintained for the Mental Health
Services by the Provincial Mental Hospital.
A spectrophotometer with accessories was approved for purchase for the clinical laboratory.   A chair scale for the infirmary wards was provided.
The Woodlands School.—Specialized physiotherapy equipment was provided
to permit the establishment of an active programme in the treatment of the cerebral-
palsied mental defective.   This approval totalled $2,100.
A grant of $7,500 was made to provide the technical equipment and instruments for a new dental clinic.
Skeenaview Hospital, Terrace.—One complete oxygen tent was provided.
School of Psychiatric Nursing.—Technical books to the value of $300 were
approved for purchase for the library of the School of Psychiatric Nursing.
Community Mental-health Programmes
The mental-hygiene programme of the Metropolitan Health Committee of
Greater Vancouver was once again supported by a grant which totalled $34,987.
This sum provided the salaries for one psychiatrist, two psychologists, two psychiatric social workers, and one clerk-stenographer.
The Vancouver School Board continues to sponsor an in-service training
course in mental hygiene for senior school counsellors. Ten trainees were enrolled
this year.   A Mental Health Grant provided the salary for the course director.
The Epilepsy Division of the British Columbia Society for Crippled Children,
which has been established to provide educational, rehabilitative, medical, and social
support to epileptics, was assisted by a grant of $10,000 to defray one-third of the
personnel budget.
Psychiatric Services in General Hospitals
The psychiatric out-patients' department of the Vancouver General Hospital
was assisted by a grant to pay the salaries of a clinical psychologist, psychiatric
social worker, and a medical clerk-stenographer.
 J 20
MENTAL HEALTH SERVICES REPORT,  1959/60
Personnel for Mental Health Services
The stipends paid to the consultants in neurosurgery, general surgery, orthopedic surgery, and internal medicine are derived from a grant to the Provincial
Mental Hospital.
The hospitals and clinics of the Mental Health Services Branch have again
had assistance in the provision of salaries for members of the treatment staff,
including such specialists as psychiatrists, psychiatric nurses, laboratory technicians, clinical psychologists, social workers, and dieticians. In all, 106 personnel
are involved in these grants.
Research Projects
Several major research projects continue to be supported with funds derived
from the Mental Health Grant. The studies are conducted at the University of
British Columbia in the Departments of Pharmacology and Neurological Research.
The sum of $65,966 was appropriated for research studies this year.
COMPARATIVE SUMMARY OF INCREASES AND DECREASES IN RESIDENT POPULATION BY MAJOR DIVISIONS OF MENTAL HEALTH
SERVICES BRANCH, 1952/53 TO 1959/60.
Institution
1952/53
1953/54
1954/55
1955/56
1956/57
1957/58
1958/59
1959/60
Provincial Mental Hospitals-
Schools  for Mental Defectives  -	
Geriatric Division          	
-64
+277
+49
+28
+ 62
+ 104
+50
— 1
+44
+ 19
+25
+2
+ 19
+ 15
— 10
—70
+ 14
+9
— 31
-49
+76
— 15
+26
-135
+ 86
— 30
— 11
-253
+93
+ 156
+24
Totals  	
+290
+215
+88
+26
—78
+ 38
—90
+20
COMPARATIVE SUMMARY OF TOTAL PATIENTS UNDER CARE FOR
MAJOR DIVISIONS OF MENTAL HEALTH SERVICES BRANCH BY
FISCAL YEARS, 1952/53 TO 1959/60.
Institution
1952/53
1953/54
1954/55
1955/56
1956/57
1957/58
1958/59
1959/60
Provincial Mental Hospitals-
Schools for Mental  Defectives 	
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
5,458
1,740
1,459
1,705
Totals	
8,995
9,072
9,212
9,749
9,618
9,844
9,975
10,362
 HEADQUARTERS
J 21
MOVEMENT OF POPULATION IN INDIVIDUAL INSTITUTIONS,
APRIL 1st, 1959, TO MARCH 3 1st, 1960
Psychiatric Division
Crease Clinic
Provincial Mental Hospitals
Total
Essondale
Colquitz
M.
F.
T.
M.
F.
T.
M.
M.
F.
T.
In residence, April 1st, 1959 .
On probation, carried forward
from 1958/59            	
107
134
241
1,822
80
3
1,457
183
4
3,279
263
7
281
1
1
2,210
81
4
1,591
183
4
3,801
264
On   escape,   carried   forward
from 1958/59	
8
Total as at April 1st, 1960...
107
134
241
1,905
1,644
3,549
283
2,295
1,778
4,073
Admissions—
First  admissions  to  Mental
Health Services —  	
Readmissions to different in-
423
24
168
578
28
237
1,001
52
405
421
81
303
315
136
275
736
217
578
844
105
471
893
164
512
1,737
269
Readmissions to same institution   	
983
615
6
843
1,458
6
805
30
726
38
1,531
68
27
1,420
63
1,569
38
2,989
Transfers in..— . 	
101
Total admissions to individual institution-
621
843
1,464
835
764
1,599
27
1,483
1,607
3,090
Total under care	
728
977
1,705
2,740
2,408
5,148
310
3,778
3,385
7,163
Separations—
584
1
799
2
1,383
3
694
112
110
8
591
58
197
4
1,285
170
307
12
5
11
1
1
1,283
124
111
9
1,390
60
197
4
2,673
Died	
184
On  probation  but  not   dis-
308
Escaped but not discharged....
13
585
801
1,386
924
850
1,774
18
1,527
1,651
3,178
23
31
54
208
147
335
4
235
178
413
Total separations from
individual institution
608
832
1,440
1,132
997
2,129
22
1,762
1,829
3,591
+ 13
+ 11
+24
-214
-46
-260
+7
— 194
—35
—229
Number  in   residence,   March
31st, 1960	
120
145
265
1,608
1,411
3,019
288
2,016
1,556
3,572
 J 22
MENTAL HEALTH SERVICES REPORT,  1959/60
MOVEMENT OF POPULATION IN INDIVIDUAL INSTITUTIONS,
APRIL 1st, 1959, TO MARCH 31st,  1960—Continued
Schools for Mental Defectives
The Woodlands School,
New Westminster
Tranquille School,
Tranquille
Total
M.
F.
T.
M.
F.
T.
M.
F.
T.
In residence, April 1st, 1959 	
On   probation,   carried  forward   from
1958/59
803
8
600
8
1,403
16
803
8
600
8
1,403
16
Total as at April 1st, 1960	
811
608
1,419
811
608
1,419
Admissions—
First  admissions  to  Mental  Health
97
3
14
75
2
13
172
5
27
	
97
3
14
75
2
13
172
5
	
..
	
27
114
4
90
1
204
5
   1    1 	
114
116
90
1
204
112
112
117
.    ..
Total admissions to individual
118
91
209
112
112
230
91
321
929
699
1,628
112
112
1,041
699
1,740
	
Separations—
36
11
16
45
10
6
81
21
22
36
11
17
45
10
6
81
Died 	
...
21
1
1
23
63
114
61
3
124
117
1
2
1
2
64
116
61
3
125
	
...
119
Total   separations   from  indi-
177
64
241
3
3
180
64
244
Net increase or decrease  	
—51
+ 35
-16
+ 109 |      | +109
+ 58
+35
+93
Number in residence, March 31st, 1960
752
635
1,287
109
109
861
635
1,496
Geriatric Division
Valleyview Hospital,
Port Coquitlam
Dellview Hospital,
Vernon
Skeena-
view
Hospital,
Terrace
Total
M.
F.
T.
M.
F.
T.
M.
M.
F.
T.
In residence, April 1st, 1959
136
392
528
93
125
218
277
506
517
1,023
Admissions—
First admissions to  Mental
	
