DEPARTMENT OF HEALTH SERVICES AND HOSPITAL INSURANCE Mental Health Services Branch PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT FOR TWELVE MONTHS ENDED MARCH 31 1967 Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty in right of the Province of British Columbia. 1968 To Major-General the Honourable George Randolph Pearkes, V.C., P.C., C.B., D.S.O., M.C, CD., Lieutenant-Governor of the Province of British Columbia. May it please Your Honour: The undersigned respectfully submits the Annual Report of the Mental Health Services Branch, Department of Health Services and Hospital Insurance, for the year ended March 31, 1967. W. D. BLACK, Minister of Health Services and Hospital Insurance. Office of the Minister of Health Services and Hospital Insurance, Victoria, B.C., January 26,1968. Department of Health Services and Hospital Insurance, Mental Health Services Branch, Vancouver, B.C., January 26, 1968. The Honourable W. D. Black, Minister of Health Services and Hospital Insurance, Victoria, B.C. Sir,—I have the honour to submit the Annual Report of the Mental Health Services Branch for the 12 months ended March 31, 1967. F. G. TUCKER, M.B., B.S., C.R.C.P., M.Sc, Deputy Minister of Mental Health Services. The Honourable Eric Martin, Minister of Health and Welfare, 1952-59 and Minister of Health Services and Hospital Insurance, 1959-66. &^.._&_..:■.»..«. if!..!*(. K_¥': '. . : ■..:■'"' .':•;?■': .:;'i«lstfe. ?■*-» sMtw^pi.'.-- ■■:■.... ., ,^$gmms$st§ ''"■"''■'"'■''aiiiiiii "Mil. :*"* _-----■ .* * * • ■ ■ ■ ■ ■.■■•■. ■ ■ ■ ■ ...- ■ ■ ..■.■■. .- ■*¥■ f ■. -.■ ■: .■■ ■ ■■■■ ■ ....■..■■; ■■ • foSg; ■■■■ i.. •.:?», h.«i!-a__t-_______g?i A. E. Davidson, B.A., M.D., F.A.P.A., Deputy Minister and Director of Mental Health Services, 1959-67. m I TABLE OF CONTENTS PART I.—GENERAL ADMINISTRATION Page Report—Director of Mental Health Services 9 Report—Business Manager 19 Report—Personnel Manager 40 Report—Social Service Consultant 44 Report—Nursing Consultant 47 Report—Consultant in Medical Records and Statistics 50 PART IL—RIVERVIEW HOSPITAL Report—Superintendent 53 Statistical Tables—Riverview Hospital 65 PART III.—THE WOODLANDS SCHOOL Report—Superintendent 81 Statistical Tables—The Woodlands School 83 PART IV.—THE TRANQUILLE SCHOOL Report—Superintendent 89 Statistical Tables—The Tranquille School 92 PART V.—GERIATRIC DIVISION Report—Superintendent 94 Statistical Tables—Valleyview Hospital, Essondale 99 Statistical Tables—Dellview Hospital, Vernon 106 Statistical Tables—Skeenaview Hospital, Terrace 111 PART VL—COMMUNITY MENTAL HEALTH SERVICES Report—Director of Mental Health Centre, Burnaby 115 Report—Director of Mental Health Centre, Victoria 124 Report—Director of Okanagan Mental Health Centre, Kelowna 126 Report—Director of Vancouver Island Mental Health Centre, Nanaimo 127 Report—Director of Kootenay Mental Health Centre, Trail 129 Report—Director of Fraser Valley Mental Health Centre, Chilliwack 131 Report—Director of North Okanagan Mental Health Centre, Vernon 133 ON is. wfc qz w I 2 n c- s* 6_ -Q73- o a K.2 "2 On B SO 'Cum a -> w .a o.Si ;_c _3 J1 O OJ O e. S ■"OS'S -2>,> C-2 eu °_=5 o SO "CS__ a, o^ as o C -T) _» 2 "^z o o S«S 3 5" S-2H H -_ u *_ .ti -t3 -J •8 .21 w a « uuu Z B- ,u «S y-ss Q__ _-> u 0 .3 5 •5 cs .13 Co ll a >i"S o Se.g -i .SSS Agd D| Q|Z u ■5 _«._* ._. _**< _t _. «< S 6a 5Sfl i£ <__ o oufl a o Z .20 o u _. a -_w « _0 0'_> Report of the Mental Health Services Branch For the Twelve Months Ended March 31, 1967 PART I.—GENERAL ADMINISTRATION REPORT OF THE DIRECTOR OF MENTAL HEALTH SERVICES A. E. Davidson, M.D., Deputy Minister of Mental Health Services and Director of Mental Health Services The report submitted herewith records the highlights of the administration of the Mental Health Services Branch during the eighth year of its existence as a Branch of the Department of Health Services and Hospital Insurance. The Department was established pursuant to the Department of Health Services and Hospital Insurance Act, which was passed by the Legislature in 1959". The Mental Health Services of British Columbia, prior to April 1, 1959, were administered by the Department of the Provincial Secretary, in which Department they were established on October 12, 1872. Upon that date was opened the first Provincial Asylum in the remodelled Royal Hospital, situated upon an Indian reserve across the inner harbour from the site of the present Parliament Buildings. There was a total of 18 patients admitted to the asylum by December 31, 1872. The first mental health legislation, namely the Insane Asylums Act, 1873, was passed by the Legislature in 1873. It is reported that there were eight employees on the staff when the Provincial Asylum was opened. It is, perhaps, not inappropriate in this Centennial year to draw attention to the fact that mental health care has been provided for the people of British Columbia 24 hours a day, 365 days every year, since 1872. A review of the narratives and tables that constitute this report for 1966/67 will disclose the scope, magnitude, diversity, and geographical distribution of mental health services available to the people of British Columbia. All of this service is supplied under the aegis of the Mental Health Act, 1964. A few highlights from the detailed reports have been selected to emphasize the magnitude and ramification of the operations of the Mental Health Services Branch:— 5,877 persons received psychiatric assessment, care, and treatment in the seven community mental health centres operated by the Branch in 1966/67. 12,029 persons received psychiatric treatment as in-patients (Riverview Hospital, 7,554; Schools for the Mentally Retarded, 2,348; Geriatric Division, 2,127). 2,166,052 patient-days of service were provided to the 12,029 in-patients (Riverview Hospital, 1,007,478 patient-days; The Woodlands School, 477,250 patient-days; The Tranquille School, 219,897 patient-days; Val- leyview Hospital, 277,668 patient-days; Dellview Hospital, 78,981 patient-days; Skeenaview Hospital, 103,778 patient-days). 4,011 persons were employed on March 31, 1967, in the Mental Health Services Branch to provide the services highlighted above. $1,144,195 was expended to operate the community mental health centres. $22,699,611 was expended to operate the in-patient institutions of the Branch. The daily per capita cost for care in the institutions was $10.48. G 10 MENTAL HEALTH SERVICES REPORT, 1966/67 MAJOR EVENTS AND TRENDS The emphasis upon the development of community mental health centres to meet regional needs upon a local basis has been again stressed and efforts well maintained in this direction. The Fraser Valley Mental Health Centre, located in Chilliwack, was officially opened by the Honourable Eric Martin, Minister of Health Services and Hospital Insurance, on July 19, 1966. Dr. W. G. Jilek has been appointed Director of this mental health centre. His report upon the first few months of service to the Chilliwack region appears at page 133 of this report. The Sage Building at The Tranquille School was completed this year. It was officially opened by the Minister on July 21, 1966. The Sage Building provides 104 beds for the care and treatment of persons afflicted with severe mental retardation. It is well suited to the purpose for which it was designed. The first group of patients was transferred to the Sage Building from The Woodlands School on September 8, 1966. The North Okanagan Mental Health Centre was established in the public health building at Vernon. Dr. A. J. Bennee was appointed as Director of the centre and it commenced operation in January. It has been well received by the local community and the surrounding region and is providing a necessary specialized health resource. Construction and planning of new mental health facilities together with major alterations, renovations, and maintenance of present plants has been constantly to the fore in the year under review. With the increasing size of our physical plant, its ageing, and the changes in assignment of space contingent upon new trends in psychiatric care, this portion of the year's work is assuming major proportions. The details of the projects in hand and contemplated are presented in the Report of the Business Manager of the Branch which follows at page 19. STATISTICAL COMMENTS Tables 1 and 2, hereunder, provide in summary form the movement of patient population in the several in-patient care psychiatric facilities operated by the Branch. During the year 5,002 persons were admitted to the in-patient units of the Branch. This is a decrease of 67 compared with 1965/66. There was a decrease of 20 in the number of patients admitted to the Riverview Hospital—4,275 compared with 4,295 in 1965/66. Table 1.—Showing Patients in Residence in Various Facilities of the Mental Health Services Branch, April 1, 1966, and March 31, 1967, Together with Increase or Decrease. In Residence, Apr . 1, 1966 In Residence, Mar. 31,1967 Increase Men Women Total Men Women Total Decrease Riverview Hospital, Essondale The Woodlands School 1,440 766 319 259 99 294 1,375 563 236 497 113 2,815 1,329 555 756 212 294 1,456 746 368 254 89 293 1,312 531 290 494 126 2,768 1,277 658 748 215 293 -47 —52 The Tranquille School + 103 —8 +3 — 1 Totals 3,177 2,784 5,961 3,206 2,753 5,959 —2 GENERAL ADMINISTRATION G 11 Table 2.—Showing in Summary the Admissions and Population Increase of the Mental Health Services Branch for the 10-year Period April 1,1957, to March 31, 1967. Year Total Admissions Admissions 65 Years and Over Admissions 15 Years and Under Informal Admissions Population Increase Index of Increase 1957/58.. 1958/59- 1959/60... 1960/61- 1961/62... 1962/63... 1963/64... 1964/65- 1965/66... 1966/67- 2,936 2,993 3,296 3,924 4,193 4,248 4,569 4,518 5,069 5,002 442 425 506 580 557 554 550 702 844 757 106 135 182 254 200 213 243 215 206 175 1,012 1,118 1,316 1,695 2,023 2,086 2,187 2,194 2,278 2,095 Totals- 40,748 5,917 1,929 18,004 38 -90 20 42 -156 —63 31 —39 -92 —2 —311 1.29 —3.00 0.61 1.07 —3.72 — 1.48 0.68 —0.86 -1.81 —0.04 In the schools for the retarded there was an increase of 57 in the numbers admitted—333 compared with 276 in 1965/66. The Geriatric Division experienced a small reduction in admissions; in 1966/67 the total was 651, which is 14 fewer than in the previous year. The three tables depicting the movement of population in the several divisions in the Branch which appear at the conclusion of this portion of the report show in full detail the operations of the Branch institutions. It is to be noted that the Riverview Hospital cared for 7,554 patients in 1966/67, a slight decrease from the 7,706 under care in 1965/66. More persons were cared for in the schools for the retarded — 2,348 compared to 2,198 in 1965/66. In the Geriatric Division there were 2,127 patients under care in 1966/67, an increase of 130 from the previous year's total of 2,097. On March 31, 1967, there were two fewer patients in residence in the institutions than on the same date in 1966. The statistical reports of the Branch, in so far as the institutions are concerned, suggest that a plateau has been reached with respect to admissions, discharges, and totals under care. This matter will be watched closely in the next 12 months to evaluate the trends that appear to be developing. GENERAL COMMENTS The 35th annual graduation exercises of the Department of Nursing Education were held in the auditorium of the New Westminster Secondary School (Massey Wing) on the evening of April 27, 1966. The address to the graduates was given by Dr. Donald H. Williams, Professor and Head of the Department of Continuing Medical Education, Faculty of Medicine, University of British Columbia. Ninety- eight students were awarded diplomas in psychiatric nursing. The graduating class contained 81 women and 17 men. The graduation tea was held in the lounge of Nurses Home 11 at Essondale on April 24, 1966, and the graduation dinner-dance was held on April 29, 1966, at the Coach House Inn, North Vancouver. The 1966 annual meeting of the Council of Psychiatric Nurses was held on April 21, 1966, in Vancouver. Two hundred and sixty-three applicants were licensed pursuant to the Psychiatric Nurses Act and regulations in 1966/67. As of December 31, 1966, 1,689 nurses were holding licenses pursuant to the Act. Psychiatric nurses numbered 1,663, and nurses in mental deficiency numbered 26. G 12 MENTAL HEALTH SERVICES REPORT, 1966/67 On March 21, 1967, at a meeting of the Mental Health Services Branch Conference, the following six persons were appointed to sit on the Council of Psychiatric Nurses for a three-year term, pursuant to section 5 (b) of the Act: Dr. B. F. Bryson, Mrs. H. Duke, Dr. L. E. Ranta, Mrs. D. Slaughter, Mr. L. J. Wallace, Mr. C. B. Watson. Public education with respect to mental health has been carried on this year in accordance with the patterns which have been described in previous reports. It should be recorded that the professional staff of the Branch have participated wholeheartedly in this most important aspect of the Service. It can be confidently reported that the cumulative impact of public education with respect to mental illness and modern concepts of treatment and community care has brought about a most welcome public understanding of this major health and social problem. Efforts to enlarge further the scope of public knowledge of mental health problems and priorities must be continued. The co-operation of the Canadian Mental Health Association and the Association for Retarded Children of British Columbia has been of assistance in many ways. Through their volunteer programmes, these public-spirited associations have assisted a great deal in the care of the patients in the mental hospitals and the schools for the retarded. Volunteer workers from the associations are an important link in the maintenance of open lines of communication between patients and their families and communities. Again, it is a pleasant duty to record on behalf of the patients and staff their appreciation for the splendid volunteer services that have been so cheerfully given. The in-service programme of training special teacher-counsellors, which is arranged by the Vancouver School Board, was provided financial assistance by means of a Mental Health Grant. In addition, the clinical facilities of the Branch provided clinical demonstrations and lectures. During this year 11 teachers were enrolled in the programme. Since it was started in 1955, 113 teachers have completed the course and upon their return to the school system they have given significant leadership in utilizing their unique skills in assisting the school, home, and community to understand the needs of students. Their influence in recognizing and referring children with special problems of learning, emotion, and behaviour has been a splendid contribution. The Mental Health Services Branch continues to be represented on the board of directors of the Narcotic Addiction Foundation of British Columbia and on the Alcoholism Foundation of British Columbia. Each of these organizations has been operating for several years. One can now detect positive changes in our communities which spring directly from their educational and clinical services. Their leadership in these health fields, which have long suffered from public prejudice and rejection, is worthy of special notice. The directors and staffs of both organizations are indeed pioneers in an especially difficult field of human betterment. MENTAL HEALTH GRANT The Government of Canada, through the Department of National Health and Welfare, made available to the Province of British Columbia 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 was the 19th year of its availability to this Branch. In 1966/67 the Mental Health Grant available totalled $793,913. Project submissions for the year utilized all funds available. By March 31, 1967, reim- GENERAL ADMINISTRATION G 13 bursement in the sum of $793,764.44 had been received by the Province for expenditures made on account of approved Mental Health Grant projects. This represents virtually 100 per cent of the funds available. In 1966/67 nine projects were supported by the Mental Health Grant. Three of the projects assisted in the postgraduate training of mental health professional staff together with the provision of professional staff employed in the treatment programmes of the Mental Health Services Branch institutions and community mental health centres. Assistance was also provided for salaries for qualified instructors employed in the School of Psychiatric Nursing operated by the Branch. The amount expended on these three projects totalled $592,515.80. The postgraduate programme of training in the specialty operated by the Department of Psychiatry, University of British Columbia, was assisted as in previous years. The purpose here remains the training of physicians to qualify as specialists in psychiatry in order that they may be available to participate in the expansion of the public psychiatric services and in the teaching and research programmes of the university department. The teaching programme is, in large measure, centred at