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Mental Health Services Branch PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT FOR TWELVE MONTHS ENDED MARCH… British Columbia. Legislative Assembly [1967]

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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
1966
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1967
  To Major-General the Honourable George Randolph Pearkes,
V.C., P.C., C.B., D.S.O., M.C.,
Lieutenant-Governor of the Province oj 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, 1966.
ERIC MARTIN,
Minister oj Health Services and Hospital Insurance.
Office oj the Minister oj Health Services and Hospital Insurance,
Victoria, B.C., December 1,1966.
 Department of Health Services and Hospital Insurance,
Mental Health Services Branch,
Vancouver, B.C., December 1,1966.
The Honourable Eric Martin,
Minister oj 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 12 months ended March 31, 1966.
A. E. DAVIDSON, B.A., M.D., F.A.P.A.,
Deputy Minister oj Mental Health Services.
 TABLE OF CONTENTS
PART I.—GENERAL ADMINISTRATION
Page
Report—Director of Mental Health Services  7
Report—Business Manager  18
Report—Personnel Manager  38
Report—Social Service Consultant    43
Report—Nursing Consultant  49
Report—Consultant in Medical Records and Statistics  52
PART II.—RIVERVIEW HOSPITAL
Report—Superintendent     54
Statistical Tables—Riverview Hospital     69
PART III.—THE WOODLANDS SCHOOL
Report—Superintendent     85
Statistical Tables—The Woodlands School     87
PART IV.—THE TRANQUILLE SCHOOL
Report—Superintendent      94
Statistical Tables—The Tranquille School     96
PART V.—GERIATRIC DIVISION
Report—Superintendent  98
Statistical Tables—Valleyview Hospital, Essondale  102
Statistical Tables—Dellview Hospital, Vernon  109
Statistical Tables—Skeenaview Hospital, Terrace  113
PART VI.—COMMUNITY MENTAL HEALTH SERVICES
Report—Director of Mental Health Centre, Burnaby  117
Statistical Tables—Mental Health Centre, Burnaby  120
Report—Director of Mental Health Centre, Victoria  126
Report—Director of Okanagan Mental Health Centre, Kelowna  130
Report—Director of Vancouver Island Mental Health Centre, Nanaimo  133
Report—Director of Kootenay Mental Health Centre, Trail  135
Statistical Tables—Kootenay Mental Health Centre, Trail  137
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 Report of the Mental Health Services Branch
For the Twelve Months Ended March 31, 1966
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
Submitted herewith is the report of activities of the Mental Health Services
Branch for the fiscal year ended March 31, 1966.
Several major organizational changes have occurred during this period. The
staff of the Branch office was augmented by the appointment of Dr. H. W. Bridge
in February, 1966, to the position of Assistant Director of Mental Health Services.
Dr. Bridge has assumed responsibility for the supervision of the in-patient units—
namely, Riverview Hospital, Valleyview Hospital, Skeenaview Hospital, and Dell-
view Hospital, as well as The Woodlands School and The Tranquille School. With
Dr. Bridge's appointment, Dr. F. G. Tucker, Deputy Director, became responsible
for supervision of the community mental health services. These include the Mental
Health Centres in Burnaby and Victoria, the Okanagan Mental Health Centre
located in Kelowna, the Vancouver Island Mental Health Centre located in Nanaimo,
and the Kootenay Mental Health Centre located in Trail. New centres will be
developed and supervised by Dr. Tucker. In addition, the Department of Nursing
Education, through the Director of Nursing, reports to the Deputy Director. These
organizational changes will provide improved supervision and will permit orderly
expansion in the development of services.
With the coming into force of the Mental Health Act, 1964, the Crease Clinic
of Psychological Medicine and the Provincial Mental Hospital, Essondale, were
combined to function as one mental health facility. This facility was named the
Riverview Hospital, Essondale. The Crease Unit (formerly Crease Clinic) and
the Centre Lawn Unit were designated admitting and active-treatment units. Because of the heavy admission load and also with a view to developing a community-
oriented programme, admissions to the two units of the Riverview Hospital were
arranged on a residential basis. Persons from the Vancouver metropolitan area
are admitted to the Crease Unit, whereas persons from the remainder of the
Province are admitted to the Centre Lawn Unit. The two units are approximately
the same size, and the standards of care and treatment are the same. This division
of service has proven quite satisfactory as slightly more than 50 per cent of all
admissions come from the Vancouver metropolitan area.
There has been a major reorganization of services at The Woodlands School.
The in-patient services have been divided into three units, designed to provide
different types of service for different groups of mentally retarded patients, as
follows:—
(1) The Hospital Unit has two functions: the first is the treatment of acute
illness arising in any patient in the total Woodlands School complex, and
the second is to provide medical and nursing care for those patients who
7
 G 8
MENTAL HEALTH SERVICES REPORT, 1965/66
have physical disabilities as well as mental handicap.   This unit is directed
by a paediatrician.
(2) The Training Unit: its function is the provision of education and training
for moderately and severely retarded patients who do not suffer from
severe physical handicap.   This unit is directed by an educator.
(3) The Psychiatric and Rehabilitation Unit has two areas of concern: the
first is the treatment of patients who are both mentally retarded and
mentally ill, and the second is the rehabilitation of the mildly retarded
who are admitted because of some personal or social behaviour problem.
This unit is directed by a psychiatrist.
This new division of services has made it possible to organize more effective
programmes for the management and treatment of the several kinds of patient
admitted to The Woodlands School.
An important reorganization has been made in the nursing services at The
Woodlands School and Riverview Hospital. The nursing services in these two units
comprise the largest group of staff members. Traditionally, the nursing service has
been organized by sex into two divisions—the women's nursing division, caring
primarily for the female patients, and the male nursing division, caring primarily for
the male patients. During the year, progress has been made in the integration of
these services into one nursing service for each unit. A Director of Nursing Services
has been appointed to the staff of The Woodlands School, and a Director of Nursing
Services has been appointed to the staff of the Riverview Hospital.
The above-mentioned organizational changes will do a great deal to improve
the efficiency of supervision, and should enable the expansion and development of
new services to proceed expeditiously.
STATISTICAL COMMENTS
Information pertaining to the movement of population in the several institutions
of the Mental Health Services Branch is found in Tables 1 and 2.
During the year 5,069 persons were admitted to the in-patient units of the
Branch. This is an increase of 451 over the preceding year. The increase in admissions is mainly in the psychiatric division. Admissions to these units have more
than doubled in the past 10 years.
Table 1.—Showing Patients in Residence in Various Facilities oj the Mental Health
Services Branch, April 1, 1965, and March 31, 1966, Together with Increase
or Decrease.
In Residence, Api
. 1, 1965
In Residence, Mar.
31, 1966
Increase
Men
Women
Total
Men
Women
Total
Decrease
1,526
742
329
268
98
299
1,392
540
242
491
126
2,918
1,282
571
759
224
299
1,440
766
319
259
99
294
1,375
563
236
497
113
2,815
1,329
555
756
212
294
—103
+47
—16
Valleyview Hospital, Essondale  	
-3
—12
—5
Totals                      	
3,262
2,791
6,053
3,177
2,784
5,961
92
i Under new Act, incorporates Crease Clinic and Provincial Mental Hospital.
 GENERAL ADMINISTRATION
G 9
Table 2. —Showing in Summary the Admissions and Population Increase oj the
Mental Health Services Branch jor the 10-year Period April 1, 1956, to March
31,1966.
Year
Total
Admissions
Admissions
65 Years
and Over
Admissions
15 Years
and Under
Informal
Admissions
Population
Increase
Index of
Increase
1956/57	
1957/58	
1958/59..	
1959/60     	
2,270
2,936
2,993
3,296
3,924
4,193
4,248
4,569
4,518
5,069
385
442
425
506
580
557
554
550
702
844
57
106
135
182
254
200
213
243
215
206
1,083
1,012
1,118
1,316
1,695
2,023
2,086
2,187
2,194
2,278
-78
38
-90
20
42
— 156
—63
31
-39
-92
-2.87
1.29
— 3.00
0.61
1960/61	
1961/62	
1962/63	
1963/64	
1964/65	
1.07
—3.72
-1.48
0.68
—0.86
1965/66   -	
— 1.81
Totals.	
38,016
5,545
1,811
16,992
-387
	
An active programme of care and rehabilitation has made possible the separation of 5,161 patients from the in-patient institutions. At the end of the fiscal year,
5,961 patients were in residence, a decrease of 92 from the previous year. An additional 628 patients had been placed in boarding homes.
The total number of patients receiving care in the various units of the Mental
Health Services Branch in 1965/66 was 12,001, compared with 11,655 in 1964/65,
an increase of 346 or 2.9 per cent.
Some 4,277 persons were admitted to the Riverview Hospital. This is an
increase of 462 over the fiscal year 1964/65. Two thousand two hundred and forty-
eight persons, or 53 per cent, were admitted on an " informal" basis; that is, patients were admitted on a medical referral. Four thousand three hundred and eighty
patients were separated from the Riverview Hospital, resulting in total numbers in
residence at the end of the year of 2,815, a decrease of 103 compared with the
preceding year.
During the year 220 persons were admitted to The Woodlands School. An
active programme of rehabilitation and boarding-home placements resulted in many
children being able to leave for varying periods. At the end of the year 1,884 persons were in residence in the schools for mentally retarded division. Seventy patients
were admitted to The Woodlands School for 30-day admissions.
The Geriatric Division consists of the Valleyview Hospital, Essondale; Dell-
view Hospital, Vernon; and Skeenaview Hospital, Terrace. This Division provides
in-patient services to geriatric patients suffering from severe psychiatric disturbances.
At the end of the year there were 1,262 patients in the three units. Altogether 571
patients were admitted to this Division. An active programme of boarding-home
placement enabled the resident population to be maintained at a fairly stable rate.
In addition to the steadily increasing number of persons receiving care and
treatment at the several in-patient units, a corresponding increase is occurring in the
number of persons being served in the expanding community mental health centres.
Altogether some 6,396 persons were referred to the five mental health centres and
received psychiatric service in some form. The service might be diagnostic, consultative, rehabilitative, or therapeutic, as indicated after the initial assessment. In
many instances, admission to the in-patient units is unnecessary because of the availability of the community mental health centres in the local area.
In summary, the amount of psychiatric service provided by the Mental Health
Services Branch to the people of this Province both by the in-patient units and the
 G 10 MENTAL HEALTH SERVICES REPORT,  1965/66
community mental health centres has been markedly increased during this past year.
The details of the operation of each mental health facility are set forth in the reports
which appear in Parts II to VI of this volume.
MAJOR EVENTS AND TRENDS
The Mental Health Act, 1964, came into force on April 1, 1965. It is thus
possible to report on the first year's operation of this Act. This new legislation was
written with a view of facilitating treatment of mental illness in keeping with modern psychiatric advances. One of the important features of the Act is that persons
are admitted on the basis of medical need. The process of legal commitment is no
longer used. During the first year approximately 45 per cent of admissions to all
Provincial mental health facilities were informal admissions; that is, on the person's
own volition and without any written form or certificate. Most of the balance were
admitted as involuntary admissions; that is, with the medical certificates but without any formal committal documents. This clearly demonstrates that the public and
the medical profession have welcomed this forward step in the case of the mentally ill.
During the year 70 persons were admitted to The Woodlands School for 30-
day admissions under section 25 of the Mental Health Act, 1964; 97 were admitted
to the Riverview Hospital for treatment of alcoholic addiction under section 26; and
130 were admitted on a Magistrate's warrant under section 27.
Provision is also made in the Mental Health Act, 1964, for the protection of
the civil rights of the person detained in a Provincial mental health facility. A patient may apply to have his case reviewed by two members of the Review Panel
under section 31 of the Act. Fourteen patients requested such review. Only one
patient was recommended for discharge following review of his case by the Review
Panel.
Provision is made in the Mental Health Act, 1964, for certain public hospitals
to be designated as observation units for the purpose of admitting mentally ill persons pursuant to section 27 of the Act. The following public hospitals were designated as observation units:—
Vancouver General Hospital, Vancouver.
Royal Jubilee Hospital, Victoria.
Lions Gate Hospital, North Vancouver.
Kelowna General Hospital, Kelowna.
Nanaimo Regional General Hospital, Nanaimo.
Penticton Hospital, Penticton.
Vernon Jubilee Hospital, Vernon.
Kootenay Lake General Hospital, Nelson.
St. Eugene Hospital, Cranbrook.
West Coast General Hospital, Port Alberni.
Campbell River and District General Hospital, Campbell River.
Prince Rupert General Hospital, Prince Rupert.
Prince George General Hospital, Prince George.
Royal Inland Hospital, Kamloops.
Trail-Tadanac Hospital, Trail.
Chilliwack General Hospital, Chilliwack.
St. Joseph's General Hospital, Dawson Creek.
Powell River General Hospital, Powell River.
It is generally considered that the Mental Health Act, 1964, represents a significant advance in mental health legislation.
 GENERAL ADMINISTRATION
G 11
Planning was instituted during the year for the abandonment of the Farm Cottage at Riverview Hospital. This building was one of the oldest buildings in use at
the Provincial mental hospital. It was not considered satisfactory for the care of
mentally ill patients, and the Public Works Department had declared it unsuitable
for renovation. Recently 56 male patients had been accommodated in the building.
Arrangements were made for these patients to be transferred to other wards of the
hospital, and the building was closed for patient accommodation on December 20,
1965.
The maximum-security area developed in the Riverside Building has functioned
effectively and has facilitated the improvement of services in various areas. All psychiatric patients requiring security measures because of their dangerous propensities
are admitted to this unit. These consisted of 107 Order in Council admissions who
came directly from the gaols. In addition, a number of patients were admitted from
the British Columbia Penitentiary, and also a number who had not appeared before
the Court but who were considered security risks because of their disturbed behaviour. With the improved security measures, it has been possible to organize a
better treatment programme for this group of patients—one designed to meet their
specific needs. It has also been possible to improve the programme in the rest of
the hospital. Open-ward programmes have been extended to the remainder of the
hospital, with the exception of one ward. In this setting the standard of care of the
whole hospital has benefited.
For several years the Mental Health Services Branch and the Department of
Social Welfare have been working together on a planned programme for the placement in the community, in licensed and supervised boarding homes, of patients who
no longer need care in a mental facility but who, because of the residuals of illness,
are disabled and unemployable. The programme was originally developed for patients from Riverview Hospital but has been expanded steadily and now includes the
placement of patients from Valleyview Hospital and trainees from The Woodlands
School and The Tranquille School. At the end of the fiscal year, 628 patients were
being accommodated in this programme—301 from Riverview Hospital, 214 from
Valleyview Hospital, 97 from The Woodlands School, and 16 from The Tranquille
School.
The After-care Clinic is operating from the Mental Health Centre in Burnaby.
It provides a follow-up service for patients who have been discharged from hospital
to communities in the Lower Mainland. As of March 31, 1966, some 953 patients
discharged from the Riverview Hospital were being followed in the After-care Clinic.
The After-care Clinic also provides a psychiatric service to those who have been
discharged to the boarding-home care programme.
The recently developed Out-patient Department at The Woodlands School has
been operating a full year. This department has been developed to examine and
screen retarded persons who have been referred for assistance. The department has
been able to provide service to families which, in many instances, make it possible
to keep the person out of an institution. Two hundred and forty-six patients were
seen during the year.
During the year a unit was developed at The Woodlands School for the treatment and care of autistic children. These children are emotionally disturbed, resulting in many instances in children who closely resemble the mentally retarded.
A ward to accommodate 25 children has been set aside for this programme, and
special staff have been assigned. The treatment programme for these conditions is
bound to extend over a considerable period of time, but it is hoped this will provide
a useful service to this group of seriously disordered children.
 G 12 MENTAL HEALTH SERVICES REPORT, 1965/66
.     Construction and planning of new mental health facilities has continued
throughout this year, as follows:—
(1) Construction of the Sage Building at The Tranquille School to accommodate 104 patients is nearing completion.
(2) Addition of facilities to the Health Building in Chilliwack to provide
accommodation for the Mental Health Centre in Chilliwack.
(3) Planning is near completion on the Mental Health Centre in Victoria and
construction of this facility was commenced during the year.
(4) Planning of the residential facility for emotionally disturbed children at
the Mental Health Centre in Burnaby is nearing completion.
(5) Planning of the Glendale School for Retarded at Royal Oak on Vancouver
Island is progressing satisfactorily.
In addition, several major renovations in various units of the service have been
carried out and provide improved facilities.
GENERAL COMMENTS
The annual graduation of the Department of Nursing Education was held in the
Vincent Massey Junior High School Auditorium on April 28, 1965. The graduation
speaker was Dr. Patrick McTaggart-Cowan, President of Simon Fraser University.
One hundred and fourteen students received diplomas in psychiatric nursing at the
graduation ceremonies, this total consisting of 89 women and 25 men. The annual
graduation tea was held on April 25, 1965, and the graduation dinner-dance on
April 30, 1965.
The 1965 annual meeting of the Council of Psychiatric Nurses was held on
April 22, 1965. The main item of business at this meeting was the consideration of
the brief which was presented to the Council by the Psychiatric Nurses' Association
recommending changes in the regulations pursuant to the Psychiatric Nurses Act.
After considerable study, the decision of Council was that it was not advisable to
recommend the suggested changes in the regulations.
One hundred and ninety psychiartic nurses have been licensed by the Council
during the fiscal year. As of December 31, 1965, 1,540 nurses were licensed under
the Psychiatric Nurses Act. This includes 1,523 psychiatric nurses and 17 nurses in
mental deficiency.
Continued efforts have been made throughout the year to inform the public in
regard to the activities carried on in various units of the Mental Health Services
Branch. Visits have been arranged for interested groups from the universities,
schools, Parent-Teacher Associations, and service clubs to all major units of the
Branch. The various activities and programmes carried on on each institution are
explained by the staff members. In addition, a number of educational programmes
and workshops have been provided for different professional groups in each of the
mental health centres.
The in-service training programme for special school councillors, which is
arranged by the Vancouver School Board, has continued to receive financial support
through mental health grants. In addition, many staff members of various disciplines
from different units of the Mental Health Services Branch have assisted in this
programme by providing lectures, clinics, and demonstrations. During this fiscal
year 11 teachers were trained in this programme. Since the initiation of the programme in 1955, 102 teachers have been given this training.
The Mental Health Services Branch continues to have representation on the
board of directors on both the Alcoholism Foundation of British Columbia and the
Narcotic Addiction Foundation of British Columbia.    Dr. Yarrow has been the
 GENERAL ADMINISTRATION G 13
representative on the Alcoholism Foundation, and Dr. A. E. Davidson has been
the representative on the Narcotic Addiction Foundation.
Both the Canadian Mental Health Association and the Association for Retarded
Children of British Columbia continue to co-operate with the Mental Health Services
Branch. Through their volunteer programme, these groups assist a great deal in the
care of the patients in both the mental hospitals and the schools for the mentally
retarded. The volunteer workers assist in maintaining communication between the
community and the hospitals. Their efforts are sincerely appreciated by patients
and staff.
Several changes in senior administrative and professional staff occurred
throughout the year. Dr. A. J. Bennee, Superintendent of The Tranquille School,
resigned on August 31, 1965, and Dr. F. G. Tucker, Deputy Director of Mental
Health Services Branch, was appointed Acting Superintendent. Dr. Margaret Neave
was appointed Clinical Director of The Tranquille School on November 18, 1965.
Mr. R. M. Poutt was appointed Director of Patient Training and Education at The
Woodlands School on September 1, 1965. Dr. R. G. Foulkes, Deputy Superintendent at The Woodlands School, resigned on February 15, 1966. Miss M. L.
Carmack was appointed Director of Nursing Services of the Riverview Hospital on
October 1, 1965. Dr. J. Phillips was appointed psychiatrist in the Mental Health
Centre in Victoria on October 12,1965. Dr. P. d'Estrube was appointed psychiatrist
in the Mental Health Centre in Victoria on July 1, 1965. Dr. R. Helgeson, who was
senior psychiatrist in the Adult Clinic of the Mental Health Centre in Burnaby, resigned on February 1, 1966. Dr. H. W. Bridge was appointed Assistant Director
of Mental Health Services Branch on February 1, 1966.
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 illness, including
rehabilitation and free treatment." The Mental Health Grant was established in
1948. This year was the 18th year of its availability to our Branch.
In 1965/66 the Mental Health Grant available was $684,196. Project submissions totalling $672,200.13 were made by the Province and approved by the
Department of National Health and Welfare. By March 31, 1966, reimbursement
in the sum of $638,225.24 had been received by the Province for expenditures made
on account of approved Mental Health Grant projects. The details of these expenditures are tabulated in the Business Manager's report on page 34.
In 1965/66, 13 projects were supported by the Mental Health Grant. Five of
the projects assisted in the provision of professional staff employed in the treatment
programmes of the Mental Health Services Branch and also assisted in expansion
of the community mental health centres.
Aid was again given to the Department of Psychiatry, University of British
Columbia, in its programme of postgraduate training in the specialty. The purpose
here is to enable physicians to qualify as psychiatric specialists in order that they
may be available to participate in an expansion of the public psychiatric services and
in the teaching programme in the university department. The teaching programme
is, in large measure, conducted at the Vancouver General Hospital. Accordingly, a
complementary grant to provide assistance in the operation of the Psychiatric Outpatient Department is made to that institution.
 G 14
MENTAL HEALTH SERVICES REPORT,  1965/66
The Metropolitan Health Committees of Victoria and Vancouver were again
aided by grahts which permitted them to hire psychiatric and supporting clerical staff
for their clinics.
The School of Social Work, University of British Columbia, received support
for the salary of a student field-work placement supervisor as in previous years.
COMPARATIVE SUMMARY OF INCREASES AND DECREASES IN RESIDENT POPULATION BY MAJOR DIVISIONS OF MENTAL HEALTH
SERVICES BRANCH, 1956/57 TO 1965/66.
Fiscal Year
Riverview
Hospital*
Schools for
Mentally
Retarded
Geriatric
Division
Total
1956/57-
1957/58..
1958/59..
1959/60..
1960/61..
1961/62..
1962/63..
1963/64..
1964/65..
1965/66-
-101
—23
— 144
—229
-92
-236
-137
—55
—134
— 103
+ 14
+76
+86
+93
+75
+73
+62
+79
+77
+31
+9
—15
—30
+ 156
+59
+7
+ 12
+7
+ 18
—20
-78
+38
—88
+20
+42
— 156
-63
+31
-39
-92
i For the years 1956/57 to 1964/65 shows combined figure for Provincial Mental Hospital and Crease Clinic
(now incorporated into Riverview Hospital).
COMPARATIVE SUMMARY OF TOTAL PATIENTS UNDER CARE FOR
MAJOR DIVISIONS OF MENTAL HEALTH SERVICES BRANCH BY
FISCAL YEARS 1956/57 TO 1965/66.
Fiscal Year
Riverview
Hospital1
Schools for
Mentally
Retarded
Geriatric
Division
Total
1956/57..
1957/58-
1958/59-
1959/60-
1960/61..
1961/62-
1962/63..
1963/64-
1964/65-
1965/66-
7,056
7,122
7,121
7,163
7,376
7,679
7,765
7,931
7,540
7,706
1,275
1,373
1,481
1,740
1,868
1,960
2,023
2,042
2,178
2,198
1,287
1,349
1,373
1,459
1,587
1,642
1,677
1,738
1,937
2,097
9,618
9,844
9,975
10,362
10,831
11,281
11,4.5
11,711
11,655
12,001
i For the years 1956/57 to 1964/65 shows combined totals for Provincial Mental Hospital and Crease Clinic.
 GENERAL ADMINISTRATION
G  15
MOVEMENT OF POPULATION OF MENTAL HEALTH SERVICES
APRIL 1, 1965, TO MARCH 31, 1966
Psychiatric
Division
M.
Schools for Mentally Retarded
Division
M.
F.
T.
Geriatric
Division
M.
F.       T
Total
M.
In residence, April 1, 1965	
On extended leave, carried forward
from 1964/65—
In boarding home	
Other	
On escape, carried forward from
1964/65	
Total as at April 1, 1965	
Admissions—
First admissions to Mental Health
Services   	
Readmission to different facility..
Readmission to same facility	
Total admissions  	
Transfers in  	
Total admissions to individual
facility	
Total under care 	
Separations—
Discharged in full	
Died   _
On extended leave in boarding
homes  	
Other  	
On escape	
Total separations.
Transfers out. 	
Total   separations  from  individual facility 	
Net increase or decrease	
In residence, March 31, 1966.
1,526
112
78
1,392
145
152
2,918
257
230
1,071
782
1,853
665
617
83
1,282
149
1
3,262
194
97
1,722| 1,689| 3,411
1,105
8171 1,922
732
976
14
1,037
1,028
32
1,190
2,004
46
2,227
86
37
147
3
70
268
12
2
700| 1,432
3,559
268
17
5
536
29
7
1,330
26
1,076
2,791
254
161
3,206
1,357
52
1,228
6,053
448
258
6,765
2,687
78
2,304
2,0271 2,250| 4,277
1231
97!    220
10|
282|    290|    572
18
11|      45|      56
2,037
2,258 4,295
134
731      20|      93
2,432| 2,637|   5,069
94|      731      167
I
142|    276
355     310     665
2,526
3,759-| 3,947| 7,706
1,239[    959] 2,198
1,0871 1,0101 2,097
5,991
2,012
2,239
72
61
131
170
80
75
5
3
4,251
133
301
155
56
35
21
12
50
63
11
6
1
91
33
113
17
1
45
249
82
29
232
132
74
481
214
2,113
342
263
91
5
2,710|   5,236
5,843| 11,8341
2,303
305
365
81
4
4,416
647
628
172
9
2,30O[ 2,548| 4,848
19*|       24|      43
2,319
2,572
4,891
—86|  —17| — 103
138|    117|    255
16|      43|      59
154
160
314
+14|  +17] +31
376
3931
769
59
6|
65
435
399]
834
-13
-7*1!
-20
2,814| 3,058|   5,872
94|
167
2,908  3,131    6,039
-85]    — 7|—92
1,4401 1,375 2,815
1,0851    799 1,884
652
610| 1,262
3,177 2,784
5,961
1 Total under care for all Mental Health Services includes total as at April 1, 1965, plus the total admissions
to individual facilities minus transfers out.
 G 16
MENTAL HEALTH SERVICES REPORT,  1965/66
MOVEMENT OF POPULATION IN INDIVIDUAL INSTITUTIONS,
APRIL 1, 1965, TO MARCH 31, 1966
Geriatric Division
Valleyview Hospital,
Essondale
Dellview Hospital,
Vernon
Skeena-
view
Hospital,
Terrace
Total
M.
F.
T.
M.
F.
T.
M.
M.
F.
T.
In residence, April 1, 1965
On extended leave, carried forward from 1964/65—
In boarding homes	
Other.  	
268
66
491
83
759
149
98
126
224
299
1
665
66
1
617
83
1,282
149
1
Total as at April 1, 1965	
334 |     574 |     908
98
126 |     224 |     300
732 |     700 [ 1,432
Admissions—
First   admissions   to   Mental
209
9
1
217
17
4
426
26
5
44
3
51
1
95
3
1
15
	