54
1
1
22
1
76
2
1
24
78
1
1
22
1
100
Readmissions to different in-
2
Readmissions to same insti-
1
146
280
56
14
23
79
14
24
39
80
187
23
146
103
Transfers in __	
134
333
Total admissions to individual institution....
134
146
280
70
23
93
63
267
169
436
Total under care	
270
538  |     808
163
148
311
340
773
686
1,459
Separations—
Discharged in full	
Died  	
1
55
6
77
7
132
3
50
2
18
5
68
51
4
156
8
95
12
251
56
8
83
4
139
12
53
4
20
73
4
51
1
160
13
103
4
263
17
Total separations from
individual institution
64
87
151
57
20
77
52
173
107
280
Net increase  	
+70
+ 59 | +129
+ 13
+ 3
+ 16
+ 11
+94
+62
+ 156
Number   in  residence,   March
31st, 1960       ..
206
451
657
106
128
234
288
600
579
1,179
Note:—The first admissions shown in the tables for individual institutions may differ
due to a different definition.
from the above figures
 HEADQUARTERS
J 23
MOVEMENT OF POPULATION OF MENTAL HEALTH SERVICES,
APRIL 1st, 1959, TO MARCH 31st,  1960
Psychiatric
Division
Schools for Mental Defectives
Geriatric
Division
Total
M.
F.
T.
M.
1
F.   1   T.
1
M.
1
F.   1   T.
I
1          1
M.  I   F.   I    T.
1          1
In residence, April 1st, 1959-   .. .
On   escape,   carried   forward   from
1958/59	
2,210
81
4
1,591
183
4
3,801
264
8
803
8
600
8
1,403
16
506
517
1,023
3,519
89
4
2,708
191
4
6,227
280
On   escape,   carried   forward   from
1958/59...   	
8
Total as at April 1st, 1960
2,295|1,778| 4,073
811
608| 1,419
506
517| 1,023
3,612| 2,903] 6,515
Admissions—
First admissions to Mental Health
Services    	
Readmissions to different institution
Readmissions to same institution.	
844
105
471
893
164
512
1,737
269
983
97
3
14
75
2
13
172
5
27
78
1
1
1
1
221    100
1         2
.._... |        1
1,019
109
486
990
167
525
2,009
276
1,011
1,420
63
1,569
38
2,989
101
114
116
90
1
204
117
80
187
231    103
146|    333
1,614
366
1,682
185
3,296
Transfers in 	
551
Total admissions to individ-
1,483
1,607
3,090
230
91
321
267
1
169j    436
1
1.9801 1.867
3.847
Total under care  	
3,778|3,385| 7,163
1,041
6991 1,740
773
686|1,459
5,228|4,585| 9,813i
Separations—
Discharged in full	
Died 	
1,283
124
111
9
1,390
60
197
4
2,673
184
308
13
36
11
17
1
45|      81
10|      21
61      23
4
156
8
95
12
251
1,323
291
128
9
1,443
165
203
4
2,766
456
331
Escaped but not discharged—.	
._	
13
1,527
235
1,651
178
3,178
413
64
116
61
3
125
119
160
13
103]    263
4|      17
1,751] 1,815
3641     185
3,566
549
Total separations from indi-
1           1
1,762| 1,829| 3,591
180
641    244
173
I
107|    280
1            1
2,115|2,000| 4,115
Net increase or decrease 	
—194| -35|—229
+58| +35| +93
+94|  +62|+156
—42] +62] +20
Number  in   residence,   March   31st,
1960
9.0161 1 556
3,572
861
635
1,496
600
579
1,179
1
T 4771? 7701 f. 747
1 Total under care for all Mental Health Services includes total as at April 1st, 1959, plus the total admissions to individual institutions minus transfers out.
Note.—The first admissions shown in the tables for individual institutions may differ from the above figures
due to a different definition.
 J 24 MENTAL HEALTH SERVICES REPORT, 1959/60
BUSINESS MANAGER'S REPORT
F. A. Matheson, Business Manager
Attached hereto are the financial reports of the in-patient care units of the
British Columbia Mental Health Services for the fiscal year ended March 31st, 1960.
In addition to those relative to the well-established units at Essondale, New
Westminster, Colquitz, Port Coquitlam, Vernon, and Terrace, for the first time
statements are presented covering the financial activities of the Tranquille School,
which commenced operations during the fiscal year. The first patients were transferred to this new unit on July 8th, 1960.
The all-inclusive daily average population shows the greatest decrease to date;
the average number in residence during 1958/59 was 6,247.40, while the 1959/60
average as shown in Table A was 6,171.22, a decrease of 76.18 patients.
Gross operating costs for the year totalled $14,531,218.39, as compared to
$12,453,445.32 for the previous year.
This increase of $2,077,773.07 is made up of $382,794.98 more in service and
supply costs, the amount of $400,957.24 required to operate the Tranquille School,
and the balance of $1,294,020.85 being increase in salary expenditure due mainly
to salary increases granted by the Government and additional staff employed. As a
result of this increase in expenditure, our gross daily per capita cost increased from
$5.46 to $6.43.
Maintenance revenue dropped from $1,838,158.33 to $1,821,810.53, a
decrease of $16,347.80 during the fiscal period.
Dairy produce, meats, fruits and vegetables to a value of $397,553.18 were
purchased from Colony Farm during the year.
A total of $642,086.17 was expended on equipment, personnel, and staff
training under approved projects of the Federal health grants. A detailed statement
as per project accompanies this report.
I am pleased to be able to report that again this year a large number of improvements and additions to our plant and equipment were made. Some of the main
items of interest in this regard are as follows:—
The New Valleyview Building at Essondale was officially opened on May 22nd,
1959, and received the first patients on September 15th, 1959.
The new reservoir at Essondale was completed and hooked up to our water
system.   However, water from the new reservoir will not be introduced
into this system until such time as the Public Health officials give their
approval.
The East Lawn kitchen and main dining-rooms were completely renovated and
equipped.
Tenders were called for the construction of a new incinerator at Essondale.
Contract in the amount of $73,394 was let for the construction of two fire-
stairs, two bridges, and an additional four exits for the East Lawn Building, Essondale.
Contract in the amount of $ 16,243 was let for the construction of fire-escapes
in the following buildings:   VV 1, VV 2, and VV 3, Essondale.    This
job was completed before the end of the year.
Funds were released and work started on the following projects at Essondale:
Sterile Supply Centre, East Lawn Building; installation of bathing facilities, Ward F 1;   consolidation of Occupational Therapy Department,
Crease Clinic;  installation of additional toilet partitions, various wards.
The following new equipment was purchased for our transportation department
at Essondale:   New hydraulic garbage truck;  new forty-one-passenger
 HEADQUARTERS J 25
bus, replacing vehicle S.T. 35; new passenger-car, replacing vehicle S. 25;
new Vi-ton pick-up truck, replacing vehicle S.T. 41; new Vi-ton pick-up
truck, by Public Works Department.
Tenders have been called for the replacement of the Wilson Ranch barn,
Colony Farm.
New theatre-type seats were purchased and installed in two demonstration
rooms and the conference room of the new nurses' home and training
centre.    These seats completed the furnishing and equipping of this
building.
The old kitchen at The Woodlands School was completely renovated and
re-equipped.
Seven thousand five hundred dollars worth of new dental equipment was purchased for The Woodlands School out of the Mental Health Grants.
A new % -ton truck was purchased for The Woodlands School.
On the recommendation of the Medical Health Officer, a requisition for a new
battery-operated floor-washing machine was issued for The Woodlands
School.
The complete interior of the Mental Health Centre was redecorated.
New tile floors were laid in the lower East Ward at the Provincial Mental
Home, Colquitz.    These new floors completed the renovation of the
basement area.
New air-cooling units were installed on three of the wards at the Dellview
Hospital, Vernon.
A new hot-water tank was installed in the kitchen at the Dellview Hospital,
Vernon.
Work was started in connection with the installation of a fire sprinkler system
in all buildings at the Dellview Hospital, Vernon.
A contract was let and work started on the new headquarters office to be
located in the Provincial Health Building, Vancouver.
The Essondale laundry started on a seven-day week operation on October 5th,
1959.   In order to go on the seven-day week operation, it was necessary
to hire thirteen additional staff, and in addition thirty-four male patients
and sixteen female patients were required.   It is hoped that this seven-day
week operation of the laundry will greatly improve the laundry service.
The laundry is presently processing over 140,000 pounds of laundry each
week.
With the opening of the new Valleyview Building at Essondale, for the first
time we have waitresses working in the dining-rooms.   This has proven
to be most successful, and we are hoping to extend this service to other
areas.
I regret to advise that Mr. J. F. Anderson, Assistant Business Manager for
the Mental Health Services, retired on superannuation on August 31st, 1959.
Mr. Anderson's position is to be filled by Mr. N. K. Barr, who has been appointed,
effective April 1st, 1960, as Hospital Administrator for the Provincial Mental
Hospitals and Crease Clinic, Essondale.
I also regret to advise that Mr. H. C. Yardley, Deputy Business Manager,
Provincial Mental Home, Colquitz, resigned on April 19th, 1960. Mr. B. M.
Prette, stockman at the Provincial Mental Home, Colquitz, has been appointed,
effective April 1st, 1960, to succeed Mr. Yardley.
 J 26
MENTAL HEALTH SERVICES REPORT,  1959/60
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, 1950/51 to 1959/60.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1950/51
Provincial Mental Hospital, New West-
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
Provincial Mental Hospital, Essondale-.
2.73
3.71
Home for the Aged, Port Coquitlam
3.11
2.90
5.14
7.47
5,359.36
$6,235,527.93
$1,163.48
$3.19
1951/52
Provincial Mental Hospital, New West-
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
Provincial Mental Hospital, Essondale.—
Provincial Mental Home, Colquitz..	
Home for the Aged, Port Coquitlam	
3.15
3.94
3.62
3.91
3.47
9.95
5,562.54
$7,482,254.93
$1,345.11
$3.68
1952/53
Provincial Mental Hospital, New West-
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
Provincial Mental Hospital, Essondale—
3.54
4.17
Home for the Aged, Port Coquitlam.	
Home for the Aged, Vernon	
3.82
4.70
3.06
9.02
5,864.33
$8,552,755.77
$1,458.44
$4.00
1953/54
1,150.76
3,491.15
285.28
469.13
228.26
293.19
235.16
$1,768,922.31
4,393,682.65
421,622.61
683,511.48
378,006.20
330,968.40
788,302.36
$1,537.18
1,258.52
1,477.93
1,456.98
1,656.03
1,128.85
3,352.20
$4.21
Provincial Mental Hospital, Essondale—
Provincial Mental Home, Colquitz	
Home for the Aged, Port Coquitlam
Home for the Aged, Vernon.   -
3.45
4.05
3.99
4.54
3.09
9.18
6,152.93
$8,765,016.01
$1,424.53
$3.90
1954/55
1,204.60
3,517.75
285.74
527.33
230.72
296.42
238.63
$1,811,848.81
4,685,444.76
426,786.04
739,859.92
368,726.10
328,553.97
860,673.73
$1,504.11
1,331.94
1,493.62
1,403.03
1,598.15
1,108.41
3,606.73
$4.12
Provincial Mental Hospital, Essondale.—
Provincial Mental Home, Colquitz	
Home for the Aged, Port Coquitlam
Home for the Aged, Vernon	
Home for the Aged, Terrace  	
3.65
4.09
3.84
4.38
3.04
9.88
Totals for the year	
6,301.19
$9,221,893.33
$1,463.52
$4.01
1955/56
1,219.45
3,508.79
285.30
539.27
229.62
287.30
257.96
$2,032,263.32
5,377,708.34
428,248.27
797,392.10
371,438.14
351,087.68
935,501.07
$1,666.54
1,532.64
1,501.05
1,478.65
1,617.62
1,222.02
3,626.54
$4.55
Provincial Mental Hospital, Essondale	
Provincial Mental Home, Colquitz	
Home for the Aged, Port Coquitlam
Home for the Aged, Vernon	
Home for the Aged, Terrace	
4.19
4.10
4.04
4.42
3.34
9.91
Totals for the year - 	
6,327.69
$10,293,638.92
$1,626.76
$4.44
 HEADQUARTERS
J 27
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, 1950/51 to 1959/60.—Continued.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1956/57
1,232.48
3,503.60
284.81
541.83
232.58
288.45
232.85
$2,246,193.06
5,851,370.53
446,497.91
831,370.73
402,867.14
350,880.96
996,288.31
$1,822.50
1,670.10
1,567.70
1,534.38
1,732.17
1,216.43
4,278.67
$4.99
Provincial Mental Hospital, Essondale
4.58
4.30
Home for the Aged, Port Coquitlam _.
4.20
4.75
3.33
11.72
Totals for the year  	
6,316.60              $11,125,468.64
$1,761.31                $4.83
1957/58
1,266.21
3,410.79
285.36
538.56
231.34
288.63
235.31
$2,484,024.86
5,716,745.90
460,863.85
898,225.93
395,584.86
379,826.63
1,077,897.96
$1,961.78
1,676.08
1,615.03
1,667.83
1,709.97
1,315.96
4,580.76
$5.37
Provincial Mental Hospital, Essondale
Provincial Mental Home, Colquitz
Home for the Aged, Port Coquitlam
4.59
4.42
4.57
4.68
3.61
12.55
6,256.20        |      $11,413,169.99
$1,824.30                $5.00
1958/59
The Woodlands School 	
Provincial Mental Hospital, Essondale.—
1,377.31
3,301.84
282.99
539.13
226.33
282.92
236.88
$2,968,725.50
6,088,091.20
488,028.69
961,921.63
410,529.00
386,804.84
1,149,344.46
$2,155.45
1,843.84
1,724.55
1,784.22
1,813.86
1,367.19
4,852.01
$5.91
5.05
4 72
4.89
4.97
Home for the Aged, Terrace	
3.75
13.29
Totals for the Year -	
6,247.40              $12,453,445.32
$1,993.38
$5.46
1959/60
226.80
3,135.48
1,395.44
53.74
283.50
560.16
230.92
285.18
$1,233,254.59
6,672,849.09
3,443,231.64
400,957.24
523,480.74
1,400,239.30
444,975.54
412,230.25
$5,437.63
2,128.17
2,467.49
7,461.06
1,846.49
2,499.71
1,926.97
1,445.51
$14,86
5.81
6 74
Provincial Mental Hospital, Essondale....
20 39
Provincial Mental Home, Colquitz 	
Valleyview Hospital, Port Coquitlam
5.05
6.83
5 26
Skeenaview Hospital, Terrace	
3 95
Totals for the year  _	
6,171.22
$14,531,218.39
$2,354.68
$6.43
 J 28
MENTAL HEALTH SERVICES REPORT,  1959/60
Table B.—Summary Statement Showing the Gross and Net per Capita
Cost of the Patients in All Mental Health Service Institutions for
the Year Ended March 31st, 1960.
Gross operating costs—
Crease Clinic  $1,233,254.59
Provincial Mental Hospital, Essondale  6,672,849.09
The Woodlands School, New Westminster  3,443,231.64
Tranquille School, Tranquille   400,957.24
Provincial Mental Home, Colquitz  523,480.74
Valleyview Hospital, Port Coquitlam  1,400,239.30
Dellview Hospital, Vernon  444,975.54
Skeenaview Hospital, Terrace  412,230.25
Gross cost of all institutions  $14,531,218.39
Less collections remitted to Treasury       1,821,810.53
$12,709,407.86
Daily average population  6,171.22
Gross per capita cost, one year  $2,354.68
Gross per capita cost, one day  6.43
Net per capita cost, one year  2,059.46
Net per capita cost, one day  5.63
Revenue (Patients' Maintenance Collections) of the Mental Health
Services for the Past Ten Years
1950/51  $763,884.12
1951/52  928,398.83
1952/53  1,147,831.65
1953/54  1,300,056.89
1954/55  1,343,848.02
1955/56  $1,358,708.26
1956/57  1,546,266.32
1957/58  1,724,046.70
1958/59  1,838,158.33
1959/60  1,821,810.53
Table C.—Expense Statement of the Crease Clinic of Psychological
Medicine, Essondale, for Twelve Months Ended March 3 1st, 1960
Salaries, Supplies, and Operating
Expense
Net
Vouchered
Expenditure
as Per
Public
Accounts
Service and Supplies from
Other Departments
Headquarters
Public
Works
Department
Actual
Cost of
Operation
Yearly
per Capita
Cost
Travelling expense	
Office expense.  	
Medical care    	
Nursing and ward supplies..	
Dietary    -— —
Heat, light, water, and power	
Laundry 	
Cars and trucking— - 	
Occupational and recreational therapy.
Incidentals and contingencies 	
Buildings, grounds, etc  	
Totals  	
$1,671.72
7,350.53
258,896.15
656,292.50
171,436.65
24,000.00
9,600.00
8,523.90
28,368.80
17,668.95
$1,183,809.20
$5,007.19
724.38
$43,713.82
$5,731.57
$43,713.82
$1
12
258
656
171
24
9
8
28
18.
43.
,671.72
357.72
,896.15
292.50
,436.65
000.00
600.00
523.90
,368.80
393.33
713.82
$1,233,254.59
$7.37
54.49
1,141.52
2,893.71
755.89
105.82
42.33
37.58
125.08
81.10
192.74
$5,437.63
 HEADQUARTERS
J 29
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 HEADQUARTERS
J 31
Table H.—Expense Statement of the Valleyview Hospital, Port Coquitlam, for Twelve Months Ended March 31st, 1960
Salaries, Supplies, and Operating
Expense
Net
Vouchered
Expenditure
as per
Public
Accounts
Service and Supplies1 from
Other Departments
Headquarters
Public
Works
Department
Actual
Cost of
Operations
Yearly
per Capita
Cost
Travelling expense -
Office expense	
Medical care 	
Nursing and ward supplies-
Dietary..
Heat, light, water, and power-
Laundry^
Cars and trucking     _
Occupational and recreational therapy-
Incidentals and contingencies 	
Buildings, grounds, etc 	
Totals _   	
$794.56
15,230.74
138,080.76
805,576.28
234,645.99
63,083.75
14,800.00
8,252.50
7,284.82
44,665.34
$12,347.43
1,786.28
$53,690.85
$794.56
27,578.17
138,080.76
805,576.28
234,645.99
63,083.75
14,800.00
8,252.50
7,284.82
46,451.62
53,690.85
$1,332,414.74
$14,133.71
$53,690.85
$1,400,239.30
$1.42
49.23
246.50
1,438.12
418.89
112.62
26.42
14.73
13.00
82.93
95.85
$2,499.71
 J 32
MENTAL HEALTH SERVICES REPORT,  1959/60
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 HEADQUARTERS
J 33
Table K.—Expense Statement of the Preventive Services
for Twelve Months Ended March 31st, 1960
Child Guidance Clinic, Burnaby
Salaries :  $158,410.24
Office expense	
Travelling expense 	
Office furniture and equipment
Heat, light, power, and water ...
Incidentals and contingencies _.
Buildings, grounds, etc.	
Total
5,223.07
8,900.99
264.13
8,451.44
1,187.79
459.30
$182,896.96
Child Guidance Clinic, Victoria
Salaries  	
Office expense	
Travelling expense 	
Office furniture and equipment
Incidentals and contingencies ___.
Total
$37,726.50
888.17
1,817.34
377.41
248.88
$41,058.30
Mental Health Centre, Burnaby
Salaries    $ 161 ,"864.32
Office expense	
Travelling expense 	
Office furniture and equipment	
Heat, light, power, and water	
Medical care	
Dietary 	
Laundry	
Cars and trucking	
Nursing and ward supplies	
Occupational and recreational therapy
Incidentals and contingencies
  4,351.18
  2,763.81
  88.04
  8,365.39
  10,359.38
  6,464.87
  1,500.00
  2,844.21
  2,518.57
  1,393.15
  714.08
Buildings, grounds, etc.   39,174.54
Total  $242,401.54
Grand total, $466,356.80.
 J 34 MENTAL HEALTH SERVICES REPORT,  1959/60
Expenditures Made under Federal Health Grants for Province of
British Columbia, Year Ended March 31st, 1960
Assistance to the Provincial Mental Hospitals—
Equipment      $ 1,681.49
Staff ..   326,767.08
  $328,448.57
The Woodlands School, New Westminster—
Equipment     $7,491.01
Staff  108,352.11
 115,843.12
Child Guidance Clinic, Day Hospital, North Burnaby—Staff       10,785.00
Neurophysiological Research Unit at University of British Columbia—
Pharmacological analysis of pathways leading to diffuse enhancement of cortical electrical activity
of E. E. G. activation  $14,819.56
Identification and quantitation of aromatic compounds in schizophrenic urine     16,520.29
Central effect of biologically active factors in the
urine extracts of normals and schizophrenics    17,850.71
Disturbed metabolic pathways as casual factors in
schizophrenia     16,383.16
       65,573.72
Home for the Aged, Port Coquitlam (Valleyview Building)—
Equipment  $12,619.20
Staff       2,040.00
       14,659.20
Home for the Aged, Terrace (Skeenaview Hospital)—Equipment  555.25
School of Psychiatric Nursing  245.73
City of Vancouver mental-hygiene programme       26,731.00
Vancouver General Hospital        4,492.26
Assistance to the epileptic programme in British Columbia         9,665.61
General personnel training—
Short courses in mental health  $6,104.79
Postgraduate training in psychiatry   49,441.92
Mental Health Committee — Training for  senior
school counsellors      9,540.00
       65,086.71
Total  $642,08 6.17
 HEADQUARTERS J 35
PERSONNEL REPORT
J. Dowling, Personnel Officer
Considerable expansion in staff numbers has taken place during the fiscal year.
The highlights are as follows:—
(1) The approved establishment has been increased by 380 positions or 13.9
per cent.
(2) The number of employees filling established positions has increased by
270 or 10.2 per cent.
(3) The number of students authorized has been increased by 100 or 45.4
per cent.
(4) The actual student enrolment increased by 57 or 23.1 per cent.
Full details of these increases are provided in the tables appended to this report.
Over-all staff turnover declined by 2.8 per cent notwithstanding an increase in
turnover of 3.8 per cent at The Woodlands School and 2.5 per cent in the Skeenaview Hospital at Terrace.
While recruitment into the professional classifications continued to be difficult,
Table B shows gains in all but one of these classifications. The provision of more
opportunities for postgraduate training under Mental Health Grant bursaries is an
important factor in several of these gains.
The shortage of nursing personnel is a perennial problem intensified during
this fiscal year by major increases in bed capacity and the resultant expansion of
nursing services. The best way to remedy the shortage of nurses is to train more
nurses. To this end, five new instructor positions have been added to the faculty
establishment and there has been a substantial increase in the student enrolment, as
noted above. The full effect of these changes will not become apparent for several
years, but steady improvement should take place commencing in 1961.
The recruitment of non-professional staff has presented no real difficulties.
The Personnel Officer participated in the following projects during the year:—
(1) The reorganization of staff of the Valleyview unit, Port Coquitlam.
(2) The staffing of the Tranquille School for Mental Defectives for limited
operation, and the planning for expansion in this unit.
(3) A proposed reorganization of the housekeeping services connected with
nurses' and students' residences.
(4) The revision of personnel functions arising out of the proposed relocation
of the offices of the Deputy Minister and General Administration staff.
This will result in a decentralization of personnel work, considerable
change in procedures and paper routing, and substantial delegation to
unit business managers.
 J 36 MENTAL HEALTH SERVICES REPORT,  1959/60
STATISTICAL TABLES
Table A.—Summary Showing Over-all Staff Total in Relation
to Separation and Recruitment
Staff recruited, excluding students      832
Staff separated, excluding students      562
Increase       270
Total staff, excluding students, as of March 31st, 1960  2,927
Total staff, excluding students, as of March 31st, 1959  2,624
Transfers—
Tranquille Farm        30
Collections Office  3
  2,657
Increase      270
Monthly staff average, excluding students, 1959/60  2,841
Monthly staff average, excluding students, 1958/59  2,620
Increase       221
Male Female Total
Student enrolment as of March 31st, 1960       89        214        303
Student enrolment as of March 31st, 1959       67        179        246
Change   +22      +35      +57
Students, monthly average, 1959/60      261
Students, monthly average, 1958/59       207
Increase        54
Panels held during the year were as follows:—
Appointments and promotions—
Number of interviews      385
Number of competitions        91
Disciplinary—
Number of panels        12
Number of cases reviewed       21
 HEADQUARTERS
J 37
Table B.—Breakdown by Classification of Recruitment and Separation
Activity for the Mental Health Services, Excluding Student
Psychiatric Nurses.
Recruited
Physicians      24
Medical interns      10
Registered nurses  38
Female psychiatric nurses   139
Male psychiatric nurses   47
Female psychiatric aides  150
Male psychiatric aides  151
Teachers   2
Occupational therapists   6
Recreational therapists  9
Industrial therapists      	
Psychologists   5
Social workers   18
  3
  3
  45
  6
  34
  16
Dieticians  	
Cooks 	
Kitchen helpers
Clerks 	
Stenographers  ..
Trades  	
Laundry-workers 	
Miscellaneous professional  8
Miscellaneous technical   13
Miscellaneous    89
Farm labour  16
Separated
22
10
27
116
36
94
93
3
6
7
2
2
15
1
3
22
8
25
4
7
8
36
15
Totals
832
562
 J 38
MENTAL HEALTH SERVICES REPORT, 1959/60
Table C.—Summary of Staff Turnover
By Major Classification
Classification
1958/59
1959/60
Change
Per Cent
Per Cent
Per Cent
22.5
19.7
-2.8
35.2
21.8
— 13.4
9.1
8.4
—0.7
24.8
27.2
+2.4
33.8
32.5
— 1.3
Over all-
Student psychiatric nurses..
Male psychiatric nurses	
Female psychiatric nurses...
Registered nurses	
Note.—Items 1 and 2 have been calculated against the monthly average and other items have been calculated against the year-end staff totals.
By Unit
Unit
1958/59
1959/60
Change
Crease Clinic and Provincial Mental Hospital, Essondale  _	
Per Cent
21.7
17.3
21.6
18.8
41.6
22.0
28.9
Per Cent
18.5
6.0
25.4
10.0
37.6
24.5
27.7
Per Cent
—3.2
— 11.3
ThR 'Woodlands School
+3.8
—8.8
—4.0
Skeenaview, Terrace _  	
+2.5
— 1.2
Note.—Percentages calculated against year-end staff totals.
Table D.—Comparison of Staff Totals by Unit with Totals for the
Preceding Fiscal Year
Fiscal Year 1958/59
Positions in
Establishment as of
Mar. 31,
1959
Positions
Filled as
of Mar. 31,
1959
Fiscal Year 1959/60
Positions in
Establishment as of
Mar. 31,
1960
Positions
Filled as
of Mar. 31,
1960
General Administration	
Collections Office (transfer)..
Colony Farm-
Colquitz Farm.— — _
Tranquille Farm (transfer)..
Total of vote	
School of Psychiatric Nursing-
Preventive Services 	
Crease Clinic  —
Provincial Mental Hospital, Essondale..
The Woodlands School 	
Provincial Mental Home, Colquitz..
Tranquille School	
Total of vote— 	
Mental Health Centre  —
Valleyview Hospital, Essondale-
Dellview Hospital, Vernon	
Skeenaview Hospital, Terrace—
Total of vote 	
Total Civil Service positions-
Student psychiatric nurses.—
Totals  	
29
60
17
55
280
1,117
721
81
2,950
29
30
52
52
29
60
89
15
24
49
54
266
1,095
665
81
285
1,151
740
80
61
2,870
3,430
29
52
23
21
43
270
1,139
704
82
50
2,199
2,107
2,315
2,245
41
39
44
40
188
77
59
193
77
55
408
77
59
329
77
57
324
325
544
463
2,725
225
2,624
246
3,105
325
2,927
303
3,230
 HEADQUARTERS J 39
Table E.—Composition of Nursing Staffs by Unit as of March 31st, 1960
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	
42
16
6
10
1
7
7.4
12.4
1.7
5.4
2.6
63.6
156
40
135
80
10
3
27.3
31.0
38.8
43.5
26.3
27.3
171
24
9
10
29.9
18.6
2.6
5.4
202
49
198
84
27
1
35.4
38.0
56.9
45.7
71.1
9.1
571
129
The Woodlands School.       	
348
184
38
11
Totals     	
82
6.4
424
33.1
214
16.7
561
43.8
1,281
Male Division
Provincial Mental Hospital, Essondale	
1
273
186
49
82
38
46
6
10
2
5
48.2
47.6
33.9
59.4
50.5
31.6
23.3
100.0
20.8
45
25
10
9
11.7
24.3
4.1
9.9
155
29
150
26
36
13
32
19
40.1
28.1
62.0
40.6
39.6
68.4
74.4
79.2
386
103
The Woodlands School           .
242
64
91
19
43
2
24
Totals  	
1
0.1
424
43.5
89
9.2
460
47.2
974
Table F.—Summary of Establishment Changes during
Fiscal Year 1959/60
Positions
Division Added
General Administration        1
Collections Office (transfer)        3
School of Psychiatric Nursing       7
Provincial Mental Hospital, Essondale     34
Crease Clinic       5
The Woodlands School     17
Tranquille School     61
Provincial Mental Home, Colquitz       1
Mental Health Centre       3
Child Guidance Clinics	
Valleyview, Port Coquitlam  220
Dellview, Vernon	
Skeenaview, Terrace 	
Tranquille Farm staff (transfer)      29
Positions
Deleted
Totals	
381
1
Approved establishment as of March 31st, 1960  3,105
Approved establishment as of April 1st, 1959  2,725
Increase
380
 J 40 MENTAL HEALTH SERVICES REPORT,  1959/60
REPORT OF THE PROVINCIAL SUPERVISOR
OF PSYCHIATRIC SOCIAL WORK
Miss A. K. Carroll, Provincial Supervisor
Throughout the psychiatric hospital units of the Mental Health Services there
has been a significant increase over that of previous years in the number of patients
and their families to whom it has been possible to extend social services. This
situation applies particularly to the Provincial Mental Hospital, the Crease Clinic
of Psychological Medicine, and The Woodlands School; in all, it reflects very
positively the following factors:—
Recent additions to the social-work establishments in the aforementioned units.
The higher standards in regard to professional qualifications and experience of
social workers appointed to positions in these units.
The quality and availability of consultation and supervision in the social service departments in the units.
The soundness and practicality of staff development and in-service training
programmes in the social service departments. These have been concerned primarily with the use of both casework and group work skills in the treatment of
patients and with the integration of the social-work contribution with the therapeutic and administrative programmes in the institutional units.
The very effective level reached in organizational and administrative development of social services in these units.
The provision of operational and procedural manual materials in the social
service departments. The progressive advancement in over-all inter-disciplinary
planning of administrative and therapeutic programmes.
The general improvement in communications, both within the units and between the units and community over the past two years.
The evaluation and assessment of purposes, goals, and services in relation to
the treatment, adjustment, and rehabilitation of patients, and in relation to community responsibilities, which have engaged the attention of administrative and
Departmental personnel throughout the units of the Mental Health Services over
the past year.
QUALIFICATIONS OF SOCIAL SERVICE STAFF IN
PSYCHIATRIC HOSPITALS
During the fiscal year, research undertaken in relation to basic factors governing the acquirement of a near-adequacy standard in the areas of job proficiency
(motion) and work-flow in social service departments in the psychiatric hospital
units of the Mental Health Services indicated the following factors as important:—
Qualifications of Staff.—Experience of staff in the nature of the work to be
done (content of professional service, competency in method and techniques, general knowledge, and knowledge of setting).
Mobility in the social-work staff pattern.
Adequacy of staff pattern (that is, the ratio of social workers to the patient
group both in and out of hospital).
Adequacy of Departmental organization and administrative structure.
In relation to qualifications of staff, research findings revealed that (1) all
administrative social-work staff in the psychiatric hospital units were equipped with
basic minimal academic qualifications (that is, Master of Social Work degree);
(2) all casework supervisory social-work staff in these units had basic minimal
 HEADQUARTERS J 41
academic qualifications; and (3) of the social-work line staff, 64 per cent held a
Master of Social Work degree, 28 per cent a Bachelor of Social Work degree, and
8 per cent a diploma of social work.
The above findings denoted a marked advancement over the past nine years
in the standard of qualifications at the three job levels of social work. In 1950 in
these units, social-work personnel at both the casework supervisory and line social
worker levels were without basic minimal academic qualifications. Only one of
the social workers at administrative level had basic minimal academic qualifications.
In relation to the experiential aspect of social-work qualifications, research
findings indicated that (1) administrative social-work personnel averaged seventeen
years' experience in social-work practice, of which an average of ten years' experience had been in psychiatric settings in a responsible working relationship to
psychiatry; (2) casework supervisory personnel averaged ten years' experience in
social-work practice, of which an average of three years nine months had been in
psychiatric settings in a responsible working relationship to psychiatry; and (3)
social-worker line personnel averaged five years and seven months' experience in
social-work practice, of which one year and eleven months' experience had been
in psychiatric settings.
Research into the experiential background of social-work personnel employed
in these units over the last nine years indicated that in the year 1950 (1) administrative social-work personnel averaged eleven years in social-work practice, of
which an average of seven years' experience had been in psychiatric settings; (2)
casework supervisory personnel averaged seven years of social-work practice, of
which an average of four years' experience had been in psychiatric settings; and
(3) social-worker line personnel averaged five years six months in social-work
practice, of which an average of four years one month's experience had been in
psychiatric settings.
In regard to adequacy of Departmental organization and administrative structure, research findings revealed that over the past nine years many advancements
have been made in the organizational and administrative structuring of social service
departments in the hospital units of the Mental Health Services. These advancements bring the departments more nearly in line with the recommendations of the
American Psychiatric Association and encompass the following developments:—
(1) The social service departments in these units now operate as specifically
designed administrative departments, with a director or chief of social
work. This person is responsible to the Medical Superintendent in those
areas which involve the planning and administration of the social service
programme, and to the Clinical Director in those areas pertaining to the
co-operation of social work in therapeutic planning and programming,
and to the collaboration of social work in the multi-disciplinary treatment
approach to mental illness.
(2) Adequate financing for social service departments in the Mental Health
Services has been achieved. Additional funds for social-work library
services and use of social service index have been provided.
(3) Facilities have been provided such as sufficient interviewing space (with
the exception of space for interviewing patients residing in Greater Vancouver and surrounding centres), transportation facilities for patient
after-care supervision and visitation, telephone services for communication with patients and their families, and sufficient secretarial and clerical
services.
(4) A beginning social-work student training programme has been established.
 J 42 MENTAL HEALTH SERVICES REPORT, 1959/60
(5) Bursaries, through the auspices of the National Health Grant, have permitted social workers in the Mental Health Services and in the School of
Social Work to complete basic minimal training. After training, the social
worker is employed on a contractual basis in the Mental Health Services.
These bursaries have been awarded since 1948 and have been a major
medium for the recruitment of qualified staff.
EXTENSION OF SOCIAL SERVICES IN INSTITUTIONAL UNITS
Additions to social service staffs in the psychiatric hospital units during the
last fiscal year have resulted in the extension of social service coverage to patients
on admission to hospital, clinic, and training-school; the earlier detection of social
problems in the newly admitted patient and pupil groups; and an acceleration in
the provision of social services of a more nearly adequately sustaining and continuous nature to these patient-groups. As important as the aforementioned are in
the treatment of patients, the provision of after-care and rehabilitative social services for patients are of equal importance in the maintenance of an adequate therapeutic programme. Over the past nine years it has been difficult for social service
to discharge its responsibilities in the aforementioned areas of patient treatment,
due mainly to insufficient numbers of staff. The increased establishment for social
work has resulted in the development of after-care social services for custodial
patients and in the extension of rehabilitative social services to patients able to
