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Mental Health Services Branch PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT FOR TWELVE MONTHS ENDED MARCH… British Columbia. Legislative Assembly [1966]

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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 31
1965
Printed by A. Sutton, Printer to the Queen's Most ExceUent Majesty
in right of the Province of British Columbia.
1966
  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 31, 1965.
ERIC MARTIN,
Minister of Health Services and Hospital Insurance.
Office of the Minister of Health Services and Hospital Insurance,
Victoria, B.C., December 20,1965.
 Department of Health Services and Hospital Insurance,
Mental Health Services Branch,
Vancouver, B.C., December 17, 1965.
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 31, 1965.
A. E. DAVIDSON, B.A., M.D., F.A.P.A.,
Deputy Minister of Mental Health Services.
 TABLE OF CONTENTS
PART I.—GENERAL ADMINISTRATION
Report—Director of Mental Health Services	
Report—Business Manager.
Report—Personnel Officer-
Report—Supervisor of Psychiatric Social Work	
Report—Director of Nursing Education	
Report—Consultant in Medical Records and Statistics	
PART II.—CREASE CLINIC OF PSYCHOLOGICAL MEDICINE
AND PROVINCIAL MENTAL HOSPITAL
Report—Medical Superintendent	
Statistical Tables—Crease Clinic	
Statistical Tables—Provincial Mental Hospital	
PART III.—THE WOODLANDS SCHOOL
Report—Medical Superintendent	
Statistical Tables—The Woodlands SchooL
PART IV.—THE TRANQUILLE SCHOOL
Report—Medical Superintendent	
Statistical Tables—The Tranquille School	
PART V.—GERIATRIC DIVISION
Report—Medical Superintendent	
Statistical Tables—-VaUeyview Hospital, Essondale	
Statistical Tables—Dellview Hospital, Vernon	
Page
7
20
41
47
53
55
57
77
87
100
103
108
112
114
118
124
Statistical Tables—Skeenaview Hospital, Terrace  128
PART VI.—COMMUNITY MENTAL HEALTH SERVICES
Report—Director of Mental Health Centre, Burnaby  132
Report—Director of Mental Health Centre, Victoria  142
Report—Director of Okanagan Mental Health Centre, Kelowna  145
Report—Director of Vancouver Island Mental Health Centre, Nanaimo  148
Report—Director of Kootenay Mental Health Centre, Trail  150
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 Report of Mental Health Services Branch
For the Twelve Months Ended March 31, 1965
PART I.—GENERAL ADMINISTRATION
REPORT OF DIRECTOR OF MENTAL HEALTH SERVICES
A. E. Davidson, M.D., Deputy Minister of Mental Health Services
and Director of Mental Health Services
The fiscal year 1964/65 has been largely devoted to the consolidation of
various programmes which have been initiated during previous years and certain
planning and organizational changes preparatory to the coming into force of the
Mental Health Act, 1964.
The Mental Hospital Division, the Geriatric Division, and the Schools for
Mental Defectives Division continue to provide the in-patient care for a very large
group of persons. Significant changes have been made in the programmes of care
in each of these divisions. The Community Services Division continues to provide
diagnostic, consultative, and therapeutic services for patients with emotional or
mental illnesses but who do not require hospitalization. These services have been
expanded considerably by the opening of the mental health centres in Nanaimo and
Trail.   Similar centres are being planned for other areas of the Province.
The Mental Health Act, 1964, was passed at the 1964 Session of the Legislature. Considerable planning has been necessary to prepare for the introduction
of this Act. Regulations have been drafted and passed by Order in Council preparatory to the Act coming into force on April 1, 1965. Many changes have been made
in the admission and discharge procedures and also in the review procedures, which
have all necessitated administrative changes. With the coming into effect of the
new Act, the Crease Clinic of Psychological Medicine and the Provincial Mental
Hospital, Essondale, will be combined to function as one mental health facility.
This combined facility will be known as the Riverview Hospital. Additionally, considerable effort has been expended in communicating and explaining the various
aspects of the new mental health legislation to those departments and agencies and
community groups who are interested and involved in its operation.
STATISTICAL COMMENTS
A very large group of persons has been served by the various units of the
Mental Health Services Branch, as indicated by the figures in the accompanying
tables.
Four thousand five hundred and eighteen persons were admitted to the inpatient units during the year. This is a decrease of 51 from the number of admissions for the preceding year. This is the first year such a decrease has been
recorded. This decrease is mainly in the Mental Hospital Division, and reference
will be made to it later in this Report.
The separation rate has been maintained at a very high level. This requires
a very active programme of care.   At the end of the fiscal year, 6,053 patients
 F 8
MENTAL HEALTH SERVICES REPORT, 1964/65
were in residence in the various in-patient units, with an additional 448 living in
boarding homes. This represents an increase of 154 patients under care at the
end of the fiscal year. Altogether 11,655 persons received services in the in-patient
units of this Branch during the year 1964/65.
All persons requiring mental hospital care have been admitted and cared for
this year in either the Crease Clinic or the Provincial Mental Hospital, Essondale.
Three thousand eight hundred and fifteen persons were admitted to these two institutions. This represents a decrease of 184 from the preceding year. It is the first time
such a decrease has been recorded since the Crease Clinic was opened in 1950. Such
a decrease in admissions results in part from the increase in services which have
become available in the community, making the care of some of these patients outside a mental hospital possible. There have been an increasing number of admissions to these hospitals on a voluntary basis. One thousand one hundred and
eighteen patients or 79.5 per cent of all admissions to the Crease Clinic and 843
patients or 34.5 per cent of all admissions to the Provincial Mental Hospital were
admitted voluntarily. Thus a total of 1,961 persons has voluntarily sought admission to these institutions to receive care and treatment.
The programme of care in the Crease Clinic and Provincial Mental Hospital
has been reflected in the marked increase in discharges, with the resulting decrease
in the resident population. At the beginning of the fiscal year 3,052 persons were
in residence in these two institutions, whereas at the end of the year 2,918 were
in residence, a decrease of 134. Considerable use was made of the boarding-home
programme in providing care and assistance for patients who had responded to the
treatment in hospital to such a degree that they no longer needed hospitalization
but still needed some protective supervision. Two hundred and fifty-seven persons
were in boarding homes as of March 31, 1965.
Table 1.—Showing Patients in Residence in the Various Institutions of the Provincial Mental Health Services, April 1,1964, and March 31,1965, Together with
Increase or Decrease.
Institution
In Residence, Apr
. 1, 1964
In Residence, Mar.
31, 1965
Increase (+)
Men
Women
Total
Men
Women
Total
Decrease (—)
104
1,552
715
311
277
106
288
142
1,254
592
15S
464
129
246
2,806
1,3071
469
741
235
288
89
1,437
742
329
268
98
299
140
1,252
540
242
491
126
	
229
2,689
1,282   ,
571
759
224
299   i
—17
Mental Hospital, Essondale  —	
—117
—25
The Tranquille School _ '	
VaUeyview Hospital, Essondale    —
Dellview Hospital, Vernon 	
Skeenaview Hospital, Terrace	
+ 102
+ 18
— 11
+ 11
Totals  	
3,353
2,739
6,092
3,262
2,791
6,053   -
-39
i Adjusted April 1, 1964, by deducting 1 male and 8 females out in boarding homes but previously shown on
in-resident census.
 GENERAL ADMINISTRATION
F 9
Table 2.—Sliowing in Summary the Admissions and Population Increase of the
Mental Health Services Branch for the 10-year Period April 1, 1955, to
March 31, 1965.
Year
Total
Admissions
Admissions
65 Years
and Over
Admissions
15 Years
and Under
Voluntary
Admissions
Population
Increase
Index of
Increase
1955/56 .
1956/57.
1957/58.
1958/59..
1959/60.
1960/61.
■1961/62..
1962/63..
1963/64_
1964/65 _
2,855
2,270
2,936
2,993
3,296
3,924
4,193
4,248
4,569
4.51S
392
385
442
425
506
580
557
554
550
702
58
57
106
135
182
254
200
213
243
215
1,153
1,083
1,012
1,118
1,316
1,695
2,023
2,086
2,187
2,194
26
—78
38
-90
20
42
-156
—63
31
—39
0.91
—2.87
1.29
— 3.00
0.61
1.07
-3.72
-1.48
0.68
-0.86
Totals..
35,802
5,093
I
1,663
15,867
-269
This reduction in resident population has been a trend which has been in
progress over the past seven or eight years. In 1957 a total of almost 3,500 was
in residence in the Crease Clinic and the Provincial Mental Hospital. This, compared with the total of 2,918 as of March 31, 1965, shows a reduction of approximately 580.
The Woodlands School and The Tranquille School provide hospital care and
training and education for certain types of mentally retarded children requiring
specialized nursing and training and for whom proper facilities are not available
in the community. At present all admissions are made to The Woodlands School,
where facilities are available to carry out specialized study and assessment. Transfers are arranged between The Woodlands School and The Tranquille School.
During the year 223 admissions were arranged directly to The Woodlands School.
At the end of the year 1,853 patients were in residence in these two facilities, compared with 1,776 at the beginning of the year.
During the year a study was made of those children whose parents had made
application for services. In many instances when parents were contacted, it was
found that admission to hospital was not required.
The VaUeyview Hospital, Essondale; the Dellview Hospital, Vernon; and
the Skeenaview Hospital, Terrace, are designed to serve the needs of the geriatric
patient with psychiatric symptomatology. With the concentration of the Provincial
population being located in the Lower Mainland and the lower portion of Vancouver
Island, the majority of admissions have been made directly to VaUeyview Hospital
However, a limited number of admissions have also been made directly to Dellview
Hospital and Skeenaview Hospital. Five hundred and forty-four geriatric patients
were admitted to the three units during the year. This represents an increase of
116 over the preceding year. Many more patients were discharged from the hospitals, returning either to their own homes or nursing or boarding homes. During
this period 147 patients were discharged, this representing an increase of 80 over
the preceding year.
The activities of the various units of the Community Services Division have
been increased largely because of the opening of additional mental health centres
at Trail and Nanaimo. These centres provide a variety of services, including
diagnostic and assessment, consultative, therapeutic, after-care, and rehabilitative
and educational services. Each of these centres provides services to other areas
in the region through travelling clinics.   A total of 3,041 patients was served by
 F 10 MENTAL HEALTH SERVICES REPORT,  1964/65
the five mental health centres functioning during this year. Of this total, 1,478
were adults and 1,563 were chUdren. One thousand four hundred and seventy-
seven patients were accepted into treatment, this total consisting of 859 adults and
618 children.
MAJOR EVENTS AND TRENDS
During the year a decision was made to develop the Riverside Building at
Colony Farm for use as a maximum-security area. Certain structural changes
were made in the building, and a specifically designed airing-court area was constructed in order to provide maximum security. The entire area was designed so
that patients confined here could move about more freely to attend occupational-
therapy and recreational-therapy activities, etc. Staff was provided who were
aware of the security measures necessary in caring for these patients. A more
therapeutic atmosphere was created for those patients who require maximum-
security measures. These include Order in CouncU patients, admissions from the
Penitentiary, and others who have criminal records associated with their mental
disorder. The two upper floors of this building have been developed for the care
of this group of patients.
Supplementing this service are arrangements for a consultative psychiatric
service, which is being provided for Oakalla Prison Farm. By this means many
patients are seen before they are transferred from Oakalla to the Mental Hospital,
and in some instances admission to the Mental Hospital is not necessary.
Additional alterations have been made to the first floor of the Riverside
BuUding in order to provide a more uniform and concentrated treatment programme
for patients suffering from chronic alcoholism. These patients are usually admitted
on a voluntary basis directly to this unit, and it is possible to organize a more
adequate programme for their care in this specially designed facUity.
The provision of this building to provide care for those requiring maximum
security has made possible the extension of the open-door policy to the remainder
of the Hospital. In this way the development of this service has resulted in an
upgrading of service throughout the entire Mental Hospital unit.
There has been a considerable change in the expansion of the rehabilitation
programme at Essondale. The previous Co-ordinator of Rehabilitation resigned
last year, and a new appointment was made to fill this position during this present
fiscal year. This department is responsible for the preparation of the patients prior
to their discharge and return to the community. A very active programme of
assessment, job placement, and evaluation has been organized in order to provide
this service to a large group of patients.
The After-care Clinic has continued to expand during this past year. This
Clinic provides services to persons following their discharge from hospital, assisting
them in their adjustment after returning to the community. One thousand four
hundred and thirty-one persons were served by the After-care Clinic during the
past fiscal year.
It has been possible through the boarding-home care programme to establish
and maintain a good many more patients outside the hospital. At the end of
March, 1965, 448 patients were being assisted through this programme. This has
helped greatly in providing for the care of those patients who do not require the
more specialized care and facilities of the Mental Hospital.
During recent years the programme of care for tubercular patients has resulted
in a marked reduction in the number of patients suffering from active tuberculosis.
Space has become available in the North Lawn Building which was designed to
 GENERAL ADMINISTRATION F 11
accommodate and treat this group of patients. The avaUable space has now been
renovated and reorganized to provide accommodation for those patients in hospital
who develop physical illnesses or become too infirm to be cared for on the general
Mental Hospital ward.
The Greaves BuUding at The Tranquille School was filled by the transfer of
multiple handicapped and severely mentally retarded children from The Woodlands
School. In addition, the Deerholme Building at The Tranquille School was
renovated to provide accommodation for 50 trainees. These patients were also
transferred from The Woodlands School.
Planning was instituted at The Tranquille School for the development of a
rehabilitation programme. This service was designed to assist in the preparation
of chUdren for discharge and placement in suitable community settings.
During the year the Kiwanis Club of Kamloops purchased a camp-site 15
miles north of Kamloops. After the renovation of the building was completed, this
site was donated to The Tranquille School for the purpose of providing camping
activities for their residents.   This camp has been named Kamp Kiwanis.
Various developments and changes have been made at The Woodlands School,
which all result in an improvement in the quality and quantity of service. After
considerable planning, the reorganization of the Nursing Department at The Woodlands School has been implemented. This results in the integration of the male
and female nursing divisions into one unified department. This integration of
nuring services should result in an improvement and standardization of the nursing
care for both male and female patients.
In November of 1964 an Out-patient Department was organized at The Woodlands School. A clinic team consisting of a paediatrician as director, a public health
nurse, a psychologist, and a social worker with the necessary clerical staff was
recruited and organized. Space was developed in the Fraserview Building for the
accommodation of this clinic. This department assists those who have sought
service from The Woodlands School by screening and evaluating applicants to
determine whether admission to the School is desirable or whether some other programme could be suggested which will help maintain the individual case in the
community. This service has proven very effective and has been well received by
those for whom it was designed.
A new service has been developed at The Woodlands School by the opening
of a Genetic Clinic. A geneticist from the University of British Columbia gives
direction to the clinic and a technician trained in chromosomal study has been
employed at The Woodlands School. Using information gained from these studies,
a counselling service for parents of mentally retarded children has been organized
and is proving to be of considerable value.
Improvements have been initiated in the services offered by the Geriatric
Division of the Mental Health Services Branch. Pre-admission services are offered
to persons seeking admission. In many instances alternate arrangements can be
made for the placement of such persons, thus rendering admission to a mental
hospital unnecessary. Sixty-two such placements were arranged by this unit during
the past year. The post-discharge services provide a follow-up service to patients
who have been discharged. This enables many patients to be kept in the community who might otherwise have been returned to the hospital.
In the Community Services Branch the modification and extension of existing
services and the development of new services have resulted in a much greater amount
of care being provided. In the Mental Health Centre in Burnaby there have been
many modifications of programmes to meet the existing demands.   An increasing
 F 12 MENTAL HEALTH SERVICES REPORT,  1964/65
number of adolescents are being referred to this clinic and are receiving care in the
Day Hospital programme. Increased emphasis is being placed on family care of
patients accepted for treatment. Considerably more time is being spent in providing
consultative service and in trying to provide an educational programme along mental
health lines for the various agencies.
The Mental Health Centre in Victoria moved from its former location in a
small bungalow on Superior Street to a new location on Fort Street adjacent to
the Royal Jubilee Hospital. A fairly large apartment house has been renovated
to provide much more suitable accommodation. This centre provides service to
both adults and children. In addition, an After-care Clinic is operative here to
serve those patients who have recently been discharged from hospital and have
returned to this community. Additional staff has been provided for, and as this
staff is recruited the scope of operation of this clinic will be expanded.
The Okanagan Mental Health Centre in Kelowna has had its second year of
operation. During this past year an additional psychiatric position has been filled
and an additional social worker has been added to the staff. This increase in staffing
has made possible an increase in service provided in this area.
During this year the Vancouver Island Mental Health Centre was opened in
Nanaimo on April 1, 1964. This centre will provide services to cities in the
Central Vancouver Island and Upper Island Health Units. On June 1, 1964, the
Kootenay Mental Health Centre in Trail was opened, providing services to the
West Kootenay, East Kootenay, and Selkirk Health Units. The opening of these
two centres renders unnecessary the visits of the travelling clinics from the other
mental health centres in the Province. They, in turn, will be able to provide more
time for the travelling clinics to visit in the other unserved areas of the Province.
The Department of Nursing Education provides education and training to
four groups of nursing personnel: (1) the student being trained to become a
psychiatric nurse, (2) the student in general nursing who is receiving affiliate training in psychiatric nursing as part of her general nursing course, (3) the registered
nurse taking postgraduate training in psychiatric nursing, and (4) the psychiatric
aide. Difficulty was encountered during the past year in recruiting sufficient instructresses to provide all of these courses in detail. It was necessary as a temporary
measure to discontinue the training of affiliate nurses. It is planned, however, to
reinstitute these programmes as soon as personnel can be obtained.
GENERAL COMMENTS
Considerable planning for new facilities and the renovation of existing facUities
have continued during this year. The following projects have either been completed
or are in the process of construction at the present time:—
(1) The renovation of the Riverside Building, Essondale, to provide facilities
for a maximum-security unit.
(2) Renovation of an area in the Fraserview Building, The Woodlands School,
to provide space for the Out-patient Clinic.
(3) Renovation of the North Lawn Building to provide facilities for the care
of the sick and infirm.
(4) Renovation of the Deerholme Building, The TranquiUe School.
(5) Planning and building of a 100-bed unit at The Tranquille School now
under construction.
(6) Renovation of apartment house, Fort Street, Victoria, to provide accommodation for the Mental Health Centre, Victoria.
 GENERAL ADMINISTRATION F 13
(7) Addition to the Public Health Building, Prince George, to provide
accommodation for the Mental Health Centre, Prince George.
The annual graduation exercises for the Department of Nursing Education
were held in the Vincent Massey Junior High School, New Westminster, on the
evening of April 29, 1964. Miss Evelyn Mallory, Director of the School of Nursing,
University of British Columbia, was the graduation speaker. There were 95 nurses
who received diplomas, 73 of these being female nurses and 22 being male nurses.
A dinner-dance was held for the graduating class at the Blue Boy Motor Hotel,
Vancouver, on May 1, 1964.
The 1964 annual meeting of the Council of Psychiatric Nurses was held on
April 23, 1964.
One hundred and eighty psychiatric nurses and three nurses in mental deficiency have been issued licences to practise psychiatric nursing during the past fiscal
year. At the time of the annual meeting, 1,403 persons were licensed pursuant to
the Psychiatric Nurses Act.
The Council of Psychiatric Nurses awarded the Dr. A. M. Gee Travelling
Bursary for 1964 to Mrs. Angeline M. Dowling, charge nurse at The Woodlands
School. This is the second occasion this bursary has been granted. Mrs. Dowling
attended the Neuropsychiatric Institute of the University of California, Los Angeles,
for the month of November to secure an extensive experience in the field of her
interests.
The registrar, Mr. J. A. Markley, submitted his resignation. Mr. Bernard
Muise was appointed as the new registrar of the Council, to be effective April 1,
1965.
The Canadian Mental Health Association has provided active support in various ways at the Crease Clinic, Provincial Mental Hospital, VaUeyview Hospital,
and the Mental Health Centre, Burnaby. A very active volunteer group visits the
patients frequently and offers many ancillary services. At Christmas each patient in
these hospitals receives a gift through the efforts of the association. Forty-two community groups with a total of 639 persons toured the mental health facilities at
Essondale for the purpose of becoming more familiar with the activities carried out
there.
The Association for Retarded ChUdren also performs a very important and
valuable service to the patients in The Woodlands School and The Tranquille
School. Volunteer centres are organized in both units and assist in many ways in
bringing the little extras to the patients in these two institutions. The contribution
of these two organizations in working with the patients in our various institutions is
sincerely appreciated by both patients and staff.
The in-service training programme for special school counsellors continues to
receive support and assistance from the Mental Health Services Branch. This programme is organized by the Vancouver School Board and provides training in various aspects of mental health to a limited number of teachers who are selected to
provide counselling service to students with emotional problems in the schools of
Vancouver. Nine teachers were selected to take this training this year. Seven
came from the Vancouver School Board, one from the Delta School Board, and
one from the Richmond School Board. During the past 10 years 91 teachers have
received this valuable training.
There have been many important changes in the senior administrative and
professional staff in the Service. The following staff changes were made during this
past year: Dr. S. Jensen was appointed as Director of the Vancouver Island Mental
Health Centre, Nanaimo;   Dr. M. S. Gavanski appointed as psychiatrist in the
 F 14 MENTAL HEALTH SERVICES REPORT, 1964/65
Mental Health Centre, Kelowna; Dr. G. R. Mansfield appointed as Director of the
Kootenay Mental Health Centre, Trail; Dr. L. Holland resigned at Mental Health
Centre, Victoria; Dr. A. Aranas appointed psychiatrist in the Mental Health
Centre, Victoria; Mr. J. Borthwick appointed Assistant Superintendent, Crease
Clinic and Provincial Mental Hospital, Essondale; Miss A. Elart appointed Coordinator of Rehabilitation, Crease Clinic and Provincial Mental Hospital, Essondale; Miss B. J. Mitchell, Director of Nursing Services, Mental Health Services
Branch, resigned; Dr. J. M. Jackson, Director of Radiological Services, Crease
Clinic and Provincial Mental Hospital, retired on superannuation; Dr. E. J. Cook
appointed Director of Out-patient Clinic, The Woodlands School; Dr. J. S. Bland
appointed Medical Superintendent of The Woodlands School.
MENTAL HEALTH GRANT
The Government of Canada, through the Department of National Health and
Welfare, made available to the Province a Mental Health Grant " to assist in an
extended programme for the prevention and treatment of mental iUness, including
rehabilitation and free treatment." This was the 17th consecutive year that the
Mental Health Grant was avaUable to this Branch as one component of the programme of Federal Health Grants.
In 1964/65 the Mental Health Grant provided $710,026. Project submissions in the sum of $709,659.01 were made by the Province and approved by the
Department of National Health and Welfare. By the end of the fiscal year, reimbursement in the sum of $669,644.33 had been received by the Province for expenditures made on account of approved Mental Health Grant projects. The detaUs
of these expenditures are provided in tabular form in the Business Manager's report at page 36.
In 1964/65, 20 separate projects received support from the Mental Health
Grant. Five of these supported professional staff employed in the programme of
the Mental Health Services Branch and assisted in the expansion of the community
mental health centres.
Assistance was continued to the Department of Psychiatry, University of British Columbia, in its programme of postgraduate training in the specialty. The purpose of this project is to enable physicians to qualify as psychiatric specialists and
then be avaUable to participate in an expansion of public psychiatric services and in
the teaching programme of the university. The teaching programme is in large
measure conducted at the Vancouver General Hospital. Accordingly, a grant to
provide assistance in the operation of the Psychiatric Out-patient Department is
made to that institution.
The Metropolitan Health Committees of Victoria and Vancouver were aided
by grants which permitted them to hire professional psychiatric and supporting
clerical workers for their clinics.
The School of Social Work, University of British Columbia, continued to receive support for the salary of a student field-work placement supervisor.
The research projects at the University of British Columbia, Departments of
Psychiatry and Pharmacology, continued to make significant studies. These projects have been sustained in large measure by Mental Health Grant funds augmented
by a Provincial grant-in-aid.
 GENERAL ADMINISTRATION
F 15
COMPARATIVE SUMMARY OF INCREASES AND DECREASES IN RESIDENT POPULATION BY MAJOR DIVISIONS OF MENTAL HEALTH
SERVICES BRANCH, 1955/56 TO 1964/65.
Fiscal Year
Provincial
Mental
Hospitals
Schools for
Mental
Defectives
Geriatric
Division
Crease
Clinic
Total
1955/56-
1956/57-
1957/58_
1958/59-
1959/60-
1960/61-
1961/62-
1962/63-
1963/64-
ise4/es_
+2
—70
-49
-135
-253
-71
-247
-100
— 83
—117
+19
+ 14
+76
+86
+93
+75
+73
+62
+79
+77
+15
+9
-15
—30
+156
+59
+7
+12
+7
+ 18
-10
-31
+26
-11
+24
-21
+M
-37
+28
—17
+26
-78
+38
-90
+20
+42
-156
—63
+31
—39
COMPARATIVE SUMMARY OF TOTAL PATIENTS UNDER CARE FOR
MAJOR DIVISIONS OF MENTAL HEALTH SERVICES BRANCH BY
FISCAL YEARS 1955/56 TO 1964/65.
Fiscal Year
Provincial
Mental
Hospitals
Schools for
Mental
Defectives
Geriatric
Division
Crease
Clinic
Total
1955/56-
1956/57-
1957/58_
1958/59-
1959/60..
1960/61-
1961/62.-
1962/63-
1963/64-
1964/65-
5,247
5,335
5,408
5,377
5,458
5,530
5,803
5,853
6,099
5,888
1,278
1,275
1,373
1,481
1,740
1,868
1,960
2,023
2,042
2,178
1,330
1,287
1,349
1,373
1,459
1,587
1,642
1,677
1,738
1,937
1,894
1,721
1,714
1,744
1,705
1,846
1,876
1,912
1,832
1,652
9,749
9,618
9,844
9,975
10,362
10,831
11,281
11,465
11,711
11,655
 F 16
MENTAL HEALTH SERVICES REPORT,  1964/65
MOVEMENT OF POPULATION OF MENTAL HEALTH SERVICES,
APRIL 1, 1964, TO MARCH 31, 1965
Psychiatric
Division
Schools for Mental Defectives
Geriatric
Division
Total
M.
F.
T.
M.
F.
T.
M.
F.
T.
M.
F.
T.
fa residence, April 1,1964	
fa boarding homes, April 1,1964	
On probation, carried forward from
1963/64                                     	
On escape,  carried forward from
1963/64         	
1,656
87
139
4
1,396
123
2SS
3,052
210
427
4
1,026
1
14
750
8
10
1,776
9
24
671
18
16
593
18
19
1,264
36
35
3,353
106
169
4
2,739
149
317
6,092
255
486
4
Total as at April 1,1964 	
1,886| 1,807| 3,693
1,041
768| 1,809
705
630
1,335
3,632] 3,205
6,837
Admissions-
First admissions to Mental Health
Services
Readmissions to different institu-
1
932 1,007
172     207
709]    788
1,939
379
1,497
78
4
55
52
1
33
130
5
88
232
6
228
12
2
460
18
2
1,242
182
764
1,287
220
823
2,529
402
Readmissions to same institution.
1,587
1,813
13
2,002
19
3,815
32
137
43
86
103
223
146
238
89
242
33
480
122
2,188
145
2,330
155
4,518
Transfers in
300
Total admissions to individual
institution..	
1,826
3 712
2,021
3,847
180
189
369
327
275
905
602
1 937
2,333
5,820
2,485
5,535
4,818
11,3551
Separations—
Discharged in full	
Died
1,852
72
78
6
2,026
60
152
3,878
132
230
6
65
17
18
33
6
9
98
23
27
10
245
1
14
190
24
435
1
1,927
334
97
6
2,073
256
161
4,000
590
On probation but not discharged...
258
6
2,008
66
2,238
S3'
4,246
119
100
34
48
101
148
135
256
45
204
1
460
46
2,364
145
2,490
155
4,854
300
Total separations from individual institution
2,074| 2,291
4,365
134
149
283
301
205
506
1
2,509| 2,645
5,154
Net increase or decrease
-130|    —*
—134
+45|  +32
+77
-6
+24]  +18
—911  +52
—39
1,526| 1,392| 2,918
1,071
782] 1,853
665
617| 1,282
3,262| 2,791
6,053
fa boarding homes, March 31,1965—
112l|    145
1
257
16
26
42
66
83
149
194f    254
1
448
i Total under care for all Mental Health Services includes total as at April 1, 1964, plus the total admissions
to individual institutions minus transfers out.
 GENERAL ADMINISTRATION
F 17
MOVEMENT OF POPULATION IN INDIVIDUAL INSTITUTIONS,
APRIL 1, 1964, TO MARCH 31, 1965
Psychiatric Division
Crease Clinic
Provincial Mental
Hospital, Essondale
Total
M.
F.
T.
M.
F.    1
T.
M.
F.
T.
104
142
246
1,552
87
139
4
1,254
123
288
2,806
210
427
4
1,656
87
139
4
1,396
123
288
3,052
In boarding homes, April 1, 1964	
On   probation,   carried   forward   from
1963/64 	
210
427
On escape, carried forward from 1963/64
4
Total as at April 1, 1964.  	
104
142 i
246
1,782 .| 1,665
3,447
1,886 | 1,807
3,693
Admissions—
First   admissions   to   Mental   Health
435
44
168
519
36
201
954
80
369
497
128
541
488
171
587
985
1    299
1,128
932
■ 1,007
1,939
Readmissions to different institutions .
172
709
207
788
'    379
1,497
647
756
'        3
1,403
3
1,166
13 ■
1,246
16
2,412
29
1,813 | 2,002
13 ]       19
3,815
Transfers in  -
32
Total admissions to individual institution  	
647
759
1,406
1,179
1,262
2,441
1,
1,826 | 2,021
3,847
751
901
1,652
2,961  f 2,927
5,888
3,712 ] 3,828
7,540
Separations—
651
2
745 i
	
	
1,396
3
1
1,201
70
78
6
1,281
59
152
2,482
129
1    230
6
1,852
72
78
6
2,026
60
1S2
3,878
Died 	
132
On probation but not discharged    	
Escaped but not discharged	
230
6
653
9
746
15
1,399
24
1,355
57
1,492
38
2,847
95
2,008
66
2,238
53
4,246
Transfers out
119
Total   separations   from   individual
institution	
662
761
1,423
1
1,412 i 1,530
2,942
2,074
2,291
4,365
Net increase or decrease	
-15
-2
-17
-115 [     —2
— 117
— 130 |     —4
-134
89
140
229
1,437 f 1,252
2,689
1,526 | 1,392
2,918
In boarding homes, March 31,1965	
____ |   ...__
	
112 I     145
f
257
112 i[     145
1
257
 F 18
MENTAL HEALTH SERVICES REPORT,  1964/65
MOVEMENT OF POPULATION IN INDIVIDUAL INSTITUTIONS,
APRIL 1, 1964, TO MARCH 31, 1965—Continued
Schools for Mental Defectives
The Woodlands School,
New Westminster
The Tranquille School,
Tranquille
Total
M.
F.
T.
M.
F.
T.
M.
F.
T.
In residence, April 1, 1964.  	
fa boarding homes, April 1,1964.	
On  probation,   carried  forward  from
1963/64..      	
715
1
13
592
8
10
1,307
9
23
311
1
158
469
1
1,026
1
14
750
8
10
1,776
9
24
Total as at April 1, 1964	
729 ]     610 | 1,339
312 ]     158
470
1,041
768
1,809
Admissions—
First  admissions  to  Mental  Health
78
4
54
52
130
1
	