1
268
12
2
268
17
5
536
Readmission  to  different facility 	
Readmission to same facility-
29
7
219
24
238
19
457
43
47
15
52
1
99
16
16
34
282
73
290
20
572
Transfers in 	
93
Total   admissions  to  indi-
243
257
500
62
53
115
50
355 •
310
665
Total under care 	
577 |     831 |  1,408
160 |     179
339
350
1,028 | 1,004 | 2,0321
Separations—■
Discharged in full	
Died	
On extended leave in board-
32
162
79
26
179
124
58
341
203
4 1         4
52 |       53
3 1         8
8
105
11
8
36
44
250
82
30
232
132
74
482
214
273
45
329
5
602
50
59
2
65
1
124
3
44
12
376
59
394
6
770
65
Total separations from in-
318 '
334
652
61
66
127
56
435
400
835
Net increase or decrease	
-9 |     +6 |     -3
+ 1 |   -13 |   -12 |     -5
— 13 |     —7 |   —20
In residence, March 31, 1966	
259 |     497
756
99
113 |     212
1
294
652
610
1,262
i Total under care for the Geriatric Division includes total as at April 1, 1965, plus the total admissions to
individual facilities minus transfers out.
 GENERAL ADMINISTRATION
G 17
MOVEMENT OF POPULATION IN INDIVIDUAL INSTITUTIONS,
APRIL 1, 1965, TO MARCH 31, 1966—Continued
Schools for Mentally Retarded
The Woodlands School,
New Westminster
The Tranquille School,
Tranquille
Total
M.   i
F.
T.
M.
F.
T.
M.
F.
T.
In residence, April 1, 1965	
On   extended   leave,   carried   forward
from 1964/65—
742
10
16
540
26
8
1,282
36
24
329
6
2
242
1
571
6
3
1,071
16
18
782
26
9
1,853
42
Other.	
27
Total as at April 1, 1965	
Admissions—
First  admissions  to  Mental Health
Services	
768
86
36
574
58
3
33
1,342
144
3
69
337
1
243
3
580
3
1
1,105
86
37
817
61
3
33
1,922
147
3
Readmission to same facility	
70
122
5
94
25
216
30
1
6
3
20
4
26
123
11
97
45
220
Transfers in	
56
Total    admissions    to    indvidual
facility	
127
119
246
7
23
30
134
142
276
Total under care	
895
693
1,588
344
266
610
1,223
916
2,1391
Separations—
53
16
37
10
33
12
60
3
86
28
97
13
3
5
13
1
2
3
3
1
5
5
16
4
1
56
21
50
11
35
12
63
6
1
91
Died                                -  .
33
On    extended   leave   in   boarding
homes	
Other                              	
113
17
1
116
13
108
22
224
35
22 '
3
9
21
31
24
138
16
117
43
255
59
Total separations from individual
129
130
259
25
30
55
154
160
314
Net increase or decrease _	
+24
+23
+47
-10
-6
-16
+ 14
+ 17
+31
766
563
1,329
319
236
555
1,085
799
1,884
i Total under care for the Schools for Mentally Retarded Division includes total as at April 1, 1965, plus
total admissions to individual facilities minus transfers out.
 G 18 MENTAL HEALTH SERVICES REPORT,  19*65/66
BUSINESS MANAGER'S REPORT
F. A. Matheson, Business Manager
Subsequent to this report are the financial tables of the British Columbia
Mental Health Services for the fiscal year ended March 31, 1966.
Table A shows the daily average population as 5,937.61, a decrease of 36.86
from fiscal year 1964/65, continuing the decline of over-all patient population in
the in-patient care units. Maintenance expenditure increased from $19,055,762
to $20,745,127 or $1,689,365, and as a result the daily per capita cost rose from
$8.59 to $9.57.
Salary increases once more were the chief cause of the new high in operational
costs, the increase of $1,689,365 being made up of salaries in the amount of
$1,375,996 and the balance of $313,369 in supplies and expenses.
Maintenance revenue increased from $1,866,781 in 1964/65 to $1,915,661
or $48,880 in 1965/66.
The Department of Agriculture supplied dairy produce, vegetables, and meat
valued in excess of $450,000 to Mental Health units from operations at Colony
and Tranquille Farms.
During the year a total of $638,225.24 was expended on Federal health grant
projects, through which were provided personnel, equipment, and staff-training. A
statement is attached listing the disbursement of these funds under the various
projects.
The Mental Health Services Planning Committee has been very busy during
this fiscal year in connection with the following major projects:—
(1) Mental Health Facility, Victoria.—The planning for this facility that will
consist of 150 adult beds and 20 beds for children, plus day-hospital and
out-patient facilities, is proceeding as rapidly as possible. The first contract in connection with this project was for the demolition of the existing
buildings on the site, and was completed by the end of this fiscal year.
Tenders will be called for the second phase, covering excavation, fencing,
etc., early in the next year.
(2) Residential Care Centre for Children, Burnaby.—This new facility for
the care and treatment of emotionally disturbed children will be located
adjacent to the Mental Health Centre in Burnaby. It will consist of
three residential units that will accommodate 15 children each. In addition, it will also have treatment and assessment facilities, a school building with seven classrooms, gymnasium and swimming-pool, plus a kitchen
and dining-rooms. These facilities will be of sufficient size that they will
provide for the treatment of 55 children on a day basis in addition to the
45 children in residence.
(3) Glendale School, Victoria.—This will be a completely new school for the
retarded. It will provide accommodation for 300 severely retarded and
physically handicapped plus accommodation for another 100 trainable
retardates. A site at Colquitz has been selected. Preliminary planning
is proceeding.
(4) Sage Building, The Tranquille School.—This is a 104-bed unit designed
for the severely retarded. A contract in the amount of $926,851 for construction of this building was let in April, 1965. This building should be
completed early in the next fiscal year.
(5) Kitchen and Dining Block, The Tranquille School.—A contract in the
amount of $945,680 was let in October, 1965, for this new kitchen and
 GENERAL ADMINISTRATION G 19
dining block that will replace the present obsolete and inadequate facilities.
(6) Medical Clinic, Essondale.—This building is being planned to centralize
all the medical services at Essondale, such as operating-rooms, laboratory,
central sterile supply, radiology, neurology, dental, and out-patient department. It will also have 39 pre- and post-operative beds. Preliminary
plans have been completed.
(7) Hillside Building, Riverview Hospital, Essondale.—During the last fiscal
year a contract in the amount of $241,296 was let for the construction
of this 60-bed unit.   This building was completed in January, 1966.
(8) Centre Lawn Kitchen Renovations, Riverview Hospital, Essondale.—A
contract in the amount of $144,230 was let for the renovation of the
Centre Lawn Building kitchen and main dining-rooms. Work on this
project was completed in March, 1966.
(9) Riverside Building Kitchen Renovations, Riverview Hospital, Essondale.—Preliminary planning was started for the complete renovation of
the Riverside Building kitchen and dining-room.
(10)  Renovation oj Centre Building, Wards J and K and G and Con, The
Woodlands School, New Westminster.—Preliminary planning was started
for the complete renovation of these three buildings that contain some 515
beds.
In addition to the above major capital projects, it is again a pleasure to be able
to report that we were able to maintain the buildings, grounds, equipment, and furnishings of all our institutions in a satisfactory manner and at the same time to
make many changes and purchase replacement and additional equipment and furniture to further improve our facilities and increase the efficiency of our operations.
Some of the main items of interest in this regard are as follows:—
Riverview Hospital, Essondale.—Ward E 1 in the Centre Lawn Building was
converted into the main admitting suite for the hospital.
Over $40,000 worth of new X-ray equipment was purchased for the Crease
unit.
Some $17,000 worth of new laundry equipment was purchased.
The Physiotherapy Department in the Crease unit was transferred to the North
Lawn Building and the space vacated in the Crease unit was made into a chapel.
The sum of $50,000 was released to make alterations and improvements to
the Centre Lawn Building.
The central pharmacy and the Riverview Hospital unit pharmacy started
operation on April 1, 1965, as separate units. This change has improved the
service provided to the Riverview Hospital as well as the service provided to our
other branches.
The last of the patients occupying the Colony Farm cottage building were
transferred to other wards in the hospital on December 20, 1965. This building
will no longer be used for patient accommodation.
Valleyview Hospital, Essondale.—New dish-washers and garbage-disposal
units were installed on Wards 6 and 7.
Over 150 new beds were purchased during the year. These were to replace
old worn-out beds.
Coaxial television cable was installed on most of the wards, replacing the
antennas previously used.
A Burroughs accounting-machine was installed in the general office.
 G 20 MENTAL HEALTH SERVICES REPORT, 1965/66
Dellview Hospital, Vernon.—A diesel-engine electrical generator was installed
to provide stand-by power.
The institution's roads and parking-lots were resurfaced.
Air-cooling units were installed in the kitchen, stores, boiler-room, offices, and
dispensary.
A new steam cooker was installed in the kitchen.
Nearly $4,000 worth of additional and replacement furniture was purchased.
Skeenaview Hospital, Terrace.—The lower-floor centre section in the single
men's quarters was converted into a three-bedroom suite, while a one-bedroom
apartment in E Block was enlarged to make it a two-bedroom apartment. A start
was also made to convert a second one-bedroom apartment into a three-bedroom
unit.
The water mains were renewed and additional fire-hydrants installed.
The Woodlands School, New Westminster.—Extensive alterations were made
to B Ward to make it suitable for the care and treatment of autistic children.
Planning was started on extensive alterations to the Fraserview Building to
provide for new X-ray facilities, new laboratory, new central sterile supply, improvements in the Physiotherapy Department, etc.
A considerable amount of work was done in the nurses' residence in order to
provide additional administrative offices, lecture rooms, etc.
The Tranquille School, Tranquille.—The East Pavilion Building was completely renovated and now provides office accommodation for the Rehabilitation
Department and Social Service Department. In addition, it also provides accommodation for the volunteer services as well as a Boy Scout activity room, a lecture
and conference room, and a staff lounge.
A programme for the complete renovation of toilets and washrooms in the
Central Building was started. In addition, a considerable amount of work was
also carried out on the wards of this building in order to bring them up to a satisfactory standard.
As it will be necessary to use the recreation hall to feed the patients during the
construction of the new dining facilities, work was started to make it possible to
install a dish-washer and cafeteria counter in this area.
A new semi-automatic telephone switchboard is being installed. This new
board should be in operation early in April, 1966.
A new dump truck and a new automobile were purchased during the year.
A new parking-lot that will accommodate 56 cars was completed. An underground sprinkler system was installed in the new playing-field.
Mental Health Centre, Burnaby.—The exterior of the building was painted.
Extensive repairs were made to the roof of the building.
A new station wagon was purchased.
Mental Health Centre, Chilliwack.—Plans were completed and a contract let
to build an addition to the Public Health Building, Chilliwack, to provide facilities
for a mental health centre.
 GENERAL ADMINISTRATION
FINANCIAL TABLES
G 21
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, 1956/57 to 1965/66.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1956/57
1,232.48
3,503.60
284.81
541.83
232.58
288.45
232.85
$2,246,193.06
5,851,370.53
446,497.91
831,370.73
402,867.14
350,880.96
996,288.31
$1,822.50
1,670.10
1,567.70
1,534.38
1,732.17
1,216.43
4,278.67
$4.99
Provincial Mental Hospital, Essondale....
Provincial Mental Home, Colquitz	
Home for the Aged, Port Coquitlam
4.58
4.30
4.20
4.75
3.33
Crease Clinic	
11.72
Totals for the year	
6,316.60
$11,125,468.64
$1,761.31
$4.83
1957/58
1,266.21
3,410.79
285.36
538.56
231.34
288.63
235.31
$2,484,024.86
5,716,745.90
460,863.85
898,225.93
395,584.86
379,826.63
1,077,897.96
$1,961.78
1,676.08
1,615.03
1,667.83
1,709.97
1,315.96
4,580.76
$5.37
Provincial Mental Hospital, Essondale ...
Provincial Mental Home, Colquitz	
Home for the Aged, Port Coquitlam	
Home for the Aged, Vernon.  	
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....
Provincial Mental Home, Colquitz
Home for the Aged, Port Coquitlam
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	
20.39
5.05
6.83
5.26
Skeenaview Hospital, Terrace
3.95
Totals for the year
6,171.22
$14,531,218.39
$2,354.68
$6.43
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
6.91
5.30
Skeenaview Hospital, Terrace
3.94
Totals for the year....
6,292.37
$15,409,097.08
$2,448.85
$6.71
1961/62
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
2,015.43
1,542.94
i
\
$15.23
Provincial Mental Hospital, Essondale...
6.72
7.38
The Tranquille School, Tranquille	
Provincial Mental Hospital, Essondale...
Valleyview Hospital, Essondale 	
Dellview Hospital, Vernon..  —
Skeenaview Hospital, Terrace	
7.20
4.88
6.88
5.52
4.23
Totals for the year	
6,207.30
$15,832,999.14
$2,550.71
!        $6.99
 G 22
MENTAL HEALTH SERVICES REPORT,  1965/66
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, 1956/57 to 1965/66—Continued.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
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	
Valleyview Hospital, Essondale	
6.95
6.12
7.34
5.53
Skeenaview Hospital, Terrace	
4.08
6,095.15
$16,354,798.43
$2,683.25
$7.35
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...
7.37
8.19
The Tranquille School, Tranquille	
Provincial Mental Home, Colquitzi	
Valleyview Hospital, Essondale	
Dellview Hospital, Vernon	
Skeenaview Hospital, Terrace	
6.78
14.41
7.52
5.92
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
2,938.71
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
The Tranquille School, Tranquille	
Valleyview Hospital, Essondale	
Dellview Hospital, Vernon	
Skeenaview Hospital, Terrace 	
8.07
8.55
6.47
4.82
Totals for the year	
6,074.47
$19,055,762.00
3,137.02
$8.59
1965/66
2,797.80
1,291.27
562.37
763.44
227.35
295.38
$10,230,637.00
4,981,190.00
1,876,093.00
2,510,228.00
595,532.00
551,447.00
$3,656.67
3,857.59
3,336.05
3,288.05
2,619.45
1,866.91
$10.02
The Woodlands School  	
10.57
The Tranquille School, Tranquille	
Valleyview Hospital, Essondale 	
Dellview Hospital, Vernon 	
9.14
9.01
7.18
5.11
Totals for the year 	
5,937.61
$20,745,127.00
$3,493.85
$9.57
 GENERAL ADMINISTRATION G 23
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, 1966.
Gross operating costs—
Riverview Hospital, Essondale  $10,230,637
The Woodlands School, New Westminster  4,981,190
The Tranquille School, Tranquille  1,876,093
Valleyview Hospital, Essondale  2,510,228
Dellview Hospital, Vernon  595,532
Skeenaview Hospital, Terrace   551,447
Gross cost, all institutions  $20,745,127
Less collections remitted to Treasury       1,915,661
$18,829,466
Daily average population  5,937.61
Gross per capita cost, one year  $3,493.85
Gross per capita cost, one day  $9.57
Net per capita cost, one year  $3,171.22
Net per capita cost, one day  $8.69
Revenue (Patients' Maintenance Collections) oj the Mental Health Services
jor the Past 10 Years
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
1960/61  1,906,847.71 1965/66  1,915,661.00
 G 24                        MENTAL HEALTH SERVICES REPORT, 1965/66
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G 27
Table F.—Expense Statement of the Valleyview Hospital, Essondale,
for 12 Months Ended March 31, 1966
Salaries, Supplies, and
Operating Expense
Net Vouchered
Expenditure
Services and
Supplies from
Public Works
Department
Actual Cost of
Operations
Yearly per
Capita Cost
$1,852,806
10,828
2,212
1,938
65,000
113,478
284,687
19,050
2,798
4,500
992
93,892
1,792
752
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$1,852,806
10,828
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1,938
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113,478
284,687
19,050
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4,500
992
93,892
1,792
752
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61,004
7,568
714
501
$2,426.92
Office expense. -	
	
14.18
2.90
2.54
85.14
Medical care . 	
	
148.64
372.90
24.95
Gratuities	
Maintenance and operation of equipment.	
	