return to their families and community.
The after-care service which the Provincial Mental Hospital and The Woodlands School social service departments have begun to develop over the fiscal year
is that of boarding-home and foster-home care for patients. Such facilities are
considered to be stages or extensions of the hospital and school treatment or care
programmes and are a responsibility of the total hospital, shared by the clinic team,
and similar to the hospital treatment programme.
Boarding or foster homes are of many types and include full or partial living-in
job placements, custodial foster homes, therapeutic foster homes and boarding
homes. The development in the Provincial Mental Hospital has been along the
lines of full- or partial-work home placements and custodial boarding homes.
These latter are generally located in a rural or semi-urban area and are used for
patients whose conditions are not likely to improve but who can live outside the
hospital or training-school and thus release a bed for the care of a patient in acute
need of treatment. Such custodial boarding homes provide, for the long-term mentally ill patient, a protected group-living situation as an extension of hospital care.
During the fiscal year the Provincial Mental Hospital social service department
has placed over fifty patients in custodial boarding homes. This has involved the
social-work staff in careful screening of patients for placement, as well as in close
and prolonged supervision of both the patients and boarding homes in which they
are placed. At the present time, boarding homes are obtained and financed through
Provincial and municipal social welfare departments on the understanding that the
necessary supervision be provided by the Provincial Mental Hospital. The city
social service department of Vancouver has for some years provided custodial
boarding-home care for patients who are residents of Vancouver and suitable for
this service. This social welfare department has always assumed full responsibility
for both the administration of the boarding-home programme and the supervision
of the patient in-care. However, in discharging these responsibilities, this authority
seeks the development of co-operative services to these patients through the extension of Mental Health Services out-patient clinics and day and night hospital-care
 HEADQUARTERS J 43
facilities. It is interesting to note that the co-operative services which the city social
service department of Vancouver has been offering custodial-care patients for many
years now is seen in the United States as a promising development in substitute care
of domiciliary mental patients.
In The Woodlands School the development of boarding-home care has been
necessitated by the following factors: The numbers of pupils who, having received
maximum training in self-care, are able to live outside the School in supervised
boarding homes, thus liberating much-needed beds for applicants awaiting admission to the care and for training facilities of the School; the numbers of adolescent
and adult pupils of slight or moderate mental subnormality who could be rehabilitated, but who need subsidized foster-home care for the purposes of accelerated
vocational training and experience, as well as opportunities for socialization prior
to job placement; and the numbers of adolescent and adult pupils of slight or
moderate mental subnormality who are at present partially earning, but who need
subsidized foster care until such time as they can become fully self-supporting. During
the last fiscal year the social service department of The Woodlands School assisted
sixty-nine pupils in return to community either by way of care and supervision of
their families or to employment placement. The further development of foster- and
boarding-home care in The Woodlands School is being studied and reviewed by administration and should be implemented in the course of the next two years.
CONTENT OF SOCIAL-WORK CONTRIBUTION IN PSYCHIATRIC
HOSPITAL UNITS
A recent study of the components of the social-work job indicated that the
following functions are of major concern:—
1. Admission services which involve the evaluation of the patient and his
family in relation to:—
(a) The patient's personality assets and liabilities.
(b) The existence and stability of the patient's family group.
(c) The patient's realization of his illness.
(d) The family's awareness of the patient's illness, the effect of the illness, the
response to the illness.
(e) Patient's desire to regain mental health.
(/) The family's desire for the recovery of the patient.
(g) The meaning that illness has for the patient.
(h) The patient's place in the family.
(i)  Changes in the family due to the illness.
(/') Vocational adjustments for the patient and his family which his hospitalization has necessitated.
(k)  Financial problems caused by the patient's illness.
(I) How the family is to be maintained during the patient's treatment; how
treatment is to be paid for.
(m) Patient's rehabilitation needs.
(n) Patient's need for protective care.
(o) Patient's ability to use and carry out medical recommendations.
(p) The degree to which the family understands the illness and the importance
of medical recommendations.
(q) The need for medical or psychiatric treatment by other members of the
family.
(r) Resources in patient, family, and community for use in patient's rehabilitation.
 J 44 MENTAL HEALTH SERVICES REPORT,  1959/60
2. Casework services to patient and family during hospitalization. Over the
past nine years there has been a 30.2-per-cent increase in the number of patients
in receipt of social services. Also, the incidence of patient interviews during hospitalization has increased from 1.2 per patient referred to social services during the
year 1950 to 3.6 per patient active with social service during the year 1959.
3. Discharge-planning and after-care social services. Over the past nine years
there has been a 24.8-per-cent increase in the number of patients to whom social
services of a discharge-planning and after-care nature have been extended. The
functions of social-work treatment and discharge services constitute some 53.5 per
cent in the functional time distribution of the social-work job in the psychiatric
hospital settings, whereas 46.5 per cent of social-work job time is distributed among
the functions of case-load administration, staff development, community education,
and social-work research.
RECRUITMENT AND TRAINING FOR THE SOCIAL-WORK JOB IN
MENTAL HEALTH SERVICES
Recruitment of professional social workers to the staffs of psychiatric institutions in Provincial mental-health programmes is generally considered difficult. This
is said to be due to such factors as large case loads, scarcity of social workers for all
social welfare positions, the use of large numbers of non-professional workers, inadequate salaries, lack of recognition and status of social work in institutions, the isolation
of institutions from the community, and the lack of adequate communications between
departments in the institutions and between the institutions and the community it
serves. Over the years of development, and these number thirty, the social service
departments in the hospitals and out-patient clinics, with the understanding and support of administration, have worked through many of these difficulties of structure,
organization, and administration. As a result, those positive factors, which make
the psychiatric hospital a source of excellent professional experience, are very much
to the fore in the recruitment of social service personnel to-day. The fact that there
are so many patients who are able to use and benefit from treatment, including
social-work treatment—patients who are highly motivated toward regaining health
and returning to community—provides a great challenge to social workers; that
psychiatric hospitals are laboratories rich in psychological and socialogical learning;
that working in close relationship with many other professions is a stimulus to the
redefining, refinement, and advancement of professional competency; and that the
social worker is afforded full scope in the application of ingenuity and skills in planning and programming—all tend to offset recruitment difficulties. Over the last ten
years the availability of bursaries for training social workers under the National
Health Grant for work in psychiatric settings has afforded the Mental Health Services a most valuable medium for the recruitment of staff. It has also tended to
place the Mental Health Services in somewhat of a preferred position in the competition with other health and welfare agencies in attracting available social workers.
However, this preference is somewhat tempered by the fact that social work in the
family and child welfare fields has prime preference among School of Social Work
graduates. During the fiscal year ten social-work student personnel were recruited
through the medium of Federal Mental Health bursaries. These permitted the students to complete basic minimal academic training. Of this number of students,
four received academic awards for scholarship. During the fiscal year all social-
work vacancies in the psychiatric hospitals were filled. Additional positions were
likewise filled. A large number of the latter were filled by the awarding of National
Health Grant bursaries to social-work students in the bachelor year.   These students
 HEADQUARTERS J 45
are contracted for service in May, 1961, on the completion of the requirements for
the Master of Social Work degree. In collaboration with the Personnel Officer of
the Civil Service Commission, a board recruitment programme has been developed
which includes media of education and interpretation, advertisement, and contacts,
both personal and by correspondence, with graduate schools of social work across
Canada and with the Provincial and National bodies of the Canadian Association
of Social Workers.
The training programme for student social workers, affording, as it does, contact with professional and student personnel of the University of British Columbia
School of Social Work, is additionally an excellent medium for recruitment of staff.
During the fiscal year, six student social workers had their field-work practice placement in the psychiatric hospitals and out-patient clinics of the Mental Health
Services.
SOCIAL-WORK CONSULTANT SERVICE
The Branch administration provides a social-work consultant service to the
psychiatric hospitals, clinics, and out-patient units of the Mental Health Services.
The consultant visits the social service departments throughout the Services approximately once a week. During the fiscal year the consultant was engaged on an average of fifty-one hours per month in direct consultative service. These concerned
social service departmental administration; adequacy of present social service staffing patterns; development of techniques and approved content for summarized
records; consideration of a uniform system of social service statistical reports to
reflect the range of direct social services and other social-work functions and responsibilities; individual and group consultation; the uses of these processes in the development of senior staff; districting for social services; boarding- and foster-home
programme; criteria for selection of patients and homes.
During the year the consultant completed a levels manual for the use of field
social workers in the voluntary and public health and welfare agencies which cooperate with the Mental Health Services in services to mental patients and their
families.
The consultant gratefully acknowledges the valuable contribution made by all
levels of social-work staff in the advancement of standards of practice and in the
extension of social service coverage of patients' needs. Particularly outstanding has
been the work of unit social-work supervisors and their casework supervisory staff.
The results of these combined efforts have had far-reaching therapeutic value to
patients, their families, and community.
 J 46 MENTAL HEALTH SERVICES REPORT, 1959/60
REPORT OF THE DIRECTOR OF NURSING SERVICES
Miss B. J. Mitchell, Director of Nursing Services
The Mental Health Services share with most other psychiatric hospitals the
problem of recruiting sufficient nurses to maintain and improve existing nursing
services and to permit expansion of treatment facilities. This problem of numbers
is coupled with the felt need of many nurses for instruction in the principles and
practices of nursing, especially in the more recent concepts of psychiatric nursing
and in the care and training of the mentally defective child. A realistic assessment
of the problem and of the measures which can be taken to improve the situation has
been made. This report will describe some of the steps which should, in the long
view, alleviate many nursing situations, but there lie ahead many similar projects
before one can permit any feeling of complacency to lessen the struggle of finding
solutions to nursing problems. The activities focused in the Department of Nursing
Education are outlined first, followed by an account of the activities of the Director
of Nursing Services.
DEPARTMENT OF NURSING EDUCATION
Through a study and reorganization of the School of Psychiatric Nursing, this
department became clearly responsible for all the formal courses offered to nurses
and nursing personnel by the Mental Health Services and is now appropriately
called the " Department of Nursing Education." The organization was developed
so that each educational programme is the responsibility of a senior instructor.
With the increased appropriation provided in the 1959/60 budget, it was possible
to plan for the expansion and improvement of existing programmes and for the
initiation of others. Without adequate instructors it is impossible to put the best-
laid plans into effect. Fortunately, concerted effort capitalized on the increased
interest of nurses in the psychiatric field and six well-prepared instructors and an
Associate Director of Nursing Education were recruited. Then, too, opportunities
offered by the reorganization presented their own appeal.
A few of the major changes and activities associated with each educational
programme are listed:—
1. Psychiatric Nursing Course.—(a) Sixty-three students (forty-nine women
and fourteen men) received their diplomas on April 16th, 1959, at the Vincent
Massey Junior High School auditorium. Professor William Dixon, Director of the
School of Social Work, University of British Columbia, gave an interesting address
to the graduating class.
(b) The number of applicants for the two-year course has been growing
steadily. Each month over 100 people, at their own request, receive information
and application forms for the course. It is possible to enrol larger classes in the
spring and fall of the year; for example, sixty-four women and twenty-three men
in August and fifty-seven women and twenty-eight men in February. Even more
important, students who have an academic standing greater than Grade X and who
show aptitude for psychiatric nursing can be selected. In November, 1959, a survey of the 253 students enrolled in the course revealed that 24.9 per cent had
University Entrance and 31.2 per cent had Grade XII (General Programme). The
Nursing Counsellor and other instructors participated in ten Occupation Days held
at the high schools in the Lower Mainland.
(c) Beginning in August, a long-awaited clinical teaching programme was
introduced for both the psychiatric nursing students and affiliating students in three
 HEADQUARTERS J 47
hospital buildings. The five clinical instructors gave individual and group instruction on five wards and participated in the classroom teaching of several subjects.
This co-ordination of the theoretical and practical aspects of the curriculum will
be further emphasized in the coming year.
(d) The rotation plan for the clinical experience of students was reviewed by
a committee composed of nursing service and nursing educational personnel. Several changes were introduced for the mutual benefit of students and the three hospitals where students gain experience. The most notable of these was the three-
month programme of instruction and nursing practice planned and conducted by
the staff of The Woodlands School for the students following their second-term
classes. Plans for 1960/61 include the establishment of a clinical instructor at
The Woodlands School to maintain and expand this successful venture.
2. Affiliation Programme in Psychiatric Nursing.—(a) In co-operation with
six schools of nursing in general hospitals, the Registered Nurses' Association of
British Columbia, and the School of Nursing at the University of British Columbia,
the affiliation programme was revised and expanded from eight to twelve weeks
(commencing March 7th, 1960), in line with the programmes offered in the other
Provinces in Canada. Beginning in July, a class of twenty-five nursing students
will arrive at Essondale every six weeks throughout the year.
(b) The nursing students from the University School of Nursing were enrolled
in the May and June programme, and with the leadership and guidance of Mrs.
Margaret Neyland, their lecturer in psychiatric nursing, they spent half of their
clinical experience on four wards in the Men's Division. This marked the first time
that women nursing students had been placed on wards for men patients. Plans
have been made to continue this placement during the coming May.
3. Orientation of Students and Nurses to the Mental Health Services.—(a)
A total of 175 nursing students from the general hospital school of nursing visited
the Education Centre on seven different days. Their orientation programme was
varied to include participation in patient activities arranged by the affiliating
students.
(b) Fifty nurses from Shaughnessy Hospital visited the department on October 13th and 15th.
4. In-service Educational Programmes.—Several instructors participated in the
in-service education programme arranged by the nursing services in the Crease
Clinic and Mental Hospital. In addition, Miss W. Van Est gave eight lectures to
Occupational Therapy staff and Mrs. I. Smith held eleven lecture-discussions with
the nursing staff in the North Lawn Building.
5. Post-basic Course for Senior Psychiatric Nurses.—In the past years, several
in-service courses have been arranged for psychiatric nurses in supervisory and
charge nurse positions. These have been useful but were not thought to be comprehensive enough. Planning for the post-basic course for senior psychiatric nurses
began in January, and eighteen students, selected by nursing services from the
thirty-five applicants, commenced the course on March 28th. The lectures, discussions, and tours will be held three afternoons a week for three months. It is hoped
that a similar kind of course will be available for senior psychiatric nurses in other
units.
6. Psychiatric Aide Training Programme.—It is recognized that all members
of the nursing staff need instruction in order to provide the best nursing care for
patients. Plans are under way to develop an aide-training course for both men
and women psychiatric aides.
 J 48 MENTAL HEALTH SERVICES REPORT,  1959/60
LIBRARY
A library committee was formed to review the policies and procedures used
in maintaining the library in the Education Centre. With the appointment of a
clerk to act as librarian, it was possible to give adequate supervision of the library
and develop a cataloguing system for the books and journals. Seventy new books
were purchased for the library through a Mental Health Grant. In November the
library was opened two evenings a week, first under the supervision of an instructor
and then with the assistance of a home supervisor. With the greater emphasis on
seminars, assignments, and student-presented clinics, the students need to make
greater use of the books and journals in the library.
PSYCHIATRIC NURSING STUDENTS' ACTIVITIES
This year's students' council met almost every week and was responsible for
initiating and co-ordinating many social and recreational activities for students. The
first issue of the " Students' Voice " was published in November, and in December
a house committee was organized to discuss and deal with problems of the residences.
STAFF CHANGES
The many staff changes in the Department of Nursing Education during the
year added its inevitable stresses to the co-ordinated functioning of the Department.
Miss Morna Kenny, Associate Director of Nursing Education since August 13th,
1956, left the Department on June 30th. Both Mr. W. Dunbar and Mr. R. Nash
transferred to the supervisory staff of the Crease Clinic and Mental Hospital. Miss
Margaret Lonergan was appointed to the position of Associate Director of Nursing
Education, but was enrolled in graduate studies at the University of Washington
until April, 1960. Mrs. E. Paulson was appointed to the new position of Assistant
Director of Nursing Education, but during her illness Mrs. E. Gibson, Nursing
Counsellor, took charge of the Department. Miss W. Van Est left in September
to take the diploma course in teaching and supervision at the University of British
Columbia. Mrs. I. Smith was appointed senior instructor for the affiliate programme.
OPEN HOUSE
On June 23rd a tea and open house held in the spacious lounge of Nurses'
Residence 11 permitted the staff of the Department of Nursing Education to express
their appreciation to all the personnel of the Mental Health Services who participated in the various educational programmes for nursing students.
REPORT OF DIRECTOR OF NURSING SERVICES
Considerable effort has been spent in assisting with the changes in the educational programmes in the Department of Nursing Education. The opportunity
to work more closely with the teaching staff and students has been a privilege and
a challenge.
Several activities related to the recruitment of nurses for the Mental Health
Services can be listed, as follows:—
(1) Circulation of notices to the nursing staff asking their assistance in the
recruitment of nurses.
(2) Writing and submission of advertisements for nurses to the Civil Service
Commission.
 HEADQUARTERS
J 49
(3) Interviewing of nurses who seek information about opportunities in the
Mental Health Services.
(4) Assisting the Civil Service Commission with the placement of the graduate psychiatric nurses through the use of employment preference slips
and with the knowledge of the priority needs of the nurses in the different
units.
(5) Assisting with the establishment of a psychiatric ward where registered
nurses interested in psychiatric nursing may be employed.
Consultation around various topics and problems has been made available to
the senior nursing personnel at Valleyview Hospital, Crease Clinic and Mental
Hospital, The Woodlands School, and the Mental Health Centre. The first unit
nursing conference was held on December 15th. The Superintendents of Nurses
and Chief Psychiatric Nurses present decided that the conference should be held
every three months for the purpose of discussing mutual problems and sharing information. Through the conference vehicle, plans have been formulated to set up
representative nursing committees, both standing and task-orientated.
Assistance has been given to co-ordinate and, at times, initiate the attendance
of nurses at institutes and university courses. Forty-eight nurses from the Mental
Health Services attended fifteen different institutes held in Vancouver and Seattle.
In October the Director of Nursing Services attended the Mental Hospital Institute
in Buffalo and spent four days visiting the Mansfield Training School and Hospital
in Connecticut. Arrangements were completed to enable six nurses to attend university with Mental Health Grant bursaries.
Membership in several professional committees assisted in the process of keeping abreast of some of the recent developments in nursing education and service,
and enabled one to contribute to the planning for local institutes and to the Provincial instructors' group's project for the year, " Current Psychiatric Concepts as
Applied to General Nursing."
The year has been busy, and at times hectic, but the enthusiastic interest and
hard work of the nursing personnel has made it an immensely satisfying experience.
L
 J 50
MENTAL HEALTH SERVICES REPORT, 1959/60
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 ninth year of service
to the mentally ill of British Columbia with the fiscal year ended March 31st, 1960.
The Crease Clinic has functioned efficiently, and all departments have operated
at capacity during the year. Residental intensive treatment care is provided for
those patients believed capable of benefiting from four months or less of psychiatric
treatment.
Incoming patients are screened by the admitting duty doctor and a senior medical staff member, who may assist the community doctor regarding the suitability of
the patients considered for admission to the Crease Clinic. Voluntary patient admissions are encouraged and are showing a satisfactory increase in numbers each
year. Those patients requiring longer than four months' treatment and care are
referred to the Provincial Mental Hospital, Essondale, where voluntary admissions
are also being encouraged.
Examination of the following table, which is a summary of the movement of
population in the Crease Clinic for the year ended March 31st, 1960, shows that the
number of patients admitted (1,464) was average, and was twenty-eight admissions
less than the previous year's total of 1,492 patients.
Male
Female
Total
107
621
452
169
391
278
113
607
585
22
1
120
134
843
606
237
495
369
126
830
799
31
2
145
241
1,464
1,058
Readmissions  -	
406
886
647
Readmissions   -
239
1,437
1,384
53
Deaths during year...	
Total in residence, March 31st, 1960  .	
3
265
The voluntary admission rate to the Crease Clinic shows a further increase
from 834 or 56 per cent in the previous fiscal year to 886 or 61 per cent of the total
patient admissions to the Clinic for the fiscal year ended March 31st, 1960. The
trend continues for women to constitute the greater number of admissions to the
Crease Clinic. The table shows 621 male and 843 female patients were admitted;
that is 222 or 15 per cent more female patients. This is a slight decrease from the
previous fiscal year's figure. An increase of five male patient admissions over the
previous fiscal year is noted.
It is interesting to note that during the years 1952 to 1959, inclusive, the average number of patient admissions to the Crease Clinic has been greater during the
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL J 51
first six months of the year (January to June, inclusive), January and May being
the months of the highest number of patient admissions and October and December
the lowest.
The total patient separations from the Clinic continued to be very good. A
total of 1,440 separations is noted for the fiscal year ended March 31st, 1960. Fifty-
three of these patients were admitted to the Provincial Mental Hospital for continued
treatment, or 3.7 per cent of the discharges. This compares with 5.7 per cent in the
previous year. One thousand three hundred and eighty-four or 96.3 per cent of the
patients were discharged directly to the community.
This past year has been a period of further improvement in the treatment and
care of the mentally ill of this Province.
The Crease Clinic has six wards for patient treatment and care. Five of these
wards are now classed as open wards, permitting a further degree of freedom to the
patients and free access to the surrounding hospital grounds.
All patients admitted to the Crease Clinic, whether voluntarily or certified,
retain their civil rights, with the exception of those very few patients who, in the
opinion of their Clinical Director, are too sick mentally to properly look after themselves or their own affairs. The total patient programme has operated very effectively under the able direction of Dr. F. G. Tucker, Clinical Director. For further
details refer to Clinical Director's report.
The many improvements and changes in our patients' treatment, housing, and
care are reflected favourably in their improved status, attitudes, and record of discharges to the community.
The operating-room, Department of Neurology, and medical library provide
service for the whole of the Provincial Mental Health Services and frequently provide service to several Provincial and Federal institutions. These services are
located in the Crease Clinic.
Operating-room
Dr. I. Holubitsky and Dr. S. Vandrick were the resident surgeons during the
past year. During their six-month rotations, each resident has provided examinations of patients requiring surgical investigation and follow-up of all patients who
had surgical procedures.
This department has again been very active. The patient bed accommodation
on the surgical ward has been used to capacity. The operative procedures in summary were:—
General surgery, major      104
General surgery, minor      222
Neurological surgery         39
Orthopaedic surgery        77
Genito-urinary surgery        88
Chest surgery  10
Ear, nose, and throat surgery  32
Eye surgery ,  30
Plastic surgery  22
Dental surgery  9
Plaster casts  34
Blocks  7
Total surgical procedures     674
Total pre- and post-surgery examinations  2,315
 J 52 MENTAL HEALTH SERVICES REPORT,  1959/60
Department of Neurology
The services of the Department of Neurology, under the direction of Dr. W. P.
Fister, have been fully utilized. It has provided daily clinical and laboratory services for in-patients of the Provincial Mental Hospital and the Crease Clinic. In
addition, an increasing number of former patients were followed up on an outpatient basis. As before, The Woodlands School and Mental Health Centre availed
themselves of this department in a consultative capacity. A number of inmates
from the Girls' Industrial School, Oakalla Prison Farm, the Haney Correctional
Institution, and New Haven were examined. Forty-one patients were intensively
investigated for the suitability for neurosurgical interventions and subsequently had
pertinent neurosurgical procedures carried out by Dr. Frank Turnbull.
Dr. E. V. Mellor has assisted in the interpretation of E.E.G. recordings and in
the carrying-out of pneumoencephalograms. An increasing number of patients
had other diagnostic measures done, such as ventriculograms and angiograms. In
addition, a number of lectures and clinical demonstrations were arranged for medical students, affiliated nurses, and auxiliary personnel.
A detailed account of the laboratory studies for the fiscal year is tabulated
below:—
Electroencephalograms   1,287
Pneumoencephalograms       263
Operations         41
Lectures—
Seventeen medical students  2
Affiliates   8
Occupational therapists  1
Postgraduate psychiatric residents, Vancouver General Hospital   4
Auxiliaries   1
Industrial Relations Board  1
The 1,287 electroencephalograms were done for the following groups: —
Provincial Mental Hospital  472
Crease Clinic  480
The Woodlands School  139
Girl's Industrial School   41
Oakalla   29
Out-patients  56
Staff   9
Haney Correctional Institute  5
New Haven   1
Mental Health Centre  55
Total  1,287
Library
The patients' library is maintained at about 3,000 books, and the 235 new
books which were ordered balanced a similar number worn out and replaced.
Circulation was 8,860, and books and magazines were made available to all patients
in the Crease Clinic, Provincial Mental Hospital, Valleyview and Riverside units
either directly, through inter-hospital mail, or by volunteers.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL J 53
One hundred new books were added to the 2,000 in the medical library, and
thirty-five borrowed from the University library on inter-library loan. Circulation
was 775, exclusive of the eighty medical journals received. Reference work is
increasing, and a considerable number of bibliographies were prepared for the
medical staff.
 J 54 MENTAL HEALTH SERVICES REPORT, 1959/60
REPORT OF THE PROVINCIAL MENTAL HOSPITAL,
ESSONDALE
REPORT OF THE MEDICAL SUPERINTENDENT
T. G. Caunt, Medical Superintendent
The Provincial Mental Hospital has completed another very active year of
service. This was the eighty-seventh year of continuous service provided for the
mentally ill of British Columbia since the conversion of the Royal Hospital in Victoria into the first " Provincial Asylum " on October 12th, 1872. This was the
beginning of the Mental Health Services of this Province.
All departments of the Hospital have been fully utilized and have operated
efficiently.    Patient treatments, housing, and care are constantly being improved.
The Mental Hospital's objective is patient care and rehabilitation, and the most
important person in the Hospital is the patient.
I am very happy to report that I have received at all times the fullest co-operation and support from all staff members in all departments of both the Crease Clinic
and Provincial Mental Hospital. All staff positions are important and all types of
work are important and vitally necessary to the attainment of the Hospital's objective. I am very appreciative of the splendid total staff contribution throughout the
year.
There have been many improvements in patient housing, treatment, and comfort in addition to an increase in numbers and improvement in quality and efficiency
of personnel.
There is a great increase in in-service training and education in Hospital staff
in addition to those staff members attending courses in the community. These
activities have further enhanced our staff attitudes and objectives, and are reflected
in an improved type of patient care with an improved rate of patient recovery and
separation from Hospital.
We are most fortunate in the appointment of Dr. F. G. Tucker as Clinical
Director, who is responsible for the Crease Clinic and Provincial Mental Hospital
clinical team.
More patients have grounds privileges. Seventeen of the twenty-five women's
wards (that is, 68 per cent) are open, and fourteen of the twenty men's wards (that
is, 70 per cent) are open. Over 2,400 patients, or 74.6 per cent, have grounds
privileges. Very large numbers of patients leave the Hospital on visits to the community for the day, a week-end, or longer. Such visits to the home or community
are therapeutic and assist in the patient's subsequent discharge and rehabilitation in
the community. Many more interested relatives, friends, volunteers, and organizations in the community are visiting the Hospital and Clinic. This is encouraged and
is permitted every day between 2 and 4 p.m., and 7 and 8 p.m. Tuesday evening.
Increased visiting by the public is another favourable indication of the increasing
awareness and interest of the community in the problems of mental illness and the
services provided by the Provincial Mental Health Services for their treatment. All
these changes tend to improve the patient's status. This is favourably reflected in
our patients' and staff's attitudes, and also in the community as a whole in matters
concerning mental health.
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, 1960:—
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
J 55
Men
Women
Total
Total in residence, April 1st, 1959     	
Admissions during the year  — —
1,822
835
1,457
764
3,279
1,599
Discharges during the year.    — —— 	
902
112
738
58
1,640
170
1,014
796
1,810
In residence, March 31st, 1960  . - -	
1,608
1,411
3,019
In residence, April 1st, 1959—
	