the Vancouver General Hospital. Therefore, a complementary grant to assist in the operation of the Psychiatric Out-patient Department is made to that institution. In 1966/67 a total of $107,425.65 was expended on these projects. The Metropolitan Health Committees of Victoria and Vancouver continue to be supported by grants which assist them in defraying the salaries of mental health professional staff for the operation of their mental hygiene clinics. The grant in 1966/67 totalled $67,673. The School of Social Work, University of British Columbia, received support for the salary of a student fieldwork placement supervisor again. In 1966/67, $6,500 was expended for this project. CONCLUDING REMARKS This report cannot leave my desk without special mention of the retirement of the Honourable Eric Martin from the portfolio of Health Services and Hospital Insurance. Mr. Martin devoted much of his energy and attention to the mental health problems in British Columbia and he was most helpful and encouraging in his efforts to keep the Mental Health Services Branch progressive and current in its facilities and purpose. It so happens that the conclusion of this fiscal year coincides with my retirement from the Civil Service of British Columbia. My career has been wholly in the field of mental health and embraces 35 years' experience. It may be of value to record some impressions and comments upon the trends in the care of the mentally ill in British Columbia during this period. In essence, my career has embraced the transition of a mental health service from an era of paternalistic custodial care to one of active modern psychiatric therapy, both within institutions and followed up into the community upon discharge of the patient. There has also been a ramification of community facilities throughout the Province to meet local needs in local regions. This, undoubtedly, will be the pattern which will continue to develop in the foreseeable future. During the 35 years that I was employed with the Mental Health Services of British Columbia, much progress was made in knowledge regarding mental health and mental illnesses and many changes have occurred in the treatment methods and in the organization of the Service. I assumed the position of Director of Mental Health Services in August, 1958, and was appointed Deputy Minister of Mental G 14 MENTAL HEALTH SERVICES REPORT, 1966/67 Health Services in April, 1959. This latter appointment occurred at the time when the Mental Health Services were transferred from the Department of the Provincial Secretary to the newly established Department of Health Services and Hospital Insurance. This development reflected considerable change in the status of mental health in British Columbia, both from the fact that it was finally included in the total health field and also from the fact that the head of the Branch had Deputy Minister status. British Columbia was the first Province in Canada to establish the position of Deputy Minister of Mental Health. This resulted in much closer recognition and more attention to mental health problems as it gave much more direct contact with the various agencies of Government. As I have noted, the Minister of Health Services and Hospital Insurance has devoted much of his energy and attention to mental health problems. The Honourable Eric Martin served as Minister during my entire tenure of office and I would like at this time to acknowledge the consideration and ready help I have always received from him in my attempts to deal with the various problems. It was also possible to have direct contact with other Government departments and the excellent and ready co-operation which I always received from the departments closely related to the Mental Health Branch has been most sincerely appreciated. The following are some of the more significant developments occurring during the eight years in which I served as Deputy Minister of Mental Health:— —The further transition from custodial care to the more active psychiatric care of patients admitted to mental hospitals. During this period of time there has been a very marked increase in the number of patients seeking admission to hospitals and, as a result of a very marked step-up in the treatment programme, considerable increase in the discharge rate of these patients has resulted. Actually during the eight years a steady decrease in the resident populations of the mental hospitals occurred. —The development of regional mental health centres scattered throughout the Province has been a most important advance. The mental health centres have been established in conjunction with the public health regions of the Province. The first regional mental health centre was established in the Okanagan Valley, centred at Kelowna, and since then similar centres have been established in Nanaimo, Trail, Chilliwack, Kamloops, Prince George, and Vernon. With the development of regional mental health centres the policy of developing psychiatric wards within a general hospital in the regions has resulted in a marked improvement in the type of psychiatric care which patients are able to obtain in their own community. —The abandonment of the mental home at Colquitz was a positive accomplishment. This institution had long been considered unsuitable for the treatment of psychiatric patients and, with the decrease in population in the mental hospitals on the Mainland, a gradual withdrawal from Colquitz was planned and carried out. The institution was closed down on January 29, 1964. Since then the expansion of the mental health centre in Victoria and the planning of a comprehensive mental health facility is aimed to bring more and improved psychiatric care to the people of Vancouver Island. Other significant developments are:— (1) The opening and development of The Tranquille School for the care and treatment of mentally retarded persons. GENERAL ADMINISTRATION G 15 (2) The beginning of a forensic psychiatric clinic at Burnaby for the evaluation and treatment of those psychiatric cases where there are medico-legal implications. (3) The planning and initiation of the construction of a residential treatment facility for emotionally disturbed children at the Burnaby Mental Health Centre. (4) The rewriting of the mental health laws of the Province, both in the replacement of the Lunacy Act by the Patients' Estate Act and the writing of the Mental Health Act, 1964. The Patients' Estate Act, administered by the Department of the Attorney-General, separates the procedure for declaring a person to be incompetent from those procedures dealing with the admission to hospital and psychiatric care of such persons. The Mental Health Act, 1964, attempts to bring the treatment and care of the mentally ill more in line with the treatment of physical illness and to make such treatment more readily accessible to those requiring it. All of these developments reflect the advances in the care of the mentally ill which have taken place in British Columbia in recent years. The developments were largely the result of a conscientious and devoted effort by the senior members of the staff of the Mental Health Services Branch. I would like to acknowledge the tremendous assistance I have always received from the staff members during my period of office as Deputy Minister of Mental Health in British Columbia. COMPARATIVE SUMMARY OF INCREASES AND DECREASES IN RESIDENT POPULATION BY MAJOR DIVISIONS OF MENTAL HEALTH SERVICES BRANCH, 1957/58 TO 1966/67. Fiscal Year Riverview Hospital! Schools for Mentally Retarded Geriatric Division Total 1957/58 —23 — 144 —229 —92 —236 — 137 —55 — 134 —103 -47 +76 +86 +93 +75 +73 +62 +79 +77 +31 +51 -15 —30 + 156 +59 +7 + 12 +7 + 18 —20 -6 +38 1958/59 —88 1959/60 +20 1960/61 1961/62. +42 — 156 196?. .63 —63 1063/64 +31 106-1/6. —39 1065/66 —92 1066/67 2 1 For the years 1957/58 to 1964/65 shows combined figure for Provincial Mental Hospital and Crease Clinic (now incorporated into Riverview Hospital). G 16 MENTAL HEALTH SERVICES REPORT, 1966/67 COMPARATIVE SUMMARY OF TOTAL PATIENTS UNDER CARE FOR MAJOR DIVISIONS OF MENTAL HEALTH SERVICES BRANCH BY FISCAL YEARS 1957/58 TO 1966/67. Fiscal Year Riverview HospitaU Schools for Mentally Retarded Geriatric Division Total 1957/58 1958/59 1959/60 7,122 7,121 7,163 7,376 7,679 7,765 7,931 7,540 7,706 7,754 1,373 1,481 1,740 1,868 1,960 2,023 2,042 2,178 2,198 2,348 1,349 1,373 1,459 1,587 1,642 1,677 1,738 1,937 2,097 2,127 9,844 9,975 10,362 1960/61 1961/67. 10,831 11,281 1962/63 . 1963/64 1964/65 11,465 11,711 11,655 1065/66 12,001 1066/67 12,029 i For the years 1957/58 to 1964/65 shows combined totals for Provincial Mental Hospital and Crease Clinic. MOVEMENT OF POPULATION OF MENTAL HEALTH SERVICES, APRIL 1, 1966, TO MARCH 31, 1967 Psychiatric Division M. Schools for Mentally Retarded Division M. F. T. Geriatric Division M. Total M. In residence, April 1,1966 On extended leave, carried forward from 1965/66— In boarding home Other On escape, carried forward from 1965/66. __ Total as at April 1,1966 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 carei.. 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 31,1967- 1,440 131 80 1,375 170 75 2,815 301 155 1,656|1,623| 3,279 980 1 1,047 984 1,250 1,964 1 2,297 2,028|2,234| 4,262 8| 5| 13 1 2,036| 2,239 4,275 .3,692|3,862] 7,554 1,937 61 156 52 4 2,181 68 186 100 4,118 129 342 152 4 2,210| 2,5351 4,745 26| 15] 41 I 2,236 j 2,550 4,786 + 16| -63] -47 1,45611,312 2,768 1,085 799 1,884 113 17 1,146| 869| 2,015 120 15 57 118] 741 192 66] 75| 141 184 149 1,330] 1,018 333 2,348 137 20 149| 1251 274 67| 721 139 216 197 413 +29| +22| +51 1,114] 821 1,935 I 652 82 610 132 1,262 214 734| 742] 1,476 237 20 11 248 24 485 44 19 268| 280] 548 69] 34| 103 1 337| 314 651 1,07111,056| 2,127 32 252 101 33 215 161 65 467 262 385] 409| 794 50| 27| 77 435 436 871 — 16] +10| —6 636 620 1,256 3,177 263 91 2,784 365 81 5,961 628 172 3,536|3,234| 6,770 1,290 29 1,095 1,279 31 1,278 2,569 60 2,373 2,414|2,588| 5,002 143| 114| 257 1 2,557] 2,702 5,259 5,950| 5,822| 11,772 2,031 326 316 67 4 2,251 288 425 105 4,282 614 741 172 4 2,744|3,069| 5,813 143| 114| 257 2,887 3,183 6,070 +29| —31( —2 3,206 2,753 5,959 i Total under care for all Mental Health Services includes total as at April 1, 1966, plus the total admissions to individual facilities minus transfers out. GENERAL ADMINISTRATION G 17 MOVEMENT OF POPULATION IN INDIVIDUAL INSTITUTIONS, APRIL 1, 1966, TO MARCH 31, 1967 Geriatric Division Valleyview Hospital, Bssondale Dellview Hospital, Vernon Skeena- view Hospital, Terrace Total M. F. T. M. F. T. M. M. F. T. In residence, April 1,1966 On extended leave, carried forward from 1965/66— 259 79 497 124 756 203 99 3 113 8 212 11 294 652 82 610 132 1,262 214 nth.:. Total as at April 1,1966 338 621 959 102 121 223 294 734 742 1,476 Admissions—■ First admissions to Mental 173 18 9 198 15 7 371 33 16 54 2 1 50 9 1 104 11 2 10 1 237 20 11 248 24 8 485 Readmission to different facility _ Readmission to same facility 44 19 200 220 420 57 60 117 11 268 280 548 Transfers in 13 11 24 8 23 31 48 69 34 103 Total admissions to indi- 213 231 444 65 83 148 59 337 314 651 551 852 1,403 167 204 371 353 1,021 1,029 2,0501 Separations—■ 25 130 96 251 46 27 158 147 332 26 52 288 243 583 72 4 69 5 78 6 57 14 "~77 1 10 126 19 155 1 3 53 F6 4 32 252 101 385 50 33 215 161 409 27 65 Died... On extended leave in board- 467 262 Other 794 Transfers out — 77 Total separations from in- 297 358 655 78 78 156 60 435 436 871 Net increase or decrease -5 -3 -8 -10 + 13 +3 -1 -16 + 10 -6 In residence, March 31,1967 254 494 748 89 126 215 293 636 620 1,256 i Total under care for the Geriatric Division includes total as at April 1, 1966, plus the total admissions to individual facilities minus transfers out. G 18 MENTAL HEALTH SERVICES REPORT, 1966/67 MOVEMENT OF POPULATION IN INDIVIDUAL INSTITUTIONS, APRIL 1, 1966, TO MARCH 31, 1967—Continued Schools for Mentally Retarded The Woodlands School, New Westminster The Tranquille School, Tranquille Total M. F. T. M. F. T. M. F. T. In residence, April 1, 1966 766 37 10 563 60 3 1,329 97 13 319 13 1 236 3 3 1 555 16 4 1 1,085 50 11 799 63 6 1 1,884 On extended leave, carried forward from 1965/66— 113 Other 17 On escape, carried forward from 1965/66. .. 1 Total on books, April 1, 1966 813 626 | 1,439 333 243 576 1,146 869 2,015 Admissions— First admissions to Mental Health Services 69 8 35 46 7 16 115 15 51 4 2 1 4 5 6 73 8 37 47 7 20 120 15 Readmission to same facility 57 112 4 69 8 181 12 6 62 5 67 11 129 118 66 74 75 192 Transfers in 141 Total admissions to individual facility — 116 77 193 68 72 140 184 149 333 929 703 1,632 401 315 716 1,263 946 2,2091 Separations— 57 12 41 11 30 4 67 3 87 16 108 14 5 1 18 4 7 1 11 2 12 2 29 6 62 13 59 15 37 5 78 5 99 Died On extended leave in boarding homes Other On escape 18 137 20 121 62 104 68 225 130 28 5 21 4 49 9 149 67 125 72 274 Transfers out 139 Total separations from individual facility. 183 172 355 33 25 58 216 197 413 Net increase or decrease _ -20 —32 | —52 +49 +54 +103 +29 +22 +51 In residence, March 31,1967 746 531 | 1,277 1 368 290 658 1,114 821 1,935 i Total under care for the Schools for Mentally Retarded Division includes total as at April 1, 1966, plus total admissions to individual facilities minus transfers out. GENERAL ADMINISTRATION G 19 BUSINESS MANAGER'S REPORT F. A. Matheson, Business Manager Attached are the financial reports of the British Columbia Mental Health Services Branch for the fiscal year ended March 31, 1967. The over-all daily average population as illustrated in Table A shows a slight decrease from $5,937.61 for the fiscal year ended March 31, 1966, as against $5,934.38 for this fiscal year. Maintenance expenditure increased from $20,745,- 127 to $22,699,611 or $1,954,484. The daily per capita cost rose from $9.57 to $10.48. The rise in expenditure is further shown in the gross operating costs (Table B). Salary increases once more were the chief cause of this increase. Maintenance revenue increased from $1,915,661 to $1,948,878 or $33,217 for 1966/67. The Department of Agriculture supplied produce valued in excess of $400,000 to mental health units from operations at Colony and Tranquille Farms. As a point of interest and additional information, this year's financial reporting has been further streamlined, that is, the total expense of the mental health care of $235,089 is shown in Table L, General Administration. Secondly, heat, light, power, and water expenses have been assumed by the Public Works Department for payment, but the cost of this charge is included under Buildings, Grounds, etc., in the expense statements. During this year activity increased within the community services, due mainly to successful personnel recruitment. This development is subsequently reflected in the expense statement appended to this report. I refer in particular to the mental health centres of Trail, Nanaimo, and Chilliwack. Again, this year, the Mental Health Services Planning Committee was very busy in connection with the following major capital projects:— (1) Mental Health Facility, Victoria.—Plans and specifications for this project were completed and are due to go out to tender on April 3, 1967. However, in the meantime, the Public Works Department let three contracts totalling $357,534 for the shell of the single-story section of the building and foundation work for the main building. These contracts have all been completed. (2) Residential Care Centre for Children, Burnaby.—Plans and specifications for this project were completed and a contract in the amount of $759,500 was let for the site preparation and construction of the three residential units. It is expected that tenders for the balance of the project, consisting of the activity and training building, school building, food centre, etc., will be called shortly before the present contract is completed. (3) Glendale School, Victoria.—Preliminary planning for the main hospital building has been completed and the architect is now working on the detailed plans. Two contracts totalling $56,961 for land clearing and some excavation work have been awarded. In addition, tenders closed in March, 1967, for the shell of the boilerhouse and laundry. Low tender was $343,000 and it is expected that the contract will be awarded early in the next fiscal year. (4) Sage Building, The{ Tranquille School. — This new 104-bed unit for severely retarded was completed and officially opened by the Honourable Eric Martin on July 21, 1966. The first group of patients was transferred from The Woodlands School to this building on September 8, 1966. (5) Kitchen and Dining-block, The Tranquille School.—These new facilities were completed and started operating during March, 1967. G 20 MENTAL HEALTH SERVICES REPORT, 1966/67 (6) Renovation of Centre Building, Wards J, K, and G, and " Con," The Woodlands School, New Westminster.