3.66
5.89
1.30
122.99
Occupational and recreational therapy	
2.35
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2.48
1.82
$61,004
79.91
Less—■
Increase in inventory from institu-
7,568
714
501
9.91
.94
.66
Totals    	
$2,449,224
$61,004
$2,510,228
$3,288.05
 G 28
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 G 30 MENTAL HEALTH SERVICES REPORT, 1965/66
Table I.—Institution Stores
Net undistributed stores as per Public Accounts  $19,478
Adjustments re farm profits   72,394
$91,872
Inventory adjustment—
Plus on hand, March 31, 1965  400,697
Less on hand, March 31, 1966  543,947
Net increase in inventory1   $51,378
1 The increase in inventory has been transferred to the following institutions proportionately using  the
' net vouchered expenditure " as the basis for distribution:—
Riverview Hospital       $29,244
The Woodlands School       14,566
Valleyview Hospital           7,568
$51,378
Table J.—Expense Statement of the Community Services for
12 Months Ended March 31, 1966
Mental Health Centre, Burnaby
Salaries   $527,521
Office expense   4,373
Travelling expense   10,339
Office furniture and equipment  2,089
Heat, light, power, and water  16,934
Medical care   30,199
Dietary   7,816
Laundry  1,500
Maintenance and operation of equipment  2,484
Transportation   1,897
General supplies   3,854
Occupational and recreational therapy  1,658
Patients' education   1,176
Motor-vehicles and accessories   2,956
General expense  8,247
Buildings, grounds, etc.   44,097
Less rentals   40
Total  $667,100
Mental Health Centre, Victoria
Salaries   $104,858
Office expense  2,621
Travelling expense  1,851
Office furniture and equipment  1,479
Medical care   11,218
Maintenance and operation of equipment  396
Motor-vehicles and accessories   1,832
General expense   2,523
Buildings, grounds, etc.   15,959
Total  $142,737
 GENERAL ADMINISTRATION
G 31
Table J.—Expense Statement of the Community Services for
12 Months Ended March 31, 1966—Continued
Mental Health Centre, Kelowna
Salaries 	
Office expense	
Travelling expense	
Office furniture and equipment
Medical care 	
Maintenance and operation of equipment
General expense 	
Total	
$39,765
751
3,365
664
5,604
1,179
954
$52,282
Mental Health Centre, Trail
Salaries 	
Office expense 	
Travelling expense	
Office furniture and equipment
Medical care 	
Maintenance and operation of equipment
General expense 	
Total
$1,021
1,225
1,245
367
3,459
357
56
$7,730
Mental Health Centre, Nanaimo
Salaries 	
Office expense 	
Travelling expense
Medical care 	
Maintenance and operation of equipment
General supplies 	
Patients' education 	
General expense 	
Total
$1,345
1,490
2,577
13,879
277
381
110
110
$20,169
Mental Health Centre, Prince Georgei
General expense
$64
Expansion oj Community Services
Expenditure ___
$41,004
Grand total, $931,086
 G 32 MENTAL HEALTH SERVICES REPORT,  1965/66
Table K.—Expense Statements of the Rehabilitation Centres for
12 Months Ended March 31, 1966
Vista Rehabilitation Centre
Salaries  -  $21,388
Office expense  193
Heat, light, power and water  988
Dietary   4,333
Transportation  18
General supplies   1,452
General expense  394
Buildings, grounds, etc.  202
Total  $28,968
Venture Rehabilitation Centre
Salaries   $18,433
Office expense  116
Heat, light, power, and water  1,080
Dietary   7,057
General supplies   898
General expense  284
Buildings, grounds, etc.  543
Total  $28,411
Rehabilitation and Ajter-care Programme
Salaries   $54,241
Office expense  1,402
Travelling expense  8,007
Office furniture and equipment  1,559
Medical care  40,000
Dietary   165
General supplies  16
General expense  133
Total  $ 105,523
Grand total, $162,902
 GENERAL ADMINISTRATION G 33
Table L.—Expense Statement of General Administration, Mental
Health Services Branch, for 12 Months Ended March 31, 1966
Salaries   $23 6,921
Office expense  6,206
Travelling expense  10,472
Office furniture and equipment  1,229
Grant to trustees of Patients' Comfort Fund  8,000
Grant to Department of Neurological Research, University of
University of British Columbia  22,500
General expense  710
Subscription, Social Service Index  20
Administration of Psychiatric Nurses Act  2,210
Council of Psychiatric Nurses for Bursary Trust Fund  1,200
Less miscellaneous receipts  12,323
Total  $277,145
Table M.—Expense Statement of the Department of Nursing Education,
Essondale, for 12 Months Ended March 31, 1966
Salaries   $755,396
Office expense  4,683
Travelling expense  1,587
Office furniture and equipment  541
Medical care  811
Dietary  7,882
Laundry  5,000
General supplies  20,288
Audio-visual   24
General expense  3,829
Less—
Rent deductions  13,580
Miscellaneous receipts  161
Total  $786,300
 G 34 MENTAL HEALTH SERVICES REPORT, 1965/66
Expenditure Made under Federal Health Grants for Province of
British Columbia, Year Ended March 31, 1966
Assistance to Provincial Mental Hospitals—Staff salaries .._ $242,792.59
The Woodlands School, New Westminster-—Staff salaries.— 46,503.33
Assistance to the Mental Health Centres—Staff salaries  104,463.01
Division of Nursing Education—Staff salaries  11,976.00
Consultant staff, Mental Health Services Branch — Staff
salaries  11,386.56
Assistance to the Department of Psychiatry  47,516.49
Assistance to the Department of Social Work  7,800.00
Mental hygiene programme, Metro Health Committee, Vancouver   60,165.00
Mental hygiene programme,  Greater Victoria Board  of
Health  6,500.00
Psychiatric services, Vancouver General Hospital  50,643.89
Assistance to the British Columbia Epilepsy Society  5,000.00
Assistance to the Children's Foundation  14,650.00
General personnel training—-Postgraduate training  28,828.37
Total  $638,225.24
Reconciliation with Public Accounts, 1965/66
Table L—General Administration (as per Public Accounts)—
Salaries       $236,921
Expenses  40,224
Vouchered expenditure       $277,145
Deduct salary adjustments   9,984
$267,161
Table M—Department of Nursing Education  (as per Public Accounts)—
Salaries       $755,396
Expenses   30,904
Vouchered expenditure       $786,300
Deduct salary adjustments  12,468
Table J—
Mental Health Centre, Burnaby (as per Public Accounts)—■
Salaries       $527,521
Expenses         139,579
773,832
Vouchered expenditure       $667,100
Deduct—
Building and grounds __    $44,097
Portion of farm profit  409
  44,506
622,594
 GENERAL ADMINISTRATION G 35
Reconciliation with Public Accounts, 1965/66—Continued
Table J—Continued
Mental Health Centre, Victoria (as per Public Accounts)—
Salaries       $104,858
Expenses   37,879
Vouchered expenditure       $142,737
Deduct buildings and grounds  15,959
Mental Health Centre, Kelowna (as per Public Accounts)—
Salaries         $39,765
Expenses   12,517
Mental Health Centre, Trail (as per Public Accounts)—
Salaries   $1,021
Expenses   6,709
Mental Health Centre, Nanaimo (as per Public Accounts)—
Salaries   $1,345
Expenses   18,824
Table C—Riverview Hospital (as per Public Accounts)—
Salaries   $6,724,325
Expenses      2,767,930
Vouchered expenditure  $9,492,255
Deduct—
Salary adjustments   $321,348
Maintenance receipts      840,020
Portion of farm profit       72,394
     1,233,762
$126,778
52,282
7,730
20,169
Mental Health Centre, Prince George (as per Public Accounts)
—Expenses   64
Expansion of community services  41,004
Deduct salary adjustments—
Mental Health Centre, Burnaby        $25,848
Mental Health Centre, Victoria  3,552
Mental Health Centre, Kelowna  2,208
Mental Health Centre, Trail  1,860
Mental Health Centre, Nanaimo  1,764
 35,232
8,258,493
 )
G 36 MENTAL HEALTH SERVICES REPORT,  19-65/66
Reconciliation with Public Accounts, 1965/66—Continued
Table K—
Vista Rehabilitation Centre (as per Public Accounts)—
Salaries         $21,388
Expenses  7,580
Vouchered expenditure        $28,968
Deduct—
Salary adjustments       $1,188
Buildings and grounds  202
  1,390
Venture Rehabilitation Centre (as per Public Accounts)—
Salaries         $18,433
Expenses   9,978
Vouchered expenditure         $28,411
Deduct—
Salary adjustments  $876
Buildings and grounds  543
  1,419
Rehabilitation and After-care Programme (as per Public Accounts)—
Salaries         $54,241
Expenses  51,282
Vouchered expenditure      $105,523
Deduct salary adjustments  22,764
Table F—Valleyview Hospital, Essondale (as per Public Accounts)—
Salaries   $1,852,806
Expenses        603,986
Vouchered expenditure  $2,456,792
Deduct—
Salary adjustments     $88,452
Maintenance receipts     442,838
Portion of farm profit        9,813
        541,103
Table G—Dellview Hospital, Vernon (as per Public Accounts) —
Salaries       $380,365
Expenses        138,145
Vouchered expenditure      $518,510
Deduct—
Salary adjustments     $17,952
Maintenance receipts     136,973
Portion of farm profit  114
   155,039
$27,578
26,992
82,759
1,915,689
363,471
 GENERAL ADMINISTRATION G 37
Reconciliation with Public Accounts, 1965/66—Continued
Table H—Skeenaview Hospital, Terrace (as per Public Accounts)—
Salaries       $322,608
Expenses        160,416
Vouchered expenditure      $483,024
Deduct—
Salary adjustments     $14,892
Maintenance receipts     166,494
        181,386
Table D—The Woodlands School (as per Public Acocunts)—
Salaries   $3,659,952
Supplies      1,067,943
Vouchered expenditure  $4,727,895
Deduct—
Salary adjustments  $196,692
Maintenance receipts „„    253,588
Portion of farm profits       15,845
        466,125
Table E—The Tranquille School (as per Public Accounts)—
Salaries   $1,073,812
Expenses        542,295
Vouchered expenditure  $1,616,107
Deduct—
Salary adjustments     $37,320
Maintenance receipts       75,748
Portion of farm profit         3,295
        116,363
Table I—Net Undistributed Stores (as per Public Accounts)         $19,478
Add distribution of farm profits to Riverview Hospital   72,394
$301,638
4,261,770
1,499,744
Adjusted undistributed stores  91,872
Special Warrant No. 13—ex gratia payment to R. H. Robinson  3,500
Total Mental Health Services Branch expenditures (as per
Public Accounts)   $18,709,888
 G 38 MENTAL HEALTH SERVICES REPORT, 1965/66
PERSONNEL REPORT
J. Dowling, Personnel Officer
The establishment of the Mental Health Services Branch increased during the
fiscal year as follows:— XT   .     .„
J Number of New
Unit Positions
General Administration  1
Riverview Hospital  24
Dellview Hospital  3
Skeenaview Hospital  3
The Woodlands School  30
The Tranquille School  111
Total  172
As of March 31, 1966, there were 3,818 persons on Branch payrolls, including
263 student psychiatric nurses. This represents an increase of 165 employees and
42 student nurses.
Recruitment and separation activity increased due to general expansion of
personnel and to the increasing use of vacation and sick relief staff. The number
of persons steadily employed on a part-time basis also increased, from 87 as of
March 31, 1965, to 119 one year later. To effectively use an increasing number
of short-term relief and part-time employees has presented problems, but there is
reason to believe that efficient utilization has been achieved in most units.
Over-all staff turnover, excluding relief staff, has increased slightly. A most
unusual rise to 5.5 per cent occurred in the male psychiatric nurse classification.
A related factor is the decreasing number of male students in the psychiatric nursing
programme. This is attributable to increasing job opportunities for young men in
other fields of endeavour.
While year-end student enrolment in the psychiatric nursing programme was
42 higher than at the close of the preceding fiscal year, the quarterly average enrolment was slightly lower.
Generally speaking, staffing throughout the Branch has been well maintained.
Departmental plans to expand the housekeeping departments in the larger units
have been delayed due to our inability to recruit well-qualified executive housekeepers. These problems have been largely overcome, and plans will proceed in the next
fiscal year.
The Personnel Officer participated in the following matters of some importance:—
(1) Planning for the reorganization and unification of the men's and women's
nursing services of Riverview Hospital.
(2) Planning and development of new employee classifications for the expansion of rehabilitation services of Riverview Hospital.
(3) Reorganization of the audio-visual department of the Riverview Hospital.
(4) Planning and staffing of the 104-bed Sage Building of The Tranquille
School.
(5) A survey intended to identify and reclassify positions classified as psychiatric aides but not functioning in accordance with the job specification for
psychiatric aide.
 GENERAL ADMINISTRATION
G 39
(6) A review of social worker position specifications and qualifications as applied to psychiatric social workers.
(7) The conversion of Branch payroll procedures to computer methods.
Figures indicative of personnel activity and reflecting the staffing position of
the Branch are contained in the tables appended to this report.
STATISTICAL TABLES
Table A.—Summary Showing Over-all Staff Totals in Relation to
Separation and Recruitment
Staff recruited, excluding students	
Staff separated, transferred, etc., excluding students
Increase 	
1,267
1,102
165
Total staff, excluding students, as of March 31, 1966  3,555
Total staff, excluding students, as of March 31, 1965  3,390
Increase
Quarterly staff average, excluding students, 1965/66
Quarterly staff average, excluding students, 1964/65
Increase 	
165
3,536
3,395
141
Male        Female
Student enrolment as of March 31, 1966     25        238
Student enrolment as of March 31, 1965     34        187
Change
Student quarterly average, 1965/66
Student quarterly average, 1964/65
Total
263
221
+51       +42
240
246
Change
—6
 G 40
MENTAL HEALTH SERVICES REPORT,  1965/66
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
Miscellaneous adjustments, transfers, etc.
Established Positions
Recruited
Separated
19
17
48
37
226
212
110
99
68
64
1
13
11
2
6
1
12
5
21
16
5
4
2
15
39
47
12
12
45
41
1
19
8
6
8
7
146
800
467
118
731
339
32
Totals   1,267
1,102
 GENERAL ADMINISTRATION
Table C.—Summary of Staff Turnover
By Major Classification
G 41
Classification
1964/65
1965/66
Change
Student psychiatric nurses.
Male psychiatric nurses	
Female psychiatric nurses...
Registered nurses	
Per Cent
24.4
10.0
25.6
25.2
Per Cent
19.6
15.5
26.1
29.9
Per Cent
-4.8
+5.5
+0.5
+4.7
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,
1964/65
Temporary
Relief Staff
Excluded,
1965/66
General Administration-
Department of Nursing Education!-
Riverview Hospital-
The Woodlands School-
The Tranquille School....
Valleyview Hospital	
Dellview Hospital	
Skeenaview Hospital	
Mental Health Centres...
Over-all turnover..
Per Cent
13.1
17.0
19.5
21.9
36.8
22.0
23.0
23.9
22.1
19.9
Per Cent
13.9
18.4
21.0
17.4
34.2
22.9
22.7
15.1
20.8
20.5
1 Student nurses not included.
Note.—Percentages calculated against year-end staff totals.
Table D.—Comparison of Staff Totals by Unit with Totals for the
Preceding Fiscal Year
Fiscal Year 1964/65
Fiscal Year 1965/66
Positions
in Establishment as of
Mar. 31,
1965
Number on
Staff as of
Mar. 31,
1965
Positions
in Establishment as of
Mar. 31,
1%6
Number on
Staff as of
Mar. 31,
1*66
43
63
140
38
59
113
44
63
140
43
60
130
Sub-totals  .  . .    -	
246
210
247
233
In-patient care—
Riverview Hospital  	
The Woodlands School , 	
1,517
826
230
440
86
68
1,537
825
236
428
87
67
1,540
856
341
440
89
71
1,558
869
298
436
90
71
Total of vote	
3,167
3,180
3,337
3,322
3,413
325
3,390
221
3,584
325
3,5551
263
Student psychiatric nurses	
Totals        	
3,738
3,611
3,909
3,818
i Includes 119 part-time employees.
 G 42
MENTAL HEALTH SERVICES REPORT,  1965/66
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 GENERAL ADMINISTRATION
G 43
REPORT OF SOCIAL SERVICE CONSULTANT
Miss A. K. Carroll
Throughout the Mental Health Services Branch, the social service departments
have found this year to be one of increasing demands for service requiring sharp
focusing and refinement of skills, extension of services, and a reaffirmation of personal and professional commitment to the service of the individual, the family, and
community. The following programme formulations and advancements taking place
this year are noteworthy:—
(1) The continuing programme of integration of hospital treatment and care
services with community health, welfare, education, and rehabilitation
services which, through the establishment of special projects, provide for
a continuum of treatment and care.
(2) Treatment planning, which involves the patient in his family wherein the
family is the unit to be treated.
(3) The continuing extension and co-ordination of community mental health
services and their integration with community mental health services.
(4) The development of community resettlement programmes, such as home
care, family care and boarding home, group homes for therapeutic care,
group homes for pre-occupational experience and training, and nursing-
home care.
PROFESSIONAL EDUCATION RESPONSIBILITIES
During the year 19 students (7 second-year and 12 first-year postgraduate
students) had field-work placements in the following divisions of the Mental Health
Services: Riverview Hospital and After-care Clinic, 10 students; Mental Health
Centre, Burnaby, 7 students; The Woodlands School, 2 students.
Supervisory social-work staff, in their capacity as field-work instructors of
student social workers, attended a one-day institute under the auspices of the School
of Social Work, University of British Columbia. Throughout the year approximately
100 in-service training students from the Department of Social Welfare were oriented
in three sessions to the Mental Health Services programme generally, and to the role
and services of social workers in a mental health setting. Additionally, this staff met
with the faculty of the Welfare Aide Course, Vancouver City College, to discuss a
programme of orientation. Later, 30 students from the college attended group sessions focused on understanding of structure, functions, and services of social service
in a large mental hospital. Additionally, educative group sessions were conducted
by Mental Health Services supervisory social-work personnel for groups of nursing
students from the School of Nursing, University of British Columbia, and from the
schools of nursing in Vancouver General Hospital, Royal Columbian Hospital in
New Westminster, and St. Joseph's Hospital in Victoria.
PUBLIC EDUCATION AND INTERPRETATION RESPONSIBILITIES
Public education and interpretation to both professional and lay groups is an
important responsibility which must be assumed by the entire staff of the Mental
Health Services Branch. In this way individuals and groups at community level are
kept abreast of developments in the mental health programme and thus are enabled
to incorporate the principles of mental health into community planning and programming. To this purpose the social service departments of the Mental Health
Services have, during the year, been active with staffs of the National Employment
 G 44 MENTAL HEALTH SERVICES REPORT,  1965/66
Services, Department of Indian Affairs and the Indian Health Services, the Department of Veterans Affairs, the probationary services, the Children's Aid Societies of
Vancouver, the family service agencies of Vancouver, Vancouver General Hospital
Social Service Department, Shaughnessy Veterans' Hospital Social Service Department, the Sisters of the Vincent Home and Shelter, and with representatives from
the Canadian Mental Health Association.
The orientation of lay people and professional people to the Mental Health
Services is another effective way to carry out the purposes of community education
and interpretation. All social workers in every division of the Mental Health Services have assisted in these orientations during this year. District Supervisors,
Department of Social Welfare, in Burns Lake, Prince George, Vanderhoof, Haney,
Abbotsford, Chilliwack, Langley, and Richmond were oriented to Riverview Hospital, Valleyview Hospital, and The Woodlands School programmes and to the social
service departments in these institutions. These orientations have been extended also
to Medical Health Officers and public health nurses as well as to the staff of the G. F.
Strong Rehabilitation Centre, the Municipality of Burnaby school social worker and
psychologist, the Pre-social Work Club, University of British Columbia, school
counsellors, and many groups of high-school students, including one from Blaine,
Wash. Additionally, well over 200 relatives and friends of patients have been
oriented to the services of divisions of the Mental Health Services.
An institute was offered by Riverview Hospital to boarding-home operators and
family-care holders working with the social workers—Mental Health Services in the
community resettlement of mentally disabled patients who no longer need in-hospital
treatment or care. The institute was focused on the understanding of mental disability and ways of effecting habilitation and rehabilitation through programmes
such as the boarding home or family care.
STAFF-DEVELOPMENT PROGRAMME
This year four social workers in the Mental Health Services attended advanced
study courses in Community Development and Organization, and in Administration
and Supervision offered by the Department of Extension, University of British Columbia. Additionally, 25 social workers attended an Institute on Family Group
Therapy given by Mrs. Virginia Satir under the auspices of the Mental Health
Centre, Burnaby; 10 social workers attended a Workshop on Religion and Psychiatry given under the auspices of the Mental Health Centre, Burnaby; 15 social
workers attended the workshop and institutes conducted by the Conference of the
American Public Welfare Association; Northwest Regional Conference, Child Welfare League of America; Northwest Conference of the American Association on
Mental Deficiency; Pacific Northwest Regional Institute, Family Service Association
of America; the Pacific Northwest Regional Institute of the National Association of
Social Workers for practitioners in medical and psychiatric settings.
SOCIAL-WORK CONSULTATIVE SERVICE
This is a staff service to superintendents, directors, and social service departments in the Mental Health Services Branch. This year 53.6 per cent of the consultant's total man-hours of work was spent in direct services through visitation to
social services throughout the divisions of the Mental Health Services Branch, on
request. Additionally, 11 per cent of man-hours of work was spent in rendering
consultation as requested by the use of the mails and telephone. The percentage of
consultative time has risen sharply from 42.6 per cent in 1964 to 64.6 per cent during
 GENERAL ADMINISTRATION
G 45
the year.   Consultation continued to be requested in the following areas, and in this
order of priority:—
(1) Community resettlement of patients resident in hospitals and schools for
the retarded; programmes for remotivation and socialization in boarding
homes and intermediate-care homes, including further reports on the
subsequent and future developments in this service.
(2) Administration and organization of small group-care homes, boarding
homes, and intermediate-care homes interdivisionally and interdepartmentally with the Department of Social Welfare. Further reports on the
extension of the use and repositioning of the Co-ordinator of Boarding
Homes position together with suggestions regarding regional development
of this programme with indications for the relocation of social-work staff
to man the service.
(3) Personnel procurement, maintenance, and retention; staff development
and training; staff-patterning, including a special report on a social-work
classification series for workers in the Mental Health Services, including
reference to the value of an establishment for technical workers.
(4) Social service emphases as these relate to the continuing organizational
and functional changes in the departments consequent to community-
centredness of services subsequent to the regionalization of mental health
services.
(5) Integration of the contribution of public health nursing in the after-care
and community resettlement of patients.
(6) Pre-admission and after-care continuum of social services in hospitals and
schools for the retarded as these become further conceptualized out of
recent changes in mental health legislation.
DISTRIBUTION OF CONSULTATIVE RESPONSIBILITIES
Riverview Hospital
Consultation has been given as requested in relation to social service organization and programme in relation to the adolescents in treatment and their resettlement
in community; staffing, organization, and programme for social service in the reception and acute-treatment areas of the regionalized hospitals at Centre Lawn and
Crease Unit; pre-admission services and after-care social services in the regionalized
hospitals; the development of boarding homes for young schizophrenic patients
during the initial phases of leave from hospital; recommendations were submitted
regarding the responsibilities to patients as well as their status on transfer to boarding
homes. The manual for co-operative services and procedures between Mental Health
Social Services and community health and welfare agencies was completed and sent
forward for printing. Continued consultation has been requested and given in relation to the development of the public health contribution in the resettlement of patients in boarding homes in the upper and central Fraser Valley public health areas.
Consultation has been given from time to time in regard to social services in complex
case situations.
The Woodlands School
Consultation was sought and given in relation to the specifics of the positions,
functions, and responsibilities of the supervisory positions in the social service department and the out-patient department; the on-going development of the adult
boarding-home programme; social-work consultative services to public health districts adjacent to the School; the development of group homes for training adoles-
 G 46 MENTAL HEALTH SERVICES REPORT, 1965/66
cents in jobs and their subsequent job placement. The project for foster-home
placement of children resident in the School was studied and an evaluation of the
programme was written. This project has proven to be a most successful experiment, indicating the value of foster-home placement as a care and training form
among a number of care and training variants necessary in a programme for retarded
children.
The Tranquille School
During the year, consultation has been requested on a regular basis. During
the year the social service department gained in established staff positions. The
organization, functions, procedures, and services have now been delineated. Staff
now stands at three trained social workers. Consultation continues in the areas of
boarding home, special group homes, and employment placement. In the latter
programme an employer-employee placement agreement has been devised which
defines the conditions under which each employee (trainee) is being hired and the
supervision and training obligations assumed by the employer. Attempts are being
made by the social service department to help families accept their retarded back
into the home when the School's education and training goals have been reached.
With the use of Disabled Person's Allowance and community health and welfare
services, the family can be assisted in assuming responsibility for care and supervision in the home. This programme is necessary as many residents in The Tranquille
School were admitted when services for the retarded did not exist in their communities. As a result, families having retardates tended to view the disability as beyond
the resources of the home and community. Today, because of the developments in
public education for the educable and trainable retardate and the services which
community health and welfare agencies are prepared to offer the family with a retardate, admissions of the mildly and moderately retarded should be largely unnecessary. The contribution of the social service department in The Tranquille School
deserves the highest commendation. The employment, placement, and boarding-
home programme developed during this year is an outstanding development.
Valleyview Hospital
Consultation was sought and given in relation to procurement and maintenance
of staff, and the continuing development of the pre-admission and post-admission
social services as well as the programmes for nursing- and boarding-home placement,
care, and supervision. The contribution of the social service department in services
to discharged patients, their relatives and families, is an outstanding one and resulted
in the community resettlement of 195 patients this year.
BOARDING-HOME AND FAMILY-CARE PROGRAMME
In the on-going development of this programme, the following factors must
receive consideration:—
(1) Basic Planning: Service Policy.—Exploration of the possibility of extending the present programme through—
(a) Formulation of a definitive statement of policy as concerns the
specific responsibilities for programme and services by Public Health and
Mental Health Branches and the Department of Social Welfare in relation
to the needs of those unemployable and disabled adults who " on account
of age, infirmity, physical or mental defect, or other disability " are in
need of " care and attention " as defined in the Welfare Institutions Licensing Act and regulations. This would include services available from decentralized mental health centres in areas not accessible to the institutions.
 GENERAL ADMINISTRATION G 47
(£>) Staff. The increase of staff in the district offices of the Provincial and municipal departments of social welfare, as well as an increase
or relocation of social-work personnel in mental hospitals and schools for
the mentally retarded to district offices. This would permit the social
workers to work directly with these adults and integratively with district
health and welfare services. Extensive work is needed at field level with
general practitioners and boarding-home operators to develop a programme of protective supervision and activation to adults who because of
" mental defect or other disability " require " care and attention " while
domiciled in a boarding home.
(c) Some study of the role of public health in services to these adults
and to boarding-home operators. In relation to this, an evaluation of the
co-operative service project between Central Fraser Valley Public Health
Unit and the Mental Health Services Co-ordinator of Boarding Home
Programme might be undertaken. Such an evaluation might provide useful guidelines in developing co-operative services across the departments.
(2) Present Programme.—(a) It is possible to extend the present programme
in Riverview Hospital, Valleyview Hospital, The Woodlands School, and
The Tranquille School with services assumed by some relocation of social
work staffs in these departments.
(£>) Provision of clothing to disabled adults continuing to reside in
a boarding home beyond an initial period of six months could be assumed
by the Department of Social Welfare through coverage which exists for
all recipients of social allowance. It is to be noted that the Municipality
of Burnaby has accepted this responsibility.
(c) It is possible for disabled adults to visit a local doctor of their
choice shortly after placement in the boarding home. A group of doctors
in the Central Fraser Valley area have asked that disabled adults be helped
to choose a doctor and visit him soon after placement before emergency
or crisis illness.
(d) Those patients who are residents of the Province and who are
admitted to hospital to undergo a course of treatment extending from a
few weeks to two years may either be discharged in full or placed on
extended leave to their area of residence with a recommendation for
boarding-home or private-hospital care. These patients are referred to
the local municipal office or the Department of Social Welfare district
office for boarding-home or private-hospital placement and related supervision.
MENTAL HEALTH CENTRES—BURNABY, VICTORIA,
KELOWNA, TRAIL, AND NANAIMO
Regular consultation has been available to the social service departments in
the Mental Health Centres in Burnaby and Victoria. Three consultative visits were
made to the Mental Health Centre in Nanaimo. During the year one consultative
visit was made to the Mental Health Centres in Kelowna and Trail. Social workers
practising in these mental health facilities are extremely active in bringing then-
competency as part of a team-directed service to the development of community-
based mental health programmes which involve them in direct treatment, consultation, community organization, community education, and the exploration of preventive measures and services. These latter have ranged from workshops on family
life, adolescence, and an institute on marriage for moderns.   Other preventive ser-
 G 48 MENTAL HEALTH SERVICES REPORT, 1965/66
vices have concerned the development of special foster homes for adolescents and
for children with beginning emotional and (or) behavioural disorders. Continuing
services for foster-parents and to the children placed are offered by the centres. The
regional supervisors of psychiatric social work in the Mental Health Centres continue
to make a significant contribution in the development of community mental health
programmes focused on the prevention of mental ill health.
CENTRAL BRANCH RESPONSIBILITIES
These centre around the following conference bodies:—
(a) The Branch staff meeting.
(£>) The Interdepartmental Case Review Committee.
(c) Unit administrative conferences.
(d) The Boarding Home Programme Committee.
(e) The Rehabilitation Consultative Council.
if) Social Work Council.
Additionally the responsibility for community development in health and welfare which this position together with all others at Branch Administration assumes
has demanded active participation in the Community Placements Committee of the
Association for Retarded, British Columbia; Scientific Planning Committee of the
Canadian Mental Health Association; the Welfare and Recreation Division of the
Council of Agencies; the Welfare Institutions Licensing Board; the Division for the
Guidance of the Handicapped and the Conference on B.C. Health and Welfare.
 GENERAL ADMINISTRATION G 49
REPORT OF NURSING CONSULTANT
Miss M. M. Lonergan, Nursing Education
At the request of the Department of Nursing Education, its various teaching
programmes were reviewed during the past fiscal year by the Branch Administration.
Purposes and functions were clarified, and significant beliefs and recommendations
approved. These decisions influenced each programme and formed the basis for
immediate and more distant goals and plans.
The psychiatric nursing programme showed a year-end census of 263 students
compared to the previous year's total of 221. The department received 1,311 and
processed 466 applications. One hundred and seventy-eight candidates enrolled in
the programme. The academic standing of the September entrance class was high-
school standing on either the University Programme or the General Programme.
The same was true of 63 per cent of the February entrance class, with the remaining
students deficient in one or two subjects. The expectation is that these will be
completed by correspondence within two years. Forty-seven students withdrew
from the programme during the year; 38 per cent failed academically, 55 per cent
for personal reasons, including marriage and illness, and 1 per cent were considered
to have unsuitable personalities. The latter figure showed a marked decrease from
the 30 per cent of previous years. The final comprehensive examination, in the
second year of its use, accounted for 17 failures at the first writing; four students
were unable to pass the supplemental and consequently were required to withdraw
from the programme. Ninety-three students successfully completed the programme
and became eligible for licensure as psychiatric nurses in the Province of British
Columbia.
The psychiatric-aide programme offered 21 five-day courses encompassing 735
hours of instruction for 274 psychiatric aides entering the Service or on staffs of
Dellview, Riverview, Skeenaview, and Valleyview Hospitals, The Tranquille School
and The Woodlands School, and Vista and Venture. The requirement that all psychiatric aides receive formal instruction was established by policy. Instructors were
assigned to clinical areas for one day a week in order to evaluate the effectiveness
of their teaching in the light of nursing service expectations of the psychiatric aide.
Projects completed by instructors included (a) revision of the Information Bulletin,
(6) implementation of a form for the assessment of aide performance in class, (c)
development of a form for the evaluation of the aide's performance following a
course, (d) completion of educational records for presently employed aides, and
(e) use of experience records as teaching-tools. A four-month time study showed
that instructors assigned to this programme contributed an average of 40 per cent
of their time to assigned teaching in the psychiatric nursing programme. The senior
instructor visited each Interior institution to conduct one two-week course to supplement on-going orientation and in-service education provided in these institutions.
A review of the Post-basic Programme prompted the decision to hold in abeyance any further refresher courses for the graduate staff of the Lower Mainland
institutions until studies concerning the priority needs of nursing staff for educational programmes had been completed.
The Clinical Programme for Registered Nurses enrolled 16 students and
graduated 12. Two graduates accepted employment with the Mental Health
Services, three went on staff in psychiatric units of general hospitals, two returned
to general nursing, two entered the public health field, and two returned to their
homes.    One hundred inquiries were processed;   it was noteworthy that a large
 G 50 MENTAL HEALTH SERVICES REPORT,  1965/66
number of these indicated a preference for a short two- to three-month programme
in basic psychiatric nursing. The curriculum included 170 academic hours correlated with clinical experience in intensive- and continued-treatment wards of
Riverview Hospital. Nurse-patient relationship therapy was the focus of learning
initially, and rehabilitation, group and community relationships for the latter half
of the programme. The instructor's hours of structured teaching and related
activities totalled 850. At the close of the fiscal year, developments in the professional nursing community were being studied to determine whether or not the
clinical programme was meeting the current needs of registered nurses for psychiatric
nursing experience.
The Affiliate Programme, which had been temporarily discontinued in October,
1964, resumed in April. Agreement, with respect to the responsibilities of each
party, was formalized by an exchange of letters between the Mental Health Services
and each of three participating schools of nursing. The Department of Nursing
Education appointed a Co-ordinator charged with the administration of the programme, teaching designated curriculum content, conducting courses for public
health nurses, and arranging tours for visiting students. Each school of nursing
assigned one of its faculty for the clinical teaching and supervision of its students.
Although the curriculum was designed to have a body of fundamental content, each
instructor was able to modify this to ensure that the affiliation was an integral part
of the students home school of nursing curriculum. For the student, the applicability
of psychiatric nursing concepts and principles to the general nursing care of patients
became more discernible. Nevertheless, such transfer of learning continued to find
obstacles in the general hospital setting. With a view toward reducing these, instructors participated in faculty and in-service programmes for nursing staffs in their
home territories.
Two hundred and two students from three schools of nursing and four nurses
from the Health Services Branch completed the programme.
The Co-ordinator contributed 602 hours of structured teaching and related
activities in the operation of the Affiliate Programme.
The department's faculty functioned through standing committees to accomplish
a number of tasks. The Library Committee revised policies, developed a guide to
evaluate books recommended for purchase, established a library-user identification-
card system, and instituted a policy of fines for a six-month trial period. The
Examinations Committee prepared and marked 95 promotional examinations for
nursing positions and two examinations for candidates seeking licensure. The
Curriculum Committee developed criteria for evaluating the psychiatric nursing
programme curriculum, reviewed content and teaching methods, and outlined lesson
guides for nursing arts. The chairman was instrumental in initiating, for psychiatric
nursing students, junior-level courses in geriatric nursing and in training the retardate.
The Evaluation of Progress Committee reviewed the performance of each student
with respect to academic and clinicial performance, personality, and deportment,
and made appropriate recommendations to the department's administration.
The physical facilities of the department were increased by the acquisition of
three additional residences, thereby increasing the capacity for student accommodation by 99 beds. Some repair and remodelling took place through the residences.
The plan for gradual replacement of residence furniture continued for the fourth
year with gratifying results, largely due to the excellent workmanship provided by
the Industrial Therapy Department.
 GENERAL ADMINISTRATION G 51
NURSING CONSULTATION
Orientation to the Mental Health Services was provided for a number of newly
employed nurses, department heads, and distinguished visitors. Among the latter
were Mrs. E. McCue, Nursing Consultant, Department of National Health and
Welfare, and Miss G. Stokes, Project Director, Maimonides Hospital, Brooklyn.
The availability and utilization of Mental Health Services for educational purposes
prompted formal and informal discussions with representatives of the Registered
Nurses' Association of British Columbia, the Health Branch, and the University of
British Columbia. Guidelines were developed for determining enrolment and
clinical placement of learners from the latter two organizations. Three visits were
made to The Tranquille School and two to the Mental Health Centre, Victoria.
Psychiatric units at the Vancouver General Hospital and the Royal Jubilee Hospital
were toured. In connection with reorganization plans in nursing departments, the
Nurse Consultant met with medical and nursing administrators, together with executive officers of the Branch, and participated in a number of recruitment activities.
She was also involved in a variety of projects, such as educational conferences,
building programmes, surveys of facilities, and assessment of staffing plans. She
represented the Mental Health Services on various professional committees and
carried out assignments which ranged from invigilating registration examinations to
participating in the development of criteria for schools of nursing in British
Columbia.
Nursing Council reviewed the work of the Core Nursing Procedure Committee
and approved new and revised nursing procedures. It sought solutions to problems
concerning supplies of all types, transfers of nursing staff between institutions,
studied the extent to which present medical-surgical stock supplies were used, and
made recommendations regarding policies affecting medicine and nursing.
The Nursing Liaison Committee enlarged its membership to include representatives from general hospitals with psychiatric services and from the University of
British Columbia School of Nursing. Discussion clarified the responsibilities of
nurses in agencies involved in mental health programmes and provided information
about changing concepts in institutional care of the mentally ill. The effect of some
sections of the Mental Health Act, 1964, upon psychiatric programmes in general
hospitals was discussed with a view toward better understanding of the factors
involved.
Through the discharge of her responsibilities, the Nursing Consultant was
privileged to acquire an overview of the nursing division, which showed convincingly
that the quality of total care available to patients in the institutions of this Service
depended largely upon the competency of nursing, that the degree of competency
was significantly greater in direct ratio to the strength of the nursing administration
and its ability to direct its own service toward specified goals, and that the attainment
of general and specific goals were dependent upon a mutually co-operative relationship with other departments and disciplines.
 G 52 MENTAL HEALTH SERVICES REPORT, 19*65/66
REPORT OF THE CONSULTANT IN MEDICAL RECORDS
AND STATISTICS
Miss A. D. Dingle
The past year has brought some important changes in procedures in the medical
records of the mental health facilities. With the proclamation of the Mental Health
Act, 1964, new terms and routines had to be employed to meet the requirements of
the Act and new forms designed for recording and communicating data.
Supplies of forms for admission under the new Act are being issued to the public
from this office, and a special effort is being made to interpret the Act and the use
of the forms to the private physician's office staff when a request for forms is received.
The change to the unit numbering system throughout the Mental Health Services Medical Records Offices was also effective on April 1, 1965.
Changes have been made in the statistical tables of this year's annual report for
all facilities which are involved in placing patients in the community in significant
numbers. These tables will show separate details regarding the actual number of
patients in residence, those in boarding homes, and those on other extended leave,
rather than grouping all patients on the books, as has been done in the past.
As a result of the appointment of a Research Officer in the Division of Vital
Statistics, 80 per cent of whose time is assigned to the Mental Health Services
Branch, additional studies have been done for the Deputy Minister and for the
various facilities.
CONSULTATION TO UNITS
Riverview Hospital
On April 1, 1965, an expanded form for the collection of statistical data was
instituted in Riverview Hospital. With the large residential population for whom
forms were required, in addition to admissions and separations, the medical-records
staff have made a very praiseworthy effort to meet the challenge, and the programme
is operating fairly smoothly. The forms are pre-coded to assist in completion.
Members of the medical staff are looking forward with interest to the first reports of
the data collected and a review of the first six months is now under way.
SCHOOLS FOR MENTALLY RETARDED
During the year special statistical-data forms were designed for The Woodlands
School. Preparatory planning was done by a committee within the school in collaboration with the Division of Vital Statistics and this Consultant. This programme
will be started on April 1, 1966. The data to be gathered includes comprehensive
diagnostic detail, and the forms have been designed to permit later information to
be added as the patients develop. The Out-patient Department will also complete
these forms for children referred to them. A manual has been compiled giving
instructions and codes, and this has been issued to staff concerned.
It is hoped to extend this programme to The Tranquille School.
An interesting development is taking place in the Medical Records Department
of The Woodlands School. Open-shelf filing is replacing the filing-cabinets, and