	
1,822
Women        	
Remaining on probation    	
1,457
263
7
Total on books, April 1st, 1959 - -	
3,549
Admissions from April 1st, 1959, to March 31st, 1960 	
1,599
         |         	
5,148
Admissions—
Ordinary   „    	
508
11
212
6
1
82
9
2
4
516
8
218
3
12
3
4
1,024
19
430
9
1
Order in Council  	
94
9
5
4
4
835
764
1,599
The admission services have been extremely busy this year, when 1,599 patients
were admitted. This is an increase of 232 over the preceding year's figure of 1,367
and is a larger increase than the total of increases in patients' admission rates for
the last four years combined.
The male patient admissions increased by 64 to total 835 and the female
patient admissions increased by 168 to total 764. This is the greatest number of
patients ever admitted to the Provincial Mental Hospital, Essondale.
It has again been possible to reduce the number of patients in residence. The
total in residence at April 1st, 1959, was 3,279, and the total in residence at March
31st, 1960, was 3,019, a reduction of 260.
This is a very splendid separation rate and creditable achievement, which does
indicate the effectiveness of the intensive treatment programme. This reduced in-
residence figure of 3,019 on March 31st, 1960, is especially noteworthy in view of
the increased number of patient admissions noted above, which in effect means the
total patient count was reduced 491.
Only fifty-three patients, twenty-two men and thirty-one women, were transferred from the Crease Clinic to the Provincial Mental Hospital (that is an average
of less than five patients per month) this year. This is a marked reduction over the
previous year's figure of eighty-five patients. Residence in the Crease Clinic is limited to a four-month period. Those few Crease Clinic patients requiring a longer
period of treatment are transferred to the Provincial Mental Hospital.
The percentage of patients recovered or improved, as compared to admissions,
was 76.2 per cent. This compares with 75.1 per cent the previous year. The percentage of deaths to the number under treatment was 3 per cent. The percentage
of discharges to admissions (exclusive of deaths) was 102.6 per cent. This is an
increase over the previous year's figure of 100.2 per cent. The average daily patient
population was 3,135.8. This is a reduction of 166.36 from the previous year, when
the daily average population was 3,301.84.
During this year ninety-five Order in Council patients were admitted from the
Courts or Provincial gaols. On March 31st, 1960, there were thirty-nine Order in
Council cases in hospital at Essondale.
 J 56 MENTAL HEALTH SERVICES REPORT,  1959/60
During this year the admission rate of Federal cases requiring psychiatric treatment remained fairly constant. Requests for service were most frequently received
from the Department of Veterans' Affairs and the Department of Indian Health
Services.    On March 31st, 1960, the following Federal cases were in residence:—
Department of Veterans' Affairs  223
Imperial veterans (D.V.A.)        1
Indian Health Service     75
Yukon Territorial Government     24
British Columbia Penitentiary        2
Total  325
This total is down thirty-four from the previous year's figure of 359. It is noted
the Department of Veterans' Affairs figure is reduced by thirty-four.
Clinical Services
Dr. F. G. Tucker was appointed Clinical Director on July 1st, 1959, succeeding Dr. I. S. Kenning, who left the Provincial Mental Health Services.
The clinical services have functioned extremely well. All departments have
been very active because of the increasing numbers of patients admitted who required
psychiatric treatment and care, and because of the more complete type of psychiatric
service being provided.
The clinical team has functioned very well, and there has been excellent cooperation between all the divisions and members of the group.
" The Vista " for women and " The Venture " for men, the two rehabilitation
homes in Vancouver, have both had a good year, assisting in the rehabilitation of
our patients into the community.
We were very pleased to have Dr. T. J. Hennelly, specialist in psychiatry, join
our clinical staff.   He is a valuable addition to the clinical team.
In the clinical treatment area, all proven types of therapy continue to be used
successfully.
Patients requiring treatment for tuberculosis are transferred from all divisions
of the Provincial Mental Health Services to the North Lawn Building at Essondale.
Dr. Kilgour, specialist in charge, with his staff, has a very active and effective programme in operation. The number of active cases is markedly reduced. A most
valuable service is provided to our patients and staff by the members of this unit.
It is gratifying to note that four of the five wards in the North Lawn Building are
now open wards.
Many improvements and advances have been made in patients' treatment and
care.   This is especially noticeable in the continued-treatment areas.
Nursing Services
Mrs. M. L. McKay, Superintendent of Nurses, Women's Division, Provincial
Mental Hospital and Crease Clinic, and Mr. R. H. Strong, Chief Male Psychiatric
Nurse, Provincial Mental Hospital and Crease Clinic, report an active year in their
respective divisions.
Women's Nursing Division
Through the co-operation of the various hospital departments, many changes
have taken place, new procedures introduced, wards reorganized, in-service education commenced, and personnel policies reviewed. Of note is the fact there is a
greater integration of activities between the men and women patients, a greater free-
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL J 57
dom in making their own decisions and in making their contributions to the various
projects which are organized. There is also the commencement of greater participation of different levels of staff in nursing matters, as well as a closer relationship
between nursing and the different disciplines.
On Ward J 4 the electroconvulsive therapy programme was reorganized in
January of 1960. This has resulted in better observation of patients and a smoother
functioning of the treatment period. Several research projects were carried out on
new medications also on this ward.
Coma insulin treatment was removed from the Women's Division of the Crease
Clinic to the male side in October. All patients now receive this treatment in the
one area, and this is proving successful with male and female nursing staff under
male staff supervision.
In January the men and women patients in the Crease Clinic commenced having their meals in mixed groups, with fewer restrictions regarding travel between
the dining-room and the ward areas.
Mixed dining has also commenced between men and women patients of West
and East Lawn. This is carried out on an irregular basis and usually made the
occasion of an evening's entertainment.
Remotivation has continued in North Lawn on a regular basis. It is still considered a valuable technique.
Ward H 5 now boasts a ward library, which has been donated by interested
individuals. It is for the use of the East Lawn Building and has been catalogued
by one of the patients, who also is responsible for its operation.
In an effort to stimulate interest in personal appearance, three " powder
rooms " have made their appearance in East Lawn as a result of a project sponsored
initially by affiliate student-nurses.
In June single grounds privileges were instituted, and this has been a happy
improvement.
Wards continue to open their doors. During the year three wards in East
Lawn, one in North Lawn, one in Centre Lawn, and the Surgical Ward in Crease
Clinic joined the ranks of those in this category.
It is also a matter of deep gratification to have Ward H 1 divided into two
wards and a charge nurse appointed to the new ward, F 1.
July was a time when staff from all departments with large numbers of patients
united to organize the most successful sports day yet. Staff members were permitted to bring their immediate families, and patients their visitors. It was the first
time that nursing staff have all worn civilian clothing to such an event, and it proved
an unqualified success.
In January the laundry went on a seven-day week, which has proved to be a
tremendous improvement over the previous service. A central supply has since been
organized, and although it has presented some problems, it is gradually acquiring
a smoother functioning and will be of great value to the individual wards.
In-service education has received much emphasis this past year. In July a
supervisor attended a week-long institute, " In-service Training," at the University
of Washington in Seattle. She returned to take over the position of Chairman of
the In-service Educational Programme, which was organized in conjunction with
the men's Nursing Division. This programme was organized for three levels of
nursing staff: (1) Staff nurses; (2) charge and assistant charge nurses and supervisors; (3) aides.
It was planned on the basis of findings derived from questionnaires which
indicated the needs of each level of staff. Each programme was organized by a
separate committee which included representation from the level of staff concerned.
 J 58 MENTAL HEALTH SERVICES REPORT, 1959/60
Lectures commenced in January and are presented one hour a week and repeated
the same day for the evening shift. Nursing staff from all areas, as well as speakers
from other disciplines, have contributed to its success.
The nursing department was most fortunate in receiving permission to employ
part-time and short-term nursing staff. This has considerably helped maintain
standards over the past year.
Fire-prevention lectures continue to be given under the direction of the Fire
Chief. By now the majority of staff have attended, and many have already found
this of practical value.
During the year a visitors' handbook was commenced by the joint nursing staff
with the aid of all other disciplines. This is now complete but has not yet been
printed. Material for a supervisors' manual has been assembled by a committee
from this group and is now ready to be incorporated into a suitable book.
A Head Nurse position was established on Ward J 3 and is occupied by the
first male nurse to be in charge of an infirmary in the East Lawn area.
A Psychiatric Charge Nurse was appointed to an active-treatment area, Ward
F 1.   This is considered a great improvement in nursing organization.
A Head Nurse was appointed to the psychiatric treatment ward of East 3,
Crease Clinic, which is rapidly becoming an active-treatment area.
The position of the Operating-room Suite and Surgical Ward Supervisor was
reclassified to a Superintendent—Grade 2 position, which is in keeping with the
tremendous responsibility such an area entails.
During the year the trend for supervisory staff to seek improved qualifications
continued, with four members on leave of absence and attending the teaching and
supervision course which is offered by the School of Nursing at the University of
British Columbia. This practice of seeking further education is commencing to
have an effect in raising of nursing standards and is being encouraged.
Representatives of nursing staff attended the registered nurses' annual meeting
in Vancouver, a group development workshop at the University of British Columbia,
lectures on tuberculosis nursing at Willow Chest Centre, and two institutes at the
University of Washington on the " Control of Infections " and " In-service Training."
During the year the nursing service was responsible for the following community teaching:—
(a) Two tours of the Crease Clinic with follow-up discussion, arranged for
two groups of high-school students who were seeking a greater understanding of the Mental Health Services.
(ft) A representative of nursing service took part in a panel arranged for
public health students from the University of British Columbia.
The beauty-parlour continues to make a valuable and therapeutic contribution
to the welfare and mental recovery of our patients.
Men's Nursing Division
A new team approach was put into effect in Crease Clinic in October. This
meant splitting of ward staff into four sections, each attached to one doctor and his
patients.
The following month one nurse was attached to each of the four doctors, to
act as a liaison nurse with a roving commission in the building. Their purpose is to
co-ordinate activities between staff and doctor, as well as gather and consolidate
information and convey this to the doctor and to the team concerned. These nurses
are left on this assignment for four months, then rotated back to ward staff and
another group takes their place.   This has proven to be very valuable from a teach-
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL J 59
ing standpoint in the benefits derived by patients, medical and nursing staff, and has
done much to stimulate nurses' interest.
In March, 1960, a 22-bed dormitory on West 4 was established as the male
admitting and observation dormitory on the male side of the Crease Clinic.
Many meetings are held weekly in each area of doctors, supervisors, nurses,
social workers, occupational therapists, psychologists, and key members of the team
to discuss their various problems.
There has been a considerable lessening of restrictions on patients, and more
mixed social activities have been encouraged. The open-door policy this year
caused six more male wards to be opened, to the present total of fourteen out of
twenty.
On Ward R 3 the staff and some of the patients changed places with Ward R 2
staff and patients. It was felt preferable to have Ward R 2 (as the infirmary area)
closed and Ward R 3 open. Ward A 3, Men's Division, staff and patients changed
places with Ward A 4. This transfer was of great advantage to both wards. With
the opening of each ward, unrestricted mail privileges have been granted, in
accordance with the hospital policy for open wards.
The Occupational Therapy Department has geared its activities more closely
with the wards' needs and is constantly seeking ways of expanding its work in as
many areas as possible.
A better and more enlightened attitude on the part of nursing staff is evident
this year because of greater emphasis on clinics, group conferences, in-service
education, and better nursing supervision.
In December Ward C 3 in West Lawn played host to fifty ladies from East
Lawn Building for supper and dance following. The behaviour level of groups was
sufficient for the experiment to be repeated several times in West Lawn, East Lawn,
and Riverside, with equal success in each area concerned, so that now the ladies
invite the men and vice versa to supper dances. Staff have volunteered much of
their time to make these events a success.
Television sets have been installed in the Riverside this year and Crease
Clinic and Ward A 1. Ironing-boards and irons were placed on Crease Clinic
wards for patients to use to keep their clothes pressed and neat.
The remotivation programme gained momentum. Many of the nurses took
their patients to classes outside for nature studies, etc., and, with the co-operation
of occupational therapy, nurses were able to give a follow-up to their classes of
patients by getting them motivated to work on two or three major outdoor projects,
such as landscaping for a picnic or garden site. All of this is very gratifying when
it is remembered that most of these patients were quite deteriorated. Many have
now improved and have grounds privileges. Ward B 4 this year has been used to
remotivate twelve patients at a time from Ward C 4 to higher standards, and the
project has met with some success. Patients then are transferred to open wards if
enough improvement is shown.
In July a new idea was evolved by a committee for a gala sports day for the
patients. This time all departments became involved and contributed greatly to
its success. The parade of floats by various departments through the hospital
grounds to open the event was comparable to any in the community. The giant
barbecue, sports, outdoor theatre, etc., attracted many visitors to mingle freely
with the patients. The evening dance and fireworks wound up the day's activities
for approximately 2,200 tired but happy patients.
The grounds supervisors interviewed 1,789 male and 1,092 female patients
for grounds privileges, a total of 2,881, or approximately 240 per month, which
 J 60 MENTAL HEALTH SERVICES REPORT,  1959/60
is a considerable increase over last year. Of the male population, 74.69 per cent
have grounds privileges, although not all of these are from open wards. The three
grounds supervisors have a tremendous task to counsel and guide this number of
patients over an area of 960 acres of cleared land.
There has been an increased amount of staff escort service carried out for
patients being discharged via aeroplanes or trains or when being transferred to other
institutions in this and other Provinces. Seventy-two escorts were required to escort
ninety-four patients in this manner. In addition, staff have provided numerous
escort services for patients required to go in to Vancouver or surrounding community for treatment of a special nature.
During the past year we have added two Chief Psychiatric Nurses—Grade 2
to our male psychiatric nursing staff, in the persons of Mr. W. Dunbar in Crease
Clinic and Mr. R. Cosser in West Lawn. Both are very capable supervisors and
have been doing an excellent job of supervision and clinical instruction, as well as
co-ordinating various therapies within the area for which they are responsible.
Eight additional staff plus two supervisors have completed the remotivation
course under Mr. Borthwick. Mr. Strong was most fortunate in having the opportunity to attend a nine-day course on group development in Seattle in June, 1959.
Two courses of in-service lectures have been running for the past several months.
Early this year a post-basic in-service course for senior psychiatric nurses was set
up by the school and is presently in progress. Length of the course is 100 hours.
Many other education opportunities in the form of films and lectures have been
offered, and staff have taken advantage of these as they can be spared from duty.
Mr. R. Jackson attended a three-day course at the University of Washington in
December on infectious-disease nursing.
It has been very gratifying to note the keen interest by male staff in the past
year in the rapidly changing concepts of treatment within our hospital and their
thirst for further knowledge to keep abreast of changing philosophies in mental
health.
PSYCHOLOGICAL SERVICES
The Department of Psychology, under the direction of Mr. J. W. Borthwick,
Senior Psychologist, reports that during the year 541 psychological reports on patients
were made, based on interviews and the administration of 1,601 psychological tests.
Six student applicants without proof of formal education were examined for the
School of Psychiatric Nursing in order to estimate their level of educational
achievement. A further fifteen students already in the school but with failing
grades were examined at the request of the instructors. A project to develop
appropriate test standards for admission to the school of nursing continues, and
eighty-four new students were examined as a cross-validation group.
Other research projects included the completion of the statistical analysis of
data derived from the evaluation of tofranil in the treatment of depression. A
rating scale to evaluate a project in the West Lawn Building of activating regressed
patients is being developed. Using the critical incident technique, a project is being
conducted to assess behaviour of patients immediately prior to suicides and suicide
attempts in order to guide staff in taking precautions.
A number of activities somewhat apart from clinical psychology but related in
general to psychological principles were undertaken. These included some help to
the Dietary Department in assessing leadership qualities for senior staff, the preparation of material on communication problems for nursing supervisors, and surveying
needs for general staff development and in-service training.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL J 61
There were 170 sessions of group therapy conducted during the year and 126
sessions of individual therapy and counselling.
Many lectures and talks were given both to staff groups and to those from
outside the Hospital. Second-term psychiatric nursing students receive a course
in some of the basic principles of psychology, and forty-six hours of lectures were
delivered to three different classes. Twelve hours of class were also conducted for
graduate nurses on remotivation techniques. A series of nine talks on psychological
appraisal techniques was given to psychiatric residents. Affiliate nursing groups
received twelve lectures as part of their orientation to Mental Health Services. A
further ten lectures and symposia for miscellaneous groups were conducted.
Social Services
Miss D. R. Begg, Supervisor, Social Services, Crease Clinic and Provincial
Mental Hospital, Essondale, reports a very active and rewarding year of service,
during which her department has considerably increased its services on behalf of
our patients.
The year has shown a significant increase over the previous year in the numbers
of patients and their families to whom it has been possible to extend social services.
This situation applies in both the Provincial Mental Hospital and the Crease Clinic
and would appear to reflect very positively the recent additions to the social-work
establishment for these two institutions. At the same time greater productivity can
be anticipated for the coming year, since staff members who have been temporarily
absent on educational leave to complete their professional training will be returning
to duty on the close of the present university term.
During the year particular consideration has been given by the department to
ways and means of accelerating and extending the service coverage of the admissions
section operating in the Centre Lawn unit of the Provincial Mental Hospital and in
the Crease Clinic. In the latter building there has been a concerted effort to reach
those patients from the more outlying areas of the Province who are presented for
admission after regular hours and whose accompanying relatives or friends must,
of necessity, return to their homes almost immediately. In order to meet such
situations, lists of suggested appointment times are now left in the admitting suite
with a request that whenever possible tentative appointments be arranged through
this means with the admissions social worker. The plan to date has proved most
effective in facilitating early contact with relatives and other important persons in
the patients' lives.
Similarly, in Centre Lawn steps have been taken to spot social problems as
soon as possible after admission in order that appropriate social services may be
provided without delay. Services in this particular building will, however, be
markedly increased following the return in May of this year of two of the group of
social workers on educational leave.
In the long-term treatment units there has been an increasing move toward
the placement of patients in sheltered employment and living situations. In the
East Lawn Building this has derived in part from the fact that the population is
ageing, and, furthermore, that a considerable proportion of the patient population
is incapacitated by lengthy mental illness beyond the point of employability. Consequently, many of those patients who are referred for discharge purposes are on
further social assessment found to be unsuited to any living situation other than
family-care homes. The use of such placements involves the social-work staff in
the careful screening of all referrals, as well as in close and prolonged supervision
both of the patients and the homes in which they are placed.   At the present time
 J 62 MENTAL HEALTH SERVICES REPORT, 1959/60
such homes are obtained and financed through municipal and Provincial welfare
departments on the understanding that the necessary supervision be provided by
the Mental Health Services.
In the West Lawn-Riverside unit a beginning has been made in placing some
of the socially depleted patients in carefully selected farm settings. Such placements are not readily available and again require extensive preparation and supportive follow-up if they are to prove successful. Generally, the patients so placed
are only partially self-supporting, and it would seem advisable that consideration be
given to some form of financial subsidization of the employers concerned in order to
ensure continuity of such placements for discharged patients from this depleted
group.
In all units the Social Service Department has continued to move toward improved communications with other treatment disciplines and has attempted to effect
closer integration of social services with those of other clinical departments. Due
to the existing needs for social services in the North Lawn Building, arrangements
were made at the request of the Clinical Director for a social worker from the East
Lawn unit to give two afternoons a week to North Lawn in order to relieve emergency pressures. This will be a temporary measure only, which will be overcome
with the return of additional staff from their university year.
The statistical summaries for the past year point up the increases in services
which have been provided. In the Provincial Mental Hospital 1,342 cases involving
6,564 interviews with or concerning patients were opened for social services, as
compared with a total of 962 cases involving 5,690 such interviews in the previous
year. Similarly, in the Crease Clinic the total intake of cases to the department in
1959/60 was 1,194 and involved 5,565 interviews with patients, relatives, and
interested collaterals, whereas the figures for the preceding year indicate an intake
of 862 cases and a total of 3,533 interviews directly with or concerning patients.
In addition, staff have participated in the usual ward rounds and medical conferences which occur regularly in the Hospital and Crease Clinic.
Staff development has continued through the media of staff meetings and supervisory council meetings on a regular basis throughout the year. In addition, all
staff have participated in orientations and in-service training programmes arranged
by other Hospital departments and by interested community groups. Regular orientation programmes were provided to five groups of in-service training students from
the Department of Social Work and included a total of some fifty persons. Other
educational responsibilities assumed by members of the social service staff of both
Hospital and Clinic were in the provision of field-work supervision to four second-
year students who were completing the requirements for the degree of Master of
Social Work. At the same time, five members of the permanent staff were granted
leave of absence under Federal Mental Health bursary in order to enrol for further
training leading to this degree. As in previous years a certain amount of supervisory
and administrative time was again devoted to assisting current students at the School
of Social Work with research projects related to social work in the field of mental
health. The expenditure of such time is exceedingly worth while, since it promotes
increased interest in the psychiatric institutional settings and in the possibility of
employment in them.
Occupational Therapy
Miss O. M. Curtis, Supervisor, Occupational Therapy, reports that over the
last year the number of qualified therapists in the department has stabilized at ten,
which is a great improvement on the last few years. At the present time all trained
staff are from abroad and therefore tend to be transient.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL J 63
There have been various improvements in occupational therapy services during
the year, the most interesting being the inauguration of a ward group programme in
the West Lawn Building at the end of last year. Prior to this time there had been
little programming for the patients concerned, who were withdrawn and had been
inactive over a period of years. The following are the statistics on this special
project:—
Patients treated  152
Patients who had been withdrawn and inactive for a long period  101
Patients discharged in full  11
Patients transferred to other hospitals  13
Patients progressed to Industrial Therapy  29
Patients progressed to Occupational Therapy Department  15
Patients discontinued  10
Miss Curtis wishes to congratulate the therapists on the high standard of their
work and to thank the staff of the male nursing department for their whole-hearted
co-operation, without which this programme could not have functioned. The programme will continue and be extended next year. With the opening of more wards
in West Lawn Building and greater emphasis being placed on realistic work, the
composition of the patient-group attending West Lawn Occupational Therapy
Department has changed, so that it is now devoted almost completely to the treatment of Ward A 4 patients.
In both Riverside and West Lawn Buildings large groups landscape-gardening
projects were started at the beginning of the summer in conjunction with the Nursing
Department's remotivation groups. In both areas considerable progress was made
in that a major part of the work was carried out by patients from the more regressed
wards. The Riverside group laid out a garden, and West Lawn levelled a large area
and almost completed a rustic garden shelter which is to be the central part of a
garden and recreation area.
The techniques used in the Centre Lawn female department were increased to
include dancing and also current affairs discussions, the latter having great possibilities for use with patients being rehabilitated.
In East Lawn Building it is planned over a period of time to gear the department programme to rehabilitation. The first step was taken in October with the
introduction of a beauty-culture programme which includes posture and exercises,
clothes care, and make-up. As a second step it is planned to introduce a home
economics programme which will approach the subject from the point of view of
a woman being rehabilitated to the home situation after a period of ten years'
hospitalization.
The Crease Clinic programme has undergone radical change in the last year.
In November a new system of patient allocation was introduced whereby each
therapist now treats the patients from two services. This system has led to a great
improvement in communication with medical staff and has assisted in fostering the
concept of the " team " approach. At the end of this year the Crease Clinic department was relocated in West 1, with obvious geographical benefits to patients and
staff. Two additional services were inaugurated in this area—an activation group
for patients having coma insulin treatment and a ward group for the more disturbed
patients on East 3.
Lectures and demonstrations were again given to student and affiliate nurses
and medical students.
The Vincent Massey Junior High School auditorium was decorated for the
nurses' graduation in April.
 J 64 MENTAL HEALTH SERVICES REPORT,  1959/60
The annual sale held at Pennington Hall in December netted a total of
$2,562.46.
An exhibition of patients' work was held in East Lawn Building in March and
was visited by large groups of patients from the various wards.
Recreational Therapy
Considerable further progress has been made by Mr. G. Maxwell, Director of
Recreational Therapy Department. This form of therapy is available to our
patients on the wards, the hospital grounds, or in special areas, depending on the
type of therapy the patient requires.
As a result of continuing effort toward greater staff and patient interest in the
total recreation programme, a steady growth in the breadth and quality of programme and in total patient participation was experienced during the year.
In large part this has been made possible because clinical leadership and staff
groups throughout the Hospital are showing greater understanding of the value
to their patients of encouraging active participation to the limit of individual
capacity. Indicative of this welcome support and co-operation has been a striking
growth in the number and quality of ward, inter-ward, and inter-building social
and recreational programmes carried out during the year.
Since these events offer especially valuable opportunities for involving patients
in the actual planning, preparation, and conducting of programmes, we look upon
this as a very real gain. Meetings of informal patient committees, ward councils,
and so-called " club " activity groups (journalism, better English, square dancing,
etc.) have offered opportunities to capture the real interest, attention, and talents
of an increasing number of patients whose former attitude was passive or indifferent.
Particularly notable in this regard was the holding of the first inter-building exchange
dinner late in the year.
The trend to open wards saw ever-greater patient use of the drop-in type of
facilities and services, with the result that participation figures for grounds-privileged
use of bowling-alleys, billiard-rooms, gymnasia, badminton, pitch-putt golf, etc.,
were well above previous totals.
Similarly, freedom to leave the wards is making possible a gradual alteration
of our programming procedures with respect to scheduled ward activation sessions
led by the staff. This type of programme is now confined to the closed wards, and
the reduction in number of these is making possible a more frequent service.
Establishment of daily full morning activation sessions for Crease Clinic patients
in the East 1 area represented a real gain in provision of service to this acute area
during the year.
Introduction of seven-day laundry operation necessitated extensive revision
of programme timing and content in certain areas of the Hospital and served to
accelerate an already established trend toward greater evening and week-end
emphasis in programme planning. Wherever possible, mid-week opportunities
such as picnics, special outings, mystery bus trips, etc., were arranged to fit in
with the " days off " schedules of these worker groups.
Fifteen special variety concerts and musical events held in Pennington Hall
during the year saw patient attendance top the 7,000 mark and brought many
hundreds of visiting entertainers (often with their accompanying parents) to the
Hospital. Even more gratifying was the splendid response to and attendance at an
annual gym display, a patient talent show, and several seasonal concerts and events
which patient-groups providing the entertainment or displaying the results of extensive training and rehearsals held outside regular programme periods.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL J 65
A full calendar of special events was carried on throughout the year, including
recognition of many annual and seasonal festive periods (Hallowe'en, Christmas,
New Year, Valentine's Day, Easter, May Day, monthly birthday parties, etc.).
Outstanding among these was the very special sports day, which saw more than
2,500 patients out on the lawns to share a gala occasion with some 4,000 or more
staff and guests.
Other special expeditions (in addition to the forty-two day-long trips which a
total of 1,400 patients made to Stanley Park during the summer) included groups
which visited the Vancouver Sun Building, British Columbia Building, art galleries,
or attended special musical or dancing events and the Shrine Circus.
In July, following the appointment of a recreational therapist as part of the new
establishment at Valleyview, it was possible to transfer the time of a staff member
formerly on loan to Valleyview to the Centre Lawn Building, making possible better-
balanced and more extensive programming in this area. The music therapist, however, continued his leadership of a choir, glee club, and church music services at
Valleyview.
The post of music therapist was vacant for two months following the resignation of Mr. Frank Knight in November and prior to the appointment of Mr. Lojze
Smrekar in January. Since that time, steps have been taken to reactivate all phases
of the previous programme, and a beginning was made on initiating additional ward-
centred activities. Availability of the East Lawn recreation area for use by the music
therapist on Saturdays has proven of great value throughout the year in stimulating
patient interest in a wide range of musical activities. In addition, the music therapist
is active in providing leadership and training for two different choirs and plays the
organ for four regular church services each Sunday.
When not required by patients' extensive activities, use of facilities is made by
off-duty staff and student-nurses' groups. It may be noted, however, that with the
growth in student enrolment has come a most desirable increase in both the interest
and need for wholesome recreational outlets, and the Recreational Therapy Department has been pleased to co-operate as fully as possible to this end. Similarly, full
advantage has been taken of opportunities to share in student orientation and training through participation on panels, lectures, and in the provision of workshop and
demonstration sessions for both student and affiliate groups.
The statistical report of the activities of the department shows great increases
in every type of therapy. The number of group sessions, 3,558, increased by 472
over the previous year, and the total patient attendance of 147,744 is an increase
of 31,368.   The sessions and attendance were made up as follows:—
Group Sessions Attendance
Crease Clinic      741 18,221
Provincial Mental Hospital, Essondale  2,083 120,160
Special events         40 5,584
Music therapy      470 3,779
Staff recreation      224 8,884
Totals   3,558 156,628
Physiotherapy
This department reports an active year under the direction of Mr. C. Stewart,
Senior Physiotherapist.
There is a considerable and increasing demand for physiotherapy for treatment
of physical disabilities of various types. Many thousands of treatments are being
given, exercising muscles following organic conditions or surgical intervention.
3
 J 66 MENTAL HEALTH SERVICES REPORT,  1959/60
The Centre Lawn Physiotherapy Department has been vastly improved through
renovation of accommodation and replacement of equipment and is now capable of
giving much-improved service to our patients.
Again during this year a valuable and continuing service by the chiropody section was provided.   This service is especially helpful to the older patients.
A total of 17,486 physiotherapy treatments was given to 2,265 patients.
Patients' School
The patients' school was opened from 9 a.m. to 4.30 p.m. for 197 days during
ten months of the 1959/60 fiscal period. Mr. R. E. Dalby, the teacher, reports a
total enrolment of sixty-three (forty-two men and twenty-one women), with an
average daily attendance of 11.4 and an attendance duration of seven weeks per
patient. Seven new Canadians came for English. Four illiterates came for about
a month each, and seven patients took correspondence courses, four with success.
The reduction in attendance, about 25 per cent less than the previous year,
allowed for more individual attention per patient. This was good, since class grouping was virtually impossible due to the diversity of ages, grades, and interests.
Enrolment is chiefly governed by referrals from doctors. Patients frequently
call at the schoolroom during the day for a chat with the teacher or a word of advice.
Some become interested in study and arrange to become regular students.
Patients are encouraged to set themselves a rehabilitative goal and to direct
their study efforts to that end. Keeping in touch with world and local news via the
newspaper is stressed and often stimulates interest where a school text fails. The
teacher realizes that study involves hard work and regrets that immediate and tangible rewards are not available for scholastic achievement.
Two-thirds (forty-one) of those enrolled at the school were discharged during
the year. Many keep in touch with the teacher by mail, telephone, and personal
visits.
Outside of the schoolroom the teacher played a part in conducting the evening
English club in co-operation with three Canadian Mental Health Association volunteers and also the journalism club, supplying copy to " The Leader," the patients'
publication. In February a series of lecture-discussion periods was tried on Wards
D 3 and A 3. Results with large groups are difficult to assess, but the greatest
difficulty seemed to be finding topics of an educational and worthwhile nature, as
well as appealing to the common interest of the men.
Health of Patients
The general physical health of the patients has been very good and the number
of notifiable diseases small. There have been no infections of epidemic proportions,
and the number of respiratory and intestinal infections have been minimal.
We are most appreciative of the assistance and service provided by the Department of Tuberculosis Control in our annual patient tuberculosis survey. The department's mobile X-ray unit surveyed all the patients at the Riverside units, Colony
Farm, and those patients in the East Lawn Building at Essondale.
All patients admitted receive a chest X-ray during their initial physical examination, and patients on continued treatment are surveyed at intervals as indicated.
Dr. Kilgour, specialist in tuberculosis, devotes his full time to the prevention and
treatment of this disease and reports a marked decrease in the number of active
cases in hospital.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL J 67
Department of Radiology
This department under the direction of Dr. J. M. Jackson, reports increasing
activity again this year. He is receiving many more requests for specialized radiological procedures, especially in connection with work being done in neurological,
surgical, and neurosurgical cases.
During this year 24,096 films were taken and reported on concerning 14,521-
patients' examinations. Included in this number were 2,208 films taken in pneu-
moencephalogram examinations, 1,586 films for barium meals, and 400 films of
the skull on 125 patients.
Department of Laboratories
Dr. G. A. Nicolson, Director of the Department of Laboratories, reports an
ever-increasing demand for the services provided by his department.
The standard of service provided has been maintained at an excellent level.
The steadily increasing demand for laboratory service is again reflected in the
ever-mounting total of tests performed—this year 57,251, an increase of 6,271 over
the previous year. This increase is fairly evenly distributed over the departments
of biochemistry, hematology, bacteriology, and tissue pathology, and indicates more
extensive and improved medical and surgical care. In spite of this increase, a high
standard of service has been maintained. In addition, supervision has been given
to the clinical laboratories at The Woodlands School, the Mental Health Centre,
and the Valleyview Hospital. A total of 199 autopsies was performed in all branches
of the Mental Health Services. The number of surgical tissues examined shows a
substantial increase.
Pharmacy Department
The Pharmacy Department, under the able direction of Mr. K. Woolcock,
Chief Pharmacist, operates smoothly and efficiently.
The pharmaceutical formulary has been highly accepted throughout the Mental
Health Services. No longer is there a conglomeration of medications and the associated confusion that resulted. The wards are now stocked with products that have
been screened by the Pharmacy Committee. All new products will continue to be
evaluated, and every effort will be taken to aid the physicians in their choice of
medication.
The sterile supply room now under construction will utilize the services of this
department. The close proximity of these departments will permit the bulk storage
of materials in the pharmacy, which may be drawn on exclusively by the sterile
supply room when required. The present system of supplying dressings and equipment from the shelves directly to the wards where they were sterilized will be taken
over by the new department.
The Chief Pharmacist will make ward rounds in the near future, and it was
the opinion of the Pharmacy Committee that such a service would be helpful to the
nursing units. It will, in effect, form a liaison between the pharmacy and the nursing units and provide closer scrutiny of those matters of a pharmaceutical nature.
Optical Department
Mr. H. H. Woodbridge, optometrist in charge of the Optical Department,
reports on the completion of another year of active service to our patients.
The service provided by this department to our patients is considerable and
is an important contributing factor to their improved health, efficiency, comfort,
and rehabilitation.
 J 68 MENTAL HEALTH SERVICES REPORT, 1959/60
A total of 1,038 procedures was carried out, consisting of 599 examinations,
264 major repairs, and 175 minor repairs.
Dental Department
Dr. G. D. Campbell, Director of the Dental Department, reports an extremely
active year. His department completed 5,993 procedures; that is 775 more dental
procedures than were completed during the previous year.
At present the Dental Department consists of two dentists, two dental assistants, and one dental technician. The Geriatric Division is expected to have its
own dental service soon. The separation of the Geriatric Division from Dr. Campbell will considerably relieve the pressure on his department.
Much of the dentist's time, due to the urgent need to relieve the patients' discomfort or pain, is used to make many mouths more hygienic by the means of tooth
extraction and other forms of treatment.
Department staff ill health and resignation caused some reduction in total
service output, Dr. Campbell reports, though the year's total service was good.
The dental technician continues to mark, once a week, the dentures of new
patients as well as the few misplaced ones.   This has cut down greatly the incidence
of lost dentures.
Chaplain
The resident chaplain, Rev. John F. O'Neil, and the visiting clergy have provided an extremely valuable service to our patients in the provision of opportunities
for worship.
The ready co-operation of all the staff is the main factor that has made possible
the work of the chaplains. In this connection special mention should be made of
the staff of the telephone switchboard, the nursing services, and the transport, but
all departments have co-operated readily and willingly.
During the year there have been sixty-one institutional funerals from the
Provincial Mental Hospital and two from The Woodlands School. Of these, two
were conducted by special clergy from the community at the request of relatives;
two by the Rev. L. Hankinson, the chaplain at The Woodlands School; ten by the
Roman Catholic chaplains under the direction of the Rev. Father A. Frechette,
B.A., O.F.M.; and forty-nine by the resident chaplain, the Rev. John F. O'Neil,
E.D., B.A., L.Th.
Also during the year there have been ninety-nine services of worship conducted in Pennington Hall, twenty-six of them being Roman Catholic and the
remainder Protestant. There have also been forty-four services at North Lawn
auditorium, forty services in Centre Lawn on Wards D 2 and E 2, and ten at Riverside on Ward R 1. This makes a total of 167 Protestant and twenty-six Roman
Catholic services.
Attendance at these services has, of course, been entirely voluntary. The
average attendance at Pennington Hall in the mornings has been 183 and in the
evenings 114, at North Lawn seventy-two, at Centre Lawn twenty-six, and at Riverside twenty-four. The average attendance is down a bit from previous years, but
this is due to a larger number of patients being able to attend services of their own
denomination in churches in the community, and this has been encouraged.
Private services, visiting of the critically ill, pastoral visiting, and counselling
have not been listed statistically but have consumed a good deal of effort.
The work on " The Leader," the patients' bi-weekly magazine, has continued
to occupy time. But this was eased toward the end of the year with the assumption
of a larger share of the responsibility by Mr. F. Palmer and Mr. J. Herring.    Mr. F.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL J 69
Palmer has now been made editor, while Mr. J. Herring, of the Industrial Therapy
Department, and the resident chaplain are the supervising editors.
Audio-Visual Department
Mr. W. E. Peters, Supervisor of the Audio-Visual Department, reports that
during the past year the 35-mm. installation was completed in The Woodlands
School. We are indebted by Mr. C. Esterbrook and Mr. F. Bennett for their
valuable assistance.   The shows are well attended and enjoyed by the patients.
The Audio-Visual Department supplied a public address system and recorded
photographically the opening of the Valleyview building and chapel. The Tranquille School has been added to the 16-mm. circuit and now enjoys a movie once
a week. The replacement of the obsolete tuners in the four-channel sound system
has improved the quality and dependability of operation.
On Boxing Day the Canadian Mental Health Association put on a stage show
in Pennington Hall using professional artists. The show was broadcast to all the
wards and heard by all the patients, as well as those present in the hall.
This department supplied three separate public address systems for the patients'
sports day on the grounds. Photographs on 16-mm. film were taken, as well as
numerous stills in 35-mm. and black-and-white pictures, size 4x5. Many interesting pictures were taken of the parade and sports events. A series of pictures for
the Public Works Department was started to record every building structure in the
Mental Health Services for a property register.
There has been a marked increase in borrowers of the 16-mm. lending library.
Three hundred and eight organizations are registered, an increase of 10 per cent
over last year. It is felt that these films help promote a better understanding of
mental health with many lay groups. They also are an invaluable aid in teaching
and training professional personnel. The popularity of the majority of the films is
evident by the fact that they are returned, inspected, and immediately shipped to
anxiously waiting borrowers.   A total of 1,147 films was loaned this year.
The following will give an indication of the regular activities of this department.
The 35-mm. films at Pennington Hall were shown 142 times to a total of 45,275
patients, and in The Woodlands School there were fifty showings to 12,447 patients.
The 16-mm. ward movies were shown 423 times to 23,860 patients. There was also
a weekly 16-mm. show at The Woodlands School; Home for the Aged, Vernon;
Allco Infirmary, Haney; Provincial Home, Kamloops; and Tranquille, run by their
own staff.
The over-all production in photography shows an average of 10 per cent
increase over the previous year. This year a camera to make negatives as large as
%Vi x 14 for lithographic copying in conjunction with the Industrial Therapy
Department was designed and built.
Industrial Therapy Department
There were no major structural changes within the department. Renovating
of present shops still continues as required.
Administrative and therapeutic guidance through a trade medium was given to
a total enrolment of 2,356 patients during the year; 177 new patients were started;
seventy-four patients were trained for acceptance as workers in other areas; twelve
patients were returned to the wards for further treatment; and ninety-four patients
were discharged to the community.
 J 70 MENTAL HEALTH SERVICES REPORT,  1959/60
The following figures show the work participant of staff and patients:—
Manufactured Repaired
Items Items
Printing Section  1,739,832 	
Mattress and Canvas Section          6,932 2,567
Cabinet Section             502 2,171
Shoe Section        4,653
Upholstery Section              721 929
Metal Section          1,725 94
Machine Section              242 1,147
Tailoring Section          6,099 12,986
Uniform Section         10,005 9,797
Dry-goods Section        66,371 	
Mending Section       89,619
The Hospital magazine, " The Leader," has proven itself an instrument of great
therapeutic value in Hospital activities.    The magazine enrols a patient staff of
eighteen—typists, artists, and reporters producing 1,200 copies a month.
Fire Department
During the year this department went to eight fires in buildings housing patients
and staff, twenty-two grass and brush fires, six rubbish fires, answered nineteen false
alarms and one inhalator call, for a total of fifty-six calls. This is an increase of
nine emergency calls over the previous year.
Staff-training programme activities increased slightly over 1958. There were
eighteen fire-drill evacuations of patients and staff, twenty-eight one-hour lectures
on fire prevention, and thirty-four four-hour classes in fire-fighting and emergency
removal of patients. To date 915 members of the staff have attended these four-
hour sessions.
The training programme for volunteer fire-fighters also shows an increase, with
115 one-hour periods of instruction in fire-fighting, rescue, and artificial respiration.
Also there were 112 periods of one to two hours allotted to outdoor practice, using
all types of fire-fighting equipment.
All buildings and shops at Essondale, The Woodlands School, and the Mental
Health Centre were inspected regularly, and 700 fire-extinguishers in the three hospitals are checked quarterly and recharged annually. The work of the chimney-
cleaning contractor was supervised by firemen, and continuous maintenance work
on all fire-fighting equipment was carried out.
Civil Defence and Disaster Committee
The past year has been a fairly active one for the Civil Defence Heads of
Service and Planning Committee at Essondale. Civil defence training continues to
form part of the nurses' training. A separate course of training in fire-fighting has
been given to all nursing staff to bring them up to date. Two members of the Committee attended a course at Civil Defence College, Arnprior, Ont. Two members
of the Committee have lectured to groups in Victoria under the auspices of the
Provincial Civil Defence. Two adjacent community groups have received training
and tests in gas-chamber and fire-hut demonstrations. Close co-operation has been
maintained with the Greater Vancouver Target Area Planning Committee, and a
member of the Planning Committee has attended meetings of this group.
Medical Records Department
The use of dictating equipment in the Crease Clinic Medical Records is now
well established, and both medical staff and stenographers are freed of the necessity
of finding mutually satisfactory dictating time.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL J 71
In order to speed up communication between the medical records offices and
other departments regarding the movement of patients, a daily report sheet was put
into operation in October, 1959. This has proved much more satisfactory than the
previous method used for so many years.
On January 1st, 1960, the Geriatric Division was brought under the operation
of the Mental Hospitals Act. This eliminated the need for admission forms under
the Provincial Home for the Aged Act for the movement of patients to that division,
and thus another well-established routine has disappeared.
At the request of the Dominion Bureau of Statistics, information is being collected regarding the incidence of addiction to alcohol or drugs among the patients
admitted. Other information supplied on the statistical cards has been reviewed in
conjunction with modifications in the procedures regarding voluntary and certified
patients and the patients moved between units. These latter changes will be effective
April 1st, 1960.
The movement of files to and from the " stack room " continues to be very
heavy, and what is being done takes much of the time of two clerk-stenographers.
It is anticipated that with the appointment of a filing clerk this function of the
Medical Records Department will be greatly improved. There continue to be heavy
demands made on this division because of the more rapid movement of patients
through the Hospital, with the consequent increase in the number of patients' files
being closed.
Dietary Department
Considerable improvements have been made in patients' dining areas, and
especially in the large kitchen area in the East Lawn Building. The area was completely renovated and re-equipped, and this has resulted in a greatly improved
service to patients.   Statistics are as follows:—
Total general-menu meals served to patients  3,264,986
Total diet-therapy meals served to patients  248,565
Total meals served to staff  153,598
Total meals served  3,667,149
Total cost of raw food for 1959/60  $1,729,117.06
Total cost per meal for raw food  .469
Expenditure on animal products—
Meats   $483,401.95
Eggs   52,095.00
Milk   242,979.00
Butter   3,555.00
Lard and shortening  1,465.00
Cheese   5,831.00
Cottage cheese  3,590.00
Fish  _'  69,589.55
Total, animal products  $869,506.50
Total expenditures on vegetable products (cereals, fruit, tea, coffee, etc.)   859,610.56
Total   $1,729,117.06
Percentage of total expenditure for animal products  51
Percentage of total expenditure for vegetable products  49
 J 72 MENTAL HEALTH SERVICES REPORT,  1959/60
Education.—All charge cooks have taken special instruction in practical and
theoretical diet therapy. This course of instruction included the lecture series
offered by this department to psychiatric nurses in training—a one-month period
of concentrated diet-therapy food preparation and service. This course was culminated by a written examination on diet therapy.
Patients' Accommodation and Hospital Maintenance
The Medical Superintendent and Business Manager visited all areas of the
Provincial Mental Hospital and Crease Clinic in a complete annual survey which
is made in connection with Hospital maintenance and alteration.
The Public Works Department is occupied constantly providing an emergency
coverage and service throughout the whole day. In addition, this department has
completed a tremendous amount of painting and decorating both inside and outside
of the many buildings located on the grounds at Essondale and Riverside.
The various Hospital units are in good general condition, and, in view of the
large number of buildings concerned, all types of maintenance must be continually
going forward.
The interiors of the buildings are being lightened considerably by the use of
lighter and more pleasing wall colours and lighter-coloured floor coverings. The
pastel colours used on hospital wards to-day are a great improvement over the
white hospital walls of former years.
The Hospital grounds and lawns have been further beautified by the gardeners
replacing many trees, shrubs, and increasing the gardens and flower-beds. Landscaping and gardening are enjoyed by many of our patients in good weather. The
hillside high above the Centre Lawn Building has been made into a splendid flower-
garden area by a large number of men and women patients under the direction of
Mr. A. Finnie, psychiatric nurse.
We are pleased to note that alterations were completed by the Public Works
Department in the Crease Clinic Occupational Therapy Department. Both male
and female Crease Clinic patients receive this therapy in West Occupational Therapy
Department now. This makes for much-improved occupational-therapy function
and efficiency in this area.
The Public Works Department, by alteration and renovation, has converted
the former pharmacy in the East Lawn Building into a central supply area. This
unit will prove to be of tremendous value in improving the nursing care of our
patients.
Visitors to the Hospital
Each year larger numbers of visitors come to the Hospital, singly or as members of the many visiting organizations. Visiting of patients is permitted every day
and is encouraged.   It is helpful for both the patient and relative in the community.
Dr. Mathew Ross, director of the American Psychiatric Association, visited
the Hospital in connection with the psychiatric survey of British Columbia which
the American Psychiatric Association is making.
The Honourable Eric Martin, Minister of Health Services and Hospital Insurance, visited on numerous occasions.
Canadian Mental Health Association volunteers' fashion show took place on
April 29th and 30th.   This was a great success.
Dr. G. F. Kincade, Director of Tuberculosis Control, visited in connection
with Hospital tuberculosis surveys.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL J 73
A splendid programme was arranged at Essondale on May 4th by Dr. I. S.
Kenning, Clinical Director, on the occasion of the annual dinner meeting of the
Neuro-psychiatric Section of the British Columbia Division of the Canadian Medical
Association.
Mrs. E. Smith, secretary of the Canadian Occupational Therapy Association,
visited the Hospital Occupational Therapy Department.
Mr. C. Ferber, Comptroller-General, and Mr. J. McDiarmid, Departmental
Comptroller, visited the Hospital.
Dr. F. R. Wake, of the Dominion Council of Health, visited in June. He visited several Provincial Mental Hospital and Crease Clinic areas and was especially
interested in our open-ward policy.
Dr. Ralph Chambers, of the American Psychiatric Association Central Inspection Board, a member of the group that is surveying the Provincial Mental Health
Services at the request of the Government of British Columbia, arrived at Essondale
on July 24th and commenced his survey at once.
Lady Patrick Hamilton visited. She is an executive member of the Women's
Volunteer Service in England.
Dr. A. E. Davidson, Deputy Minister and Director of Mental Health Services,
on many occasions visited departments of the Provincial Mental Hospital and
Crease Clinic with members of his headquarters staff.
Large numbers of visitors and entertainers visited Essondale over the Christmas season. Professional performers from CBUT television station donated a show
in Pennington Hall, 600 patients attending. This programme was tuned to the
wards, while eighty-five men and women Canadian Mental Health Association
volunteers distributed parcels to our patients on Boxing Day. The Honourable and
Mrs. Lyle Wicks assisted in this distribution in the wards.
We were happy to welcome Dr. Duncan MacMillan, from Mapperly Hospital,
Nottingham, England, for a brief visit in March. He possessed a wealth of knowledge and experience, and his visit was most stimulating and informative.
Volunteer Activities
Mr. T. G. Dodsworth, the Essondale co-ordinator of volunteers of the British
Columbia Division of the Canadian Mental Health Association, reports a very
rewarding year. The volunteers have made a tremendous contribution to the well-
being of our patients. In addition to the many thousands of gifts and comforts
they have provided our patients, they have given the most valuable thing they possess—that is, their time, understanding, and assistance—in many ways to assist
our patients toward recovery and rehabilitation. The numbers have increased to
243 regular visitors to the Hospital. The total number of evening volunteers has
surpassed that of day visitors, probably due to the difficulty with transportation.
One significant point is the fact that our male volunteers have increased over 100
per cent.   We now have twenty-two men visiting regularly.
Volunteers were introduced to all the male wards and to North Lawn Building
this year. This has increased the scope of the programme, and the results have been
excellent.   The male staff are very receptive to the volunteers.
Weekly luncheon dates for patients started in October at private homes of
non-volunteers. These have been very useful, and bookings are complete to September, 1960.
There has been an increasing number of requests from the Social Service
Department for help with individual patients in preparation for discharge. This
involves shopping trips, visits to town, and post-discharge follow-up.
 J 74 MENTAL HEALTH SERVICES REPORT,  1959/60
The apparel-shops have continued to function well. In the past year we
served 2,114 patients and gave out 8,203 articles of clothing.
In November the Hospital invited the volunteers as a group to visit them in
the Crease Clinic. After several very interesting talks by senior medical staff, a
complete tour of the Clinic was made, and the Dietary Department served refreshments in the dining-room.   This successful venture was enjoyed by 135 volunteers.
The newest innovation has been the " Volunteer Booster." This is a monthly
paper produced by volunteers to keep each one abreast of the over-all programme.
Gifts
Many societies and groups frequently donate gifts to the patients and Hospital.
The Three R's Club, a society devoted to the interests of patients in tuberculosis
hospitals, generously donated a gift (cigarettes) to each patient in the North Lawn
Building.
The Ladies' Auxiliaries to the Canadian Legion and Army and Navy ex-
servicemen's organizations visited the Hospital regularly with generous gifts of
candy, fruits, cigarettes, and other patient comforts to our patients.
A very splendid record-player with two speakers was donated by friends of
the Hospital. This has been quite helpful in the East Lawn recreational and activity
programme.
The Canadian Mental Health Association, British Columbia Division, made
a generous donation of outside lawn furniture to the Hospital. This has greatly
added to the comfort of patients and visitors to the patio of the coffee-shop at Pennington Hall.
The Pacific National Exhibition officials generously donated 300 tickets for
Provincial Mental Hospital, Essondale, patients to attend the Pacific National
Exhibition.
The Vancouver Shrine organization kindly donated tickets and provided buses,
which enabled 200 Provincial Mental Hospital patients to attend the Shrine Circus.
General Comments
There have been again this year many occasions when staff devotion to duty
has been responsible in preventing injury to or loss of a patient's life.
I wish to report two excellent examples of this nature in our nursing division.
The first, on September 23rd, 1959, Miss Linda Freiheit, through her alertness and
resourcefulness, was the means of saving a female patient's life through her knowledge of artificial resuscitation. The next instance occurred when Mr. L. Gadsby,
nurse's aide, was responsible for the safe return to their ward of two male patients
from dangerous situations.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL J 75
TREATMENT SERVICES
F. G. Tucker, Clinical Director
The past year has been a period of increasing growth and refinement in the
treatment services of the Crease Clinic and Provincial Mental Hospital, with
emphasis on the development of the personal skills of the many members of the
treatment team and an attempt to make admission to hospital as brief and as
therapeutic as possible in all its aspects.
During the year 1,464 patients have been admitted to the Crease Clinic and
1,599 to the Provincial Mental Hospital. In reviewing this considerable number
of admissions, it is apparent that patients requiring in-patient care can be classified
into three groups. Firstly, those who suffer from an acute illness of whatever severity
and for whom a rapid recovery can be anticipated. Such patients require intensive
individualized therapy and are normally catered for by the facilities of the Crease
Clinic. In order that these facilities may be used to the best advantage, it has
been necessary, as far as possible, to screen patients prior to their admission, and
we have been grateful for the co-operation which we increasingly received from
private physicians who personally arrange for the admission of their patients, and
we have found the exchange of information has been to advantage both to the
private physician and to the Hospital. We have been able to place increasing stress
upon psychotherapy, and there has been a decreasing use in somatotherapy. In this
respect we have reduced the use of coma insulin therapy, although we believe that
this treatment still serves a useful purpose in a limited number of selected cases.
There has been a continued use of and interest in the many psychopharmacological
preparations available. These drugs continue to be important adjuvants in therapy,
and problems have arisen in ensuring that patients continue to receive the necessary
medication on discharge from the Hospital. Difficulties have arisen from the lack
of supervision and the high cost of drugs for patients in receipt of marginal incomes.
The second group of patients may be called the " remitting group," who
periodically fail to function adequately in the community and from time to time
require a relatively brief admission to hospital. A high readmission rate should
not be viewed as evidence of failure. Rather should one emphasize the period of
remission when the patient is established within the family circle and is able to
pursue useful and gainful employment. Such periods of remission are further
enhanced by adequate follow-up in the community. Such patients recover rapidly
within the hospital setting, and it has and will be our increasing endeavour to
involve these patients in " a therapeutic community," in which they may develop
new methods of group living and leave hospital not merely in remission but
functioning more efficient than hitherto.
The final group of patients are those requiring continuing treatment. During
the year there has been increasing progress in this area. Many factors play a part.
The more active involvement of the nurses in therapy and their development of
greater skills is one. In this they have been aided by the expanding programme
in education in the Department of Nursing Education and the advent of clinical
instructors on the wards to supervise the nursing student. Fourteen out of twenty
male wards and sixteen out of twenty-four female wards are now open, and the
resulting freedom, sense of personal integrity, and increasing social awareness
continue to bring patients to a level of behaviour not long ago deemed impossible.
The volunteers continue to be invaluable in meeting those needs of patients for
which they alone can provide, and the multiplicity of their effort, their enthusiasm,
and their increasing skill warrants high commendation.
 I 76 MENTAL HEALTH SERVICES REPORT,  1959/60
Improvement of patients in the continued-treatment area of the Hospital
has led to an increasing rate of discharge, so that the total numbers in these areas,
which constitute 60 per cent of the total population, have been reduced by 260.
It has become evident during the past year that an increasing emphasis must be
made on rehabilitation if we are to bring our remaining Hospital population to
a level of functioning that will allow them to return to the community. With this
in mind, every effort has been made to employ patients usefully within the Hospital,
and " The Vista " and " The Venture " continue to play a useful part as stepping-
stones to a job and a new life in the outside world. A limited start has been made
in placing patients in family welfare homes and nursing homes, where they may
more readily become an integral part of society within the sheltered environment
of the family.
Medical and surgical treatment of patients continues at a very high level, and
an average of fifty-five surgical procedures and 169 examinations are carried out
each month. There are approximately 200 patients requiring infirmary care at all
times, and a further fifty acute medical cases. As the Hospital population ages,
physical illness becomes an increasingly demanding problem.
At the close of the year the Physiotherapy Department, which had long suffered
from difficulties in recruitment, was well staffed and, under the initiative of the Chief
Physiotherapist, was providing excellent service.
The past year, then, has been a period of consolidation within the treatment
services, bringing to fruition the rapid changes of the past decade. It has been
a time of re-examination and re-evaluation of treatment methods, so that they may
readily be incorporated in the ever-changing concept of psychiatric practice.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
J 77
STATISTICAL TABLES
CREASE CLINIC
Table 1.—Movement of Population, Crease Clinic, April 1st, 1959,
to March 31st, 1960
Male
Female
Total
In residence, April 1st, 1959    	
107
423
29
169
134
578
28
237
241
Admissions—
1,001
Readmissions to a different institution of Mental Health Services	
57
406
621
843
1,464
728
977
1,705
Separations—
607
1
830
2
1,437
Died _       	
3
608
832
1,440
Net increase or decrease  	
+ 13
120
+ 11
145
+24
265
 J 78
MENTAL HEALTH SERVICES REPORT, 1959/60
Table 2.—First Admissions to Crease Clinic, by Health Unit and School
District of Residence and Sex, April 1st, 1959, to March 31st, 1960
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
School District No. 1 	
„   2 	
1
1
1
1
1
1
5
4
2
4
5
2
8
3
2
3
3
1
6
1
1
2
1
9
3
9
9
6
25
2
7
149
27
1
1
3
"~i
i
8
1
2
3
1
1
3
6
2
1
17
2
1
2
1
2
2
\
1
1
1
1
1
1
7
1
3
16
9
5
35
2
17
205
35
2
2
4
1
4
2
13
1
2
7
1
3
7
11
4
1
25
5
3
5
1
5
3
13
2
1
1
1
1
3
1
2
16
1
6
25
18
11
60
4
24
354
62
Metropolitan Health Committee,
Vancouver—Continued
School District No. 44 	
 ,   45	
Simon   Fraser,   New  Westminster—
School District No. 40	
 43. 	
North Fraser Valley, Mission—
School District No. 42	
 75.
 76 	
Upper Island, Courtenay—
School District No. 47	
„   71	
„   72
16
5
15
11
8
5
2
4
5
3
5
1
3
1
2
14
8
1
1
2
__
11
4
4
1
1
1
1
3
3
1
4
25
8
23
22
7
11
2
2
5
4
1
2
3
3
3
1
11
5
1
2
7
3
4
10
3
3
2
3
5
4
1
2
1
___
41
„   3	
13
„   4. 	
, 5 	
„   18	
Selkirk, Nelson—
School District No. 7	
38
33
„   8	
15
West Kootenay, Trail—
School District No. 9	
, 11
16
4
„   12	
„   13	
6
10
4
School District No. 14	
„   15	
„   16	
Skeena, Prince Rupert—
School District No. 50 	
 52
4
7
„   17 .,	
„   23	
 77 	
North Okanagan, Vernon—
School District No. 19. 	
„   20
„   53 	
„   54...	
Peace River, Dawson Creek—
School District No. 59	
„   60	
 81
4
3
4
5
1
„   21	
Victoria-Esquimalt Union Board
of Health—
School District No. 61 (part1)
Saanich  and  South Vancouver
Island—
School District No. 61 (part2)
„   62      	
„   22	
 78...	
South Central, Kamloops—
School District No. 24	
 26	
„   29	
25
13
1
„   30 	
„   31...    	
 63	
„   64...._	
Central Vancouver Island, Na-
naimo—
School District No. 65	
 66	
„   67.	
„   68. 	
„   69._	
 70   	
2
2
Cariboo, Prince George—
School District No. 27 	
„   28	
„   55	
 56	
9
3
5
 57.	
„   58.	
21
7
7
wack—
School District No. 32 ~_
„   79	
School districts not covered by
health units—
School District No. 46	
 48	
„   49	
„   61 (part3)
„   74     	
1
33
„   34	
Boundary, Cloverdale—
School District No. 35	
„   36..	
2
3
6
5
„   37	
2
Metropolitan Health Committee,
 80	
5
4
School District No. 38...	
„   39	
Unknown .   — — -	
1
8
 41	
Totals	
452
606
1,058
1 Includes Victoria and Esquimau only.
2 Excludes Victoria, Esquimau, and Oak Bay.
3 Includes Oak Bay only.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
J 79
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MENTAL HEALTH SERVICES REPORT,  1959/60
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 J 84
MENTAL HEALTH SERVICES REPORT,  1959/60
Table 6.—First Admissions to Crease Clinic by Marital Status, Mental
Diagnosis, and Sex, April 1st, 1959, to March 31st, 1960
Table 7.—Readmissions to Crease Clinic by Marital Status, Mental Diagnosis, and Sex, April 1st, 1959, to March 31st, 1960
Table 8.—First Admissions to Crease Clinic by Mental Diagnosis, Years
of Schooling, and Sex, April 1st, 1959, to March 31st, 1960
Table 9.—Readmissions to Crease Clinic by Mental Diagnosis, Years of
Schooling, and Sex, April 1st, 1959, to March 31st, 1960
Table 10.—First Admissions to Crease Clinic by Citizenship, Age-group,
and Sex, April 1st, 1959, to March 31st, 1960
Table 11.—First Admissions to Crease Clinic by Religion and Sex,
April 1st, 1959, to March 31st, 1960
Table 12.—First Admissions to Crease Clinic by Previous Occupation and
Sex, April 1st, 1959, to March 31st, 1960
Detailed information for the above tables may be obtained on request.
Table 13.—Live Discharges from Crease Clinic by Condition on Discharge,
Disposition to, and Sex; April 1st, 1959, to March 31st, 1960
Disposition to—
Condition
Home
Clinic
Agency
General
Hospital
Welfare
Institution
Other
Mental
Hospital
Other
Total
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Recovered	
Much improved..
Improved 	
Unimproved	
42
50
430
56
23
68
654
51
	