—A contract in the amount of $498,000 for the renovation of Wards H, E, and F and the centre section of the Centre Building was let and the contractor is now making good progress on this phase. Planning is proceeding on the next phase of this project and it should be ready for tender when the present contract is completed. I am pleased to be able to report that again this year, in addition to maintaining the buildings, grounds, equipment, and furnishings of all our institutions in a satisfactory manner and the purchase of a considerable amount of furniture and equipment, both new and replacement, a great deal of planning and major improvements were also carried out. Some of the main items of interest in this regard are as follows:—■ Riverview Hospital, Essondale.—A new electronic pill counter was purchased for the joint use of the Central Pharmacy and the Riverview Pharmacy. The new admitting suite in the Centre Lawn Building was completed late in the last fiscal year and was furnished and placed into operation on May 18, 1966. The main entrance to the Centre Lawn Building was completely renovated. Central garbage-can washing facilities were installed at Colony Farm. Some $40,000 worth of new X-ray equipment ordered during the last fiscal year was received and installed in the Crease unit. Traffic lights were installed at the intersection of the Pitt River Road and Colony Farm Road. Wall-to-wall carpets were installed on Ward West 3, Crease unit, on an experimental basis. Plans have been completed for the relocation of the H-l dining-room, Occupational Therapy Department, and Recreational Therapy Department facilities in the East Lawn Building. Plans have been completed and work started in the old Public Works Building to provide accommodation for the Rehabilitation Department. Plans were completed for the alterations to the ground floor of the West Lawn Building to provide for central linen service, Housekeeping Department, and barber shop. The Woodlands School, New Westminster.—A complete new sound system for all the buildings was installed. A contract in the amount of $52,141 was let for the first phase of the new Industrial Therapy Building. New central supply facilities were installed in the Fraserview Building. Alterations are under way on the ground floor of the Fraserview Building to provide new facilities for the X-ray Department, Laboratory, Physiotherapy Department, etc. The Tranquille School, Tranquille.—The Public Works Department purchased a new pumper truck for the Fire Department. The old pumper truck is to be transferred to the Skeenaview Hospital, Terrace. Contract was let in the amount of $21,900 to construct a covered link to the Recreation Hall. This covered link ties in with the tunnel system and will allow the students to make use of the Recreation Hall without going outside in the inclement weather. Contract in the amount of $123,661 was let for the airconditioning of the Greaves Building. Plans for the expansion of the laundry building have been completed. GENERAL ADMINISTRATION G 21 A contract in the amount of $47,900 was let for improvements to the filter system. Valleyview Hospital, Essondale.—Garburetors were installed in the kitchen on all nine wards of the cottage units. A new passenger vehicle was purchased. The Valleyview Building was redecorated. Street-lighting was installed in front of Wards 1, 6, 7, 8, and 9. New draperies were installed on Wards 4, 5, 7, and 9. Dellvie\w Hospital, Vernon.—A standby diesel-electric generator was installed. Skeenaview Hospital, Terrace.—A standby diesel-electric generator was installed. The hospital sewerage system was connected with the municipal system. The Public Works Department is making arrangements to replace all the light fixtures and locks on the hospital building. Mental Health Centre, Burnaby.—Alterations were completed to provide accommodation for a Forensic Clinic. Dr. E. Lipinski was appointed Director and this new service started operation on October 13, 1966. Mental Health Centre*, Vernon.—Accommodation was provided in the Public Health Building, Vernon, for a mental health centre. Dr. A. J. Bennee was appointed Director and this new mental health centre started operating in January, 1967. Mental Health Centre, Chilliwack.—The addition to the Public Health Building to provide accommodation for the mental health centre was completed and officially opened by the Honourable Eric Martin on July 19, 1966. Dr. W. G. Jilek has since been appointed Director. Retirements, Resignations, and Staff Changes.—It was with regret we learned that due to ill health, the Honourable Eric Martin, Minister of Health Services and Hospital Insurance, had to relinquish his portfolio. We are, however, pleased to receive the announcement that the Honourable W. D. Black was appointed Minister of Health Services and Hospital Insurance, succeeding the Honourable Eric Martin. It was also with regret that we learned that Dr. A. E. Davidson, Deputy Minister of Mental Health, resigned on March 31, 1967, to accept a post with the Federal Government in Ottawa. Dr. A. D. Sleigh was appointed Director of the Mental Health Centre, Burnaby, succeeding Dr. K. Davies, who resigned to enter private practice. Mr. W. Tattrie, Superintendent of Works, Prince George, was appointed Superintendent of Works, Tranquille, succeeding Mr. W. Smith, who passed away suddenly. Miss Peggy Dingle, Consultant in Medical Records, retired after forty-two years' service with the Branch. The Honourable Eric Martin presented Miss Dingle with a watch on behalf of the Government on her retirement. Mr. N. K. Barr, Business Administrator, Riverview Hospital, resigned on May 31, 1966, to accept a position as Director, Royal Inland Hospital, Kamloops. Mr. W. O. Booth, Business Administrator at The Woodlands School, was appointed on September 1, 1966, as Business Administrator of the Riverview Hospital, succeeding Mr. Barr. Mr. H. F. Hayes, Habilitation Officer, The Tranquille School, was appointed Business Administrator at The Woodlands School on January 1, 1967, succeeding Mr. W. O. Booth. G 22 MENTAL HEALTH SERVICES REPORT, 1966/67 FINANCIAL TABLES Table A.—Showing the Average Number of Patients in Residence Each Year, the Total Amounts Spent for Maintenance, and the Gross Yearly and Daily per Capita Cost, 1957/58 to 1966/67. Institution Average Number in Residence Maintenance Expenditure Yearly per Capita Cost Daily per Capita Cost 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 Home for the Aged, Terrace— 4.59 4.42 4.57 4.68 3.61 12.55 Totals for the year 6.256.20 $11,413,169.99 $1,824.30 $5.00 1958/59 The Woodlands School 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 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... The Woodlands School 5.81 6.74 The Tranquille School, Tranquille 20.39 Provincial Mental Home, Colquitz . 5.05 6.83 Dellview Hospital, Vernon _ 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 The Tranquille School, Tranquille Provincial Mental Home, Colquitz Valleyview Hospital, Essondale 11.80 4.95 6.91 Dellview Hospital, Vernon 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 $15.23 Provincial Mental Hospital, Essondale... The Woodlands School 6.72 7.38 The Tranquille School, Tranquille Provincial Mental Hospital, Essondale... Valleyview Hospital, Essondale... 7.20 4.88 6.88 5.52 Skeenaview Hospital, Terrace 4.23 Totals for the year 6,207.30 $15,832,999.14 $2,550.71 $6.99 1962/63 236.68 2,719.32 1,365.03 307.13 214.18 724.07 232.55 296.21 $1,371,120.17 7,058,027.01 3,817,685.18 779,642.07 478,229.75 1,939,191.04 469,458.08 441,445.13 $5,793.14 2,595.51 2,796.78 2.538.48 2.232.84 2,678.18 2,018.74 1,490.31 $15.87 7.11 7.66 6.95 6.12 7.34 5.53 4.08 Provincial Mental Hospital, Essondale.... The Woodlands School The Tranquille School, Tranquille Provincial Mental Home, Colquitz Valleyview Hospital, Essondale.- Skeenaview Hospital, Terrace Totals for the year.. 6,095.15 $16,354,798.43 $2,683.25 $7.35 GENERAL ADMINISTRATION G 23 Table A.—Showing the Average Number of Patients in Residence Each Year, the Total Amounts Spent for Maintenance, and the Gross Yearly and Daily per Capita Cost, 1957/58 to 1966/67—Continued. Institution Average Number in Residence Maintenance Expenditure Yearly per Capita Cost Daily per Capita Cost 1963/64 220.63 2,791.99 1,306.35 433.92 94.07 737.69 236.51 292.83 $1,442,627.00 7,534,673.00 3,916,660.00 1,077,011.00 414,787.00 2,029,118.00 512,128.00 713,594.00 $6,538.67 2,698.67 2,998.17 2,482.05 4,409.35 2,750.64 2,165.35 2,436.89 $17.87 Provincial Mental Hospital, Essondale... 7.37 8.19 6.78 14.41 Valleyview Hospital, Essondale Dellview Hospital, Vernon ... Skeenaview Hospital, Terrace 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... The Woodlands School 8.05 9.38 The Tranquille School, Tranquille. 8.07 8.55 Dellview Hospital, Vernon Skeenaview Hospital, Terrace 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 9.14 Valleyview Hospital, Essondale 9.01 7.18 Skeenaview Hospital, Terrace 5.11 Totals for the year. 5,937.61 $20,745,127.00 $3,493.85 $9.57 1966/67 Riverview Hospital, Essondale 2,760.21 1,307.53 602.46 760.73 219.13 284.32 $11,162,462.00 5,376,492.00 2,267,399.00 2,668,056.00 635,710.00 589,492.00 $4,044.06 4,111.95 3,763.57 3,507.23 2,901.06 2,073.34 $11 08 The Woodlands School.. 11 27 The Tranquille School, Tranquille . 10 31 Valleyview Hospital, Essondale 9.61 Dellview Hospital, Vernon 7.95 Skeenaview Hospital, Terrace 5 68 Totals for the year 5,934.38 $22,699,611.00 $3,825.10 $10.48 G 24 MENTAL HEALTH SERVICES REPORT, 1966/67 Table B.—Summary Statement Showing the Gross and Net per Capita Cost of Patients in All Mental Health Institutions for the Year Ended March 31, 1967. Gross operating costs— Riverview Hospital, Essondale $11,162,462 The Woodlands School, New Westminster 5,376,492 The Tranquille School, Tranquille 2,267,399 Valleyview Hospital, Essondale 2,668,056 Dellview Hospital, Vernon 635,710 Skeenaview Hospital, Terrace 589,492 Gross cost, all institutions $22,699,611 Less collections remitted to Treasury 1,948,878 $20,750,733 Daily average population 5,934.38 Gross per capita cost, one year $3,825.10 Gross per capita cost, one day $10.48 Net per capita cost, one year $3,496.70 Net per capita cost, one day $9.58 Revenue (Patients' Maintenance Collections) of the Mental Health Services for the Past 10 Years 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 1961/62 2,150,802.56 1966/67 1,948,878.00 GENERAL ADMINISTRATION G 25 SO as u 5, Q W Q z w H Z o CN rH e. O __ uf .J < Q Z O </) w < o_ O X _. > c_; W > w a H B. O H Z w § w H < w u_ Z W P. X p. u w I-l m < x ° CU <l> ■__..£■ SO VOTj-hO\Nff)H^OOttTtVCHO'tHNinn Os -n t^ Os 'sO ^ CA cn sq p so Ttcn in p cncA ti os ti oo cA c~ os Tt tnostncA p tOT^TtcAcn'ciTtoo " r" r-" oi <J* ro ' oo* r-. vo rh vo bro«nri^r t-CS 00 ** th Wj <N th t- rH T-t iit SO ti Tf rH m O iONooo^<omo\mi»i/.in'tHD\OH vo '^rn^TrcohamiflOooooaHinrroo *-> lS.*^^_.t^^^^"^*N-ri*Nr~"':^,£,cn,/*lf0 " rcst^in^r4'o^<-jCboi--rb oCcnoO'-H 1 Ti ONHln r. CSr.r.r. r- r.(N tn ca Tt <«t ft ^f o v Tf CO Os * CA OO Os c •at— Ml 32 i j j t- jw- 1 1 i *OV£> tfOS HI •35 1 ! "** i oo •> m 1 i j i •oSjSti oo*a ag ?" o, zw CO rH tn vo ortw.OTtmm^mr.v.vi'tHNio v.motxr'ONnv-i/.MoocoTHio'T O^^^c^TH^qvirtcsr^tN r-^cs ^cn in (S C^* W rn" cl o m o\" o vo in o os tn CO ti tn ca ti in ti ca ca ca ti r- *h tn ca Tt os o ca so tn O *3 i __ c_*3 E o ii _. o g » c.2 __ u o o o T, I. __ a « _! 9 _i C 2 3 : .s* ,5H '3 C rt tn _. -^ i.S ■~ "_i e o — S ~ "_i — > ™ a. a 3 S _i E. H C_ ■ 3 -I '3 '3 % C u ►JOfcShOO Om2( a, tj ._.._, w __ __ *o « ^ TJ & B <__--. TJ 4> h B _i c g. I TJ ! S •a < G 26 MENTAL HEALTH SERVICES REPORT, 1966/67 o as ffl u a w Q Z w w ffl H z o CN o p. <_T w H c/_ z HH § H </_ w t-f o o ffl !/_ o z < I-l 8 o _. ffl H o Z w s w H < H C/_ P. z w a. x - « Eh v\» o Onpi owh-r-tr-voMwtnr-f. w rl o t— r. t- «-i O rH CO rH CO rH rH s 8.2 r.t; mvomoosOQ'-iosO-h'tr.ti.^r.ovOv oor-0\mnmc"* - _.._.....-_. .-. - ... _.._. CN © v<0 Ov rn © C hin^f rn in v© cn in rn' o cn ^t *t oi ci <Sh tn Os cn tn CA O rH -<t CM r- vOvom 00 oo r- tM^C rH *-H 3S 53 ~ ES III! ootSg 111! > C~ Ch -«_.=>Q -_ «Sh z mvOnO«ioOHftO\h^N(nOvr.O\ a.t-0\nr.rogvOiHNmr.n.TtQooio csOvjS 0\NOO»mio^vO'tNi3i>-H r—in-'t' cs"Wvj5co«nrHom,r/itcsrf 8~ vo vo cn VOHH m cn m ©' if C?1* Q. o sis ;,»»■ s _Th5 ' b 0 ■g- -► o 3 <p.m a 2 i— ii . O _' —111 i ? TJ <1 GENERAL ADMINISTRATION G 27 as ffl o D W 5 z W o_ ffl H Z o B. o fa w" I-l ij 5 c. z <: fti H o o ffl Q C/_ W -J _J z « H _. o H Z « S w H < H OO W to z _. ft. X m w w ►J « 8 o _K. »ncnito\cscsoocoiJ,\oooo\(s-Voo\cninrH moocScncStsawocncoitrHOvin qiohio cnooooosoo©©itrHVOTtcScocNCorl cn «. I •_■_■ O n (N(N l-A VU cnooooosoo©©^ cNrH"fsr-TifgCcn' rH rH If) O H incT(^'©' coif So ■* }OOv vo CS vo CO rH -SS i I ! I ! ! i i 49,355 ffl™ ft, 2 oo oo Tf o OO rH 3*2 > a zw incnitovtNrHoooo^tvooovoitvoovcnin incocNcnc-l(SC7\vocnooitcNComo'nrH cnooooo\oor*oit'Hvoitt^r-cNcocs rH vo 0\ ov r- m it rivd in i-i as p, s rt 5 _". 2 | 3 u G fi § « a 2 s « s 5 a 6 Ii o 3 o< 2 "i C o u _. ft .8 x __ ?_. - H) o H "o S ° 3 3 ■° l Si Kn TJ < G 28 MENTAL HEALTH SERVICES REPORT, 1966/67 Table F.—Expense Statement of the Valleyview Hospital, Essondale, for 12 Months Ended March 31, 1967 Salaries, Supplies, and Operating Expense Net Vouchered Expenditure Services and Supplies from Public Works Department Actual Cost of Operation Yearly per Capita Cost Salaries — Office expense _ Travelling expense Office furniture and equipment- Medical care Dietary Laundry Gratuities to patients Patients' library- Maintenance and operation of equipment- Transportation General supplies- Occupational and recreational therapy~ Audio-visual Motor-vehicles and accessories- General expense Burials Buildings, grounds, etc... As per Public Accounts.. Less—' Increase in inventory from institutional stores Rent deductions Board Adjusted expenditure.. $2,011,294 9,220 2,779 2,101 120,031 304,433 19,000 3,776 64 4,727 384 97,798 2,218 741 8,480 2,034 920 $2,590,000 7,568 197 15,030 $2,567,205 $100,851 $100,851 $100,851 $2,011,294 9,220 2,779 2,101 120,031 304,433 19,000 3,776 64 4,727 384 97,798 2,218 741 8,480 2,034 920 100,851 $2,690,851 7,568 197 15,030 $2,668,056 $2,643.90 .12 3.65 2.76 157.78 400.19 24.98 4.96 .08 6.21 .50 128.56 2.92 .97 11.15 2.67 1.21 132.57 $3,537.20 9.95 .26 19.76 $3,507.23 GENERAL ADMINISTRATION G 29 *- u_ ^ o inMHHaiHVDMinr.w.NH csovrnmrHitrfcrioO'-;ooovoo © in Ov VO O O 00 o r- •nvoitM^initts"itcNC^i--it t-^ t^ oo VO "S-S cs so cn -ri cA ti CA CS rH © 2*5. 0\ Cn rH It Ov °1 OS (N cs" *—1 fee- w «■ CO ffl Oh O o ■M C o-2 US H0vtH»CM3\OO\'tHO0. ov 4 ■* © ootNit>noo\vorHinvocsr-oo ootnostnTtTtT-ttncnTtxr~cAO m m rn t- ■n ti cncncn r- r-icncn rH »r4 ■^■ in 3S1 j3 rH t- IN Os VO cn vo Q fee Vi- &e- W < Q Z w ■or- IO ffl H ffl Ov w oo : i vo tn ; m ffl™. 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Cf 1 < a. . •a u 3 TJ £ TJ c u. ffl O 3 ? C a. P X i q.mE 5 t/ SS- n 3 X D m _ _- ./■ 3 1 f^m « 0 £ T c; "c. CO X o 1 .5 i. Ih H 3 o 1 •a cj if 2 _ s n c. Ih 0 B _ o c cn 9 H ■5 IH 3 <u 0 3- rt D 3 o o T 3 ■3 Ih d O y T 3 n s B TJ •3 ft, u ft < S m 3 < GENERAL ADMINISTRATION G 31 Table I.—Institution Stores Net undistributed stores as per Public Accounts Adjustments re farm profits Inventory adjustment— Plus on hand, March 31, 1966 __ Less on hand, March 31, 1967 __ Net increase in inventory1 $63,700 62,561 $126,261 543,947 584,074 $86,134 iThe increase in inventory has been transferred to the following institutions proportionately using the 1 vouchered expenditure " as the basis for distribution:— Riverview Hospital $48,235 The Woodlands School _ 24,979 Valleyview Hospital 12,920 $86,134 Table J. Salaries -Expense Statement of the Community Services for 12 Months Ended March 31, 1967 Mental Health Centre, Burnaby Office expense Travelling expense Office furniture and equipment. Medical care Dietary Laundry _, Maintenance and operation of equipment. Transportation General supplies Occupational and recreational therapy Patients' education Motor-vehicles and accessories General expense. Buildings, grounds, etc. Total - $573,395 4,642 __ 11,161 4,045 __ 30,852 - 12,338 1,500 2,267 1,563 4,409 1,297 1,133 1,916 __ 38,572 __ 78,474 .. $767,564 Salaries Office expense Travelling expense Office furniture and equipment. Medical care Mental Health Centre, Victoria $124,006 1,802 1,404 193 14,391 Maintenance and operation of equipment 530 General expense 10,286 Buildings, grounds, etc. 13,166 Total $165,778 G 32 MENTAL HEALTH SERVICES REPORT, 1966/67 Table J.—Expense Statement of the Community Services for 12 Months Ended March 31, 1967—Continued Mental Health Centre, Kelowna Salaries $49,514 Office expense 559 Travelling expense 3,136 Office furniture and equipment 236 Medical care 6,274 Maintenance and operation of equipment 411 General expense 2,753 Total $62,883 Mental Health Centre, Trail Salaries $34,966 Office expense 824 Travelling expense 1,033 Office furniture and equipment 555 Medical care 3,803 Maintenance and operation of equipment 298 General supplies 118 General expense 137 Total $41,734 Mental Health Centre, Nanaimo Salaries $38,654 Office expense 1,158 Travelling expense 3,264 Office furniture and equipment 52 Medical care 10,937 Maintenance and operation of equipment 810 General expense 266 Total $55,141 Mental Health Centre, Kamloops Salaries $4,878 Travelling expense 427 Medical care 931 General supplies 13 General expense 41 Total $6,290 GENERAL ADMINISTRATION G 33 Table J.