colour coding is being installed for a numerical system of filing. This is the first
departure from alphabetical filing of active medical records in the in-patient faculties
of the Mental Health Services of this Province.
 GENERAL ADMINISTRATION G 53
Geriatric Division
Special statistical-data forms have also been designed for Valleyview Hospital.
A first attempt is being made on these forms to indicate periods of extramural care,
such as boarding-home placement, as this now involves a significant number of the
patients on the books of Valleyview Hospital. This statistical programme will also
start on April 1, 1966, and it is hoped that after a period of trial it can be expanded
to Dellview and Skeenaview Hospitals. A manual of instructions and codes has been
issued for the guidance of staff.
Mental Health Centres
With approval being given for appointment of part-time clerical assistance in
the smaller centres, there has been a considerable improvement in the completion
of statistical forms. However, some difficulties are still being experienced. The
index of cases referred is proving its value in linking up medical records of persons
appearing at more than one centre.
A visit was paid to the Victoria Mental Health Centre to discuss problems in
the statistical programme and to the Okanagan Mental Health Centre in February
following a change in clerical staff there.
In September, 1965, a meeting was held in Vancouver bringing together the
clerical staff of the various Mental Health Centres. The main topic was the statistical
programme. The meeting was felt to be of great value to those present, who gained
an understanding of the purpose and of the processing of the statistical forms, and
were able to clarify points of difficulty. It also provided an opportunity to discuss
other mutual problems and get acquainted with each other's counterpart in the
widely separated centres.
 G 54
MENTAL HEALTH SERVICES REPORT,  1965/66
PART II.—RIVERVIEW HOSPITAL
REPORT OF THE SUPERINTENDENT
B. F. Bryson, Superintendent
GENERAL COMMENTS
March 31, 1966, marks the end of the first year of operation of Riverview
Hospital as a distinct entity and as a mental health facility under the Mental Health
Act, 1964.
It has been a challenging, exciting, and productive year as new programmes
and procedures became possible with the stimulus of the more liberal and progressive
legislation, and the combination of the previously separate Provincial Mental Hospital and the Crease Clinic into a single administrative unit. Riverview Hospital is
composed of six units, each with a specialized function and treatment programme
co-ordinated by a Unit Director who is a psychiatric or medical specialist. Crease
unit serves as the admitting and acute-treatment unit for all patients admitted from
the Greater Vancouver area, while Centre Lawn unit functions similarly for patients
from the remainder of the Province. West Lawn unit and East Lawn unit provide
special treatment and rehabilitative services for men and women respectively who
require continued in-patient care. Riverside unit has been extensively reorganized
and contains security wards, as well as the alcoholism clinic and improved accommodation for patients working at the Colony Farm. North Lawn unit continues to
provide chronic infirmary and acute medical and surgical care.
Every effort has been made to provide a high standard of service to all patients,
and treatment and administrative policies have been revised or new ones developed
to reflect the progressive intent of the new legislation and the concepts of modern
psychiatry. In our efforts to reach these goals, the Superintendent has been ably
assisted by the senior officers and department heads, and by the co-operation and
loyalty of all Riverview staff.
During the year a total of 7,706 patients received psychiatric treatment at
Riverview Hospital, an increase of 166 over the total of the Provincial Mental Hospital and the Crease Clinic during the previous year.
The following table gives a summary of the movement of population for
Riverview Hospital for the year ended March 31, 1966:—
Male
Female
Total
1,526
112
78
6
1,392
145
152
2,918
On extended leave—
257
Other                                                	
230
6
Totals                                                 	
1,722
1,689
3,411
2,027
7
3
2,250
5
3
4,277
12
6
2,037
2,258
4,295
3,759
3.947
7,706
 RIVERVIEW HOSPITAL
G55
Male
Female
Total
2,012
2,239
4,251
72
61
133
15
19
34
4
5
9
131
170
301
80
75
155
5
3
8
2,319
2,572
4,891
-86
-17
— 103
1,440
1,375
2,815
Separations—
Discharged in full..
Died  	
Transferred to geriatric facilities 	
Transferred to facilities for the mentally retarded .
On extended leave—
Boarding home _	
Other    _	
On escape...    	
Total separations	
Decrease in population	
In residence, March 31, 1966.-
A comparison of the above table with those for the Provincial Mental Hospital
and Crease Clinic during the previous year shows that there has been a considerable
increase in both total intake of patients and total separations, a reversal in trend
from that noted last year, when there was a decrease in both categories from that of
two years ago. It is felt that this trend reflects the greater acceptance of the hospital
by patients and the less restrictive nature of the new admitting criteria of the new
Act. During the year 4,295 patients, including 2,037 men and 2,258 women, came
in to hospital as either new admissions, readmissions, or, to a small extent, transfers
from other units.   This is an increase of 448 patients compared to last year.
There were 2,345 informal admissions, representing 55 per cent of the total.
Separations increased by 526 and totalled 4,891 for the year, including 2,319
men and 2,572 women.   Of the separations, 4,251 were discharged in full directly
The admitting office. At admission, the admitting clerk in a few minutes gets necessary information from the patient and her relative. The clerk types directly on to a stencil
which is used to prepare the beginning of the medical record. The stencil at the same time
is used to set up all the records needed in other departments of the hospital.
 G 56
MENTAL HEALTH SERVICES REPORT,  1965/66
to the community, an increase of 373 over the previous year, and represents 86.91
per cent of all separations.
In spite of the greater number of patients under care at Riverview during the
year, deaths increased by 1 to a total of 133. This represents only 2.7 per cent of
total separations and 1.7 per cent of the total number of patients under care during
the year.
As of March 31, 1966, the number of patients in residence at Riverview Hospital totalled 2,815 (1,440 men and 1,375 women). This is a decrease of 103
compared to the same date a year ago.
The admitting office. A new, bright and cheerful admitting office has recently been
opened. Its hours are from 7 a.m. to 11 p.m., 7 days per week. There is little doubt that
if the patient and her relatives have a good initial impression, they will have far less apprehension about admission to the hospital.
TREATMENT SERVICES
Implementation of the Mental Health Act, 1964, promoted much clinical
progress, but the full effect of the facilitating legislation will not be experienced until
next year as the initial impact presented more challenges than solutions and meeting
new demands absorbed a great part of our energies.
Despite the almost overwhelming volume of admissions, the number of long-
stay patients was reduced by 176 (118 male and 58 female) during the 12 months,
and 92 per cent of all admissions were returned to the community after an average
stay of 45 days. Only 312 patients admitted during the year were transferred to
long-stay units of Riverview Hospital, but a small number were transferred to other
facilities, such as the Valleyview Hospital.
Psychoactive drugs are still of great importance, and their variety and complexity have increased. During the year we undertook clinical trials of Haloperidol
for psychotic overactivity, of Tegretal for psychomotor (temporal lobe) epilepsy,
B
 RIVERVIEW HOSPITAL G 57
and of a phenothiazine injected twice monthly in a slow-release medium for maintenance therapy of schizophrenic in-patients and out-patients.
Electroconvulsive therapy is invariably modified by anaesthesia and muscle
relaxation, and approximately 1,050 such treatments are given each month.
A significant increase in therapeutic community methodology has developed.
Several wards have community meetings, as often as every day, and different specialized groups have included marital partners' groups, adolescents, intensive interaction,
and various staff-training groups.
On September 7th, the first integrated admission ward (West 3 in Crease unit)
came into operation, followed by daytime integration of the patients on the fourth
floor of Centre Lawn unit in December in mixed clinical teams.
Various methods of treatment of alcohol addiction were conducted, including
electrical and drug-induced motor-deprivation ("paralysed awareness") aversion
therapy. An out-patient pre-admission and follow-up service was provided in
Vancouver in space made available by the Alcoholism Foundation.
A new standard of medical staffing was achieved, with an increase of five new
positions in our psychiatric establishment, bringing our medical strength to 21
medical specialists in psychiatry and one each in neurology, pathology, radiology,
and internal medicine.
Teaching activities by the medical staff were increased, and a record of 226
professional visitors observed parts of our programme in the month of February.
Third-year as well as second-year medical students visited the hospital for seminars
and demonstrations.
Research continues, and in particular Dr. Greiner, who was enabled to attend
the NATO Advanced Study Institute on Schizophrenia at Oslo in August, led his
co-workers in a profitable investigation of that disease and its relationship to
melanosis, culminating in two very well-received publications in the Lancet of
December 4, 1965, and February 12, 1966.
During February, after-care services at Burnaby Mental Health Centre came
under the direction of the Crease Unit Director, facilitating greater contact with the
community and the future development of out-patient and pre-admisison services.
DEPARTMENT OF NURSING
During the year the nursing staff have been required to make adjustments to
meet the challenge of rapidly changing attitudes and philosophies of patient care.
With the increased number of patients admitted to hospital, the nursing staff have
continued to strive toward higher standards through more individualized care
afforded by the Mental Health Act, 1964. They have met these challenges
admirably.
More is being demanded of the nursing staff than ever before, and they have
sought out all educational opportunities, including films, lectures, and clinics. A
group of the ward administrators attended an institute at the University of British
Columbia on psychiatric nursing. All new staff were given an orientation to the
hospital, and all new psychiatric aide staff had a one-week orientation course, held
in the Department of Nursing Education.
In June the first steps were taken to establish an integrated admission ward in
the Crease unit. Although the concept of a patient and staff integrated ward is not
new to our hospital, it was a new venture in an acute psychiatric treatment admission
area. Careful planning in staff selection and orientation took place. Minor constructional changes were made.    A therapeutic environment for the patients was
 G 58 MENTAL HEALTH SERVICES REPORT,  1965/66
thereby achieved. Subsequently, two other admission areas have been similarly
organized.
Nurses have continued to be encouraged to seek post-basic education. During
the year one supervisor has been on leave of absence in order to take the Administration of Hospital Nursing Units Diploma Course at the University of British Columbia.
Four head nurses and assistant head nurses are enrolled in the combined workshop
and extension course in nursing unit administration being presented jointly by the
Canadian Nurses' Association and the Canadian Hospital Association.
The Central Supply Room continues to provide an excellent service in supplying
sterile supplies to the nursing units. This year services were extended to the Crease
unit.
The Surgical unit reports an increase in the number of surgical procedures and
consultations. The completion of the post-anaesthetic recovery room and consultation area for examinations has greatly facilitated the work flow in this unit.
Several units have completed the first year of decentralization of duty rostering
to the ward level. The rostering of vacations and adjustment of hours from the
ward level resulted in much better ward coverage, and in most cases the staff were
satisfied with their choice of vacation.
Crease unit has had a busy year, with the increased number of admissions.
Team nursing is established on all wards. This method of nursing care appears to
provide the best means of staff supervision, as well as the most individual attention
to patients.
October 1, 1965, marked the appointment of a Director of Nursing. This
position is a new position established to integrate the two nursing divisions into one
department under one nursing administrator. This major change in the administration of nursing will encourage a uniform pattern of nursing care throughout the
hospital. There will be one nursing policy. Duplication of duties and responsibilities
at the administrative level will be eliminated.
Since October 1, 1965, one of the main foci of interest has been an assessment
of the nursing services presentiy provided at Riverview Hospital. This evaluation
has been done with a view toward the objective of the reorganization of the divisions
of nursing into one department. A complete evaluation, report, and organizational
chart was submitted for approval in January, 1966.
On February 15, 1966, 17 female staff were assigned to the West Lawn unit.
This included an exchange of two assistant charge nurses to female wards, one in
East Lawn and one in Crease unit. In addition, the male charge nurse on R3 was
replaced by a female charge nurse, plus two female psychiatric nurses. After a period
of adjustment it was found that the exchange proved to be an asset to the wards
and much appreciated by the patients.
Riverside unit has undergone considerable reorganization, particularly as a
result of the closing of the Riverside Cottage as a patient residence. To accomplish
this, 48 patients were moved from the Riverside Building to West Lawn. Minor
physical changes were made on Riverside 2 to make two wards—R2 East, a closed
ward with a capacity of 40 beds, and R2 West, an open ward with a capacity of 70
beds. The transfer of the patients was planned and executed without incident on
December 20, 1965.
DEPARTMENT OF PSYCHOLOGY
Considerable progress has been evident in the Department of Psychology,
particularly in the attraction and maintenance of qualified staff and in the development of a variety of adjunctive treatment methods. Riverview psychologists participated in the total treatment of patients by the development of several differential
 RIVERVIEW HOSPITAL G 59
programmes, including group therapy (900 hours), joint and individual interviews
(412 hours), and 204 hours of behaviour therapy. Marital group therapy and joint
interviews totalling 540 hours have also been conducted with out-patients at the
After-care Clinic.
In addition, the department administered 2,780 psychological tests and prepared 373 reports for patients, as well as administering group tests to new students
in the School of Psychiatric Nursing.
Department staff participated with medical and nursing staff in several treatment research projects, including systematic desensitization treatment of anxiety
states, the effect of verbal conditioning on group therapy, the relative merits of two
techniques in differentiating organic from non-organic patients, the psychological
functioning of aged individuals with normal and abnormal electroencephalograms,
and a study designed to assess whether two analogues of mescaline have the same
psychomimetic effects as mescaline itself.
SOCIAL SERVICE DEPARTMENT
Changes brought about by the Mental Health Act, 1964, were of major significance in determining the activities of the Social Service Department. This was
particularly evident in the two principal admitting areas of the hospital where, as
a result of regionalization of in-patient services, it became necessary to revise
considerably existing social-work programmes. Of primary importance was the
need to plan in recognition of the growing emphasis on the extension into community
of hospital services generally, with specific reference to the provision of adequate
pre-admission and after-care social services.
In accordance with hospital policy, responsibility for the supervision and
maintenance of essential social services at the Burnaby After-care Clinic was assigned
to Crease unit social services. The practical advantages of integrating these clinical
services under a single unit administration are obvious, in view of the location of
the After-care Clinic within the Crease unit catchment area, from which the majority
of its clients have been drawn. Plans are presently under way to offer similar outpatient social services from Centre Lawn.
The continuing development of community-based services for patients should
be of assistancee to the social-work staff in extending its present coverage in family
services, including those focused on helping the family as a unit, as well as additional
services related to family group therapy. Throughout recent years, individual social
workers in various areas of the hospital as well as in after-care have become increasingly engaged with family groups.
Social services in long-stay units continued to have as a major focus the community resettlement of patients, either to their own homes when feasible or to such
alternative care situations as boarding homes and private hospitals. The office of
the Public Trustee was invaluable in many cases in the planning and carrying-out
of placement arrangements.
Community interest in the boarding-home programme remained high, particularly in such Fraser Valley areas as Mission, Haney, Langley, and Port Coquitlam.
This was apparent on the part of both service clubs and individual citizens, and was
due in large measure to the responsible attitude displayed by Public Health Nursing
and the stimulation provided by the Canadian Mental Health Association. In its
more practical aspects, such interest took the form of employment offers, usually
on a part-time basis, although in the case of women patients there were also increasing opportunities for full-time work.
 A quiet corner in the Hillside unit. The unit helps long-term patients to become reestablished in the community. Among other things, they become used once again to living
in an informal, relaxed atmosphere where institutional rules are minimal.
The kitchen unit of Hillside. For a woman who has been in hospital for years, the
thought of preparing meals again may be almost overwhelming. The unit gives her a
chance to get used to planning and preparing meals and also to try out all the new
equipment and food products which she is likely to encounter upon leaving hospital.
 RIVERVIEW HOSPITAL
G61
As of March 31, 1966, there were 302 patients in supervised boarding homes,
the majority of which were located in the Fraser Valley and Lower Mainland.
Ninety-one new placements were effected during the year.
The statistical summaries for the year reflect the direct-services aspect of the
social-work job. In all, the department was active with 5,407 patients in hospital,
which total is somewhat higher than that for the previous year (5,075). It is notable
that coverage in the Riverside Building increased markedly as a result of the
assignment of one social worker full time to that area, with office accommodation
in the building. Because of these two factors it was possible to offer service to 297
patients and (or) interested family members, including a growing number of referrals concerned with security patients.
As in previous years, educational commitments were fulfilled through field-
work supervision of social-work students, orientations and discussion groups with
other disciplines and interested people in community. Such contacts are worth
while in promoting patient services generally, since their ultimate rehabilitation and
adjustment are dependent upon community support and understanding.
REHABILITATION DEPARTMENT
The Rehabilitation Department has increased its service so that a patient's
hospitalization includes the kind of experiences necessary to help him prepare for
effective useful living following his discharge into the community. Emphasis has
been placed on guided work experience within the hospital as a means of making
the patient employable, and therefore more self-sufficient when he returns to community living. During this year, 1,479 placements were made in a variety of
hospital work areas and 441 changes in work programmes. These placement programmes were handled by the four job placement officers within the department. In
35 cases, direct placement into employment has been made for patients being discharged but who would be unable to find employment without special help.
A total of 174 referrals was made for formal work assessment. These evaluations helped the treatment team to understand the patient's ability to handle work
situations and were helpful to the National Employment Service in doing job placement following discharge. The occupational therapist responsible for these assessments has also worked with the Rehabilitation Workshop, which has served approximately 30 long-term patients daily.
The rehabilitation residences of Vista and Venture have been active this year,
serving a total of 64 patients. An administrative change was made to bring the staff
of these residences under the direct supervision of the Rehabilitation Department.
This has allowed a more consistent programme based on the needs of the patients
who are learning to live and work comfortably in the community. A staff-training
programme has been carried out to ensure that the programme maintains an active
rehabilitation focus.
OCCUPATIONAL THERAPY DEPARTMENT
The year has been one of constant change in the Occupational Therapy
Department, partly due to frequent staff changes and the reduced number of
qualified staff available. In an effort to recruit qualified staff, a more intensive
advertising programme has been successful in recruiting some occupational therapists
from England, Australia, and South Africa.
It has been possible to maintain service in all units and to expand at least one
programme significantly.   Through the year many programmes have been reviewed
 G 62
MENTAL HEALTH SERVICES REPORT,  19*65/66
fi
Home laundry at the Hillside unit. Good personal grooming is undoubtedly helpful
in the rehabilitation of patients. Washers, driers, and ironing-boards are available in an
increasing number of wards.
and modified to meet new demands arising from changes in policies and priorities
in the hospital. In the acute-treatment areas, staff have been assigned to specific
wards and have been able to maintain steady contact with the allied medical teams.
In the long-term areas a variety of activity groups have enabled the staff to
meet some of the specific needs of the patients. Much emphasis has been attached
to the development of group identity, and patients have been encouraged to assume
responsibilities within the group structure. Special groups such as the " Home-
makers," " Interest," and " Boarding Home " groups have pursued a weekly pattern
of activities both inside and outside the hospital. Regular excursions have been
made to local shopping centres and department stores, where patients have been
able to view new products, services, and current fashions.
Statistics for the Activities of Daily Living unit show an increase in the number
of referrals to the unit throughout the year. Fifty-nine patients, including 1 male,
were referred for treatment. Of these, 38 returned home, 5 were discharged to
boarding homes or relatives, and the balance were returned to their wards for
further treatment.
In October the boarding-home visiting programme was expanded to a full-time
service, 21 homes being visited on a bi-monthly or weekly basis involving approximately 170 patients. With the assignment of an occupational therapist to this
service, it is anticipated that it will be possible to develop the programme further by
gradually exploring community resources and forming a closer liaison with local
public health personnel.
Fourteen students from the University of British Columbia, the University of
Toronto, the University of Montreal, and McGill University interned in the department during the year. Working with graduate therapists, they succeeded in organizing a variety of activities for patients.
 RIVERVIEW HOSPITAL G 63
The Pacific National Exhibition was again successful in interesting a number
of patients. Over 40 entries of work were submitted to the Home Arts Building,
and 14 of these were awarded prizes.
The annual occupational-therapy sale, held in mid-November, was again successful and realized $3,591.
During the year, staff were active, with 3,731 patients referred to the department, constituting an average attendance of 614 patients per day, all units; 106,224
treatments were given during the same period.
RECREATIONAL THERAPY DEPARTMENT
Further progress has been made in making available the values of a comprehensive recreational-therapy programme. Through opportunities on the wards and
special recreation areas in Pennington Hall and the swimming-pool and on the
extensive grounds, the breadth and quality of the programme has shown steady
growth. The Mental Health Act, 1964, and regular work assignments for certain
patients brought about a considerable change in the type, age level, and numbers of
patients attending daily therapy sessions within the acute-treatment units. Programme changes were made to adjust to the needs of this group of patients, necessitating attendances totalling 34,344 in 1,545 group sessions during the year.
The development of more meaningful work programmes through the Rehabilitation Department has made it necessary for this department to provide recreational
opportunities for those patients who work during the day. Numerous outings to
attend plays, visit industrial plants, and fish the river bars were conducted. Programmes were developed to provide activation and socialization programmes for
the older, less able, non-working patients. Daily keep-fit routines were conducted
on a number of wards, and swim sessions enabled many hundreds to enjoy this
stimulating activity.
More than ever before, Pennington Hall has become the recreation centre for
the hospital, and greater emphasis has been placed on providing evening and weekend activities. Bowling, roller skating, badminton, gymnastics, volleyball, bingo,
dances, movies, concerts, and church activities saw the hall used morning, afternoon,
and evening every day of the week. An interesting innovation at Pennington Hall
was the establishment of a nominal admission fee for patients to play bingo. This
first venture seems to have brought about very beneficial results in helping patients
to establish normal concern for the care and budgeting of money they receive from
their work assignments. As usual, the seasonal highlights to mark the different
recreational activities available throughout the seasons and the special holidays
celebrated all found the recreational staff in active participation.
PATIENTS' SCHOOL
Throughout the year, the school was open from 8 a.m. to 4 p.m. for 227.5
regular school-days. Fifty-one male and 24 female patients were enrolled. These
included 42 adolescents with an average age of 15.8 years and 33 adults with an
average age of 28.2 years. Daily classes in the schoolroom were conducted for 57
of the students, and individual instruction was provided for 18 patients confined to
their wards. Thirty-two patients were discharged during this period, and the average
attendance period per patient was 7.6 weeks.
There was a perceptible increase in the number of students who began instruction by means of correspondence courses. This was largely due to a growing
participation among patients from the Riverside unit. Thirty-nine students undertook one or more of these courses, while the remaining 36 followed the regular
 G 64 MENTAL HEALTH SERVICES REPORT,  1965/66
school programme of studies.   Twenty-two were enrolled in the elementary grades,
33 in the junior secondary grades, and 20 in the senior secondary grades.
The school continued to stress a scholastic programme suited to the individual
needs of the patient. To this end, emphasis was placed on studies that would prepare the patient for either a resumption of interrupted schooling or for suitable
employment after discharge.
PHYSIOTHERAPY DEPARTMENT
The Physiotherapy Department moved into new quarters on South 1 early in
the year. The size and setting of the department is now an ideal one. The total
number of treatments that could be given was 5,612 to 644 patients. The number of
patients requiring treatment, however, continues to increase gradually due to the
increasing average age of patients in the long-stay and infirmary areas.
RADIOLOGY DEPARTMENT
During the year the Department of Radiology has provided a comprehensive
diagnostic service. The year-end report, when compared to the previous year,
shows an increase in the number of films taken of 1,117 and an increase of 494 in
the number of patients examined. Eleven more pneumoencephalograms were carried out than in the previous year. The radiologists were also required on a number
of occasions to do special procedures, such as femoral arteriograms, aortograms,
and venograms. A total of 16,138 films was taken, and the number of patients
examined was 11,146.
DEPARTMENT OF LABORATORIES
The number of procedures performed in the Riverview laboratories totalled
78,230 during the year, an increase of 6,480 over the previous year. This increase
occurred mainly in the hematology service, where there was a marked increase in the
number of white-blood counts, hematocrits, and sedimentation rates performed. In
histology there was an increase in the number of special staining procedures carried
out on tissue sections. The chemistry division performed an increased number of
blood sugars, serum electrolytes, and liver-function tests. There were moderate
increases in the number of smears and cultures performed by the bacteriology
division.
The pathologist and the technical staff continue to contribute to the publication
of scientific articles. Two papers were published concerning the association of
mental illness and disorders of melanin metabolism. These articles present a new
approach to our understanding of mental illness, leading to improvements in our
methods of treatment, and they have aroused a great deal of interest in various
medical research centres around the world.
Our laboratories continue to function as a training-school for laboratory technologists. One student completed her training and was successful in obtaining her
certification by examination. Students are now being seconded to us from the
British Columbia Institute of Technology for completion of their training as medical
laboratory technologists.
DEPARTMENT OF NEUROLOGY
Clinical neurological consultations during the year totalled 206. A total of
1,006 electroencephalograms were performed, of which 638 were on patients at
 RIVERVIEW HOSPITAL G 65
Riverview Hospital, 314 at The Woodlands School, and 54 at the Mental Health
Centre in Burnaby.
Dr. Frank Turnbull continues as the neurosurgical consultant, and during the
year performed 27 neurosurgical procedures.
Seventy-nine special electroencephalograms were done in co-operation with
the Department of Psychology at the University of British Columbia toward a study
of organic brain changes in the elderly patient. Most of the patients in this project
were residents of Valleyview Haspital.
PHARMACY DEPARTMENT
As of April 1, 1965, the pharmacy area in East Lawn Building became separated structurally and organizationally into two entities. One section comprises the
headquarters pharmacy, which serves as the purchasing and major distributing centre
for pharmaceutical supplies for all units of the Mental Health Services, and is organizationally responsible to the Mental Health Services' Business Manager. The
remaining area functions as the Riverview Hospital unit pharmacy and provides
pharmaceutical service to the Riverview Hospital only. A total of 20,799 prescriptions was filled, of which 11,748 were issued to out-patients.
DENTAL DEPARTMENT
Dental services for Riverview Hospital patients cover most branches of dentistry.
The increasing number of admissions created a larger number of emergency cases
to be treated. To conserve technicians' time, ward marking of dentures has been
discontinued for short-term patients and is confined entirely to the long-term cases.
During the year, 3,139 patients were seen who required a wide variety of treatment procedures, including 2,327 extractions, 832 fillings, 414 prophylactic treatments, 1,250 denture fittings, and 874 initial examinations. Further to this, 246
dentures were completed, 275 repairs made to broken dentures, 140 dentures
marked, and 21 gold castings prepared for various appliances.
CHAPLAIN SERVICE
The work of the chaplain service has been steady throughout the year. Some
changes have been made as a result of changing functions of the hospital. The great
reduction in the number of patients on the tuberculosis ward resulted in the mid-
weekly services being changed to pastoral visiting. After the summer recess it was
no longer possible to arrange for the choirs from city churches to assist with the
Sunday morning services in Pennington Hall. During the year a minister of the
Lutheran Church has been able to visit most of the newly admitted Lutheran patients.
A postgraduate theology student of the United Church has worked weekly with the
male Order in Council patients. Also during the year, 193 clergy from the community have visited patients in hospital.
LIBRARY
Efforts were made to improve the 4,000-volume book collection in the Patients'
Library. Older books were discarded and almost 500 new books were bought,
with emphasis on fiction and poetry. An adequate book budget enables the library
to keep abreast with current best sellers and subscribe to 30 popular magazines as
well as some book series in art, nature, and geography. The library has been drawing
 G 66 MENTAL HEALTH SERVICES REPORT,  1965/66
more readers from the patient population than in previous years; over 6,500 books
were circulated. The use of patients as library assistants was continued, with benefit
to themselves and to the library.
In the Medical Library, several projects were undertaken, all dealing with
publicizing the library's resources. They not only increased the use of library
materials, but engaged much of the professional staff in scanning current journal
literature, commenting on worth-while articles, writing book reviews, and forming
discussion groups. Over 200 books were purchased, bringing the total number of
volumes to nearly 3,600. The figure for current journal subscriptions is almost 200.
MEDICAL RECORDS DEPARTMENT
The staff of the Medical Records Department felt the impact of many changes
in hospital policy and procedures consequent to the implementation of the Mental
Health Act, 1964. The transitional period of setting up new admitting routines,
modifying office procedures, and becoming acquainted with new forms and terminology to comply with the regulations of the Act was marked by interest and cooperation on the part of all staff, so that the work of the department progressed
satisfactorily and services to both patients and medical staff were rendered without
interruption.
Considerable time and effort were devoted to the introduction of an extensive
statistical programme involving the processing of admission and discharge statistical
sheets. The responsibility for completing these forms on all admissions and discharges is shared by medical-records staff and medical staff. Pertinent information
regarding a patient's illness, treatment, diagnosis, etc., is recorded and later processed
on to punch-cards as a permanent source of information easily accessible for reference or research purposes.
The medical-records staff also assisted in several statistical surveys conducted
by the Riverview Social Service Department, the Superintendent of The Woodlands
School, as well as a review of the use of the Magistrate's Warrant (Form A) under
the new Act.
VOLUNTEER SERVICES
During the year 170 Canadian Mental Health Volunteers gave 19,436 hours
of service to Riverview Hospital in carrying on such activities as typing classes,
grooming and hair styling, discussion and activity groups, shopping trips, luncheons
and picnics, dancing classes, and other social and recreational programmes throughout the hospital.
The apparel-shops were areas of considerable change and expansion of services.
Here volunteers served 2,044 patients individually and gave out 10,658 articles of
clothing. In addition, the apparel-shops took care of all requisitions from female
patients living in boarding homes in the Lower Fraser Valley. These patients received 3,333 articles of clothing, mostly drawn from the hospital stores.
As part of our community education role, the volunteers sponsored two public
activities—the first a professional fashion show in the City of New Westminster, and
the other an " open house " and reception at the apparel-shop and volunteer centre.
One hundred and fifty people visited on this day, and many of them were taken on
tours of the hospital.
The annual Christmas gift programme again provided gifts for all patients, and
a few were left over for prizes during the year.
 RIVERVIEW HOSPITAL
G67
BUSINESS ADMINISTRATION
This year has seen many notable physical changes improving the facilities of
the hospital. The most significant of these changes has been the near completion of
the Hillside Building, a valuable new facility for the Rehabilitation Department; in
the Centre Lawn unit (where extensive changes are planned) the renovation of the
main dining-room and kitchens, the complete renovation of one of the wards to
provide an up-to-date admitting suite, the renovation of the main entrance to the
unit, the provision of new duty doctor's quarters adjacent to the admitting suite and
the setting-up of a central linen room; in the Crease unit the near completion of a
small but beautiful chapel with an office for each of the chaplains, the redecoration
and refurnishing of the conference room, and the completion of a post-anaesthetic
room; in the East Lawn unit the completion of physical changes to the pharmacy
together with the setting-up of a unit pharmacy; and at Colony Farm the construction of a new scullery, thus releasing a valuable area in East Lawn unit for a future
central linen room.
There is an ever-increasing demand for drapes in the hospital, and this past
year reflected extensive installation of drapes, which have done so much to enhance
the general appearance of many areas. Emphasis was placed upon furniture for
dining-rooms, and this has resulted in the much-improved appearance of these areas.
The Safety Committee has been active, and although wider participation by all
staff members is sought, much has been accomplished toward making the hospital a
safer place for both patients and staff.
The responsibility for all staff residences has now been vested in the Education
Centre, and due to the increase in female nursing staff and decrease in male staff
enrolment, changes have been made in residence allocation in order to reflect
changing needs.
The beginning of a Housekeeping Department occurred with the appointment
of an executive housekeeper at the end of the year. During the ensuing year, in-
service training programmes will be developed for present building service workers
and for new staff as the department expands to meet the need for a specialized
housekeeping service in the various units.
The Business Office showed an increase, reflecting increased activity in patients'
trust accounts, maintenance collections, direct over-the-counter transactions with
patients, and the handling of patients' personal property.
DIETARY DEPARTMENT
This year has witnessed continued physical improvement in the department,
improvements which are bringing our kitchen and dining-room facilities up to date.
These include:—
(1) The complete redesigning and rebuilding of the dining-room and servery
facilities in the Centre Lawn unit, together with radical improvements in
the main kitchen area.
(2) The complete redesigning and vastly improved facilities for garbage-
handling both in the East Lawn and Centre Lawn units.
(3) The provision of new dining-room furniture in the patients' dining facilities
in the East Lawn unit and in the staff facilities in the Crease unit.
Meetings have been held with a Public Works architect in order to design and
plan for completely new facilities in the Riverside dining and main kitchen areas.
 G 68 MENTAL HEALTH SERVICES REPORT,  1965/66
INDUSTRIAL THERAPY DEPARTMENT
During the year the Industrial Therapy Department continued to work closely
with the Rehabilitation Department in developing manufacturing methods to keep
pace with progressive modern trends in patient therapy.
The Audio-Visual Department ceased to be separate and became incorporated
in the Industrial Therapy Department. The effect of this has been to consolidate the
resources of what were these two departments in one location, thus providing a better
and more continuous service to patents and staff in the Mental Health Services.
A tailoring service previously located within the Industrial Therapy Department
was relocated in the Volunteer Centre by the transfer of the tailoress. This change
has enabled the volunteers to continue to develop a personal-service programme of
clothing issue to patients. Such a service is more personalized and will help to bridge
the gap between bulk general stores supply of clothing on one hand the the bulk
receipt of orders by the wards on the other.
During the year 2,500 patients were employed in the trade shops, the average
intake being 40 patients per month. Two hundred patients were discharged from
the department in order to gain useful employment outside of the hospital.
The changing-over of 35-mm. movie scheduling from two evenings a week to
three showings on Saturdays only was well received, reflecting an increase in
attendance. The 16-mm. movie programme was reorganized, such that ward
movies were discontinued in the intensive-treatment areas, while expanded in the
long-term treatment areas.
The film library continues to be a widely used resource, with 374 registered
borrowers using its facilities. During the year 1,633 films were shipped to these
borrowers, who represented a viewing audience of about 50,000 persons.
LAUNDRY DEPARTMENT
The volume of linen processed through our laundry has continued to rise in
volume, such that there were processed during the year 10,284,996 pounds of linen,
representing an average daily production of 32,574 pounds. The drycleaning
decreased slightly in volume to 127,620 pounds. No new equipment was bought
for the laundry during the year, although a new Smith-Grantham tumbler bought in
the previous fiscal year was installed. This new machine, together with increased
trapping of our flatwork ironers, has enabled the flatwork ironing process to be
speeded up.
PODIATRY SERVICE
The Riverview podiatrist, who provides a service for Riverview and Valleyview
Hospitals and, on a limited basis, to The Woodlands School, reports a busy year,
with a total number of 3,220 treatments to 1,709 patients. Special attention has
been given to preventive foot care by providing special instructions to patients
regarding the care of their feet and by attempts to provide proper fittings and types
of footwear. This form of preventive service has been especially directed to patients
going out to boarding homes, where supervision of foot hygiene is less direct than on
hospital wards.
ESSONDALE CIVIL DEFENCE DISASTER ORGANIZATION
The Essondale Disaster Planning Committee has met regularly throughout the
year to review preparedness to meet possible local emergencies and to make recommendations for improvements in facilities and organization.
 RIVERVIEW HOSPITAL
G69
Contact has been maintained as before with the Provincial Civil Defence
authorities and the Vancouver Target Zone headquarters. Through these authorities,
arrangements were made for Mr. John Borthwick, Riverview Assistant Superintendent, to attend the Provincial Civil Defence Orientation Course No. 34 (Emergency Services Representatives) held in Victoria from January 24 to 27, 1966.
Mr. Borthwick has since been appointed as a Deputy Civil Defence Co-ordinator
for the Essondale area.
On June 17 and 18, 1965, several members of the Planning Committee attended
an excellent Disaster Institute held in New Westminster.
Regular instruction has been provided to the new students of the School of
Nursing regarding Essondale disaster planning and the role of nursing staff in our
organization.
During the past month the Planning Committee has been reviewing our total
organization with a view to bringing this up to date and compiling a master plan
for all services and facilities available to meet emergencies, as recommended for
municipalities by Civil Defence authorities.
STATISTICAL TABLES
Table 1.—Movement of Population, Riverview Hospital, Essondale,
April 1, 1965, to March 31, 1966
Male
Female
Total
1,526
112
78
6
1,392
145
152
2,918
257
On extended leave, carried forward from 1964/65—
Other                                                                                	
230
6
Total on books as at April 1, 1965. - 	
1,722
1,689
3,411
Admissions-
976
24
1,037
1,028
40
1,190
2,004
64
2,227
Total admissions* —	
2,037
2,258
4,295
3,759
3,947
7,706
Separations—
2,012
72
15
4
131
80
5
2,239
61
19
5
170
75
3
4,251
133
Died                                                           	
34
9
On extended leave and still out-
301
Other	
155
8
2,319
2,572
4,891
-86
1,440
— 17
1,375
— 103
2,815
i Includes 7 male and 5 female transfers from geriatric facilities, 3 male and 3 female transfers from
facilities for the mentally retarded.
 G 70
MENTAL HEALTH SERVICES REPORT,  1965/66
Table 2.—First Admissions to Riverview Hospital, Essondale, by Health
Unit and School District of Residence and Sex, April 1, 1965, to
March 31, 1966.
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
Central Vancouver Island, Na
School District No. 1 _~     	
4
4
8
naimo—
„   2	
1
6
7
School District No. 65	
6
3
9
„   3	
4
3
7
„   66  _
1
1
, 4	
1
1
2
„   67	
2
2
4
„   5 	
4
4
8
„   68	
16
6
22
„   18	
4
4
„   69	
2
1
3
Selkirk, Nelson—
„   70 _
10
6
16
School District No. 7	
4
6
10
 ,   79	
2
1
3
»           „       ,,   8
1
1
Upper Islands, Courtenay—
School District No. 71	
West Kootenay, Trail—
2
3
5
School District No. 9	
6
3
9
„   72	
6
2
8
„   11	
10
5
15
„   84 	
1
2
„   12  ...
3
1
4
„   85	
1
2
„           „        „   13
1
1
North Okanagan, Vernon—■
School District No. 27	
11
5
16
School District No. 19	
8
4
12
 28	
7
15
„   20	
1
2
3
„   82	
1
„   21	
1
Skeena, Prince Rupert—■
, 22  	
8
8
School District No. 50..	
2
3
„           „        „   78
1
2
„           „       „   51
2
2
South Okanagan, Kelowna—
„   52	
10
7
17
School District No. 14	
2
3
„   53	
8
8
16
„   15 	
7
12
„   54 	
4
1
5
„   16
1
„       „   80
3
2
5
„   17	
1
2
Peace River, Dawson Creek—
 23	
7
3
10
School District No. 59	
5
7
12
„   77	
2
	