1
78
4
55
52
1
33
130
Readmissions to different institutions
Readmissions to same institution	
1
33
5
87
5
88
136
12
86 |     222
10 j       22
1
31
93
1
124
137
43
86
103
223
Transfers in  —-    ..   	
146
Total admissions to individual in-
148
96        244
32
93
125
180
189
369
877 |     706 ] 1,583
344 |     251
595
1,221
957
2,178
Separations—
64
13
33
5
97
18
1
4
2
1
1
1
5
3
65
17
18
33
6
9
98
Died
23
On probation but not discharged	
16
8
24
27
93 I
32
46
94
139
126
7
2
2
7
9
9
100
34
48
101
148
135
Total separations from individual
125 \     140
265
9
9
18
134
149
1    283
Net increase or decrease
+27 ]   -52 |   -25
+ 18 ]   +84
+ 102
+45
+32
+77
In residence, March 31, 1965 ..   .
742 |     540 | 1,282
329 |     242
571
1,071
782
1,853
In boarding homes, March 31,1965
10 ]       26 1       36
6
	
6
16
26
42
 GENERAL ADMINISTRATION
F 19
MOVEMENT OF POPULATION IN INDIVIDUAL INSTITUTIONS,
APRIL 1, 1964, TO MARCH 31, 1965—Continued
Geriatric Division
Valley view Hospital,
Essondale
Dellview Hospital,
Vernon
Skeenaview
Hospital,
Terrace
Total
M.
F.
T.
M.
F.
T.
M.
M.
F.
T.
In residence, April 1,1964	
In boarding homes, April 1,1964.
On probation,  carried forward
from 1963/64   	
277
18
15
464
18
17
741
'      36
32
106
129
235
3
288
671
18
16
593
18
19
1,264
36
*
Total as at April 1,1964	
310
499
809
107
131
238
288
705
630
1,335
Admissions—
First  admissions   to   Mental
195
5
194
12
2
389
17
2
32
34
66
5
1
232
6
228
12
2
460
Readmissions to different in-
18
Readmissions   to   same   insti-
2
200
31
208
33
408
64
32
8
34
66
8
6
50
238
89
242
33
480
122
Total   admissions   to   indi-
231 i
241
472
40
34
74
56
327
275
602
Total under care.-	
541
740
1,281
147
165
312
344
1,032
905
1,937
Separations-
Discharged in full	
Died    	
10
166
!      11
155
21
321
	
37
3
35
3
72
42
1
10
245
1
14
190
-
24
435
On  probation  but  not  discharged     	
1
176
31
166
342
31
37
12
38
1
i      75
13
43
2
256
45
204
1
460
46
Total separations from indi-
207
166
373
49
39
88 .
45
301
205
506
-9
+27
+ 18
— 8
-3
-11
+ U
-6
+24
+18
In residence, March 31, 1965	
268 i
491
759
98
126
224
299
665
617
1,282
In boarding homes, March 31,
1965	
66
83
149
	
	
66
83
149
 F 20 MENTAL HEALTH SERVICES REPORT, 1964/65
BUSINESS MANAGER'S REPORT
F. A. Matheson, Business Manager
Attached are the financial reports of the British Columbia Mental Health
Services Branch for the fiscal year ended March 31, 1965, together with a resume
of general business operations and service additions.
Table A shows the daily average population as 6,074.47, a decrease of
39.52 from the fiscal year 1963/64. Maintenance expenditure increased from
$17,640,598 to $19,055,762 or $1,415,164, resulting in a daily per capita cost
increase from $7.90 to $8.59.
Salary increases proved to be the chief cause of the ever-growing cost of
operations, the difference of $1,415,164, as mentioned in the foregoing paragraph,
being made up of $1,255,974 in salaries and the balance of $159,190 in supplies
and expenses.
Maintenance revenue reversed an apparent downward trend that was evident
over the past few years and shows an increase from $1,751,281 in 1963/64 to
$1,866,781 or $115,500 in 1964/65.
Produce from the Department of Agriculture operations at Colony and Tranquille Farms supplied milk, vegetables, meat, and canned goods valued at approximately $450,000 to the various units of the Mental Health Services.
The extremely valuable and important assistance from the Federal Government through health grant projects contributed a total of $669,644.33 to our
programme in 1964/65. These funds provided personnel, equipment, and staff-
training, and a statement is attached showing allocation and disbursement of
these funds.
Due to the number of major capital construction projects being planned, the
Deputy Minister appointed a Mental Health Services Planning Committee consisting of the following: Dr. A. E. Davidson, Deputy Minister (Chairman); Dr. F. G.
Tucker, Deputy Director; Mr. C. B. Watson, Assistant to the Deputy Minister;
and Mr. F. A. Matheson, Business Manager. The Business Manager is also to act
as secretary to the Committee and liaison officer between the Mental Health Services
Branch, the Department of Public Works, and the institutions.
During the year the Planning Committee worked on the following projects:
Mental health facility, Victoria; School for Retarded, Victoria; Residential Care
Centre for Children, Burnaby; Medical Clinic, Essondale; Hillside Building, Essondale;   104-bed unit, Tranquille;  new kitchen and dining-rooms, Tranquille.
Again this year it is a pleasure to report that in addition to being able to
maintain the buildings, grounds, equipment, and furnishings of all our institutions
in a satisfactory manner, a considerable amount of new and replacement furniture
and equipment was also purchased. In addition, it was also possible to complete a
number of major improvements and to plan for further improvements of our
facilities in order to keep abreast with the changing treatment programme. Some
of the main items in this regard are as follows:—
Provincial Mental Hospital and Crease Clinic.—Work in connection with the
complete renovation of the West Lawn Building kitchen and dining-rooms was
completed.   Contract price was $ 147,827.
Contract in the amount of $115,827 for the improvement of garbage-handling
facilities and the renovation of ward kitchens and dining-rooms in the East Lawn
Building was let.
Plans for the improvement of the Centre Lawn Building garbage-handling
facilities were completed.
 GENERAL ADMINISTRATION F 21
Contract in the amount of $241,296 for the Hillside Building was let, and
work in this connection was started in January, 1965.
Some major changes were made in the Riverside Building to provide a maximum-security area.
The pharmacy was divided to provide facilities for a central pharmacy and a
unit pharmacy. Plans for the operation of these two pharmacies have been completed, and they will go into operation on April 1, 1965.
The programme of replacing the wooden floors in the West Lawn Building
continues. Three day-room and three dormitory floors were replaced with lightweight concrete and tile floors this year.
Approximately $25,000 was spent during the year on new and replacement
furniture.
The sorting area in the laundry was completely remodelled, and the patients
who had helped in this area have been replaced with staff.
The following laundry equipment was purchased during the year: 1 conditioning tumbler, 2 presses, 3 Sager spreaders, and 1 washer-extractor for the dry-
cleaning department.
VaUeyview Hospital.—Part of the main lobby in the VaUeyview Building was
made into a conference room.
A new steam-line from the VaUeyview Building to the other units was installed.
Cost of this installation was approximately $25,000.
A new passenger vehicle was purchased for the social service department.
A new 16-mm. sound projection machine, complete with portable screen,
was purchased.
Dellview Hospital.—A new boiler-house, complete with two new gas-fired
high-pressure boilers was constructed at a cost of approximately $70,000.
An air-cooling system, complete with a heavy-duty exhaust fan, was installed
in the kitchen.
An air-cooling unit was installed on Ward M3. All the wards are now
equipped with air-cooling units.
Skeenaview Hospital, Terrace.—Approximately $12,000 worth of new laundry
equipment was purchased and installed.
The staff recreation hall was converted into an occupational-therapy workshop.
Extensive repairs were made to the sewage-disposal system.
The 6-bed intensive-care unit on the infirmary ward has been increased to
12 beds.
The Woodlands School, New Westminster.—An Out-patient Department was
established in the Fraserview Building.
The rotundas in the Fraserview Building were altered to provide additional
office space and an admitting suite.
Wards K, C, 2, 6, and G were renovated.
A new apparel-shop for volunteers was established in the nurses' home.
A new fire-escape was installed in the Occupational Therapy Building.
Kitchen No. 1 was renovated and the old staff cafeteria was redecorated for
the use of patients.
The dietary department was reorganized and a number of dietary aides employed to assist the nursing staff in the handling of the patients' food.
A housekeeping department has been established to assist the nursing staff.
The Tranquille School, Tranquille.—Contract in the amount of $926,851 was
let for the construction of the new 104-bed building.
 F 22
MENTAL HEALTH SERVICES REPORT, 1964/65
Inspectors of the Fire Marshal's department made a complete survey of the
institution and a report in this connection was submitted.
Planning was started for a new kitchen and dining block.
A new Volkswagen seven-passenger bus was purchased.
Work was started on a new playing-field.
The Deerholme Building was completely renovated and new furniture purchased.   This building will be used for the better-class girls.
Major interior structural alterations were started on the East Pavilion Building
to convert the main floor to offices.
Major renovations and alterations were made to the boiler-house and plant.
A new 120-position telephone board was installed in place of the old 20-
position board.
Some $27,000 worth of new furniture and equipment was purchased in addition to the new furniture purchased for the Deerholme Building.
Mental Health Centre, Burnaby.—The interior of the building was completely
redecorated.
A new parking-lot to accommodate 50 cars was completed.
A new automobile was purchased.
Mental Health Centre, Victoria.—Work in connection with the conversion of
the apartment block adjacent to the Jubilee Hospital for the Mental Health Centre
was completed, and the staff of the Mental Health Centre moved into their new
quarters in December, 1964.
Mental Health Centre, Prince George.—A contract was let to remodel the
Public Health Building, Prince George, to provide for facilities for a Mental Health
Centre.
Requisitions covering the furniture and equipment for this new Mental Health
Centre were forwarded to the Purchasing Commission.
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, 1955/56 to 1964/65.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1955/56
The Woodlands School-
Provincial Mental Hospital, Essondale..
Provincial Mental Home, Colquitz	
Home for the Aged, Port Coquitlam—
Home for the Aged, Vernon	
Home for the Aged, Terrace	
Crease Clinic  —   -
Totals for the year_
1956/57
The Woodlands School .
Provincial Mental Hospital, Essondale-
Provincial Mental Home, Colquitz	
Home for the Aged, Port Coquitlam—
Home for the Aged, Vernon	
Home for the Aged, Terrace	
Crease Clinic	
Totals for the year..
1,219.45
3,508.79
285.30
539.27
229.62
287.30
257.96
6,327.69
1,232.48
3,503.60
284.81
541.83
232.58
288.45
232.85
6,316.60
$2,032,263.32
5,377,708.34
428,248.27
797,392.10
371,438.14
351,087.68
935,501.07
$10,293,638.92
$2,246,193.06
5,851,370.53
446,497.91
831,370.73
402,867.14
350,880.96
996,288.31
$11,125,468.64
$1,666.54
1,532.64
1,501.05
1,478.65
1,617.62
1,222.02
3,626.54
$1,626.76
$1,822.50
1,670.10
1,567.70
1,534.38
1,732.17
1,216.43
4,278.67
$1,761.31
$4.55
4.19
4.10
4.04
4.42
3.34
9.91
$4.44
$4.99
4.58
4.30
4.20
4.75
3.33
11.72
$4.83
 GENERAL ADMINISTRATION
F 23
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 Costs, 1955/56 to 1964/65—Continued.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1957/58
The Woodlands School 	
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
4.59
4.42
4.57
4.68
3.61
Crease Clinic	
12.55
Totals for the year
6,256.20
$11,413,169.99
$1,824.30
$5.00
1958/59
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
Provincial Mental Hospital, Essondale—
5.05
4.72
4.89
4.97
3.75
Crease Clinic    —,	
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
Provincial Mental Hospital, Essondale...
5.81
6.74
The Tranquille School, Tranquille
Provincial Mental Home, Colquitz	
20.39
5.05
6.83
Dellview Hospital, Vernon 	
Skeenaview Hospital, Terrace	
5.26
3.95
Totals for the year	
6,171.22
$14,531,218.39
$2,354.68
$6.43
1960/61
237.72
3,008.02
1,415.30
126.01
287.16
695.41
232.05
290.70
$1,313,678.32
6,775,567.11
3,637,555.12
542,556.16
518,591.72
1,754,500.08
448,792.02
417,856.55
$5,526.16
2,252.50
2,570.17
4,305.66
1,805.93
2,522.97
1,934.03
1,437.41
$15.14
Provincial Mental Hospital, Essondale_.
The Woodlands School	
6.17
7.04
11.80
4.95
VaUeyview Hospital, Essondale..—	
Dellview Hospital, Vernon_	
Skeenaview Hospital, Terracn
6.91
5.30
3.94
Totals for the year 	
6,292.37
$15,409,097.08
$2,448.85
$6.71
1961/62
Crease Clinic  _	
Provincial Mental Hospital, Essondale—
241.92
2,824.58
1,351.62
250.33
284.90
736.29
230.38
287.28
$1,344,906.48
6,927,591.07
3,639,782.25
657,736.27
507,315.85
1,848,097.68
464,314.47
443,255.07
$5,559.30
2,452.61
2,692.90
2,627.47
1,780.68
2,510.01
2.01S.43
1,542.94
$15.23
6.72
7.38
7.20
4.88
VaUeyview Hospital, Essondale
6.88
5.52
Skeenaview Hospital, Terrace	
4.23
Totals for the year	
6,207.30
$15,832,999.14
$2,550.71
$6.99
1962/63
236.68
2,719.32
1,365.03
307.13
214.18
724.07
232.55
296.21
$1,371,120.17
7,058,027.01
3,817,685.18
779,642.07
478,229.75
1,939,191.04
469,458.08
441,445.13
$5,793.14
2,595.51
2,796.78
2,538.48
2,232.84
2,678.18
2,018.74
1,490.31
$15.87
Provincial Mental Hospital, Essondale—
7.11
7.66
The Tranquille School, Tranquille	
Provincial Mental Home, Colquitz	
6.95
6.12
7.34
5.53
4.08
Totals for the year	
6,095.15
$16,354,798.43
$2,683.25
$7.35
 F 24
MENTAL HEALTH SERVICES REPORT, 1964/65
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 Costs, 1955/56 to 1964/65—Continued.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1963/64
220.63
2,791.99
1,306.35
433.92
94.07
737.69
236.51
292.83
$1,442,627.00
7,534,673.00
3,916,660.00
1,077,011.00
414,787.00
2,029,118.00
512,128.00
713,594.00
$6,538.67
2,698.67
2,998.17
2,482.05
4,409.35
2,750.64
2,165.35
2,436.89
$17.87
Provincial Mental Hospital, Essondale—
The Woodlands School
7.37
8.19
6.78
Provincial Mental Home, Colquitzi	
14.41
7.52
5.92
Skeenaview Hospital, Terrace	
6.66
Totals for the year
6,113.99
$17,640,598.00
$2,885.28
$7.90
1964/65
227.59
2,740.84
1,314.20
512.79
753.91
234.70
290.44
$1,573,366.00
8,054,536.00
4,501,364.00
1,509,947.00
2,351,885.00
553,985.00
510,679.00
$6,936.16
2,93:8.71
3,425.17
2,944.57
3,119.58
2,360.40
1,758.29
$18.94
Provincial Mental Hospital, Essondale—
8.05
9.38
8.07
VaUeyview Hospital, Essondale	
Dellview Hospital, Vernon  	
8.55
6.47
4.82
6,074.47
$19,055,762.00
$3,137.02
$8.59
i Because Provincial Mental Hospital, Colquitz, was closed January 29, 1964, the daily per capita cost
for 1963/64 cannot be arrived at by dividing 366 into the yearly per capita cost but is arrived at by dividing
the total patient-days, 2,232,073, into $17,640,598.
Table B.—Summary Statement Showing the Gross and Net per Capita
Cost of Patients in All Mental Health Services Institutions for
the Year Ended March 31, 1965.
Gross operating costs—
Crease Clinic -  $1,573,366
Provincial Mental Hospital, Essondale  8,054,536
The Woodlands School, New Westminster  4,501,364
Tranquille School, Tranquille  1,509,947
VaUeyview Hospital, Essondale  2,351,885
Dellview Hospital, Vernon  553,985
Skeenaview Hospital, Terrace  510,679
Gross cost of all institutions  $19,055,762
Less collections remitted to Treasury       1,866,781
$17,188,981
Daily average population	
Gross per capita cost, one year
Gross per capita cost, one day __
Net per capita cost, one year ____
Net per capita cost, one day —
6,074.47
$3,137.02
$8.59
$2,829.71
$7.75
 GENERAL ADMINISTRATION
F 25
Revenue (Patients' Maintenance Collections) of the Mental Health Services
for the Past 10 Years
1955/56  $1,358,708.26 1960/61  $1,906,847.71
1956/57  1,546,266.32 1961/62  2,150,802.56
1957/58  1,724,046.70 1962/63  2,025,854.46
1958/59  1,838,158.33 1963/64  1,751,281.00
1959/60  1,821,810.53 1964/65  1,866,781.00
Table C.—Expense Statement of the Crease Clinic of Psychological
Medicine, Essondale, for 12 Months Ended March 31, 1965
Salaries, Supplies, and Operating
Expense
Net Vouchered
Expenditure as
per Public
Accounts
Services and
Supplies from
Public Works
Department
Actual Cost
of Operation
Yearly per
Capita Cost
Salaries  	
Office expense  	
Travelling expense	
Office furniture and equipment	
Heat, light, power, and water	
Medical care  _	
Dietary  	
Laundry 	
Gratuities  	
Patients' library..	
Transportation	
General supplies	
Occupational and recreational therapy
Audio-visual department 	
General expense   	
Burials	
Buildings, grounds, etc	
Less rent deductions _	
Totals _ _	
$1,174,570
4,103
2,739
1,628
25,000
84,961
157,239
9,600
3,658
1,618
3,786
36,056
12,076
200
1,150
120
J,59J
$56,457
$1,174,570
4,103
2,739
1,628
25,000
84,961
157,239
9,600
3,658
1,618
3,786
36,056
12,076
200
1,150
120
56,457
1,595
$5,160.90
18.03
12.03
7.15
109.85
373.31
690.89
42.18
16.07
7.11
16.64
158.43
53.06
.88
5.05
.53
248.06
7.01
$1,516,909
$56,457
$1,573,366
$6,913.16
 F 26
MENTAL HEALTH SERVICES REPORT, 1964/65
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F 29
Table G.—Expense Statement of the Valleyview Hospital. Essondale,
for 12 Months Ended March 31, 1965
Salaries, Supplies, and
Operating Expense
Net Vouchered
Expenditure
as per
Public Accounts
Services and
Supplies from
Public Works
Department
Actual Cost of
Operation
Yearly per
Capita Cost
$1,722,122
9,329
1,619
456
63,550
109,854
255,697
19,000
403
5,000
16
85,348
2,275
721
2,354
3,480
1,477
$1,722,122
9,329
1,619
456
63,550
109,854
255,697
19,000
403
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2,275
721
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3,480
1,477
69,878
690
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12.37
2.15
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84.29
145.71
	
339.16
25.20
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Maintenance and operation of equipment-
6.63
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113.21
Occupational and recreational therapy	
3.02
.96
3.12
	