	
1
1
	
16
11
10
23
1
42
50
446
69
23
68
665
74
65
118
1,111
143
Totals
578
796
	
1
1
	
27
33
1
607
830
1,437
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
J 85
Table 14.—Live Discharges from Crease Clinic by Mental Diagnosis, Condition on Discharge, and Sex, April 1st, 1959, to March 31st, 1960
Mental Diagnosis
Condition on Discharge
Recovered   In^"*ed     Improved
M.
F.
M.
1
F.
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3
15
17
144
2
6
9
24
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1
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9
10
11
18
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1
2
	
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4
1
8
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M.
Total
M.   |   F.
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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 re action 	
Obsessive-compulsive reaction _	
Neurotic-depressive reaction. 	
Psychoneurosis with somatic symptoms
(somatization reaction) affecting circulatory system    	
Psychoneurosis with somatic symptoms
(somatization reaction) affecting digestive system
Psychoneurosis with somatic symptoms
(somatization reaction) affecting other
systems
Psychoneurotic   disorders,
and unspecified types..
other,   mixed,
Chronic brain syndrome with neurotic reaction   	
Total with psychosis ..
Without Psychosis
Pathological personality. 	
Imm atu re personality	
Alcoholism	
Other drug addiction	
Primary childhood behaviour disorders..
Mental deficiency
Other and unspecified character behaviour
and intelligence disorders.
Chronic brain syndrome with behavioural
reac ti on	
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 ._ -	
210
30
29
9
1
1
4
43
61
23
2
2
196
28
174
258
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1
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4
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42  |    23
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2
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12
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31
37
14
2
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4
14
6
21
24
169
1,437
 J 86
MENTAL HEALTH SERVICES REPORT,  1959/60
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 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
PROVINCIAL MENTAL HOSPITAL
J 89
Table 1.—Movement of Population, Provincial Mental Hospital, Essondale, April 1st, 1959, to March 31st, 1960
Male
Female
Total
1,822
80
3
1,457
183
4
3,279
263
7
Totals as at April 1st, 1959 	
1,905
1,644
3,549
Admissions—
421
109
301
4
315
168
281
736
Readmissions to a different institution of Mental Health Services
277
582
4
835
764
1,599
2,740
2,408
5,148
Separations—
875
112
27
110
8
738
58
197
4
1,613
170
Died  	
27
307
12
1,132
997
2,129
—214
1,608
—46
1,411
—260
In residence, March 31st, 1960    	
3,019
 I 90
MENTAL HEALTH SERVICES REPORT,  1959/60
Table 2.—First Admissions to Provincial Mental Hospital, Essondale,
by Health Unit and School District of Residence and Sex, April 1st,
1959, to March 31st, 1960.
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
School District No. 1	
1
2
1
4
2
1
1
3
4
2
6
2
2
5
1
4
8
12
2
1
1
5
2
1
1
10
1
2
5
8
4
20
4
6
206
52
4
3
2
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1
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4
4
1
1
3
4
8
6
1
2
1
2
6
1
5
3
5
2
29
2
5
219
33
20
3
2
1
5
1
6
3
2
5
7
4
3
7
2
2
8
1
8
16
18
1
4
1
2
5
4
1
1
16
1
1
7
8
13
6
49
6
11
425
85
24
Metropolitan Health Committee,
Vancouver—Continued
School District No. 45	
Simon   Fraser,   New  Westminster—
School District No. 40.—	
„   43	
North Fraser Valley, Mission—
School District No. 42	
 75.....	
 76 	
Upper Island, Courtenay—
School District No. 47 	
„   71. 	
 ,   72	
Skeena, Prince Rupert—■
School District No. 50 	
 52    	
 53	
„   54..	
Peace River, Dawson Creek—
School District No. 59 	
 60	
 81	
Victoria-Esquimalt Union Board
of Health-
School District No. 61 (part1)
Saanich  and  South Vancouver
Island—
School District No. 61 (part2)
 ,   62.. 	
„   63	
„   64	
Central Vancouver Island, Na-
naimo—
School District No. 65	
„   67	
„   68	
„   69	
, 70	
School districts not covered by
health units—
School District No. 46	
 48	
 49	
 61 (part3)
 73	
, 80	
Unorganized 	
26
7
13
4
1
1
1
2
1
2
1
1
18
8
2
3
5
1
8
2
3
3
1
4
3
2
2
3
5
4
15
8
6
2
1
1
2
3
3
2
1
1
1
1
8
2
6
8
1
7
2
6
2
3
1
1
6
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 5...	
 18	
4
Selkirk, Nelson—
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 7 	
„   8	
41
15
19
„   10	
West Kootenay, Trail—
School District No. 9 _	
„   11   	
,,   12 	
South Okanagan, Kelowna—
School Disrtict No. 14—	
„   15
6
1
2
3
4
2
„   16..	
4
„   17    .
4
,,23	
1
„   77
North Okanagan, Vernon—
School District No. 20	
„   22	
2
2
1
South Central, Kamloops—
School District No. 24	
„   26.-	
26
 29	
    30     _   .   .
 31	
Cariboo, Prince George—
School District No. 27	
 28    -.
10
1
2
9
 55
„   56... ... .   .
 57 ..   .
„   58	
„   82 	
13
2
15
Upper    Fraser   Valley,    Chilli-
wack—
School District No. 32	
„   33	
 34	
Boundary, Cloverdale—
School District No. 35	
„   36	
„   37 	
Metropolitan Health Committee,
Vancouver—
4
3
9
2
1
7
4
3
2
3
„   39	
„   41.	
„   44
Ex-Province  _ 	
Totals  	
11
530
483
1,013
1 Includes Victoria and Esquimau only.
2 Excludes Victoria, Esquimau, and Oak Bay.
3 Includes Oak Bay only.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
J 91
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Table 6.—First Admissions to Provincial Mental Hospital, Essondale, by
Mental Diagnosis, Marital Status, and Sex, April 1st, 1959, to March
31st, 1960.
Table 7.—Readmissions to Provincial Mental Hospital, Essondale, by
Mental Diagnosis, Marital Status, and Sex, April 1st, 1959, to March
31st, 1960.
Table 8.—First Admissions to Provincial Mental Hospital, Essondale,
by Mental Diagnosis, Years of Schooling, and Sex, April 1st, 1959, to
March 31st, 1960.
Table 9.—Readmissions to Provincial Mental Hospital, Essondale, by
Mental Diagnosis, Years of Schooling, and Sex, April 1st, 1959, to
March 31st, 1960.
Table 10.—First Admissions to Provincial Mental Hospital, Essondale, by
Citizenship, Age-group, and Sex, April 1st, 1959, to March 31st, 1960
Table 11.—First Admissions to Provincial Mental Hospital, Essondale, by
Religion and Sex, April 1st, 1959, to March 31st, 1960
Table 12.—First Admissions to Provincial Mental Hospital, Essondale, by
Previous Occupation and Sex, April 1st, 1959, to March 31st, 1960
Detailed information for the above tables may be obtained on request.
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 J 98
MENTAL HEALTH SERVICES REPORT,  1959/60
Table 14.—Resident Population of Provincial Mental Hospital, Essondale, by Mental Diagnosis, Number of Previous Admissions, and Sex,
December 31st, 1959.
Table 15.—Resident Population of Provincial Mental Hospital, Essondale, 25 Years of Age and under, by Mental Diagnosis, Length of
Stay, and Sex, December 3 1st, 1959.
Table 16.—Resident Population of Provincial Mental Hospital, Essondale, 26 to 49 Years of Age, by Mental Diagnosis, Length of Stay,
and Sex, December 3 1st, 1959.
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, 1959.
Detailed information for the above tables may be obtained on request.
Table 18.—Live Discharges from Provincial Mental Hospital, Essondale,
by Condition on Discharge, Disposition to, and Sex, April 1st,-1959,
to March 31st, 1960.
Disposition to—
Condition
Home
Clinic
Agency
General
Hospital
Welfare
Institution
Other
Mental
Hospital
Other
Total
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Recovered	
Much improved-
Improved	
Unimproved	
16
13
514
49
36
20
477
38
~~l
—
3
	
~~2
—
1
40
173
1
18
128
3
2
60
25
1       19
1       16
13     617
5  1 250
37
22
508
171
56
38
1,125
421
Totals	
592
571
1
—
3
—
2
214
147
90
20
902
738
1,640
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
J 99
Table 19.—Live Discharges from Provincial Mental Hospital, Essondale,
by Mental Diagnosis, Condition on Discharge, and Sex, April 1st,
1959, to March 31st, 1960.
Mental Diagnosis
Condition on Discharge
Recovered      *$•* „
M.
F.
M.
Improved
M.
Unimproved
Total
M.
F.
1
M.
75
16
421
1
13
13
	
1
8
20
15
23
21
70
30
	
1
39
1
1
; 12
1
	
6
1
3
5
3
1
1
	
3
4
11
	
1
1
1
1
5
11
Grand
Total
With Psychosis
Schizophrenic disorders	
Manic-depressive reaction	
Involutional melancholia	
Paranoia and paranoid states..
Senile 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 other
systems
Psychoneurotic   disorders,
and unspecified types -
other,   mixed,
Chronic brain syndrome with neurotic reaction 	
Syphilis and its sequelae-
Total with psychosis..
Without Psychosis
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 —
Total without psychosis-
Grand totals	
34
333
11
13
7
3
9
32
7
3
291
22
14
4
9
14
8
17
335
29
18
5
15
80
17
12
20
11
14
22 I 444
421
126 I 113 [ 601 | 590
19       37
16
22
25
4
114
3
3
9
173
617
1
2
10
1
87
508
22
2
22
2
10
5
28
1
124
250
13
48
6
137
5
3
20
9
34
3
34
58 I 301
171     902
148
756
42
31
13
38
110
56
24
26
16
5
1
6
50
3
11
1,191
72
17
175
8
6
46
18
44
17
42
1
449
728     1,640
 I  100
MENTAL HEALTH SERVICES REPORT,  1959/60
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 J   104
MENTAL HEALTH SERVICES REPORT,  1959/60
PART III.—THE WOODLANDS SCHOOL,
NEW WESTMINSTER
REPORT OF THE MEDICAL SUPERINTENDENT
L. A. Kerwood, Medical Superintendent
PATIENT POPULATION
On March 31st, 1960, total cases on register, including cases on probation,
were 1,409.   There were 1,387 patients in residence.
ADMISSIONS
There were 134 cases admitted to permanent care at The Woodlands School
during the year.
As time passes, we need more accommodation for the crib cases, which grow
larger and are required to be transferred to beds. It should be noted in passing
that many of these are maldeveloped and crippled and suffer from cerebral palsy.
With increasing medical knowledge, the life-span of the severely retarded is increasing annually.
Admissions by Diagnosis
During the year the provisional classifactory system of the American Association on Mental Deficiency has been utilized to classify patients studied in our
diagnostic clinic.
The following table shows the diagnoses of the cases studied this year:-—
Diagnosis
Male
Female
Total
Cerebral birth trauma   — — 	
Cerebral infection, postnatal (specify)	
Congenital cerebral maldevelopment due to prenatal infection (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 (iso-immunization, other)..
Other-postnatal forms	
Progressive neuronal degeneration	
Psychogenic _ _. — 	
Unclassified  	
Unknown..   	
10
1
16
5
5
1
12
3
4
1
4
5
11
4
Totals-
82
6
2
1
20
5
3
7
2
2
2
1
12
63
16
3
1
36
5
10
4
19
5
6
1
4
2
6
23
4
145
Temporary Admissions (Thirty-day)
There were 107 cases given temporary thirty-day care during the year (males,
51; females, 56).   Thirty-two of these cases were admitted more than once.
Waiting List
We have attempted to assess the urgency of all admissions and to make
admissions on a priority basis.   Decisions of this kind are difficult to make in view
 THE WOODLANDS SCHOOL
I  105
of the knowledge we have of the hardships to which some of these children and
their parents are subjected. We are endeavouring to secure more information
which will lead to a finer assessment of these children. We are endeavouring to
give help and a measure of temporary relief to those on our waiting list.
PHYSICAL CARE AND THERAPEUTIC PROGRAMME
During the year the following infectious diseases were notified to the public
health authorities: Infectious hepatitis, 103 cases; German measles, 28 cases;
Shigella dysentery, 39 cases; scarlet fever, 45 cases; and 1 case of poliomyelitis on
February 10th which made an adequate recovery.
I would like to thank our many colleagues in this service, in the Public Health
Branch, and in the Department of Pediatrics of the University for the assistance
that they have given during the year.
Sewing class in the domestic science room at The Woodlands School.
 J 106 MENTAL HEALTH SERVICES REPORT, 1959/60
Staff
It is with great regret that the resignation of Dr. P. Hughes on January 31st,
1960, is reported. Her contribution to the programme to The Woodlands School
during her years of service has been exemplary, and her loss is deeply felt by both
staff and patients.
Discussions have taken place during the year with the Director of Nursing
Services and the Personnel Officer to analyse types of care needed and the training
of suitable personnel. A programme for the student psychiatric nurses was installed
by the staff of The Woodlands School. We have had many favourable reports on
increased interest because of this course.
All departments of the School have functioned adequately. During the year
there has been an increase in patient activities and patient-training in all areas.
It is fair to say that many of the patients have a full and enjoyable life at the School.
This has only been possible because of the active co-operation and interest of the
staff members.
THE TRANQUILLE SCHOOL
In October, 1958, the Tranquille Sanatorium was transferred to the Mental
Health Services Branch. One hundred and ten adult male patients have been
transferred. All these patients were minimal nursing care and were not receiving
active training or medical attention. The Branch has been under the supervision
of Mr. E. V. Roy Merrick, who has enthusiastically interested himself in the further
development and care of these people. A population breakdown shows the types
of patients in residence: Dull normal, 1; border line, 3; moron, 18; imbeciles, 75;
idiots, 13. Seven of these are handicapped physically but not to a degree which
necessitates being confined to a bed or wheelchair. One of the interesting factors
about the operation of the Tranquille School is that, given adequate living conditions, efficient laundry, and good dining-room facilities, many of these patients have
developed (as regards self-care) very considerably since their transfer. There is
an active recreational and occupational programme, and most of the patients are
involved in work on or around the grounds and farm. This residential care home
is functioning effectively in keeping the patients healthy, happy, and well cared for.
Many favourable comments have been received from their relatives.
 THE WOODLANDS SCHOOL
I 107
STATISTICAL TABLES
THE WOODLANDS SCHOOL
Table 1.—Movement of Population, The Woodlands School, New Westminster, April 1st, 1959, to March 31st, 1960
Male
Female
Total
803
8
600
8
1,403
16
Total as at April 1st, 1959 .   _ _	
Admissions—
811
97
4
15
2
608
75
3
13
1,419
172
7
28
2
Total admissions _	
118
91
209
929
699
1,628
Separations—
10
28
11
112
16
14
34
10
6
24
62
T">1><1
21
112
22
Total separation*
177
64
241
—51
752
+35
635
— 16
1,387
 I  108
MENTAL HEALTH SERVICES REPORT, 1959/60
Table 2.—First Admissions to The Woodlands School by Health Unit
and School District of Residence and Sex, April 1st, 1959, to March
31st, 1960.
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
Metropolitan Health Committee,
School District No. 2	
1
1
Vancouver—Continued
„   4 	
1
2
School District No. 44—	
4
6
10
„   5    .
	
1
1
„   45      	
Simon   Fraser,   New   Westmin
1
1
2
„   18 	
West Kootenay, Trail—
ster—
School District No. 9	
1
1
School District No. 40	
4
2
6
 ,   11	
1
„   43	
1
1
2
„   12	
2
3
North Fraser Valley, Mission—
South Okanagan, Kelowna—
School District No. 42	
2
1
3
School District No. 14	
1
2
1
 75
3
3
„   15..	
Upper Island, Courtenay—
 16 	
	
1
School District No. 71—	
1
1
2
„   77	
	
1
1
„   72	
Skeena, Prince Rupert—
1
2
3
North Okanagan, Vernon—
School District No. 19	
1
2
School District No. 52 -	
3
2
5
„   22	
1
2
„   53.- 	
1
1
 78 	
1
Peace River, Dawson Creek—
South Central, Kamloops—
School District No. 59	
1
1
2
School District No. 24	
3
3
„   60	
1
1
„   26..	
1
Victoria-Esquimalt Union Board
„   31	
1
of Health-
Cariboo, Prince George—
School District No. 61 (part1)
2
2
4
School District No. 27	
1
2
Saanich  and  South Vancouver
 28	
1
2
Island—
„   57	
2
1
3
School District No. 61 (part2)
2
1
3
Upper   Fraser   Valley,   Chilli-
Central Vancouver Island, Na-
wack—
naimo—
School District No. 32	
1
1
School District No. 65	
1
1
33
2
1
1
3
„   66-	
„         „   67        	
1
1
4
2
1
„   34
1
Boundary, Cloverdale—
„   68	
6
School District No. 35	
5
2
7
 70	
2
2
 36	
7
4
11
School districts not covered by
„   37.	
1
1
health units—
Metropolitan Health Committee,
School District No. 46	
1
1
Vancouver—
„   49	
1
1
School District No. 38 	
7
7
Unorganized _	
1
1
„          ,,         ,,   39. .
20
6
17
11
37
17
1
1
„   41	
Totals	
101
78
179
1 Includes Victoria and Esquimau only.
2 Excludes Victoria, Esquimau, and Oak Bay.
 THE WOODLANDS SCHOOL
I 109
Table 3.—First Admissions and Readmissions to The Woodlands School
by Method of Admission, Age-group, and Sex, April 1st, 1959, to
March 31st, 1960.
Age-group (Years)
Method of Admission
Under
1
1-3
4-6
7-9
10-14
15-19
20-29
30-39
40 and
Over
Grand
Total
M.  F.
M.|F. |M.|F.
1      1      1
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
First Admissions
Warrant—  	
1
8
6
8
4
13
__
11
8
8
1
8
6
5
23
~~9
7
7
1
9
7
5
1
~4
1
~~4
i
2
..-
1
69
1
30
46
"32
1
115
Urgency	
Temporary admission	
l|    3
1
62
■ 1    11 14
12
18| 19
17
11
32| 14| 11| 10
6|    4
1|    5
2|    2
1011 78
179
Readmissions
. .......     2
1
1
2
2
1
2
1
3
4
1
1
1
4
1
1
..._.
1
13
4
5
8
18
Temporary admission.....
12
Totals 	
...  1    3
1
3
3
3
3
4
2
1
5
1
1
17
13
30
Table 4.—First Admissions and Readmissions to The Woodlands School by
Mental Diagnosis, Age-group, and Sex, April 1st, 1959, to March 31st,
1960.
Age-group (Years)
Mental Diagnosis
Under
1
1-3
4-6
7-9
10-14
15-19
20-29
30-39
40 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
First Admissions1
Mental deficiency—
Idiocy and imbecility-
Moron   —
Border-line intelli-
1
12
1
1
9
2
1
8
5
~5
14
5
8
8
1
8
3
7
17
5
3
1
10
2
1
1
8
2
3
6
1
1
4
1
1
3
1
3
1
1
1
1
2
38
44
9
10
37
34
4
3
75
78
13
Mongolism —	
13
Totals 	
	
1|  14
12
18
19
17
11| 32|  14
11
10
6|    4|    1
5|    2
2
101
78
179
Readmissions2
Mental deficiency—
Idiocy asd imbecility
Moron    	
_._.
2
1
1
3
2
1
2
3
2
2
2
1
3
2
1
1
—
5
8
2
2
5
5
1
2
10
13
Border-line intelligence —	
Mongolism 	
	
	
3
4
Totals	
	
3
1
—
3
3
3
3
4
2
1
5
1
	
1
17
13
30
1 Of the first admissions, 60 had epilepsy:   38 idiots and imbeciles, 18 morons, 4 border-line intelligence,
and 1 mongol.
2 Of the readmissions, 12 had epilepsy:   7 idiots and imbeciles, and 5 morons.
 I  110
MENTAL HEALTH SERVICES REPORT,  1959/60
Table 5.—First Admissions to The Woodlands School by Mental Diagnosis,
Years of Schooling, and Sex, April 1st, 1959, to March 31st, 1960
Table 6.—First Admissions to The Woodlands School by Citizenship, Age-
group, and Sex, April 1st, 1959, to March 31st, 1960
Table 7.—First Admissions to The Woodlands School by Religion and Sex,
April 1st, 1959, to March 31st, 1960
Table 8.—First Admissions to The Woodlands School by Previous Occupation and Sex, April 1st, 1959, to March 31st, 1960
Detailed information for the above tables may be obtained on request.
Table 9.—Resident Population of The Woodlands School by Mental
Diagnosis, Age-group, and Sex, December 31st, 1959
Age-group (Years)
Mental Diagnosis
Under
1
1-3
4-«
7-9
10-14
15-19
20-29
30-39
40 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
With Psychosis
Schizophrenic disorders—
	