2
„   60	
4
7
11
South Central, Kamloops—
Northern  Interior,   Prince
School District No. 24	
20
8
28
George—
 26	
1
	
1
School District No. 55	
1
3
4
„   29	
2
1
3
„   56	
4
2
6
„   30 	
3
4
7
„   57	
25
12
37
„   31	
2
2
4
„   58.  —
1
1
2
Upper Fraser Valley, Chilli
Greater  Victoria  Metropolitan
wack—
Board of Health-
School District No. 32	
	
2
2
School District No. 61  _
36
26
62
;)   33	
18
22
40
 62	
2
2
4
„        „   34 	
17
10
27
„   63 	
2
1
3
76
5
5
„   64
1
1
Central Fraser Valley, Mission
Metropolitan Health Committee,
City-
Vancouver—
School District No. 35 	
10
6
16
School District No. 38	
27
36
63
„   42	
13
20
33
, 39	
380
446
826
„   75	
8
6
14
, 41	
52
86
138
Boundary, Cloverdale—
„   44  _
34
33
67
School District No. 36	
54
64
118
„   45  -
7
15
22
„   37	
4
9
13
School district not covered by
Simon   Fraser,   New  Westmin
health unit—
ster—
School District No. 49	
5
4
9
School District No. 40     . ...
17
44
61
3
3
„   43 _
16
46
62
36
10
46
Coast Garibaldi, Powell River—
1
9
10
Totals	
1,000
1,068
2,068
„  47	
5
8
13
„   48 -
3
5
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MENTAL HEALTH SERVICES REPORT, 1965/66
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P
 THE WOODLANDS SCHOOL G 85
PART III.—THE WOODLANDS SCHOOL,
NEW WESTMINSTER
REPORT OF THE SUPERINTENDENT
J. S. Bland, Superintendent
The main events of the past year have been the reorganization of The Woodlands School into separate functional units and the integration of the male and
female nursing departments under one director.
The school is now divided into three in-patient units. The Hospital Unit
caters for those whose prime need is for medical and nursing care, the Training
Unit houses those who require training and education rather than medical treatment, and the Psychiatric and Rehabilitation Unit looks after those suffering from
major psychiatric disorders, together with the mildly retarded whose rehabilitation
is the main objective. Each unit has a specialized clinical team which supervises
the individual programmes. In almost all wards there is a mixed staff of both
male and female nurses, and in selected wards the patients are also of both sexes.
As stated in last year's report, the waiting list has been redefined and consists
of those who are actively awaiting admission now. There were slightly more admissions from the waiting list than there were applications, so that some progress
was made. The Mental Health Act, 1964, although welcomed, did not markedly
alter admission policy, and the majority of patients were admitted involuntarily.
There were, however, a small number of informal admissions, and the number of
30-day admissions was reduced. The statistical tables show the exact movement
of population during the year.
The medical staff are divided into two separate sections; they have maintained
their previous high standard. Both the doctors working in the Hospital Unit and
those in the Psychiatric Unit provide medical coverage to the Training Unit areas.
Regular medical staff meetings have continued, and during the year each physician
has presented an important topic for discussion at a monthly medical grand rounds.
The Out-patient Department saw 246 new patients during the year. The age
range was from a few months to 56 years, but over 60 per cent of the patients were
between the ages of 2 and 12 years. The majority were referred from metropolitan and other local areas, but 24 per cent came from more outlying parts of the
Province. The functional level of the patients was evenly distributed, but it is of
interest that 4 per cent showed no evidence of mental retardation.
We were again fortunate in having no major epidemics during the year, and
were thus able to complete biochemical screening tests on the whole population.
A number of abnormalities were found, and paper chromatographic investigation
of these is proceeding. In addition, the buccal smear test for sex chromatin was
completed on all patients, and abnormalities are receiving chromosomal studies.
The latter are being processed by the Chromosomal Laboratory, which was set up
at the school during the year, and which is presently under the auspices of the
Department of Paediatrics at the University of British Columbia.
The various medical ancillary departments are now part of the Hospital Unit.
They have continued their previous work. The laboratory, as mentioned above,
has managed to extend its activities. The Dental Department has dealt with the
dental emergencies as well as most of the routine work. The Physiotherapy Department has continued a high standard, particularly in teaching physiotherapeutic tech-
 G 86 MENTAL HEALTH SERVICES REPORT, 1965/66
niques to both our own staff and to visiting nursing staff. The Hospital Unit
Director has maintained a close liaison with the University of British Columbia
Department of Paediatrics, has been responsible for teaching medical students during
their pediatric rotation, and has collaborated with members of the department in
publishing several research papers.
The Education, Recreation, and Occupational Therapy Departments are now
part of the Training Unit and under the supervision of its Director. There have
been various changes made in their functions, the most important being the utilization of the senior staff as chairman of various ward meetings, thus bringing them
into closer contact with the ward situations. The academic school has laid particular emphasis on community liaison, and an increased number of field trips were
arranged for the students. The Occupational Therapy Department extended its
sheltered workshop activities as well as broadening its programme to all areas of
The Woodlands School. The recreational-therapy staff were successful in promoting community participation in their activities, together with increasing outside
facilities such as bowling, ice skating, and square dancing. The Director of the
Training Unit, who arrived only half-way through the year, did an excellent job in
providing goals and training programmes for many areas which were relatively
neglected previously.
The Psychiatric Unit comprises the wards for the mildly retarded, together
with the wards for the seriously psychiatrically disturbed. With selective admissions, with increased placements into boarding homes, and with selective transfers
to The Tranquille School, the problems in this area increased during the year.
There was a much greater proportion of patients suffering from severe personality
disorders, and a much smaller proportion who were able to play a major role in
their own care. These facts placed a marked strain on therapeutic efficiency, but
there was progress in some aspects. The major event during the year was the
opening of a small unit for boys suffering from childhood psychosis. This ward had
the advantage of a relatively high staff-patient ratio, and was thus able to carry out
increased programming. The addition of an extra psychiatrist also enabled more
specialized treatment to be given. The Unit Director was able to make a start in
introducing a " therapeutic milieu " into the various wards of the unit.
The integration of the nursing services proceeded smoothly during the year.
In addition to integration, unitization also took place, so there were major nursing
administrative changes. These changes highlighted the need for adequate staffing
patterns, and one analysis was carried out during the year. The changing role of
The Woodlands School makes it imperative to have agreed standards of care in the
form of staff-patient ratios for all areas. The standard of nursing care has remained
very high, and the enthusiasm of the staff in embracing new programmes was most
commendable.
The Psychology Department has managed an increasing number of requests
for assessment. The Director encouraged continuing education, which increased
standards of all members of the department and played an active role in team
programming.
The Social Service Department was unitized, and for the first time all areas
of The Woodlands School were covered by social services. Individual members of
the department played major roles as part of the clinical team in each unit, whereas
others were primarily concerned with pre-admission and follow-up cases. The
foster-home project was completed during the year with the placement of another
12 children. Further boarding-home placements were also made, and 18 older
patients were transferred to a private nursing home.   The department was largely
 THE WOODLANDS SCHOOL
G 87
responsible for the excellent community liaison in these various projects, which have
proved mutually satisfactory. The supervisor encouraged the department's participation in a large number of orientations for outside professional staff, as well as
playing a major role in teaching workshops.
The Business Administrator completed a number of projects during the year,
and the various departments under his care all increased their efficiency. The
emphasis on in-service training and the encouragement given to personnel in furthering their own education showed marked dividends in promoting professional
standards. The continued enthusiasm of the staff in all service areas has ensured
the smooth running, without which therapeutic and training programmes cannot
function.
Volunteer services were yet again increased during this year. Over 100 persons contributed more than 5,665 hours of personal service to The Woodlands
School. Volunteers now work in many different departments, and their participation is competently organized by the Co-ordinator of Volunteer Services. We are
grateful to them and to the Provincial auxiliary for their continued support.
The chaplains increased their services to us during the year, and an active
Religious Committee was of benefit to both patients and staff. Participation by
some of the patients in community religious activities was expanded.
In summary, the year was more one of reorganization and consolidation than
advance. Progress was, however, made in liaison with university departments and
in achieving more understanding in the community. We extend thanks to the many
departments of Government and private agencies that have helped us, and we look
forward to increasing our own efficiency.
STATISTICAL TABLES
Table 1.—Movement of Population, The Woodlands School,
New Westminster, April 1, 1965, to March 31, 1966
Male
Female
Total
In residence, April 1, 1965  	
On extended leave, carried forward from 1964/65-
Boarding home	
Other.  	
Total on books as at April 1, 1965	
Admissions—
First admissions to Mental Health Services..
Readmissions to a different institution of Mental Health Services..
Readmissions to the same institution	
Total admissions 1-
Total under care	
Separations—
Discharged in full..
Died  _
Transferred to The Tranquille School-
Transferred to Riverview Hospital	
Transferred to Skeenaview Hospital	
On extended leave and still out—
Boarding home	
Other	
Total separations-
Net increase	
In residence, March 31,1966-
10
16
53
16
5
2
6
37
10
129
+24
766
26
8
33
12
19
3
60
3
130
+23
563
36
24
768
574
1,342
86
4
37
58
24
37
144
28
74
127
119
246
895
693
'  1,588
86
28
24
5
6
97
13
259
+47
1,329
i Indues 2 male and 21 female transfers from The Tranquille School, 3 male and 4 female transfers from
Riverview Hospital.
 G 88                         MENTAL HEALTH SERVICES REPORT,  1965/66
Table 2.—First Admissions to The Woodlands School by Health Unit
AND
School District of Residence and Sex, April 1,1965, to March 31, 1966
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
Central Vancouver Island, Na
School District No. 1	
	
1
1
naimo—
„  2	
1
1
School District No. 65  .
2
2
11           ii       ,i   3. . ... .. .
1
1
2
„           „       „   67	
2
2
„   18	
1
1
„   68	
3
3
6
„   69 ._.
1
1
School District No. 7	
1
1
 70 	
2
2
„   79	
1
1
School District No. 11	
3
1
4
Upper Island, Courtenay—
„   12	
1
1
School District No. 71	
1
1
2
„   13 -	
1
1
„   72	
2
2
4
North Okanagan, Vernon—
„   85	
2
1
3
School District No. 20—	
	
2
2
Cariboo, Williams Lake—
„   22 —
1
1
School District No. 28 	
1
1
2
South Okanagan, Kelowna—
Skeena, Prince Rupert—
School District No. 14..	
1
1
2
School District No. 51 	
1
	
1
„       „   52	
1
1
School District No. 24	
1
1    1        2
 53	
1
1
2
„   26
1
1
„   54	
1
1
2
„   29 - ....
1
1
„   80	
1
1
„   31 	
1
1
Peace River, Dawson Creek—
Upper Fraser Valley, Chilliwack—
School District No. 59-    .   .
1
1
Northern  Interior,   Prince
School District No. 32	
2
1
3
George-
„           „       „   33      	
4
2
6
School District No. 56	
1
1
„   34 _
1
2
3
 57	
4
1
5
Central Fraser Valley, Mission
Greater  Victoria  Metropolitan
City—
Board of Health—
2
2
School District No. 61
6
5
11
„       „   42     	
3
3
„   62 _
1
1
„   75	
2
2
 63	
1
1
2
Boundary, Cloverdale—
Metropolitan Health Committee,
School District No. 36	
6
9
15
Vancouver—
 37.	
1
1
School District No. 38	
1
1
2
„   39	
13
16
29
ster—■
, 41 	
4
5
9
School District No. 40. 	
2
4
6
„   44	
4
2
6
„  43 ..  	
3
3
6
„   45	
....    |        3
3
Coast Garibaldi, Powell River—
School District No. 48	
	
1
1
Totals	
1
90     |       82
1
172
  .  „-  .
 THE WOODLANDS SCHOOL
G 89
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MENTAL HEALTH SERVICES REPORT,  1965/66
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 G 92
MENTAL HEALTH SERVICES REPORT,  1965/66
Table 8.—Patients of The Woodlands School Out on Extended Leave by
Mental Diagnosis, Age-group, and Sex, December 31, 1965
3
Age-group (Years)
Total
o
H
•o
Mental Diagnosis
Under
1
1-3
4-6
7-9
10-14
15-19
20-29
30-39
40 and
Over
es
IH
o
M. F.
M.
F.
M.
F.
M.
F. 1 M.
F.
M.
F.
M.
F.
M.l F.
M.
F.
F.
M.
F.
Mental deficiency1—
Profound	
	
	
	
 1	
1
1
1
Severe 	
	
	
	