4.62
1.96
$69,878
92.69
Less—
690
4
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Sundry receipts
Totals
$2,282,007
$69,878
$2,351,885
$3,119.58
 F 30
MENTAL HEALTH SERVICES REPORT, 1964/65
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 F 32
MENTAL HEALTH SERVICES REPORT,  1964/65
Table J.—Expense Statement of the Community Services for
12 Months Ended March 31, 1965
Mental Health Centre, Burnaby
Salaries   $475,781
Office expense 	
Travelling expense	
Office furniture and equipment
Heat, light, power, and water ...
Medical care	
Dietary 	
Laundry 	
Transportation
Maintenance and operation of equipment
General supplies	
Occupational and recreational therapy	
Patients' education	
Motor-vehicles and accessories
General expense	
Buildings, grounds, etc.	
Total
3,597
9,450
1,995
18,857
26,567
6,798
1,558
1,854
2,111
2,247
1,649
2,016
2,071
162
42,319
$599,032
Mental Health Centre, Victoria
Salaries  	
Office expense	
Travelling expense	
Office furniture and equipment
Medical care 	
Maintenance and operation of equipment
Motor-vehicles and accessories 	
General expense 	
Total
$54,147
682
1,119
1,156
11,348
675
1,684
725
$71,536
Mental Health Centre, Kelowna
Salaries 	
Office expense	
Travelling expense	
Office furniture and equipment
Medical care	
Maintenance and operation of equipment
General expense	
$27,434
300
1,517
695
3,993
568
58
Total
$34,565
 GENERAL ADMINISTRATION
F 33
Table J.—Expense Statement of the Community Services for
12 Months Ended March 31, 1965—Continued
Mental Health Centre, Trail
Salaries 	
Office expense 	
Travelling expense	
Office furniture and equipment
Medical care	
Maintenance and operation of equipment
Motor-vehicles and accessories 	
General supplies	
General expense	
Total
$1,345
688
1,988
253
3,104
116
2,404
773
207
$10,878
Mental Health Centre, Nanaimo
Salaries 	
Office expense	
Travelling expense	
Office furniture and equipment
Medical care 	
Maintenance and operation of equipment
Motor-vehicles and accessories	
General supplies	
General expense	
Total
$1,602
780
1,925
1,017
7,127
140
2,530
572
172
$15,865
Expansion of Community Services
Expenditure
$34,786
Grand total, $766,662
 F 34 MENTAL HEALTH SERVICES REPORT, 1964/65
Table K.—Expense Statements of the Rehabilitation Centres
for 12 Months Ended March 31, 1965
Vista Rehabilitation Centre
Salaries   $18,136
Office expense   142
Heat, light, power, and water  1,078
Dietary  4,257
General supplies  340
General expense  137
Buildings, grounds, etc.  420
Total  $24,510
Venture Rehabilitation Centre
Salaries   $18,393
Office expense  182
Heat, light, power, and water  1,353
Dietary  7,313
Laundry  16
General supplies  807
General expense  272
Buildings, grounds, etc.   430
Total  $28,766
Rehabilitation and After-care Programme
Salaries    $33,857
Office expense  782
Travelling expense  4,280
Office furniture and equipment  995
Medical care  36,000
Dietary   166
Maintenance and operation of equipment  6
General supplies  101
General expense  226
Total  $76,413
Grand total, $129,689
 GENERAL ADMINISTRATION
F 35
Table L.—Expense Statement of General Administration, Mental
Health Services Branch, for 12 Months Ended March 31, 1965
Salaries 	
Office expense	
Travelling expense	
Office furniture and equipment	
Grant to trustees of Patients' Comfort Fund	
Grant to Department of Neurological Research, University of
British Columbia	
General expense	
Subscription, Social Service Index	
Administration of Psychiatric Nurses Act	
Council of Psychiatric Nurses for Bursary Trust Fund	
Less miscellaneous receipts	
Total
$204,330
8,455
10,067
1,284
5,000
22,500
4,108
251
2,496
1,200
11,158
$248,533
Table M.—Expense Statement of Department of Nursing Education,
Essondale, for 12 Months Ended March 31, 1965
Salaries 	
Office expense 	
Travelling expense	
Office furniture and equipment
Medical care	
Dietary	
Laundry	
General supplies	
General expense	
Less rent deductions	
$786,949
5,635
914
512
729
6,655
5,000
13,466
2,179
14,618
Total
$807,421
 F 36 MENTAL HEALTH SERVICES REPORT,  1964/65
Expenditure Made under Federal Health Grants for Province of
British Columbia, Year Ended March 31, 1965
Assistance to Provincial Mental Hospitals—Staff salaries  $301,780.52
The Woodlands School, New Westminster—
Equipment   $2,902.41
Staff salaries  40,094.03
42,996.44
Assistance to the mental health centres—Staff salaries       78,978.31
Division of Nursing Education—Staff salaries         7,110.00
Consultant Staff, Mental Health Services Branch—Staff salaries         5,340.00
Assistance to the Department of Psychiatry       40,244.62
Assistance to the Department of Social Work, University of British
Columbia         7,374.99
Neurological Research Unit at University of British Columbia—
Epidemiologic studies in hospitalized psychiatric illness   $11,795.78
Central amines and psychoactive drugs     13,111.01
A development and validation study of psychometric
tests of mental impairment in brain-damaged
children       2,478.73
An investigation of short-term memory and " neutral
excitability " with special reference to elderly
memory-disordered psychiatric patients     12,195.34
Developmental bio-assay of early brain injury     14,889.40
Determination  of heterozycosity  for  phenylketonuria and its possible relationship to mental
illness     10,066.03
p-Methozyphenyl derivatives in human urine     11,235.34
75,771.63
Mental hygiene programme, Metropolitan Health Committee, Vancouver   49,665.00
Mental hygiene programme, Greater Victoria Board of Health  4,550.00
Psychiatric services, Vancouver General Hospital  30,634.40
Assistance to the British Columbia Epilepsy Society  4,999.92
Assistance to the Children's Foundation  12,200.00
General personnel training—Postgraduate training  7,998.50
Total  $669,644.33
Reconciliation with Public Accounts
Table L—General Administration (as per Public Accounts)—
Salaries     $204,330
Expenses   44,203
Vouchered expenditure      $248,533
Deduct salary adjustments  10,800
$237,733
 GENERAL ADMINISTRATION
F 37
Reconciliation with Public Accounts—Continued
Table M—Department of Nursing Education  (as per Public Ac
counts)—
Salaries 	
Expenses 	
Vouchered expenditure	
Deduct salary adjustments	
Table J—
Mental Health Centre, Burnaby (as per Public Accounts)—
Salaries 	
Expenses 	
Vouchered expenditure	
Deduct—
Salary adjustments     $19,320
Maintenance of buildings
and grounds       42,319
$786,949
20,472
$807,421
12,696
$475,781
123,251
$599,032
61,639
Mental Health Centre, Victoria (as per Public Accounts)—
Salaries         $54,147
Expenses   17,389
Vouchered expenditure	
Deduct salary adjustments
$71,536
1,524
Mental Health Centre, Kelowna (as per Public Accounts)—
Salaries         $27,434
Expenses   7,131
Vouchered expenditure	
Deduct salary adjustments
$34,565
768
Mental Health Centre, Trail (as per Public Accounts)—
Salaries   $1,345
Expenses   9,533
Mental Health Centre, Nanaimo (as per Public Accounts)—
Salaries  $ 1,602
Expenses   14,263
$794,725
537,393
70,012
Expansion of Community Services
33,797
10,878
15,865
34,786
Table C—Crease Clinic (as per Public Accounts)-
Salaries .	
Expenses 	
Vouchered expenditure
Deduct—
$1,174,570
342,339
$1,516,909
Salary adjustments     $53,892
Portion of farm profit         2,454
56,346
1,460,563
 F 38 MENTAL HEALTH SERVICES REPORT, 1964/65
Reconciliation with Public Accounts—Continued
Table D—Provincial Mental Hospital, Essondale (as per Public Accounts)—
Salaries   $4,995,650
Expenses      2,446,987
Vouchered expenditure  $7,442,637
Deduct—
Salary adjustments  $222,216
Maintenance receipts     815,437
Portion of farm profit       41,392
     1,079,045
Table K—
Vista Rehabilitation Centre (as per Public Accounts)—
Salaries        $18,136
Expenses   6,374
Vouchered expenditure        $24,510
Deduct—
Salary adjustments         $372
Maintenance of buildings
and grounds  420
792
Venture Rehabilitation Centre (as per Public Accounts)—
Salaries        $ 18,393
Expenses   10,373
Vouchered expenditure        $28,766
Deduct—
Salary adjustments  $552
Maintenance of buildings
and grounds  430
  982
Rehabilitation and After-care Programme (as per Public Accounts)—
Salaries       $33,857
Expenses   42,5 5 6
Vouchered expenditure       $76,413
Deduct salary adjustments  2,112
$6,363,592
23,718
27,784
74,301
 GENERAL ADMINISTRATION
F 39
Reconciliation with Public Accounts—Continued
Table G—VaUeyview Hospital, Essondale (as per Public Accounts)—
Salaries   $ 1,722,122
Expenses         559,885
Vouchered expenditure
Deduct—
$2,282,007
Salary adjustments    $63,180
Maintenance receipts     454,036
Portion of farm profit         2,650
519,866
$1,762,141
Table H—Dellview Hospital, Vernon (as per Public Accounts)—
Salaries      $347,661
Expenses         134,096
Vouchered expenditure
Deduct—
Salary adjustments
Maintenance receipts
Add portion of farm loss.
$14,232
150,234
$481,757
164,466
$317,291
112
317,403
Table I—Skeenaview Hospital, Terrace (as per Public Accounts)—
Salaries     $287,198
Expenses         158,673
Vouchered expenditure	
Deduct—
Salary adjustments	
Maintenance receipts
$12,144
155,578
$445,871
167,722
278,149
Table E—The Woodlands School (as per Public Accounts)—
Salaries  $3,289,629
Expenses        967,128
Vouchered expenditure
Deduct—
Salary adjustments
$4,256,757
  $121,272
Maintenance receipts     233,528
354,800
3,901,957
 F 40 MENTAL HEALTH SERVICES REPORT, 1964/65
Reconciliation with Public Accounts—Continued
Table F—The Tranquille School (as per Public Accounts)—
Salaries      $821,042
Expenses         447,485
Vouchered expenditure  $1,268,527
Deduct—
Salary adjustments     $26,952
Maintenance receipts      57,968
  84,920
$1,183,607
Add portion of farm loss  5,399
$1,189,006
Total Mental Health Services Branch expenditures (as per
Public Accounts)  $17,133,803
 GENERAL ADMINISTRATION F 41
PERSONNEL REPORT
J. Dowling, Personnel Officer
The establishment of the Mental Health Services Branch increased by 54
positions during the year. As of March 31, 1965, there were 3,390 persons on
staff excluding student nurses. This represents a staff increase of 177 during the
year.   The quarterly staff average for the fiscal year shows an increase of 172.
Notwithstanding a year-to-year decrease in student psychiatric nurse enrolment, the quarterly average shows a minor increase.
Recruitment and separation activity increased, reflecting continued staff expansion as well as greater use of short-term relief staff when required.
The position of the Branch in respect to staffing in most professional and
technical classifications improved. The position in respect to physiotherapists deteriorated and was under review at the close of the fiscal year.
Part-time employment has been expanded in a number of classifications.
Numbers so employed as of March 31, 1965, are as follows:—
Medical specialists     5
Clinical psychologists     5
Social workers     1
Psychiatric nurses  55
Dietary aides   21
Total  87
Part-time employment enables the Branch to utilize professional services which
would not be otherwise available. In the case of dietary aides, four- and six-hour
shifts are used, making available adequate staffing for peak periods as well as
providing useful employment for people who are unable to work full time.
Over-all staff turnover has declined. An increase has, however, occurred at
The Tranquille School. This reflects the difficulty of staffing a unit of this type
remote from a large centre of population and the problems of providing trained
personnel to meet the rapid expansion which is taking place.
Extensive reviews of social-work classifications and staff turnover in the faculty
of the Department of Nursing Education were undertaken, and good results were
achieved.
Plans were completed for the expansion of the staff of the Mental Health
Centre, Victoria, and recruitment prospects seem to be favourable.
The Personnel Officer served as chairman of the Provincial Government section
of the United Good Neighbour fund-raising campaign. Contributions through the
payroll deduction method rose 200 per cent.
The Personnel Officer participated in the following matters of some importance:—
(1) Planning and staffing of the maximum-security unit of the Provincial
Mental Hospital.
(2) A review of institutional ambulance-driver qualifications and salaries.
(3) A review of organization and staffing of the Vista and Venture half-way
houses.
(4) The functional reorganization of The Woodlands School and the unification of the men's and women's nursing services.
 F 42 MENTAL HEALTH SERVICES REPORT, 1964/65
(5) Staffing of the Out-patient Department of The Woodlands School, which
opened November 16, 1964.
(6) Planning and staffing and expansion of output by The Tranquille School
laundry.    The capacity was increased by revised shift arrangements.
(7) A review of nursing supervisory arrangements at The Tranquille School.
(8) A study and report on vacation entitlements in the nursing services.
Pertinent figures are set forth in the tables which follow.
STATISTICAL TABLES
Table A.—Summary Showing Over-all Staff Totals in Relation to
Separation and Recruitment
Staff recruited, excluding students  1,123
Staff separated, transferred, etc., excluding students      946
Increase       177
Total staff, excluding students, as of March 31, 1965  3,390
Total staff, excluding students, as of March 31, 1964  3,213
Increase       177
Quarterly staff average, excluding students, 1964/65  3,395
Quarterly staff average, excluding students, 1963/64  3,223
Increase       172
_______
Male Female        Total
Student enrolment as of March 31, 1965       34        187        221
Student enrolment as of March 31, 1964      60       204       264
Change   -26      -17      -43
Student quarterly average, 1964/65         246
Student quarterly average, 1963/64         238
Change         -f 8
 GENERAL ADMINISTRATION
F 43
Table B.—Breakdown by Classification of Recruitment and Separation
Activity for the Mental Health Services, Excluding Student Psychiatric Nurses.
Physicians
Registered nurses	
Psychiatric nurses	
Female psychiatric aides
Male psychiatric aides	
Teachers 	
Occupational therapists _
Recreational therapists ._
Industrial therapists	
Psychologists 	
Social workers	
Dieticians	
Cooks 	
Kitchen helpers 	
Clerks 	
Clerk-stenographers
Trades 	
Laundry-workers 	
Miscellaneous professional
Miscellaneous technical	
Miscellaneous 	
Sub-totals
Temporary relief staff recruited	
Temporary relief staff separated	
Temporary relief staff transferred, etc
Totals 	
Established Positions
Recruited
Separated
28
24
45
30
234
187
76
127
71
78
2
1
6
6
5
4
1
4
8
7
19
18
6
3
5
4
48
38
20
15
32
26
5
6
16
11
5
8
4
7
169
69
805
673
318
258
15
1,123
946
 F 44
MENTAL HEALTH SERVICES REPORT,  1964/65
Table C.—Summary of Staff Turnover
By Major Classification
Classification
1963/64
1964/65
Change
Student psychiatric nurses
Male psychiatric nurses—
Female psychiatric nurses...
Registered nurses 	
Per Cent
19.7
10.4
31.5
43.6
Per Cent
24.4
10.0
25.6
25.2
Per Cent
+4.7
-0.4
-5.9
-18.4
Note.—Item 1 has been calculated against the quarterly average and other items have been calculated against
the year-end staff totals.
By Pay Division
Pay Division
Temporary Relief
Staff Excluded,
1963/64
Temporary Relief
Staff Excluded,
1964/65
Per Cent
10.8
19.6
18.7
20.8
23.0
29.4
23.1
21.7
17.5
Per Cent
13.1  ,
17.0
Crease Clinic and Provincial Mental Hospital, Essondale .- 	
19.5
*               21.9
36 8
22.0
23 0
23.9
22.1
20.6
19.9
i Student nurses not included.
Note.—Percentages calculated against year-end staff totals.
 GENERAL ADMINISTRATION                                           F 45
Table D.—Comparison of Staff Totals by Unit with Totals for the
Preceding Fiscal Year
Fiscal Year 1963/64
Fiscal Year 1964/65
Positions
in Establishment as of
Mar. 31,
1964
Number on
Staff as of
Mar. 31,
1964
Positions
in Establishment as of
Mar. 31,
1965
Number on
Staff as of
Mar. 31,
1965
39
60
135
37
56
100
43
63
140
38
59
113
234                     193                     246        f           210
In-patient care—
Crease Clinic    - 	
287
1,232
817
195
440
86
68
282                    287
1.210                  1.230
281
1,256
825
236
1          428
87
67
The Woodlands School 	
770
183
424
85
66
826
230
440
86
68
3,125
3,020        |        3,167                3,180
Total Civil Service positions _ _	
3,359
325
3,213                3,413
264                   325
3,3901
221
Totals	
3,684
3,477        f       3,738                3,611
1                        1
i Includes 87 part-time employees.
'
 F 46
MENTAL HEALTH SERVICES REPORT, 1964/65
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 GENERAL ADMINISTRATION F 47
REPORT OF THE PROVINCIAL SUPERVISOR OF
PSYCHIATRIC SOCIAL WORK
The year 1964/65 has called for even greater effort on the part of social
workers in all social service departments throughout the divisions of the Mental
Health Services. Not only has this effort had to be directed toward the furtherance
of social-work contribution, but also toward the necessity and urgency to extend
social services to as many patients as possible during a short period of treatment
in hospital and after-care. This is in line with changes in treatment philosophy
which have evolved in recent years and which adhere to the concept that hospitalization is but one short phase in the continuum of psychiatric treatment. As a result,
there has been a significant shift in emphasis from an old system of treatment and
care which was legalistic in approach and designed for the protection of the individual
and property to a system whose aim is to provide the sick patient with a continuum
of treatment and care. Because this treatment—psychiatric therapy—is primarily
concerned with the modification of behaviour, a whole series of treatment settings,
ranging from complete psychiatric hospital care to independent life in the community, with open rapid communication between all treatment settings, is necessary.
Our present community resources for the provision of a continuum of treatment
facilities are very much in process of development. As a result, the hospital social
worker is in the position of bridging the gap by the extension of skills and services,
by the exploration of every means of help available to increase social service coverage of patients' needs in a way that is as community based and oriented as possible.
PROFESSIONAL EDUCATION AND STAFF-DEVELOPMENT
PROGRAMME
Social Service Department, Mental Health Services
During the year, 23 students (12 second-year and 11 first-year postgraduate
students) were placed from the School of Social Work, University of British
Columbia, in social service departments throughout the Mental Health Services.
This student-training programme, in which supervisors and senior social-work practitioners in the Mental Health Services share in the educational programme of the
university, offers opportunities whereby staff may benefit from contact with faculty
and by attendance at educational conferences and institutes and seminars in
advanced studies, and whereby faculty may have an opportunity to gain some
understanding of the standards of practice and thus keep abreast of programme
developments in community agencies. Such a co-operative educational process has
mutual benefits which are inestimable in the advancement of social-work education
and social-welfare services.
Throughout the social service departments, orientations were given to in-trained
student personnel from the Department of Social Welfare. Additionally, refresher
courses were offered to supervisory personnel from this department. Included in
the courses was an orientation to the mental health facilities of the Mental Health
Services. During this a careful review of new programmes in the social service
departments of the Mental Health Services was undertaken.
An institute was offered by the social service department of the Provincial
Mental Hospital and Crease Clinic to public health nurses in those public health
districts offering services to the disabled adult mental patient and retardate resettled
in community in the care of families and boarding homes.
 F 48 MENTAL HEALTH SERVICES REPORT,  1964/65
An institute was offered to those family careholders and boarding-home operators working with the Mental Health Services in the community resettlement of
disabled patients who no longer need extensive medical and nursing care. This
institute was attended by fully 98 per cent of operators caring for patients, and
was considered to be most successful in the interchange of ideas and the discussion
of responsibilities.
To offset to a degree the effects of the acceleration of hospital treatment and
the enormous deficiencies which exist in necessary community mental health resources (such as industrial training centres and sheltered occupational facilities for
psychiatric patients; sheltered workshops for the physically, the emotionally disabled, and the adult retardate; protective health and welfare services for the aforementioned groups of disabled; day and night hospital services; hostels and
group accommodation) mental health social workers must be well trained professionally as well as mature experientially. Additionally, professional skills must
be maintained, enriched, and advanced by means of an adequate staff-development
programme. To this end, last year social workers throughout the Mental Health
Services and under this auspice attended the following institutes and seminars:
Canadian Conference on Social Welfare; Northwest Regional Conference, Child
Welfare League of America; Northwest Conference of the American Association
on Mental Deficiency; American Orthopsychiatric Association; Pacific Northwest
Regional Institute, Family Service Association of America; and Pacific Northwest
Regional Institute for Medical and Psychiatric Social Workers.
A number of social workers in the Mental Health Services attended an Institute
on Advanced Casework, a Symposium on Mental Retardation, the Annual Meeting
and Institute of the Canadian Mental Health Association, the Conference of the
Canadian Psychiatric Association, a Workshop on Suicide given by the University
of Washington, and the British Columbia Conference on Social Welfare. One social
worker, a senior practitioner, took a course in advanced casework at the Columbia
University School of Social Work.
Personnel and Recruitment for Social Service Departments,
Mental Health Services
The social-work staff stability of the previous year has not continued in this
fiscal year. Replacements by the appointment of professionally trained personnel
have been possible in a large number of positions. Some vacancies have had to be
filled by the appointment of social-work assistants.
A project to recruit social-work assistants was commenced during this fiscal
year. The social-work assistant has an undergraduate B.A. degree in either psychology or sociology, which is followed by in-training. This personnel works alongside a professional social worker, who refers all technical services tangential to the
psychosocial problem to him. Thus the professionally trained worker is able to bring
to many more patients those services requiring those skills which are dependent on
full professional training.   During the year five social-work assistants were employed.
The assistants are a valuable acquisition to the social service department when
the full quota of professional positions is able to be filled. It is they who undertake those technical aspects of social-welfare need such as applications for Social
Security and Social Allowances, the procuring of suitable accommodation, the
facilitation of appointments for job placement, medical services, etc. The latter
services are brought to the patient following the assistants acquiring a generalized
understanding of the patient as a person, his illness, and the specific needs which
must be met in order to establish his more easeful functioning.    The social-work
 GENERAL ADMINISTRATION F 49
assistant, therefore, must, through in-training, be equipped to generally support the
client psychologically, as the technical services destined to alleviate his problem-
situation are introduced.
Again continuing to take into account the significant shift in emphasis from
hospital to over-all community responsibility in the treatment of mental illness in its
various stages, the most effective utilization of professional personnel is essential.
Much of the treatment of the social pathology of mental illness falls to social work.
It is, therefore, important that provisions for its utilization be sought. The proper
use of technicians undoubtedly may further better utilization of professionals and
may correct the imbalance in the ratio of social work to medical personnel in Mental
Health Services.
Social Work Consultative Service
This is a staff service to medical superintendents and chief social workers in
divisions of the Mental Health Services. This year the service entailed 61.2 per cent
of the consultant's time. Direct consultative service was given to all divisions and
concerned:—
(1) Personnel procurement, maintenance, and retention; staff and staff-
patterning, including a special report regarding use of technicians and
assistants; organization and administration of social services in hospitals,
training-schools, and community mental health centres.
(2) Community resettlement of patients resident in hospitals and training-
schools; programme suggestions for the remotivation of groups of
patients to the use of intermediate care facilities such as family care,
boarding and nursing homes, including a special report on the present
boarding-home programme and a conceptualization of subsequent and
future developments in this programme.
(3) Administration and organization of family-care and boarding-home programme interdepartmentally as well as interdivisionaUy, including a special report on the extension and use of the position of Co-ordinator of
Boarding Home Programme in the Mental Health Services.
(4) Organizational and functional changes in social services as concern relocation of staff in line with the significant shift in emphasis from hospital
to community responsibility in the treatment and care of the mentally ill
and retarded and the unitization and regionalization of hospital services.
(5) Pre-admission and after-care functions of social service departments in
hospitals, training-schools, and clinics in line with the conceptualization
of services outlined in the new mental health legislation.
(6) Integration of public health nursing contribution in the boarding-home
programme for resettlement of patients.
DISTRIBUTION OF CONSULTATIVE RESPONSIBILITIES
Provincial Mental Hospital and Crease Clinic
Consultation was sought and given in relation to social services to children in
residence; pre-admission services and their development in reception areas of the
hospital; extension of social services in boarding-home and nursing-home programme; revision of manualized procedures in operation between hospital and community health and welfare services and the development of co-operative services
between hospital and the public health nurse at field level in the development of
the boarding-home programme.
 F 50 MENTAL HEALTH SERVICES REPORT, 1964/65
The Woodlands School
Consultation was sought and given in relation to job content and written specification of senior administrative social-work position; job content and written specification for social-work supervisor in the out-patient department and social-work
supervisor in the training-school; use of technicians such as welfare aides in a
training-school programme; on-going development of adult boarding homes; ongoing use and development of foster-home care for mentally retarded children resident in the School; and standards of service and practice for social work in the
traning-school setting.
The Tranquille School
Consultation was sought and given in relation to development of boarding-
out facilities for residents of The Tranquille School who have completed their course
of education and training; continuing organizational development of the social
service department; community development programme toward community resettlement of residents, meetings with the Department of Social Welfare, Public
Health Branch, and community chapter of the Association for Retarded Children;
personnel procurement, retention, and development; staffing and staff-patterning
for social services at Tranquille; job content and specification for appointment of a
supervisor of social service; the community placement of 18 adult fully trained but
dependent residents into family care and boarding homes; manualization of the
social service procedures in relation to the community placement of adult residents.
Over the fiscal year the consultant has averaged three days' consultation per
month to this development service.
Valleyview Hospital
Consultation was sought and given in relation to extension of boarding- and
nursing-home placement programme; personnel procurement, maintenance, and
retention; staffing and staff-patterning and out-patient services.
Boarding-home and Family-care Programme
Present Boarding-home Programme and a Conceptualization of Subsequent
and Future Developments in Programme
As of January 31, 1965, there are 244 patients from the Provincial Mental
Hospital transferred to boarding-home care. There are 24 adult retardates from
The Woodlands School in boarding homes on a transferred basis and 64 aged from
Valleyview Hospital, a total of 332 patients in all. For the most part, these patients
could be described as a chronically disabled group for whom no further extensive
rehabilitative measures would be planned other than perhaps an eventual return to
families or relatives when these exist. However, approximately 10 per cent of the
Provincial Mental Hospital patients transferred to boarding-home care could benefit
from further rehabilitative measures, and for these people the boarding home can
be seen as a half-way house. This 10 per cent includes a group of younger patients
receiving intensive casework and community services from the time of initial placement, as well as older patients who are demonstrating an increased potential in
social and occupational skills. This increased potential usually evidences itself after
a period of from 18 months upwards in the boarding-home setting.
The above transferred patients were carefully selected for the boarding-home
programme, and they are people who can live in the community with the supervision
 GENERAL ADMINISTRATION F 51
and supports that are provided in a licensed boarding home operated by lay people,
receiving consultation from a psychiatric social worker. It has been possible to
maintain this group of patients in the community on this basis with few returns to
hospital. During the past five months the percentage of returns from the total group
of patients in boarding homes has stabilized at approximately 2.1 per cent, or
four to five patients are returning to hospital each month. Of these four to five
patients, one will have come back for treatment of some physical condition that
cannot be treated in the community because of shortages of hospital beds or other
reason. Of the four or five patients, three or four will return to a boarding home
after a period of hospitalization which will either be very brief or prolonged (several
months). One patient will stay in hospital indefinitely, either because placement in
a boarding home was premature or because of deterioration of the patient's condition (for example, a neurological involvement) after a successful period of placement over a few years.
However, it seems to be becoming apparent now that, at least as far as a
large proportion of the female population of the East Lawn Unit of the Provincial
Mental Hospital is concerned, patients who would benefit from placement in the
existing types of boarding homes are few. There is a large group of patients in East
Lawn, however, who have now received the maximum of psychiatric treatment
available in the hospital, who could live in the community providing that the following conditions were fulfilled:—
(1) A prolonged period of intensive preparation for leaving the hospital was
provided in hospital for the patient.
(2) Homes were found offering higher standards of supportive care where the
operator would be more skilled and more accepting, and where there
would be possibly a higher ratio of staffing. A special rate for care of
these might need to be considered. Such homes might need to be situated
in outlying communities or in the more enlightened urban areas.
(3) Consultation to the operators could be more intensive than is usual, and
that the development of the home with all the necessary consultation to
hand could be undertaken.
(4) Supervision of the patient-group could also be more intensive, and, in
this respect, time spent in assisting those public health units which have
shown an interest in the boarding-home programme might be profitable
in leading toward a sharing of the supervision of patients in the boarding
homes by local public health and welfare agencies.
(5) Patients in such special boarding homes, as well as those whose adjustment to boarding-home care is now relatively stable, might be seen in
community mental health clinics held either in local general hospitals or
public health centres.
Another group of patients in the Provincial Mental Hospital who could benefit
from placement in a boarding home in the community, providing the facility was an
exceptional resource, offering more in the way of programme, understanding, and
support, is the group of young disabled people coping with schizophrenic reactions.
One such home now in operation in Burnaby is having remarkable success with
young patients who had virtually little in ego strengths. This type of boarding home
could likely be deemed an intermediate care facility as legislative programme
evolves.
A new step in the boarding-home programme recently initiated is a plan to
move patients who have been stabilized for several years in a living situation in a
group boarding home to the more intimate family-care home, where one patient is
 F-52
MENTAL HEALTH SERVICES REPORT,  1964/65
the only boarder in the home. This is seen as a further step in the patients' resettlement into the community, as this type of care is closer to a normal living situation.
Such a patient might obtain employment in his area and eventually become self-
supporting.   The rate of social assistance granted to these patients could be flexible.
Mental Health Centres, Burnaby, Victoria, Kelowna,
Trail, and Nanaimo
Regular consultation has been available to the Mental Health Centres in
Burnaby and Victoria. One consultative visit each was made during the year to
the centres at Trail, Kelowna, and Nanaimo. Social workers practising in these
mental health facilities are faced with the task of bringing their competency and
contribution to the development of community-based mental health services where
in the past the concern was with mental illness services; to an understanding of
local social needs and local cultural patterns; to an understanding of family identity
in the treatment and prevention of mental illness; to an understanding of the need
for community mental health planning, education, and continuing consultation. The
regional supervisors of psychiatric social work in these Mental Health Centres are
making a significant contribution in the development of community mental health
services.
Central Branch Responsibilities
These are largely centred around three conference bodies—namely, the
Branch staff meeting, the unit administrative conference, and the interdepartmental
Case Review Committee. Attendance has involved responsibilities in consultation,
research, and reporting.
Also the responsibility for community development, which this position with
all others at Branch Administration carries, has required activity in the following
areas: Community Placements Committee for the Association for Retarded
Children of British Columbia; the Children's Foundation; Canadian Mental Health,
Scientific Planning Committee, Welfare and Recreation Division of the Council of
Agencies; Division for the Guidance of Handicapped, Council of Agencies; and
the Welfare Institutions Licensing Board.
This has been a year offering much creative opportunity and offering the
support and acceptance of able colleagues.
 GENERAL ADMINISTRATION F 53
REPORT OF THE DIRECTOR OF NURSING EDUCATION
Miss M. M. Lonergan
During the past fiscal year the faculty of the Department of Nursing Education
focused its attention on curriculum development. Senior instructors responsible
for conducting the various programmes for different categories of nursing personnel
reviewed, evaluated, and revised curricula content and structure in the light of
student differences, recent advances in scientific knowledge, and changing trends
in community needs. The immediate changes and evolving plans showed the influence of four fundamental educational beliefs. These were (a) comparable educational experiences for all students in any one programme, (b) increased attention
to the learning needs of the individual student, (c) an attitude stressing student
responsibility for learning, and (d) emphasis on clinical performance as the measure
of real learning. Nursing service personnel from most of the institutions participated
in the work by discussion, planning, problem-solving, supervision, and formal
teaching. Such active interest and co-operation were instrumental in ensuring the
feasibility of implementing curricula changes.
The psychiatric nursing programme showed a year-end census of 221 students,
compared to the previous year's 264. Inquiries received totalled 1,261; applications, 375; and 137 candidates enrolled in the programme. Seventy per cent of the
latter had earned high-school diplomas. One hundred and twenty-one students
completed the programme and 59 withdrew. Of the withdrawals, one-third who left
were unsuited to psychiatric nursing, one-third failed academically, and one-third
left for personal reasons. A final comprehensive examination was introduced on
recommendation of the curriculum committee and on authorization of the Deputy
Minister. Sixty-one students of the February, 1964, class were successful pioneers
of this innovation to determine the senior student's preparedness for graduate-nurse
responsibilities.
The affiliate programme offered to students from general hospital schools
of nursing was discontinued for six months. This period of time was used to
reorganize the programme in respect to its structure, curriculum, and teaching
methods. To this end, senior staff of the Mental Health Services Branch met with
representatives of general hospital schools of nursing and the Registered Nurses'
Association of British Columbia. At the conclusion of the fiscal year, a comprehensive plan for a conjoint programme was designed to (a) enable students to learn
how to use the psychiatric-care resources in the Province, (_>) acquire basic skills
in nursing patients in intensive-treatment units, and (c) develop increasing understanding of the application of psychiatric nursing concepts and principles to the care
of patients in general hospitals.
The clinical programme for registered nurses enrolled 17 students and graduated 15. Of the latter, six nurses accepted employment in the nursing service
division. The programme enjoyed good publicity promoted by its graduates. The
graduates of the programme have a decided appreciation of their opportunity for
extensive individual and group guidance and for close supervision in the practice of
psychiatric nursing skills.
The psychiatric-aide programme conducted 17 courses, encompassing 793
hours of instruction for 155 psychiatric aides on the staffs of the Provincial Mental
Hospital and Crease Clinic, the Valleyview Hospital, and The Woodlands School.
These courses varied in length from 3 to 10 days, according to the needs of students
and the nursing services from which they were released.   Following visits to Dellview
 F 54
MENTAL HEALTH SERVICES REPORT, 1964/65
Hospital, Skeenaview Hospital, and The Tranquille School, a two-week programme
was provided in December for two psychiatric nurses from each of two Interior
hospitals with the object of assisting these nurses to initiate orientation courses for
aides in those facilities. The faculty responsible for the psychiatric-aide programme
was increased by two psychiatric nurses who won positions through Civil Service
competition. They embarked upon a comprehensive study programme, directed by
the senior instructor and designed to prepare them for teaching responsibilities.
The post-basic programme was offered to psychiatric nurses interested in preparing themselves for promotional opportunities. It was organized in the form of
four hours of planned teaching per week from October through December. Twenty-
two nurses from The Woodlands School, Valleyview Hospital, and the Provincial
Mental Hospital and Crease Clinic participated in 66 hours of lecture and discussion on psychiatric nursing, rehabilitation, and ward management. Interest was
good, and all nurses successfully completed the programme.
Miss Beverley Mitchell, who had for many years been responsible for the
department's development and progress, left the Mental Health Services to further
her educational goals in Europe. Her departure created a vacuum which was
partially filled in January when a limited nursing consultation service, by the Director of Nursing Education, was made available to the institutions of the Mental Health
Services Branch. In this capacity the Director participated in finalizing plans for
the reorganization of the nursing department at The Woodlands School. An extension of the service was the provision of information concerning nursing functions
and programmes in reply to requests from various parts of Canada and the United
States and the arrangement of tours for several visiting nurses. Nurse leaders
concerned with mental health services and those in related agencies continued to
use the Nursing Council and the Nursing Liaison Committee as vehicles for facilitating communication and for seeking solutions to many practical problems relating
to patient-care both within and outside the Mental Health Services Branch.
 GENERAL ADMINISTRATION F 55
REPORT OF THE CONSULTANT IN MEDICAL RECORDS
AND STATISTICS
Miss A. D. Dingle, Consultant in Medical Records and Statistics
The approaching Proclamation of the new Mental Health Act, 1964, made
it necessary to plan changes in procedures. Several meetings of medical-records
staff were held for interpretation of the Act. Supplies of new forms were distributed, together with explanatory material.   Related forms were also revised.
As a step toward obtaining information regarding the amount of care received
by a psychiatric patient, a decision was made to change the system of numbering
from " serial " to " unit " for all in-patient facilities. Commencing April 1, 1965,
a patient being readmitted will be reassigned his previous hospital number and will
retain this for all future admissions. A new patient will be assigned a new number,
which will be retained for future admissions. By punch-card application the number of admissions and the length of time on the hospital books for each patient will
be available. The same system of numbering is in operation for the Mental Health
Centres.
CONSULTATION TO UNITS
Provincial Mental Hospital and Crease Clinic
Following the formation at Essondale of a Committee on Statistics, their suggestions were discussed with the Research Officer, Division of Vital Statistics, and
this Consultant. Forms have been designed and plans made for collection of more
detailed statistics dealing with diagnosis and treatment, commencing April 1, 1965.
Assistance was given in the study of the results of statistics gathered regarding
a group of Crease Clinic admissions.
On instruction of the Deputy Minister, plans were made through the Medical
Superintendent for a review of the diagnosis of mentally defective patients in residence in the Mental Hospital. The results have been recorded on the patients'
records and the I.B.M. cards revised as necessary.
Schools for Mental Defectives
Assistance was given in the review of the waiting-list of The Woodlands School.
The Consultant attended meetings of the Deputy Director of Mental Health
Services, the Medical Superintendent of The Woodlands School, and the Research
Officer, Division of Vital Statistics, regarding co-operation with the Registry of
Handicapped Children in maintaining The Woodlands School waiting list of applications for service.
Initial discussions were held regarding the development by the medical staff at
The Woodlands School of a statistical form to be processed by I.B.M.
The Medical Records Supervisor of The Woodlands School was accompanied
on a visit to the records department of the Health Centre for Children and the
Children's Hospital. This has resulted in better communication between these
areas when patients are being admitted to or discharged from The Woodlands
School.
At the request of the Medical Superintendent, The Tranquille School was
visited twice following a change of medical-records staff.
 F 56
MENTAL HEALTH SERVICES REPORT,  1964/65
Geriatric Division
In view of the changes taking place in the geriatric treatment goals, statistics
regarding length of stay in recent years were supplied to the Medical Superintendent
of the Geriatric Division.
Mental Health Centres
Meetings of the Directors of Mental Health Centres were instituted by the
Deputy Minister, with this Consultant attending and acting as secretary.
A further revision was made in the statistical forms with a view to reducing the
amount of detail. This change will be effective April 1, 1965. The monthly report
forms were also revised for the same date.
The numbering system for records was changed so that a patient would retain
the same number for all contacts no matter what centre was involved, and it was
arranged that the patients' records would move between centres as required.
Consultation was held with the Public Health Nursing Consultant regarding
the information submitted for patients referred to the Mental Health Centres in
connection with a revision of instructions in the Public Health Nursing Manual.
Visits were paid to the Mental Health Centres in Trail, Kelowna, and Nanaimo
for discussion of work-load problems.
Statistics
Co-operation was given for the collection of material in reference to two
projects being done under the direction of the Department of Psychiatry, University
of British Columbia.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL F 57
PART II.—CREASE CLINIC OF PSYCHOLOGICAL MEDICINE
AND PROVINCIAL MENTAL HOSPITAL
REPORT OF THE MEDICAL SUPERINTENDENT
B. F. Bryson, Medical Superintendent
GENERAL COMMENTS
The year ended March 31, 1965, was a busy and productive one for this
division of the Mental Health Services. During the year a total of 7,540 patients
received psychiatric treatment within the Provincial Mental Hospital and Crease
Clinic. Admissions decreased by 335 to 3,847. At the end of the year the total
in-residence population was 2,918 (229 in the Crease Clinic and 2,689 in the
Mental Hospital).
Treatment and administrative policies have continued toward the goal of
providing a progressive standard of service to all patients. Treatment programmes
have been revised and many administrative changes have been instituted in both
the Provincial Mental Hospital and Crease Clinic to improve patient-care, to
continue the hospital's development as a therapeutic community, and to prepare
for operation under the Mental Health Act, 1964.
A new senior administrative position designated Assistant Superintendent was
established to replace the position of Deputy Medical Superintendent. On September 16,1964, Mr. J. Borthwick, previously head of the Department of Psychology
and a recent graduate in hospital administration from the University of Toronto,
was appointed to the position. He has been given the responsibility for the
administration of the patient-care departments of the hospital. Mr. N. Barr,
Business Administrator, has continued to give administrative direction to the
business and personnel offices and to the service departments. Dr. P. Middleton,
Clinical Director, has directed the activities of the medical staff and has provided
psychiatric consultation to departments involved in treatment.
A major development was the establishment of a maximum-security area at
the Riverside Building. Concurrently, in that building, a programme was developed
for the treatment of patients suffering from alcoholism.
The administration of the male nursing staff in the North Lawn Building was
transferred to the Women's Nursing Division to provide more satisfactory supervisory control.
The Radiology Department came under the direction of a group of radiological
consultants.
The Inhalation Therapy Section of the Nursing Division was reorganized and
agreements were made between this hospital and other divisions of the Mental
Health Services for inhalation-therapy coverage.
Procedures in the admitting offices were reorganized to make admission as
simple as possible for the patient and his relatives.
The Physiotherapy Department was moved to a new location in the North
Lawn Building with the anticipation of expanding its services for the forthcoming
year. _;. •
Significant changes were made in the assignment of staff and rostering procedures in the Women's Nursing Division.
 F 58
MENTAL HEALTH SERVICES REPORT,  1964/65
Many programmes were developed and extended in order to make the hospital
more truly a therapeutic community. The payment of patients for work was
instituted. A programme of placing patients in jobs suited to their needs was
commenced. The contract workshop was expanded. The apparel-shops run by
the Canadian Mental Health Association were moved to new quarters and their
operation improved. Rules for evening grounds privileges were revised and made
more liberal to allow patients to attend evening activities on a freer basis. The
Recreation Department's programming was revised to allow for greater evening
participation of those patients who work during the day. The library, too, was
opened for evening use.
Further changes were made in the patient-care departments to improve community contact. Pre-admission services for patients were developed and expanded.
Improvements were made in informing community doctors of their patients' progress.
The operation of Vista and Venture, the half-way houses, was modified so that the
transition from hospital to community would be made easier. At the After-care
Clinic, patients and their spouses attended group therapy designed for people with
marital difficulties. Boarding-home care was linked with community public health
services. Supervisors employed with the Department of Social Welfare throughout
British Columbia were brought to the hospital to improve liaison with community
welfare services.
Plans were made for operation in accordance with the new legislation. The
spirit of change and a sense of optimism mark the feelings of the staff as they
prepare to operate as the Riverview Hospital under the Mental Health Act, 1964.
CREASE CLINIC OF PSYCHOLOGICAL MEDICINE
March 31, 1965, marks the termination of the Crease Clinic as a separate
entity operating under the Clinics of Psychological Medicine Act. It has for 14
years provided an intensive and varied programme of in-resident psychiatric care
for mentally disordered persons whose illnesses were considered amenable to treatment within a four-month period. As of April 1, 1965, the Crease Clinic will be
known as the Crease Unit and will be the admitting and acute-treatment centre for
patients admitted to the Riverview Hospital from the Greater Vancouver area.
The following table briefly outlines the movement of population in the Crease
Clinic during the past year:—
Male
Female
Total
104
142
246
Admissions—
1
!■     647
J
756
3
Readmissions to a different institution of Mental Health Services	
Readmissions to the same institution
1,403
3
647
!        759
1,406
751
901
1,652
Separations—
651
9     i
2
745
14     i
1
1
1,396
23
1
Piefi
3
662
761
1,423
-15
89
-2
140
—17
229
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
F 59
As will be noted, there were 1,406 admissions (647 men and 759 women),
which is a decrease of 208 compared to the previous year. There were 1,118 voluntary admissions or 79.5 per cent of the total.
Separations totalled 1,423 (662 men and 761 women), of which 1,395 or 98
per cent were discharged to the community.
As all diagnostic, treatment, and operational services of this division are available to both the Crease Clinic and Provincial Mental Hospital, the details of each
department will be found under reports of the Provincial Mental Hospital.
PROVINCIAL MENTAL HOSPITAL
The Provincial Mental Hospital, after 92 years of operation as a separate
institution under the Mental Hospitals Act, will cease to exist as such as of April 1,
1965, and combined with the Crease Clinic will form the mental health facility to
be known in future as Riverview Hospital, Essondale.
The following table gives a summary of the movement of population for the
Provincial Mental Hospital for the year ended March 31, 1965:—
Male
Female
Total
1,552
87
139
4
1,254
123
288
2,806
210
427
4
Total as at April 1, 1964    ..
1,782
1,665
3,447
Admissions—
1
[ 1,166
J
9
2
2
1,246
»          14
1
1
Readmissions to a different institution of Mental Health Services -      .
2,412
23
3
3
1,179
1,262
2,441
2,961      i
2,927
5,888
Separations—
1,201
70
46
1.1
78
6
1,281
3
59
32
3
1        152
2,482
3
Died 	
129
78
14
230
1,412
1,530
2,942
-115
1,437
112
-2
1,252
145
117
In residence, March 31,1965     . .
2,689
A comparison of the above table with that for the previous year shows that
there has been a decrease in both the admissions and separations. There was a
total of 2,441 patients (1,179 men and 1,262 women) admitted to the Provincial
Mental Hospital, a decrease of 127 or approximately 5 per cent compared with the
previous year.
There were 843 voluntary admissions or 34.5 per cent of the total.
Separations decreased by 201 and totalled 2,942 for the year. Of these (1,201
men and 1,281 women), a total of 2,482 patients was discharged in full to the
community, a significant increase of 195 compared to the previous year. These
discharges constitute 84 per cent of separations.
Deaths in the Provincial Mental Hospital decreased by 20 to a total of 129
or 4.3 per cent of the total separations and only 2.2 per cent of the total number
of patients under care during the year.
 F 60 MENTAL HEALTH SERVICES REPORT,  1964/65
The number of newly admitted patients requiring special security supervision
decreased by 21 and totalled 151. Of these, 91 men and 18 women were admitted
by Order in Council from Oakalla Prison Farm Gaol, 11 men from the British
Columbia Penitentiary, and 25 men and 6 women were referred by Magistrate's
warrant for psychiatric assessment.
As of March 31, 1965, the number of patients in residence in the Provincial
Mental Hospital totalled 2,689 (1,437 men and 1,252 women). This is a decrease
of 117 compared to the same date a year ago. There were 257 patients in boarding-
home care under the supervision of the hospital. This is an increase of 47 over the
previous year.
Treatment Services
This final year of the separate existence of the Crease Clinic of Psychological
Medicine and the Provincial Mental Hospital has been by no means a period of
marking time and waiting for April 1, 1965, when the Mental Health Act, 1964,
takes effect. On the contrary, in preparation for the significant clinical advances
made possible by the new Act, it was a year of great activity.
In May the tuberculosis service was confined to a single ward of 26 beds, both
male and female, on Ward South 1 in the North Lawn Building, and by the end of
the year this area was being prepared for further subdivision into a mixed tuberculosis ward of only 12 beds (all that are now necessary) and a much-improved
physiotherapy and hydrotherapy service.
November saw the transfer to the Riverside Building of all male security
patients. This group includes prisoners of the Provincial correctional institutions
and Federal Penitentiary who are being treated or observed for mental disorders,
persons charged with offences on remand for pre-trial psychiatric observation and
opinion, and others found not guilty of various offences by reason of insanity
awaiting the Lieutenant-Governor's pleasure. The new location permits the patients
to use a large and pleasant exercise courtyard at some part of each day in which
weather permits.
A system of security ratings was instituted, making it clear how much supervision and control were required for each security patient. At the end of the year
the Riverside Unit was established as a separate entity under a Unit Director. By
then a good relationship existed with prison authorities for the transport of patients
and the rapid exchange of relevant information.
In January the service for motivated male alcohol addicts who had volunteered
to receive in-patient treatment was transferred to a small open ward in Riverside
Unit. A busy treatment programme involving group activities and aversion therapies is oversubscribed, and there is usually a short waiting-list of applicants. Outpatients are seen on a pre-admission or after-care basis once weekly at the Alcohol
Foundation, Vancouver. The organization of Alcoholics Anonymous has continued
to hold regular meetings at the hospital and has provided valuable assistance.
The transfer of the security and alcoholism services from Centre Lawn Unit
enabled that unit by the end of the year to have all of its eight wards open and to
institute four clinical services, each serving two wards. In addition, preparation
and planning were well advanced to equalize treatment, staffing, and physical
standards at the high level set by the Crease Clinic.
There has been a significant increase in therapeutic community concepts
involving ward community meetings, discussion of patient problems by ward staff
groups, including the most junior as well as the most senior staff members. Inevitably the physician is cast in the role of leader of such groups however democrati-
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL F 61
cally they may be promoted, and this calls for better than average competence in
the physicians.
Apart from a therapeutic trial of tegretal, found valuable in controlling behaviour as well as convulsive tendencies of disturbed epileptics, and of variants of
imipramine, there has been no major departure in the use of drugs.
Electroconvulsive therapy is used in moderation on the admission services in
conjunction with phenothiazine drugs in the treatment of schizophrenia, in severe
depressions, or depressions resistant to appropriate drugs. Approximately 80
patients in the admission units at any given time are receiving a course of electroconvulsive therapy, and the average course is fewer than eight treatments. In the
other services there are usually fewer than 40 patients on this type of therapy. In
all cases both intravenous anaesthesia and muscle relaxants are employed. There