	
	
1
._...
3
1
3
1
_
3
1
3
1
1	
1
3
Catatonic type.  ,   _
	
	
1
Paranoid type	
Alcoholic psychosis ...
Neurotic-depressive
	
	
	
3
1
1
Total with psychosis- 	
I	
1
8
8
1
9
Without Psychosis
Mental deficiency—*
Idiocy and imbecility
1
6
1
17
1
31
10
1
21
1
34
4
14
......
49
14
3
22
3
42
'   4
18
2
88
37
9
24
2
74
16
5
18
5
72
38
10
24
4
59
33
3
16
2
69
43
12
20
3
58
31
4
25
2
48
6
7
7
45
18
6
8
37
19
3
7
3
52
13
4
4
400
168
45
126
16
382
120
22
103
12
782
288
Border-line  intelli-
67
	
1
1
229
Other and unspecified. ...	
28
Total   without
psychosis-  ...
1
8
19
64
52
91
66
160
118
148
113
147
12o| 68
77
69
73
755
639
1,394
Grand totals
i    1
8
19
64
52
91
66
1601,118
148
114
147
120
68
77
77
73
763
640
1,403
■ Includes 118 male and 135 female diagnoses of mental deficiency with epilepsy.
Table 10.—Resident Population of The Woodlands School by Mental
Diagnosis, Length of Stay, and Sex, December 31st, 1959
Detailed information for the above table may be obtained on request.
 THE WOODLANDS SCHOOL
I  111
Table 11.—Live Discharges from The Woodlands School by Mental Diagnosis, Condition on Discharge, and Sex, April 1st, 1959, to March 31st,
1960.
Condition on Discharge
Total
Mental Diagnosis
Recovered
Much
Improved
Improved
Unimproved
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Mental deficiency—
1
1
z i :::
2
—
1
6    1    ._.
10    1      8
1         __
67
42
4
18
16
20
4
73
52
7
18
16
28
4
89
Moron                                  ._
Border-line intelligence.	
80
7
22
Totals
i
2
—
17
8
131
40
150
48
198
1
Note.—Of the above cases, 42 had epilepsy:   22 idiots and imbeciles, 19 morons, and 1 mongol.
Table 12.—Live Discharges and Deaths from The Woodlands School by
Mental Diagnosis, Age-group, and Sex, April 1st, 1959, to March 31st,
1960.
Age-group (Years)
Mental Diagnosis
Under
1
1-3
4-6
7-9
10-14
15-19
20-29
30-39
40 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.  F.
M.
F.
M.
F.
Live Discharges1
Mental deficiency-
Idiocy and imbecility
3
1
4
1
1
3
1
6
2
4
7
3
2
1
5
1
1
1
7
"~2
7
3
2
5
7
1
20
18
2
10
1
4
1
1
1
19 _
6|    2
1
11
1
16
11
1
1
1
3
73
52
7
16
28
4
89
Moron
80
Border-line    intelligence
7
 1 18
22
Totals 	
   1,1    4|    6
4|    8| 11
5
8| 10| 17|    8
501    5| 271    2
29
4|150
48
198
Deaths"
Imbecility	
1
2|    1
 1_
2
3
1
2
1
1
.1
2
1
1
21 10
 1    1
7
3
17
Mnrnn
_|_
—
	
	
—
I    i
Totals   	
1
2
1
2
4
2
1
2
2
—
2
10
21
1 Of the live discharges, 42 had epilepsy:   22 imbeciles, 19 morons   and 1 mongol.
2 Of the cases who died, 12 had epilepsy:   10 imbeciles, and 2 morons.
Table 13.—Live Discharges and Deaths Occurring in The Woodlands
School by Mental Diagnosis, Length of Stay, and Sex, April 1st,
1959, to March 31st, 1960.
Detailed information for the above table may be obtained on request.
 I  112
MENTAL HEALTH SERVICES REPORT, 1959/60
Table 14.—Deaths Occurring in The Woodlands School by Cause of Death,
Age-group, and Sex, April 1st, 1959, to March 31st, 1960
Age-group (Years)
1-3
4-6
7-9
10-14
15-19
20-29
30-39
40 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
—
1
~I
1
1
1
1
1
1
1
1
1
—
—
—
—
1
1
	
1
1
1
2
3
1
2
2
1
1
3
2
1
1
1
Late effects of intracranial abscess
1
1
1
1
1
2
1
1
—
—
1
1
Arteriosclerotic and degenerative
i
—
2
6
Other diseases of the respiratory
system  	
Diseases of the digestive system	
Congenital malformations	
Other and unspecified diseases	
—-
—
1
	
1
2
2
1
Totals	
1
2
1
2
4
2
—
—
1
2
21 1    2
2
11
10
21
Table 15.—Deaths Occurring in The Woodlands School by Cause of Death,
Length of Stay, and Sex, April 1st, 1959, to March 31st, 1960
Detailed information for the above table may be obtained on request.
 THE WOODLANDS SCHOOL
TRANQUILLE SCHOOL
I  113
Table 1.—Movement of Population, Tranquille School, Tranquille,1
April 1st, 1959, to March 31st, 1960
In residence, April 1st, 1959	
Admissions—Transfers from The Woodlands School
Total under care	
Separations—■
Transferred to The Woodlands School
On probation and still out	
Number
112
112
2
1
Total separations
Net increase or decrease  -|-109
In residence, March 31st, 1960       109
1 This institution cares for male patients only.
Table 2.—Transfers to Tranquille School, Tranquille, by Mental
Diagnosis and Age-group, April 1st, 1959, to March 31st, 1960
Mental Diagnosis
Age-group (Years)
Total
15-19
20-29
30-39
40 and
Over
Mental deficiency—•
6
3
19
16
1
18
5
1
15
11
1
1
58
35
2
5                 10
17
Totals	
14
46
24
28
112
Note.—Of the above cases, 9 had epilepsy:   4 idiots and imbeciles, 4 morons, and 1 mongol.
 J  114 MENTAL HEALTH SERVICES REPORT, 1959/60
PART IV.—PROVINCIAL MENTAL HOME, COLQUITZ
REPORT OF MEDICAL SUPERINTENDENT
L. G. C. d'Easum, Medical Superintendent
The fiscal year April 1st, 1959, to March 31st, 1960, was an uneventful one
at this institution, and there were no outstanding events to report. However, all
the departments were kept busy doing their routine tasks.
There were a few changes in the personnel of the staff. During the year one
psychiatric nurse, Mr. A. H. Stevenson, retired, having reached the age of superannuation, and three psychiatric aides left the service for various reasons. The
vacancies were filled by the appointment of four psychiatric aides. The percentage of psychiatric aides to the total nursing staff is approximately 40.6 per cent.
Our patient population on April 1st, 1959, was 281, and on March 31st, 1960,
was 288. During the year twenty-seven patients were received from the Provincial
Mental Hospital, Essondale, and four patients were transferred from this institution
to Essondale. Three of the latter were transferred to the North Lawn Building
for treatment for pulmonary tuberculosis.
Three patients were discharged in full during the year. One was discharged
on transfer to St. John's Hospital in Newfoundland and the second patient was
considered sufficiently recovered to be returned to the British Columbia Penitentiary.   Two patients were discharged on probation.
During the year fifteen patients were seen by the Appeal Board. There were
eleven patient deaths during the year, most of these being in the old-age group, and
in most cases the cause of death was due to cardiac failure.
During the year a number of patients were allowed to go home on leave for
varied periods of time, from a week-end to two to three weeks. These patients
have always returned on the appointed date and have not abused their privileges.
As always, the Vancouver Island Chest Clinic has been most co-operative and
has made regular visits to the Home with a portable X-ray unit to X-ray both
patients and staff.
Throughout the year the general health of the patients was good. Regular
visits were made during the year by Drs. S. S. Avren and W. Dempsey to care for
the physical and dental needs of the patients respectively.
Occupational Therapy Department
This department was kept busy during the year, and both occupational-therapy
shops were utilized to the fullest. With the various crafts of ceramics, art metal-
work, leatherwork, and woodwork of all kinds, as well as maintenance of buildings
and decorating, the two occupational-therapy shops had a busy year. A large number of toys were made, others repaired, and taken to the Cosmopolitan Club in Victoria for distribution to needy families at Christmas.
A display of handicraft was shown at the Victoria Exhibition in May, 1959.
Many favourable comments were heard about this display.
Twenty oak and mahogany tables of period furniture design were made for
the new Government House. These were not available in Victoria and were required for the occasion of the Queen's visit.
A group of patients was kept busy during the year working under supervision
repairing and maintaining the buildings and equipment.
 provincial mental HOME J 115
The second wooden stairway leading from the Lower East Ward to the Top
East Ward was replaced by a concrete stairway. In the Lower East dining-room,
which comprises an area of approximately 1,600 square feet, light-green asphalt
tile was laid on the concrete floor. This has enhanced the appearance of this room,
as well as making it a lot easier to keep clean.
A new fire-escape was made and installed at the staff house. A new gutter
was installed all around, and the staff house roof was completely reshingled with
composition shingle.
The greenhouse was all reputtied and painted during the summer.
During the year the Top East Ward kitchen was enlarged, and new cupboards
were made for it.
The sewage plant, which has been in operation for four years, was completely
emptied, cleaned, scraped, painted, and overhauled. This was a big undertaking,
as the work had to be done in winter under adverse conditions.
Fire-fighting equipment was checked regularly and was found to be in satisfactory condition when inspected by the Saanich Fire Department in November.
Tailor and Shoe Shop
During the year an average of five patients was kept occupied in the tailor-
shop and shoe-shop, and many new articles were made and supplied to Stores. In
the previous report I mentioned that most of the material was used in making new
canvas blankets. I am glad to report that the patients who were destroying blankets
have responded to treatment and no longer have a propensity for destroying clothing.
Laundry
The laundry has continued to work to capacity. The amount of work done
was around 3,500 pounds each week and approximately 1,000 blankets a year.
Once again this department was called upon to give service to the linen used in the
Legislative dining-room during the sitting of the Legislature.
Machinery in the laundry continued to give good service.
Recreation
During the year a total of ten band and variety concerts was presented for the
patients' entertainment in addition to the regular programme of picture shows, television, radio, and various indoor table games.
Weather permitting, the recreation court was in daily use during the summer
months, and in the winter months the more active patients were allowed outside to
exercise on the cement sidewalks on the inside of the enclosure. Three sightseeing
bus tours were arranged during the year, and these are always enjoyed very much
by the patients participating.
In October, 1959, a group of volunteer workers of the Canadian Mental Health
Association commenced regular weekly visits and added a great deal of enjoyment
for the patients at the bingo games and card games.
The Canadian Mental Health Association, Canadian Legion, the combined
Women's Institutes, and the Salvation Army provided gifts for the patients at Christmas. The Red Cross Society and the Canadian Legion provided comforts for the
ex-servicemen monthly. Books for the patients are supplied by the Public Library
Commission and are changed every four months. This library consists of a very
good assortment of reading.
The spiritual needs of the patients were cared for by the Roman Catholic,
Salvation Army, and Protestant churches on alternate Sundays.
 I 116
MENTAL HEALTH SERVICES REPORT, 1959/60
STATISTICAL TABLES
Table 1.—Movement of Population, Provincial Mental Home, Colquitz,1
April 1st, 1959, to March 31st, 1960
Number
In residence, April 1st, 1959  281
On probation, carried forward from 1958/59       1
On escape, carried forward from 1958/59       1
Total as at April 1st, 1959  283
Admissions—Transfers from Provincial Mental Hospital     27
Total under care
310
Separations—
Discharged in full
Died 	
  5
  11
  4
  1
On escape but not discharged              1
Transferred to Provincial Mental Hospital
On probation and still out.
Total separations
Net increase or decrease	
In residence, March 31st, 1960
22
288
1 This institution cares for male patients only.
Table 2.—Transfers to Provincial Mental Home, Colquitz, by Health
Unit and School District of Residence, April 1st, 1959, to March
31st, 1960.
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, 1959, to March 31st, 1960
Method of Admission
Age-group (Years)
Total
20-24
25-29
30-34
35-39
40-44
45^*9
50-54
55-59
60-64
65-69
Warrant	
1
2
1
4
2
3
1
4
4
1
3
--
1
5
22
Totals	
3
5
5
1
4
4
1
3
—
1
27
 PROVINCIAL MENTAL HOME
I  117
Table 4.—Transfers to Provincial Mental Home, Colquitz, by Mental
Diagnosis and Age-group, April 1st, 1959, to March 31st, 1960
Mental Diagnosis
Age-group (Years)
Total
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
With Psychosis
2
1
4
1
4
1
1
4
4
1
2
1
—
1
23
Without Psychosis
Immature personality.	
1
2
....    |    .._
1
Totals 	
3
5
5
1
4
4
1
3
....    |      1
1
27
Table 5.—Transfers to Provincial Mental Home, Colquitz, by Mental
Diagnosis and Marital Status, April 1st, 1959, to March 31st, 1960
Table 6.—Transfers to Provincial Mental Home, Colquitz, by Mental
Diagnosis and Years of Schooling, April 1st, 1959, to March 31st, 1960
Table 7.—Transfers to Provincial Mental Home, Colquitz, by Citizenship
and Age-group, April 1st, 1959, to March 31st, 1960
Table 8.—Transfers to Provincial Mental Home, Colquitz, by Religion,
April 1st, 1959, to March 31st, 1960
Table 9.—Transfers to Provincial Mental Home, Colquitz, by Previous
Occupation, April 1st, 1959, to March 31st, 1960
Detailed information for the above tables may be obtained on request.
 I 118
MENTAL HEALTH SERVICES
REPORT, 1959/60
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Sow
 PROVINCIAL MENTAL HOME
I  119
Table 11.—Resident Population of Provincial Mental Home, Colquitz, by
Mental Diagnosis and Number of Previous Admissions, December 31st,
1959.
Table 12.—Resident Population of Provincial Mental Home, Colquitz, by
Mental Diagnosis and Length of Stay, December 31st, 1959
Detailed information for the above tables may be obtained on request.
Table 13.—Live Discharges from Provincial Mental Home, Colquitz, by
Mental Diagnosis and Condition on Discharge, April 1st, 1959, to
March 31st, 1960.
Condition on Discharge
Total
Improved
Unimproved
3
1
5
g
1
4
5
9
Table 14.—Live Discharges and Deaths from Provincial Mental Home,
Colquitz, by Mental Diagnosis and Age-group, April 1st, 1959, to
March 31st, 1960.
Mental Diagnosis
Age-group (Years)
Total
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70 and
Over
Live Discharges
Schizophrenic disorders...
Immature personality	
1
1
2
1
1
—
1
--
1
1
8
1
Totals	
1    |      1    |      2    |      1
1    |    ....    |      1    |    -
1
....    |      1
9
Deaths
Schizophrenic disorders-
Syphilis and its sequela?.—
Alcoholism	
Epilepsy	
--
—
—
—
2
1
2
....
1
1
—
4
6
1
1
1
2
Totals 	
—
-—
—
....
—
5
—
2
—
4
11
Table 15.—Live Discharges from and Deaths Occurring in Provincial
Mental Home, Colquitz, by Mental Diagnosis and Length of Stay,
April 1st, 1959, to March 31st, 1960.
Detailed information for the above table may be obtained on request.
 I  120
MENTAL HEALTH SERVICES REPORT,  1959/60
Table 16.—Deaths Occurring in Provincial Mental Home, Colquitz, by
Cause of Death and Age-group, April 1st, 1959, to March 31st, 1960
Cause of Death
Age-group (Years)
Total
50-54
55-59
60-64      65-69
70 and
Over
Malignant neoplasm	
4
1
-
1
1
1
1
3
1
1
8
1
Totals    	
5
2      |      ....
4
11
Table 17.—Deaths Occurring in Provincial Mental Home, Colquitz, by
Cause of Death and Length of Stay, April 1st, 1959, to March 31st, 1960
Detailed information for the above table may be obtained on request.
 GERIATRIC DIVISION I  121
PART V.—GERIATRIC DIVISION
REPORT OF MEDICAL SUPERINTENDENT
B. F. Bryson, Medical Superintendent
The Geriatric Divsion of the Mental Health Services Branch has continued to
provide special medical and psychiatric care for a large number of the elderly citizens of the Province. During the fiscal year 1959/60 the three units of this Division were able to provide this special care for over 1,400 patients.
The year has seen several major changes in the organization of the Division
as a whole, and at the Port Coquitlam unit new facilities and accommodation became
a reality with the opening of the Valleyview Building.
Since 1936 the Home for the Aged at Port Coquitlam and later the Homes
for the Aged at Vernon and Terrace, which constituted the Geriatric Division of
the Mental Health Services Branch, have operated under the Provincial Homes for
the Aged Act. The Mental Hospitals Act Amendment Act, 1958, provided for the
Provincial Homes for the Aged at Port Coquitlam, Vernon, and Terrace to be
public mental hospitals administered under the Mental Hospitals Act, and further
provided that the Provincial Homes for the Aged Act be repealed. This legislation
was proclaimed and became effective January 1st, 1960.
The prime function of the three units of this Division is to provide treatment
for our elderly patients with a view to rehabilitation to home or other suitable environment in the community wherever possible. The term " Home for the Aged,"
however, has tended to create a false impression of the purpose of these units and
has long connoted the negative attitude that they are " places of final rest and little
hope." It was considered advisable, therefore, to dispense with this term and to
adopt more suitable names. Accordingly, the Home for the Aged, Port Coquitlam,
was renamed Valleyview Hospital, Essondale; the Vernon unit was renamed Dellview Hospital;  and the Terrace unit renamed Skeenaview Hospital.
There has been no change in the general administration of the Geriatric
Division, however, which remains under the jurisdiction of the Medical Superintendent with headquarters at Valleyview Hospital. In addition, the problem of finding
adequate accommodation and treatment for the mentally disturbed elderly citizens
of the Province remains great, so that it is necessary to use available vacancies for
the care of those persons most in need. Applications for the admission of persons
over the age of 70 years must still be forwarded to the Medical Superintendent at
Valleyview Hospital.
The continued problem of finding suitable treatment and accommodation for
elderly persons is reflected in the significant increase in the number of applications
received during the year. During the past twelve months a total of 387 new applications was received. This represents an increase of fifty-one or 15 per cent over
the previous year. Of this total, 213 were for men and 174 for women. The
average number received per month has risen to thirty-two, compared to the monthly
average of twenty-eight over the past several years.
As in past years, the greatest number of requests was received from the
Lower Mainland for admission to Valleyview Hospital, and this year totalled 278,
an increase of twenty-seven. From the Okanagan and Kootenay areas, requests
for admission to Dellview Hospital totalled eighty-nine, in increase of sixteen, while
from the northern section of the Province there were twenty applications received.
 I  122 MENTAL HEALTH SERVICES REPORT, 1959/60
Although the increase in the number of applications has been relatively uniform
throughout the Province, there has been a significant change in the sex ratio of
requests. In previous years there has usually been a slightly greater number of
requests for women, whereas during this past year the number of applications for
men totalled 213, compared to 174 for women.
Of the total number of new applications received, 170 were considered of
sufficient urgency to be accepted immediately although other applications were on
hand. In all such instances, especially in those for admission from the Lower
Mainland, the patients were acutely disturbed or were in situations where their
behaviour or symptoms made their management impossible outside of a mental
hospital environment.
Vacancies created by deaths and discharges made it possible to accept a total
of 331 patients from the community. This total included 188 men and 143 women,
an increase of twenty-six over the previous year. It was possible to admit all male
applicants for admission from the areas of the Province served by the Vernon and
Terrace units, so that at the end of the fiscal year 1959/60 there were no names on
the waiting list for men at these two hospitals. However, there was a small list of
applications on hand for the admission of women to the Dellview Hospital and
a considerably larger accumulation of requests for both men and women for care
in the Valleyview Hospital.
With the provision of additional nursing staff and the opening of new wards
in the Valleyview Building in September and October, it was possible to accommodate an increased number of patients in the Geriatric Division. As will be noted
in the accompanying tables, the total number of patients in residence in the three
units as of April 1st, 1959, was 1,023, including 506 men and 517 women. At the
end of the year, however, the total resident population had increased to 1,179, of
which 600 were male and 579 female. This is an increase of 156. Most of this
increase has occurred at the Vallyeview Hospital, where the year-end resident population will be seen as totalling 657, representing an increase of 129 over the population count at the end of the previous year. At the Vernon unit there were sixteen
more patients in residence, while at Terrace the population count increased by
eleven.
New admissions to this division of the Mental Health Services during the year
totalled 425, including 103 who came directly from the community into the Dellview or Skeenaview Hospitals and 322 who were first admitted to the Provincial
Mental Hospital and later transferred to the Valleyview Hospital. Separations due
to death or discharge totalled 269, which is a decrease of sixty-three compared to
the previous year. As it is still most difficult to make arrangements for the return
of improved patients to the community, separations due to discharge have shown
little change and, in fact, were one less than for the previous year. The significant
decrease in separations, therefore, is due to the reduction in the number of deaths
within the divisions, which totalled only 251, compared to 313 last year. It is felt
that this improvement in the death rate reflects the higher standard of medical and
nursing care that has been possible with the provision of more nursing and medical
staff and improved facilities. There are still many elderly men and women in residence who have improved to the point that they could be cared for at home or in
nursing or rest homes in the community.
The accumulation of vacancies for men during the year at the Terrace and
Vernon units again made it possible to arrange several transfers of patients from
the Essondale area to these hospitals, thus providing much-needed accommodation
for admissions from the Lower Mainland area.    On May 26th, 1959, twenty men
 GERIATRIC DIVISION
J 123
were taken to the Skeenaview Hospital, and on November 17th, 1959, a further
nineteen were moved to the same unit. On June 23rd, 1959, a group of twelve
elderly gentlemen were transferred to the Dellview Hospital from the West Lawn
Building at Essondale. On each occasion, transportation was carried out by special
car via Canadian National Railways, and all patients arrived safely and happily at
their destination.
Table A.—Resident Population, Geriatric Division, by Mental Diagnosis,
Age-group, and Sex, December 31st, 1959
Age-group and Sex
Mental Diagnosis
50-54
55-59
:    '   S
60-64
65-69
70-74
75-79
80 and
Over
Not
Stated
Total
M.
F.
M.
I      1
F. IM.JF.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
With Psychosis
Schizophrenic disorder—
4
1
2
1
2
23
1
5
1
1
1
1
4
1
59
1
3
1
5
1
13
2
1
1
4
27
1
3
1
7
1
3
19
2
2
1
1
8
1
3
1
6
~1
134
46
—i
2
~~i
15
1
3
130
3
15
3
2
1
2
134
1
81
4
4
4
2
~1
i
2
13
15
4
3
5
—
7
40
2
3
1
5
Manic-depressive reaction—
7
1
1
"1
1
4
1
1
2
i
~2
~3
1
15
~16
2
3
~1
16
"23
1
1
1
1
41
26
1
1
1
1
4
1
1
71
39
1
1
1
1
71
33
1
"71
1
7
I'M
Psychosis with cerebral arteriosclerosis	
	
—
2
2
1
111
1
Psychosis of other demonstrable etiology-
Resulting from epilepsy and other con-
—
._..
	
—
?
Secondary or due to accidents or vio-
	
—
—
Secondary or due to other diseases—	
Other and unspecified psychosis—
1
Psychosis   with   psychopathic  person-
	
—
—
	
—-
1
?,
Anxiety reaction without mention of so-
1
1
	
3
—
l
	
4
Chronic brain syndrome without neuro
1
—
■>.
syphilis and its sequelae 	
	
Total with psychosis	
__ |—|    6
__ | 221    3
51|    8|110| 66|112|150
117|192|   4]    1
4221420
Without Psychosis
Alcoholism—
1
.   1
2
	
—
1
1
2
1
1
1
1
19
9
3
43
12
3
56
12
—-
—
3
1
2
2
2
9
82
29
Alcohol intoxication without qualify-
Mental deficiency—
1
—
1
1
—
	