1
1
 |	
1
1
2
2
4
Moderate  	
	
	
1
 1	
1
.4
2
7
1
8
Mild	
—
—
—
	
 |-—
—
1
1
2
—
4
—
4
Totals 	
....... |
1 II	
__|    1|    2|__|_4   1
6|	
31    1|    3
14|    3| 17
1 Includes 5 males with epilepsy, 1 male and 1 female with mongolism.
Table 9.—Total Population on Books of The Woodlands School by Mental
Diagnosis, Length of Stay, and Sex, December 31, 1965
Detailed information for the above table may be obtained on request.
Table 10.—Live Discharges from and Deaths Occurring in The Woodlands
School by Mental Diagnosis, Age-group, and Sex, April 1, 1965, to
March 31, 1966.
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.
i
F.'
i
m.;
F.
M.
F.
M.
i
Fj
1
M.
F.
M.
F.
m.|f.';
M.'
F.
M.
F.
M.
F.
Live Discharges
Mental deficiency -—
Profound	
2
2
2
1
1
1
1
4
1
3
2
1
3
2
7
3
3
1
1
1
1
2
2
1
1
4
1
1
2
7
3
1
3
5
1
2
5
1
__
7
7
2
2
~2
2
5
3
2
2
1
4
19
22
21
6
7
21
17
2
1
1
10
26
Moderate	
Mild 	
Schizophrenic disorders
Mental deficiency with
psychosis  	
Chronic brain syndrome, N.O.S	
43
38
2
1
 1    1
1
Totals	
- 1 1    6
3|    9|    8
13
3|    S\    7
13
9
8
17|    2|    3
10|    5
66
55
121
Deaths
Mental deficiency2—
1
1
2
1
2
1
1
2
2
1
3
1
—
2
1
2
—
2
1
1
1
5
7
3
1
8
4
13
11
Moderate	
Schizophrenic disorders
	
—
	
3
1
Totals     	
1
1
1
3
3
1
2
3
3
1
—
2
1
2
_l    3
2
16
12
28
- Includes 15 males and 13 females with epilepsy, 7 males with mongi
2 Includes 7 males and 7 females with epilepsy, 1 male and 2 females
olism.
with mongolism.
 THE WOODLANDS SCHOOL
G 93
Table 11.—Live Discharges from and Deaths Occurring in The Woodlands
School by Mental Diagnosis, Length of Stay, and Sex, April 1, 1965,
to March 31, 1966.
Detailed information for the above table may be obtained on request.
Table 12.—Deaths Occurring in The Woodlands School by Cause of Death,
Age-group, and Sex, April 1, 1965, to March 31, 1966
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
Total
Grand
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
—
	
1
1
3
__
1
	
1
3
1
1
1
—■
1
1
1
1
1
	
1
2
1
1
1
5
1
2
1
5
1
2
4
1
3
1
1
1
Diseases   of   the   nervous system and sense
7
Rheumatic heart disease
Pneumonia  _.
Diseases of the genito-
1
6
2
Congenital malformations
1
1
	
1
8
2
Symptoms, senility, and
ill-defined conditions-
1
Totals	
—
	
1     1
3
3
1
2
3
3
1
—
2
1
2
	
3
2
16
12
28
Table 13.—Deaths Occurring in The Woodlands School by Cause of Death,
Length of Stay, and Sex, April 1, 1965, to March 31, 1966
Detailed information for the above table may be obtained on request.
 G 94 MENTAL HEALTH SERVICES REPORT, 1965/66
PART IV.—THE TRANQUILLE SCHOOL, TRANQUILLE
REPORT OF THE SUPERINTENDENT
F. G. Tucker, Acting Superintendent
The past year has been one of consolidation in The Tranquille School programme with the elaboration and expansion of existing services. In spite of changes
in the senior administration, divisions and departments have maintained a high level
of care in all areas of the institution.
On August 31, 1965, Dr. A. J. Bennee resigned as Superintendent to take up
private psychiatric practice in Vernon and provide services on a sessional basis to
the area covered by the Mental Health Centre, Kelowna. Dr. Bennee has been
a dedicated and imaginative leader during his years at the school, and his resignation
was accepted with considerable regret. Dr. R. G. Foulkes, Deputy Superintendent
of The Woodlands School, assumed the additional responsibility of Acting Superintendent of The Tranquille School from September until lanuary, when he resigned
from the Provincial Mental Health Services. At that time Dr. F. G. Tucker, Deputy
Director of Mental Health Services, was appointed as Acting Superintendent in
addition to his existing responsibilities. On November 18, 1965, Dr. Margaret
Neave was appointed as Clinical Director and assumed responsibility for the clinical
departments, whilst Mr. Merrick remained in charge of business administration. In
the absence of a full-time Superintendent, considerable responsibility has fallen
upon the shoulders of these two senior staff members, which they have discharged
with great effectiveness.
There has been relatively little change in the patient population. Thirty
patients were transferred to the school and 34 patients separated, so that the number
of patients on the register was reduced from 580 to 576. The number of patients
in boarding homes on extended leave increased from 6 to 16, and on extended leave
in other resources, from 3 to 4. All admissions continue to be processed through
The Woodlands School.
The health of the resident students remains at a high level, with a relatively
low incidence of staphylococcal infections. The average occupancy of the 10-bed
infirmary ward has been 6, exclusive of March, 1966. During the year, 5 deaths
occurred, giving a mortality rate of 8.6 per 1,000, which is similar to that for the
Interior of the Province. During March a high incidence of virus illness occurred,
especially amongst the physically handicapped.   However, no deaths resulted.
An X-ray machine was installed in luly, 1965, which permits routine chest
X-rays to be taken at the school, together with other simple procedures. More
specialized radiological investigation is carried out at the Royal Inland Hospital,
Kamloops. Simple hsematological and urinalyses are performed at the school, with
other laboratory tests undertaken in the Department of Pathology at the Royal
Inland Hospital.
The Nursing Division functioned effectively under Mr. Alexander Mcintosh.
Complete integration of male and female nursing staff has occurred during this year
with the appointment of male charge nurses in some of the female wards and the
placing of " house mothers " in the male areas, thus providing a more normal family
setting. The role of the psychiatric nurse in the school is gradually evolving with
increasing emphasis on training. They actively participate in such events as the
May Day and Carnival Day programmes and assist in the camping, scouting, gardening, and other recreational activities.
 THE TRANQUILLE SCHOOL G 95
Mr. H. F. Hayes was appointed as Co-ordinator of Habilitation in October,
1965, and has been assisted by two job placement officers. In addition, he is
responsible for the recreational-therapy, occupational-therapy, and volunteer programmes. Swimming classes were held at McDonald Park, and male trainees
organized into ball teams with a league schedule. Physical activity groups have
been carried out in the recreational hall, with an average monthly attendance of
4,861. Weekly socials with dances at special times such as Hallowe'en and St.
Valentine's Day have been organized, together with other special events.
The Occupational Therapy Department was well attended, with an average
monthly attendance of 1,235. Special classes in sense training were also organized.
The male handicraft area had an average monthly enrolment of 170 male trainees,
who are taught such skills as leatherwork, weaving, lapidary work, and woodworking. There have been 28 active Scouts in the school troop and 17 girls in the
Guide company. Mrs. M. Mcintosh was selected and sponsored to attend a
month's course in guiding for handicapped girls in Australia in the spring of 1966,
being one of two selected in Canada. Camp Kiwanis has also been well used
throughout the summer of 1965, with 325 students spending one week's holiday
there.
The volunteers continue to provide valuable and varied services to the school,
ranging from the escort of trainees to the Lower Mainland during the holiday period
to the operation of a clubroom in Kamloops for trainees and the provision of an
apparel-shop within the school. A dinner in honour of the volunteers was given at
the school in March, 1966, and was attended by 234 persons.
As Director of the Department of Social Work, Mr. R. Atkinson, M.S.W., has
initiated and carried out an intensive programme of community education. Twenty-
six different organizations attended by some 900 people plus innumerable persons
of a radio audience were introduced to The Tranquille School's increasing emphasis
on resettlement of trainees in the community. New and meaningful relationships
were established with the local Association for Retarded Children, and a high level
of co-operation has been maintained with the Department of Social Welfare and
the Department of Public Health, enabling new avenues of preventive institutionalization to be explored.
Increased contact between parents and students has been promoted and resulted
in three to four trainees per year returning to their homes. The agreed quota of 10
boarding-home placements in the Kamloops area was filled, and this is to be increased by 20. Over and above this quota, 20 trainees were transferred to The
Woodlands School for placement in Lower Mainland boarding homes. A total of
eight trainees is residing in the Provincial Home at Kamloops. Such community
programmes make heavy demands upon the Social Service Department of the
school.
Community employment of mildly retarded trainees is also increasing. Ten
male and female trainees have been employed in the community five days a week
whilst living at the school.
The resignation of our Protestant chaplain, Rev. Robert McRae, M.S.W.,
L.Th., was reluctantly accepted on February 7, 1966. The Very Rev. J. C. lolley,
M.A., D.D., Dean of St. Paul's Cathedral, kindly assented to assume the duties.
The Most Rev. M. A. Harrington, Bishop of Kamloops Diocese, and the Sisters of
St. Martha ministered to the Roman Catholic students at the school.
The Department of Public Works completely remodelled the East Pavilion to
provide areas for habilitation, Social Service Department, and volunteer services,
together with a staff common room and lecture room.   Changes were also made to
 G 96
MENTAL HEALTH SERVICES REPORT, 1965/66
the business offices, recreational hall, Central and Beaverdell Buildings. The new
104-bed unit and the first phase of the kitchen/dining-room complex at the end of
the fiscal year was nearing completion.
STATISTICAL TABLES
Table 1.—Movement of Population, The Tranquille School,
April 1, 1965, to March 31, 1966
Male
Female
Total
In residence, April 1, 1965   	
On extended leave, carried forward from 1964/65—
Boarding home   	
Other  _	
329
242
571
Total on books as at April 1,1965 	
Admissions—
First admissions to Mental Health Services    	
Readmissions to a different institution of Mental Health Services..
Readmissions to the same institution	
Total admissions!   __ _.	
Total under care _ _.	
Separations—
Discharged in full  	
Died   _ 	
Transferred to The Woodlands School _  	
Transferred to Riverview Hospital. _	
On extended leave and still out—
Boarding home   	
Other    _ _ 	
337        |        243                580
6
1
3
20
3
26
1
7                  23                  30
344                 266                 610
3
5
2
1
13
1
On escape but not discharged..
Total separations	
Net decrease._ _	
2
21
5
5
23
1
16
4
1
25
30
55
In residence, March 31, 1966.
—10
319
—6
236
— 16
555
i Includes 5 male and 19 female transfers from The Woodlands School, 1 male and 1 female transfer from
Riverview Hospital.
Table 2.—First Admissions and Readmissions to The Tranquille School
by Mental Diagnosis, Age-group, and Sex, April 1, 1965, to March
31, 1966.
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
1
M.IF.
M.
F.
1
M.|F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
1
M.
F.
M.
F.
First Admissions
Mental deficiency i—
Idiocy and imbecility-
—
—
......
	
	
1
1
—■
1
2
1
1
1
1
2
2
1
1
2
5
—
3
—
3
1
2
1
2
1
4
7
11
1
6
8
Border-line   intelligence	
Mongolism	
—
13
2
Totals	
 |. | | |	
	
__|    21—|    I]    5
5
1
8| |    3
__|    4
6| 23
29
Readmisisons
Mental deficiency—
Moron	
! ! ! 1
 LLLL
MM
1  \  \
1
1      1
__f_1_-
1
1
1
1
Totals.	
1
1
__
	
1      1     ■
	
	
1
-—j	
—
	
—-
1
1
i Includes 1 male and 8 females with epilepsy.
 THE TRANQUILLE SCHOOL
G 97
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Q
 G 98 MENTAL HEALTH SERVICES REPORT, 1965/66
PART V.—GERIATRIC DIVISION
REPORT OF THE SUPERINTENDENT
J. Walsh, Superintendent
During the year a total of 2,097 elderly persons received special care and
treatment in the three hospitals of the Geriatric Division, an increase of 64 over
the previous year. Six hundred and five applications for admission were received,
an increase of 129. Of this number, 487 were for Valleyview Hospital, 103 were
for Dellview, and 15 were for Skeenaview Hospital.
Actual admissions to the three hospitals totalled 612, an increase of 53 over
the previous year. Of this number, 572 were direct admissions from the community.
In addition, 40 geriatric patients were received on transfer from other Provincial
mental health facilities.
Separations due to death totalled 482. A total of 229 patients was returned
to the community (an increase of 55).
The resident population of the three hospitals as of March 31, 1966, numbered
1,262. To this may be added 214 patients who, although resident in the community,
are still on the hospital register, making a total of 1,476.
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 complement of beds is 791, with a staff complement
of 432.
A total of 487 applications for admissions were received, an increase of 89
over the previous year. Four hundred and fifty-seven patients were admitted directly
from the community (an increase of 51 over the previous year). In addition, 30
recently admitted geriatric patients were received on transfer from Riverview Hospital and 13 patients were transferred from other geriatric units.
As the demand is persistently in excess of beds available, a pre-admission
service is able to advise and help inquiring relatives. Assistance was given in placing
81 elderly persons in alternative accommodation in the community. These placements have invariably been successful and have obviated the necessity for admission
to hospital.
During the year, 195 patients were returned to the community (an increase of
51 over the previous year). Of those patients who left hospital, approximately
one-third (64) went to the care of spouse, relatives, or to their own private arrangements. Approximately one-third (67) went to licensed boarding homes, and
approximately one-third (64) went to private hospitals.
Of the total number of patients who left hospital during the year, 20 were
returned to hospital. Of those who returned to hospital, seven were again able
to return to the community within the year. Care in the placement of elderly people
in the community is of the utmost importance. The medical care of these patients
is undertaken by physicians practising in the area, and these patients are well cared
for.
There were 295 deaths in hospital. Of the total number of patients released
on leave to the community, 44 died.   Some had been out of the hospital since 1962.
 GERIATRIC DIVISION G 99
In the hospital an active-treatment and rehabilitation programme utilizing
modern techniques is maintained. Simple procedures such as correcting dietary
and other deficiencies, stabilizing physical treatments, and eliminating toxic factors
form a large part of treatment in the geriatric group. Where a social situation
precipitates admission to hospital, satisfactory adjustments can be made. There
is a particular need to reactivate interest and initiative and to re-establish self-
confidence.
The services of consultants are available from Riverview Hospital, and all
surgical procedures are performed there. A high standard of medical care is
provided for patients.
The Dental Department has provided satisfactory dental services. It is planned
to introduce a new denture service, whereby the services of dental laboratories in the
community will be used.   This should expedite the service considerably.
The nursing staff have provided a good standard of nursing care. In-service
education and involvement in more active-treatment programmes provides a stimulus
toward a better orientation for the geriatric nurse.
Two senior nurses attended an Institute of Psychiatric Nursing Problems at
the University of Washington. Five nurses attended an Institute on Psychiatric
Nursing at the University of British Columbia.
One nursing supervisor joined the staff.
The incidence of staff illness has been high throughout the year. Knee and
back injuries are a constant feature, and several staff members have been absent
through illness for prolonged periods.
The Social Service Department has had an active year. Emphasis has, of
necessity, been placed on post-admission services. Preparation and placement of
those patients referred by physicians for discharge from hospital constitutes the
prime objective. The advent of a social worker into the admissions area of the
hospital has been particularly advantageous. The reception of patients is improved,
and where relatives or friends accompany the patient, a social history is obtained.
This has overcome, to a considerable extent, the lack of information available on
newly admitted patients. Relatives also appreciate understanding and advice at
this time.
Nearly 200 persons, mainly social workers and trainees, public health nurses,
and relatives of prospective patients, were shown over the hospital and oriented to
its facilities and programme.
The X-ray Department, under the supervision of a visiting radiologist, has
provided the necessary diagnostic services. In addition to services to patients, staff
chest X-rays are taken annually.
The laboratory, under the supervision of the pathologist at Riverview Hospital,
has been kept busy in accordance with increased admissions. Bacteriology continues
to be done at Riverview Hospital.
The Recreational Therapy Department has provided a varied programme in
accordance with the needs and abilities of the patients. The more active patients
provide some of their own group entertainment. Several outings were arranged
during the summer months. Feature films are shown regularly. Special concerts
have been arranged with the help of volunteer artists.
The Occupational Therapy Department plays an active role in the reactivation
of interest and initiative in the patients. An average of 230 patients are actively
engaged.   There is an improvement in the regularity and frequency of attendance.
Three first-year students and two second-year students from the School of
Rehabilitation Medicine of the University of British Columbia spent four to six
weeks in the department as part of their clinical practice.
 G 100 MENTAL HEALTH SERVICES REPORT,  1965/66
A sale of work was held in December, at which practically all articles offered
were disposed of.
The Vancouver Dahlia Society has been a friend to our patients for several
years, and its efforts are much appreciated. Activities include a visit to its annual
show in Vancouver, talks and film shows, as well as planting and tending dahlias in
the garden.   Monthly meetings (except for December and January) have been held.
A podiatry service is maintained for two days per week.
Mr. D. M. Bartlett, auditor for the Division of Narcotic Control, inspected the
pharmacy and wards of the hospital with regard to drug-control procedures. Some
minor improvements in procedure were suggested.
DELLVIEW HOSPITAL, VERNON
This hospital, with a complement of 239 beds and a staff of 89, operated with
a 95-per-cent capacity during the year. A total of 99 patients was admitted directly
from the community, and 13 were received on transfer from other units of the
geriatric service, as well as three from the Riverview Hospital.
Eight patients were discharged in full, and 18 patients were released on leave
to the community. Of those on leave in the community, three were returned to
hospital.
During the year a total of 105 patients died.
The general health of the patients was maintained, except for two periods
during which influenza was prevalent.
Medical care is provided by a local physician on a part-time basis. The facilities of the adjacent Vernon Jubilee Hospital are available for surgery and other
special procedures. A visiting dentist, podiatrist, and ophthalmologist provide
satisfactory service in these areas.
An annual chest X-ray survey was conducted by a mobile unit of the Division
of Tuberculosis Control for the patients and staff.
A senior instructor, In-service Education, conducted refresher courses for
nurses and aides.
Fire drills are held regularly.
Mr. D. M. Bartlett, auditor for the Division of Narcotic Control, inspected
control of drug procedures and was satisfied with the method in use.
Occupational- and recreational-therapy activities, supported by Canadian Mental Health Volunteers and fraternal and service organizations in the Vernon district,
have been much appreciated by patients. A centrally operated audio sound installation capable of supplying radio or recorded music, with individual ward volume
control, is a valuable addition.
The various departments of the hospital report satisfactory functioning. Satisfactory repair and maintenance work has been accomplished.
SKEENAVIEW HOSPITAL, TERRACE
This hospital has a complement of 300 beds, all for male patients. There is a
staff of 71. A total of 350 elderly men received care and treatment. Sixteen
patients were received or admitted directly from the community. Thirty-four
patients were received on transfer from other facilities. Thirty-six patients died
during the year, and seven patients were discharged from hospital. Eleven patients
were transferred to Valleyview Hospital for rehabilitation and placement in the
community.   One patient was transferred to Riverview Hospital.
Medical care for these patients is provided by a visiting physician. Patients
are referred to the local general hospital for surgical or other special procedures.
 GERIATRIC DIVISION G 101
Diagnostic X-ray and laboratory services are supplied by the Terrace Mills
Memorial Hospital.
The travelling clinic of the Division of Tuberculosis Control conducted its
regular twice-yearly X-ray survey of staff and patients.
Minor structural alterations have provided means for improved care of the
physically ill as well as extending the open-ward areas.
In-service educational programmes for nursing staff have been maintained
through the senior training instructor, Education Centre, Essondale.
Occupational- and recreational-therapy programmes are supported by volunteer groups from the local community. An area formerly used for staff recreation
has been converted to a woodworking shop.
An " open house " was held on July 7, 1965, and approximately 150 people
took the opportunity to visit and inspect the hospital.
All departments of the hospital report satisfactory functioning. A volunteer
fire department has carried out regular drills and practices under the direction of
the local fire department.
 G 102
MENTAL HEALTH SERVICES REPORT,  1965/66
STATISTICAL TABLES
VALLEYVIEW HOSPITAL
Table 1.—Movement of Population, Valleyview Hospital, Essondale,
April 1, 1965, to March 31, 1966
Male
Female
Total
In residence, April 1, 1965 ... 	
On extended leave, carried forward from 1964/65—
268
66
491
83
759
149
Other                                         	
Total on books at at April 1, 1965 -	
334
574
908
Admissions—
209
32
2
217
34
6
426
66
8
243
257
500
577
831
1,408
Separations—
32
162
40
5
79
26
179
_.._
124
...._
58
TVpiI
341
40
10
On extended leave and still out—
203
Other
.
318
334
652
-9
259
+6
497
—3
756
i Includes 12 male and 1 female transfers from other geriatric facilities, 12 male and 18 female transfers
from Riverview Hospital.
 GERIATRIC DIVISION
G 103
Table 2.—First Admissions to Valleyview Hospital, Essondale, by Health
Unit and School District of Residence and Sex, April 1, 1965, to
March 31, 1966.
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
School District No. 1	
1
1
2
1
2
1
3
4
5
5
7
14
1
17
7
4
2
1
1
1
1
2
1
5
1
1
1
5
4
10
2
16
6
1
4
1
2
1
1
1
2
1
2
2
1
1
8
5
1
6
10
11
24
3
33
13
5
6
Central   Vancouver    Island,
Nanaimo—
School District No. 65 	
1
1
4
2
1
1
1
1
17
2
11
80
23
10
6
3
2
1
1
1
1
1
6
1
4
130
25
13
1
1
1
„           „        „   4	
 ,   66.._	
 68__  .
 ,   69	
„       „   70	
Upper Island, Courtenay—
School District No. 711	
1
Selkirk, Nelson—
School District No. 7	
6
3
„   8	
West Kootenay, Trail-
School District No. '11 _	
i
1
North Okanagan, Vernon—
„   72
2
School District No. 20	
Cariboo, Williams Lake—
School District No. 28	
South Okanagan, Kelowna—
1
School District No. '14	
„   23 	
South Central, Kamloops—
School District No. 29	
Skeena, Prince Rupert—
School District No. 52	
„   53....	
Northern    Interior,    Prince
George—
School District No. 57	
Greater   Victoria   Metropolitan
Board of Health-
School District No. 61. 	
1
1
„       „   3il 	
Upper   Fraser   Valley,   Chilliwack—
School District No. 33	
1
„   34	
 76 	
23
Central Fraser Valley, Mission
„   63 	
1
City-
School District No. 35	
 ,   64	
Metropolitan Health Committee,
Vancouver—
School District No. 38.	
 39	
„   41	
„       „   44    -
2
„           „       „   42...	
 75..._	
Boundary, Cloverdale—
School District No. 36	
, 37	
Simon  Fraser,   New  Westminster—
School District No. 40 	
„   43..	
15
210
48
23
„   45	
School district not covered by
health unit—
School District No. 49	
6
1
River—
School District No. 46 	
„           „       „   47	
Unknown ._	
Totals	
4
241
251
492
Table 3.—First Admissions and Readmissions to Valleyview Hospital,
Essondale, by Method of Admission, Age-group, and Sex, April 1, 1965,
to March 31, 1966.
Age-group (Years)
Method of Admission
20-29
30-49
50-59
60-69
70-79
80-89
90 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.|F.
1
M.
F.
M.
F.
M.
F.
First Admissions
14
8
3
91
13
104
3
115
6
104
15
13
6
235
19
232
25
467
Involuntary_      	
2
	
1
	
	
Totals          _ 	
|    2( 1    1
 1__
14]    8| 94|117
118|110| 15| 13
Readmissions
1
11
_..-|__.|    4
1
1
	
	
1
1
2
4
Involuntary
5
Totals
1
1!      1    _
1
1
	
->'   e.
g
 G 104
MENTAL HEALTH SERVICES REPORT,  1965/66
Table 4.—First Admissions to Valleyview Hospital, Essondale, by Mental
Diagnosis, Age-group, and Sex, April 1, 1965, to March 31, 1966
Age-group (Years)
Mental Diagnosis
Under
60
60-69
70-79
80-89
90 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
—
1
1
1
2
1
1
1
2
~5
2
1
1
1
2
3
4
3
1
1
16
2
1
7
54
1
4
3
5
10
4
5
~~I
10
~i
2
64
12
4
2
2
1
11
1
1
9
1
79
4
3
-1
6
2
3
1
8
1
1
2
72
10
3
1
~_
12
11
2
10
6
3
3
1
29
1
~~2
2
17
~~2
1
150
7
7
5
6
16
6
1
9
~"3
1
1
18
1
2
~1
4
150
24
3
15
12
19
9
2
38
1
3
3
Anxiety reaction without mention of somatic symptoms	
3
35
Chronic brain syndrome with neurotic reaction _	
1
2
2
1
Other and unspecified character, behaviour, and intelligence disorders —
Chronic brain syndrome with behavioural reaction	
5
300
31
Diagnosis deferred—           - 	
10
Totals                ..            	
3
14
8
94
■117
118
110
15
13
2411251
492
Table 5.—First Admissions to Valleyview Hospital, Essondale, by Mental
Diagnosis, Marital Status, and Sex, April 1, 1965, to March 31, 1966
Table 6.—First Admissions to Valleyview Hospital, Essondale, by
Religion and Sex, April 1, 1965, to March 31, 1966
Detailed information for the above tables may be obtained on request.
 geriatric division
G 105
Table 7.—Population in Residence at Valleyview Hospital, Essondale,
by Mental Diagnosis, Age-group, and Sex, December 31, 1965
Age-group (Years)
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.
5
2
1
1
4
8
1
I
1
2
1
1
3
7
1
1
1
1
1
4
1
2
1
1
1
1
4
1
" 1
~3
4
1
~~1
1
6
1
1
2
4
1
2
14
2
3
6
~2
4
1
1
~3
1
24
7
5
1
I
1
15
2
1
6
12
8
2
2
9
18
2
5
52
34
~4
2
144
23
4
42
5
3
12
2
28
3
1
1
~~9
3
~~5
4
1
131
9
1
6
44
5
1
11
66
1
51
2
3
2
1
11
2
1
1
9
1
231
39
5
86
10
1
Paranoia and paranoid states	
14
78
3
Psychosis with cerebral arteriosclerosis 	
9
1
1
35
4
1
1
12
2
1
4
1
1
57
9
1
13
2
1
1
76
3
2
79
5
Psychosis of other demonstrable
etiology	
Other and unspecified psychosis	
Anxiety reaction without mention
4
3
1
Neurotic-depressive reaction	
Chronic   brain   syndrome   with
20
2
3
1
6
13
Other and unspecified character,
behaviour,   and   intelligence
disorders	
Chronic   brain   syndrome   with
behavioural reaction	
Chronic brain syndrome, N.O.S-.
2
362
48
1
Diagnosis deferred	
11
Totals   	
7
6
11
7
9
3
10
1
13
9
31
49
60
124
125
288
266
487
753
 G 106
MENTAL HEALTH SERVICES REPORT,  1965/66
Table 8.—Patients of Valleyview Hospital, Essondale, Residing in Boarding Homes, by Mental Diagnosis, Age-group, and Sex, December 31, 1965
Age-group (Years)
-
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.IF.
M.
F.
M.IF.
1
M.
F.
M.
F.
Schizophrenic disorders
Manic-depressive reaction	
Involutional melancholia	
Paranoia and paranoid states	
	