has been no fracture or accident from electroconvulsive therapy in the past year,
except for one instance of transient cardiac arrest.
The After-care Clinic carries an average case load of just over 1,000 patients,
and plans are being finalized to subdivide this group into those (about 80 per cent)
who reside in the greater Vancouver area from the smaller number who reside
elsewhere in the Lower Mainland and provide more suitably located facilities for
this service. It is hoped that we will be able to add pre-admission and also admission preventing out-patient services to our existing after-care services, for we
continue to receive as in-patients many individuals who do not need to occupy beds
or to have the continuity of their family life disrupted.
Research under the leadership of Dr. Greiner, Unit Director of North Lawn
(and a certified specialist in internal medicine), into the phenomena associated with
melanin deposition in chronic schizophrenics, especially following prolonged courses
of phenothiazines, entered a new phase. Low copper diets and penicillamine were
employed with two groups of patients to determine whether reduction of melanin
pigmentation and of psychotic symptomatology would result. The findings are in
course of publication.
The Psychology Department was active in validating modes of alcohol aversion
therapy involving the association of cue words and phrases relating to alcohol with
electric shocks applied to skin surfaces. Estimates of the degree of concern evoked
by such words subsequently were made with the psychogalvanic reflex (polygraph)
method. Further extension of behaviour therapy methods in the treatment of
alcohol addicts is in prospect.
Thursday morning staff conferences continued to be well attended and varied
in scope. A proportion involved case presentations and discussions, but in addition
there were guest speakers from related disciplines. There were also 20 brief
presentations of various psychiatric and general medical themes as part of the
Wednesday medical-staff noon meeting.
Many groups and individuals visited our facilities, including high-school
students, Royal Canadian Mounted Police, boarding-home operators, public health
nurses, etc., and our medical staff were well represented in lectures, panels, and
workshops on psychiatric and related themes in the community. Instruction was
again offered to school special counsellors and second-year medical students.
Women's Nursing Division
The focus of the Women's Division of Nursing has been on the evaluation and
improvement of the level of patient-care by analysing the specific nursing-care
needs of 24 wards.
 F 62 MENTAL HEALTH SERVICES REPORT,  1964/65
As the year progressed, it became apparent that the changing emphasis of
various wards was resulting in the inefficient use of nursing personnel and adversely
affecting both patient-care and staff morale. Under these conditions it became
imperative to determine the necessary ratio of nursing staff to patients in order to
rectify this situation. As a result, each ward was assessed on the basis of function,
average patient census, physical plant, as well as involvement in extra duties such as
teaching commitments either for students or staff members.
Charge and head nurses are responsible for the rostering of days off for their
wards. This results in a greater feeling of security and solidarity on the part of ward
staff. Senior supervisors, although still responsible for the ward coverage of their
buildings, are finding more time to supervise nursing care and to plan programmes.
Team nursing has continued to spread and is now in effect on all wards in
Centre Lawn, two wards in East Lawn, and one in the North Lawn unit. This
method of assignment appears to provide the best means of staff supervision as well
as individual attention to the patients.
There has been considerable emphasis on staff orientation. Each of four
charge nurses who was assigned to a different ward received a four-day orientation
previous to commencing duty. Seventeen psychiatric aides received an orientation
to the hospital programmed by the School of Nursing. Work is presently being
carried out on an orientation programme for staff nurses, this group being the only
one not yet provided with a formal orientation. Two staff nurses, however, were
selected to attend the post-basic programme presented by the School of Nursing,
which extended over a period of 18 weeks. Registered nurses have continued to be
encouraged to seek post-basic education, and during the year the operating-room
supervisor has been on leave of absence in order to complete the baccalaureate
programme at McGill University.
The Women's Division of Nursing again presented an in-service programme to
charge and head nurses from both divisions of nursing. The programme took the
form of a workshop, with the objective of compiling ward manuals for each of the
46 wards in the hospital. Guest speakers discussed such pertinent subjects as staff
evaluations, orientation, communications, and ward teaching.
In this connection senior supervisors reviewed all policies from their manuals,
and these are being revised in order to be brought up to date with the changing
philosophy. The objective is to provide up-to-date manuals which will be graduated
from the broad information necessary for the Superintendent of Nurses' office to
that required for senior building supervisors' offices, down to the specifics of the
ward situation.
The Central Supply Room continues to provide supplies for the hospital and
extended its services to the newly created staff health service. Since the reorganization of the pharmacy, the storage area, previously available from this department,
has been withdrawn. This has further reduced the already limited space of the
Central Supply Room.
The surgical unit continues to increase its operative procedures and consultations. Plans are under way to improve its facilities and to provide the much-needed
post-ansesthetic recovery-room. An instrument count for major cases was instituted
in the operating-room in October as an additional safety measure. There is also a
programme in effect which provides an orientation for surgical-ward staff, the objective being to build up a reservoir of experienced nurses for emergency situations.
Considering the various projects and trends which have been mentioned and
which are indicative of growth within the department, there is reason to feel great
optimism for the future.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL F 63
Men's Nursing Division
In the past year the male nursing staff adjusted to a rapidly changing era in
mental health which has brought about many new ideas in the planning, philosophy,
and treatment policies of the hospital. This department's staff have continued to
improve their standard of nursing care and to adjust to the changes.
More responsibility was placed upon unit nursing supervisors in the operation
and control of their units. They have, therefore, felt freer to co-ordinate unit
activities with other disciplines concerned and are better able to further plans in line
with the philosophies as laid down by the various unit medical directors.
Nurses are involved in therapeutic-ward discussion groups, in which they often
act as group leaders who report the progress of patients to a clinical team. Nurses
conduct progressive relaxation groups in the Crease Clinic and act as leaders in
reactivation, remotivation, and resocialization programmes.
The Royal Canadian Legion, Army, Navy and Air Force Veterans, and their
women's auxiliaries have continued to be faithful visitors. They have also been
most generous with their gifts. One group donated a pool table to a West Lawn
ward.   A number of other organizations have visited regularly.
From May to October the male nursing division dealt with a series of incidents
and problems with patients transferred from the prisons of the Province. There
were a number of escape attempts and four actual escapes. In November, Wards
R2 and R3 of the Riverside Building were converted into a maximum-security area.
Increased security is now possible because of the better physical facilities and
increased staff ratio in the area. Concentrated programmes of recreational therapy
and occupational therapy were put into effect with these patients to lessen tensions
and problems.
In 1964 a number of infirmary patients were moved from Al to North Lawn,
thus leaving Al available to be used for the treatment of acutely ill patients and as
a receiving area for patients from other units. With the transfer of the security
patients from the West Lawn Building, there was a rearrangement of patients which
permitted the introduction of a changed philosophy and one which puts more
emphasis on group therapies, remotivation, ward discussion groups and reactivation.
The grounds supervisors again had a busy year. They interviewed 3,287
patients prior to their being granted grounds privileges. In addition, the grounds
supervisors kept a watchful eye on an average of 2,800 patients in a 1,000-acre area
for problems such as unacceptable behaviour, patients wandering out of bounds, and
patients becoming ill. This has proven a very useful service throughout the years,
for by then counselling and direction grounds-privileged patients may enjoy their
privileges with safety and confidence.
Department of Psychology
Educational and professional standards have been rising steadily in this profession in the last few years. As a result, recruitment may continue to be difficult
for some time to come until a sufficient pool of psychologists is available.
In total, 58 lectures were given and again were mainly within the framework
of instructional programmes for nurse trainees, but included as well some talks
delivered to other affiliating students and visiting groups.
A total of 1,366 psychological tests was administered, the greater number of
which were used in the preparation of written reports about patients. Altogether
400 such reports were submitted in response to requests made for diagnostic evaluation, intellectual measurement, and personality assessment.
 F 64 MENTAL HEALTH SERVICES REPORT,  1964/65
In total, 633 group meetings were conducted. At the Crease Clinic, this year
saw the repetition of an intensive group programme for young acutely ill schizophrenic patients and the continuation, in modified form, of a programme for the
neurotically disabled person. As an additional service in this unit, a group programme was established catering specifically to patients whose admissions seemed
primarily referable to marital problems. Group therapy services also principally
oriented to resolving marital conflict continued strongly at the After-care Centre.
The year also saw a continuation of therapeutic services within the Provincial
Mental Hospital in the form of group discussions and activation sessions for long-
hospitalized female patients thought suitable for discharge. Of growing interest to
the staff has been the application of learning principles to the alleviation of symptoms, and several challenging treatment problems were undertaken utilizing learning
techniques.
In respect to the latter, a study was undertaken to examine the efficacy of
aversive conditioning in the treatment of alcoholism. Additionally three other
research projects were initiated, two relating to the utilization of certain psychological tests and one examining a screening procedure potentially useful in selecting
chronic schizophrenic patients for social rehabilitation.
The department has continued an affiliation with the University of British
Columbia in repeating, for a fifth summer, an internship programme designed to
familiarize the prospective graduate clinical student with the duties and demands
facing the psychologist working in a clinical setting. This programme has aided
recruitment and probably will do more in the future.
Social Service Department
The past year has been one of challenge and increased activity for social workers in all major areas of the Provincial Mental Hospital and Crease Clinic. Continuing high rates of admission to the Mental Hospital were reflected in a rapid
turnover of patient loads and corresponding growth in the provision of brief social
services, particularly in the admitting and acute-treatment unit.
The work of the department, as depicted in the statistical summaries, remained
fairly consistent with that of the previous year. A total of 3,676 patients in the
Provincial Mental Hospital was given service, as compared with 3,325 in the
preceding year, whereas in Crease Clinic the statistics disclosed a slight reduction
in numbers of patients served, from 1,588 in the year 1963/64 to 1,399 in the
current year, which drop, however, was offset by an increase in services to groups
of patients. Services such as these involved the casework staff in more than 23,000
interviews, of which total some 13,600 were held with, or on behalf of, patients in
the care of the Provincial Mental Hospital, and approximately 9,600 were concerned
with patients in the Crease CUnic. In addition, some 3,500 interviews, primarily
related to the provision of brief services, were held with patients discharged from
all areas and registered in the After-care Clinic for on-going help and supervision
on an out-patient basis.
Within the long-stay areas of the Mental Hospital, the resettlement of chronically handicapped patients in selected boarding homes under the on-going supervision of psychiatric teams continued to play a major role in facilitating hospital
clearance. By the end of the year, 257 patients (112 male and 145 female) or
approximately 10 per cent of the total patient population of the long-term treatment
units were accommodated in 38 licensed boarding homes under this programme.
The appointment of additional staff to this section has enabled the co-ordinator to
devote more time to the selection and licensing of suitable homes.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL F 65
A significant step during the year in the integration of hospital services with
those of other community resources in the rehabilitation of patients was the
incorporation into the boarding-home programme of the services of public health.
This was effected through policies with the North Fraser and Upper Fraser Valley
Health Units, whereby it was agreed that certain aspects of care and supervision
would be provided to patients in boarding homes by public health nursing personnel.
This has proved to be a satisfactory division of responsibilities which might be
applied to other locales.
In the Crease Clinic the growth of pre-admission services was an important
development. Some 30 pre-admission visits were made each month and were
concerned with the preparation of prospective patients and their families for the
experience of hospitalization.
Considerable time was given to working with groups of patients. For those
social workers engaged in preparing large numbers of patients for discharge, this
proved to be a most economical means of dealing with common concerns regarding
such matters as housing, employment, boarding-home care, community attitudes,
etc. Other groups concerned with adjustments in marital and family relationships
were carried by members of the psychology and social service staffs working
together.
Group services to adolescents and young adult patients continued in both the
Crease Clinic and Centre Lawn Building under the general direction of the respective unit directors. Although adolescent patients continued to present problems in
discharge planning, co-operative services with the Child Welfare Division have been
greatly enhanced by the appointment of a Special Placements Consultant to that
division. Liaison has been maintained with this officer, who also has contact with
the various regional offices of the Department of Social Welfare as well as with the
three Children's Aid Societies in the Province. This has been of particular assistance to the social-work staff in the acute-treatment units, where a fairly large
proportion of social-work time has been devoted to this group of patients.
In the After-care Clinic, the emphasis during the year has been in developing
policies of co-operation with community agencies whereby better services to discharged patients can be provided.
Twelve visiting teams from the Crease CUnic and Provincial Mental Hospital
were active with 1,431 patients who were registered in the After-care Clinic. In
addition, the resident staff provided social and casework services to or on behalf
of 531 patients.
The School of Social Work again requested, and was granted, the opportunity
to place students for field-work experience in both the institutional areas and in the
After-care Clinic. Individual case and group supervision was provided by either
senior members of the Social Service Department or by a field instructor appointed
to the faculty of the school. In addition to fulfilling speaking engagements with
interested community groups, orientations were given to in-service training students
of the Department of Social Welfare and to groups of first-year students in training
at the School of Social Work.
The supervisory personnel of the Department of Social Welfare were given
refresher courses, which included a one day's orientation to the hospital services.
This contact was valuable in promoting understanding of the problems of each other.
Rehabilitation Department
This has been a year of considerable change within the RehabiUtation Department.   The original Co-ordinator of Rehabilitation left the service in May, 1964,
 F 66 MENTAL HEALTH SERVICES REPORT,  1964/65
and a new Co-ordinator was appointed in due course.   In the interim his position
of Acting Co-ordinator was fiUed by the department's social worker.
The work placement programme has continued as a large and active service
within the hospital. A total of 1,992 new job assignments was made, and 442 job
transfers were arranged for the patient-group. A grant of $35,000 was received
for paying patient workers, and at the end of the year 1,133 patients were receiving
payment for their work. All patients have been assigned a grade according to their
work performance and are paid every two weeks. The payment system has brought
an increase in interest from the patients about their hospital jobs, and attendance
and punctuality have improved. Assignment of patients to jobs is done by means
of an individual interview, and it has been necessary to hire two new job placement
officers in addition to the two already employed in order to handle this large placement activity.
The vocational assessment programme received 141 referrals during the year.
Of this number, 14 patients proceeded on to extended job-training programmes.
The vocational assessment service is one valued by the National Employment Service, which has a real interest in obtaining concrete information on the discharged
patient's work ability when he returns to the community. The assessment reports
enable more realistic placement in community jobs. Many non-clinical areas of the
hospital have co-operated in helping assess patients within their work areas. The
occupational therapist, who is responsible for the vocational assessments, also has
been active in contacting industrial firms in the community in order to obtain
contract work for the RehabiUtation Workshop. This workshop is a joint project
with the Occupational Therapy Department and furnishes opportunities for approximately 30 regressed patients to perform meaningful work of a simple kind under
supervision. This workshop provides a service to the patient who cannot be given
grounds privileges and has few opportunities to leave his ward. The workshop
experience furnishes an initial stimulating phase where the patient can be prepared
for more independence within the hospital. One hundred and nine firms have been
solicited for work, and 31 of these have expressed interest and willingness to
consider supplying work to the workshop. Approximately $400 has been earned
by the workshop.
The rehabilitation residence programmes at Vista and Venture have needed a
great deal of attention this year. During this period these residences have been
defined as resources for working with patients who are on active rehabilitation
programmes leading to employment in the community. These houses have been
found very suitable for those who are undertaking vocational training or who are
in the early stages of employment and need a supportive living situation. A total
of 66 patients has been involved in this programme, and of these only 13 had to be
returned to the hospital due to exacerbation of symptoms. The social worker has
worked closely with the staff at Vista and Venture in order to bring about a climate
of rehabilitation rather than extended nursing care. She has been able to obtain
tickets to a variety of community functions and has worked toward making the
patient more able to use normal community resources. A sizeable number of former
patients use the rehabflitation residences on a " drop-in " basis and gain considerable
support from the staff.
There has been much community-oriented activity within this department.
The Consultative Council, formed as an advisory body to the rehabilitation programme at Essondale, has met regularly. This Council ensures that the programme
here is co-ordinated with existing and developing resources in the community. The
co-ordinator has been involved with rehabilitation efforts of the Community Chest
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL F 67
and with the activities of the National Employment Service. Through these and
other community contracts it is possible to focus the attention of those in community agencies on the problems of the psychiatric patient who is returning to the
community. It is felt to be important that this department be considered a part of
community services as well as a part of the over-all hospital programme to prepare
patients for discharge and independent living.
Occupational Therapy Department
The Occupational Therapy Department has endeavoured to formulate its programme to be consistent with new trends in hospital treatment. Outlined below
are changes in departmental activity consistent with modifications in poUcy.
The movement of the Order in Council patients to Riverside Building necessitated a reorganization of staff in the Occupational Therapy Department to provide
an active ward and workshop programme.
The boarding-home visiting programme initiated last year has continued as a
part-time service to provide materials and activities for patients transferred to
boarding-home care. The need to extend this programme to a full-time service is
more evident with the increasing number of referrals for boarding-home placement.
The Third Annual Art Exhibition, held in late October, was successful in
interesting a large group of staff and patients. Proceeds from the yearly occupational-therapy sale amounted to $3,497. This represented an increase of $600
over the amount reaUzed last year.
In total, 3,391 patients were referred to the department. An average of 585
patients attended our facilities per day. A total of 108,686 treatments was given
during the year. Fifty-five patients were referred to the Activities of Daily
Living Unit for assessment and retraining. The length of stay ranged from four to
six weeks.
Seven graduate students from the Universities of Toronto, Montreal, and Manitoba and seven second- and third-year students from the University of British
Columbia School of Rehabilitation Medicine interned in the department from May
to October. Staff participation in educational and orientation programmes for all
groups of students and staff continued to be extensive. A number of guest speakers
were invited to staff meetings as part of a continuing educational programme.
Recreational Therapy Department
There was a steady growth in the number of new and interesting developments
in the employment of social and recreational activities as a part of the active-
treatment programme. Much of the change concerns the way in which the programme is developed and made available to patients and, with the increasing
unitization of the hospital, a trend has developed to place recreational programmes
directly under the control of the medical directors of each separate unit.
Working within this relationship, the recreational-therapy staff assigned to the
various units have carried on a varied programme tailored to the interests and needs
of the particular types of patients in each section. In acute-treatment areas, such
as Centre Lawn and the Crease Clinic, this has involved offering morning and
afternoon treatment sessions for groups of referred patients five days a week. These
activities are carried on in special areas within the unit or in airing-courts immediately adjoining the unit building. In addition, opportunities are offered these same
patients for special group activities outside the unit, such as bowling, golf, swimming,
 F 68 MENTAL HEALTH SERVICES REPORT, 1964/65
basketball, floor hockey, and roller skating. Social recreational needs in turn are
met through the provision of weekly dances, card socials, bingos, concerts, and
musical events.
The extensive relocation of patients carried out during the year affecting West
Lawn, Centre Lawn, North Lawn, and Riverside necessitated frequent alterations
in the pattern of activities and the scheduling of routines within each of these units
to meet the needs of new types of patients. Centre Lawn and Riverside areas in
particular came in for wide revision of a more comprehensive programme of activities. Structural alterations affecting the recreation facilities at Riverside have made
possible the regular use of these areas by security patients with a resultant heavy
daily traffic, while the shift in population at Centre Lawn opened up space suitable
for recreational activity which, for the first time in many years, permitted patients
in this unit an organized daily activities programme.
Spring marked the opening interest in out-of-door activities, which saw the
establishment of flourishing softball leagues, pitch-putt golf, horseshoes, outdoor
volleyball, and soccer, leading to a summer which brought a season-long battle
against adverse weather to carry out scheduled picnics, cook-outs, industrial tours,
expeditions to Stanley Park, Alouette Lake, Squamish, Queen Elizabeth Park, the
Pacific National Exhibition and Shrine Circus, and a variety of other points. The
fall and winter seasons brought their full complements of indoor activities—gymnastics, calisthenics, badminton, basketball, volleyball, floor hockey, and bowling,
together with inter-unit dances, card socials, glee club and dramatic activities, and
regular expeditions to outside community attractions. Use of the Hillside swimming-
pool as an integral part of the hospital's recreation facilities continued and expanded
during the year.
Patients from both acute and long-term areas who have ground privileges share
in the wider programme organized directly by the Recreational Therapy Department.
In keeping with normal community patterns, these patients, for the most part, are
fully occupied during the working-day, but are free during the late afternoon, evenings, and week-ends to leave the unit and voluntarily seek social and recreational
opportunities on the grounds, at sports fields, swimming-pool, golf course, or at
the hospital recreation centre, Pennington Hall. It is in these areas that the Recreational Therapy Department finds its chief opportunity to plan, develop, and direct
a wide-ranging programme of wholesome, constructive social and recreational
activities designed to meet the leisure-time needs and interest of grounds-privileged
patients.
Special events were held, including some 24 concerts put on by outside community groups, special Easter celebrations, the gala Carnival Day in June, expedi-
ditions to the Pacific National Exhibition and the Shrine Circus, and a major
Hallowe'en party. Christmas with its popular open-house events involving the attendance of scores of volunteer community entertainment groups embracing several
hundred special guests, the New Year's Frolic, and, finally, a Valentine's BaU were
special highlights of the year's activities.
The addition of a piano and three new billiard tables to the complement of
recreational equipment now avaUable for ward use, the establishment of inter-unit
dinner parties, the operation of a bowling league, the introduction of roller skating
as a regular activity and the carrying-out of a Wednesday evening co-ed " Gym
Fun " night were among other interesting developments of the year. A change in
the editorial staff and the resultant revisions in publishing procedures during the
year have transformed the Leader into a more interesting and readable patients'
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL F 69
magazine, while at the same time offering much greater values in terms of therapy
to the considerable body of patients involved in its reporting, writing, and publishing.
Patients' School
The school was open from 8 a.m. to 4 p.m. for 216.5 regular school-days during the past year. Forty male and 22 female patients with an average age of 20.8
years were enrolled. These included 29 adolescents, 8 young adults, and 25 adults.
Fifty students attended the daily classes, and the 12 who were unable to do so received instruction on the wards. The average period of attendance per patient was
8.6 weeks, and 31 patients were discharged during the year.
Twenty-two students, or approximately one-third of the enrolment, undertook
one or more correspondence courses offered by the Department of Education. The
remainder followed the standard school programme at appropriate grade levels.
Twenty-one were enrolled in the elementary grades, 26 in the junior secondary
grades, and 15 in the senior secondary grades.
A flexible curriculum suited to the needs of the individual was emphasized.
While several patients began courses that ultimately would aid them in an employment situation, the majority attended class in order to resume or complete an
interrupted programme of formal education. To this end, the co-operation of the
Provincial schools continued to prove valuable. By providing the hospitalized
pupils with scheduled term examinations, these schools enabled several of the students to rejoin their former classes after discharge with a minimum loss of regular
schooling.
Physiotherapy Department
Staffing of the Physiotherapy Department has been most uncertain during the
year. Physiotherapists left the service to go into private practice and to move to
other parts of the world. Two physiotherapists have been employed, however,
since the middle of the fiscal year.
In line with the establishment of the North Lawn Building as the infirmary
area for the hospital, the Physiotherapy Department was moved there in September.
Temporary quarters were found for the department in the building's recreation
room, but by the end of the year plans were well under way to move into new
quarters in a former dormitory of Ward South 1. This space was made available
as the number of tubercular patients has been dramatically reduced.
The number of treatments performed and the patients seen was reduced from
previous years.   A total of 8,540 treatments was given to 1,058 patients.
Department of Radiology
On December 31, 1964, Dr. J. M. Jackson, who for the past 34 years has been
a member of the medical staff of the Provincial Mental Hospital and Crease Clinic,
first as a psychiatrist and more latterly as Director of the Radiology Department,
left the service on retirement.
In keeping with the practice commonly used by general hospitals, specialist
radiological consultation and professional supervision of this department is now
being provided on a contract basis by a radiological clinic in Vancouver, with Dr.
G. I. Norton, a senior member of the clinic, being responsible for the professional
direction of the Radiology Department Staff. This new arrangement came into
operation during November, 1964, and has been functioning most effectively.
A wide variety of diagnostic procedures was performed during the year, a total
of 15,021 films being taken.   The number of patients examined was 10,652.
 F 70 MENTAL HEALTH SERVICES REPORT, 1964/65
Department of Laboratories
This department reports increased activity over the year.
The total number of procedures performed was 71,750, an increase of 4,507
over the previous year. This increase occurred mainly in the department of bacteriology, where there was a marked increase in the number of smears, cultures, and
antibiotic sensitivity tests. In histology there was an increase in the number of
tissue sections processed. The chemistry department showed a significant increase
in the number of copper determinations performed. There were 171 autopsies
performed and 461 surgical tissues examined for patients from The Woodlands
School and Valleyview as well as the Mental Hospital and Crease CUnic.
The pathologist and the technical staff contributed to the publication of three
scientific articles concerning the cutaneous and visceral pigmentation which has
occurred in a number of patients who were on prolonged high-dosage ataractic
therapy.
Department of Neurology
This department has continued to function as a consultative centre in neurology,
providing neurological, electroencephalographical, and neurosurgical consultative
services to the Mental Health Services. There has been a change in the staffing of
the department. Dr. Kenneth Berry resigned, and Dr. Paul Bratty was appointed to
the position of Consultant in Neurology, beginning the last two weeks in December,
1964.
During the period April, 1964, to March, 1965, inclusive, there were 188
clinical neurologic consultations which were associated with 50 pneumoencephalo-
grams, 8 lumbar punctures, 8 perimetric examinations, and 11 carotid arteriograms.
Neurosurgical consultation was provided by Dr. Frank Turnbull in 24 patients, and
6 neurosurgical procedures were performed.
During the year there were 865 electroencephalograms. Of this figure, 550
were done at Essondale, including 86 for penal institutions and 15 as part of a
research project. Fifty-eight were performed at the Mental Health Centre in
Burnaby and 257 at The Woodlands School.
Pharmacy Department
This year, as for the past several years, the pharmacy has continued to provide
a greater volume of medications for patients at the Provincial Mental Hospital and
Crease Clinic. WeU over 50,000 items of surgical and pharmaceutical nature were
dispensed to the wards. Prescriptions filled, both individually and those which were
considered for multiple use, amounted to 24,000.
At the end of the year, preparations were being made by the Pharmacy Department to develop two separate functions—one as a general pharmaceutical service
for all the Mental Health Services and, separately, a pharmacy for the Riverview
Hospital.
Dental Department
The staff of the Dental Department have continued to maintain as high a degree
of dental care and treatment as possible. Evidence of dental neglect is seen in a
high percentage of new patients of all ages, many of whom are edentulous or are in
need of new or repahed dentures to establish good oral health.
A wide variety of dental service has been provided for the patients of the
Mental Hospital and Crease Clinic during the year.   Difficult extractions or other
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL F 71
forms of oral surgery were carried out by the dentists through the co-operation and
facilities of the Crease Clinic surgical service.
Instructions in oral hygiene are given to all patients, particularly younger
patients, and a recall system is used to examine long-term patients to provide early
recognition and treatment of new cavities or other oral problems.
During the year a total of 10,637 dental procedures was carried out.
Chaplain Service
Services were held in Pennington Hall every Sunday morning and evening,
also on all Feasts of Obligation, Good Friday, Remembrance Day, and Christmas
Eve. Each Wednesday a service is held on the tuberculosis ward. The Rev. W. S.
Lacko conducted the church service for the graduating class of the School of
Psychiatric Nursing, whUe the Rev. John F. O'Neil participated in annual graduation exercises. Both of them assisted with occasional lectures at the Education
Centre.
Of special interest during the year was the showing of the film on the rebirth of
Coventry Cathedral. Also much appreciated were the filmstrips loaned by Valleyview Hospital. There were special services on the Sundays following the death of
Sir Winston S. Churchill and his funeral. The Industrial Therapy Department
helped a great deal when they constructed a new hanging cross and refinished the
church furniture in Pennington Hall.
During the year a total of 33 choirs from churches in the Greater Vancouver-
New Westminster area attended the Sunday morning services and aided with
anthems and the musical parts of the services. Also during the year clergymen from
23 different denominations paid 332 visits to patients in the hospital. At the same
time the chaplains, apart from their regular work, responded to 93 special requests
for aid from the patients.
Library
The principal developments in the patients' library have been the extension of
library hours and the use of patient help. Through hospital volunteer services and
partly through the use of patient assistance, it has been possible to keep the library
open two evenings a week. The longer hours have been particularly appreciated
by those patients who are working in the hospital and are thus deprived of library
privileges during the day. The library itself has been one of the job placement
areas in the hospital rehabilitation programme, and there has been a continuous
succession of patients assigned to library work.
The patients' reading-room has been redecorated, and the general appearance
greatly improved by the new colour scheme, the reupholstered chairs, and some
new oak shelving.
The library's coUection was increased by 737 new books, which is almost twice
the number acquired during the previous year. However, about the same number
of older books was distributed to other areas, maintaining the total library holdings
at approximately last year's level of over 4,000. Besides book shipments to
Skeenaview and Dellview Hospitals and additions to North Lawn BuUding, books
were placed into a new deposit library at Riverside for the use of patients there.
In the medical library, 230 new books were acquired during the year, bringing
the total figure to 3,450. Current journal subscriptions were increased to 177.
The professional staff have made heavy use of the library's coUection, with particular
 F 72 MENTAL HEALTH SERVICES REPORT,  1964/65
emphasis on the use of journal literature.   Help was given to the hospital's research
teams in literature search and in obtaining reference material.
In order to make the library's resources available to other Mental Health
Centres in the Province, acquisition lists have been circulated to persons concerned
and cataloguing assistance given when required.
Medical Records Department
The Medical Records Department reports a year of progress in the development of recording procedures to speed the dictation and transcription of case summaries. Forwarding of these case summaries on discharge of patients to the famUy
physician and Mental Health Centres has, as a result, been speeded up and services
to the medical profession in the community improved.
Procedural changes in the Crease Clinic admitting office were initiated, resulting
in more efficient processing of admissions. The Centre Lawn admitting office was
equipped with a duplicating-machine, thus bringing the admitting procedures into
line with those of the Crease Clinic. The reorganization of the Riverside Unit for
male security patients and patients suffering from alcoholism necessitated the
deployment of stenographic staff from the West Lawn Building to maintain the
medical records.
The medical-records staff were able to assist in several surveys and research
projects. Medical records were made avaUable for a research project dealing with
psychotic children under 15 years of age admitted over a 10-year period from the
Greater Vancouver and New Westminster areas. Assistance was also given to the
Dental Department by providing a list of patient deaths occurring over a two-year
period.   From this list they were able to bring their records up to date.
During the year the Medical Records Department was requested to arrange
for transfer of approximately 2,000 medical records from the Crease Clinic stack-
room to a storage area in the Valleyview Hospital.
The Medical Records Committee was active during the year in its efforts to
improve forms and methods employed in the maintenance of the medical records.
Monthly meetings were held in the various units, and routine checks for accuracy
and completeness were made of the files. Some of the recommendations made at
these meetings have been effected with satisfactory results. Considerable time was
spent in the study and development of new admission and discharge statistical sheets
which would meet the demands of medical staff, as weU as tying in with the Dominion
Bureau of Statistics requirements and the hospital's own needs. The new statistical
sheets wUl be placed into use AprU 1, 1965.
In anticipation of the new Mental Health Act, many planning and organizational meetings were held with the senior medical-records staff and administrative
personnel in order that new policies and procedures could be set up to meet the
requirements of the Act. CoincidentaUy, arrangements were made to convert the
serial system of numbering medical records to the unit system, which is to be used
throughout all the mental health facilities after April 1, 1965.
Volunteer Services
One hundred and seventy-two volunteers from the Canadian Mental Health
Association provided 15,022 hours of service to the Provincial Mental Hospital and
Crease CUnic during the year. Thirty-nine volunteers resigned, but an additional 42
were recruited, to give a net increase of three.
The major improvement this year was the relocation of the two apparel-shops
into a building next door to the Volunteer Centre. This three-story building made
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL F 73
it possible to combine both the male and female shops, and its proximity to the
Centre enables service to be given daily. The volunteers have developed a keen
interest and sense of responsibility for the new shop and are working hard to make
it a most attractive setting. In spite of a closure of almost three months due to
remodelling and painting, 1,840 patients were served and provided with 9,660
articles of clothing. An additional service taken on by the apparel-shop since this
move has been the responsibility for clothing needs of the ladies Uving in hospital-
supervised boarding homes. This was previously done by the social service staff and
nursing staff.
The regular socio-recreation programme continued as in the past, with one
most interesting and chaUenging addition. A group of 12 long-term withdrawn and
regressed male patients was invited to the Volunteer Centre one night each week to
discover how they would respond to a group of " non-professional" workers. The
volunteers have been encouraged to try any techniques they beheve would help the
patients. The results of this activity are still inconclusive, but there have been some
notable changes in some of the patients.
As a result of the annual Christmas gift programme sponsored by the Canadian
Mental Health Association, the hospital received over 7,000 presents for distribution
among the patients.
An educational workshop for volunteers was held in October for two days.
The highlight of this workshop was a banquet hosted by the Provincial Government.
The Honourable Eric Martin was the master of ceremonies and assisted in the
presentation of certificates and pins to volunteers in recognition of their various
years of service. Eight volunteers received 10-year pins, which is equal to the
length of time the programme has been in operation.
Volunteers arrange for increasing numbers of patients to attend activities in
the community. Opportunities to send patients to the Queen Elizabeth Theatre continue; patients have gone to private homes for lunch. Shopping trips, pleasure rides,
and picnics have continued. There seems to be an increase in the community desire
to learn and to help, and volunteers plan to take advantage of this keenness.
Forty-two community groups totalling 639 individuals toured the mental health
facihties at Essondale. Many organizations have offered their assistance and shown
sufficient interest to indicate a continuing rise in this number over the next few years.
The forthcoming year will undoubtedly see a number of major changes in
volunteer service to Riverview Hospital.
Business Administration
During the year a number of significant physical changes have been made in
order to improve the facilities of the hospital. The most important of these is the
complete renovation and redecoration of the patients' dining-room facUities and main
kitchen of the West Lawn Building; this dining-room now provides much brighter
and more up-to-date amenities for the long-term male patients, and the main kitchen
with its new equipment brings it up to present-day standards. Work commenced in
the East Lawn Building as the first step toward a programme of improved garbage-
and linen-handling facilities.
In the Crease Clinic a group therapy room with an adjacent observation room
separated by a one-way mirror has been constructed, and this has been widely used
for therapeutic and educational use.
Physical changes were made to the Pharmacy Department so as to separate
the central pharmacy from the unit pharmacy activity. This division has been both
physical and organizational.
 F 74 MENTAL HEALTH SERVICES REPORT,  1964/65
With the development of a boarding-home programme, it is being found necessary to replace patient workers with paid staff. Those patients who previously
worked in our various departments and who contributed considerably to the work
of the departments have been, and are still being, discharged, with the result that
the more deteriorated patients are left to perform the work.
The Business Office over the years has been increasingly involved directly with
the patients, and during the year received and disbursed approximately a quarter of
a million doUars in patients' trust funds. Although much of this activity was handled
through the mails, there were nevertheless about 20,000 transactions carried out
directly with the patient at the counter.
Among its other activities the Business Office receives cheques and sorts personal valuables for patients, and during the year this was done for 4,000 patients.
About 2,000 patients applied to the counter to take out various articles from safekeeping during the time spent in the hospital.
Applications are made on behalf of the patients for pensions including Old Age
Security, Old-age Assistance, Blind, War Veterans' Allowance, and War Widows'
Pensions. A hundred such applications were made on behalf of patients during the
year, and 125 unemployment insurance claims were made on behaff of patients.
About 1,200 patients were given financial assistance at the time of their discharge
from hospital.   Such assistance does not exceed $20 for any one person.
For patients leaving hospital, arrangements were made for 205 travelling to
points outside the Lower Mainland and to distant destinations such as Europe.
Dietary Department
The dietetics administrator reports a year of improvements, particularly with
respect to physical facilities. Some of the activities previously performed by patients
are now performed by staff members who have replaced patients.
The following significant physical improvements have been made, which have
greatly facilitated the continuing provision of a high standard of dietary service:—
(1) The West Lawn Building kitchen and dining-room have been completely
remodelled and renovated. This has included the addition of new cooking
equipment, refrigerated garbage faciUties, increased refrigerator spac?,
and the installation of a completely up-to-date dish-washing machine.
In addition, tray service has been implemented in the A4-C4 dining-room.
(2) The dish-washing room in the North Lawn Building has been renovated,
and as part of an over-all programme a new garburator has been installed.
(3) Ward J4 dining-room in the East Lawn Building has been completely
renovated to provide consolidated facilities consisting of new refrigeration,
heated cafeteria counter, and dish-washing facilities in one convenient
location.
(4) Ward J3 in the East Lawn Building has now a renovated dining-room,
which involved the installation of a new dish-washing machine and improved dining-room facilities.
(5) Although not completed, work commenced in the East Lawn kitchen area
to provide refrigerated garbage facilities.
Industrial Therapy Department
During the year the industrial-therapy staff have worked closely with the Rehabilitation Department personnel, particularly in the field of job assessment and job
training for patients being assessed or prepared for discharge to the community.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL F 75
The facilities and skUled tradesmen in this department have been of great assistance
in this regard.
Improvements and expansion of the various services of the Industrial Therapy
Department have been made, particularly in the electronics division, the print-shop,
and the machine-shop. Six members of the staff have attended night classes at
Vancouver technical schools in order to improve their skills and quaUfications.
During the year 2,797 patients were employed in the trade-shops; 35 on the
average were brought into the department each month. Two hundred and sixteen
were referred to other work areas, and 199 were discharged to the community.
The productivity of the department is reflected in the foUowing figures:—
Manufactured Repaired
Item Items Items
Cabinet Section             521 2,666
Upholstery             303 996
Finishing Section  3,876
Printing Section  2,354,807 2,127
Electronics Section  977
Machine and Metal Section          2,199 3,175
Mattress and Canvas Section          5,262 2,677
Shoe Section             304 2,070
Tailoring Section          9,441 5,130
Uniform Section         9,226 10,070
Dry-goods Section        84,453 	
Mending  89,029
Audio-Visual Department
Plans have been made to show films on Saturdays only in Pennington Hall
instead of twice weekly in order to enable the haU to be kept free during the week
for recreational activities. The Saturday movies are staggered to provide three
showings, thus allowing a large number of patients to attend on a " drop-in " basis.
A weekly broadcast of recorded classical music was started with a view to
expanding this to include a second hour of popular music.
During the year 35-mm. films were shown at Pennington Hall on 141 occasions
to a total of 32,042 patients, and at The Woodlands School on 47 occasions to
12,513 patients. The 16-mm. ward movies continued to be shown at Riverside
Building, North Lawn BuUding, and at VaUeyview Hospital. Each week 16-mm.
films were provided for The Woodlands School, the Provincial Home in Kamloops,
and The Tranquille School.
The educational film library now has 439 registered borrowers, who were sup-
pUed with 1,329 films.
The radio-telephone system has been expanded to 19 mobUe units, one of these
being the ambulance; this ensures that aU the emergency vehicles are on the network. In connection with this, another class of 32 members was trained in radio
operation, bringing the total of trained operators to 214 since the inception of the
programme.
The photographic department, in addition to its regular duties, assisted members of the medical staff and consulting staff in the preparation of scientific papers
for publication by preparing photographs of patients and charts for both prints
and shdes.
 F 76 MENTAL HEALTH SERVICES REPORT, 1964/65
Laundry Department
The laundry manager reports a slight increase in volume of processed Unen
over that of the previous year. There were processed 9,950,215 pounds of laundry
and 133,875 pounds of dry cleaning. This represents an average daily production
of 31,807 pounds.
During the year the sorting area was remodelled, and patient workers who had
previously assisted in the operation of sorting were removed from and completely
replaced by staff members.
New equipment bought for the department included one conditioning tumbler,
two presses, three Sager spreaders, and one washer-extractor for the dry-cleaning
department.
Civil Defence Disaster Organization
The Essondale Disaster Committee continued to meet regularly throughout
the year in order to maintain its organization and preparedness for possible local
emergencies.
Communication and contact by means of correspondence and bulletins were
maintained with the Vancouver Target Zone and Provincial Civil Defence authorities, and through the assistance of these two organizations several staff at Essondale
received training and experience in current policies and procedures in civil defence
disaster planning. During June Dr. Bryson, Essondale Civil Defence Co-ordinator,
attended the Provincial Civil Defence Orientation Course No. 31 for elected municipal representatives and Civil Defence Co-ordinators in Victoria. During the same
month Mrs. M. Marr, Director of Dietetics, attended the Federal civU defence training course in mass feeding for dieticians held at Arnprior. One member of the
Essondale Fire Department staff attended a civil defence rescue course, 32 hospital
staff received basic training in radio-communication from the Audio-Visual Department, and three male staff have completed auxiliary poUce training.
The Disaster Planning Committee studied and completed a written plan for the
emergency housing and temporary care of patients who might require evacuation
from any of the main buildings in the Essondale area for reasons other than protection from nuclear fallout.   A plan for the latter was developed several years ago.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
STATISTICAL TABLES
F 77
Table 1-
CREASE CLINIC
-Movement of Population, Crease Clinic, April 1, 1964,
to March 31, 1965
Male
Female
Total
104
435
44
168
142
519
36
201
3
246
Admissions—
954
Readmissions to a different institution of Mental Health Services	
80
369
Admissions direct from Provincial Mental Hospital, Essondale    	
3
647
759
1,406
751
901
1,652
Separations—
651
9
2
745
14
1
1
1,396
23
Discharged direct to Valleyview Hospital    	
1
Died. 	
3
662
761
1,423
—15
89
-2
140
— 17
229
 F 78                          MENTAL HEALTH SERVICES REPORT,  1964/65
Table 2.—First Admissions to Crease Clinic by Health Unit and School
District of Residence and
Sex, April 1, 1964, to March 31,
1965
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
Metropolitan Health Committee,
Sr4\nn1 nistrirt NO, 1
2
2
r
1
1
2
School District No. 44 	
22
25
47
2
5
7
 45.
7
10
17
1
2
3
University Endowment Lands	
2
.	
2
„       „   18	
2
1
3
Simon Fraser, New Westmin
Selkirk, Nelson—
ster—
School District Nn 7
6
3
9
School District No. 4(1
20
24
44
,.          »       ,i   10
1
1
»  4^
16
28
44
West Kootenay, Trail—
North Fraser Valley, Mission—
•Schnnl nistrirt Nn, 0
1
3
4
fjr-.hnnl District Nn 4?
11
6
17
••          „    I1
2
1
3
„           „       „   75
7
10
17
i,        »   17-
1
2
1       3
„           „       „   76
1
1
„           „        „   13
1
1
2
Srhnnl njstrict N". 71
2
2
School District No. 14
1
2
3
„           „       „   72
3
1
4
„       „   15
3
3
6
1
1
School District No. 50
1
1
23
5
5
„          ,i       ii   W.
3
2
5
,,       u   77
1
1
2
,   53
4
4
North Okanagan, Vernon—
ii           ii       ii   ~—	
2
2
4
School District No. 19	
2
1
3
80
3
3
„ ?n
5
1
3
8
1
Peace River, Dawson Creek—
School District No. 59
5
2
7
..           ,,       „   22
1
1
2
11           ,,        ii   60
2
9
11
1
1
ffrhrvnl TVetrirt N<\ 74
2
3
5
2
1
3
River—
■>           »        ii   30
1
1
School District No. 46	
6
2
8
Cariboo, Williams Lake—
9
4
13
School District No. 27.
3
2
5
 48
4
4
, 28	
Northern  Interior,   Prince
4
2
6
Greater Victoria Metropolitan
Board of Health-
George—
School District No. 61.
12
16
28
2
2
„        „   62	
2
1
3
2
2
 63.    .     .
1
1
2
57
10
10
20
„   64
1
1
„   58.. _       -
2
2
Central   Vancouver   Island,
Upper Fraser Valley, ChilU
Nanaimo—
wack—
School District No. 66
1
_
1
7
10
17
68
4
7
11
„       „   34
g
5
13
„   6"
1
1
2
.,           ,.       „   70
2
3
5
Srhnnl District Nn  35
6
24
2
47
8
71
 79	
School districts not covered by
1
1
m            »i        t,   36	
„   37
3
4
7
health units—
Metropolitan Health Committee,
School District No. 49	
1
3
4
1
1
21
25
46
1
1
„        „   39
171
189
360
6
6
24
53
77
„                    „             ,,     tx __
Tntnls
479
558
1,037
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
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F 87
PROVINCIAL MENTAL HOSPITAL, ESSONDALE
Table 1.—Movement of Population, Provincial Mental Hospital,
Essondale, from April 1, 1964 to March 31, 1965
Male
Female
Total
In residence, April 1,1964	
In boarding homes, April 1,1964       _
1,552
87
139
4
1,254
123
288
2,806
210
427
4
Total as at April 1, 1964 	
1,782
1,665
3,447
Admissions—
497
128
541
9
2
2
488
171
587
14
1
1
985
Readmissions to a different institution of Mental Health Services...	
299
1,128
23
Transfers from geriatric units   	
3
Transfers from schools for mental defectives	
3
1,179
1,262
2,441
Total under care	
2,961
2,927
5,888
Separations—
1,201
70
46
11
78
6
1,281
3
59
32
3
152
2,482
3
Died
129
78
14
230
6
1,412
1,530
2,942
—115
1,437
112
-2
1,252
145
—117
Tn residence, March 11, 1965
2,689
Tn hoarding homra, March 31, 1965
257
 F 88                          MENTAL HEALTH SERVICES REPORT, 1964/65
Table 2.—First Admissions to
Provincial Mental Hospital, Essondale,
by Health Unit and School District of Residence and Sex
, April 1,
1964, to March 31, 1965.
Health Unit
Male 1 Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
Metropolitan Health Committee,
School District No. 1
2
2
4
„       „   ?■
7
8
Schnnl njQtriVt Tvln   18
19
16
35
*
1
„   39
233
290
523
;;    „   X s-
4
8
„        „   41
35
39
74
„   18	
1
2
i,        ..   44
15
32
47
Selkirk, Nelson—
„   45
2
9
11
1
,,   1
4
5
.. s
1
1
School District No. 40
24
24
48
>■   10
1
1
,,           ii        ii   43
11
16
27
West Kootenay, Trail—
North Fraser Valley, Mission—
School District No. 9- _
1
4
5
School District No. 42
7
8
15
5
8
13
,.    7S
5
6
11
,.       •■   12
2
2
South Okanagan, Kelowna—
School District No. 71 	
1
3
4
flc-tinn] pisrrict Nn   14
4
4
..    77
3
4
7
„         „    15
4
1
3
1
7
2
Skeena. P
„        „   73
3
2
5
„   16
i,           „        ,i   17
1
1
School District No. 50
5
5
23
7
7
..   51
1
1
2
,i           ,.        i,   77
1
1
2
»
,,   tft
14
7
4
2
18
9
..   53  	
School District No. 19_
1
3
4
..   54 _	
2
2
„  20..     .    .
1
1
2
2
2
,.    sft
1
1
2
„  ,1
 22
3
5
8
School District No. 59	
4
5
9
i        ,.   lx
1
	