—Expense Statement of the Community Services for 12 Months Ended March 31, 1967—Continued Mental Health Centre, Chilliwack Salaries $7,143 Office expense 811 Travelling expense 468 Office furniture and equipment 8,950 Medical care 1,645 General supplies 154 General expense 110 Total $ 19,281 Expansion of Community Services All expenditure $25,524 Grand total, $1,144,195 G 34 MENTAL HEALTH SERVICES REPORT, 1966/67 Table K.—Expense Statements of the Rehabilitation Centres for 12 Months Ended March 31, 1967 Vista Rehabilitation Centre Salaries $25,566 Office expense 203 Travelling expense 51 Dietary 4,660 Laundry 31 General supplies 565 General expense 274 Buildings, grounds, etc. 1,551 Total $32,901 Venture Rehabilitation Centre Salaries $23,106 Office expense 229 Travelling expense 152 Dietary 6,749 General supplies 852 General expense 347 Buildings, grounds, etc. 2,083 Total $33,518 Rehabilitation and After-care Programme Salaries $ 142,291 Office expense 555 Travelling expense 8,058 Office furniture and equipment 1,949 Gratuities 20 Medical care 40,340 Dietary 307 Transportation 1,061 Occupational therapy 447 General expense 248 Total $195,276 Grand total, $261,695 GENERAL ADMINISTRATION G 35 Table L.—Expense Statement of General Administration, Mental Health Services Branch, for 12 Months Ended March 31, 1967 Salaries $278,036 Office expense 10,927 Travelling expense 10,669 Office furniture and equipment 2,811 Grant to trustees of Patients' Comfort Fund 8,000 Grant to University of British Columbia for Mental Health Research 30,000 General expense 854 Administration of Psychiatric Nurses Act 2,317 Council of Psychiatric Nurses for Bursary Trust Fund 1,200 Mental health care 235,089 Total $579,903 Table M.—Expense Statement of the Department of Nursing Education, Essondale, for 12 Months Ended March 31, 1967 Salaries $909,131 Office expense 5,889 Travelling expense 1,765 Office furniture and equipment 948 Medical care 731 Dietary 9,527 Laundry 5,000 General supplies 27,919 Audio-visual 276 General expense 5,986 Total $967,172 G 36 MENTAL HEALTH SERVICES REPORT, 1966/67 Reconciliation with Public Accounts, 1966/67 Table L—General Administration— Salaries $278,036 Expenses 301,867 Vouchered expenditure $579,903 Deduct salary adjustments 14,820 As per Public Accounts $565,083 Table M—Department of Nursing Education— Salaries $909,131 Expenses 58,041 Vouchered expenditure $967,172 Deduct salary adjustments 18,924 As per Public Accounts 948,248 Table J— Mental Health Centre, Burnaby— Salaries $573,395 Expenses 194,169 Vouchered expenditure $767,564 Deduct— Buildings and grounds $78,474 Portion of farm profit 480 78,954 As per Public Accounts 688,610 Mental Health Centre, Victoria— Salaries $ 124,006 Expenses 41,772 Vouchered expenditure $165,778 Deduct buildings and grounds 13,166 As per Public Accounts 152,612 Mental Health Centre, Kelowna— Salaries $49,514 Expenses 13,369 As per Public Accounts 62,883 Mental Health Centre, Trail— Salaries $34,966 Expenses 6,768 As per Public Accounts 41,734 GENERAL ADMINISTRATION G 37 Reconciliation with Public Accounts, 1966/67—Continued Table J—Continued Mental Health Centre, Nanaimo— Salaries $38,654 Expenses 16,487 As per Public Accounts $55,141 Mental Health Centre, Kamloops— Salaries $4,878 Expenses 1,412 As per Public Accounts 6,290 Mental Health Centre, Chilliwack— Salaries $7,143 Expenses 12,138 As per Public Accounts 19,281 Expansion of Community Services—Deduct salary adjustments, all mental health centres 38,400 Table C—Riverview Hospital— Salaries $7,387,587 Expenses 2,387,673 Vouchered expenditure $9,775,260 Deduct salary adjustments 423,588 $9,351,672 Add sundry adjustments, board, rent, etc 89,354 As per Public Accounts 9,441,026 Table K— Vista Rehabilitation Centre— Salaries $25,566 Expenses 7,335 Vouchered expenditure $32,901 Deduct— Salary adjustments $672 Buildings and grounds 1,551 2,223 As per Public Accounts 30,678 G 38 MENTAL HEALTH SERVICES REPORT, 1966/67 Reconciliation with Public Accounts, 1966/67—Continued Table K—Continued Venture Rehabilitation Centre— Salaries $23,106 Expenses 10,412 Vouchered expenditure $33,518 Deduct— Salary adjustments $648 Buildings and grounds 2,083 2,731 As per Public Accounts $30,787 Rehabilitation and After-care Programme— Salaries $ 142,291 Expenses 52,985 Vouchered expenditure $195,276 Deduct salary adjustments 5,064 As per Public Accounts 190,212 Table F—Valleyview Hospital, Essondale— Salaries $2,011,294 Expenses 555,911 Vouchered expenditure $2,567,205 Deduct— Salary adjustments $118,164 Portion of farm profit 10,082 128,246 $2,438,959 Add sundry adjustments, board, rent, etc. 22,795 As per Public Accounts 2,461,754 Table G—Dellview Hospital, Vernon— Salaries $421,8 81 Expenses 121,510 Vouchered expenditure $543,391 Deduct salary adjustments 21,300 $522,091 Add— Portion of farm loss $330 Sundry adjustments, board, rent, etc 5,684 6,014 As per Public Accounts 528,105 GENERAL ADMINISTRATION G 39 Reconciliation with Public Accounts, 1966/67—Continued Table H—Skeenaview Hospital, Terrace— Salaries $343,760 Expenses 141,382 Adjusted expenditure $485,142 Deduct salary adjustments 17,700 $467,442 Add sundry adjustments, board, rent, etc. 7,784 As per Public Accounts $475,226 Table D—The Woodlands School- Salaries $4,027,285 Expenses 931,857 Adjusted expenditure $4,959,142 Deduct— Salary adjustments $216,108 Portion of farm profit 20,396 236,504 $4,722,638 Add sundry adjustments, board, rent, etc. 31,395 As per Public Accounts 4,754,033 Table E—The Tranquille School— Salaries $1,412,355 Expenses 523,791 Adjusted expenditure $1,936,146 Deduct salary adjustments 61,836 $1,874,310 Add— Portion of farm loss $1,481 Sundry adjustments, board, rent, etc 19,075 20,556 As per Public Accounts 1,894,866 Table I—Net Undistributed Stores (as per Public Accounts) (prorated to Riverview Hospital, The Woodlands School, and Valleyview Hospital) 63,700 Total Mental Health Services Branch expenditures as per Public Accounts $22,397,393 G 40 MENTAL HEALTH SERVICES REPORT, 1966/67 PERSONNEL REPORT J. Dowling, Personnel Manager The establishment of the Mental Health Services Branch increased during the fiscal year as follows:—• Community services 20 In-patient care facilities 69 Total 89 As of March 31, 1967, there were 4,011 persons on Branch payrolls. This is 193 more than on March 31, 1966, comprising 152 employees in various classifications and 41 student psychiatric nurses. The increase was constant throughout the fiscal year with quarterly averages showing 207 more people on the payrolls than in the previous year. Over-all staff turnover, excluding students and relief staff, was up substantially from 20.5 per cent to 28.6 per cent. Notwithstanding the very high volume of separation and recruitment activity as detailed in Table B attached, staffing throughout the Branch was fairly well maintained. Staff turnover in the psychiatric nurse classifications was only fractionally different from the previous year. There was, however, a 15.9 per cent rise in the turnover of registered nurses. While this rate of turnover is regrettable it is not alarming because registered nurses comprise only 5.54 per cent of the total nursing staff. At the close of the fiscal year the number of registered nurses on staff was at a record high. While the total number employed in the nursing services of the in-patient care facilities has risen by 3.43 per cent, the number of males as a percentage of total nursing staff has declined again. Ten years ago male staff comprised 42.94 per cent of nursing staff. At the close of the fiscal year the corresponding figure was 32.89 per cent. This trend is important and is likely to continue. It must be taken into account in all planning and over-all considerations affecting nursing services. The volume of work throughout the year was exceptionally heavy, but apart from participation in effecting the reorganization of Riverview Nursing Services, nothing of particular importance has been undertaken. Figures covering personnel activity and the staffing position are provided in the following tables:— STATISTICAL TABLES Table A.—Summary Showing Over-all Staff Totals in Relation to Separation and Recruitment Staff recruited, excluding students 1,589 Staff separated, transferred, etc., excluding students 1,437 Increase 152 Total staff, excluding students, as of March 31, 1967 3,707 Total staff, excluding students, as of March 31,1966 3,555 Increase 152 GENERAL ADMINISTRATION G 41 Table A.—Summary Showing Over-all Staff Totals in Relation to Separation and Recruitment—Continued Quarterly staff average, excluding students, 1966/67 3,975 Quarterly staff average, excluding students, 1965/66 3,809 Increase 166 Male Female Total Student enrolment as of March 31,1967 14 290 304 Student enrolment as of March 31,1966 25 238 263 Change —11 +52 +41 Student quarterly average, 1966/67 281 Student quarterly average, 1965/66 240 Change +41 Table B.—Breakdown by Classification of Recruitment and Separation Activity for the Mental Health Services, Excluding Student Psychiatric NURSES. Established Positions Recruited Separated Physicians 42 42 Dentists 1 2 Registered nurses 74 61 Psychiatric nurses 326 244 Female psychiatric aides 183 188 Male psychiatric aides 72 93 Teachers 4 5 Occupational therapists 30 29 Recreational therapists 5 4 Industrial therapists 4 7 Psychologists 14 13 Social workers 26 21 Dietitians 3 3 Cooks 7 6 Kitchen helpers 63 70 Clerks 27 20 Clerk-stenographers 50 41 Trades 3 2 Laundry workers 56 43 Miscellaneous professional 16 8 Miscellaneous technical 12 11 Miscellaneous 184 150 Sub-totals 1,202 1,063 Temporary relief staff 387 319 Miscellaneous adjustments, transfers, etc. 55 Totals 1,589 1,437 G 42 MENTAL HEALTH SERVICES REPORT, 1966/67 Table C.—Summary of Staff Turnover By Major Classification Classification 1965/66 1966/67 Change Student psychiatric nurses- Male psychiatric nurses Female psychiatric nurses.- Registered nurses Per Cent 19.6 15.5 26.1 29.9 Per Cent 20.6 16.3 24.3 45.8 Per Cent +1.0 +0.8 -1.8 + 15.9 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, 1965/66 Temporary Relief Staff Excluded, 1966/67 Per Cent Per Cent 13.9 16.3 18.4 19.1 21.0 24.7 17.4 26.4 34.2 40.9 22.9 21.5 22.7 36.8 15.1 21.9 20.8 25.9 General Administration- Department of Nursing Educationi.. Riverview HospitaL The Woodlands SchooL The Tranquille School— Valleyview Hospital Dellview Hospital Skeenaview Hospital— Mental health centres— Over-all turnover.. 20.5 28.6 i 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 1965/66 Positions in Establishment as of Mar. 31, 1_66 Number on Staff as of Mar. 31, »66 Fiscal Year 1966/67 Positions in Establishment as of Mar. 31, 1967 Number on Staff as of Mar. 31, 1967 General Administration Department of Nursing Education- Mental health centres Sub-totals In-patient care— Riverview Hospital The Woodlands SchooL The Tranquille School— Valleyview Hospital Dellview Hospital- Skeenaview Hospital- Total of vote Total Civil Service positions- Student psychiatric nurses Totals 44 63 140 43 60 130 44 63 160 247 233 267 1,540 856 341 440 89 71 3,337 3,584 325 3,909 1,558 869 298 436 90 71 1,569 868 358 444 92 74 3,322 3,405 3,555 263 3,672 325 3,818 3,997 43 68 135 246 1,574 886 390 446 92 73 3,461 3,7071 304 4,011 i Includes 121 part-time employees. GENERAL ADMINISTRATION G 43 I've ON X cj fc < < t/_ < z « fc fc < H 1/3 O tn a. 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Xi ffl j a H 3 ic m so * 3 c Cf C Cc t "o J c .S-C ♦a o O ST O £ _= t a i _> c *i_ S .5-3 » U_a - > rt nl *M " t-h" Ih , m o 3 •§ + S a 1 4} > 5 p __ > j '* c o _ •§__ <_. £ _- S rt c 1 o H I-l te s G 44 MENTAL HEALTH SERVICES REPORT, 1966/67 REPORT OF SOCIAL SERVICE CONSULTANT Miss A. K. Carroll The year 1966/67 has continued to afford challenge and to present opportunities for evaluative practice and creative thinking and planning for all social workers in the facilities of the Mental Health Services Branch. Studies in the conceptualization of the scope of skills and processes involved in community planning and development for regional and community based health services and of the patterns of agency co-ordination and co-operation were undertaken. PROFESSIONAL EDUCATION AND STAFF-DEVELOPMENT PROGRAMME A total of 23 first-year and second-year students were placed for field-work experience in facilities of the Mental Health Services during the year. Additionally, a programme of block field-work placement was planned co-operatively by the School of Social Work, University of British Columbia, and specific mental health facilities. The student-training project in After-care, Riverview Hospital, was extended to the adult clinic to integrate both case and group-work methods, thus affording a practicum more generically based in theory and method. The co-operation between the faculty instructors in the School of Social Work and supervisory and senior practitioner personnel in the social service departments in the mental health facilities continued as in the past. In-trained social-work personnel from the Department of Social Welfare were oriented to the programme and services of the various mental health facilities. Additionally, welfare-aide students from Vancouver City College were afforded a practical aide duty-level experience. To be equipped to make an effective contribution to community health services in the train of events such as the explosion of knowledge, advancing methodologies, refinement of techniques, and a sharpening of skills occurring in both the behavioural and health sciences fields, opportunities for on-going study are of prime importance. To this end, social workers, some under the auspices of the Mental Health Services, others on their own resources, attended relevant institutes and seminars. PERSONNEL AND RECRUITMENT Social-work staff stability has further declined over the past year. Every social-work department operated with staff vacancies. A major personnel practice gain was the institution of a psychiatric social-work series based on basic minimal qualifications and recognizing the contribution of the senior practitioner additional to those skills basic to the duties of supervisory, consultant, and administrative personnel. Whereas in the past the recruitment of social workers to the Mental Health Services was contingent upon the availability of Federal mental health bursaries, this year 14 social workers, including two part-time employees and three summer- relief personnel, were recruited, some on graduation from the schools of social work, others from the field of practice. Six social-work personnel were recruited and awarded Federal Mental Health Grant bursaries, bringing the total of social workers recruited through the efforts of this officer to 18. This year, 10 persons were the recipients of this bursary (six were awarded to first-year post-graduate social workers in the School of Social Work and four were awarded to social-worker personnel in the Mental Health Services). GENERAL ADMINISTRATION G 45 SOCIAL-WORK CONSULTATIVE SERVICE This staff service accounted for 51 per cent of the consultant's man-hours and was carried out by visitation to all facilities of the Mental Health Services. BOARDING-HOME PROGRAMME The boarding-home programme in the Lower Mainland and Upper Fraser Valley areas of British Columbia has become stable in so far as procedures, administration, and resources are concerned. This has freed some time for boarding- home social workers to devote to community organization, rehabilitation with certain patients, and the development of programme in the boarding homes. Since the start of the boarding-home programme in late 1959, some 1,000 patients have been released from the four participating institutions with a breakdown as follows (approximate figures):— Riverview Hospital 676 Valleyview Hospital 237 The Woodlands School 62 The Tranquille School 25 1. Community Reaction.—The majority of these persons have been placed in boarding homes in the Lower Mainland and Upper Fraser Valley areas (Regions 2 and 6 of the Department of Social Welfare). We have had excellent co-operation with the district offices of the Department of Social Welfare, both in the placement programme and in the development of new resources in the various districts. The programme has also been accepted by the municipal administrations in these regions, and during 1966 the Municipality of Surrey co-operated in the development of further resources in that area. The Burnaby administration has continued its fine co-operation and found it necessary to hold the line on placements in the year. 2. Community Involvement.