1
—-
2
2
	
—•
—-
	
1
1
1
1
2
2
1
2
2
1
~1
3
1
2
1
1
7
1
2
2
1
1
5
2
1
2
3
1
2
1
1
2
2
1
1
2
6
1
2
2
4
16
8
•1
7
4
1
1
3
15
1
1
5
2
1
1
33
4
2
3
9
2
4
21
10
1
2
1
2
2
53
6
1
3
16
6
.1
5
24
Psychosis with cerebral arterio-
25
1
Psychosis of other demonstrable
	
—
~T
1
Anxiety reaction without mention
1
Neurotic-depressive reaction	
Psychoneurosis   with   somatic
symptoms  (somatization reaction) affecting digestive system-
Chronic   brain   syndrome   with
7
1
2
3
—
1
2
1
6
1
3
Chronic   brain   syndrome   with
16
3
1
1
20
2
1
33
2
2
86
Chronic brain syndrome, N.O.S	
10
3
6
Totals    	
1
2
2
—
—
1
3
3
11
13
28
29
40
68
841117
201
 GERIATRIC DIVISION
G 107
Table 9.—Live Discharges from and Deaths Occurring in Valleyview
Hospital, Essondale, by Mental Diagnosis, Age-group, and Sex, April
1, 1965, to March 31, 1966.
Mental Diagnosis
Age-group (Years)
Under
60
M.  F.
60-69
M.   F
70-79
M.  F,
80-89
M.  F.
90 and
Over
M.  F,
Total
M. F
Grand
Total
Live Discharges
Schizophrenic disorders  	
Manic-depressive reaction	
Paranoia and paranoid states	
Senile psychosis-
Psychosis with cerebral arteriosclerosis-
Psychosis of other demonstrable etiology-
Anxiety reaction without mention of somatic symptoms..
Neurotic-depressive reaction  	
Syphilis and its sequelas	
Pathological personality^     	
Immature personality	
Alcoholism	
Mental deficiency  	
Other and unspecified character, behaviour, and intelligence disorders-
Chronic brain syndrome with behavioural reaction .
Chronic brain syndrome, N.O.S.-
Other, unknown, and unspecified conditions-
Totals	
281 16
Deaths
Schizophrenic reaction	
Manic-depressive reaction-
Paranoia and paranoid states..
Senile psychosis-
Psychosis with cerebral arteriosclerosis-
Psychosis of other demonstrable etiology-
Other and unspecified psychoses	
Neurotic-depressive reaction	
Pathologicai personality— 	
Mental deficiency-
Chronic brain syndrome with behavioural reaction	
Chronic brain syndrome, N.O.S..
Other diseases of the central nervous system not associated with psychosis	
Totals -
54
36|    9
101
11 771 31
29
162
179
11
5
4
6
9
2
4
9
2
1
1
1
1
2
43
6
1
108
6
1
4
36
33
1
1
8
1
1
228
20
341
Table 10.—Live Discharges from and Deaths Occurring in Valleyview
Hospital, Essondale, by Mental Diagnosis, Length of Stay, and Sex,
April 1, 1965, to March 31, 1966.
Detailed information for the above table may be obtained on request.
 G 108
MENTAL HEALTH SERVICES REPORT,  1965/66
Table 11.—Deaths Occurring in Valleyview Hospital, Essondale, by
Cause of Death, Age-group, and Sex, April 1, 1965, to March 31, 1966
Age-group (Years)
Cause of Death
50-59
60-69
70-79
80-89
90 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
1
~~3
1
1
15
57
1
1
2
1
1
3
1
	
4
1
1
1
26
115
1
2
7
3
.1
4
8
1
2
11
127
2
7
12
1
3
1
1
3
1
8
1
1
2
8
70
1
5
7
1
1
1
3
2
17
1
2
22
1
1
3
1
1
1
2
8
39
33
1
2
4
2
1
37
1
—
242
3
	
—*
2
	
1
2
2
9
19
4
a
i
2
Accidental deaths
1
7
Totals   -
1
	
4
3
54
46
83
101
20
29
162
179
341
Table 12.—Deaths Occurring in Valleyview Hospital, Essondale, by Cause
of Death, Length of Stay, and Sex, April 1, 1965, to March 31, 1966
Detailed information for the above table may be obtained on request.
 GERIATRIC DIVISION
DELLVIEW HOSPITAL
G 109
Table 1.—Movement of Population, Dellview Hospital, Vernon,
April 1, 1965, to March 31, 1966
Male
Female
Total
98
126
224
Admissions—■
44
17
1
51
1
1
95
Readmissions to a different institution of Mental Health Services	
1«
2
62
53
115
Total under rare
160
179
339
Separations—
4
52
1
1
3
4
53
1
8
8
Pisrt
105
2
1
On extended leave and still out—Boarding home  	
11
61
66
127
+ 1
99
—13
113
— 12
212
i Includes 13 male transfers from other geriatric facilities, 2 male and 1 female transfers from Riverview
Hospital.
Table 2.—First Admissions to Dellview Hospital, Vernon, by Health
Unit and School District of Residence and Sex, April 1, 1965, to
March 31, 1966.
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
School District No. 2    .
„   4	
Selkirk, Nelson—
School District No. 7	
1
2
3
1
2
2
2
1
16
3
2
6
4
2
1
1
1
1
6
20
1
1
6
1
1
1
2
2
4
1
1
1
2
2
8
1
36
4
3
12
1
1
5
2
South Central, Kamloops—
School District No. 24	
„   31 	
Upper   Fraser   Valley,    Chilliwack—
School District No. 76	
Coast     Garibaldi,     Powell
liiver—
School District No. 47	
Cariboo, Williams Lake—
School District No. 27 	
Skeena, Prince Rupert—
School District No. 52
3
1
1
1
1
7
4
1
1
1
1
3
7
1
„   8	
1
West Kootenay, Trail—
School District No. 9	
„   11 	
„   12
„   13—	
North Okanagan, Vernon—
School District No. 20	
1
1
1
„   21    —
„   22	
„   78	
Northern    Interior,    Prince
George—
School District No. 56   .  .   .
1
South Okanagan, Kelowna—
School District No. 14 —	
 15
„   16	
 17—   ..     ..
„   23 -
 77	
„   57	
Greater   Victoria   Metropolitan
Board of Health—
School District No. 62	
Metropolitan Health Committee,
Vancouver—
School District No. 39	
Totals   	
4
1
7
61
52
113
 G 110
MENTAL HEALTH SERVICES REPORT, 1965/66
Table 3.—First Admissions and Readmissions to Dellview Hospital,
Vernon, by Method of Admission, Age-group, and Sex, April 1, 1965,
to March 31, 1966.
Age-group (Years)
Mental Diagnosis
50-59
60-69
70-79
80-89
90 and
Over
Grand
Total
M.    F.
M. 1 F.
M.
F.
M.
F.
M.
F.
M.
F.
First Admissions
involuntary
2
-
3
4
15
20
1
38
1
26
3
2
61
1
52
1
113
Readmissions
Involuntary                         ..    ,	
2
Table 4.—First Admissions to Dellview Hospital, Vernon, by Mental
Diagnosis, Age-group, and Sex, April 1, 1965, to March 31, 1966
Age-group (Years)
Mental Diagnosis
50-59
60-69
70-79
80-89
90 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Schizophrenic disorders	
—
-
1
2
1
3
1
1
1
11
1
20
1
1
36
26
-
-
2
1
1
1
1
54
1
1
51
3
1
1
1
....     ....
3       2
1
Chronic  brain syndrome with  behavioural
2 | —
105
1
Totals           	
2
—
3
4
15
20
38
?fi
3
2
61
52
113
Table 5.—First Admissions to Dellview Hospital, Vernon, by Mental
Diagnosis, Marital Status, and Sex, April 1, 1965, to March 31, 1966
Table 6.—First Admissions to Dellview Hospital, Vernon, by Religion
and Sex, April 1, 1965, to March 31, 1966
Detailed information for the above tables may be obtained on request.
 GERIATRIC DIVISION
G 111
Table 7.—Total Number of Patients on Books1 of Dellview Hospital,
Vernon, by Mental Diagnosis, Age-group, and Sex, December 31, 1965
Age-group (Years)
Mental Diagnosis
Under
60
60-64
65-69
70-74
75-79
80 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F. |M.
1
F.
M.
F.
2
T
4
1
1
3
2
	