1
„   60	
Coast    Garibaldi,    Powell
2
4
6
South Central, Kamloops—
School District No, 74
8
4
12
River—
>i   25
1
1
1
1
School
nicctricf Tvln   4«
2
6
1
1
3
7
 ,   26
„           „        „   29
2
5
2
2
4
7
Greater  1
,,   48
1
1
2
„   30	
/ictoria Metropolitan
..   11
1
4
5
Board of Health-
School District No. 61	
27
13
40
Cariboo, Williams Lake—
School District No ?,7
11
5
16
67
1
3
4
„   28...
3
1
8
11
1
■•
,,   fii
1
1
1
 82	
„   64	
Northern   Interior,   Prince
Central   Vancouver   Island,
George—-
Nanaimo—
School District No. 55 .
2
2
School District No 65
4
3
7
„            „        „   56
1
21
1
8
2
29
"
„   66.     .     .
1
1
2
3
3
4
„         .,   57
„   67	
Upper Fraser Valley, Chilli-
„   68
5
4
9
„   69
2
2
4
3
2
5
n     7(1
2
4
6
33
7
10
17
„   79
1
1
„   34	
4
11
15
School districts not covered by
Boundary, Cloverdale—
health units—
School District No. 35. .
8
13
21
School District No. 49	
1
2
3
„   36
31
4
33
5
64
9
Unorgani,
Ex-Provin
1
1
23
1
15
2
38
„        u   ,7
'otals	
636
672    | 1,308
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 F 100
MENTAL HEALTH SERVICES REPORT,  1964/65
PART III.—THE WOODLANDS SCHOOL, NEW WESTMINSTER
REPORT OF THE MEDICAL SUPERINTENDENT
J. S. Bland, Medical Superintendent
The past year has been notable for increased communication and co-operation
with the community. An Out-patient Department has been opened and joint
projects with the Department of Social Welfare have led to the placement of selected
children in foster homes and suitable adults into boarding homes. In addition,
liaison with both Provincial and municipal public health authorities has brought
about greater involvement of the community in the selection and recommendation
of cases requiring admission or other services. Within the school there have been
additions to both the therapeutic and educational programmes.
On April 1, 1964, there were 1,339 pupils on the register at The Woodlands
School, with 1,318 registered at the end of the year. The slight decrease was due
to an excess of patients transferred to The Tranquille School over the admission
rate.    The following table shows the movement of population during the year:—
Male
Female
Total
715
1
13
592
8
10
1,307
In boarding homes, April 1, 1964 -  -	
9
23
Total as at April 1, 1964    .             _   .
729
610
1,339
Admissions—
I   136
2
10
86
7
3
222
Transfers from The Tranquille School  	
9
13
148
96
244
Total under care — -	
877
706
1,583
Separations—
]      64
S
13
30
2
16
33
5
93
1
8
97
Discharged in full from temporary care 	
Died         —              _-_.-.
18
123
3
24
125
140
265
Net increase or decrease....
+27
742
10
—52
540
26
—25
1,282
36
In boarding homes, March 31,1965  	
For administration to be efficient, basic facts are required. Two surveys were
conducted during the year—one to better understand the type of service being
requested and the other to examine the characteristics of the present population.
At the beginning of the year the waiting list consisted of 845 names. The
composition of the list was, however, obscure. By means of a questionnaire, the
list was examined and the official " waiting list" was redefined. The list now consists of those who, in the opinion of their near relatives or professional advisers,
require immediate institutional care.
An examination of the present population showed a high proportion of those
suffering from severe mental retardation; thus 74 per cent of the residents fit into
 THE WOODLANDS SCHOOL F  101
the category of severely or profoundly retarded, 17 per cent moderately retarded,
and only 9 per cent mildly retarded. Epilepsy (30 per cent), cerebral palsy (23
per cent), and mongolism (14 per cent) were the common physical handicaps.
Nearly 20 per cent of the population is severely handicapped and bedridden.
The medical staff have continued their high standard of medical, p_ediatric,
and psychiatric care. In addition to the clinics and pathological conferences previously held, medical grand rounds were started in December. Important topics
are presented and discussed, with invitations being extended to medical staff in
the other mental health facilities and in the community. Regular medical-staff
meetings are held twice monthly.
The Out-patient Department was opened in November, 1964. By the end of
the year 120 patients had been seen. The majority of these (90) were from the
waiting list, the others being referred by community agencies. The age range was
wide, being from infants to the middle aged. The functional level was also wide,
although the majority were in the severely and profoundly retarded group. Owing
to geographical location, the large majority of referrals came from the Fraser
Valley area, but a small percentage was referred from elsewhere in the Province.
During the year the emphasis was on initial assessment and recommendations for
management rather than follow-up and continuing service.
During 1964 we were fortunate in having no major epidemics, and this particularly helped the laboratory, which was able to concentrate on biochemical procedures. There was a 70-per-cent increase in biochemical tests, and these included
new urinary screening tests for biochemical disorders. In addition, it was possible
to arrange a buccal smear for sex chromatin of all admissions. In conjunction
with the University of British Columbia, a technician is presently being trained to
establish a separate chromosomal laboratory at The Woodlands School.
Co-operation with the University Department of Paediatrics has led to the
establishment of two new clinics. In February a Genetic Clinic was organized to
provide counselling to parents. This takes place twice monthly, as does the
Audiology Clinic, which was established later in the same month. Both these
services are necessary, and we are grateful for their provision.
The increase in awareness of psychiatric disability in both residents and their
parents has put a great strain on the psychiatric services. In addition, the opening
of the Out-patient Department has stressed the need for increased psychiatric consultation. Despite these demands, there has been an increase in group meetings,
both of staff and patients. The " Mirror Room " project mentioned in last year's
report has continued but has yet to be evaluated. The results, however, have been
sufficiently favourable to warrant the use of the " Mirror Room " in day-to-day
treatment of the autistic child.
The Psychology Department has become stabilized during the year. The
staffing situation has improved, and the staff are to be congratulated on furthering
their education during their own time. Referrals for assessment have increased,
and the department has played a major role in initiating new programmes and
supervising research. In addition, it has helped in improving communication between the different departments in the school.
There have been major changes in the nursing service during the year. A
Director of Nursing was appointed in May, 1964, and has been responsible for
reorganizing and integrating the previous male and female nursing departments.
The stage is now set for unitization of nursing personnel in line with general reorganization of the school services into separate units. Ward integration was also
started, with male nurses working on female wards for the first time.   An adequate
 F 102 MENTAL HEALTH SERVICES REPORT,  1964/65
in-service education programme for psychiatric aides has been continued. The
standard of nursing remained high. In addition, the department played a major
role in the development of community placement of pupils into both foster homes
and boarding homes.
The academic school has continued its programme with approximately the
same enrolment (200) as last year. The teachers have played a considerable part
in community education and, in addition to participating in staff workshops, have
received over 800 visitors to the Education Department. Play-to-learn classes
have proceeded as last year, and the teacher in charge held a successful farm project
in Abbotsford during the summer. Here again community interest was great, and
over 1,000 visitors toured the classroom.
The Occupational Therapy Department was able to extend its activities in
two directions. A programme was started for blind pupils, and a separate programme was initiated for the cerebral palsied and multiple handicapped. Monthly
visits were also paid to the boarding homes to supervise their activities.
The Recreational Therapy Department extended its activities, particularly in
the community. A successful venture was the award won by the square dancing
team in the Northwest Square Dance Festival. The Woodlands team entered under
a pseudonym and was not known to be in any way handicapped. An ice-skating
project was started at the local ice rink through the generosity of the New Westminster Board of Parks and Recreation.
After stability for two years, the Social Service Department had several staff
changes during the year. The establishment, however, was increased to 11 in the
fall. Much time during the year was spent in initiating, refining, and developing
new arrangements with public health and social welfare personnel concerned with
screening applications for admission. The gradual shedding of the load of preadmission work will release social-work time for in-patient service and follow-up.
The department has been active in community placement and largely responsible
for the 18 children presently placed in foster homes and 24 adults in boarding
homes. These two schemes have proved most successful. The initial screening
has also been carried out for patients thought suitable for nursing-home placement.
The promising start made in community involvement has been dependent on good
co-operation, and the department has spent much time on orientation of professional
groups.
The Business Administrator has had a busy year. Both housekeeping and
dietary services were reorganized into separate departments and have increased the
school's standards. An effective in-service training programme was started for
both areas. In addition to ward services, the main cafeteria was reorganized to
cater exclusively for pupils, many of whom are now eating off the ward for the
first time. Despite space limitations, the Industrial Therapy Department continued
its wide and varied programme. The Medical Records Department maintained
its high standard of service despite an almost complete turnover in staff.
The main projects undertaken by the Public Works Department during the
year were renovation of some of the older wards and the public works buildings
together with alterations of part of the Fraserview Building to accommodate the
Out-patient Department. In addition, other changes were made in the Fraserview
Building to improve office space and to facilitate the transfer of the admitting suite
to that area.
Volunteer participation was greatly increased this year. Up to the end of
March, 1965, there were 80 persons actively engaged as volunteers. A new centre
for volunteers was opened in the Administration Annex.    Thanks are again due
 THE WOODLANDS SCHOOL
F 103
to the Provincial auxiliary for their ever enthusiastic help. The Coordinator of
Volunteers was responsible for successfully organizing the increased volunteer staff
and also for arranging 17 orientation tours for lay personnel.
We are grateful to our chaplains for their continued service. During the year
more pupils attended local church services, and this was helpful in increasing understanding and tolerance.
Research has continued throughout the year and has been wide in scope. Previous investigations into phenylketonuria were extended in co-operation with the
University of British Columbia. The study of the therapeutic effect of " Mirror
Room " technique in autistic children was completed. Adminstrative research
consisted of the waiting-list analysis and a complete ward survey as previously
mentioned. A start was made on an epidemiological study of the problem of mental
retardation within the Province.
In summary, the year showed encouraging advances in many areas, and we
are grateful to numerous outside agencies for their help and co-operation. Much
remains to be done in both internal programming and outside service. The ground
has, however, been prepared for reorganization of the school into separate functional
units, for the development of a separate unit for autistic children, for the placement
of older patients into nursing-home accommodation, and for greater co-operation
with both university departments and community service agencies.
STATISTICAL TABLES
Table 1.—Movement of Population, The Woodlands School,
New Westminster, April 1, 1964, to March 31, 1965
Male
Female
Total
715
1
13
592
8
10
1,307
In boarding homes, April 1,1964      '	
9
23
Total as at April 1,1964 	
729
610
1,339
Admissions—
78
4
54
2
10
52
1
33
7
3
130
5
87
9
Transfers from Provincial Mental Hospital, Essondale     	
13
148
96
244
877
706
1,583
Separations—
7
57
13
30
2
16
5
28
5
93
1
8
'          12
85
Died....     . 	
18
Transferred to The Tranquille School	
123
Transferred to Provincial Mental Hospital, Essondale
3
24
125
140
265
Net increase nr riprrpnsp.
+27
742
10
—52
540
26
25
In residence, March 31, 1965	
1,282
36
In boarding homes, March 31, 1965 	
 F 104
MENTAL HEALTH SERVICES REPORT,  1964/65
Table 2.—First Admissions to The Woodlands School by Health Unit and
School District of Residence and Sex, April 1, 1964, to March 31, 1965
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
Metropolitan Health Committee,
School District No. 2 	
1
1
Vancouver—Continued
Selkirk, Nelson—
School District No. 44	
5
2
7
School District No. 7.....
1
1
1
1
„   45.
2
—
2
„   8 	
„   10	
1
1
ster—
West Kootenay, Trail—
School District No. 40	
1
1
2
School District No. 11	
1
3
1
4
1
„          „       ,.  <M
1
2
3
 12	
North Fraser Valley, Mission—
South Okanagan, Kelowna—
School District No. 75	
1
1
School District No. 23	
2
2
4
Upper Island, Courtenay—
North Okanagan, Vernon—
School District No. 71 	
1
1
School District No. 19	
1
1
2
„   72. _
1
1
„   20
1
1
„   22 -
1
1
2
School District No. 52 _..
2
2
,.   78
1
1
„   54 	
1
1
2
South Central, Kamloops—
 80	
1
1
School District No. 24	
4
2
6
Peace River, Dawson Creek—
„   26	
1
.
1
School District No. 60	
1
1
2
Cariboo, Williams Lake—
Coast    Garibaldi,    Powell
School District No. 27  	
1
1
2
River—
School District No. 47 _..
1
Northern   Interior,   Prince
1
George—
„   48.    ...
2
2
School District No. 56	
1
1
Greater  Victoria  Metropolitan
„   57	
2
3
5
Board of Health-
„   58....	
1
1
School District No. 61	
3
3
6
Upper Fraser Valley, Chilli
 62...	
1
1
wack—
Central   Vancouver   Island,
School District No. 32	
1
1
Nanaimo—
33
3
1
4
School District No. 65	
3
3
„   34	
1
2
3
„   66	
2
2
Boundary, Cloverdale—
 68	
1
2
3
School District No. 35	
1
1
2
„   69	
1
1
„   36 _-	
10
3
13
 ,   70 _
2
1
3
 ,   37 	
1
1
2
School districts not covered by
Metropolitan Health Committee,
health units—
School District No. 49	
2
2
School District No. 38	
3
1
4
„   39	
15
13
28
Totals	
91
60
151
„   41	
8
3
11
 THE WOODLANDS SCHOOL                                           F 105
Table 3.—First Admissions and Readmissions to The Woodlands School by
Method of Admission, Age-group, and Sex, April 1, 1964, to March 31,
1965.
Age-group (Years)
Total
Method of Admission
Under
1
1-3
4-6
7-9
10-14
15-19
20-29
30-39
40 and
Over
cd
O
H
•o
c
2
0
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
m.If.
1
M.
F.
M.
F.
M.
F.
1
M.|F.
1
First Admissions
Certification             _
Temporary	
Totals...	
—
2
10
6
11
1
10
11
2
7
20
1
8
4
24
1
13
	