—It should be noted that there has been an upswing in community interest and involvement in integration of the boarding-home residents into the employment and activities streams in the communities. A branch of Canadian Mental Health Association has been formed in one district (largely due to the activity of the local public health unit), which has laid on a well-defined, organized, and executed programme which includes recreational, training, employment, and socialization activities for patients, and educational activities directed towards the community. The Coquitlam Mental Health Association group have consistently provided a recreational programme and the Council of Women in White Rock is active in a recreational programme that has, because of the representative nature of the membership of this group, involved numerous other service organizations and individuals. In co-operation with and under the leadership of the occupational therapist from Riverview Hospital, the community groups in Haney and White Rock are developing occupational-therapy centres which may well become sheltered workshops and recreational centres, managed by the community group and the patients, with Mental Health Services in a consultative role. Community reaction to the boarding-home programme at The Tranquille School has been generally good because (a) trainees are widely scattered in the community, and (b) an intensive public-relations programme was done. Cooperation has been forthcoming from churches and the Association for Retarded Children in a programme of integration into the community. 3. Future Expansion of Programme.—The total number of patients in the boarding-home programme supervised by Mental Health Services increases by approximately 45 persons per year from Riverview Hospital, and by a proportionate number from the other institutions. This figure does not, however, describe G 46 MENTAL HEALTH SERVICES REPORT, 1966/67 increases in case loads as it does not include patient movement such as returns to hospital and replacements, rehabilitation activity leading to discharge, and transfers between homes. These activities increase the work load of not only the Mental Health social workers, but also the work load of the staffs of the district offices of the Department of Social Welfare and municipal social service departments. While there are some areas in the Lower Mainland and Upper Fraser Valley still open to development for this programme, other areas would seem to have reached a point of saturation. 4. Public Health.—The demonstration project that Mental Health Services and the Department of Social Welfare engaged in with the Central Fraser Valley Health Unit has now been completed and a report is before the administrations of the.participating departments for consideration as to future policy. The purpose of the project was to discover the role (if any) of the public health unit and the visiting public health nurse in the boarding-home programme. The project amply demonstrated that the health unit and the nurse have valuable services to offer such programmes and that the integration of these services with those of the other public agencies results in an improved level of health and social services to the residents of the boarding home. 5. Discharges from Programme.—Over the past two years 39 Riverview Hospital patients have been discharged from the boarding-home programme following a rehabilitation plan, and only four of these people have subsequently returned to hospital. These results have been achieved while average case loads of the boarding- home social workers have been 125. Without going further back than the past two years, the 337 patients on boarding-home leave from Riverview Hospital at the end of 1966, plus the 35 still discharged, gives a total of 372 patients, which figure, in terms of beds freed at Riverview Hospital, is much greater than the capacity of either of the Admitting Units. 6. Training Programme.—One boarding home has for four years offered a total training and rehabilitation programme geared to the needs of young female schizophrenic patients. Five young women have " graduated " from this home and are self-supporting. Previous to this experience these women had had long periods of hospitalization or frequent admissions over a long period and had not worked or had worked only sporadically. A second home is now being developed along the same lines. Additionally, on an individual basis, some patients are being trained in household or labouring skills by volunteers in the community. Expansion of this programme is planned. Other patients are attending vocational courses while in residence in boarding homes. The training programme for boarding-home patients at The Tranquille School is based on exposure of the trainee to other trainees who have had success in employment in order to foster motivation. Employment opportunities are made available once appropriate motivation is evident. All trainees are encouraged and helped to keep on with established interests and hobbies. SUMMARY Throughout the year the consultant has been impressed with the high level of motivation of social workers on the job. Also commendable has been the skill level of social services rendered, the organization of the case load, the foci of services, and the coverage of patients referred for service. Social workers throughout the service are to be congratulated for the purposeful, committed, and positive contributions they have continued to make in the treatment of patients and families during this period of extensive study, analysis, evaluation, and change in the nature, scope, and organization of mental health programmes and services. GENERAL ADMINISTRATION G 47 REPORT OF NURSING CONSULTANT Miss M. M. Lonergan, Nursing Education The psychiatric-nursing programme showed a year-end census of 304 students compared to 263 for 1965/66. The department sent out 1,470 bulletins and application forms and processed 489 applications for entrance into the fall and spring classes. One hundred and ninety students enrolled in the programme; of these, 165 had earned complete high-school standing, one-third on the University Entrance and the remainder on the General Programmes. Fifty-eight students withdrew from the programme. Thirty-four withdrew for personal reasons, representing approximately the same percentage as that for the previous fiscal year. Twelve withdrew because of illness and another 12 because of academic failure. Ninety-five students completed the programme and all but five were employed by the Mental Health Services. The final comprehensive examination, in the third year of its use, accounted for nine failures at the first sitting; one student was unable to pass the supplemental examination and was required to withdraw. Under the direction of their senior instructor, the members of the psychiatric- nursing programme faculty were able to improve the correlation of content among classroom subjects and between the latter and clinical teaching. Student experience in intensive-treatment areas emphasized learning techniques in interpersonal relationships, the use of therapeutic milieu, rehabilitation methods, and participation in team nursing. In continued treatment areas the focus of learning was on the development of skills in group work. Special efforts were made to communicate to nursing service the objectives of student learning experiences. Courses in the care of the mentally retarded were further defined to provide educational experiences in training, psychiatric and pa_diatric nursing, with resultant good correlation of the academic and clinical aspects of these courses. With the appointment of an instructor in geriatric nursing, the emphasis of that experience was placed on learning bedside nursing-care. Nursing staff co-operated fully with the establishment of a clinical teaching programme and made it possible for all students to attend all clinics. The curriculum committee devoted its meetings to preparing material for the revision of the curriculum, defining course objectives, and identifying required learning experiences. Five thousand two hundred and eight hours of formal academic-clinical teaching was recorded for this programme, indicating an average of 372 hours of planned structured teaching by each instructor. In the psychiatric-aide programme, 26 courses were conducted at the Education Centre. The Woodlands School and The Tranquille School provided one week of instruction for a total of 230 psychiatric aides. At Dellview and Skeenaview Hospitals, orientation for newly employed aides was available throughout the year through in-service programmes; in addition, the majority of psychiatric aides took part in concentrated refresher courses ranging from one to two weeks in duration. During the year 287 aides requiring instruction were recruited into the Mental Health Services; of these 142 enrolled in formal orientation courses. At the end of the year it was determined that 642 of the 1,034 psychiatric aides currently employed in the Service had had orientation and brief training in the classroom. A total of 1,084 hours of formal classes was taught by four instructors who also contributed 28 per cent of their teaching-time to other programmes in the department. A continuing challenge to these instructors has been the diversity of the aides' learning needs, since those enrolled in any one course were either newly employed or experienced in the Service and were assigned to nursing programmes for either geriatric G 48 MENTAL HEALTH SERVICES REPORT, 1966/67 or for acutely-ill psychiatric patients. A plan to follow through at the conclusion of courses by means of ward clinics was instituted the previous year in an effort to provide specific and situational teaching. During the year there was a distinct increase in the number of teaching interviews, meetings with nursing services, weekly clinics, and the number of aides attending the latter. Two hundred and seventy students enrolled in the Affiliate Programme in Psychiatric Nursing; of these, two were instructors from general hospital schools of nursing and 24 were public health nurses employed by the Health Branch. The National League for Nursing Achievement Test in Psychiatric Nursing was used for selected enrollees. The test scores when plotted showed a distribution conforming to the " normal bell curve " and provided useful information for the programme co-ordinator. The programme instructors held a four-day workshop in the fall, at which curriculum outline was revised. The Director of Education Services of the Registered Nurses Association of British Columbia met with the instructors concerned, twice in an advisory capacity. Terms of agreement for the continuation of the programme for another year were reviewed and approved by representatives of the Mental Health Services and the schools of nursing concerned. Bulletins providing information about the affiliate programmes for both general hospital students and for public health nurses were compiled and made available to interested nurses across the country. Five students enrolled in the six-month Clinical Programme for Registered Nurses completed their studies in July, 1966. Three of these obtained employment in psychiatric units of general hospitals. For some time the programme had been under review to determine whether it met the current needs of registered nurses for psychiatric nursing experience. It became obvious that needs could best be met by two different programmes: (a) a short course in basic concepts and principles with appropriate selected experience for a large number of registered nurses and, (b) a university programme designed to produce registered nurses with a competency in psychiatric-mental health nursing. The University of British Columbia opened the latter Diploma Programme in Psychiatric Nursing, in the fall of 1966. The Registered Nurses Association of British Columbia was giving consideration to the development of the former. The clinical programme was, therefore, discontinued. It had made a contribution to nursing in Canada by graduating a number of nurses competent in the practice of psychiatric nursing and had provided a limited number of staff for the Mental Health Services. NURSING CONSULTATION The consultative process in mental health-psychiatric nursing is carried out generally in four major functional spheres. These are: administrative, educational, clinical, and research. During the past year consultation responsibilities were weighted heavily toward the first two. The amount of consultation time required for priority matters only increased over that of the previous year by 75 per cent. Five institutions were visited one or more times as well as three of the mental health centres. Several meetings were held with representatives of the Health Branch and with the Hospital Insurance Branch with a focus on standards of nursing care, categories of nursing personnel, and programmes in nursing education. The consultant represented the Branch on various professional nursing committees concerned with standards of nursing and nursing education. Discussion was initiated with the Vancouver City College and with the Registered Nurses Association of British Columbia with the purpose of exploring educational opportunities for psychiatric nurses. Attention was given to studies on the state of psychiatric nursing in the Province GENERAL ADMINISTRATION G 49 and reports prepared for the Deputy Minister. The reorganization of nursing services, with subsequent recruitment and selection of nurses for Riverview Hospital, was satisfactorily concluded with respect to the organizational structure. Orientation programmes were arranged for selected newly employed nurses, visitors, and university field students. The consultant was privileged to participate in the first Federal-Provincial Conference on Mental Health-Psychiatric Nursing held in Ottawa in June, 1966. It provided opportunities for senior nurses in Provincial psychiatric services to gain information about developments in other services and to explore solutions to common problems. The Nursing Liaison Committee met bimonthly with the aim of promoting liaison among nurses involved in mental health work. Services represented were public health, nursing education, psychiatric units in general hospitals, and the Mental Health Services. Topics explored through discussion included the following: nursing involvement in boarding-home programmes, reports of studies of nursing time spent in mental health programmes, and new and existing programmes of common interest. Directors of Nursing met in council monthly. Their deliberations included assessing the safety of various medico-nursing procedures, determining the effectiveness of several personnel policies, and exploring methods of solving nursing administration problems. Each nurse administrator emphasized the need for staff education in his or her department. A high degree of priority was given to in-service education programmes and to enabling nurses to attend educational events sponsored by other agencies. The most notable of the latter were courses on supervision, psychiatric and geriatric nursing, and methods of teaching. A rewarding outcome of many activities this year has been a notable increase in the degree to which Directors of Nursing were able to plan and work together on many aspects of their responsibilities. G 50 MENTAL HEALTH SERVICES REPORT, 1966/67 REPORT OF THE CONSULTANT IN MEDICAL RECORDS AND STATISTICS Mrs. P. A. West The fiscal year ended March 31, 1967, has been a busy and productive one, particularly in the area of the development of statistical programmes for the various facilities. A major change in personnel also occurred with the retirement on January 15, 1967, of Miss A. D. Dingle, who served in the Medical Records Department of the Mental Health Services Branch for a period of 42 years. Miss Dingle will long be remembered for her dedication and devoted interest in medical records, particularly as they apply to the psychiatric facilities in British Columbia. Mrs. P. A. West, formerly Medical Record Librarian of Riverview Hospital, was appointed as Miss Dingle's successor and assumed her duties as Consultant in Medical Records and Statistics on January 16, 1967. With the assistance of the Research Officer assigned from the Division of Vital Statistics, continuing efforts were directed toward the development and improvement of the statistical programmes in all facilities and to ensure that they were maintained at a current level. As a result of these efforts, all divisions of the Mental Health Services now have statistical forms designed to collect data relative to the particular type of care and treatment provided by the specific facility, thus making available pertinent information which is valuable in clinical research and administrative planning. The content of medical records in the various facilities has been under discussion in an effort to reduce the bulk in records of long-term cases and obtain more satisfactory filing methods. Associated with this is the open-shelf colour- coded numerical system of filing active cases at The Woodlands School, which has proved most satisfactory since its introduction last year. The closed medical records of The Woodlands School and Valleyview Hospital, formerly stored at Riverview Hospital, have now been transferred to the storage areas of the individual facilities; this transfer of approximately 2,800 files released valuable space for the closed records of Riverview