8
1
1
5
1
2
" 8
6
1
1
10
2
1
17
1
2
4
3
38
5
7
11
1
60
■14
18
1
4
5
1
1
60
7
12
11
1
1
93
15
30
1
1
1
4
15
Psychosis with cerebral arteriosclerosis	
6
1
Neurotic-depressive reaction. .„	
1
1
Chronic brain syndrome with behavioural reaction
Chronic brain syndrome, N.O.S	
153
22
Totals	
2
i
5
4
4
4
16
10
18
21
52
93    97
133
230
i Of this total, 3 males and 8 females were in boarding homes at December 31, 1965.
Table 8. — Live Discharges from and Deaths Occurring in Dellview
Hospital, Vernon, by Mental Diagnosis, Age-group, and Sex, April 1,
1965, to March 31, 1966.
Age-group (Years)
Total
Mental Diagnosis
50-59
60-69
70-79
80-89
90 and
Over
Grand
Total
M.    F.
1
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Live Discharges
Chronic brain  syndrome  with  behavioural
__
1
1
2
2
1
2
1
1
„_
3
3
4
1
7
Chronic brain syndrome, N.O.S.  	
4
Totals	
.... | ....
1
1 |    2
3
2 |    1
1 |-
<-
5
11
Deaths
Chronic  brain   syndrome  with  behavioural
1
3
3
12
2
14
2
28
1
24
3
5
7
49
3
48
5
97
8
Totals  	
1 1 —
3
3   1   14
16
29
27
5
7
52
53
105
 G 112
MENTAL HEALTH SERVICES REPORT, 1965/66
Table 9. — Live Discharges from and Deaths Occurring in Dellview
Hospital, Vernon, by Mental Diagnosis, Length of Stay, and Sex,
April 1, 1965, to March 31, 1966.
Detailed information for the above table may be obtained on request.
Table 10.—Deaths Occurring in Dellview Hospital, Vernon, by Cause of
Death, Age-group, and Sex, April 1, 1965, to March 31, 1966
Age-group (Years)
Cause of Death
50-59
60-69
70-79
80-89
90 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Vascular lesions affecting the central nervous
1
-
2
1
3
14
1
15
29
2
25
5
6
1
51
1
3
49
■1
3
100
2
Totals	
1
—
3
3
14
16
29
27
5
7
52
53
105
Table 11.—Deaths Occurring in Dellview Hospital, Vernon, by Cause of
Death, Length of Stay, and Sex, April 1, 1965, to March 31, 1966
Detailed information for the above table may be obtained on request.
 GERIATRIC DIVISION
SKEENAVIEW HOSPITAL1
G 113
Table 1.—Movement of Population, Skeenaview Hospital, Terrace,
April 1, 1965, to March 31, 1966
In residence, April 1, 1965
On extended leave	
Total on books
299
1
300
Admissions—
First admissions to Mental Health Services  15
Readmissions to a different institution of Mental Health Services 34
Readmissions to the same institution  1
Total admissions2
50
Total under care
350
Separations—
Discharged in full
Died	
  8
  36
Transferred to other geriatric facilities  11
Transferred to psychiatric facility  1
Total separations.
Net decrease	
In residence, March 31, 1966
56
-5
294
1 This institution cares for male patients only.
2 Includes 27 transfers from other geriatric facilities, 1 transfer from Riverview Hospital, 6 transfers from
The Woodlands School.
Table 2.—First Admissions to Skeenaview Hospital, Terrace, by Health
Unit and School District of Residence, April 1, 1965, to March 31, 1966
Health Unit                                              No. Health Unit                                              No.
East Kootenay, Cranbrook— Cariboo, Williams Lake—
School District No. 1.._    2 School District No. 28    2
North Okanagan, Vernon— Skeena, Prince Rupert—
School District No. 22   1 School District No. 51    1
South Okanagan, Kelowna— School District No. 52    4
School District No. 17      1 School District No. 53    6
South Central, Kamloops— School District No. 54  _   1
School District No. 24        1 Peace River, Dawson Creek—
Upper Fraser Valley, Chilliwack— School District No. 59 _   2
School District No. 32 __   _.    1 Northern Interior, Prince George—
Central Fraser Valley, Mission City— School District No. 55    1
School District No. 35     1 School District No. 56  2
School District No. 42 _     1 Greater Victoria Metropolitan Board of Health—
Boundary, Cloverdale— School District No. 61    8
School District No. 36 —   1 Metropolitan Health Committee, Vancouver—
Simon Fraser, New Westminster— School District No. 39    9
School District No. 40 _.   3 School District No. 41  _   1
Total . 49
 G 114
MENTAL HEALTH SERVICES REPORT, 1965/66
Table 3.—First Admissions and Readmissions to Skeenaview Hospital,
Terrace, by Method of Admission and Age-group, April 1, 1965, to
March 31, 1966.
Age-group (Years)
Total
Method of Admission
30-49
50-59
60-69
70-79
80-89
90 and
Over
First Admissions
Informal	
Involuntary _ 	
1    |      "2
5
17
1
21
2
1
48
Totals —  	
1    j        2    |        5    |      17    |      22    |        2    |      49
Readmissions
--             1
--
1
Table 4.—First Admissions to Skeenaview Hospital, Terrace, by Mental
Diagnosis and Age-group, April 1, 1965, to March 31, 1966
Mental Diagnosis
Age-group (Years)
Total
Under
60
60-69
70-79 1 80-89
I
90 and
Over
2
1
2
3
6
2
1
2
4
2
1
3
1
10
6
1
1
1
8
1
3
3
1
Syphilis and its sequelas. - — 	
2
5
Chronic brain syndrome with behavioural reaction 	
15
8
Diagnosis deferred .   — _. ....
3
Totals           '             	
3
5
17
22
2
49
Table 5.—First Admissions to Skeenaview Hospital, Terrace, by Mental
Diagnosis and Marital Status, April 1, 1965, to March 31, 1966
Table 6.—First Admissions to Skeenaview Hospital, Terrace, by Religion,
April 1, 1965, to March 31, 1966
Detailed information for the above tables may be obtained on request.
 GERIATRIC DIVISION
G  115
Table 7.—Total Number of Patients on Books of Skeenaview Hospital,
Terrace, by Mental Diagnosis and Age-group, December 31, 1965
Mental Diagnosis
Age-group (Years)
Total
Under
60
60-64
65-69
70-74
75-79
80 and
Over
11
4
24
1
1
3
1
3
5
22
1
~4
3
1
1
1
1
3
29
1
1
5
1
1
2
1
2
~~3
1
1
37
1
10
4
"T
1
~7
5
2
2
31
1
1
23
8
1
1
1
13
8
i
154
Manic-depressive reaction
4
1
Senile psychosis     	
35
22
7
Psychosis of other demonstrable etiology	
4
2
1
Alcoholism.   	
6
8
Chronic brain syndrome with behavioural reaction
24
15
Syphilis and its sequela	
11
Other, unknown, and unspecified conditions    .
4
Totals   ..
15
38
37
48
70
90
298
Table 8.—Live Discharges from and Deaths Occurring in Skeenaview
Hospital, Terrace, by Mental Diagnosis and Age-group, April 1, 1965,
to March 31, 1966.
Mental Diagnosis
Age-group (Years)
Total
Under
60
60-69
70-79
80-89
90 and
Over
Live Discharges
Schizophrenic disorders	
1
5
2
2
2
2
....
4
1
1
—
12
Psychosis with cerebral arteriosclerosis.  —
2
Alcoholic psychosis	
2
Chronic brain syndrome with behavioural reaction       	
1
Chronic brain svndmmr-, N D S
2
Observation without further need of psychiatric care.	
4
Totals
'1    |.       9
4
6
20
Deaths
—
1
2
1
6
1
1
2
1
2
6
3
1
1
2
1
2
1   1
"tt
10
1
3
2
2
2
2
1
5
8
Tntals
—
4
19
12
1
36
Table 9.—Live Discharges from and Deaths Occurring in Skeenaview
Hospital, Terrace, by Mental Diagnosis and Length of Stay, April 1,
1965, to March 31, 1966.
Detailed information for the above table may be obtained on request.
 G 116
MENTAL HEALTH SERVICES REPORT,  1965/66
Table 10.—Deaths Occurring in Skeenaview Hospital, Terrace, by Cause
of Death and Age-group, April 1, 1965, to March 31, 1966
Cause of Death
Age-group (Years)
Uj$er    60-69
70-79
80-89
90 and
Over
Total
Malignant neoplasms-
Allergic disorders-
Vascular lesions affecting central nervous system _
Arteriosclerotic and degenerative heart disease	
Diseases of arteries	
Pneumonia	
Other diseases of the respiratory system-
Diseases of the digestive system	
Totals...  .	
19
12
6
1
8
11
3
3
3
1
36
Table 11.—Deaths Occurring in Skeenaview Hospital, Terrace, by Cause
of Death and Length of Stay, April 1, 1965, to March 31, 1966
Detailed information for the above table may be obtained on request.
 COMMUNITY MENTAL HEALTH SERVICES G 117
PART VI.—COMMUNITY MENTAL HEALTH SERVICES
MENTAL HEALTH CENTRE, BURNABY
K. J. Davies, Director
During the year this clinic has continued to make efforts at better community
liaison. The intake, treatment, and travelling clinic teams have all provided a
more immediate consultation and treatment service to the referring physicians, as
well as consultation with the community professionals (social workers, public health
nurses, probation officers, teachers, clergy). This has been made possible by all
the staff increasing their patient load in intensive, brief, and community consultation. The total numbers of families being seen has progressively increased in all
these areas. The staff has also given increased indirect service by professional
education, public education, and involvement in a variety of professional and lay
committees in the local community, as well as different areas in the Province being
serviced by travelling clinics.
OUT-PATIENT DEPARTMENT
Individual psychotherapy is still the principal approach, although increasing
time is being used in joint interviews, family group therapy, and group therapy for
adolescents, adults, and parents of children being seen. The Social Club and its
patients' executive have also had an active programme on Tuesday evenings. Of the
patients treated, neurotic reactions outnumber the psychotic ones by about two to
one, but the personality disorders have increased to about the level of neurotic
reactions. This seems to be the result of younger people being referred, with the
peak age of treated patients being in their late teens and early twenties.
CHILDREN'S DAY CENTRE
During the past year the Day Centre expanded to offer services in three distinct
programmes. The morning programme is a continuation of last year's group of
autistic children, with five to seven children attending four mornings a week. The
afternoon programme was started to include six pre-school children attending five
sessions a week. The children selected for this programme require carefully planned
and guided social and peer group experiences. The most recently started programme is that combined with Day Hospital. The mother attends the Day Hospital
daily, and the child or children attend the Day Centre daily from 8.30 a.m. to 4 p.m.
The goal with these children is initially for observation and assessment, following
which further treatment plans are formulated as appropriate.
Continued interest is shown by the community in these various programmes,
and students in nursing, education, and social work are among the many regular
observers in the Day Centre during the year. A nurse functioning as a child-care
worker has been placed full time in the Day Centre this year for the first time, and
this has assisted the nursing staff greatly in their efforts to maintain continuity of a
person for the children and communication with other departments.
LEARNING CLINIC
A special programme has provided a service for children with perceptual problems as basic to their learning disability.   This programme was begun at the Mental
 G 118 MENTAL HEALTH SERVICES REPORT,  1965/66
Health Centre because the schools were not able to provide this service to the
children. Since children with learning problems develop behaviour disturbances
following the frustration experienced from repeated failure, such difficulties can be
considered a mental health problem. The school area concentrated upon was
Burnaby, due to its proximity and hope that such a programme could be integrated
into the school system. The experimental venture proved so effective that Burnaby
will be starting three specialized classes for children with perceptual disorders in
September of 1966. The activities of the Learning Clinic during the past year have
included assessments, consultation to the schools, and direct treatment here. The
assessments involve from 2 to 6 hours, and results were interpreted directly to the
school involved. A group of five children was seen in a local Burnaby school on a
daily basis for 2Vi hours each morning. In addition, 12 children were seen at the
clinic for two sessions a week of 2 hours' duration. Consultation and community
education has taken the form of demonstrations, lectures, and workshops.
ADOLESCENT AND ADULT DAY HOSPITAL
The Day Hospital staff continues to refine their concepts and practice of
milieu therapy. The emphasis has been on group rather than individual therapy,
with more patient self-government assisted by the establishment of three patient
committees. The senior psychiatrist has deployed about one-half of his time to be
available as direct consultant to the Day Hospital programme and thus channel and
streamline lines of authority and communication. Population in the Day Hospital
has ranged between 20 and 35 patients, with a noticeable decrease in the average
length of stay during the past year.
GROUP-LIVING HOMES
The group-living homes in Burnaby, Surrey, Kamloops, Prince George, and
Prince Rupert, as well as the new unit at New Denver operated by the Department
of Social Welfare, have been provided a screening and consultation service. Individual and group therapy have also been used for the adolescent boys in the group-
living homes in Burnaby and Surrey. The demand for this service is increasing
throughout the Province and necessitated a much closer liaison between our clinic
and the Special Placement Division of the Child Welfare Department, which has
established its offices within our building. This type of service will become increasingly important with the expansion of services to adolescents when the new residential treatment unit is completed here in 1967.
LOCAL AGENCY CONSULTATION SERVICE
Consultation and psychiatric treatment when appropriate have been provided
by a child psychiatrist making a weekly visit to the Health Centre for Children,
Children's Aid Society, Catholic Children's Aid Society, Juvenile Courts of Vancouver and Burnaby, and the Willingdon School for Girls.
TRAVELLING CLINICS
Fifteen towns throughout the Province have received a regular frequent service
from a psychiatric team seeing a large number of families but with considerable
emphasis on co-ordinating communities' professionals. This sharing in dealing with
local community mental health problems has been quite productive. Mental health
nurses have joined the travelling clinic teams to two areas of the Province in the past
year.   The function of the nurse is particularly to assist public health nurses with
 COMMUNITY MENTAL HEALTH SERVICES
G  119
psychiatric nursing concepts related to team recommendations and to assist the
unit nursing supervisors in improving their staff interviewing techniques.
RESEARCH
The role of research in the clinic is becoming more apparent, and it is stressed
as constituting part of the duties of staff, especially psychologists. The elaborate
investigation into the causes of infantile autism is now completed and in the process
of being written up. One of the summer psychology interns wrote up his contribution on this investigation, which was accepted as his thesis for his master's degree.
Another psychologist summer intern working on a different section has submitted
papers for publication. A study into the interaction between marital partners and
the effect they have on each other on the decision-making process is currently in
progress. The Sociometric Investigation of the Day Hospital Interaction also is
being written up for publication. An evaluation of the effectiveness of the travelling
clinic service to the Chilliwack area has been completed.
TRAINING
During the past three years an internship programme has been undertaken for
the training of clinical psychologists. There were two purposes for this venture, and
both have been realized in part. Of prime concern to the Mental Health Services is
recruitment of new staff. There have been some psychologists remaining with the
Mental Health Services Branch following the internship, so it has served the function
of recruitment. However, a far greater role of the internship has been the training
of clinical psychologists so they could be more productive when employed.
Study of the methods involved and training for added skill are important in
improving our own standard of service and also in fulfilling an education role in
development of community services for mental health. Social workers here have
participated in the training of quite a large number of staff from other units and
community services, and these aids are being increasingly requested. The institutes
we have sponsored have fulfilled some of the role, and our staff has gone out on
request to discuss the application of newer methods. Many professionals have been
able to use at least some opportunity to come into the centre for observation and
learning experience, especially in regard to family group therapy and group therapy.
The centre has continued in this year to train seven social-work students in field
placement, and an additional seven students in after-care have made use of experience in the centre's programme. Social-work students from other field agencies
have also been using much increased opportunity to visit and observe. If we are to
fulfil the educational role that community mental health concepts require of a
facility such as this clinic, it is important that this aspect be administratively acknowledged and planned. It will become even more important as residential treatment is
established in conjunction with this centre.
There have been four important institutes held during the past year. In April,
1965, a group of 102 professionals (psychiatrists, social workers, psychologists, and
nurses) attended a two-day Workshop on Family Group Therapy led by the Director
of Training at the Palo Alto Research Institute, Virginia Satir. In June of 1965,
110 professionals (psychiatrists, psychologists, social workers, and clergy) attended
a two-day Symposium on Religion and Mental Health. In March, 1966, 41
therapists (psychiatrists, psychologists, social workers, and nurses) attended a
three-day Workshop in Group Psychotherapy led by the Director of Training of
Group Psychotherapy for the American Psychiatric Association, Dr. Milton Berger.
 G 120
MENTAL HEALTH SERVICES REPORT,  1965/66
A very active in-service training programme is offered here for all professional
staff. Every Wednesday from 12.30 p.m. to 2 p.m., 50 to 60 professionals attend
the staff development with outside speakers or demonstrations given on treatment
techniques or subjects related to the mental health field. Every Thursday from
4 p.m. to 5 p.m., 10 to 15 of the staff meet to discuss various presentations on
day-hospital milieu treatment. Each Friday from 4 p.m. to 5 p.m., approximately
15 staff discuss theories and techniques of child psychiatry in day-centre treatment.
Each Friday from 9 a.m. to 10 a.m., all the psychiatrists attend a journal club for
the presentation in review of various articles on psychiatric treatment. All the social
workers during their first year of employment here attend a weekly 2-hour supervision conference. Each Friday from 8.45 a.m. to 10 a.m., there is a staff-development programme, which has now expanded to include all the mental health services
as well as clinical psychologists from School Boards and rehabilitation, university,
and vocational counselling for a seminar and discussion on current issues and recent
advances in psychology. Each Wednesday from 9 a.m. to 10 a.m., approximately
15 therapists attend a multi-disciplinary meeting to discuss current family group
therapy techniques.
Table 1.
STATISTICS
-Summary of Operations, Mental Health Centre, Burnaby,
Adult Clinic, April 1, 1965, to March 31, 1966
Male
Female
Total
Brought forward, April 1,1965
160
289
281
436
441
725
449
717
1,166
222
227
310
407
532
634
Table 2.—First Admissions to Mental Health Centre, Adult Clinic, by
Health Unit and School District of Residence, April 1, 1965, to
March 31, 1966.
Detailed information for the above table may be obtained on request.
 COMMUNITY MENTAL HEALTH SERVICES
G  121
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MENTAL HEALTH SERVICES REPORT, 19.5/66
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G  123
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 G 124
MENTAL HEALTH SERVICES REPORT, 1965/66
Table 7.—Movement of Population, Day Hospital, Mental Health
Centre, Adult Clinic, April 1, 1965, to March 31, 1966
Male
Female
Total
Tn flay hnr;pit*il, April 1, 1965
6
63
18
15
98
2!8
21
161
46
TntaW
87
76
141
121
228
Less discharges
197
111
20
311
Total patient-days of those discharged..
Total discharges-
Average stay in day hospital ~
 4,545
      197
23.07 days
Table 8. — Summary of Operations, Mental Health Centre, Burnaby,
Children's Clinic (Travelling Clinic and Direct Cases), April 1, 1965,
to March 31, 1966.
intake section
Total
Total number pending at April 1,1965-
Plus assessments—■
Mental Health Services	
Medical units	
Public health units	
Correctional agencies-
Social agencies-
General practitioners-
Private psychiatrists—
Totals-
Disposition of assessments—
O.P.D. activated	
Day-hospital admissions	
Social agency recommended-
Other medical care	
Assessment and advice	
Total pending at March 31,1966-
TREATMENT SECTION
Report of service:—
Active cases brought forward, April 1, 1965_
Cases activated, April 1, 1965, to March 31, 1966..
Total   	
Less cases closed-
Total under treatment as of March 31, 1966..
Under treatment at Mental Health Centre, Burnaby.-
Under treatment, travelling clinic	
Plus cases pending, March 31, 1966-
Total   _	
270
1,019
1,289
684
605
297
285
582
23
605
 COMMUNITY MENTAL HEALTH SERVICES
G 125
Table 9.—Referrals to Children's Clinics by Health Unit and School
District of Residence, April 1, 1965, to March 31, 1966
Health Unit
Travelling
Clinic
Direct
Total
15
13
28
32
9
13
95
14
43
2
8
33
26
24
14
8
8
7
1
1
1
7
1
2
14
2
21
255
178
25
7
34
41
18
1
1
3
3
7
1
3
1
North Okanagan, Vernon—School District No. 20 	
Cariboo, Williams Lake—
Sr-hnnl District Nn 9.7
1
16
Srhi"l District Nn. M
!         13
Northern Interior, Prince George—School District No. 57 	
Upper Fraser Valley, Chilliwack—
Sr-hnnl nistrir-t Nn. 33
28
39
Sr-hnnl District Nn. 34
10
Boundary, Cloverdale—
Sr-hnnl nistrir-t Nn   35
15
Sr-hnnl District Nn, 36
109
Sr-hnnl T*)istr,Vt Nn. 37
16
Metropolitan Health Committee, Vancouver—
School District No. 38
School District No. 39 (Unit No. 1, 34;   Unit No. 2, 3®; Unit No. 3,
47;   Unit Nn. 4, 68;  Unit Nn. 5, 68)
21
255
Sr-hnnl Tlistrir-t Nn  41
178
25
Sr-hnnl nistrir-t Nn  45
7
Simon Fraser, New Westminster—
School District No. 40..           ...             	
34
84
North Fraser Valley, Mission—
Sr-hnnl nistrir-t Nn. 4**>.
20
Sr-hnnl District Nn. 75
Sr-hnnl TMstrirr Nn  76
9
1
Skeena, Prince Rupert—
Sr-linnl Tlistrir-t Nn   I***.
33
29
Srhnnl nistrir-t Nn. 80
24
Peace River, Dawson Creek—
Sr-hnnl nistrir-t Nn   59
14
Sr-hnnl nistrir-t Nn  60
8
Coast Garibaldi, Powell River—
11
Sr-hnnl nistrir-t Nn 47
7
Sr-hnnl nistrir-t Nn   _R
7
Central Vancouver Island, Nanaimo—School District No. 70
School districts not covered by health units—School District No. 49	
1
3
Totals
392
627
1,019
 G 126 MENTAL HEALTH SERVICES REPORT,  1965/66
MENTAL HEALTH CENTRE, VICTORIA
C. Gregory, Director
STAFF AND ORGANIZATION
Organization of work in any mental health centre depends on three main factors: the physical plant available, the number of staff and their levels of training and
experience, and the general policy to be followed.
(a) Physical Plant.—This was the first year of operation in the new building
occupied in January, 1965, and after the initial settling-jn period the vast improvement in accommodation became reflected in the marked increase in both quality and
quantity of service offered to the community. Its proximity to the Royal Jubilee
Hospital has proved most useful for both hospital and centre, and has been an
important factor in the promotion of closer working relationships with the medical
profession. The availability of more than adequate space has not only enabled us
to offer a wider range of activities than before, but has promoted an atmosphere of
ease of access for the workers in the various social agencies, thereby encouraging a
free, less inhibited use of the centre by them.
(_>) Staff.—Establishment increased with the provision of a new building but
the actual recruiting took place during this year, in which we achieved complete
establishment.
(c) Policy.—The basis of policy is the provision of a comprehensive mental
health service for the community of Greater Victoria, and by far the most important
and difficult single problem facing us is the attainment of the optimum integration
and co-operation between all the various agencies which are concerned with mental
health, directly or indirectly. A number of significant steps were taken toward
this end:—
(1) A conference was held in September, 1965, under the sponsorship of the
University of Victoria, to which all agencies and individuals working in
this field were invited, the immediate objective of which was to ensure
exposure of those from each discipline to the viewpoints of those from
other disciplines. This was eminently successful, and a follow-up conference is being planned to discuss both the immediate steps which can be
taken to promote inter-agency co-ordination and to consider the objectives
of a long-term plan for the development of mental health facilities in this
community during the next 10 to 20 years.
(2) Since that conference, a series of discussions has taken place involving the
full staff of the centre in each case, and those of the major agencies in
turn, the object in each case being to explore the overlaps and gaps in
service, the mutual problems faced, and ways in which we might more
effectively co-operate with one another. These discussions have been most
valuable, and have had quite a dramatic effect in improving both the
services we all offer and the atmosphere in which we all operate.
(3) Liaison committees consisting of one professional worker from the centre
and one from each agency have been established to put into practice the
proposals which emerged from the meetings. Thus we have a regular
liaison meeting with each of the agencies weekly, to ensure quick and
effective handling of problem cases, to discuss management of cases carried mutually, to facilitate inter-agency referral, etc.
(d) Organization.—These staff increases, new physical facilities, and the first
steps in the direction of the goal we aim for necessitate changes in organization if
 COMMUNITY MENTAL HEALTH SERVICES
G 127
we are to realize our potential. Thus the old dichotomy of the centre into adults'
and children's clinics has been abandoned as unwieldly and irrational, the procedures for referral, assessment, and disposition of case completely changed and
clarified, and a flexible system adopted which can be, and has been, modified whilst
the centre is operating at full pressure, to meet changing conditions.
ACTIVITIES OF PROFESSIONAL STAFF
All of the above factors have played a part in determining the kind of service,
as well as the quality and quantity, we offer, but paramount is the decision to spend
more professional time and effort in indirect as against direct service. By direct
service is meant acceptance of full and exclusive responsibility for any patient by
the centre, whereas indirect service involved the centre as the major mental health
resource in the area which offers a range of professional service to agencies which
require them, in cases for which the primary responsibility will remain with the
agency rather than the centre.
1. Direct service includes:—
(a) Psychotherapy carried out on an individual, group, and family basis, and
although the first is still available for those who need it, ever greater
emphasis is being placed on group, and particularly family group, therapy,
which, as the experience of the staff increases with these techniques, is
assuming a most potent therapeutic importance, a tendency which is
entirely in keeping with current concepts.
(b) Pharmacotherapy, which, when taken in conjunction with concern for
the general welfare of the individual, plays a paramount role in sustaining
patients in the community who, only a few years ago, would have been
consigned to a large mental hospital, far from their relatives and friends.
In terms of sheer economic investment, the provision of drugs to patients
who need them brings great returns.
(c) After-care programme, which caters for those patients who have been
discharged from the Riverview Hospital. Many of these are found
boarding homes in which to live, and are then seen in the boarding home
regularly, sometimes jointly with the welfare agencies. This is likely to
develop into a major aspect of our work.
(d) Electro-shock treatment on an out-patient basis. This was started early
in 1966, and in the few cases we have treated in this way, improvement
has followed, with complete remission in most. There will be more demand for this service now it has started.
2. Indirect service covers a wide and growing range of activities in the areas
we serve, which is roughly equivalent to that of the Greater Victoria Metropolitan
Board of Health, but which also includes service to the Brannan Lake School.
(a) Assessment of cases, both psychiatric and psychological, is performed for
a number of agencies, including the medical practitioners, social agencies,
the various School Boards, the Courts. This by itself is, of course, not
enough, and we therefore provide—
(b) Consultation and, where necessary, joint management of cases with
agencies who so desire. Case conferences frequently involve a number
of different agencies, and for those cases where the emotional factors are
most pressing, we asume a major role without taking over direct reponsi-
bility for management.
(c) Education is one of our most important functions, whether for professionals or for the general public.
 G 128 MENTAL HEALTH SERVICES REPORT, 1965/66
(i) Medical Profession.—As a harbinger of things to come, we have
tried the experiment of having an interested general practitioner attend
the centre and manage one of the patients whom he had referred to us,
under the supervision of a psychiatrist. He also attended some of our
staff-training sessions, and has declared himelf highly pleased with the
results, both for the patient and for himself, in his own enhanced ability
to deal with such cases. This has now been extended to include several
practitioners, and will almost certainly continue to expand as its usefulness becomes more widely demonstrated. Other ways in which the medical profession has been involved are by means of lectures to the medical
staffs of both the Royal Jubilee and St. Joseph's Hospitals, and the
Victoria Medical Society has reciprocated our attempts at closer cooperation by demonstrating a more active interest in the practice of
psychiatry in the community.
(ii) Nursing.—We have continued the course of lectures for the
nurses at the Royal Jubilee Hospital, who are doing their three months'
training in psychiatry, and regularly have orientation lectures to nurses
from St. Joseph's Hospital and other places.
(iii) Family Group Therapy.—In conjunction with the consultation
service we provide to the various welfare and family agencies, we offer
instruction in family group therapy, the practical results of which have
been most encouraging, according to the agencies, measured in terms of
their increased ability to manage difficult cases.
(iv) The General Public.—In spite of the greatly increased demand
for talks to various community groups, these have been met by the influx
of new staff to the centre, and we are now reaching a fairly large number
of people. However, this is not yet sufficient, and a more organized plan
for public education and information is now under consideration.
(v) Participation in Community Activity.—This has increased, and
the centre is represented on a variety of committees which represent organizations involved in some aspect of mental health.
(vi) Staff-training.—Continuation of one's professional education
is essential if maximum effectiveness is to be sustained, and a regular
programme has been carried out since the absorption of new professional
staff was completed.
3. Research.—We have decided to examine two questions which we have been
compelled to ask, by our experience at the centre over the past several years, both
of which have great practical significance.   The first relates to what we consider to
be an inordinately large percentage of referrals from armed forces families, and will,
we hope, enable them to be dealt with more appropriately and effectively.    The
second is an attempt to clarify the major reasons for referral of young children to
the centre, with a view to formulating more clearly possible measures of prevention
of emotional disturbances.
COMMUNITY CO-OPERATION FOR CHILDREN
A fine example of co-operation in the community is the class for emotionally
disturbed children which is operated jointly by the Association for Emotionally
Disturbed Children, the School Board of District No. 61, and the Mental Health
Centre. There are up to eight children in the class, between 6 and 8 years old,
and the object is to take them to the point where they can return to ordinary school
 COMMUNITY MENTAL HEALTH SERVICES
G 129
class. This necessarily excludes retarded and severely brain-damaged children, for
whom separate facilities are planned. So far results have been good, in spite of
some initial difficulties, and several children have returned to their normal classes.
SUMMARY OF OPERATIONS
Adult
Children
Total
108
341
72
223
180
564
449
187
295
137
744
324
Cases carried forward at March 31, 1966
262
158
420
Total patient interviews—
Psychiatric	
    2
527
647
574
866
Psychological       „,.                 ..
Social worker-  	
    1
Nurses	
 G 130 MENTAL HEALTH SERVICES REPORT,  1965/66
OKANAGAN MENTAL HEALTH CENTRE, KELOWNA
F. E. McNair, Director
A regional service is set up to meet the needs of a selected population group,
the selection being determined by natural geographic boundaries or commercial
groupings. The emphasis is on service with direct office consultation and hospital
consultation being offered patients without regard to economic standing, chronicity
of disorder, or the obstreperousness of the patient. Direct treatment of cases must
also be undertaken, and the consultant in psychiatry has to be available at all times
in case of emergency. The task of treating emotional disturbances in a community
is far more than a specialist group can undertake, however. More than half of the
problems of emotional disorder are looked after by family doctors, social agencies,
and other resources, and the professional people so engaged need help from the
specialist group both in case consultation and in provision for on-going education.
Together all persons concerned for the mental health of the community need to
strengthen the community resources by identifying special areas of need, by providing for specific educational opportunities and projects, and by taking initiative to
start new services.
A regional service is community based and depends upon personnel rather
than a special building. Many more qualified people are needed in the various
regions of the Province before a comprehensive regional service is possible. The
part-time employment of qualified personnel within this district has increased considerably the amount of coverage that is given. This is true both with regard to the
sessional employment of the private psychiatrist in Vernon and also of the utilization of the pharmacy services in Kelowna and Vernon to provide a prescription
service and the laboratory services in Kelowna, Vernon, and Penticton for periodic
blood tests.
It has been indicated in some studies that the well-integrated community
manifests a lesser degree of mental illness and emotional disturbance than a poorly
integrated community. This theory parallels experience and theory about groups,
families, and individuals. A regional mental health service relies on and contributes
to community integration to better meet the needs of its citizens. In the past year
we have been involved with the clergy and adult education in a marriage course,
initially in Kelowna and later in Vernon and Penticton. We have been called upon
to assist in training homemakers and in the formation and training of a volunteer
group to visit lonely persons in boarding homes. There has been a continued liaison
with the Canadian Mental Health Association both in regard to present services and
future programmes.
Professional collaboration is an essential aspect in providing services in an
integrated manner. Co-operation in this area has been excellent. There is an ongoing dialogue with the Department of Social Welfare in regard to a group-living
home for disturbed adolescents and the provision of specialized boarding-home care
for the improved mentally ill. We are exploring with the Courts and probation
branches, schools, the Public Health Branch, and the Department of Social Welfare
how our combined services can be better utilized to meet the needs of the people
we serve.
We feel that the regional mental health centres must encourage groups and
individuals in the communities to build on their strengths in a preventive as well as
a recuperative manner. Improved recreational, educational, and employment services provide an atmosphere which makes for the prevention of illness as well as for
recovery.   A Directory of Community Services, compiled this year by the local
 COMMUNITY MENTAL HEALTH SERVICES
G 131
University Women's Club, required the active participation of many community
agencies. It is hoped the directory will stimulate the formation of a community
information centre and promote the establishment of a community service council.
In this regard we are part of a local group working on the Canadian Conference on
Children and are examining the needs of our senior citizens.
Early case findings have not altered the incidence of mental disorder. On the
other hand, early treatment can reduce the amount of suffering and increase the
success of rehabilitation planning and follow-up treatment and reduce the severity
and the frequency of relapse. There is room for a new concept of prevention. When
children become emotionally ill, diagnosis is made of the nature of the child's disorder and the nature of the family and school setting in which the disorder has
occurred. For the most part, treatment is administered through parents but also
through school personnel to improve the emotional climate in which the child lives,
to promote a change in the attitudes of the people who are dealing with him day in
and day out. The implication is that these persons who have the most authority with
the child and spend the most time with the child are the ones most likely to influence
his life one way or another. We believe earnestly that family life can be strengthened by any service that will help parents do their job better. We have been
co-operating with other community resources to develop a family life education
programme within the schools which will be beyond the provision of elementary
biological facts at puberty to help the teen-ager understand his own emotional
growth better and find acceptable standards of conduct, and to help him as an
emerging adult to be better prepared to enter marriage and face responsibilities of
parenthood. Such a programme requires collaborative effort of teachers, doctors,
nurses, social workers, and, most important of all, parents who so often want to help
but are not prepared to be considered sick in order to get the kind of help they need.
There was a slight decrease in the number of patients treated in the Psychiatric
Unit of the Kelowna General Hospital during the year, reflecting a utilization of
the ward setting for the treatment of patients requiring a modified therapeutic environment for a somewhat longer period of time. Some of the patients who were
previously requiring hospital care for electric treatment are now being managed as
out-patients. It is also noted that the development of a treatment service under Dr.
W. H. N. Bennee in private psychiatry at Vernon in September, 1965, has reduced
the number of patients treated on the ward from Vernon and district from 30 to 16.
Although last year there was a fair balance between Kelowna and Penticton utilization of the ward, there is now an increased number of Kelowna cases and a corresponding decreased number of Penticton cases. At first glance it might appear that
preference is given to cases closer to the headquarters of the service. One should
note, however, that there are still over 50 cases a year being certified to the Riverview
Hospital from this total area, though only six have been certified from the Psychiatric Unit. The 93.3 percentage bed occupancy means that it is rare that a bed is
available immediately, hence the deferring of admissions is more easily withstood
in the area immediately adjacent to Kelowna; on the other hand, a deferred admission from a more distant point may often result in certification and admission to
Riverview.
The number of cases seen in consultation is shown in the accompanying tables.
There is a 34-per-cent increase in the number of children seen and approximately
the same number of adults. The big increase is in the amount of treatment given,
which is almost double that given the previous year. Increased service reflects the
additional personnel—namely, a psychiatric social worker attached to the clinic at
Kelowna and a psychiatrist employed on a sessional basis with headquarters in
 G 132
MENTAL HEALTH SERVICES REPORT, 1965/66
Vernon. Many adults have been seen in private consultation in the North Okanagan
area by Dr. Bennee, and these figures, of course, are not shown in these tables, but,
none the less, the service has been given and that is what counts.
CONSULTATIONS BY AREA, APRIL 1, 1965, TO MARCH 31, 1966
Adults
Children
Male
Female
Total
Male
Female
Total
Kelowna   	
70
17
28
10
4
6
94
33
26
7
10
3
164
50
54
17
14
9
54
25
23
33
4
9
24
8
10
5
3
2
78
33
Kamloops	
33
38
7
Revelstoke	
11
Totals     	
135
173
308
148
52
200
PATIENTS RECEIVING REGULAR TREATMENT,
APRIL 1, 1965, TO MARCH 31, 1966
Kelowna                .   ~     -
Adults
  186
Children
60
Penticton .                    -         -   -
     97
31
Kamloops     - _
     49
19
Vernon                                 - - 	
     31
34
Salmon Arm                -   	
     11
7
Revelstoke    -
     18
8
Totals   	
  392
159
 COMMUNITY MENTAL HEALTH SERVICES
G 133
VANCOUVER ISLAND MENTAL HEALTH CENTRE,
NANAIMO
S. E. Jensen, Director
The Vancouver Island Mental Health Centre is a community-oriented and
family-oriented centre for the control of mental illness through prevention, education, and treatment.   The main functions of the clinic are:—
(1) The programming of services for the prevention and control of mental
disorder through consultation to community care-giving agencies and individuals through preventive intervention directed toward selected high-
risk groups within the population of the area served and through screening
and early case finding.
(2) Consultation to schools, management, and community leaders, to assist
them in dealing with communities as dynamic entities rather than as a
group of single individuals, and in the interpretation of mutual adjustment
processes and in effectively minimizing conflict and competition among
agencies.
(3) Education of lay persons, as well as professionals and semi-professional
personnel, in techniques of healthier personal relations and in prevention
of primary and secondary maladjustment and mental illness.
The Mental Health Centre began operation in April, 1964, in a hereto un-
serviced area of British Columbia—namely, that part of Vancouver Island north
of the Malahat and constituted by the combined Central Vancouver Island Health
Unit and Upper Vancouver Island Health Unit. During the year 1965/66, the
centre has been served by a staff consisting of a psychiatrist, a psychiatric nurse,
a social worker, and a receptionist.
The clinic is located at the Public Health Centre, in Nanaimo, and travelling
clinics serving Duncan, Alberni, Courtenay, and Campbell River work out of offices
in the local public health unit. Beds in the Nanaimo Regional Hospital have been
available for those patients who require hospital care, and, as a result, few patients
have needed to be certified to Riverview Hospital, 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.
While selected patients have been accepted in treatment, this is basically seen
as a function belonging with the privately practising psychiatrist, the family doctors,
and other professions skilled in counselling (welfare workers, nurses, school counsellors, clergy, etc.), and our aim has been to guide these groups in their management of the patients.
During the year a total of 412 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 the
spouse to accompany an adult.
In the main, service to children has had to be limited to assesment and a few
hours of counselling to the parents in selected cases.
Conferences with school officials are conducted weekly in Nanaimo and
monthly in the centres to which the clinic travels. Closeness is also maintained
with the Department of Social Welfare and with the probation services. Lecture
series on counselling and other relevant aspects of psychiatry have been held for
 G 134
MENTAL HEALTH SERVICES REPORT,  1965/66
the Ministerial Association, Registered Nurses' Association, and Medical Societies
in Nanaimo, Duncan, Alberni, Courtenay, and Campbell River.
MENTAL HEALTH REFERRALS IN 1965
Patients
Confer-
enced
Only
Adults
Children
School District
or
Metropolitan Health Unit
New
Repeat
New
Repeat
M.
F.
M.
F.
M.
F.
M.
F.
Central Vancouver Island Health Unit—
Duncan, No. 65	
Nanaimo, No. 68  	
Qualicum, No. 69  	
Alberni, No. 70 _ _ . ...
Upper Island Health Unit—
2
6
4
3
1
7
8
3
4
3
6
17
1
1
4
7
4
1
5
22
6
10
4
14
7
13
1
1
4
1
~2
~2
Campbell River, No. 72	
Totals     -    _
16       I     25
29
7
5
61
27    1      2
2
TOTAL NUMBER OF INTERVIEWS BY THE CLINIC IN 1965
Staff Member
Psychiatrist _
Psychiatric social worker (since April, 1965)_
Psychiatric nurse	
Total number of referrals in 1965—412.
Number of
Interviews
__ 1,820
.___ 520
.___     988
 COMMUNITY MENTAL HEALTH SERVICES
G  135
KOOTENAY MENTAL HEALTH CENTRE, TRAIL
G. R. Mansfield, Director
The Kootenay Mental Health Centre, serving the East and West Kootenay
regions, was opened June 1, 1964. This second annual report covers the first full
year of operation. The first 10 months was chiefly devoted to integration with other
existing community and regional resources. The 12 months covered by this report
reveal considerable expansion of service and concentration on developing programmes in co-operation with other agencies.
STAFF
The present staff consists of one full-time and one half-time clerk-stenographer,
one psychiatric nurse who was with us for five months, a psychiatric social worker,
and a psychiatrist-director. It is anticipated that the position of psychologist will
be filled on a part-time basis next year.
EDUCATION
The staff have participated in over 30 major educational functions and a host
of minor ones involving over 100 meetings. Noteworthy was a regional workshop
on the emotionally disturbed child for teachers and public health nurses, a counsellors' workshop, a family life lecture-discussion series, a panel on family and society,
and a panel on youth in a changing world.
TRAIL DISTRICT YOUTH LIAISON COMMITTEE
The psychiatric social worker is a member of this committee, which meets
monthly for discussions on children and youths with particularly complex problems.
Represented are all the agencies in the community which deal with young people.
It has proved a valuable means of communication, pooling of knowledge, and the
development of a co-ordinated treatment and rehabilitation programme eliminating
overlapping of service.
TRAINING FOSTER-PARENTS
An initial group of carefully selected couples are undergoing training by
weekly lecture-discussion meetings with the psychiatric social worker. A second
group will be started in September, 1966. The Department of Social Welfare is
co-operating by furnishing a list of prospective foster-parents, from which we select
those with the most potential. The school is undertaking to set up a special class for
emotionally disturbed children. This is envisaged as a treatment resource for the
more severely disturbed child, who is usually treated in an institution. It will
probably be several years before this project is fully operational, but a good start
has been made.
PROGRAMME FOR THE NEUROLOGICALLY IMPAIRED CHILD
In co-operation with the schools, public health, and a local optometrist, the
neurologically impaired child is receiving special attention. This is the child with
specific learning defects involving the acquisition of language function. The majority
of these suffer from congenital dysphasia of various types. The most common is
dyslexia.   Over 50 of these children have been identified in the past year.   These
 G 136
MENTAL HEALTH SERVICES REPORT,  1965/66
children require special remedial teaching techniques. In September, 1966, two
special classes for these children will be established in the Trail area with teachers
trained in this field.
PREVENTION
In accordance with the philosophy of development adopted by the Mental
Health Services Branch, prevention of mental ill health by working with the public
health nurses has been given due consideration. Every Friday is devoted to conferences, and 2 hours are allotted for formal teaching and discussion of cases carried
by the nurses. This has proved quite rewarding as the nurse's knowledge of mental
hygiene has permitted her to approach families with a member ill or emotionally
disturbed with greater confidence and effectiveness.
TRAVELLING CLINIC
A consultative service to the East Kootenay is rendered by a travelling clinic 2
days each month to Cranbrook. This has served to develop an enthusiastic climate
of acceptance in the East Kootenay region.
REGIONAL SERVICE
The total number of patients seen was 401, of which 379 are covered in the
detailed statistical tables following. This difference is due to the fact that the 23
cases seen by the psychiatric nurse are not included in the annual statistical case load.
These cases involved 87 interviews, chiefly to ex-patients from Riverview Hospital
in boarding homes. There were 901 interview hours by the social worker, of which
80 per cent was spent in casework. The psychiatrist participated in 1,021 psychotherapeutic hours and in addition carried out psychological testing on 83 children.
Treatment offered is child guidance, adult psychotherapy, family-centred group
psychotherapy, pre-marital counselling, marital counselling, and pharmacotherapy.
Consultations are carried out chiefly on the travelling clinic, for the Department of
Social Welfare and the Attorney-General's Department, but family doctors also
avail themselves of this service.
A detailed breakdown of referrals and service to various areas follows in the
statistical tables.
Referrals
Source
Total
Area
Adults
Children
195
82
38
36
28
379
Trail	
130
8
1
2
1
10
4
2
1
8
2
_-
39
16
1
Referrals initiated by schools —  	
Trail...	
54
22
Referrals initiated by Department of Social Welfare    	
Nelson 	
Trail  	
3
14
7
3
Trail
19
12
Nelson	
Trail	
2
14
4
Totals _.   ...
169
210
 COMMUNITY MENTAL HEALTH SERVICES
Service
G 137
Mental Health Centre, TraiL
Consultations
Travelling Clinic, Cranbrook-
Directly to Mental Health Centre from East Kootenay-
Travelling Clinic, Nelson-
Directly to Mental Health Centre from Nelson area-
Total assessments	
Treatment
Mental Health Centre, Trail-
Adults
63
16
22
1
24
Children
126
67
33
60
14
9
22
Patients
96
112
56
138      |     264
72
139
STATISTICAL TABLES
Table 1.—Summary of Operations, Kootenay Mental Health Centre,
Trail, April 1, 1965, to March 31, 1966
Adults
Children
Total
Brought forward, April 1, 1965	
14
169
19
210
33
379
183                229                412
168                201
15                        ?R
369
43
 G 138
MENTAL HEALTH SERVICES REPORT,  1965/66
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