2
3
1
1
1
4
1
6
1
13
78
14
46
27
124
_    || 12|    6| 11| 11
11|    9| 20|    9| 28| 14
• 1    2|    4|    2|    5|    7
91| 60|   151
Readmissions
Certification	
Urgency	
Temporary.	
Totals	
1
2
3
g
5
6
1
8
4
5
5
1
15
3
2
1
9
1
1
2
3
2
......     3
1
13
1
43
18
18
31
1
61
	
1
1
3
11
11
9
9
21
5
10
2
2
5
3
1
57
36
93
Table 4.—First Admissions and Readmissions to The Woodlands School by
Mental Diagnosis, Age-group, and Sex, April 1, 1964, to March 31, 1965
Age-group (Years)
Total
Mental Diagnosis
Under
1
1-3
4_6
7-9
10-14
15-19
20-29
30-39
40 and
over
3
o
H
X)
c
CCJ
O
M.
F.
M.
F.
M. F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
First Admissions
Mental deficiency—
Profound	
Severe	
Moderate	
Mild	
5
7
3
2
1
6
1
3
1
1
10
1
4
3
2
1
2
3
3
1
2
8
4
4
1
1
2
1
5
1
2
12
12
2
1
1
7
4
1
	
1
1
1
2
1
~2
1
1
2
1
1
1
4
18
23
25
19
S
11
20
22
6
1
29
43
47
25
6
Schizophrenic disorders	
Totals..	
1|....|     1
91| 601 15U
_    |      | 12|    6| 11| 11
11|    9| 20!    9\ 28|  14
|   2|   4|   2|    S|   6
Readmissions
1
Mental deficiency—
Profound 	
Severe	
Moderate-	
Mild	
Mongolism 	
Totals	
1
1
2
3
6
1
1
1
9
1
8
1
2
5
2
1
7
9
4
1
3
1
4
3
2
1
1
1
2
1
2
1
1
—
	
1
1
5|    5
271 21
16|    7
3|    2
6|    1
10
48
23
5
7
—
—
3
1
3
11
11
9
9
21
5
10
2
2
5
—
......
3
1
57| 36|   932
1      1
1 Includes 30 males and 19 females with epilepsy—14 profound, 20 severe, 7 moderate, and 8 mild.
2 Includes 20 males and 15 females with epilepsy—7 profound, 18 severe, 7 moderate, and 3 mild.
Table 5.—First Admissions to The Woodlands School by Religion and Sex,
April 1, 1964, to March 31, 1965
Table 6.—First Admissions to The Woodlands School by Previous Occupa
tion and Sex, April 1, 1964, to March 31, 1965
Detailed information for the above tables may be obtained on request.
 F 106
MENTAL HEALTH SERVICES REPORT, 1964/65
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 THE WOODLANDS SCHOOL
F 107
Table 9.—Live Discharges from and Deaths Occurring in The Woodlands
School by Mental Diagnosis, Age-group, and Sex, April 1, 1964, to
March 31, 1965.
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 Discharges
Mental deficiency—
2
2
3
2
3
3
1
6
~~6
1
4
2
1
6
11
1
5
1
1
13
13
2
1
11
9
4
1
2
2
1
1
7
3
1
	
2
33
28
19
12
2
1
1
4
61
43
7
11
1
4
Severe	
9
5
6
3
1
1
16
16
1
8
1
5
8
8
1
94
71
Mild  	
26
23
2
Primary  childhood behav-
1
Other and unspecified types
—
	
2
Totals	
..._|....|    2|    2
11|    7
7|    7
241 291 251 42
22| 26|    5| 12
 1    2
96
127
223
Deaths
Mental deficiency—
1
1
2
3
1
1
1
2
1
1
2
1
8
2
2
1
5
13
—
	
2
Mild	
2
Mongolism	
	
	
	
1
	
	
	
	
	
1
Totals	
1 1    1|	
11...
2|    3
|    1|    3|
si—r ii -
2|    1
13|    5
18
Table 10.—Live Discharges from and Deaths Occurring in The Woodlands
School by Mental Diagnosis, Length of Stay, and Sex, April 1, 1964,
to March 31, 1965.
Detailed information for the above table may be obtained on request.
Table 11.—Deaths Occurring in The Woodlands School by Cause of Death,
Age-group, and Sex, April 1, 1964, to March 31, 1965
Age-group (Years)
Cause of Death
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.
1
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Epilepsy and all other
diseases   of  the   nervous system and sense
organs	
Arteriosclerotic and degenerative heart  disease—	
1
1
1
2
1
1
1
...
1
	
1
1
1
5
1
2
1
1
2
1
2
1
2
7
1
2
1
Diseases of the genito-
	
1
	
	
1
2
Infections of skin and
subcutaneous tissue	
All   other   diseases   of
skin   and   musculo-
1
1
—
1
1
	
	
	
1
1
Congenital  malforma-
2
Accidental death.. _
	
	
	
	
1
Totals	
......I     11 1     11. ...
31    31 .   1    11    2:...
31. 1    11 1    21    1
131     51     18
Table 12.—Deaths Occurring in The Woodlands School by Cause of Death,
Length of Stay, and Sex, April 1, 1964, to March 31, 1965
Detailed information for the above table may be obtained on request.
 F 108
MENTAL HEALTH SERVICES REPORT, 1964/65
PART IV.—THE TRANQUILLE SCHOOL, TRANQUILLE
REPORT OF THE MEDICAL SUPERINTENDENT
A. J. Bennee, Medical Superintendent
GENERAL
The patient and staff populations of The Tranquille School have grown considerably in the year, and with these have come the development of a new department
(Habilitation) and expansion of existing departments. The patient population has
risen from 469 to 571. The staff population has risen from 183 to 236. With the
current concept that the more mildly retarded should be living in the community,
the role and responsibility of the Habilitation Department has become an essential
and vital one, as has the patient placement responsibilities of the Social Service
Department.
Preparations were made for the erection of a 100-bed building for severely retarded, and it is expected that construction will be completed in the spring of 1966.
The renovations to the Deerholme Building were completed in February, and
soon after it was filled with trainees. The renovations to the East Pavilion Building
are almost completed and will be used mainly as offices for our expanding administration. When staff move in, there will be no vacant buildings remaining on the
grounds and we shall be filled to capacity.
The current policy is to admit patients who could be cared for in the type of
building available. With the exception of the new building which is now being
erected, none of our present wards is suitable for severely retarded patients. For
this reason, future transfers will have to be limited to the moderately and mildly
retarded group (except for the 100 who will be accommodated in the new building
next year).
PATIENT POPULATION
Male
Female
Total
311
1
158
469
1
Total as at April 1, 1964	
312
158
470
Admissions—
30
1
93
1
123
Transfers from Provincial Mental Hospital, Essondale	
1
32
93
125
Total under care 	
344
251
595
Separations—
Discharged in full  —
1
4
2
2
1
7
1
1
5
9
3
9
9
18
+ 18
329
6
+84
242
+ 102
571
In boarding homes, March 31, 1965                  	
6
 THE TRANQUILLE SCHOOL
MEDICAL
F  109
Dr. G. Tomm is still visiting on a part-time basis.
The health of the trainees has been remarkably good and even the small outbreaks of diarrhoea and vomiting have been much less evident.
The X-ray equipment is almost ready for use.
We are continuing to guest committed patients overnight from the community
who are awaiting transport to the Provincial Mental Hospital, Essondale. This is
done at the request of the Royal Canadian Mounted Police to avoid having to hold
them in gaol.  Twenty-five such patients were accommodated during the year.
DENTAL
Dr. N. Wilson and Dr. D. Vogel are working one morning per week each. All
patients have been surveyed now, and urgent dental work has been completed. The
less urgent work is now being attended to.
MEDICAL RECORDS
During most of the year the Medical Records Clerk was also acting as stenographer for the Director of Nursing. She has now been relieved of this extra duty
and is devoting all of her time to medical records.
NURSING
Two new wards were opened during the year—a 40-bed cerebral palsy bed-
care area and a 48-bed building for mildly retarded girls to act as a stepping-off
point for placement in the community.
Staff was seconded by nursing to the Habilitation Department in order that they
could function effectively. Nursing staff are enthusiastic about the programme to
habilitate trainees into the community.
The orientation programme has been expanded so that staff have a better concept of their role in relation to other departments. Nursing staff volunteer much
of their time for the benefit of trainees; were it not for this, the camp programme,
Christmas, carnival, Easter, May Day, etc., would not be the success that they are.
The Nursing Department has been divided into three areas, each with its own
supervisor.
Much staff effort has gone into providing a homelike atmosphere for the
patients, and house mothers have been provided to give the feminine touch where
possible.
SOCIAL SERVICE DEPARTMENT
One of the main services has been to encourage relatives to maintain contact
with trainees and investigate the possibility of resettlement in homes. Four trainees
have been returned to their homes.
Working in collaboration with the Habilitation Department, six trainees have
been transferred to the Provincial Men's Home in Kamloops and 16 to The Woodlands School for placement in boarding homes.
Nineteen trainees have been employed in various jobs, and a number of community agencies have been contacted. One of the main areas of concern at the
moment is that of finding and licensing of boarding homes in the Kamloops area.
 F 110 MENTAL HEALTH SERVICES REPORT,  1964/65
HABILITATION
This department was organized in June, 1964, for the purpose of co-ordinating
all aspects of patient training, selection, preparation for community placement, and
placement in work areas in the institution. The Co-ordinator of Habilitation (Mr.
Hayes is acting in this position at present) is administratively responsible for recreational therapy, handicrafts, chaplaincies, Kamp Kiwanis, Scouts and Guides, and
the newspaper. He is also responsible for training and assessment of students in
the occupational classes in Kamloops who attend The Tranquille School for job
training. Each student works for a five-week period, and a total of 12 students
was involved during the year.
A contract was made with the Gyro Club of Kamloops to provide it with $250
worth of baskets and jewellery manufactured by the patients.
Male Handicraft
The average monthly attendance is 751.
Woodworking and crafts classes are held and simple diversional programmes
for the lower-grade patients.
Female Handicraft
The average monthly attendance is 832.
Mrs. Chapman also operates the patients' library, a domestic science area, and
a hobby club. On visitors' day, goods manufactured by the trainees were sold for
approximately $500.
Recreational Therapy
The average monthly attendance is 3,368. Latterly, a good deal of emphasis
has been placed on staff recreation.
Various community groups provided entertainment for the trainees. The
annual carnival in September was the highlight of the year.
Chaplaincy
In September Dean Jolley resigned his position as chief Protestant chaplain
and was succeeded by the Reverend MacRae. The trainees are divided into four
classes, depending on their functional ability. Those trainees who are pending community placement are encouraged to attend the church of their own particular
Protestant denomination in the community.
Bishop Harrington and the sisters who assist him provide training for the
Roman Catholic patients.
Boy Scouts
There are now 24 boys enrolled and the troop is active, as is also the Group
Committee.
Girl Guides
There are now 20 girls enrolled. This troop also has its own Group Committee and is a real going concern.
Kamp Kiwanis
On August 14, 1964, the Kiwanis Club officially donated the use of a quarter-
section ranch on the Red Lake Road, 14 miles north of The Tranquille School.
During the summer, approximately 150 patients were able to spend time at the camp
and thoroughly enjoyed this.   In conjunction with the camp operation, a Christmas-
 THE TRANQUILLE SCHOOL F 111
tree farm licence has been obtained from the Forest Service, and a number of
trainees are being employed for the harvesting of Christmas trees.
Patient-training
Trainees continue to be used very effectively in the laundry and dietary areas
and somewhat by the Department of Public Works and the Department of Agriculture on The Tranquille School grounds. Beaverdell and Deerholme Buildings are
the final stepping-off places for boys and girls respectively, where they are trained
socially and functionally before placement in the community.
VOLUNTEER SERVICES
During the year there has been a gratifying growth of projects and contributions of time and material. There are presently 154 active volunteers, a growth of
38 in the last year. The annual banquet for volunteers was attended by 160 people.
Mr. Clow, the Co-ordinator, was instrumental in arranging for the donation of the
Kamp Kiwanis.
The R.C.A.F. station in Kamloops was very helpful, as were many other volunteer groups. Tickets have been arranged for almost all sporting events at a reduced
rate or no cost to the trainees.
BUSINESS
Staff
Total strength, April 1, 1964  183
Total strength, March 31, 1965  236
Separations for the year to March 31, 1964  56
Separations for the year to March 31, 1965  87
Recruited for the year to March 31, 1964  126
Recruited for the year to March 31, 1965  140
Fire Protection
A basic rescue course was conducted by the Fire Department under the direction of the civil defence organization.
A one-day fire college was hosted by the Tranquille Fire Department for 168
delegates.
Inspectors from the Provincial Fire Marshal's office made a complete survey
of the institution.
Regular fire drills and testing of equipment were carried out, and all new staff
are oriented.
A number of staff continue as auxiliary volunteer fire-fighters.
Dietary
Mrs. Koreen, Chief Dietician, came on strength in May, 1964, and has been
a real asset.
Mr. Scott, the Head Cook, who acted as dietician for five years until the
arrival of Mrs. Koreen, will retire at the end of this year after 42 years' service at
Tranquille.  This is an outstanding record and worthy of commendation.
The kitchen and dining areas are strained almost beyond capacity. Plans are
well on the way to completion for tenders to be called for the construction of a new
kitchen and dining area.
 F 112
MENTAL HEALTH SERVICES REPORT,  1964/65
Laundry
Laundry is still also being done for the Provincial Men's Home. In May,
1964, it was necessary to commence a seven-day work-week.
There is an increase over last year of 40 per cent in the quantity of laundry
processed.
Transportation
One additional driver has been employed during the year, and a new Volkswagen passenger bus was purchased.
Grounds, Buildings, and Housing
Work has commenced on the construction of a large new playing-field south
of the male staff residence and is progressing.
Central Building is constantly requiring repairs and renovations. Deerholme
Building was completely renovated and furnished. East Pavilion Building, when
completed in June, 1965, will be used as a second administration building.
A large amount of additional facilities was added to various buildings throughout the institution. The co-operation of Public Works Department in this regard is
appreciated.
Commissionnaire services continue satisfactorily and are now expanded to
include a year-round service on week-ends and holidays.
Telephone Service
A 120-position board has been installed by the British Columbia Telephone
Company.   It is expected that a semi-automatic system will be installed next year.
STATISTICAL TABLES
Table 1.—Movement of Population, The Tranquille School,
April 1, 1964, to March 31, 1965
Male
Female
Total
311
1
158
469
1
Tntjil as at April 1, 1964
312
158
470
Admissions—
Readmissions to the same institution
1
30
1
93
1
123
Transfers from Provincial Mental Hospital, Essondale  —_ 	
1
32
93
125
344
251
595
Separations—
1
4
2
2
1
7
1
1
Tlicrl
5
9
3
9
9
18
+ 18
329
6
+84
242
+ 102
In residence, March 31, 1965
In boarding homes, March 31,1965
571
6
 THE TRANQUILLE SCHOOL
F 113
Table 2.—First Admissions and Readmissions to The Tranquille School
by Mental Diagnosis, Age-group, and Sex, April 1, 1964, to March
31, 1965.
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.'
i
m.;
F.
M.
F.
M.
F.'
M.
F.
M.
F.
M.
F.<
M.'
F.
M.
F.
M.
F.
First Admissions
Mental deficiency—
Idiocy and imbecility-
2
1
1
5
4
1
12
5
3
6
15
2
13
3
2
11
3
10
5
1
1
1
2
1
1
2
6
2
1
2
10
8
12
1
20
36
10
26
1
30
44
Border-line intelligence   	
Mongolism
Other and unspecified
types   	
22
26
2
Totals	
II -1 1 1
_..|    3|    1| 22|    8| 36
16| 20|    5|  10|    1|    2
311 93|    1241
Readmissions
Mental deficiency—
Moron    	
—
1
- 1 -
1
1
1
1
- 1	
1
1
1 Includes 1'6 males and 25 females with epilepsy—18 idiocy and imbecility, 11 moron, 11 border-line intelligence, and 1 mongol.
Table 3.—Resident Population of The Tranquille School by Mental
Diagnosis, Age-group, and Sex, December 31, 1964
Age-group (Years)
Mental Diagnosis
4-6
7-9
10-14
15-19
20-29
30-39
40-49
50-59
60-69
Grand
Total
M.
F.
1
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M
F.
M.
F.
M.
F.
M.
F.
Mental deficiency 1—
Imbecility	
Moron	
Border-line intelli-
2
	
3
1
18
1
5
16
6
3
10
4
4
55
35
6
33
18
21
5
21
1
34
28
3
14
1
17
17
4
9
23
16
3
4
13
13
1
5
9
7
2
1
10
4
1
1
1
2
2
160
93
15
56
7.
61
10
40
11
1
236
154
215
Mongolism	
Other  and  unspecified 	
96
Chronic   brain   syndrome, N.O.S	
1
1
1
Totals    .
2
3
1
19
5
25
18
129
66
80
47
46
32
19
16
2
4
325
189
514
1 Includes 51 males and 34 females with epilepsy.
Table 4.—Resident Population of The Tranquille School by Mental
Diagnosis, Length of Stay, and Sex, December 31, 1964
Detailed information for the above table may be obtained on request.
 F 114 MENTAL HEALTH SERVICES REPORT,  1964/65
PART V—GERIATRIC DIVISION
REPORT OF THE MEDICAL SUPERINTENDENT
J. Walsh, Medical Superintendent
During the year a total of 1,823 elderly persons received special care and
treatment in the three hospitals of the Geriatric Division, an increase of 138 over
the previous year. Four hundred and seventy-six applications for admission were
received, an increase of 54. Of this number, 398 were for Valleyview Hospital (an
increase of 64), 72 were for Dellview Hospital (a decrease of 7), and 6 were for
Skeenaview Hospital (a decrease of 6).
Actual admissions to the three hospitals totalled 559, an increase of 131. Of
this number, 480 were direct admissions from the community, an increase of 147.
In addition, 79 patients were received on transfer from other Provincial mental
health facilities. This latter group mainly consisted of geriatric patients who had
recently been admitted.
Separations due to death totalled 435, an increase of 84, and a total of 174
patients were returned to the community, an increase of 107.
The resident population of the three hospitals as of March 31, 1965, numbered
1,282, an increase of 16 over the previous year. To this figure may be added 150
patients who returned to the community but were still on the hospital register,
making a total of 1,432.
VALLEYVIEW HOSPITAL, ESSONDALE
Valleyview Hospital is the largest of the three hospitals of the Geriatric Division, and the majority of patients admitted are from the Lower Mainland and
Vancouver Island. The total number of beds is 791. The total complement of
staff is 428.
A total of 472 patients was admitted, an increase of 145 over the previous
year. This represents a very considerable increase in the work load for all departments dealing directly with patients.
Although 65 per cent of the hospital's beds are now devoted to women patients,
the problem of coping with the demand for beds for women is persistently greater
than that for beds for men. This is accounted for to some extent by the fact that
the average length of stay in hospital of those who died and those who returned to
the community is greater for women than for men—six months for those who died
and seven months for those who returned to the community.
During the year 144 patients were returned to the community, an increase of
85 over the previous year. Of this number, 14 were returned to hospital, though
not necessarily all because of a recurrence of their illness. Six of these were again
placed in accommodation more acceptable to the patients and their relatives within
a short time. Careful consideration is given to the placement of each patient, and
continuing advice and assistance are made available to the patients and others
responsible for their care.
The return to the community of those patients who recover or improve sufficiently to do so is an essential part of any programme for the care and treatment
of psychiatric illness in the aged if the programme is to meet the needs of that
community at the time they require it.    Detention of aged patients in hospital
 GERIATRIC DIVISION F 115
unnecessarily, as well as being unjust to the patient, is contrary to all modern mental
health legislation, including our own. For the patient, the knowledge that he can
return to the community, if well enough, is a factor of the greatest importance in
treatment.
An active-treatment and rehabilitation programme utilizing modern techniques,
as indicated, is maintained. Ataractic and anti-depressant medications, electroconvulsive therapy, as weU as individual and group psychotherapy are available.
The arousal and maintenance of interest and the encouragement of activity
both physical and intellectual are important factors in hastening readjustment as
well as preventing social deterioration. Integration of male and female patients on
convalescent wards has been beneficial.
A high standard of medical care has been provided. The services of specialist
consultants are available from Riverview Hospital visiting staff as required.
The nursing staff have continued to provide a good standard of nursing care.
Co-operation with other departments and assistance where possible has enhanced
the treatment programme. Full advantage has been taken of opportunities for in-
service training. The curriculum for student nurses has been extended to include
convalescent wards. This extension gives the student nurse a comprehensive picture
of geriatric nursing.
The advent of a public health nurse under the direction of the Provincial
Occupational Health Officer has proved to be of value in health matters concerning
staff. A full inoculation of all staff against influenza, on a voluntary basis, was
completed. This nurse is available for counselling in occupational health matters
on request.
In the social service pre-admission area, a reduction in pressing demands for
admission led to a decrease in activity. Advice and help enabled relatives and
friends to find suitable alternate placement for 62 persons who were willing and
capable of using other community resources rather than coming into hospital.
In the post-admission area, social service activity has increased considerably,
the main effort being devoted to preparation of suitable patients for return to the
community. Because of Old Age Security benefits, elderly persons are rarely destitute. Many have income or assets in addition. Of the 144 patients returned to the
community, 81 had adequate means to meet care costs, whether in private care in
their own home or previous place of residence, in boarding homes, or in nursing
homes. Twenty-nine patients returned to the same financial status as before admission, and only five patients were fully dependent on social assistance. The remaining
24 required special supplement to meet boarding-home and nursing-home costs.
Post-discharge social services also showed a marked increase. Improved communications within the hospital, with relatives and friends, and with professional
persons and social agencies in the community have improved service to patients
after they leave hospital. The hospital has made its services immediately available
should the need arise. In addition to their work with patients, the social service
staff have made themselves available to interested persons who wish to visit the
hospital and learn of its facilities and programme. A total of 132 persons was
oriented to the hospital in this way.
The School of Social Work of the University of British Columbia has again
used the facilities of the hospital for a student placement.
The X-ray Department, under the supervision of a visiting radiologist, has
provided satisfactory service. Of 4,420 films taken, about 40 per cent consisted of
chest X-rays in accordance with a policy of regular annual surveys for tuberculosis
in patients and staff.
 F 116 MENTAL HEALTH SERVICES REPORT,  1964/65
The laboratory, under the supervision of the pathologist at the Provincial
Mental Hospital, provides adequate service, with the exception of bacteriology,
which is referred to the Provincial Mental Hospital. The work of the department
has increased considerably due to the increased admission rate.
A recreational-therapy programme specially designed for elderly persons can
be a valuable aid to treatment. Such a programme has been available and is being
more and more adapted to the patients' special interests and abilities.
The Occupational Therapy Department has extended its services to a maximum,
and the number of patients reached by this form of treatment has shown a sharp
increase. There is need for more involvement of nursing staff wherever possible.
Canadian Mental Health Association volunteers have provided some assistance.
The Dietary Department has provided a good service, and a variety of special
diets has been available to patients.
The Dental Department continues to provide good service. Every patient
admitted has a dental examination during the first week. A system of recall ensures
that the necessary dental work is done as soon as possible.
Religious services have been provided by a full-time Protestant and part-time
Roman Catholic chaplain. The value of their visits extends beyond the purely
religious sphere.
The Pharmacy Department, in common with other departments, has had to
meet increasing demands on its services. A Pharmacy Committee, of which the
pharmacist is a member, makes recommendations to the Mental Health Branch
Pharmacy Council in relation to the special pharmaceutical needs of Valleyview
Hospital.
In the area of business management, the Public Works Department has maintained good standards of repair and maintenance. Installation of insulation on the
ceiling of the steam equipment room has lowered the floor temperature of the
physiotherapy room immediately above by 13 degrees. A new steam-fine has been
installed underground, connecting the Main Building with the lines to the other
buildings.   Smaller projects of great value have been completed.
A new 16-mm. projector and portable screen were received at the end of the
year as a contribution from the Patients' Comfort Fund.
A new conference room was framed in an area which was part of a lobby and
completely finished.
DELLVIEW HOSPITAL, VERNON
This hospital has a complement of 239 beds, male and female, with a total staff
complement of 86. During the year 66 patients were admitted directly from the
community and 8 patients were received on transfer from other units. During the
same period 72 patients died, 13 were transferred to other units, and 2 were returned
to the community.
Medical care and responsibility for patients are provided by a local physician
who visits regularly and at other times when called.
Personnel and equipment facilities of the adjacent Vernon Jubilee Hospital
have been made available when necessary.
An annual chest survey of both patients and staff was completed by a mobile
unit of the Division of Tuberculosis Control. One patient was suspected of having
active pulmonary tuberculosis and was transferred to the tuberculosis section at the
Provincial Mental Hospital.
A visiting dentist, optometrist, and podiatrist provided necessary services in
these areas.
 GERIATRIC DIVISION F  117
A good standard of nursing care has been provided. In-service education has
been promoted as much as possible.
Occupational therapy is provided for patients, and a programme of recreation
generously supported by members of the Vernon Branch of the Canadian Mental
Health Association is very well received by the patients. Visiting clergy provide
religious services.
SKEENAVIEW HOSPITAL, TERRACE
This hospital has a complement of 300 beds for men and a total staff of 68.
Six patients were admitted directly from the community, 16 patients were received
from other facilities of the Mental Health Services, and 34 were received from other
geriatric units.
Forty-one patients died, one patient was discharged to the community, and
one patient was transferred to another unit.
Medical services have been supplied by a visiting physician. Diagnostic X-ray
and laboratory services have been supplied by the Mills Memorial Hospital. All
major surgery is performed in the Mills Memorial Hospital, but patients are returned
to Skeenaview Hospital for post-operative care.
Classification of patients has improved since changing from two wards to a
four-ward complex and the provision of a 6-bed intensive-care unit within the infirmary area.   Plans are in hand to enlarge this unit to 12 beds.
A travelling clinic from the Division of Tuberculosis Control made two visits.
One-half of the patients and staff are X-rayed at each visit, allowing a recheck in
doubtful cases every six months.
In-service instruction with the help of the Department of Nursing Education
at Essondale has been of much benefit to nursing staff.
With the help of volunteers from the community, there has been a marked
increase in activity in the occupational and recreational programmes.
A satisfactory dietary service and an adequate laundry service contribute much
to the general health and comfort of patients. Essential maintenance work has
been completed.
 F  118
MENTAL HEALTH SERVICES REPORT,  1964/65
STATISTICAL TABLES
VALLEYVIEW HOSPITAL
Table 1.—Movement of Population, Valleyview Hospital, Essondale,
April 1, 1964, to March 31, 1965
Male
Female
Total
277
18
15
464
18
17
741
36
32
Total as at April 1, 1964	
310
499
809
Admissions—
195
5
1
30
194
12
2
1
32
389
Readmissions to a different institution ot Mental Health Services  .  .
17
Readmissions to the same institution	
2
1
Transfers from geriatric units  -	
f             l
62
Total admissions    _	
231
241
472
Total under care—.  	
541
740
1,281
Separations—■
10
166
1
30
11
155
21
Died    —         _	
321
Transferred to Provincial Mental Hospital, Essondale-	
1
30
207
166
373
Net increase or decrease..
—9      ]
268
66
+27
491
83
+ 18
759
tn hoarding homes, March 31, 1965
149
 GERIATRIC DIVISION
F  119
Table 2.—First Admissions to Valleyview Hospital, Essondale, by Health
Unit and School District of Residence and Sex, April 1, 1964, to
March 31, 1965,
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
Metropolitan Health Committee,
School District No. 4...	
1
1
2
Vancouver—Continued
Selkirk, Nelson—
School District No. 44	
7
11
18
School District No. 7
1
1
„   45. 	
3
4
7
West Kootenay, Trail—
School District No. 12 	
U.E.L.  .
1
1
1
1
Simon Fraser, New Westmin
South Okanagan, Kelowna—
ster—
1
1
2
18
18
36
 15	
1
1
„   43	
5
5
10
„   16- 	
1
1
North Fraser Valley, Mission—
„   23 	
1
1
School District No. 42 — —	
13
10
23
North Okanagan, Vernon—
„   75	
1
2
3
School District No. 20	
1
1
Upper Island, Courtenay—
„   22
3
1
4
School District No. 73
1
1
South Central, Kamloops—
Skeena, Prince Rupert—
School District No. 24 	
4
4
School District No. 51 	
	