Hospital. CONSULTATION TO UNITS Riverview Hospital A review has been made of statistics gathered on schizophrenic patients discharged from Riverview Hospital during 1965/66. These cases will be checked for possible readmission and further studies are contemplated as research continues into this particular form of mental illness. In order to provide comparable statistics on patients in residence prior to the initiation on April 1, 1965, of the original statistical forms, it was necessary that admission data be obtained on all these patients. This large undertaking invloved completing an admission statistical form on each of 2,200 patients; it was necessary to retain one summer-relief clerk for one month to assist the regular staff in this project. In connection with the Pre-Admission Service pilot plan being developed by Riverview Hospital and the Burnaby Mental Health Centre, consultative services were given in the development of a record form and also with regard to the deployment of medical records staff. GENERAL ADMINISTRATION G 51 During the year consultative meetings were held with members of the medical staff with a view to revising the statistical forms in order to meet the specific needs of the Riverview Hospital in the collection of pertinent and detailed diagnostic and treatment data concerning admissions to and separations from this facility. In collaboration with the Research Officer, finalization of the revisions and the production of an accompanying manual of instructions and codes were accomplished in time for the revised forms to be introduced on April 1, 1967. Schools for Mentally Retarded Steady progress has been made in the statistical programme which was put into operation in The Woodlands School on April 1, 1966. Some minor procedural problems were encountered initially following the programmes introduction, but these were overcome by the staff members involved showing a genuine interest and co-operating fully in establishing efficient routines which enable them to complete the statistical forms with a minimum of effort. Steps are being taken to obtain admission statistical data for the patients who were in residence prior to April 1, 1966, and who continue to reside in this facility. Two brief visits were made to The Tranquille School. The operation of the medical-records office in this facility has been disrupted by frequent change of staff; consequently, new appointees have required instruction and support to cope with unfamiliar routines in a single-staff office. Geriatric Division Valleyview Hospital staff have adjusted well to the procedures involved in completing the statistical forms introduced on April 1, 1966. Efforts will be made shortly to obtain statistical data on all patients who were in residence prior to April 1, 1966. In the meantime, admissions and separations are being promptly recorded on the statistical forms. The development of a similar statistical programme for Dellview and Skeenaview Hospitals is a future goal of this department. Mental Health Centres The Children's Clinic at the Burnaby Mental Health Centre has now submitted statistical forms for all cases open as at March 31, 1967, and is completing the forms on a routine basis. The development of the Forensic Clinc at Burnaby and the Pre-Admission Service of Riverview Hospital, which will be operating in part at the mental health centre, have brought attention to the need for review of the methods of recording movement of patients. The Victoria Mental Health Centre's medical-records office is now operating most efficiently, with statistical forms and reports being promptly and regularly submitted. Notable success was achieved during the year in bringing the statistical programme for the Okanagan Mental Health Centre to a current level. Initially, changes of staff played a large part in the creation of a backlog. However, now that there is more constancy of staff who have become familiar and proficient with the codes and instructions of the statistical-forms manual, regular reporting has been established. The medical-records staff in the Kootenay Mental Health Centre has been more permanent and no difficulty has been experienced in keeping the statistical programme reasonably current. G 52 MENTAL HEALTH SERVICES REPORT, 1966/67 Vancouver Island Mental Health Centre at Nanaimo has been making headway in overcoming a somewhat underdeveloped approach to the statistical programme. Initial steps have been taken in a concerted effort to bring current the statistical forms and reports for the 1966 year. Two visits were made to the Upper Fraser Valley Mental Health Centre at Chilliwack during January and March for the purpose of instructing and assisting the medical-records clerk during the initial stages of organizing and establishing the clerical department, which is functioning quite satisfactorily with a current statistical programme. The North Okanagan Mental Health Centre at Vernon opened in February, 1967. It is planned to visit this centre as soon as possible in order to give assistance and guidance in establishing an efficient medical-records office. The need for further revision and simplification of the statistical form used by the mental health centres over the past several years was met by a concerted effort on the part of the Research Officer assigned from the Division of Vital Statistics, who, in close collaboration with the Director of Mental Health Services and the Medical Records Consultant, developed and made ready for implementation on April 1, 1967, a comprehensive and efficient form primarily designed to provide administrative data regarding the case loads carried by the mental health centres throughout the Province. An important benefit accruing from this revision will be a marked reduction in the clerical work formerly necessary in maintaining complex registers. RIVERVIEW HOSPITAL G 53 PART II.—RIVERVIEW HOSPITAL REPORT OF THE SUPERINTENDENT B. F. Bryson, Superintendent GENERAL COMMENTS The following table gives a summary of the movement of population for Riverview Hospital for the 12 months ended March 31, 1967:— Male Female Total In residence, April 1, 1966 On extended leave— Boarding home Other On escape Totals- Admissions Transfers from geriatric facilities Transfers from facilities for the mentally retarded.. Total admissions Total under care 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 . Increase or decrease in population . In residence, March 31,1967 1,440 131 80 5 1,375 170 75 3 2,815 301 155 1,656 1,623 3,279 2,028 3 5 2,234 4 1 4,262 7 6 2,036 2,239 4,275 3,692 3,862 7,554 1,685 60 22 4 156 52 4 1,815 64 11 4 186 100 3,500 124 33 8 342 152 4 1.983 2,180 4,163 16 | 1,456 | —63 1,312 —47 2,768 In comparing the above statistical information with that of the previous year, it is noted that there has been some decrease in both admissions and separations. This year there were 4,275 patients, including 2,036 men and 2,239 women, admitted to Riverview as either new admissions, readmissions, or transfers from other mental health facilities, a slight decrease of 20 compared to the previous year. Of a total of 4,262 direct admissions, 2,059 or 48.3 per cent came as informal admissions, and 1,891 or 44.3 per cent under involuntary certification. The remaining 312 or 7.4 per cent were admitted under various legal procedures, including 77 by Order in Council, 56 by Court orders, 16 on transfer from Federal penal institutions, and 101 by Magistrate's warrant under the Mental Health Act. Special alcoholic admissions numbered 62. Separations dropped considerably compared to the previous year, by 728, and totalled 4,163, including 1,983 men and 2,180 women. Of the separations, 3,500 were discharged to the community, a decrease of 751 over the previous year, and represents 84 per cent of all separations. The number of deaths again decreased slightly by 9, to a total of 124, and represents only 2.1 per cent of total separations and 1.6 per cent of the total number of patients under care during the year. G 54 MENTAL HEALTH SERVICES REPORT, 1966/67 At the year's end there were 41 more patients in boarding-home care, totalling 342, including 156 men and 186 women. As of March 31, 1967, the number of patients in residence at Riverview Hospital totalled 2,768 (1,456 men and 1,312 women), a decrease of 47 compared to the same date a year ago. NURSING SERVICES During the year the Department of Nursing has taken further steps toward the proposed reorganization of our nursing services as outlined early in 1966. These changes have made it necessary for the nursing staff to make many adjustments, both in attitude and procedure, to meet the demands which occur through administrative changes, new concepts, and philosophies which pertain to modern methods of patient care. The first major step toward implementing the new organization occurred on May 1, 1966, when the former separate men's and women's nursing divisions became united into one nursing service under the direction and leadership of the Director of Nursing. At the same time the former Director of the men's division became the Assistant Director of Nursing Personnel and has concentrated on the personnel aspects of this large department, with improved efficiency and satisfaction in this important area. September 1, 1966, saw the appointment of the Associate Director of Nursing and on January 1, 1967, the appointment of two Assistant Directors of Nursing, who carry the continuity of senior nursing administration throughout the evening and night hours. These positions are entirely new to this hospital and are in keeping with modern concepts of nursing administration in large hospitals. The beginning of January also saw the appointment of Unit Nursing Supervisors to each of the six units of Riverview, as well as two Assistant Unit Supervisors to the two large units, East Lawn and West Lawn. The concept of the function of the Unit Nursing Supervisor has broadened considerably in that these senior staff are responsible for providing comprehensive nursing care required by the needs of the patients in their unit and within the existing policies and philosophy of the hospital administration. During February, 1967, the appointment of three female psychiatric nurses to the position of Chief Grade I marked the first opportunity for the promotion of this group above the position of Charge Nurse. In addition, five clerk-typists have become available to free nursing supervisors of clerical duties, thus giving them more time for direct nursing supervision. Since February, the former Chief Psychiatric Nurse in charge of staff rostering for the male division has been reassigned to the position of Supervisor of Outdoor Workers. This further innovation provides for better communication to the Unit Nursing Supervisor of patient programmes off the wards, as well as acting as a liaison between the Department of Nursing and the Rehabilitation Department. During the year job descriptions have been completed on all categories of nursing staff, which has assisted greatly in clarifying the function of each position and in making the role of nursing more meaningful, both within the department and in the hospital as a whole. This delineation of nursing responsibilities has also made possible the release of 28 nursing positions toward the development of non- nursing services, such as housekeeping and reception-desk personnel. Because of the increasing difficulty in recruiting suitable male staff into nursing service, female staff have been placed on most of the male wards of the hospital. At the end of the year 34 of the 43 wards have an integrated nursing staff. Integration of patients on wards has proceeded slowly, with close consideration being given to the therapeutic value as well as the economy of staffing. Five wards RIVERVIEW HOSPITAL G 55 now care for both men and women patients with both male and female staff, a change which has been accepted well by all concerned. Because of the many changes within the department and in an effort to effect as many of the newer concepts in psychiatric nursing as are applicable to this hospital, we have taken advantage of many educational programmes. During the latter part of the year, a 10-week course in " Principles and Methods of Supervision " was conducted at Riverview for 35 nursing supervisors under the general direction of Miss A. Valdstyn, of the Allan Memorial Institute, Montreal. Six nurses from our security-ward staff attended sessions of the British Columbia Corrections Institute in July, and five nurses from the geriatric wards attended an institute in November, sponsored by the Registered Nurses' Association of British Columbia, on " Meeting the Nursing Needs of the Elderly." In February and March, 33 nursing staff attended an Institute on Psychiatric Nursing, sponsored by the Department of Extension and the School of Nursing at the University of British Columbia. The emphasis of this institute was on group work and was considered useful, as this form of treatment programming is becoming increasingly prevalent in the in-patient care of the mentally ill. In addition, 137 psychiatric aides attended orientation classes offered at the Education Centre at Essondale and conducted by instructors of the School of Psychiatric Nursing. The Nursing Department has also been actively involved in contributing clinical facilities and instruction in nursing education, both to our own psychiatric-nursing students and to affiliate students from several major general hospitals in the Lower Mainland, the University of British Columbia, and for the public health nurses. Specific wards in the various units of the hospital have been established as teaching wards and have become a normal rotation for the student programme. PSYCHOLOGY DEPARTMENT Productivity and development of new programmes in the Department of Psychology continued to increase as it has in recent years. The Riverview psychologists have been active in a wide variety of functions, including group therapy (956 hours), joint and individual interviews (782 hours), and behaviour therapy (184 sessions). A new programme in group dynamics was instituted for the instructors of the Rehabilitation Department, Hillside Unit. An innovation in our After-care Clinic programme is found in the Young Adult Group Therapy. This complements our continued after-care programme of marital group therapy and joint interviews, totalling approximately 270 hours. The Department administered 3,682 psychological tests and completed 392 psychological reports for patients. In addition, tests were administered to students from the School of Psychiatric Nursing in a continuing programme of collecting information for the prediction of success in the nursing programme. In the field of research, a normative study is in progress, comparing, by the use of several tests, the performance of different population samples, including psychiatric patients, penitentiary inmates, and normal groups. SOCIAL SERVICE DEPARTMENT Implicit in the programmes and activities of the Social Service Department has been continuing recognition for more extensive integration of hospital treatment services with those of other community health and welfare facilities. To this end, unit Directors and social-work personnel were engaged in developing co-operative G 56 MENTAL HEALTH SERVICES REPORT, 1966/67 relationships and referral procedures with agencies which share responsibility for the provision of services to patients and their families. The two regionalized, acute- treatment units of Crease and Centre Lawn continued to plan and to implement, where feasible, out-patient programmes entailing increased responsibility for community-based clinical services. In line with such plans, one social worker from the staff of the Crease unit was assigned full time to the Burnaby After-care Clinic to extend the coverage of essential social and casework services for patients discharged to the Vancouver area. In addition, social workers attached to the regional service of Burnaby and North and West Vancouver were charged with providing both in-patient and outpatient services and for co-ordinating them with those of other health and welfare agencies within these specific regions. Social workers employed in the Centre Lawn unit, in addition to providing direct services, were actively engaged in unit programmes concerned with the application at ward level of the concept of the therapeutic community, as well as with the enhancement of treatment-oriented staff-patient relationships. Services to adolescents and young adult patients, while significant in all units, continued in this building to account for a large proportion of social-work time, both in relation to individuals and to groups. In the long-stay units, a major emphasis was again the selection and preparation of patients for community resettlement. A review of patients in long-term treatment during the year revealed a growing number whose handicaps and degree of disablement were such that extended-care facilities were indicated if community resettlement were to be considered. A percentage of this group, while not suitable