-—
1
1
Chronic brain syndrome with behaviour-
1
1
2
16
6
2
8
5
4
19
11
7
2
—
	
2
84
Other and unspecified diseases of central
nervous system        .
__
26
II
- I-I   5|
3|    2| 28| 16| 35] 30
58| 71| | _|130|119
II ...
61
27
3
54
10I13R
82
147
180
557K39
 J 124 MENTAL HEALTH SERVICES REPORT, 1959/60
Throughout the year the Medical Superintendent has continued to follow the
policy of accepting for admission those patients most urgently in need of specialized
care and treatment, and of attempting to accommodate elderly patients in the unit
which is closest to their home, family, and friends. Many hours have been spent
through personal interview or by other means of communication with relatives,
physicians, and various welfare agencies in the Province in attempting to assess each
application as accurately as possible so that the vacancies could be used to the
greatest advantage. Advice and assistance have been given wherever possible to
encourage the maintenance of the elderly in the community and near familiar faces
and surroundings, which are so important to the aged person, to whom age itself
is a cause for insecurity and anxiety. For those who have been admitted, every
attempt is made to find ways to allay anxiety, depression, and apathy, and to develop
an environment which will re-create a feeling of security and belonging, a sense of
accomplishment, and a realization that the later years of life can be meaningful and
worth while.
A census of the resident population of the three units of the Geriatric Division
was taken on December 31st. The results have been tabulated by mental diagnosis,
age-group, and sex, as shown in Table A. It will be noted that the total number
of patients in residence on December 31st was 1,091, of whom 765 or 70 per cent
were 75 years of age or over.
Valleyview Hospital
The past twelve months have been eventful ones at this unit of the Geriatric
Division, with major advances in services and provision of staff and facilities for
the care of the many elderly men and women at Valleyview. These welcome
changes include the opening and occupation of the Valleyview Building, the expansion in staff, particularly nursing, and the reorganization of the general administration of the unit as an independent hospital within the Mental Health Services.
The most outstanding event was the official opening of the Valleyview Building
and auditorium by the Honourable Wesley Black, Provincial Secretary, on May
22nd, 1960. The impressive ceremonies were conducted by the Honourable Eric
Martin, Minister of Health Services and Hospital Insurance, and were followed by
an " open house," during which many distinguished visitors and a large number
of the interested public toured the new buildings and viewed the new services and
wards, which have been gradually placed into operation during the year. The new
diagnostic and treatment services thus provided have greatly enhanced the nursing
and medical care for the patients in this area, as well as providing relief to the overtaxed departments at the Crease Clinic and Provincial Mental Hospital, which
have previously provided these services to the patients at Valleyview Hospital. The
six new wards, with 328 new beds, have been gradually occupied as new nursing
staff became available, making it possible to increase the total accommodation for
aged patients, as well as providing an opportunity to remove patients from two of
the older buildings which were severely overcrowded and in need of renovation.
At the end of the year all departments in the new building, except the dental area,
were in full operation, and the four infirmaries were occupied by patients transferred
from the old infirmaries and with new patients from the community.
A major administrative change occurred on April 20th, 1959, when the
nursing department began operating independently from the nursing department
at Essondale, under the direction of Miss E. Johnstone. This policy of unitization
of the Port Coquitlam unit has progressed during the year. The name given to the
new building was officially accepted as the most appropriate name for this area on
January 1st, 1960, when the Home for the Aged Act was removed from the Statutes.
 GERIATRIC DIVISION J 125
Since that date the Home for the Aged, Port Coquitlam, has become known as
Valleyview Hospital, Essondale, with an identity and a purpose of its own to serve
and care for the increasing number of elderly persons who are in need of the special
services available here.
These notable improvements in facilities, enlarged staff, and administrative
reorganization have already proven fruitful, with definite evidence of improvement
in the standard of medical and nursing care in the new infirmary wards. The
general health and welfare of this patient-group has been maintained at a very
satisfactory level throughout the year, and there have been no major medical
problems.
Dr. W. Lazorko has continued to give diligent service to his patients and was
joined by Dr. K. Greer, who began medical duties at Valleyview on April 13th,
1960. This increased medical service has assured constant and reliable medical
attention for all patients and provides time for each doctor to give more personal
attention to his patients and to detect medical conditions in early stages of development when preventive therapy is most effective. The medical staff have continued
the policy of keeping elderly patients as physically and as mentally active as their
condition warrants, and everything is done to prevent them becoming bedridden any
sooner than absolutely necessary. This policy not only serves to preserve the
integrity and independence of the patient, but reduces to a minimum the burden
of time-consuming bed care that is necessary for those who have become completely
helpless and dependent on the nursing staff.
Specialist consultant services have been readily available to a large number
of Valleyview patients through the Crease Clinic and Mental Hospital consultant
staff. During the year there were 270 new referrals, nearly double the number
that were seen the previous year. Of these, there were eighty men and women who
required general surgical procedures, which were carried out in the surgical department at the Crease Clinic. Orthopaedic care for fractures received in accidental
falls has again shown a decrease, as there were only eleven referrals of this nature,
compared to fourteen for the previous year. Consultations for special medical and
dermatological conditions have been more readily available, and an increased
number of elderly patients have improved vision and hearing following special
surgical or other forms of treatment by the eye, ear, nose, and throat consultant.
Infectious illnesses have been at a minimum, with only the usual seasonal
increases of pneumonia and upper respiratory conditions in the fall and spring
months. Antibiotic medications continue to be used regularly as indicated in the
control of these infections. Several small outbreaks of salmonella intestinal infection occurred during the year, but with prompt isolation of patients and intensive
treatment, individual cases soon cleared and there was no problem of epidemic
proportion. In each instance the infective organism appeared to have entered
the Hospital originally with a newly admitted patient. Local skin infections due
to staphylococcal organisms were a concern during the first part of the year and
were most prevalent in V.V. 1 and the crowded infirmaries, where it was most
difficult to carry out strict isolation procedures. However, since the new infirmaries
became available and with the renovation of V.V. 6 and 7 and the closing of V.V. 1,
the incidence of this type of infection has decreased markedly.
During the month of June all patients received annual tuberculin tests under
the direction of Dr. Kilgour and the Division of Tuberculosis Control. All patients
showing positive reactions were further investigated by chest X-rays, which were
processed through the new X-ray Department in the Valleyview Building. Three
patients showed suspicious evidence by X-ray and were moved to North Lawn
 I  126 MENTAL HEALTH SERVICES REPORT,  1959/60
Building for further observation and sputum tests, but were ultimately found to be
negative for tuberculosis. This survey was completed in August and involved the
taking of 471 large chest plates. Annual chest X-rays for staff were also carried
out throughout the year.
The tranquillizing medications continue to be an important form of therapy
in the treatment of elderly patients suffering from anxiety, restlessness, or depression.
In most cases this type of treatment can be reduced or eliminated shortly after
admission as the patient becomes adjusted to the hospital environment, although a
few do require this medication over prolonged periods. However, the prime
approach in the treatment of the emotionally disturbed elderly person is directed
toward assessment of the factors that contributed to the problem and the provision
of an environment that will provide a sense of security and belonging for the individual, and which will provide opportunities for regaining a feeling of independence
and a sense of accomplishment. Adequate diet, regularized living habits, correction
of physical defects where possible, activity commensurate with physical ability,
manual and social interests of varying degrees of complexity, and primarily the
friendship and patient understanding of all who are in contact with the elderly
person provide the therapeutic total environment which is required. This approach
involves close co-operation and teamwork on the part of all departments and staff
within the Hospital, and which has been most evident and gratifying in Valleyview
Hospital during the year.
As previously mentioned, the new building provided diagnostic facilities which
have assisted tremendously in reducing the burden on the main departments at
Essondale, which previously provided service to this area, but have also reduced the
demand of limited transportation and escort services required in taking patients to
the Crease Clinic. In addition, the elderly patients are relieved of the fatigue and
discomfort entailed in long periods of waiting and the difficulties in transportation
over to the Crease Clinic or Mental Hospital for various examinations. These departments have been placed in operation during the year as staff became available.
On July 30th Miss G. Fuller was appointed as X-ray technician for the Valleyview X-ray Department, which has been in operation since August 1st, 1960, and
has provided full X-ray service for this area. Technical supervision and radiological
consultation have been provided by Dr. J. M. Jackson, Director of Radiology at
the Crease Clinic. During the period August 1st, 1959, to March 31st, 1960, a
total of 1,470 patients was X-rayed, involving the processing of 2,266 X-rays.
The Valleyview laboratory was opened on June 17th, 1960, with the appointment of Mrs. H. Bartz. Following a period of organization and calibration of
equipment, this department was able to provide laboratory service to Valleyview
patients by the middle of July. Dr. G. A. Nicolson, Director of Laboratories, has
provided technical supervision and direction in this department. Unfortunately,
Mrs. Bartz had to leave the service at the end of October, so that laboratory service
was reduced to a bare minimum until the appointment of Miss K. Piro, R.T., in
February. The total number of procedures carried out in this department was
2,138 and represents quite a respectable volume of work considering the laboratory
was in operation for only a short period during this fiscal year. On November 23rd
the morgue in the new building was also placed in operation and has been available
since that time for autopsy examinations, which are carried out by Dr. Nicolson.
The Valleyview pharmacy is another important service which became available
to patients in this area during the year, and which has relieved the central pharmacy
at Essondale of pharmaceutical service for this unit. Mr. G. Kelly was appointed
to the position of pharmacist on April 6th. Several weeks were required to organize
and stock the new pharmacy and arrange changes in routines and transportation
 GERIATRIC DIVISION
J 127
Scene of the admission office. Valleyview Building, Essondale.
View of the occupational-therapy shop, Valleyview Building, Essondale.
 J  128 MENTAL HEALTH SERVICES REPORT, 1959/60
for ward service, but since May 4th this department has been in full operation, and
all wards have benefited from this efficient and reliable service.
The Physiotherapy Department in the new building, was the last of the auxiliary
medical services to be placed in operation and provided a treatment service which
has long been needed in the care of this patient-group. Miss Sylvie Morissette,
registered physiotherapist, was appointed to this position at Valleyview during the
last week of February, and by the end of the fiscal year had developed a regular
schedule of service both on the wards and in the treatment centre in the new building, where special physiotherapy equipment is now available.
As indicated above, the Valleyview Nursing Department has expanded and
developed considerably during the year under the very efficient leadership and direction of Miss E. Johnstone, Superintendent of Nursing Services. This has involved
a great deal of reorganization and planning for the staffing and operation of the new
wards in the Valleyview Building and later the transfer of staff and patients from
V.V. 10 and 1 into the renovated V.V. 6 and 7 wards. In addition, the recruitment
of a full supervisory staff has greatly enhanced the standard of nursing care in this
area. Although many problems and difficulties were encountered due to shortages
of staff through illness and other forms of absenteeism, delays in recruitment of staff
and in disruption of routines as new staff became accustomed to new equipment and
surroundings, it is felt that important progress has been made in developing a high
standard of geriatric nursing. The recruitment of nursing staff to complement level,
increased supervision, improved morale amongst nursing personnel, the inauguration of housekeeping and dietary services, the renovation and relocation of wards,
as well as the provision of educational interests for staff and the teamwork of all
departments in the unit are all factors which have contributed to the improvement
in nursing care which is evident at the end of the year. This improvement is evident
in a decrease in the number of patient accidents resulting from lack of staff supervision, the increased number of patients who are being mobilized and able to take
meals in ward dining-rooms or attend and take part in the occupational- and recreational-therapy programme, as well as a generally higher level of interest and awareness on the part of deteriorated patients in their surroundings.
Interest in geriatric nursing has been stimulated by the attendance of several
members of the Valleyview nursing staff at special institutes away from the Hospital.
During the year six different institutes relating to special aspects of geriatric nursing
were attended by members of the supervisory staff and by several of the charge
nurses. On each occasion, reports were brought back for the benefit of the total
nursing staff. In addition, an in-service educational programme was conducted by
the department over a period of five months and was well attended by ward nursing
personnel. The fire lectures and drills provided by the Essondale Fire Department
for nursing staff have also contributed greatly to the standard of nursing efficiency
and protection provided for Valleyview patients.
The important auxiliary treatment services provided by the Occupational and
Recreational Departments have also expanded during the year as the patient population increased and as more patients became available and able to participate in
these programmes.
Miss Alice Anderson, O.T.Reg., has continued to direct the occupational-
therapy programme, and throughout most of the year has provided this service
without assistance and without adequate facilities. However, the new Occupational
Therapy Department in Valleyview Building was finally equipped and ready for use
toward the end of July and has made possible an expanded treatment programme,
including a larger number of patients and a wider range of activities. The appointment of Mrs. Vaal Henke, handicraft worker, to the staff in January made further
 GERIATRIC DIVISION J 129
expansion of the programme possible. At the end of the year a comprehensive
programme was in operation, including regular ward-centred handicraft activities
and bi-weekly mixed programmes for men and women in the new Occupational
Therapy Department, where more advanced craftwork and art therapy is conducted.
An average of fifty men and women are able to attend these special sessions. This
department has also worked closely with the Recreational Department in assisting
patients and staff to provide for ward decorations at Christmas and in making
decorative items for use on other special occasions. During the year the average
number of patients involved in the occupational programme has risen from 159
to 198.
The recreational-therapy programme has also expanded appreciably during
the year, especially since the opening of the Valleyview auditorium. During the
first portion of the year the previoously existing programme under the part-time
direction of Mr. Harrison Smith, of the Essondale recreational-therapy staff, was
carried out efficiently and was most appreciated by a large number of patients.
With the appointment of Mrs. Mildred Franklin during July in a full-time capacity
on the Valleyview staff, it has been possible to expand this form of therapy both
in scope of activities and in the number of patients involved. The basic programme
as organized so well by Mr. Smith has been developed to reach patients of varying
degrees of ability, and auditorium-centred activities as well as ward-centred socials
have been encouraged. Socials have been expanded to include a monthly birthday
party where special attention is given to those who have reached a further milestone
in their lives, and extra efforts are made to stimulate renewed interest in the social
and religious celebrations in our society, such as Christmas, Easter, Valentine's Day,
etc. Dancing, both in the ward dayrooms and at weekly intervals in the auditorium,
stimulates physical activity and social awareness that tends to fade so quickly from
the lives of elderly men and women. Bingo parties during the winter months and
picnics during the summer have had special appeal to an increasing number of
patients. The activities of the Happy Gang Club and the Drama Club have also
contributed greatly toward stimulating interest in the more handicapped patients,
as well as providing a means by which the more capable men and women can contribute to the welfare of their less fortunate friends. Mrs. Franklin has been assisted
throughout the year and could not have developed the programme to the point of
effectiveness that now exists without the ready co-operation of the Valleyview
Nursing and Dietary Departments, and especially the invaluable interest and assistance of the volunteers of the Canadian Mental Health Association. Many organizations and individuals from the community have been more than kind in providing
entertainment, prizes, and their time and energy in contributing to the recreational-
therapy programme and the general health and welfare of the Valleyview patients.
The religious needs of our men and women have been met through the continued devotion of Rev. J. O'Neil and Father Frechette. The provision of chapel
equipment was completed in June and became available for weekly religious services following a special dedication service conducted by the Right Rev. G. P.
Gower, Bishop of New Westminster, on June 21st. In addition to the weekly
Sunday services in the chapel, Reverend O'Neil has continued ward services for
those who are unable to go to the chapel. During the year there were forty services
in the Valleyview chapel and 130 on the wards, with average attendances of forty-
six and twenty-six respectively.
Through the efficient and conscientious efforts of Mr. A. I. Smith, Valleyview
Business Manager, the several departments under his direct jurisdiction have been
organized and expanded during the year.
 J  130 MENTAL HEALTH SERVICES REPORT,  1959/60
The dietary service to patients and staff has continued to be of high standard
throughout the year, under the professional guidance of our dietician, Mrs. A. Frith.
During June the special-diets section of the main kitchen was organized to provide
diet service to all wards and has provided an important addition to the medical care
of many patients. An additional progressive step occurred in September with the
organization of a new food service department and the appointment of a diet aide
(waitress) staff to operate the dining areas and ward diet kitchens in the new building. This innovation has proven most successful, permitting the full control of
patients' food preparation and serving in the hands of trained dietary personnel, thus
relieving ward nursing staff, who are able to concentrate on nursing procedures at
all times and are concerned only in the serving of food to those patients requiring
special or bedside feeding. These new staff members are recognized by special
uniforms and are now considered an essential addition to the total dietary staff.
In addition to the many thousand meals prepared for patients, a total of 32,851
staff meals was served in the Valleyview cafeteria during the year.
In conjunction with the development of the diet aide service, a further innovation occurred with the introduction of a Housekeeping Department, which was first
organized with the appointment of Mrs. A. Warren as Valleyview housekeeper in
June. This department not only utilizes specially trained staff for routine maintenance of public areas in the new building, but also provides this service on the
wards. This new service has also become established as an essential permanent
part of our organization, the staff being recognized also by a suitable uniform.
During the year the general office has expanded as increasing responsibilities
and duties became centred there. During the month of May all pay records and
related duties formerly carried out at the Crease Clinic were transferred to the
Valleyview office. In November patients' property was transferred to the new
property storage cabinets in the vault and arrangements made for cash advances to
patients from comfort accounts. A further major addition to the responsibilities
of the Business Manager occurred with the transfer during March of personnel
records and their maintenance. The opening of wards and the expansion of all
services during the year required an increase in total staff from 193 as of April 1st,
1959, to 329 as of March 31st, 1960.
The Medical Records Department has continued to carry out the many and
varied duties required in the maintenance of adequate patient records, but has also
provided stenographic and clerical services for other departments as required.
Miss Marlynn Jorgensen has carrried out efficiently the varied duties required in the
office of the Medical Superintendent and has also given supervision and stenographic
service to the staff in the records office as required.
The beauty-parlour, now organized under the Business Manager, has continued
to provide a very essential service to our patients. In December Mrs. Mary Lutner
was appointed to the Valleyview staff and opened the new beauty-parlour facilities
in the new building. Many more ladies are now appreciating the attention and
personal satisfaction that comes with an attractive hair-do.
The Public Works Department has attended to the maintenance needs of the
Valleyview buildings and grounds in an efficient manner throughout the year and
has had many extra demands on its service consequent to the occupation of the
new building and the reallocation of patients in the other buildings. Many maintenance problems developed with the opening of the Valleyview Building, but these
were gradually taken care of and few are of a recurring nature. Wards 6 and 7
were extensively repaired and redecorated in February to receive patients from
Wards 1 and 10.
 GERIATRIC DIVISION J 131
In addition, Public Works staff completed the partitioning of the large unfinished area in the basement of the new building, which now provides secure storage
for bulk pharmaceuticals, surplus ward equipment, patients' trunk room, and a large
workshop area. A two-year programme of landscaping and grounds development
was commenced this year, which will eventually fully restore the attractive lawns and
flower-beds previously enjoyed by patients and staff. A major project completed
under capital construction by tender involved the provision of three new fire-escapes
from Wards 1, 2, and 3.
Although there are needs in building maintenance, it is felt that much has been
accomplished this year, and as we are now authorized to requisition against our
maintenance list, it is expected that the most urgently needed items will be dealt
with during 1960/61.
Dellview Hospital
The Vernon unit of the Geriatric Division has operated to capacity without
any major changes during the year under the able guidance of Mr. L. W. Fox, the
unit Supervisor, and his deputy and Superintendent of Nurses, Miss H. O.
Lipsey, R.N.
As will be noted in the accompanying tables, the number of new admissions
to this unit has remained practically the same as for the previous year, with a total
of ninety-three. This includes fifty-six men and twenty-three women admitted
directly from the community, an increase of seven, and fourteen transfers from the
Mental Hospital. Separations totalled seventy-seven and represent a significant
decrease, especially in the number of deaths, which totalled sixty-eight compared to
ninety during 1958/59. Five discharges and four transfers to Essondale for special
treatment account for the remaining separations. Patients in residence at the end
of the year numbered 234, an increase of sixteen. Throughout the year a total of
311 patients received care and treatment at this unit, for a total of 84,515 patient-
days, an increase of nearly 2,000 patient-days over the previous year.
There have been no major medical problems during the year, and the general
health of the patients has been very satisfactory, although there has been noticeable
a general increase in the degree of feebleness and morbidity of this patient-group,
whose average age is over 80 years. In addition, the greater number of new admissions came from general hospitals and were either bed patients on arrival or were
more enfeebled than patients admitted from private homes.
Medical care and supervision of the Dellview patients has again been provided
regularly by Dr. J. Smith.
Illness due to infectious organisms has been minimal, with only the usual
seasonal increases of upper respiratory infections. During June the travelling unit
of the Division of Tuberculosis Control carried out chest X-ray examinations on
all ambulant patients and discovered two patients with positive symptoms. These
patients were immediately transferred to the North Lawn Building at Essondale for
further care and treatment.   No further cases have been discovered.
Several patients required specific surgical treatment, which was carried out by
Dr. Smith in the Vernon Jubilee Hospital, including one herniorrhaphy and a mid-
thigh amputation. Four patients suffered hip fractures, and one lady received a
Colles fracture through accidental falls. This represents a marked reduction in
injuries of this nature compared to the previous year.
Auxiliary medical care has been supplied as required, including special eye
examinations and provision of corrective lenses by the local optometrist. Dr. Bishop
has visited the Hospital regularly for the purpose of dental examinations, extractions,
and the provision of dentures where necessary.
 I  132 MENTAL HEALTH SERVICES REPORT,  1959/60
The administrative and technical staff of the Vernon Jubilee Hospital have been
most helpful and co-operative throughout the year. All X-ray and laboratory
services required for the Dellview patients have been promptly supplied through the
Jubilee Hospital facilities.
Miss H. O. Lipsey, Superintendent of Nurses, has continued to give devoted
leadership and supervision to the nursing staff. A very satisfactory standard of
nursing care has been maintained. An innovation occurred during the year when a
female psychiatric nurse was appointed to fill a vacancy on the staff of the men's
division. This introduction of female staff on the male wards has been well
accepted.
Recreational and other diversional activities have continued under the very
able direction of Mrs. Sherlock. With the valuable assistance of the volunteer
ladies' group, she has been able to conduct a regular handicraft programme and
special parties to celebrate such occasions as Hallowe'en, Valentine's Day, and, of
course, the very special celebration of Christmas. In addition, weekly movie shows
and monthly bingo parties have been most popular with all patients. During the
summer months, picnics in Poison Park and social activities on the Hospital grounds
have been organized.
Community interest in the Dellview Hospital has again been most evident and
appreciated by patients and staff. Groups who have contributed include the Ladies
of the Royal Purple, who provided car rides for many women patients; the Lutheran
Church ladies, who entertained in the Hospital with parties; the men of the I.O.O.F.
lodge, who provided car rides for the men; and special musical entertainment by
such groups as the Vernon Girls' Mcintosh Pipe Band and carol groups from the
Boy Scout, Girl Guide, and C.G.I.T. organizations.
The religious needs of the Dellview patients have been met throughout the year
by the regular attendance of Monsignor Miles and Reverend Reeve. Regular devotional services have been held at the Hospital, as well as special visiting of patients
by both ministers, who have been most sincere and conscientious in their duties.
The Dietary Department has continued to function with little change in personnel or the high standard of service to patients and staff. During November Mr.
Owens, Chief Cook, was able to attend the Food Service Institute held in Prince
George, and with new knowledge gained there has introduced several innovations
in the day-to-day food service. His staff have contributed a great deal to the
general welfare of the patient-group with their ready co-operation in providing
special menus at Christmas and special cakes and other treats for social programmes.
The Laundry Department has also maintained a reliable and efficient service to
the wards in spite of decreasing patient help and increasing quantities of soiled linen.
During the year a total of 544,743 pounds of soiled linen was processed and represents an increase of 45,888 pounds over the previous year. The average monthly
load has risen to 4,395 pounds and is primarily due to the supplies required in the
nursing care of a larger number of feeble bed patients.
The many and varied duties in the general office, which includes the maintenance of medical records, have been attended to.
The Public Works staff at this unit have again been most conscientious in
fulfilling the routine maintenance requirements of the Hospital. In addition, they
were able to complete a number of new projects, including the construction of a
vegetable-room adjacent to the main kitchen, reinforcement of foundations under
the Stores building, and a large amount of redecorating both inside and out, which
has enhanced the appearance of the buildings and grounds considerably. At the
year-end the installation of a fire-prevention sprinkler system was well under way,
 GERIATRIC DIVISION I 133
and it is anticipated that this fire-protection plan will be ready for operation in the
near future.
The operation of the greenhouse and the maintenance of the beautiful lawns
and flower-beds, as well as the year-round ward supply of bright flowers, have been
capably performed by the relief gardener, Mr. Malowany. It is with regret that we
learn that Mr. Legg, the Chief Gardener at this unit for many years, is still unable
to resume his duties following his serious injuries incurred on duty last year.
Skeenaview Hospital
The Skeenaview unit has also operated to capacity and with little change under
the capable direction of the Supervisor, Mr. W. E. Skillicorn, and his deputy, Mr.
F. Stewart.
During the year this Hospital has provided care and treatment for 340 elderly
male patients and completes the year with a resident population of 288, an increase
of eleven over the previous year. Direct admissions have shown a marked increase
during the year, with a total of twenty-four compared to thirteen for 1958/59. Separations due to deaths have also increased sharply from thirty-four to fifty-one, a
further indication of the increasing age and feebleness of this patient-group. As
previously mentioned, the additional vacancies were utilized for the transfer of thirty-
nine elderly men from the Essondale area.
The general health of the patients has been maintained at a satisfactory level,
and there were no major medical problems or infectious illnesses of epidemic proportions. Several cases of influenza and mild intestinal infections were prevalent
during the spring and fall months, but all responded well to treatment.
The medical care and supervision of the Skeenaview patients have continued
under the capable and conscientious attention of Dr. R. E. Lee and Dr. J. R.
Nicholson.
Accidental falls resulted in five fracture injuries, which were treated conservatively at the unit. Several patients required major surgical procedures, including one
herniorraphy, two leg amputations for circulatory disturbances, and one gastrectomy.
One patient was transferred to the Valleyview unit for further investigation and
treatment of a carcinoma of the larynx.
The annual chest X-ray survey of patients and staff took place during the
months of October and February. No active or suspicious cases of tuberculosis
were found.
The nursing staff, under the direction of Mr. Stewart, Chief Psychiatric Nurse,
have continued to provide devoted and conscientious service to their patients. The
maintenance of a satisfactory standard of nursing care has been difficult, and several
innovations have been instituted in an attempt to utilize available staff to the best
advantage. Changes in shift schedules have made it possible to concentrate staff
during peak activity periods, with a corresponding decrease in staff coverage during
periods of minimal activity.
During July vacancies created by the resignation of male aides were filled by
the recruitment of three female psychiatric aides, who are employed in the ward
dining areas. Further vacancies during the year have allowed for the appointment
of three additional female aides, who are employed on the wards and have demonstrated the importance of " a women's touch " in the care of the sick and elderly.
During March a Heidbrink oxygen machine and tent were supplied to this unit
and is an important addition to the nursing equipment as pneumonia and cardiac
failures are becoming more frequent.
 I  134 MENTAL HEALTH SERVICES REPORT, 1959/60
The staff are to be commended for the efforts that have been taken to increase
recreational interests for patients during the year. The provision of a 16-mm. sound
projector through the Patients' Comfort Fund has been of great benefit and has
allowed the showing of two to three movie shows on each ward each week. Deck-
type shuffleboard and indoor horseshoe games have recently been added to the programme of bingo parties, and crokinole and cribbage tournaments are organized
whenever possible. Many patients have been stimulated into interesting activity who
previously showed little interest in their surroundings.
During the year a combined reading-sitting room and library was completed
and suitably furnished and is regularly patronized by patients on grounds privileges.
The library cart, which visits each ward weekly, provides stimulation to many
patients. Through the interest and generosity of local residents and organizations,
a wide selection of books and periodicals is available in the library.
During the summer months a programme of daily car-ride outings was developed for groups of patients, who were taken to local points of interest whenever
possible.
Archdeacon Hinchcliffe and Father Mohan have continued their devoted interest with regular weekly services and visits throughout the year.
The dietary service has also been maintained at a high level with nourishing
and appetizing menus at all times. In the absence of Mr. H. F. Piffer, Chief Cook,
this unit was represented at the Food Service Institute at Prince George by Mr. J.
Gould. The installation of a new dish-washer and vegetable-peeler in early April
has been of great assistance to the dietary staff, who are no longer dependent on
unreliable and inefficient patient help.
Laundry service has also been maintained without serious interruption, although on several occasions is was only with great difficulty that major interruptions
were avoided. Repeated equipment failures of the washer and extractor have necessitated a major overhaul of both these machines.
In September the office of Mrs. C. McConnell, Housekeeper-Home Supervisor,
was transferred to the laundry building, where a central linen and clothing repair
and distribution system was inaugurated. This new change has proven very efficient, and a noticeable saving in linen and clothing has been evident.
The Public Works staff, under the direction of Mr. McLachlan, Chief Engineer,
have maintained the buildings and equipment in good order throughout the year.
No major interruptions in service occurred, and the safety and comfort of the
patients were maintained at all times.   Other than routine maintenance and repairs,
no major projects were completed during the year.
 GERIATRIC DIVISION
J  135
STATISTICAL TABLES
VALLEYVIEW HOSPITAL
Table 1.—Movement of Population, Valleyview Hospital, Essondale,
April 1st, 1959, to March 31st, 1960
Male
Female
Total
136
131
3
392
146
528
Admissions—■
Readmissions to a different institution of Mental Health Services	
277
3
Total admissions
134
146
280
270
538
808
Separations—
1
55
8
10
77
11
Diprt
132
8
64
87
151
+70
206
+59
451
+ 129
657
 I  136
MENTAL HEALTH SERVICES REPORT, 1959/60
Table 2.—First Admissions to Valleyview Hospital, Essondale, by Health
Unit and School District of Residence and Sex, April 1st, 1959, to
March 31st, 1960.
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—
North Fraser Valley, Mission—
School District No. 18	
2
2
School District No. 42	
5
1
6
Selkirk, Nelson—
„   75	
1
1
2
School District No. 7 	
1
1
2
Upper Island, Courtenay—
West Kootenay, Trail—
School District No. 47 	
1
1
School District No. 11	
1
1
„   71	
1
1
South Okanagan, Kelowna—
„   72 -   ..
1
1
School District No. 14. 	
1
	
1
Skeena, Prince Rupert—
„   15	
1
1
School District No. 50	
1
1
, 17	
2
2
„   52	
1
2
3
„   23	
1
1
„   54 	
1
1
North Okanagan, Vernon—
Peace River, Dawson Creek—
School District No. 19 	
1
1
School District No. 59	
1
1
„   22  ..
i
1
, 60	
1
1
South Central, Kamloops—
Victoria-Esquimalt Union Board
School District No. 24 	
l
1
of Health-
, 30	
l
1
School District No. 61 (part1)
7
7
Cariboo, Prince George—
Saanich  and South Vancouver
School District No. 28	
l
1
Island—
„   56	
l
1
School District No. 61 (part2)
4
2
6
„   57 	
2
2
 62  .
2
2
Upper   Fraser   Valley,   Chilli-
 63	
3
3
wack—
„   64.._	
3
3
School District No. 33—-	
l
1
Central Vancouver Island, Na-
„   34	
1
1
naimo—
Boundary, Cloverdale—
School District No. 65	
3
2
5
School District No. 35 	
2
2
„   68 	
1
3
4
„   36 	
7
4
11
 70..	
1
1
„   37	
2
2
School districts not covered by
Metropolitan Health Committee,
health units—
Vancouver—
School District No. 46	
3
3
School District No. 38	
3
3
 ,   49...	
1
„   39	
61
76
137
 61 (part3)
1
„   41.	
7
13
20
1
„   44	
3
1
8
11
1
1
1
„   45	
Simon   Fraser,   New  Westmin
ster—
134
146
280
School District No. 40	
4
6
10
„   43.....	
3
3
6
Table 3.—First Admissions to Valleyview Hospital, Essondale, by Method
of Admission, Age-group, and Sex, April 1st, 1959, to March 31st,
1960.
Age-group (Years)
Method of Admission
20-291
30-391
40-491    50-59
60-69
70-79
80 and
Over
Total
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
3
4
4
8
11
6
~6
11
1
~l2
1
5
—6
1
8
~9
14
14
54
"54
58
58
41
50
1
132
1
1
145
2
277
1
3
4
4
,8
11
41
50
134
1461   280
1Admitted from Provincial Mental Hospital, Essondale, as working patients.
 geriatric division
J  137
Table 4.—First Admissions to Valleyview Hospital, Essondale, by Mental Diagnosis, Age-group, and Sex, April 1st, 1959, to March 31st,
1960.
Age-group (Years)
Mental Diagnosis
20-29
30-39
40-49
50-59
60-69
70-79
80 and
Over
Total
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.IF.
With Psychosis
1
1
4
3
7
3
9
4
5
7
1
1
1
11
8
3
9
31
1
1
1
9
7
1
5
31
27
1
1
20
15
1
3
22
1
16
66
1
1
49
Manic-depressive reaction. _	
2
1
2
4
36
Psychosis with cerebral arteriosclerosis
—-
-—
	
	
—
1
81
1
1
Chronic brain syndrome with neurotic
	
	
	
1
	
2
■—
1
Syphilis and its sequela;  —	
3
Total with psychosis 	
1
1|    4
3
8
3
11
4|    6| 14
211 45
17| 37| 68|107
175
Without Psychosis
1
4
12
3
6
1
9
14
5
3
1
4
1
7
6
21
1
30
13
8
9
1
8
1
2
3
5
3
3
	
2
2
1
	
20
Chronic   brain   syndrome   with   beha-
14
30
Epilepsy.. _	
1
Other diseases  of the  central  nervous
	
—
	
	
1
16
4
1
Senility .            	
38
2
3|
5
3
3
1
2
3
33| 13
24| 13| 66
39
105
Totals	
3
41    4
8
11
6
12
6
9
14
541  58
41
501134
146
280
Table 5.—First Admissions to Valleyview Hospital, Essondale, by Mental
Diagnosis, Marital Status, and Sex, April 1st, 1959, to March 31st,
1960.
Table 6.—First Admissions to Valleyview Hospital, Essondale, by Mental
Diagnosis, Years of Schooling, and Sex, April 1st, 1959, to March
31st, 1960.
Table 7.—First Admissions to Valleyview Hospital, Essondale, by Citizenship, Age-group, and Sex, April 1st, 1959, to March 31st, 1960
Table 8.—First Admissions to Valleyview Hospital, Essondale, by Religion
and Sex, April 1st, 1959, to March 31st, 1960
Table 9.—First Admissions to Valleyview Hospital, Essondale, by Previous
Occupation and Sex, April 1st, 1959, to March 31st, 1960
Detailed information for the above tables may be obtained on request.
 I  138
MENTAL HEALTH SERVICES REPORT,  1959/60
Table 10.—Live Discharges from Valleyview Hospital, Essondale, by Mental Diagnosis, Condition on Discharge, and Sex, April 1st, 1959, to
March 31st, 1960.
Condition on Discharge
Total
Mental Diagnosis
Much
Improved
Improved
Unimproved
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
1
1
2
1
2
2
~ i
2
1
2
1
2
2
1
1
1
2
2
3
5
2
5
2
7
1
1
Chronic brain syndrome with behavioural reaction
1
1
2
Totala..  ..             	
1
3
1
3
7
4
9
10
19
Table 11.—Live Discharges from and Deaths Occurring in Valleyview
Hospital, Essondale, by Mental Diagnosis, Age-group, and Sex, April
1st, 1959, to March 31st, 1960.
Mental Diagnosis
Age-group (Years)
70-79
M.
80 and
Over
M.
Total
M.
Grand
Total
Live Discharges
Schizophrenic disorders1..
Senile dementia-
Psychosis wtih cerebral arteriosclerosis..
Mental deficiency-
Chronic brain syndrome with behavioural reaction-
Chronic brain syndrome, N.O.S.. 	
Senility	
Totals..
4 I      6 I
Deaths
Schizophrenic disorders ..
Senile dementia	
Psychosis with cerebral arteriosclerosis.— 	
Chronic brain syndrome with neurotic disorder	
Chronic brain syndrome with behavioural reaction-
Chronic brain syndrome, N.O.S	
Senility	
Totals..
29
35
20
17
1
3
1
26
42
55
37
33
1
3
1
2
77
181
1
53
52
1
6
6
13
132
1 Plus 1 female in age-group 30-39 for discharged schizophrenic disorder.
Table 12.—Live Discharges from and Deaths Occurring in Valleyview
Hospital, Essondale, by Mental Diagnosis, Length of Stay, and Sex,
April 1st, 1959, to March 31st, 1960.
Detailed information for the above table may be obtained on request.
 geriatric division
J  139
Table 13.—Live Discharges from Valleyview Hospital, Essondale, by Condition on Discharge, Disposition to, and Sex, April 1st, 1959, to March
31st, 1960.
Disposition to—
Condition on Discharge
Home
Other
Mental
Hospital
Other
Total
Grand
Total
M.
F.   |   M.
F.
M.
F.
M.
F.
	