1
1
„   29 -
1
1
„   52	
1
1
Cariboo, Williams Lake—
Peace River, Dawson Creek—
School District No. 27. 	
1
1
School District No. 59	
1
	
1
„   28	
1
2
3
Coast    Garibaldi,    Powell
Northern   Interior,   Prince
River—
George—
School District No. 56 	
1
2
3
1
1
„   47	
1
1
2
„   57..	
3
3
„   48	
1
1
 58 	
1
1
Greater Victoria Metropolitan
Upper Fraser Valley, Chilli
Board of Health-
wack—
School District No. 61 	
12
8
20
School District No. 32 	
2
2
 62	
1
1
33
1
1
„   63	
1
1
 34 	
3
3
6
„   64	
1
1
Boundary, Cloverdale—
Central   Vancouver   Island,
School District No. 35 	
5
5
Nanaimo—
 36	
9
8
17
School District No. 65	
2
1
3
„   37	
3
1
4
„   68	
1
1
2
Metropolitan Health Committee,
 69	
2
2
Vancouver—
 70	
1
1
School District No. 38 . 	
7
95
4
116
11
211
Unknown	
2
1
2
,   39
1
 41	
20
21
41
Totals  	
231
237
468
There were 4 male readmissions—2 from School District No. 39, 1 from School District No. 42, and 1 from
School District No. 61.
Table 3. — First Admissions and Readmissions to Valleyview Hospital,
Essondale, by Method of Admission, Age-group, and Sex, April 1, 1964,
to March 31, 1965.
Age-group (Years)
Total
Method of Admission
30-49
50-59
60-69
70-79
80-89
90-99
Grand
Total
m.;
F.
M.
F.
M.
F.
M.
F.
M.'
F.
M.
F.
1
M. IF.
1
First Admissions
2
1
2
~~i
7
83
3
86
1      1
1      1
11      1
1
1
2]    6
21	
227J231
8
11	
15|    5
 :i \~\-
104 110| 18| 18
2
Certification   	
5
11
458
Totals 	
5| 11|    5|    1
16|    7| 83| 89
104|111| 18| 18
93il?v7l  dns
1
Readmissions
Voluntary  	
1
1
1
1
1
1
f
1
1
1    1
Certification	
 1	
 1    3|       3
Totals 	
|
|
rt_
—-
1
	
2
1
I     M         A
1
1
I
 F 120                       MENTAL HEALTH SERVICES REPORT,  1964/65
Table 4.—First Admissions to Valleyview Hospital, Essondale, by Mental
Diagnosis, Age-group, and Sex, April 1, 1964, to March 31, 1965
Age-group (Years)
Mental Diagnosis
30-49
50-59
60-.9
70-79
80-89
90-99
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
m.;
F.
M.
F.
M.
F.
Schizophrenic disorders	
5
5
3
1
l
10
5
15
Manic-depressive reaction	
1
1
7
i
1
7
4
6
1
i
7
>1
2
3
5
—
1
7
3
1
6
2
10
1
5
7
19
24
Presenile psychosis   .
2
6
~2
3
~2
3
4
	
1
9
2
8
1
3
17
1
1
—
—
	
—
1
Psychosis of other demonstrable etiology	
5
i
7
2
Anxiety reaction without mention of somatic
2
?
2
Neurotic-depressive reaction	
—
1
2
4
1
1
1
7
	
'—
2
4
5
1
7
1
1
7
1
1
—
—
	
	
—
1
1
2
Chronic brain syndrome with behavioural re-
9
3
49
7,
29
1
70
1
44
13
1
6
141
4
82
1
223
Chronic brain syndrome, N.O.S	
5
Other diseases of central nervous system not
3
1
14
3R
7?
47
3
10
47
96
138
Other, unknown, and unspecified conditions	
Totals                              	
	
	
4
2
1
5|    2
7
5
11
5
1
16|    7| 83
1      1
89
104
111
18
18
231|237
1
468
Table 5.—First Admissions to Valleyview Hospital, Essondale, by Mental
Diagnosis, Marital Status, and Sex, April 1, 1964, to March 31, 1965
Table 6.—First Admissions to Valleyview Hospital, Essondale, by
Religion and Sex, April 1, 1964, to March 31, 1965
Table 7.—First Admissions to Valleyview Hospital, Essondale, by
Previous Occupation and Sex, April 1, 1964, to March 31, 1965
Detailed information for the above tables may be obtained on request.
 GERIATRIC DIVISION
F  121
Table 8.—Resident Population of Valleyview Hospital, Essondale, by
Mental Diagnosis, Age-group, and Sex, December 31, 1964
Age-group (Years)
Total
Mental Diagnosis
20-39
40-49
50-59
60-64
65-69
70-74
75-79
80 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
4
1
4
2
7
3
1
4
3
3
2
1
7
1
1
9
1
~7
7
1
1
1
1
1
1
1
11
9
8
1
2
12
15
2
1
2
22
17
2
2
1
6
4
1
2
20
25
1
1
3
21
1
3
80
49
39
6
2
2
23
49
2
3
1
3
52
4
1
5
109
73
2
3
3
2
1
1
4
11
124
142
2
4
91
Manic-depressive reaction	
Involutional melancholia	
Paranoia and paranoid states	
10
3
7
132
Psychosis with cerebral arteriosclerosis— 	
—
1
4
1
1
1
122
Alcoholic psychosis- -	
Psychosis of other demonstrable
4
6
4
Neurotic-depressive reaction.
Psychoneurosis    with    somatic
symptoms  affecting   digestive
5
1
Chronic  brain  syndrome  with
	
1
1
15
10
2
1
2
1
2
39
13
1
1
2
1
33
44
1
2
2
61
28
3
1
1
77
87
1
2
2
7
5
118
56
3
6
5
3
Alcoholism  .
1
2
1
2
2
4
1
2
2
11
2
5
1
1
1
2
1
16
Chronic  brain   syndrome  with
	
1
2
242
Chronic brain syndrome, N.O.S..
198
5
6
Other,  unknown,  and unspecified conditions	
9
Totals     	
6
6
7
4
91
12
4
14
8
47
51
R0I147
1571323 332
543
875
 F 122                       MENTAL HEALTH SERVICES REPORT,  1964/65
Table 9.—Live Discharges from and Deaths Occurring in Valleyview
Hospital, Essondale, by Mental Diagnosis, Age-group, and Sex, April
1, 1964, to March 31, 1965.
Age-group (Years)
Total
«
Mental Diagnosis
50-59
60-69
70-79
80-89
90-99
C
O
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Live Discharges
1
1
3
7
1
7
1
8
2
	
	
2
1
2
1
1
Senile psychosis _	
1
3
	
	
1
5
?
1
5
2
1
7
—
1
Pathological personality  _ __	
	
1
3
9
—
	
1
3
15
4
1
3
19
1
3
5
1
1
1
1
Other diseases of the central nervous system not associ
ated with psychosis             	
	
	
1
	
1
1
4
1
	
1
6
3
9
Totals 	
1|.__.|    6|    1
19|    6| 15|    3
 1    1| 411 11|     52
Deaths
1
7
1
1
7
1
4
4
8
1
1
1
7
1
2
1
9
1
18
3
1
27
1
5
11
1
7
?
5
8
8
13
4
1
19
77
41
Psychosis of other demonstrable etiology    _
1
1
1
Obsessive-compulsive reaction  	
	
	
	
1
1
	
1
Chronic brain syndrome with neurotic reaction	
1
	
	
1
1
Alcoholism
7,
1
7.
1
3
Chronic brain syndrome associated with behavioural re-
4
t
79
-77
57
37
8
4
98
64
162
1
1
1
1
2
1
4
3
7
Other diseases of the central nervous system not associ-
	
—
	
5
1
11
14
25
4
6
23
1
42
65
1
Totals                             	
7
1
49
48
91
91
19]  15I166I155I   321
111
Table 10.—Live Discharges from and Deaths Occurring in Valleyview
Hospital, Essondale, by Mental Diagnosis, Length of Stay, and Sex,
April 1, 1964, to March 31, 1965.
Detailed information for the above table may be obtained on request.
 GERIATRIC DIVISION
F  123
Table  11.—Deaths Occurring in Valleyview Hospital, Essondale, by
Cause of Death, Age-group, and Sex, April 1, 1964, to March 31, 1965
Age-group (Years)
Total
Cause of Death
60-69    70-79 1 80-89
90-99
_
o
H
M.I F.   M. F.   M. F.
i      1      1      1
M.
F.
M.
F.
a
rt
0
1
1
4
2
1
2
1
4
1
28
1
3
1
4
1
1
1
3
3
2
1
30
2
1
3
1
6
3
5
1
58
3
2
3
1
2
3
3
1
6
69
1
2
4
1
2
1
1
13
1
1
1
1
2
1
8
1
1
2
7
6
1
11
3
103
1
6
1
6
4
2
3
3
2
1
1
2
1
1
1
8
4
11
1
107
3
3
8
2
2
1
1
1
3
15
10
1
22
3
1
210
1
9
1
9
12
4
3
Intestinal obstruction and hernia   .—	
5
2
1
1
1
1
1
1
1
2
1
3
1
1
1
1
4
Totals ..               	
71     2
49
47
91
91
19
15
166
155
321
Table 12.—Deaths Occurring in Valleyview Hospital, Essondale, by Cause
of Death, Length of Stay, and Sex, April 1, 1964, to March 31, 1965
Detailed information for the above table may be obtained on request.
 F 124
MENTAL HEALTH SERVICES REPORT,  1964/65
DELLVIEW HOSPITAL
Table 1.—Movement of Population, Dellview Hospital, Vernon,
April 1, 1964, to March 31, 1965
Male
Female
Total
106
1
129
2
235
3
Total as at April 1, 1964
107
131
238
Admissions—
32
8
34
66
8
40
34
74
Total under rare
147
165
312
Separations-
37
12
3
35
1
3
Died	
72
Transferred to Provincial Mental Hospital, Essondale	
Transferred to other geriatric units           .   .
1
12
49
39
88
—8
98
-3
126
— 11
224
Table 2.—First Admissions to Dellview Hospital, Vernon, by Health
Unit and School District of Residence and Sex, April 1, 1964, to
March 31, 1965,
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
1
2
2
1
7
1
7
1
1
5
2
2
1
2
2
7
2
1
4
4
1
2
1
1
2
2
4
1
14
1
9
1
5
1
9
3
South Central, Kamloops—
School District No. 24     ....
4
1
1
2
1
1
4
1
1
1
1
8
„   3	
„   26
1
„   5-_	
„   30 	
2
Selkirk, Nelson—
School District No. 7	
Northern   Interior,   Prince
George—
School District No. 57	
1
School District No. 9	
„   11	
South Okanagan, Kelowna—
Metropolitan Health Committee,
Vancouver—
School District No. 39
3
„   41 	
Skeena, Prince Rupert—
School District No. 52	
1
„   15 	
„        »   16
1
„           „       „   23    	
Greater  Victoria Metropolitan
Board of Health—
School District No. 64      	
„       „   77-   	
North Okanagan, Vernon—
1
Totals  .. 	
■i   21
40
34
74
 22	
„        „   78
 GERIATRIC DIVISION
F  125
Table 3.—First Admissions to Dellview Hospital, Vernon, by Method of
Admission, Age-group, and Sex, April 1, 1964, to March 31, 1965
Age-group (Years)
Method of Admission
60-69
70-79
80-89
90 and
Over
Grand
Total
M.
F.
M.      F.
M.      F.
M.
F.
M.
F.
Voluntary-.-  	
6
3
2
8
12
1
19
15
4
*
2
1
37
34
2
1
Certification   	
71
Totals	
6
3
10
12
20
15
4
4
40
34
74
Table 4.—First Admissions to Dellview Hospital, Vernon, by Mental
Diagnosis, Age-group, and Sex, April 1, 1964, to March 31, 1965
Age-group (Years)
Mental Diagnosis
60-69
70-79
80-89
90 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
1
5
3
10
12
2
16
2
15
4
4
3
35
2
34
3
Chronic brain syndrome with behavioural reaction	
Senility    ...
69
2
Totals	
6
3
10
12
20
15  I     4
4
40
34
74
I
Table 5.—First Admissions to Dellview Hospital, Vernon, by Mental
Diagnosis, Marital Status, and Sex, April 1, 1964, to March 31, 1965
Table 6.—First Admissions to Dellview Hospital, Vernon, by Religion
and Sex, April 1, 1964, to March 31, 1965
Table 7.—First Admissions to Dellview Hospital, Vernon, by Previous
Occupation and Sex, April 1, 1964, to March 31, 1965
Detailed information for the above tables may be obtained on request.
 F 126
MENTAL HEALTH SERVICES REPORT,  1964/65
Table 8.—Resident Population of Dellview Hospital, Vernon, by Mental
Diagnosis, Age-group, and Sex, December 31, 1964
Age-group (Years)
Mental Diagnosis
50-59
60-64
65-69
70-74
75-79
80 and
Over
rt
O
h
M.
F.
M.
1
F.
M.
F.
M.|F.
1
M.
F.
M.
F.
M.
F.
q
O
1
3
—
9
1
2
11
1
4
1
2
5
4
8
13
1
51
16
26
1
6
4
1
1
60
11
14
13
1
1
83
18
40
1
19
5
1
	