for placement in boarding-home resources presently available, could nevertheless adjust to community-living situations offering a greater degree of supervised care. The placement of patients in boarding-home care remained an important aspect of community resettlement. At the end of the fiscal year, 342 patients were on leave from the hospital and resident in boarding homes under the on-going supervision of hospital services. The above figure represents an increase of 41 patients in placement over the previous year. The boarding-home programme in the Lower Mainland has now been well stabilized in so far as procedures, administration, and resources are concerned. As a result, social workers attached to the programme have had time for community organization, rehabilitation planning for selected patients, and the development of suitable programmes within the individual boarding homes. The statistical summaries for the department are indicative of services rendered during the year. In 1966/67 a total of 5,110 patients in hospital and 913 patients in after-care were given social and casework services. A research project concerned with a follow-up study of the social adjustment of a sample group of mothers who had been admitted to the hospital was undertaken and completed by a senior member of the staff. It is hoped that this will stimulate further studies related to social work in psychiatric hospital settings. REHABILITATION DEPARTMENT This has been a year of considerable expansion of rehabilitation services. More patients have been given a wider range of services related to preparation for community living following discharge. This has involved an increase in appropriate staff and physical facilities, and gives recognition to increased hospital concern with preparing the patient to function adequately following hospital discharge. RIVERVIEW HOSPITAL G 57 The hospital provides a wide variety of work opportunities for patients during their stay. As patients recover from their acute symptoms, it is important that they move on to experiences similar to those involved in community living. The work programme provides an opportunity to observe the patient's ability to function in the kind of situation he may have to face following discharge. Help in job placement outside of hospital can be given realistically on the basis of work performance observed here. Approximately 1,100 patients were involved in work programmes at any one time. A total of 1,747 patients were referred and were given individual interviews, during which a work plan was made and implemented. Token wages were paid and fringe benefits were given to patients on extended-work placements in an effort to duplicate conditions in the community. The Vocational Assessment Service was active this year, handling 171 referrals for patients who are planning to return to employment or seek further vocational training following discharge. These on-the-job vocational assessments were valuable in supporting referrals for community-job placement and vocational-school training as they supply the practical concrete information necessary for those working with the patient following discharge. The Department has continued to be involved with the Rehabilitation Workshop, which provides work programmes for patients who are unable to take part in the majority of hospital activities. There has been an expansion of small work projects onto wards and an effort has been made to obtain contracts and materials from the community which are suitable for stimulating groups of rather limited patients. This is a joint venture with the Occupational Therapy Department. The rehabilitation residences, Vista and Venture in Vancouver, have been active. They have increased their total bed-count to 23 and are supplying a vital link in the re-establishment of patients in the community. There has frequently been a waiting-list for beds in these residences, which has been kept to a minimum by an active programme. A total of 66 patients has been resident in Vista and Venture during this year as they progressed in their rehabilitation. These residences also provide a drop-in programme for patients who have been discharged into the community but who still need some contact for social or vocational help. A new service within the Rehabilitation Department this year is that provided at Hillside unit. Hillside is a 60-bed residential unit with a staff of 20, which provides specific preparation for community living for patients who are unable to return to the community without improving their ability to cope with the normal demands of society. This service is designed particularly for the long-term patient who has become very dependent on the hospital but who is no longer so ill that he requires full-time hospital care. The programmes here teach self-care and appropriate social behaviour. For patients who will seek employment following discharge, a vocational training programme is provided, as well as help in job-finding in the community. The Hillside unit took its first patient on August 17, 1966, and has had 78 patients in the programme up to March 31, 1967. While this new unit provides a significant service for its patients, it is also viewed as a pilot project to evaluate and improve techniques of rehabilitation within the psychiatric-hospital setting. OCCUPATIONAL THERAPY DEPARTMENT Throughout the year the occupational-therapy programmes were maintained, initially with difficulty because of some shortage of qualified staff. However, with the appointment in October of four English occupational therapists and two recent graduates from the University of British Columbia, the tempo of activity in the department changed. Under the direction of these therapists, significant progress G 58 MENTAL HEALTH SERVICES REPORT, 1966/67 was made in a number of areas. In North Lawn unit a new occupational-therapy workshop was developed, to remotivate a group of physically disabled male patients resident in the unit. The patients, who were previously unemployed, now work daily on simple dismantling jobs for outside contracts. This work, combined with physical exercises and a varied social programme conducted on a multi-disciplinary basis, has resulted in increased mobility of the group and an improvement in general behaviour patterns. Building changes in Centre Lawn unit resulted in the closure of the Occupational Therapy Woodwork Department. In place of this, a heavy workshop was set up in part of the old Public Works building. The workshop is intended to provide a more realistic work situation for male patients returning to construction jobs and allied trades. Under these conditions an assessment of the patient's skill and ability to perform can more readily be made. As this programme is allied to work of the Department of Rehabilitation, referrals to the workshop are co-ordinated by one of the Job Placement Officers. Steady progress has been made in the boarding-home programme following the appointment of a full-time therapist. The therapist and Co-ordinator of Boarding Homes, in conjunction with the sponsoring local groups of the Canadian Mental Health Association, started two activity centres in White Rock and Haney. These centres, which opened in October, have enabled the therapist to use a wider range of techniques. Assisted by interested volunteers, a varied programme of social, recreational, and educational activities has been well attended by patients boarding in these areas. As in previous years, educational commitments were fulfilled. Eleven occupational-therapy students from the Universities of Montreal, Toronto, and British Columbia interned in the department during the summer months. It was noted that this year the calibre of the students was particularly high and their contribution to the hospital programme most worthwhile. Throughout the year, occupational-therapy staff in all units of the hospital were active with 3,349 patients, an average of 620 patients daily. A total of 100,665 treatments was given during the same period. RECREATIONAL THERAPY DEPARTMENT Following unitization of the hospital and the subsequent integration of nursing services, the Recreational Therapy Department has striven to adapt programme methods and staff coverage to meet the needs of the rapidly changing treatment patterns. The initiative in the use of recreational therapy as a treatment modality, as well as in meeting the general recreational needs of the patients, increasingly rests with the nursing staffs. The total extent of the use of recreation as a treatment medium within the hospital is not, therefore, necessarily reflected in the attendance reports. Nevertheless, under the direction of members of the department, there were 6,327 sessions, with a total attendance of 224,721. Highlights of the Department's activities included activation programmes for regularly scheduled keep-fit activities. Special vacation programmes were coordinated with the Rehabilitation Department's annual vacation policy for patient workers. Ward parties, card-games, and afternoon teas were convened on more than 400 occasions. The use of music in many forms showed a decided upsurge during the year with the employment of a part-time staff music specialist. Two periods of resident camping, using the facilities of the New Westminster Y.M.-Y.W. Camp Garibaldi, were conducted for groups of patients from the West and East Lawn units. RIVERVIEW HOSPITAL G 59 More extensive use was made of nearby community resources and both bus and station-wagon trips took many patients to various events or points of interest. There were 230 such expeditions. The Department has also made available a list of recreational resources available in the Greater Vancouver area to help patients re-establish themselves after a period in hospital. The patients' magazine, " The Leader," continued to be published under the direction of the Department. Thirteen issues, including a special issue marking the Provincial Centennial, were circulated within the hospital and to institutions and individuals around the world. Approximately 20 patients are occupied in writing copy, editing, and compiling each issue. PATIENTS' SCHOOL The school was open for 223.5 regular school-days during the past year. Ninety-three patients (21 female, 72 male) were enrolled. This was an increase of 24 per cent compared to the previous year. Sixty-four of these attended the daily classes and 29 received instruction on their wards. The enrolment included 38 adolescents with an average age of 16.3 years and 55 adults with an average age of 29.5 years. Thirty-three students or 35 per cent were discharged after an average period of attendance per patient of 7.6 weeks. The extensive range of the studies undertaken by the students reflected their widely varied educational needs. Both the standard grade curricula and correspondence courses from the Department of Education were employed. Thirty-one students were enrolled in the elementary grades, 39 in the junior-secondary grades, and 17 in the senior-secondary grades. Two students advanced their university studies and four new Canadians attended in order to improve their written and spoken English. For the majority, completion of an interrupted school term and personal advancement by means of both academic and technical subjects were the principal goals. Although all the hospital units were represented by the enrolment, 30 students, approximately one-third of the total enrolment, were patients from the Riverside Unit. This ever-increasing participation among Riverside patients led to the formation of a second class in that unit and weekly instruction was made available on both security wards. RADIOLOGY DEPARTMENT The Department of Radiology took 15,806 films during the year and examined 11,069 patients. There has been a slight decrease in both the number of routine films taken and the number of patients examined, as compared to the previous year. There was, however, a significant increase in the number of more complex procedures such as intravenous pyelograms, femoral arteriograms, aorto- grams, and venograms. This department has continued to provide a comprehensive diagnostic service. Early in the year a modern new X-ray unit, equipped with image amplification, was installed, which has improved both the efficiency of the department and the quality of the work. DEPARTMENT OF LABORATORIES This department reports activity maintained at the same high level as during the previous year. The total number of procedures performed is 76,730, representing 145,196 units of clinical laboratory work. Hematological, biochemical, microbiological, and histological procedures continue to constitute the greater part of this G 60 MENTAL HEALTH SERVICES REPORT, 1966/67 work load. The biochemistry department continues to provide some special services for other institutions through the performance of serum copper determinations and quantitative urinary porphyrin estimations, and has established analytical methods for L.S.D. analyses, utilizing the recently acquired fluorospectrophotometer. The pathologist and technical staff continue to participate in the investigation of melanin metabolism as it relates to the etiology of schizophrenia. Our laboratories function as a training-school for laboratory technologists, and again received approval from the inspection team from the Canadian Medical Association for this purpose. DEPARTMENT OF NEUROLOGY During the year our technicians completed a total of 957 electroencephalograms, of which 704 were done at Riverview, 200 at The Woodlands School, and 53 at the mental health centre in Burnaby. Of the 704 cases examined at Riverview, 94 were referrals from either the Provincial or Federal Penal Services. Dr. P. Bratty has continued as our part-time neurological consultant, visiting the hospital regularly to prepare electroencephalographic reports and to provide clinical neurological consultations, which totalled 184 this year. Dr. F. Turnbull has also continued to provide neurological consultation, and carried out 27 neurological operations. PHARMACY DEPARTMENT The pharmacy has been faced with a year of marked increase in its prescription services. The total number of prescriptions filled for the year was up one-quarter to a total of 25,807. Most of this increase was related to the large number of outpatient prescriptions filled for patients in boarding homes. Nearly every patient at the time of discharge receives medication to carry him through at least the initial phase of his discharge from hospital. For those patients who continue to require psychiatric medication, their personal physicians in the community may submit prescriptions to the hospital. These prescriptions are for those patients who could not ordinarily afford the rather expensive psychiatric medications and who would probably discontinue using them. Besides the individual prescriptions mentioned above, the pharmacy dispensed 48,500 items of ward-stock pharmaceuticals, as well as 13,500 items of surgical sundries. DENTAL DEPARTMENT The Dental Officers continue to provide a comprehensive service to Riverview patients, but report they are receiving increasing numbers of requests for dental services to the newly admitted patients, or those who are only in hospital for a short time. It is only possible, however, to provide basic dental service on an emergency basis for these short-stay patients. For the longer-staying patients, who tend to be a more elderly group, partial or full dentures are being requested in increasing numbers. During the year 2,896 patients were seen and 9,620 dental procedures performed. CHAPLAIN SERVICE The effectiveness of the chaplaincy service was greatly enhanced during the year with the provision of improved facilities in the Crease unit. In April a new office was provided for each of the two chaplains on the second floor of the unit, which is much more accessible to patients and which provides a greater sense of privacy. In May the Public Works staff also completed the building of a small but RIVERVIEW HOSPITAL G 61 beautiful chapel adjacent to the chaplain offices. In a special and perhaps unprecedented service this chapel was consecrated by Bishop G. P. Gower of the Anglican Church and Bishop J. Carney representing the Roman Catholic Church. Since then there have been daily services in the chapel, which has also been used frequently by patients as a retreat for prayer and meditation, and on several occasions by clergy from the community for a private service for a patient and his relatives. Regular Sunday church services have been conducted in Pennington Hall as in past years. In addition, " Illustrated Bible Hour " programmes, using filmstrips and recordings, have been introduced and provided for patients most weeks in Pennington Hall, North Lawn, and on the Riverside security wards. During the year 286 visits were made by clergy from the community to patients in hospital. This is in addition to the weekly visits by Pastor Vinge and Pastor Klein, the two institutional chaplains of the Lutheran Church, and by Pastor Bottlin- ger, the chaplain to the deaf. LIBRARY