2
2         1
7
1
3
1
1
1
1
1
7
3
3
4
4
4
11
Totals
4
8
4
1
2
9
10
19
Table 14.—Deaths Occurring in Valleyview Hospital, Essondale, by Cause
of Death, Age-group, and Sex, April 1st, 1959, to March 31st, 1960
Age
-group (Years)
Total
Cause of Death
70-79
80-89
90-
-99
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
1
_
17
2
4
1
1
3
3
20
1
3
3
1
1
4
2
9
1
2
1
1
1
1
4
5
30
2
3
5
1
1
1
1
1
6
1
1
3
43
2
8
7
2
1
1
1
1
1
2
1
1
21
1
4
4
1
4
1
10
1
1
8
73
4
11
12
3
1
2
1
2
Accidents      	
1  |      1
2
Totals         _
29
35
21
36
5
6
55
77
132
Table 15.—Deaths Occurring in Valleyview Hospital, Essondale, by Cause
of Death, Length of Stay, and Sex, April 1st, 1959, to March 31st,
1960.
Detailed information for the above table may be obtained on request.
 J  140 MENTAL HEALTH SERVICES REPORT, 1959/60
DELLVIEW HOSPITAL
Table 1.—Movement of Population, Dellview Hospital, Vernon,
April 1st, 1959, to March 31st, 1960
Male
Female
Total
93
54
15
1
125
22
1
218
Admissions—
76
16
1
70
23
93
Total under care                                                           	
163
148
311
Separations—
5
50
2
2
18
7
Died
68
2
57
20
77
Net increase or decrease
In residence, March 31st, 1960  - -  	
+ 13
106
+3
128
+ 16
234
Table 2.—First Admissions to Dellview Hospital, Vernon, by Health
Unit and School District of Residence and Sex, April 1st, 1959, to
March 31st, 1960.
Health Unit
Male
Female
Total
Health Unit
Male
Female  Total
East Kootenay, Cranbrook—
South Central, Kamloops—Con.
School District No. 1	
1
1
School District No. 31	
1
	
1
„   2.	
1
1
Cariboo, Prince George—
„   3	
1
1
School District No. 28	
2
2
Selkirk, Nelson—
Metropolitan Health Committee,
School District No. 7	
2
2
Vancouver—
„    10
1
1
School District No. 39    	
5
5
West Kootenay, Trail—
„   41	
1
School District No. 9 	
1
1
Simon  Fraser,  New Westmin
 11-	
1
2
3
ster—
„    12	
1
1
School District No. 40	
1
South Okanagan, Kelowna—
North Fraser Valley, Mission—
School District No. 14	
1
1
2
School District No. 42	
1
	
, 15	
6
3
9
 75...	
1
„   16 —
1
1
Upper Island, Courtenay—
, 17	
i
1
2
School District No. 47—	
1
	
„   23	
131
1
14
 ,   71	
1
	
„   77-	
3
1
4
North Okanagan, Vernon—
School District No. 52	
1
School District No. 19	
1
1
2
Peace River, Dawson Creek—
„   20	
2
4
6
School District No. 59	
1
, 21	
1
1
Victoria-Esquimalt Union Board
„   22-	
5
3
8
of Health-
„   78	
1
1
School District No. 61 (part2)
1
	
South Central, Kamloops—
Saanich  and  South Vancouver
School District No. 24 	
5
3
8
Island—
„   25	
1
1
School District No. 61 (part3)
5
5
„   29	
1
1
Totals  	
70
23
93
1 Includes 1 readmission (male).
2 Includes Victoria and Esquimalt only.
3 Excludes Victoria, Esquimalt, and Oak Bay.
 GERIATRIC DIVISION
J  141
Table 3.—First Admissions and Readmissions to Dellview Hospital, Vernon, by Method of Admission, Age-group, and Sex, April 1st, 1959,
to March 3 1st, 1960.
Age-group (Years)
Method of Admission
50-59
60-69
70-79
80 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
2
11
1
1
24
9
32
13
69
1
23
92
1
Table 4.—First Admissions and Readmissions to Dellview Hospital, Vernon, by Mental Diagnosis, Age-group, and Sex, April 1st, 1959, to
March 31st, 1960.
Age-group (Years)
Total
Mental Diagnosis
1
50-59             60-69
70-79
80 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
With Psychosis
Schizophrenic disorders - 	
Alcoholic psychosis..  — 	
2
	
6
1
1
	
1
	
9
1
1
9
1
1
2 | — |      8 |       -|      1 | —
-  1 	
11
11
Without Psychosis
1       3           1   1    23
9
9"
32
13
58
23
81
1  1    24
Totals                     	
2  I  .   ...   1     11
32 |    13
69
23
92
Readmissions
1
	
	
	
1
Table 5.—First Admissions to Dellview Hospital, Vernon, by Mental Diagnosis, Marital Status, and Sex, April 1st, 1959, to March 31st, 1960
Table 6.—First Admissions to Dellview Hospital, Vernon, by Mental
Diagnosis, Years of Schooling, and Sex, April 1st, 1959, to March
31st, 1960.
Table 7.—First Admissions to Dellview Hospital, Vernon, by Citizenship,
Age-group, and Sex, April 1st, 1959, to March 31st, 1960
Table 8.—First Admissions to Dellview Hospital, Vernon, by Religion and
Sex, April 1st, 1959, to March 31st, 1960
Table 9.—First Admissions to Dellview Hospital, Vernon, by Previous
Occupation and Sex, April 1st, 1959, to March 3 1st, 1960
Detailed information for the above tables may be obtained on request.
 I  142
MENTAL HEALTH SERVICES REPORT,  1959/60
Table 10.—Live Discharges from Dellview Hospital, Vernon, by Mental
Diagnosis, Condition on Discharge, and Sex, April 1st, 1959, to March
31st, 1960.
Condition on Discharge
Mental Diagnosis
Recovered
Much
Improved
Improved
Unimproved
Grand
Total
M.
F.
M.
F.      M.
F.
M.      F.
1
M.
F.
	
	
	
1
2
3
1
2
3
1
3
2
3
Senile psychosis   	
Chronic brain syndrome, N.O.S	
1
5
Totals  	
	
	
1
2
6
7
2
9
Table 11.—Live Discharges from and Deaths Occurring in Dellview
Hospital, Vernon, by Mental Diagnosis, Age-group, and Sex, April
1st, 1959, to March 31st, 1960.
Age-group (Years)
Mental Diagnosis
50-59
60-69
70-79
80 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Live Discharges
Schizophrenic disorders    —
2
	
i
1
1
2
1
1
3
1
3
2
3
1
Chronic brain syndrome, N.O.S	
5
Totals	
2
— | .- |      1
4
1
1 |
7
2
9
Deaths
1
18
5
31
13
50
18
68
Table 12.—Live Discharges from and Deaths Occurring in Dellview Hospital, Vernon, by Mental Diagnosis, Length of Stay, and Sex, April
1st, 1959, to March 31st, 1960.
Detailed information for the above table may be obtained on request.
Table 13.—Live Discharges from Dellview Hospital, Vernon, by Condition
on Discharge, Disposition to, and Sex, April 1st, 1959, to March 31st,
1960.
Disposition to—
Condition on Discharge
Home
Other Mental
Hospital
Grand
Total
M.
F.
M.
F.
M.
F.
1
2
2
4
1
6
2
3
Unimproved _    -
6
Totals     	
3
2
4
	
7
2
9
 geriatric division
I  143
Table 14.—Deaths Occurring in Dellview Hospital, Vernon, by Cause of
Death, Age-group, and Sex, April 1st, 1959, to March 31st, 1960
Age-group (Years)
Cause of Death
60-69
70-79
80-89
90-99
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
1
	
18
4
1
1
25
1
1
8
1
3
4
1
47
1
1
16
2
1
Arteriosclerotic   and   degenerative   heart
63
3
Diseases of the urinary system 	
1
Totals.. 	
1 |-
1
18
5
28
9
3
4
50
18
68
Table 15.—Deaths Occurring in Dellview Hospital, Vernon, by Cause of
Death, Length of Stay, and Sex, April 1st, 1959, to March 31st, 1960
Detailed information for the above table may be obtained on request.
SKEENAVIEW HOSPITAL1
Table 1.—Movement of Population, Skeenaview Hospital, Terrace,
April 1st, 1959, to March 31st, 1960
Number
In residence, April 1st, 1959     277
Admissions—
First admissions
Readmissions to  a different institution of Mental Health
Services 	
Transfers from other geriatric units	
Total admissions
Total under care
24
31
63
340
Separations—
Died ___„_
Transferred to other geriatric units
Total separations 	
Net increase or decrease	
In residence, March 31st, 1960
51
1
52
+ 11
288
1 This institution cares for male patients only.
 J  144
MENTAL HEALTH SERVICES REPORT, 1959/60
Table 2.—First Admissions to Skeenaview Hospital, Terrace, by Health
Unit and School District of Residence, April 1st, 1959, to March 31st,
1960.
Health Unit
Number
Health Unit
Number
East Kootenay, Cranbrook—
School District No. 2 .„          	
2
2
.    3
2
1
2
-     1
Upper Island, Courtenay—
School District No. 47    	
Skeena, Prince Rupert—
School District No. 50   	
„    52            .   .   ...
 53 	
„    54
Victoria-Esquimalt Union Board of Health-
School District No. 61 (part1)	
Central Vancouver Island, Nanaimo—
School District No. 65            _.    .
2
Selkirk, Nelson—
School District No. 7	
Cariboo, Prince George—
School District No. 27	
„    28 	
 55 —	
„    57	
„    58 	
1
8
-   5
1
5
Metropolitan Health Committee, Vancouver-
1
18
..    1
1
School District No. 38 	
„    39  	
 41     .	
 68        	
Unknown
2
3
Simon Fraser, New Westminster—
School District No. 43     ...
2
Total	
63
1 Includes Victoria and Esquimalt only.
Table 3.—First Admissions to Skeenaview Hospital, Terrace, by Method
of Admission and Age-group, April 1st, 1959, to March 31st, 1960
Method of Admission
Age-group (Years)
Total
50-59
60-69
70-79
80 and
Over
1
22
23
17
63
Table 4.—First Admissions to Skeenaview Hospital, Terrace, by Mental
Diagnosis and Age-group, April 1st, 1959, to March 31st, 1960
Mental Diagnosis
Age-group (Years)
50-59
60-69
70-79
80 and
Over
Total
With Psychosis
Schizophrenic disorders	
Manic-depressive reaction	
Senile psychosis-
Psychosis with cerebral arteriorsclerosis—
Psychosis of other demonstrable etiology-
Syphilis and its sequelae	
Total with psychosis..
Without Psychosis
Alcoholism-
Mental deficiency	
Chronic brain syndrome, N.O.S.
Senility	
Total without psychosis .
Totals  	
11
1
3
1
2
18
22
18
23
10
4
15
17
15
1
19
12
2
3
52
11
63
 geriatric division
J  145
Table 5.—First Admissions to Skeenaview Hospital, Terrace, by Mental
Diagnosis and Marital Status, April 1st, 1959, to March 31st, 1960
Table 6.—First Admissions to Skeenaview Hospital, Terrace, by Mental
Diagnosis and Years of Schooling, April 1st, 1959, to March 31st, 1960
Table 7.—First Admissions to Skeenaview Hospital, Terrace, by Citizenship and Age-group, April 1st, 1959, to March 31st, 1960
Table 8.—First Admissions to Skeenaview Hospital, Terrace, by Religion,
April 1st, 1959, to March 31st, 1960
Table 9.—First Admissions to Skeenaview Hospital, Terrace, by Previous
Occupation, April 1st, 1959, to March 31st, 1960
Detailed information for the above tables may be obtained on request.
Table 10.—Live Discharges from and Deaths Occurring in Skeenaview
Hospital, Terrace, by Mental Diagnosis and Age-group, April 1st,
1959, to March 31st, 1960.
Mental Diagnosis
Age-group (Years)
60-69
70-79
80 and
Over
Total
Senile psychosis1
Live Discharges
Schizophrenic disorders	
Manic-depressive reaction-
Senile psychosis-
Deaths
Psychosis with cerebral arteriosclerosis	
Psychosis of other demonstrable etiology-
Syphilis and its sequelae  	
Senility	
19
6
11
1
24
11
1
2
1
Totals-
18
26
51
1 This case was transferred to another unit and his condition was unimproved.
Table 11.—Live Discharges from and Deaths Occurring in Skeenaview
Hospital, Terrace, by Mental Diagnosis and Length of Stay, April
1st, 1959, to March 31st, 1960.
Detailed information for the above table may be obtained on request.
 J  146
MENTAL HEALTH SERVICES REPORT, 1959/60
Table 12.—Deaths Occurring in Skeenaview Hospital, Terrace, by Cause
of Death and Age-group, April 1st, 1959, to March 31st, 1960
Cause of Death
Age-group (Years)
Total
60-69
70-79
80-89
90-99
5
2
3
7
1
2
2
2
1
1
3
16
1
3
2
1
8
28
1
3
2
4
1
Accidents.    	
3
Totals                   - 	
7
18
24
2
51
Table 13.—Deaths Occurring in Skeenaview Hospital, Terrace, by Cause
of Death and Length of Stay, April 1st, 1959, to March 31st, 1960
Detailed information for the above table may be obtained on request.
 MENTAL HEALTH CENTRE I 147
PART VI.—MENTAL HEALTH CENTRE
DIRECTOR'S REPORT
F. E. McNair, Director
A considerable volume of community service has been offered through the
Mental Health Centre during the year. Over 2,200 persons were assisted, about
half of whom were children. The aim of the Mental Health Centre is to prevent
mental disorder and hospitalization, and also to follow up certain patients who
have already had hospital experience. Close working relationships are maintained
with family doctors and with health and welfare resources. This Centre's experience
clearly demonstrates that psychiatric problems can be dealt with at the community
level.
The treatment service both in Adult and Children's Clinics was enhanced
during the year by the addition of two specialists in psychiatry—namely, Dr. F. H. G.
Mills and Dr. A. A. Cashmore. Treatment services were reorganized to provide
medical participation in treatment, supervision, and consultation.
There was a noteworthy attention on the part of staff to further academic
advancement. Dr. M. A. Menzies was awarded a Mental Health Grant bursary
to permit him to take one year of advanced postgraduate training in child psychiatry
at the Johns Hopkins University, Baltimore. Miss Annamarie Leuchte was granted
a bursary to attend the University of British Columbia School of Social Work for
three months. The following staff attended courses in their own time: Mrs. Joan
Peterson and Mr. Stanley Bodlak—social work; Mrs. Opal MacRae and Mr. James
Geddes—psychology; Miss Dorothy Arneson, Miss Susan Shaughnessy, and Mrs.
Helen Blind—nursing; Miss A. Bailey and Mrs. B. Holloway—occupational therapy.
In addition, in-service education has been promoted in the Departments of
Social Work and Nursing. Such programmes, requiring effort and preparation, are
a productive method of staff development and help make the best use of knowledge
acquired through reading, experience, and attendance at professional conferences
and activities. Also, we believe staff are attracted and held when it is policy to
improve constantly the standards of professional practices.
Lectures, seminars, and case presentations have been carried out for university
students of medicine, social work, education, nursing, and psychology. All Lower
Mainland undergraduate nursing students attend the Centre on two occasions for
case presentations and a tour of the facilities. Three University of British Columbia
nursing students have had a four-week placement in Adult Clinic during the year.
Two social-work students received field instruction in the Adult Clinic.
Analysis of Statistics, Adult Clinic
The volume of service this year was similar to that of the previous year; 544
persons were seen for assessment, of whom 247 were taken on for treatment. There
were 190 treatment cases on strength at the beginning of the fiscal year, 233 cases
were closed during the year, leaving 204 under treatment at the close of the year.
The majority of cases were referred by family physician or specialists other than
specialists in psychiatry in the metropolitan area. There was a significant reduction
in the number of women patients referred from private psychiatrists, from sixty-two
to forty-three, which is attributed to the increased number of psychiatrists in private
 I  148
MENTAL HEALTH SERVICES REPORT, 1959/60
practice.   There was a corresponding increase in referrals from out-of-town physicians, from fifty-four to sixty-four.
There has been almost a 50-per-cent decrease in physical treatment this year.
Electroconvulsive therapy fell off from 408 treatments to 210 treatments, somnolent
insulin from 364 treatments to 196 treatments, and intravenous chlorpromazine from
689 treatments to 377 treatments. However, 76 per cent of the patients attending
received tranquillizers at one time or another for an average of twenty-five weeks.
One hundred and forty-six patients were treated in Day Hospital, for an average
stay of 35.9 days. There has been a shift in the emphasis in the Day Hospital programme from physical treatments to more social and occupational activities.
Patients who previously were brought in for physical therapies have been more apt
to receive out-patient care by medication and interviews. This shift in emphasis has
made possible a more effective application of group methods of treatment and of
nursing relationships with patients. Masculine activities have been augmented
with the addition of a male psychiatric nurse, the use of power-tools, and the development of a gymnasium room in the basement.
Play-therapy group, Children's Clinic, Mental Health Centre, Burnaby.
 MENTAL HEALTH CENTRE J 149
Statistics, Children's Clinics
The Children's Clinic gave a service to 1,166 children during the year. This
number is composed of 188 children who were receiving a treatment service at the
close of last year, 717 children who were seen for a diagnostic examination, and
249 children who were given a full examination with a view to a treatment service.
The statistics show that the Victoria Children's Clinic principally devotes its
efforts to direct service to parents who make application for treatment for their
children; the proportion is 3Vz to 1 over cases referred by agencies for consultation.
The Burnaby Clinic has had principally a diagnostic service in the proportion of
5 to 1 over treatment cases, but there is a trend toward more treatment and the use
of frequent consultation for agency cases. Toward the end of the year, plans were
well under way for the establishment of a Day Centre for Children in Burnaby.
In the Burnaby Clinic our consultative service to agencies and health resources
in which a child is seen for diagnostic study only has remained very much the same
from the previous year, there being 248 patients last year and 245 this year. On
the other hand, there was a decline in the number of new cases taken on for treatment from seventy to fifty. We have had to establish priorities in the groups of
children to be given service, and we have principally been seeing children who are
not yet teen-agers.
Toward the end of the year one psychiatrist commenced holding weekly conferences at some of the agencies in order to determine which problem cases should
be examined at the Clinic and which could be carried by agency staff with continued
consultative help. In this manner fewer cases have been brought to the Clinic,
though just as many cases have been seen and consultative service has increased.
Travelling Clinic
The Travelling Clinic to communities distant from the Lower Mainland has
continued through the year, except for the months of July and August. This service
has been strengthened by the participation of one of the senior psychiatric staff on
50 per cent of the Travelling Clinics since January, and the service has been streamlined by dropping the nurse from the travelling team. The social worker in the
group has functioned not only as a consultant, but as the executive officer of this
service. Trips were arranged on alternate weeks to the major centres of the Province, most of which were visited twice during the year. There was an increase in
Travelling Clinic days of service from 134 to 172, but not a proportional increase
in cases seen, the figures being 341 cases seen as against 325 last year, because of
the increasing emphasis on consultative function. Trips were made to Vernon,
Salmon Arm, Quesnel, Williams Lake, Terrace, Kitimat, Trail, Prince Rupert,
Powell River, Kamloops, Nelson, Penticton, Kelowna, Haney, Abbotsford, Chilli-
wack, Mission, Prince George, Dawson Creek, Cranbrook, Creston, and Revelstoke.
On two occasions the psychologists have gone out separately to perform a specific
function, such as screening children for admission to special schools for the retarded.
In the past this travelling group has served largely a diagnostic function, with
a secondary importance being given the functions of consultation, co-ordination, and
education. There has been a good deal of demand from various parts of the Province for more travelling service, particularly a service which would assist in the
ongoing management of problem cases. The psychiatric service being requested
can only be offered when there are regional psychiatric services available closer to
home. In the meantime we have endeavoured to modify the service of the Travelling Clinic in the hope that this change in our function will permit the fuller utilization of local services and thus assist the development of regional psychiatric clinics.
 J 150 MENTAL HEALTH SERVICES REPORT, 1959/60
We have tried to arrange for continuity in the psychiatrist who would be visiting a
certain community and at times to have him travel on his own to meet interested
people in the community, especially the local doctors. We have stressed the consultative as opposed to the diagnostic services Travelling Clinic can offer; we have
encouraged the closer co-ordination of the local public health office with the Social
Welfare Branch and the family doctors; we have endeavoured to channel community demands for local psychiatric services into constructive channels so that efforts
expended will be fruitful. We hope to be able to provide more frequent visits to
some areas of the Province in the near future and also to provide in-service education
through visiting consultants offering case consultations and seminars for professional
staff currently working in the field.
Sustaining Service for Discharged Hospital Patients
A pilot project designed to give better after-care to the hospitalized patient
through the services of the adult Clinic by closer working relationships between the
staff of the Mental Health Centre and the Provincial Mental Hospital has been
working out very well. A special form of service was developed to provide sustaining psychiatric care for those patients in the community whose principal mode of
treatment was monthly contact with the clinic through clinical personnel and a social
club. All patients enrolled had enough self-determination to attend voluntarily.
Emphasis has been made on personal contact and the relationship established with
the patient together with tranquillizing medication. This service was backed up
with the regular out-patient services if they became necessary, including the use of
Day Hospital. A total of eighty patients who have been carried in the sustaining
service had been resident in the Provincial Mental Hospital within one year of
receiving out-patient care. This group had spent a total of 251 years in mental
hospital. During the period of the study, only eleven of the patients returned to
hospital, four for a period of less than one month and seven for longer periods.
• The patients responded to the responsibility of regular attendance on a voluntary basis. When gains were measured by improved performance, reduced tension,
and greater ability to form social relationships, this group of patients made significant
progress. It is noted that the group of patients relied upon their families and upon
financial assistance for support. They did not have to assume responsibilities with
regard to family or finances.
Buildings and Maintenance
The repainting of the building, both exterior and interior, was completed during
the year. The doors of the offices in the Children's Clinic were each painted a
different colour, which gives a pleasing effect of special interest to children. A contract was let for the maintenance of the grounds and lawns. By this arrangement
there has been much less distraction to therapeutic activity in the building from the
daily operation of mowing-machines.
Further alterations to the building will be made to accommodate the Day
Centre treatment programme for children in the group therapy room. The playground equipment has now been installed in the grounds by the Department of
Public Works.
 MENTAL HEALTH CENTRE
J 151
STATISTICAL TABLES
Table 1.—Summary of Operations, Mental Health Centre, Adult Clinic,
April 1st, 1959, to March 31st, 1960
Male
Female
Total
7
10
17
Plus assessments—
41
1
8
1
119
22
30
37
1
3
179
42
43
78
2
11
1
298
64
73
222
305
527
Totals                                                                             -
229
315
544
Disposition of assessments—■
20
3
8
92
14
84
17
6
7
91
18
163
37
9
15
No case made—
183
32
Cases opened for treatment... -	
247
221
302
523
Total pending at March 31st, 1960   	
8
13
21
Patient load—
Brought forward at April 1st, 1959	
59
84
131
163
190
247
143
78
294
155
437
233
Total under treatment, March 31st, 1960 	
65
139
204
Family members under treatment at March 31st, 1960:   Parents, 3;   spouses, 13;   other, 1;   total, 17.
Table 2.—Movement of Population, Out-patient Department, Mental
Health Centre, Adult Clinic, April 1st, 1959, to March 31st, 1960
Male
Female
Total
CasR load as af March 31st, 1959
59
84
73
11
78
65
131
163
137
26
155
139
190
247
210
37
233
Case load as at March 31st, 1960
204
Table 3.—First Admissions to Mental Health Centre, Adult Clinic, by
Health Unit and School District of Residence, April 1st, 1959, to
March 3 1st, 1960.
Detailed information for the above table may be obtained on request.
 J 152
MENTAL HEALTH SERVICES REPORT, 1959/60
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 MENTAL HEALTH CENTRE
J 157
Table 8.—Movement of Population, Day-hospital Unit, Mental Health
Centre, Adult Clinic, April 1st, 1959, to March 31st, 1960
Male
Female
Total
Tn "lay hosrital  April 1"=t 19J9
8
30
13
88
7
21
118
7
Totals
38
34
108
96
146
130
Tn Hay-hospital, March list, IQfiO
4
12
16
Total patient-days of those discharged _..
Total discharges
Average stay in day-hospital
4,673
130
35.9
CASE LOAD,  CHILDREN'S  CLINIC,  MENTAL HEALTH  CENTRE
DIRECT-SERVICE CASES, APRIL 1st, 1959, TO MARCH 3 1st, 1960
Burnaby
Victoria
New
Repeat
Total
New
Repeat
Total
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
Intake Section
6
12
18
2
1
6
9
3
1
6
1
4
5
3
1
12
32
22
10
2
23
45
24
5
2
12
15
4
8
23
1
4
3
10
4
68
65
32
13
5
12
Cases opened—
Self-referral, friends, relatives	
100
87
32
23
Other
7
Total cases carried in intake during year...
39
19
11
9
78
99
39
31
14
183
261
Cases closed in intake—
Closed.	
12
3
20
6
-
13
2
....
9
1
1
21
3
50
11
1
87
39
1
30
14
12
1
170
33
4
Cases carried in intake at end of year.....	
4
-
....
4
-.. | .... | _ | _ |    ....    |      4
Treatment Section
87
12
64
40
8
35
6
14
9
5
16
11
138
50
119
29
87
73
17
39
32
4
30
22
14
5
50
170
132
251
Cases carried in treatment at end of year	
35
13
11
10
69
43
24
12
9
88
157
Diagnostic Service for Agency Cases for Stationary and Travelling Clinics
Place of Examination
New
Repeat
Total
M.
F.
M.
F.
107
38
15
6
16
23
133
82
17
1
8
2
12
5
73
39
5
9
1
15
1
9
57
19
5
1
1
1
16
247
60
Burnaby Travelling Clinics—
Jericho Hill School  _ 	
1
Cerebral Palsy Association 	
37
10
44
G. F. Strong Rehabilitation Centre.	
1
38
Mainland Travelling Clinics	
279
Grand total _    _	
—
....
717
 J 158
MENTAL HEALTH SERVICES REPORT, 1959/60
C5
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Si
 MENTAL HEALTH CENTRE J  159
Summary of Children's Clinics Activities, April 1st, 1959, to March 31st, 1960
Stationary Clinics
Mainland
Travelling
Clinics
Vancouver
Island
Travelling
Clinics
Vancouver
Victoria
253
324
283
246
37
16
45
17
253
137
136
32
104
2
96
7
172
455
341
341
116
20
41
38
38
3
698
957
Total number of children given full examination	
Other agency diagnostic cases given full examination (social, health, etc.)	
Clinic direct-service cases given full examination	
798
657
141
137
Clinic direct-service cases referred (private)—
141
24
 J 160
MENTAL HEALTH SERVICES REPORT, 1959/60
Sources of All Cases Referred to Children's Climes Showing Service Given,
April 1st, 1959, to March 31st, 1960
Number
of Cases
Type
of Service G
iven
Agency or Source
Diagnostic
Study Only
Consultative Study
Only
Clinic
Direct
Service
1. Social Agencies—
121
19
30
22
1
4
2
1
102
19
26
18
1
4
2
1
18
4
2
1
2
Snh-total
200
	
18
17
1
.
3. Medical and Health Agencies—
1
1
1
1
36
3
10
53
99
1
4
12
6
26
57
24
6
55
4
2
39
27
18
7
8
1
1
1
34
1
10
45
85
1
4
7
6
21
14
13
2
48
1
2
31
23
18
5
8
1
8
4
5
" 5
43
11
4
7
3
8
4
"  2
1
1
2
10
Selkirk TTpalth TTnit
South Central Health Unit                 	
North Fraser Health Unit      	
	
Upper Island Health Unit   _  .   . ..
501
..._.
	
4. Schools—
Public -	
22
32
6
28
3
1
13
3
Snh-total
54        |        _
	
27
20
26
18
1
1
1
Sub-total 	
47
	
.—
66
66
1
	
66
65
8. Other—
2
3
2
2
1
R <" A F   Holbure
Snh-tota'
5
	
	
957
655
137
165
 MENTAL HEALTH CENTRE
J  161
Diagnoses of All Cases Examined by Children's Clinics,
April 1st, 1959, to March 31st, 1960
Children
Adults
Total
Male
Female
Male
Female
Psychoses—
300?
2
3
1
32
1
1
1
2
4
1
2
8
5
3
3
1
2
35
26
13
7
11
102
13
11
12
17
34
41
2
3
15
3
1
1
3
2
3
1
4
1
3
47
	
	
~~2
2
300.8                       	
3
3ns 1
1
2
Psychoneurotic disorders—
310
7
1
1
1
1
1
1
5
4
4
31
10
6
1
1
10
43
7
6
3
12
27
23
4
2
4
1
1
1
1
1
1
22
—
2
1
39
311                   	
2
31?.
1
314
2
316.3	
317                                       	
2
4
317^
1
318-	
1
318.4	
3
Disorder  of  character,  behaviour,  and  intelligence—-
320..                        	
9
320.1         ...
320.3	
320.4                      .          	
1
10
7
320.5	
320.6                     _                  ...
7
1
370.7
2
321	
66
321.1	
36
321.2
321.3  	
321.4
19
1
8
321.5	
324
21
149
324.1        	
324.2                      .    .
325
20
17
15
325.1 	
325.2                        	
29
61
325.3    	
64
325.5   	
325.7      	
325.8	
326     	
6
3
2
19
326.1	
326.2              .   .   .
1
4
326.3	
326.4                                            -
3
1
326.6 - -
4
378
I
2
378.3
3
_
i
3
328.4...	
328.9. 	
1
5
Other—
353	
1
353.1   ..    	
353.9
1
3
793	
73
793.2	
733
39                    20
1         1             1
	
_        |        _
59
2
Totals	
523         1         266         1             6         1             3
798
Printed by Don McDurmid, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1961
460-1260-8260
   

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