1
2
3
2
1
~~4
1
1
8
1
8
19
2
16
2
27
7
1
1
Chronic brain syndrome with behavioural reaction
Chronic brain syndrome, N.O.S  	
2
143
29
Totals                          	
21     11     3
3
6
4
21
10
33
23
45
89
no
130
240
Table 9. — Live Discharges from and Deaths Occurring in Dellview
Hospital, Vernon, by Mental Diagnosis, Age-group, and Sex, April 1,
1964, to March 31, 1965.
Age-group (Years)
Mental Diagnosis
60-69
70-79
80-89
90-99
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Live Discharges
Chronic brain syndrome with be-
2
1
1
5
11
2
8
5
21
1
15
4
1
11
12
37
4
35
16
Deaths
Chronic brain syndrome with behavioural reaction	
72
Table 10. — Live Discharges from and Deaths Occurring in Dellview
Hospital, Vernon, by Mental Diagnosis, Length of Stay, and Sex,
April 1, 1964, to March 31, 1965.
Detailed information for the above table may be obtained on request.
 GERIATRIC DIVISION
F  127
Table 11.—Deaths Occurring in Dellview Hospital, Vernon, by Cause
of Death, Age-group, and Sex, April 1, 1964, to March 31, 1965
Age-group (Years)
Cause of Death
60-69 | 70-79
1
80-89
90-99
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Vascular lesions affecting central nervous system 	
1
1
11
8
18
2
1
1
14
4
2
9
34
2
1
3
32
3
66
2
1
Totals...      .
1
1
11
8
21
15
4
111  37
35
72
Table 12.—Deaths Occurring in Dellview Hospital, Vernon, by Cause of
Death, Length of Stay, and Sex, April 1, 1964, to March 31, 1965
Detailed information for the above table may be obtained on request.
 F 128
MENTAL HEALTH SERVICES REPORT,  1964/65
SKEENAVIEW HOSPITAL1
Table 1.—Movement of Population, Skeenaview Hospital, Terrace,
April 1, 1964, to March 31, 1965
In residence, April 1, 1964   288
Admissions—
First admissions  5
Readmissions to a different institution of Mental Health Services 1
Transfers from Provincial Mental Hospital, Essondale  16
Transfers from geriatric units  34
Total admissions
Total under care .
Separations—
Died	
Transferred to Provincial Mental Hospital, Essondale
Transferred to other geriatric unit	
On probation and still out	
Total separations
56
344
42
1
1
1
45
Net increase  +11
In residence, March 31, 1965  299
1 This institution cares for male patients only.
Table 2.—First Admissions to Skeenaview Hospital, Terrace, by Health
Unit and School District of Residence, April 1, 1964, to March 31,
1965.
Health Unit
East Kootenay, Cranbrook—
School District No. 2 	
„    5	
Selkirk, Nelson—
School District No. 7 —	
South Okanagan, Kelowna—
School District No. 15   	
No.
     1
     1
     4
     1
Health Unit
Metropolitan Health Committee, Vancouver—
School District No. 39 _	
„   41 	
„    44	
Upper Island, Courtenay—
School District No. 71  	
Skeena, Prince Rupert—
School District No. 50   	
„    52  	
„    53 ...	
Peace River, Dawson Creek—
School District No. 59 _	
Coast Garibaldi, Powell River—
School District No. 47                        	
No.
18
3
1
1
North Okanagan, Vernon—
School District No. 20	
„    78	
South Central, Kamloops—
School District No. 24	
      1
     1
     1
1
1
..    4
.     1
Northern Interior, Prince George—
School District No. 55  .
_     1
.     1
„    56 	
„    57  	
     1
     4
Greater Victoria Metropolitan Board of Health-
School District No. 61  	
7
Upper Fraser Valley, Chilliwack—
School District No. 32	
     1
Central Vancouver Island, Nanaimo—
School District No. 67   - 	
1
„    33     	
         1
     2
     1
.     1
„    34 .— - 	
Boundary, Cloverdale—
School District No. 35 	
Total    	
56
 GERIATRIC DIVISION
F 129
Table 3.—First Admissions to Skeenaview Hospital, Terrace, by Method
of Admission and Age-group, April 1, 1964, to March 31, 1965
Method of Admission
Age-group (Years)
Total
60-69
70-79
80-89
90-99
22
1
13
1
1
17
1
53
2
1
Totals	
23
15
17
1
56
Table 4.—First Admissions to Skeenaview Hospital, Terrace, by Mental
Diagnosis and Age-group, April 1, 1964, to March 31, 1965
Mental Diagnosis
Age-group (Years)
1       !       I
60-69 | 70-79 | 80-89 | 90-99
! 1 I
Total
Schizophrenic disorders-
Senile psychosis....
Psychosis with cerebral arteriosclerosis-
Alcoholic psychosis-
Psychosis of other demonstrable etiology-
Other and unspecified psychosis-
Syphilis of the central nervous system-
Pathological personality .—
Alcoholism  	
Mental deficiency-
Chronic brain syndrome with behavioural reaction-
Chronic brain syndrome, N.O.S	
Senility	
Totals-
12
1
2
3
1
23
IS
3
3
_2_
17
21
4
3
3
1
1
2
1
1
1
8
6
4
56
Table 5.—First Admissions to Skeenaview Hospital, Terrace, by Mental
Diagnosis and Marital Status, April 1, 1964, to March 31, 1965
Table 6.—First Admissions to Skeenaview Hospital, Terrace, by Religion,
April 1, 1964, to March 31, 1965
Table 7.—First Admissions to Skeenaview Hospital, Terrace, by Previous
Occupation, April 1, 1964, to March 31, 1965
Detailed information for the above tables may be obtained on request.
 F 130
MENTAL HEALTH SERVICES REPORT,  1964/65
Table 8.—Resident Population of Skeenaview Hospital, Terrace, by
Mental Diagnosis and Age-group, December 31, 1964
Mental Diagnosis
Age-group (Years)
4(M9
50-59
60-64
65-69
70-74
75-79
1
80 and
Over
3
12
2
28
1
4
1
1
1
5
26
1
4
2
2
1
2
1
29
1
3
4
1
1
1
2
3
2
1
40
2
1
11
5
~4
1
1
1
6
3
1
76
25
1
21
7
I
....
1
1
3
1
1
61
163
Manic-depressive reaction— 	
4
1
1
35
21
7
Psychosis of other demonstrable etiology
6
1
6
4
Chronic brain syndrome with behavioural re-
6
12
Syphilis and its sequela.   	
Other, unknown, and unspecified conditions	
12
3
Totals 	
3
14
41
39
48
282
Table 9.—Live Discharges from and Deaths Occurring in Skeenaview
Hospital, Terrace, by Mental Diagnosis and Age-group, April 1, 1964,
to March 31, 1965.
Mental Diagnosis
Age-group (Years)
Total
50-59
60-69
70-79
80-89
90-99
Live Discharges
Schizophrenic disorders   _
1
1
-
1
1
Totals    -_-rt-	
1      1
1      |      ....
....
2
Deaths
3
11
1
1
2
1
2
6
4
1
1
1
2
3
2
1
20
7
2
1
Syphilis and its sequelae-
3
1
1
4
Other diseases of the central nervous system not associ-
... i ....
3
Totals      '
—      1        3
18
18     '
3
42
Table 10.—Live Discharges from and Deaths Occurring in Skeenaview
Hospital, Terrace, by Mental Diagnosis and Length of Stay, April 1,
1964, to March 31, 1965.
Detailed information for the above table may be obtained on request.
 GERIATRIC DIVISION
F  131
Table 11.—Deaths Occurring in Skeenaview Hospital, Terrace, by Cause
of Death, Age-group, and Sex, April 1, 1964, to March 31, 1965
Cause of Death
Age-group (Years)
Total
60-69
70-79
80-89
90-99
2
1
1
11
4
3
1
10
3
1
1
1
1
1
Vascular lesions affecting central nervous system	
3
1
24
1
Pneumonia  —	
8
1
1
1
....         |         -
1
1
1
Totals	
3
1fi         I         18
3
42
Table 12.—Deaths Occurring in Skeenaview Hospital, Terrace, by Cause
of Death and Length of Stay, April 1, 1964, to March 31, 1965
Detailed information for the above table may be obtained on request.
 F 132 MENTAL HEALTH SERVICES REPORT,  1964/65
PART VI.—COMMUNITY MENTAL HEALTH SERVICES
MENTAL HEALTH CENTRE, BURNABY
K. J. Davies, Director
During the year this clinic has continued to serve many areas of the Province,
although the tentacles of service are shortening as new regional Mental Health
Centres are being developed. The area being served is still too large for this clinic
to provide a comprehensive community service, but some trends in this direction
are emerging. Better community co-operation and participation, improved selection
of clinic services to community needs, closer liaison with the community professionals (doctors, teachers, social workers, public health nurses, probation officers,
clergy), training of professional staff, and research are revealed in the reports on
different aspects of treatment provided through this clinic.
The good recruitment of professional staff, as well as maintaining at least two-
thirds of our experienced clinicians, has enabled this progressive expansion of services in unproved community direction. The intake, treatment, and travelling clinic
teams have all provided a more immediate consultation and treatment service to
families as well as each member increasing the case load. The total number of
patients and family members being seen has more than doubled during the past
three years. In the past year, assessed cases have increased in the Adult Clinic
from 631 to 687 and in the Children's CUnic from 414 to 447. Travelling clinic
cases increased from 521 to 547. The total treatment load within the Adult Clinic
increased from 535 to 681 and in the Children's Clinic from 387 to 490 families.
It is important to note that beside the number of cases mentioned above at least
half the patients in the Adult Clinic have family members also under treatment,
and the family members nearly double the patients under treatment in the Children's Clinic.
Specialized programmes in the Adult Day Hospital (total patient-days 5,694,
with the average length of stay coming down to 39 days from 45 days last year)
and the Children's Day Centre have continued to operate at the same level as last
year. There has been a 30-per-cent increase in the number of families discussed
in conference only (253) with various health and welfare agencies. These conferences provide a means of liaison as well as training for the staff of other agencies.
Despite these increased direct services to the community, the staff has also given
increased indirect service by professional education, public education, and involvement in a variety of professional and lay committees throughout the community.
OUT-PATIENT DEPARTMENT
In both the Children's and Adult Clinics, all professional staff give about
one-third of their time to each of the three services—intensive, brief, and community consultation. Individual psychotherapy is still the principal approach,
although increasing time is being used in joint interviews, family group therapy, and
for group therapy programmes which have been meeting on Tuesday evenings. The
social club and its patients' executive have also had an active programme on Tuesday evenings.
The referrals to the Children's Clinic have continued to show the boys outnumbering the girls by two to one. All referrals are medical, but the source of the
 COMMUNITY MENTAL HEALTH SERVICES
F 133
referral has shown an increase from the family doctor to 50 per cent with 15 per
cent from private psychiatrists and the rest from social agencies and public
health units.
The family doctor is the source of referral for 90 per cent of the adults and
adolescents (16 years of age and over). An increasing number of the adolescents
are being referred because of multiple family complications, necessitating more
interview time with family members as well as family group therapy.
CHILDREN'S DAY CENTRE
There has been one programme for five to seven autistic children attending
four mornings a week. An effort was made to give each child as much human
contact as possible while he was encouraged in learning activities and speech.
The mothers were seen in a weekly group meeting with the day centre supervisor
on practical problems and also met in weekly group therapy with a psychologist
and social worker. This is the second year of a research project to investigate the
genesis, pathological interactions between parents and child, psychopathology of
each parent and their interactions with each other, and the effect that group psychotherapy of the mothers might have on the child. This project is nearing completion now.
LEARNING CLINIC
This is a specialized remedial instruction programme to assist children who
have primarily a perceptual impairment and thus are unable to benefit from the
regular school programme. The assessment of these children is being improved
with the addition of new techniques designed for detection of brain damage to
to provide more precise information about the cerebral deficits so other modalities
could be applied for retraining and learning. Part of this programme has been
carried out within the Mental Health Centre and part within one of the local
Burnaby elementary schools.
ADOLESCENT AND ADULT DAY HOSPITAL
About 30 per cent of the Day Hospital patients have continued to be adolescents with complicated family problems who have not responded to other outpatient and in-patient treatment services. Over 50 per cent of the patients received
a pre-admission home assessment. Nearly 50 per cent of the patients treated
showed border-line or overt schizophrenic reactions. Their ratio reverted from
one male to two females in the programme from the equal ratio shown last year.
The emphasis continued on group rather than individual therapy, with more patient
self-government assisted by the establishment of three patient committees. The
four bi-weekly smaller group therapy meetings have been increasingly effective as
the staff becomes more experienced in this type of treatment. Continuing investigation into the interaction between the patients has been carried out in the form
of a weekly sociogram.
GROUP-LIVING HOMES
A screening and consultation service is being provided to social welfare
group-living homes in Burnaby, Surrey, Kamloops, Prince George, and Prince
Rupert. Individual and group therapy have also been provided to the adolescent
boys in the group-living homes in Burnaby and Surrey. The demand for this
service is greatly increasing throughout the Province, necessitating a much closer
liaison between our clinic and the Special Placement Division of the Child Welfare
 F 134 MENTAL HEALTH SERVICES REPORT,  1964/65
Department. There is a trend and a need to integrated and shared programmes.
A co-ordinated assessment and placement unit for children in need of special care
could be an effective step if undertaken as a real joint project. There are encouraging signs of recognition that progress in mental health is inexorably tied to progress
in family and child welfare and, indeed, to the general level of social health of
the community.
LOCAL AGENCY CONSULTATION SERVICE
Mental Health Centre child psychiatrists have been making weekly visits to
the Health Centre for Children, Children's Aid Society, Catholic Children's Aid
Society, Juvenile Court, and Willingdon School for Girls to provide consultation as
well as recommend psychiatric treatment when appropriate. There have been many
requests to increase this service to these agencies as well as extend it to others.
Approximately 50 per cent of the children seen have been referred from the Juvenile
Court, where the male-female ratio is three to one. The other 50 per cent of the
referrals show a male-female ratio of three to two. About one-third of the total
referrals are repeat consultations where the male-female ratio goes up to seven
to one.
TRAVELLING CLINICS
Besides the large number of families seen on these travelling clinics to 15
towns throughout the Province, there has been considerable emphasis on co-ordinating community professionals. The more frequent service being provided is an
increased contribution, but the shared relationship in dealing with mental health
problems has been even more productive.
With the establishment of the Mental Health Centre in the Kootenays, some
staff time was released to start a travelling clinic service to the Simon Fraser Health
Unit in Surrey as well as make the visits to the Skeena Health Unit (Prince Rupert,
Kitimat, Terrace) three times more frequent. When the Mental Health Centres
are established in Prince George and Chilliwack during the coming year, then a
similar intensification of service can be provided to the Coast-Garibaldi Health Unit
(Powell River, Sechelt, Squamish) as well as new travelling clinic service be set
up in the New Westminster and Haney areas. Another new development with the
travelling clinics has been the inclusion of a mental health nurse with two of the
psychiatric teams to assist with the education of the public health nurses in the
area being served. An investigation into the effectiveness of the travelling clinic
service to the Chilliwack area is now being assessed through the local professionals
involved with the various families seen.
EDUCATION
Besides the extensive service and specific research described above, this clinic
has provided an important educational programme within the community. In the
service training programmes for all professionals, they have developed staff for
more senior positions within the Government and agency services. A full auditorium attendance of local professionals (120) participated in three two-day
workshops with outside lecturers on learning problems in children, family group
therapy, and religion in mental health. Seventeen students from the University of
British Columbia School of Social Work had their field placements in the centre.
Two psychology interns were involved in summer clinical programmes. One resident from the University of British Columbia Department of Psychiatry was placed
in the Adult CUnic during the year. The nursing staff were involved in the education
 COMMUNITY MENTAL HEALTH SERVICES
F 135
programmes for students from the University of British Columbia School of Nursing,
the clinical programme and psychiatric nursing programme of the Essondale Education Centre and other hospital training-schools in the Greater Vancouver area.
Four occupational-therapy students also received field training in the Day Hospital
programme. A great many lectures were given by different staff members throughout the community as well as a dozen staff members serving on various health and
welfare committees. It is clear that this cUnic is an important training centre for
aU disciplines, and if the Mental Health Services are to contribute to a stronger
emphasis on community mental health, then the educational role must be a more
recognized function.
Table 1.-
STATISTICAL TABLES
-Summary of Operations, Mental Health Centre, Burnaby,
Adult Clinic, April 1, 1964, to March 31, 1965
Male
Female
Total
Intake Section
Total number pending
10
258
20
465
30
723
268
485
753
131
118
256
199
387
317
19
30
49
Treatment Section
110
100
31
184
197
59
294
297
90
241
98
440
184
681
282
Total under treatment at March 31, 1965.	
143
256
399
Table 2.—First Admissions to Mental Health Centre, Adult Clinic, by
Health Unit and School District of Residence, April 1, 1964, to
March 31, 1965.
Detailed information for the above table may be obtained on request.
 F 136
MENTAL HEALTH SERVICES REPORT, 1964/65
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MENTAL HEALTH SERVICES REPORT, 1964/65
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 COMMUNITY MENTAL HEALTH SERVICES
F 139
Table 7.—Movement of Population, Day Hospital, Mental Health
Centre, Adult Clinic, April 1, 1964, to March 31, 1965
Male
Female
Total
5
40
11
9
75
24
14
115
35
Totals -	
56
50
108
93
164
143
6
15
21
Total patient-days of those discharged.
Total discharges    	
Average stay in day hospital _	
....... 5,694
.. _     143
. 39.8 days
Table 8.—Summary of Operations, Mental Health Centre, Burnaby,
Children's Clinic, April 1, 1964, to March 31, 1965
Male
Female
Total
Intake Section
Total number pending at April 1, 1964—	
Pius assessments—
Mental Health Services... 	
Medical units   __ _	
Public health units  	
Correctional agencies   	
Social agencies  _ 	
General practitioners and other specialists-
Private psychiatrists 1_	
Totals   	
Disposition of assessments—
Social agency recommended __.. 	
Other medical care	
Assessment and advice only  	
Patient withdrew 	
Cases opened in treatment  	
Total pending at March 31, 1965 .
Treatment Section
Patient load—
Brought forward at April 1, 1964	
First admissions  	
Readmissions   	
Total admissions 	
Less cases closed .
Total under treatment at March 31, 1965..
11
7
10
70
8
40
125
25
285
296
3
9
84
6
174
178
2
5
17
26
26
66
5
147
151
3
3
61
3
77
68
15
9
15
87
34
66
191
30
432
447
6
12
145
9
251
27C
147
423
20
4
24
170
69
239
130
44
59
18
189
62
174
77
251
344
166
146
78
490
244
246
 F 140
MENTAL HEALTH SERVICES REPORT,  1964/65
Table 9.—Summary of Diagnostic Service Given to Agencies by Mental
Health Centre, Burnaby, Travelling (Children's) Clinics, April 1,
1964, to March 31, 1965.
Place of Examination
New
Male
Female
Repeat
Male
Female
Total
Local agencies and medical units—
Children's Aid Society— ._
Catholic Children's Aid Society-
Juvenile Court —
St. Christopher's School.-..	
Public health units—
Boundary Health Unit _ -
Cariboo Health Unit	
North Fraser Health Unit	
Simon Fraser Health Unit	
Upper Fraser Health Unit-	
Coast-Garibaldi Health Unit	
East Kootenay Health Unit	
West Kootenay Health Unit	
Peace River Health Unit	
Selkirk Health Unit 	
Skeena Health Unit	
Totals 	
9
9
42
55
23
7
16
16
2
2
3
11
4
34
13
4
15
24
14
1
3
16
2
3
1
6
3
19
124
13
2
14
5
38
11
3
6
19
5
2
2
3
2
14
139
15
6
1
6
9
51
37
15
74
5
132
54
12
31
60
9
7
6
21
11
73
547
Table 10.—Summary of Mental Health Centre, Burnaby, Travelling
(Children's) Clinics Service, April 1, 1964, to March 31, 1965
Total Number of
Children Seen on
Travelling Clinic
Vancouver  131
Abbotsford  14
Burns Lake  1
Chilliwack  45
Coquitlam  31
Cranbrook..
Dawson Creek-
Fort St. John ..
Gibsons	
Kitimat	
Millar Bay	
Mission	
Nelson	
Powell River -
Prince George.
Prince Rupert..
Quesnel	
Smithers	
Terrace	
Trail	
Williams Lake.
Surrey	
7
11
10
4
23
5
12
11
5
32
24
13
3
18
6
12
129
Other Agency
Consultative
Cases
82
11
19
57
2
5
1
7
7
5
8
1
2
38
Totals.
547
253
 COMMUNITY MENTAL HEALTH SERVICES
F  141
Table 11.—Source of All Cases Referred to Children's Clinics and
Service Given, April 1, 1964, to March 31, 1965
Agency or Source
Number
of
Cases
Type of Service Given
Agency
Diagnostic
Study
Clinic
Direct
Service
1. Mental Health Services—
After-care CUnic.	
Mental Health Centre, Nanaimo.
Mental Health Centre, Adult Clinic, Burnaby..
The Woodlands School	
Medical units—
Health Centre for Children _ _..
Canadian Arthritis and Rheumatism Society-
Children's Hospital   	
Sunny Hill Hospital...
Cerebral Palsy Association-
Out-patient Department, Vancouver General Hospital-
3. Public health units—
Boundary Health Unit     	
Burnaby Health Unit  	
Cariboo Health Unit _ 	
Coast-Garibaldi Health Unit	
Metropolitan Health Unit (Vancouver)..
North Fraser Health Unit 	
Simon Fraser Health Unit	
Upper Fraser Health Unit...
East Kootenay Health Unit	
West Kootenay Health Unit	
North Okanagan Health Unit_
North Shore Health Unit 	
Peace River Health Unit	
Selkirk Health Unit. _	
Skeena Health Unit 	
4. Social agencies—
Department of Social Welfare-
Family Service Agency..
Canadian National Institute for the Blind..
St. Christopher's School 	
Children's Aid Society-
Catholic Children's Aid Society-
Vancouver Epilepsy Centre	
5. Correctional agencies—■
Willingdon School for Girls	
Juvenile Court	
6. General practitioners 	
7. Private psychiatrists	
Totals	
6
1
3
1
7
1
2
1
1
1
153
8
54
25
12
19
51
60
2
1
73
24
3
1
6
52
36
1
25
83
191
30
979
132
54
9
T2
31
60
7
6
21
11
73
5
37
15
74
6
1
3
1
7
1
2
1
1
1
21
16
12
7
20
24
3
1
1
15
21
1
25
9
191
30
432
 F 142 MENTAL HEALTH SERVICES REPORT, 1964/65
MENTAL HEALTH CENTRE, VICTORIA
C. Gregory, Director
This year has seen a dramatic change in the pattern of mental health services in
Victoria, wrought by the provision of a new Mental Health Centre and by the expansion of our staff establishment. From a small bungalow behind the Parliament
Buildings, we have moved to a large converted apartment building which gives us
ample space and which has the advantage of being situated in the next block to the
Royal Jubilee Hospital. The move took place in late December, and although there
has been some inevitable disruption of service, we were able to open for limited
service on January 1st. This move has the added advantage of ending the sense of
isolation from professional contact and has thus facilitated improvement in integration of our services with those of other agencies, one simple but important example
being the increasing use made of inter-agency consultation of cases, which was
virtually impossible before. Eventually this greatly improved physical facility will
lead to a service far superior to that formerly provided.
POLICY
The purpose of this centre is to provide a comprehensive community psychiatric service for the Greater Victoria area, and two clinics—nominally separate but
functionally integrated—cater for adults and children. The emphasis in both clinics
is on the involvement of families in the treatment of disturbed patients, and the
results obtained vindicate this orientation. This is most obvious in considering the
treatment of children and in the after-care programme for those patients who have
been discharged from mental hospital where on-going care is a major factor in maintaining them in the community.
STAFF
Concomitant with our move, the following increases in establishment were
agreed on: One psychiatrist, one psychologist, two social workers, one nurse, and
two clerical staff. Unfortunately, recruitment has not kept pace with these establishment gains. However, we have had certain valuable additions. Dr. A. Aranas
replaced Dr. L. Holland in the Adult Clinic, one social worker and two nurses joined
us on a full-time basis, and three psychologists began working part time. These
latter are Ph.D. staff members of the Department of Psychology at the University of
Victoria, and this has meant a closer liaison between the university and this centre,
which can only be beneficial in terms of the quality of service provided.
CHILDREN'S CLINIC
Our new accommodation has enabled us to offer vastly improved treatment
facilities to patients; in fact, we could reasonably say that we have passed from a
centre providing assessment almost entirely to one which will be increasingly therapeutically orientated. This is particularly so in the Children's Clinic, where the
acquisition of ample space, of new testing equipment, and of more modern and
useful toys for play therapy have entirely transformed the nature of our service.
Emphasis has swung further toward family involvement, although individual treatment of children and adolescents must proceed concomitantly with family therapy.
A small-scale experimental remedial reading programme has been started in an
attempt to deal with the large numbers of children who are referred to this clinic
 COMMUNITY MENTAL HEALTH SERVICES F  143
with emotional disturbances which are secondary to school problems occasioned by
the inability to read.
More use of group therapy is being employed with adolescents, and, apart from
its therapeutic value, this is also a way of dealing with the vastly increased demand
for service, both assessment and therapeutic, for the 12—17 age range. This demand
is particularly heavy from the probation service and reflects both the increasing
delinquency problem faced by all communities today and the lack of in-patient
facilities for dealing with these young maladjusted people.
ADULT CLINIC
The activities of the Adult Clinic have considerably increased during the year.
The main avenues of endeavour have been the development of a sound after-care
programme; assessment and, where possible, treatment of the acute case; and
service, both consultatory and educational, to the local agencies. The increased
demand for service has been reflected in the number of after-care patients being
carried at the year's end, the ever greater flow of referrals from private physicians,
agencies, etc., and it has been found necessary to curtail the length of time given to
a single individual. However, when considered advisable, extensive case work-up
with individuals is made available.
In the after-care programme, involvement of the spouse and family of the
patient is requested where possible and, failing the availability of a home, a boarding
home has been tried. This latter service has involved the psychiatrist, nurse, and
social worker, and each boarding home in which patients reside has been visited by
at least one of our staff. The provision of drugs for those patients who require them
is an indispensable part of treatment; without them we would be far less able to
maintain patients in the community.
We plan to offer greater opportunities for the private practitioner to participate
in the therapeutic programme, to extend our home visiting and boarding-home
supervision, to offer out-patient electroconvulsive treatment and an experimental
day-care programme. These plans are all, of course, contingent on the successful
recruitment of staff.
SERVICE
In spite of changes in staff and the move to our new quarters, both of which
necessitated a temporary hiatus in intake, the total service over the year was considerably better quantitatively than the previous year. The quality of service has
taken a marked upward swing, initiated by the part-time appointment of Dr. A. G.
Milton, of the University of Victoria, and carried on by the further recruitment of
university personnel. Indeed, we can reasonably say that few centres of this kind
have anything like our quality of psychological service, whether diagnostic or therapeutic. The latest university staff member has initiated an out-patient service for
alcoholics, and in view of the size of the problem and the scarcity of resources to
cope with it, this should be a most valuable feature of our community activity.
Although direct service is our most obvious function, a great deal of other
important work is done. Consultation to other agencies, advice on how to manage
cases, regular lectures to nurses undergoing training at the Royal Jubilee Hospital,
public education in a variety of ways, participation in the planning of agency programmes such as those of the Association for the Mentally Retarded, irregular visits
to Brannan Lake School, psychological assessments for the remainder of Vancouver
Island, supervision of a group-living home—these are all aspects of this centre's
work.
.
 F 144
MENTAL HEALTH SERVICES REPORT, 1964/65
SUMMARY OF OPERATIONS
Adult
Children
Total
88
79
17
176
105
255
Total under treatment
167
59
193
121
360
180
108
72
180
Assessment only
88
54
Patients discussed without actual examination	
Total interviews—
Psychiatric  1,665
Psychological      224
Social workers  2,423
Nurses       564
 COMMUNITY MENTAL HEALTH SERVICES F 145
OKANAGAN MENTAL HEALTH CENTRE, KELOWNA
F. E. McNair, Director
The basic components of this community mental health service are as follows:—
(1) A psychiatric out-patient service based at the community health centre.
(2) Collaboration with other community resources to cope with various problems of mental health and mental illness in the community.
(3) In-patient service in the Kelowna General Hospital.
Our staff has been augmented during the year and now includes a psychiatrist-
director, a resident psychiatrist in his final year of training for his certification by the
Royal College of Physicians and Surgeons of Canada, two social workers with
M.S.W. degrees, and a receptionist-stenographer who now has a half-time assistant.
We were not able to recruit a clinical psychologist during this year. The table shows
a 30-per-cent increase in the number of adult patients seen in consultation and a
50-per-cent increase in the number of adults and children given an out-patient
service. The resident psychiatrist and one of the social workers hold a clinic at the
health unit in Penticton one day each week. There continues to be a demand both
in Vernon and Penticton for additional psychiatric service, and efforts have been
made by responsible bodies in both communities to attract a psychiatric specialist
into practice there.
Special facilities are available elsewhere in the Province for a limited number
of disturbed youngsters requiring residential care, but these require adequate diagnostic study, including psychological evaluation, before their suitability for admission to special resource can be determined. There is also a group of patients whose
eligibility for The Woodlands School is under consideration or whose eligibility for
Disabled Persons' Allowance is being questioned by the appropriate board, who also
require psychological study to evaluate their condition. In addition to the clinic
needs, the schools are finding that a number of children with learning problems
require individual study from a qualified psychologist to place them in the appropriate stream of learning so that their achievement can measure up to their capacity
and the number of school drop-outs can be reduced.
The service continues to be well received and is given thorough-going cooperation by various health and welfare resources in the communities served. We
could not function without the complete and ready co-operation between these
various resource groups. The practice of community psychiatry cannot limit itself
to the direct face-to-face treatment of a person designated as ill. Nor is it enough
to have treatment available close at hand. There would be less illness to treat if we
can assist disturbed family relationships so that families can be strengthened to
manage their own problems and couples can be assisted to build a more satisfactory
marriage. We look forward to the development of resources to strengthen family
relationships. We will be assisting during the coming year in a marriage course,
sponsored by an inter-faith group and organized under the adult education programme, in Kelowna. Marriage counselling will be augmented and new approaches
to family therapy undertaken. Two groups of teen-age boys are meeting regularly
for a therapy programme. Our own treatment resources have been enlarged to
include a more immediate service to relatives of patients in hospital. We have been
happy to see the development of a more active foster-home programme under the
Department of Social Welfare, including the organization of a foster-parent society.
There is special need for foster homes in the management of the disturbed teen-ager
 F 146
MENTAL HEALTH SERVICES REPORT, 1964/65
who no longer fits into life within his own family and requires some alternative community placement if he is not to be too hastily designated as incorrigible and banished to an institution. Since special facilities such as school and workshops for the
mentally retarded can only be organized on a regional basis, there is need for foster
day care or foster care through the week in the larger centres for retardates whose
homes are in rural communities. In addition, there is need to look forward to developing a type of boarding or foster care for some of the chronically mentally ill
persons who can now be managed readily in the community without need for hospitalization but who should not be allowed to remain stagnant in adapting to community life as partially disabled persons. There are already in the Province some
group-living homes for disturbed teen-agers, and there is need for such a group-
living home to be established in this region. All of these developments cannot occur
overnight, but a comprehensive mental health service will be incomplete until they
are represented. The development of more complete hospital resources for children
and adults, the child resources to be worked out in co-operation with the paediatricians of the region, is also a very important part of the total community psychiatric
programme.
One hundred and forty-two patients were treated in the Kelowna General
Hospital psychiatric ward during the year; 322 patients received out-patient treatment during the year. There is no doubt that when service is available locally, the
need for hospital admission is reduced. Statistics are noted below with regard to
the over-all consultation service and the number of patients receiving treatment, both
in Kelowna, where the clinic has its headquarters, and in the adjacent communities.
The psychiatric unit of the Kelowna General Hospital also serves the whole region,
and the number of patients admitted is tabulated by district.
CONSULTATIONS BY AREAS
Adults
Children
Male
Female
Total
Male
Female
Total
Kelowna	
48
26
29
12
3
10
62
44
45
19
5
12
110
70
74
31
8
22
27
31
19
9
5
3
16
17
7
7
6
2
43
48
Kamloops  	
26
16
11
Revelstoke        	
5
Totals
128
187
315
94
55
149
 COMMUNITY MENTAL HEALTH SERVICES
PATIENTS RECEIVING REGULAR TREATMENT
Kelowna 	
Penticton	
Kamloops	
Vernon 	
Salmon Arm
Revelstoke ...
F 147
Adults
Children
91
31
58
15
56
8
28
6
9
7
10
3
Totals
252
70
ADULT PATIENTS ADMITTED TO PSYCHIATRIC UNIT OF
KELOWNA GENERAL HOSPITAL
Kelowna and district	
Penticton and district ._
Vernon and district ___.
Kamloops and district
Others	
Total
54
56
30
142
The psychiatric ward at the Kelowna General Hospital was open for 12 months
during the past year; 111 patients received 142 admissions during that time. Nine
of these patients had to be admitted to a Provincial mental health facility.
It is noted that during the past year 61 admissions to facilities of the Mental
Health Services Branch came from the Okanagan area, a figure which continues to
be less than 50 per cent of the admission rate from this area prior to the inauguration of this service.
 F 148 MENTAL HEALTH SERVICES REPORT, 1964/65
VANCOUVER ISLAND MENTAL HEALTH CENTRE,
NANAIMO
S. E. Jensen, Director
The Mental Health Centre began operation in April, 1964, in a hitherto un-
serviced area of British Columbia—namely, that constituted by the combined Central Vancouver Island Health Unit and Upper Vancouver Island Health Unit. The
centre was budgeted for a staff consisting of a psychiatrist, psychiatric nurse,
psychologist, and a social worker. The centre is located at the Public Health Centre
in Nanaimo, and travelling clinics servicing Duncan, Port Alberni, Comox, and
Campbell River work out of offices in the local public health units. Beds in the
Nanaimo Regional Hospital have been available for those patients who required
hospital care, and, as a result, practically no patients have needed to be certified to
the Provincial Mental Hospital or the Crease Clinic, Essondale.
The objective has been to provide as comprehensive a service as possible in
Nanaimo and to extend the scope and usefulness of the centre by travelling each
month to the other principal centres in the district. The centre has met with initial
acceptance amounting to enthusiasm from doctors, social workers, public health and
probation staff, and special school personnel in the area.
During the year a total of 310 patients was seen. Attendance has been
excellent, missed appointments have been rare, and there have been few drop-outs.
It has been usual for both parents to accompany a child to the centre and for a
spouse to accompany an adult.
In the main, service to children has had to be limited to assessment and a few
hours of counselling to the parents in selected cases. When a psychologist is added
to the staff, play therapy as well as other specialized techniques and psychometric
testing will add to the usefulness of the centre.
The work of the centre has been assisted by the availability, skill, and enthusiasm of the public health nurses. We feel that the centre's association with the public
health nurses and the public health unit both here and in the Upper Island area has
been a happy one, and has proved the point often made that the services of public
health and mental health are so closely related that efficient service can be provided
with a minimum of changes and expansions by assimilating the two. It would seem
that the future will see psychiatry to a larger and larger extent become community-
oriented, and our experience has indicated that the public health nurses can carry
a considerable responsibility in such a programme. Many basic tools and methods
are common to public health and mental health: both experience the same sense of
responsibility for the total health problems within their jurisdiction, the same sense
of responsibility for what ails the community, and both work toward improving the
over-all health of the community.
The Mental Health Centre's philosophy of treatment is basically multi-directive,
stressing as well psychodynamic and physiologic and sociocultural factors as responsible for the syndromes we attempt to treat.
Out-patient interviews are carried out with an average frequency of once per
month. More intensive interviewing is done when indicated, but the heavy case
load prevents the average patient from being seen at more frequent intervals. Our
experience indicates that this frequency is adequate in most cases.
The orientation of the interview is basically an examination of the symptoms
as related to the past and present experience of the patient relying heavily on
psychodynamic techniques of interpretation.    Other members of the family are
 COMMUNITY MENTAL HEALTH SERVICES
F 149
interviewed routinely in the case of children and very frequently in the case of adult
referrals. One may say that the centre is family-oriented, since we are constantly
aware of the significance of family interaction both for pathology and for treatment.
Marital counselling, while not strictly a psychiatric function, invariably becomes a significant part of the centre's function. Pharmacotherapy today has become an essential part of therapy as well. Like most medical therapy, it is usually
of a palliative nature but useful if used with discrimination; for example, to break a
vicious circle or to enable a patient to readjust.
 F 150 MENTAL HEALTH SERVICES REPORT,  1964/65
KOOTENAY MENTAL HEALTH CENTRE, TRAIL
G. R. Mansfield, Director
The Kootenay Mental Health Centre, Trail, is reporting on its initial organizational programme, which took place in the last 10 months of the fiscal year, from
June 1, 1964, to March 31, 1965. The Mental Health Centre located at Trail is
serving the West and East Kootenay regions. The West Kootenay area comprises
approximately 7,150 square miles with a population of 66,000. The East Kootenay
consists of an estimated 20,000 square miles with a population of 48,000. The
total area is 27,150 square miles and total population is in the order of 114,000.
There are three public health units in this area: Selkirk Health Unit, Nelson; East
Kootenay Health Unit, Cranbrook; and West Kootenay Health Unit, Trail. The
terrain is mountainous with extensive waterways. Logging, pulp-mills, and mining
and smelting operations are the chief industries which account for substantial
pockets of populations scattered throughout the region to be serviced. The largest
complex is at Trail, which has a population of 12,000, but the addition of nearby
villages brings up the population figure close to 20,000.
FACILITIES
The facilities consist of an out-patient department, located on the second floor
of the West Kootenay Public Health Unit, Trail. It was officially opened June 26,
1964, by the Honourable Eric Martin, Minister of Health Services and Hospital
Insurance, accompanied by Dr. A. E. Davidson, Deputy Minister of Mental Health
Services. In the planning stages is a psychiatric unit in-patient treatment centre,
which will be an additional wing constructed on to the Trail-Tadanac Hospital.
STAFF
The Mental Health Centre staff consists of Mrs. G. Hopland, secretary-
receptionist; Mr. R. Cameron, social worker; and Dr. G. R. Mansfield, psychiatrist.
We are able to make some use of two psychologists in this area indirectly by virtue
of close liaison ties with the school and the personnel department of the largest
industrial complex, Cominco. The psychiatrist is also engaged in doing some
psychological testing. We have always adopted the viewpoint that no one member
of the psychiatric team is more important than another. We are pleased to see our
team strengthened by the addition of a part-time clerk-stenographer, which will
eliminate the bottleneck in this area and render our operations more efficient in 1965.
INTEGRATION
Priority was given to the task of integrating the Mental Health Centre with
established medical practice and the various agencies and resources in this area.
Following traditional medical practice, all referrals must come from family doctors.
Some early skepticism and misgivings on the part of the " helping agencies "
rapidly disappeared as the doctors co-operated fully.
Direct lines of communication have been established with the schools in the
Trail area through the school psychologist, who receives a copy of conference reports on all school-children seen in this area. The school is interested directly or
indirectly in 9 out of 10 children seen, which is not reflected in the statistical table
that follows. Steps are being taken to record more accurate statistics for the coming
year.   Friday has been set aside for conferences as this is the most convenient time
 COMMUNITY MENTAL HEALTH SERVICES F 151
for public health personnel who have shown an active interest in mental health by
their attendance. Conferences are structured to be teaching experiences, as the role
of the public health nurse in the school is conceived of as a consultant to the teacher
in determining whether a child is emotionally disturbed and should be referred.
Direct interpretation of our findings and recommendations to the teacher are made
by the school psychologist, although the public health nurse may still be involved
via teacher-nurse conferences, which are held regularly. The public health nurse
may also be working with the family in the home. The public health nurses frequently consult a member of our staff on an informal basis for a discussion of a
particular case.
The Department of Social Welfare personnel and the Probation Officers attend
conferences and communicate freely with us by telephone. The clergy are also
being involved. This seems logical as 42 per cent of people in trouble first turn to
their pastor for help, and many are engaged in pastoral counselling.
To facilitate communication and share information with the various people
working with children, a group has been organized which meets once a month. This
consists of the social worker from the Mental Health Centre, school psychologist,
head of the Department of Social Welfare, local Probation Officer, and the local
paediatrician.
Liaison has been established with industry through the plant physician, psychologist in personnel, and several of his staff who are active in Alcoholics Anonymous
and who form the plant's own group working actively with people in their own
industry who have problems with alcohol. We meet informally for luncheon
and co-ordinate our efforts in developing individual programmes and pooling information.
We now have a good working relationship with all interested bodies in the
community.
EDUCATION
A most active programme of community education has been carried out by the
social worker and psychiatrist in the past 10 months. The staff have participated
in 32 addresses, panels, institutes, and discussion groups. We were particularly
pleased to reach the high-school students and talk to them about careers in mental
health. Other highlights were addresses to the Registered Nurses' Association of
British Columbia, the ministerial association, various service clubs, doctor groups,
local and regional Canadian Mental Health Association, etc.
In-service education is always an on-going process, and Mr. Cameron has been
teaching public health nurses and social workers how to prepare better social histories. The nurses have also been formally lectured on detecting emotional problems in children.
Worthy of special note is Mr. Cameron's participation in regular meetings with
foster-parents, where the foster-parents have an opportunity to ask questions and
discuss problems. The object is to develop a roster of " professional" foster-
parents who will become skilled enough to handle more difficult problem children.
This is part of a larger plan in which the schools and the Department of Social
Welfare will co-operate in developing a local resource for treatment of disturbed
children. The schools will provide special classes and carefully selected teachers for
emotionally disturbed children. The Mental Health Centre will provide psychiatric
treatment individually and in groups. This is conceived of as a resource for the
treatment of disturbed children which will serve the whole of the Kootenays and will
tide us over the period until more adequate facilities can be developed.
 F 152 MENTAL HEALTH SERVICES REPORT,  1964/65
Mr. Cameron has brought his experience and skills in an advisory capacity to
the steering committee in developing a homemaker service for the community of
Trail.
It is anticipated that next year integration and education will occupy a great
deal less of our time and the focus will be on providing service, especially treatment,
to a larger number of people.
TRAVELLING CLINIC SERVICE
Travelling clinics serve the Nelson district and East Kootenay at Cranbrook.
The cases at Nelson dwindled to one or two a month as the patients preferred to
come directly to Trail. Efforts are now directed in Cranbrook to developing " community readiness " for a permanent psychiatric service at a later date. Cranbrook
is presently receiving two days' service each month (except July and August), with
a maximum of 14 cases seen each month. Usually a detailed social history prepared by the agency concerned permits an assessment every 45 minutes. Occasionally a direct referral from a doctor (usually an emergency) is seen outside regular
clinic hours without a prior work-up and treated statistically as if that patient were
seen at the Mental Health Centre, Trail.
Owing to the number of scattered agencies located long distances apart, it is
not practical to utilize a formal screening committee following the usual pattern.
The medical officer of health and senior public health nurse in consultation with the
family doctor or agency involved select the cases to be seen. To date there is no
backlog of children's cases. At the beginning of the year there was some pressure
from the Juniper Day School for retarded children requesting psychological testing.
An attempt was made to bring them to a realization that their need was not psychological testing but more training for their teachers. We are seeing more and more
retarded children as the backlog of emotionally disturbed children has been dealt
with, and the psychiatrist is quite prepared to make psychometric assessments on a
limited number of these children. Usually the retarded child is referred in an
attempt to get the parents to accept the child's disability and do something constructive about it.
At the request of the doctors in the Cranbrook area, we have offered our
services to them on an informal telephone consultation basis to discuss psychiatric
problems. More and more physicians are taking advantage of this and more are
attending our conferences.
Because the East Kootenay region does not have the services of a school
psychologist, counsellors, principals, and teachers have been invited to attend our
conferences.   This is working out satisfactorily.
There were 48 consultations carried out at Cranbrook during the period of
operation. Either the family doctor or public health nurse is involved in carrying
out our recommendations. Some time is set aside each visit for discussion of cases
where the nurse is actively involved in working with the family over a period of
time. Movement and new problems can be evaluated and dealt with jointly. This
has reduced the anxieties of the nurses and has permitted them to work more
effectively with a case. As they become more skilled in casework of this nature,
conferences as a teaching medium become more meaningful.
MENTAL HEALTH CENTRE SERVICE
A total of 626 interview hours was carried out by the psychiatrist and 443
interview hours by the social worker.    There were 161 adults and 111 children
 COMMUNITY MENTAL HEALTH SERVICES
F 153
referred. Of these 272 patients, 169 received assessment only and 103 were taken
on for treatment.
No attempt has been made to rigidly define hours for treatment or assessment.
Similarly, the agencies have not been assigned specific time allotments. The needs
of each patient and each agency are met with whatever time is required. We have
no waiting-list, due to many adults being seen privately outside of clinic hours.
The clinic has been functioning to capacity during the past six months.
Treatment of children follows traditional child guidance principles. Adolescents are dealt with either on an individual basis or by family-centred group
psychotherapy. Adults receive individual psychotherapy and are encouraged to be
seen on a private basis outside of clinic hours in order to leave clinic time available
for children who can more effectively be dealt with by a team approach. Pharmacotherapy is used as an adjunct treatment. The following tables give a breakdown of
referrals and service to various areas:—
Referrals
Source
Total
Area
Adults
Children
Referrals initiated by Department of So-
52
11
23
48
138
Mental Health Centre, Trail	
25
8
5
1
15
1
1
6
3
	
83
10
1
10
7
Travelling clinic, Nelson	
Mental Health Centre, Trail	
Travelling clinic, Cranbrook	
Travelling clinic, Nelson	
Mental Health Centre, Trail	
Travelling clinic, Cranbrook	
Travelling clinic, Nelson 	
Mental Health Centre, Trail-
2
Referrals initiated by Attorney-General's
Department
Referrals initiated by Public Health	
2
1
4
1
1
21
14
i           4
Mental Health Centre, Trail	
35
Travelling clinic, Cranbrook	
7
2
Totals
272
161
111
Service
Area
Adults
ChUdren
Patients
Consultations
Mental Health Cpntrf, Trail
45
10
24
17
4
22
8
6
31
2
67
18
30
Travelling clinic, Cranbrook	
48
g
.—
—
169
Treatments
Mental Health Centre, Trail	
61
42
103
ACKNOWLEDGMENTS
We gratefully acknowledge a great deal of courtesy and assistance from various
sources in launching this new enterprise. For the sake of brevity, only a few will
be mentioned. Ready community acceptance of our service is credited to the efforts
of the travelling clinics from Burnaby Mental Health Centre, who prepared the way.
A great deal of assistance was given by Mr. McCallum, Business Manager, Mental
 F 154
MENTAL HEALTH SERVICES REPORT, 1964/65
Health Centre, Burnaby, and Mr. Matheson, Business Manager for the Mental
Health Services Branch. Mrs. Quinn, Okanagan Mental Health Centre, has been a
constant source of help in setting up records. The directors and superintendents of
the various units visited have freely given of their time in promoting a better understanding of the functioning of their facility. Special mention must be given to Dr.
K. Davies for his role in orientation and definition of policy. The Deputy Minister's
consultant staff have never failed to respond in support of this development. We
were pleased to have Miss Carroll and Miss Dingle visit us. Finally, the understanding and sympathetic guidance of Dr. A. E. Davidson has made a pleasure the
challenge of creating a new regional comprehensive Mental Health Centre in the
Mental Health Services Branch of the Department of Health Services and Hospital
Insurance.
SUMMARY
Integration of our out-patient department service with established medical
practice and community agencies has been completed. Plans are being developed
for an in-patient service. Next year concentration will be on giving more treatment
service and completing the psychiatric team. Some comments on the meaning of a
permanent psychiatric service to the Trail community are interesting. School: " It
wasn't much help having our diagnosis confirmed by the travelling clinic—now the
children are being treated and we see change—children are adjusting, achieving,
and becoming useful citizens." Probation Officer: "My work load has been reduced one-third." Department of Social Welfare: " Our work is expedited as we
can get assessments carried out immediately. With treatment available our salvage
rate has been sharply increased."
We have established firm ties in the community and are prepared to move forward next year with providing greater service.
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1966
1,160-1065-9029

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