Activity in the Patients' Library has been concentrated on keeping abreast with current best sellers, expanding the reference section, and purchasing a wider selection of non-fiction. Almost 6,000 books were borrowed during the year. In addition, the small collections at North Lawn and Riverside were used extensively. Patients have continued to help in the library, and have also continued to contribute book reviews to the hospital's magazine. Thirty-two popular journals are now subscribed to, several of these subscriptions were donated as Christmas gifs from charitable organizations. In the Medical Library, 1,606 books and 1,849 journals were circulated. These figures are considerably higher than in any previous year and emphasize the heavy use made of the library's collection. One hundred and fifty-three inter-library loans were received. This, too, is a record and reflects the increased use made of periodical literature. The library's collection was augmented by 206 new volumes, bringing the total bookstock to 3,737. Literature searches continued to be made not only in response to questions from Riverview staff but also in answer to queries from other Provincial mental health institutions. Acquisition lists of pamphlets and new bookstock have been circulated regularly to Provincial mental health centres notifying them of the library's expanding resources. MEDICAL RECORDS DEPARTMENT The Medical Records Department was extremely active throughout the year in its function of maintaining the large volume of medical records for which it is responsible and in its continuing endeavour to improve procedures and forms. The new admitting office in the Centre Lawn unit was opened in May, 1966. This admitting area is the main centre for recording of admissions and discharges to and from the Riverview Hospital and is in operation from 7 a.m. to 11 p.m., seven days per week. This extended coverage necessitated an increase in clerical staff. The senior admitting clerk conducted several formal classes to acquaint the new staff members with admission procedures, hospital policies, and the regulations of the Mental Health Act, 1964. Considerable time was devoted to the completion of 2,270 admission statistical sheets on in-resident patients admitted prior to April 1, 1965. This special project was carried out in order to enable the Division of Vital Statistics to compile data for the annual report in reference to the in-resident population. G 62 MENTAL HEALTH SERVICES REPORT, 1966/67 VOLUNTEER SERVICES The Volunteer Service of the Canadian Mental Health Association at Riverview has completed a busy and active year. A total of 128 volunteers gave 16,044 hours of voluntary time to the patients and staff of this hospital. The apparel shop was again a hub of activity. This facility served a total of 2,355 patients individually and a grand total of 14,365 articles were given out from the shop. Our patients in boarding homes of the Lower Mainland were accommodated fully from apparel-shop supplies and with new clothing issued through it from the hospital Stores Department. Since June, three volunteers have provided a new service in the admitting suite at Centre Lawn. Volunteers extend hospitality to the relatives, and generally assist the staff in accepting the new patient into the hospital. During slack hours these volunteers spend their time visiting the wards. In June, the volunteers organized a group of professional hairdressers who completed a programme of beauty culture in the East Lawn Building, involving 40 patients and 10 student nurses. Following the programme, 40 boarding-home patients were also invited to a professional shop for beauty treatments. This first attempt to involve this group on a community level was most encouraging. Tours through this mental health facility saw approximately 738 people accommodated from various units. A new programme inaugurated during the year and referred to as the " Volunteers Luncheon Programme " provided an opportunity for 158 patients to visit the homes of volunteers for luncheons. These special visits have been much enjoyed by all patients involved. During the year the seamstress from the tailor shop was transferred to the supervision of the volunteers in the apparel shop, where 1,482 articles of clothing were repaired, mended, fitted, or altered for patients' use. BUSINESS ADMINISTRATION During the year there has been considerable effort expended in several areas of the hospital to improve or to project future improvements to our facilities, services, and methods. Structural improvements completed during the year included the installation of new X-ray equipment and renovation of the main X-ray room housing this equipment in the Crease unit, as well as the installation of carpeting throughout Ward West 3 as a trial project. West Lawn unit received a complete interior decoration, and a complete renovation of the C 4 dining-room. In Centre Lawn the main entrance foyer and the main dining-room and kitchens were completely renovated and modernized, and a start made on the development of Ward D 5. East Lawn was also redecorated throughout and supplied with a central linen-supply area. Other improvements included the provision of cablevision and a sound system for the Hillside unit, improved hot-water storage for the laundry, and a new road and drainage in front of the staff residences. Specific studies and reports have been prepared on the requirements of the Riverside Building, the swimming-pool building, and renovation of the former Public Works building to provide for expansion of the rehabilitation workshops, as well as renovation and relocation of the H 1 dining-room facilities in East Lawn. An evaluation of hospital housekeeping requirements was conducted during the year and a comprehensive report prepared which indicates a need for improved and expanded housekeeping services throughout the hospital. RIVERVIEW HOSPITAL G 63 On October 1, 1966, Mr. W. O. Booth, formerly of The Woodlands School, was appointed as Business Administrator of Riverview Hospital, replacing Mr. N. K. Barr, who left the Service to become Hospital Administrator for the Royal Inland Hospital, Kamloops. DIETARY DEPARTMENT During the year the dietary staff planned and prepared a total of 2,900,036 meals for patients, of which nearly a quarter were special therapeutic diets of all types required in medical care, for reducing, or to meet the needs of an increasing geriatric population. In addition, a total of 161,921 meals was served to staff, of which 4,351 were special diets. Dietary staff also provided catering services for many Recreational Department social activities and other special occasions, involving activities for 3,786 staff and 73,293 patients. HOUSEKEEPING DEPARTMENT This newly formed department expanded in July with the appointment of four new staff from reclassified nursing positions. At the same time, the first training syllabus for housekeeping staff was prepared for the orderly development and training of present and future housekeeping and cleaning staff. This Department has now taken from Nursing Services the responsibility for operating the central linen rooms now established and functioning in the Crease unit, Centre Lawn, and the North Lawn units. INDUSTRIAL THERAPY During the year more than 2,500 patients were enrolled in the industrial programmes, which have offered many media of interesting employment in manufacturing and repair. Opportunities have been offered to patients in the pursuit of advanced technology, inventive and experimental outlets, electronics, photography, public address system, machine shop, welding, and metalsmithing. The mattress-manufacturing department is now making urethane-filled mattresses which are light to handle and ideal for emergency transportation, and which will eventually replace the felt mattress. A bed-renovation programme has been in progress throughout the year. Three thousand beds have been stripped, refinished, and provided with new springs. A personalized service has been offered to patients in the way of a " While- You-Wait " service on shoe repair, hearing aids, electronic items, radios, and small personal items. Through the 12-month period, the Flm Library shipped 1,667 films to borrowers who comprised an audience of 49,000 viewers. Of these totals, 46 per cent of the shipments and 38 per cent of the viewers received service during the final four months of the year, an indication of the increasing use of this facility. A new programme inaugurated on February 1, 1966, is one in which film is used to stimulate patient groups or activities. For this purpose films are borrowed from community film libraries. This service has provided 107 showings for 5,270 patients. LAUNDRY The Riverview laundry, which also services Valleyview Hospital and The Woodlands School, processed a total volume of 10,464,444 pounds of linen during the year, an increase of 179,448 pounds over the previous 12-month period. The average volume per month also increased proportionately to 872,037 pounds. G 64 MENTAL HEALTH SERVICES REPORT, 1966/67 BARBER AND BEAUTICIAN SERVICE The beauticians continue quietly to carry out their efficient hair-dressing functions and are responsible, very frequently, for the improvement, not only in appearance but in spirit, of the patients they serve. They have effected 47,707 treatments during the year. The barbers have also been busy, particularly in an effort to meet the changing coiffure demands of the male population. Personalized service is rendered as often as staff and facilities allow. There has been a great increase in the number of patients being sent to boarding homes, on leaves, and on discharge, which has increased the demands on the personal services of the barber department. The barbers were involved in their first job-assessment placement this past year, assisting a patient who was a barber to become re-established into the community. The patient is now gainfully employed in a Vancouver barber shop. PODIATRY SERVICE The Podiatry Department provides service to the Riverview Hospital for three days per week and to the Valleyview Hospital two days per week. The Woodlands School has received service on a referral basis. Regular consultation with the Surgical Resident and Consultant Orthopaedic Surgeon has been established and as a result cross-referrals ensure a better follow-up of those patients requiring surgical treatment and appliances. TRANSPORT SERVICE Our Transport Division has rendered consistently dependable service to Riverview Hospital, The Woodlands School, Valleyview, boarding homes, Venture, Vista, and the community during the past year. The mechanics have serviced, on a regular basis, 64 vehicles and 10 trailers. Thirty units have worked directly out of the Riverview garage. In addition to the thousands of passenger miles, transport have moved over 20,000,000 pounds of laundry, together with many million pounds of foodstuffs, stores supplies, and hospital equipment. The department is radio- equipped and is on constant alert for emergency services. ESSONDALE CIVIL DEFENCE DISASTER ORGANIZATION Although general interest has waned considerably during the year in Civil Defence planning, the Essondale Disaster Planning Committee has remained active and met on several occasions to further review our facilities and organization to meet emergency situations. On two occasions the Riverview Civil Defence Communications personnel were involved in a communications exercise with the Vancouver Target Zone and sector organizations. 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 the event of a Civil Defence emergency. RIVERVIEW HOSPITAL STATISTICAL TABLES G 65 Table 1. -Movement of Population, Riverview Hospital, Essondale, April 1, 1966, to March 31, 1967 Male Female Total 1,440 131 80 5 1,375 170 75 3 2,815 On extended leave, carried forward from 1965/66— 301 Other 155 8 1,656 1,623 3,279 Admissions—■ 980 9 1,047 984 5 1,250 1,964 14 2,297 2,036 2,239 4,275 3,692 3,862 7,554 Separations— 1,937 61 22 4 156 52 4 2,181 68 11 4 186 100 4,118 ni.rl 129 33 8 On extended leave and still out— 342 Other ... 152 4 2,236 2,550 4,786 + 16 1,456 -63 1,312 —47 2,768 i Includes 3 male and 4 female transfers from geriatric facilities, 5 male and 1 female transfers from facilities for the mentally retarded. G 66 MENTAL HEALTH SERVICES REPORT, 1966/67 Table 2.—First Admissions to Riverview Hospital, Essondale, by Health Unit and School District of Residence and Sex, April 1, 1966, to March 31, 1967. Health Unit Male Female Total Health Unit Male Female Total East Kootenay, Cranbrook— School District No. 1 1 4 4 1 4 3 4 3 1 8 2 3 3 2 4 3 3 7 1 1 4 2 9 6 9 1 6 7 2 5 5 6 3 4 16 3 5 6 2 6 4 4 14 1 1 7 2 15 7 15 2 10 34 23 5 29 22 14 127 13 57 51 13 11 11 Central Vancouver Island, Nanaimo— School District No. 65 5 2 7 7 4 „ ?■ 2 3 1 1 2 2 3 8 1 2 3 2 1 1 7 9 „ 3 - „ 66 2 „ 4 „ „ 67- 6 11 3 9 1 2 4 4 7 8 1 4 1 1 7 3 2 12 1 22 2 5 37 390 62 50 22 13 „ 5 „ 68 18 „ 18 „ „ „ 69 3 „ „ 70 8 1 5 6 5 7 12 6 2 14 7 3 3 5 7 1 1 5 14 1 44 5 3 1 26 336 49 30 10 5 1 6 17 School District No. 7 „ 79.... 2 „ 8 Upper Islands, Courtenay— School District No. 71 West Kootenay, Trail— School District No. 9 7 „ „ 72 . 10 „ „ „ 11 „ 85 .. 9 „ 12 North Okanagan, Vernon— School District No. 19 Cariboo, Williams Lake— School District No. 27 14 „ „ „ 28 20 „ 20 ..... Skeena, Prince Rupert— School District No. 50 „ 21 7 „ 22 „ 51 2 „ ■> „ 78 „ 52 21 South Okanagan, Kelowna— School District No. 14 „ 53 11 „ „ 54 4 „ „ 15 „ 80 . 4 „ 16 Peace River, Dawson Creek— School District No. 59 , 60 „ 83 Northern Interior, Prince George— School District No. 55 „ 17 12 „ 23 „ 77 3 7 1 South Central, Kamloops— School District No. 24. „ „ „ 29 6 1 6 2 7 17 12 3 20 8 7 73 8 31 27 7 6 4 4 „ „ „ 30 „ 56 7 , 31 57 „ 58 Greater Victoria Metropolitan Board of Health- School District No. 61 26 Upper Fraser Valley, Chilliwack—■ School District No. 32 3 17 11 2 9 14 7 54 5 26 24 6 5 7 2 66 „ „ 34 „ 62 . .. 7 .. 76 Central Fraser Valley, Mission City— School District No. 35 „ „ 42 „ 75 63 „ 64 . Metropolitan Health Committee, Vancouver— School District No. 38 „ 39 8 1 63 726 Boundary, Cloverdale— School District No. 36 „ 37 _ Simon Fraser, New Westminster— , 41 „ „ „ 44 „ 45 School districts not covered by health units— School District No. 49 111 80 32 5 „ 43 , 87 1 3 9 School District No. 46 _. „ 47 Totals 932 978 1,910 48 ..._ RIVERVIEW HOSPITAL G 67 G 68 MENTAL HEALTH SERVICES REPORT, 1966/67 w cn g < cu __ O P. o I w o < o O < rejox Pubjo so B s Imr-Cl !hh" I I i I IM'tr. ! CS! SO cit-i *■_ ; cs ' -r-t y-t cn : cs *=i" I *H It-iNNH ! esi NH " rt^ i *n ; l tn \ ca t-i HH CO I l-H HHVO Nh ; T-t cn *M iCAQsCA \ t* «o ; «o I tn th ! T-i CS i co (SHin I m cs : CS CS " CS ~j rH SO CA ON S H H H n !rl ! ! CS ! I i i c^ th I cs i i : i ! iii! :-|(N TS ■* | t-F< "I 11 i C. r. "! rH *# IrH I r. m t- -. ! i-t iii i i cs ti icn^H : cn ^ i cs m l^t n j i tn T-t t-< c- oo T-i cn II 111 I Os tn ; cA in tn \cAso as piHNmmHiomH cs i th cn r- CS CS CS ti t-i '■3 <_ __ o. 9 •a §•__ B Is • _. OJ IS O'c* 3 O B(j. rt u q D. o cd u s u _. rH CS 00 CO I I I i ! ! Mil °3 _3 3 2 i 5 s3 tu S _1§f a a § o c. _? _, <_ a ~ '3 a ^ QO-. gj, g 0 _J IrJ _) *■ a c 8 £ & .. S o sip • 7_! 35 o . -2 cS -fl > > b ■ !'?§.'3S! ' O O cn •o " . _ hil -» o -» 2 o U m w ^j >. >. ^_:^ _ ° ° 6 9, o mm & b ■g 5? «h s B <s <3 a.2.___o. a .5 j=p< +- CJ i R8 i , = 3 5 £? a 5 'o fi T3 I 3 Tt 3 U a__ s-3 P C-: -_ C Ph<!B. : o fl -a I O rt •fl '^3 «_ o u '- O O nj m i •^ -Q fi *rr_ ' y U M C3 . gj &£?*§ , Pt P-i.« g • X tr_ ' C >> <Xi Jh (tl w_ 3 oz RIVERVIEW HOSPITAL G 69 m th cs » | so tn T-t Tt T-ttn th ! cn CS IrH ■I I I I I ! ! j »h jcn^iH^io | ! i i Iii tH lHhr.m i I i i i i i j I I I i Tf r-t ^ ! 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TJ >* rt • S*a 3 3 5 8 R 8 Oi 0, ■- N S O U 5 B.^2 ) &_ Oh ■a qj r. s i a a si§ 2 &3S sill ■a °« qj T- K rt TJ B qj B I rf „ rt a o II I g S 3 !<i_OSm 1 __■ 5 &s qj QJ -a ■§11 ill tu T3 u «g I CD d L &**'§ S3 « .23 rt 3 O ftnO -A rt -fl If J to ja fl •g'S.a bD-fl <fi tL> 3 O 4> >h •9 b_ > 111 j a OJ .2 E-B D.TJ H a QJ «9 .. ra _J S § y- 3 ■_« « i « sSaf t? 2 *S 1 ° I f rt B rt „ oSS __^ 9 ; T_ *0 lip __ < o «J % &UB a ™ 2 2.2b ** § « u 5 fl S-fl --H j_, (w rt Tn __i -H T) T3 .H : ti _.^ D O S § o ™ 43 3 ri B S qj (_ -B _* s *| rt g-S p cn H U rt 5j 161 O U M •SJ-S UOQ G 70 MENTAL HEALTH SERVICES REPORT, 1966/67 X w </_ O z < Oh" -3 O P- o I w o 8 < 6 < H Z t~H ^ r-T CO ▼—I co w X d ° go pq H ON HH r-l Ph « a x _. « )_. w > o H «_ Z o < W w r-l PQ 3 Tf OS rH 00 Tt cn cn m \o cn th \o t^^f m cs vo *-» th >o r> l^JOX PUBJQ cn th m t-i r-t cA oo" cnTt tn oOTf ■rt cn p. p H s T-t en a > -2° p. a n j * j | j ~ ~ i 1 i j i 1 i ii ii" ii •" 111r 1 II CS | rH CH | J p. ! ! Ii I I Mill ] II 1 I a ~! : : es i : »h 1 1 th cn i cn th i | cs tn \ | 1 | 1 rH 1 M 1 1 VO iiiiiii 1 J i 1 I ■ 1 i iii 1 u. i i ! i iii i i : 1 III a i"": it i i | vo : nm "imHri i m i ~i i Iiiiiii i ! ! iii jrn rH |cn | j ; it r. *n : cs m es : rj-oonm i i :h : i : tn .A p. a m i A p. 1 rH CS .1 1 ! 1 I I i i 1 i th i ies i es en e- : Tt cn :cses 1 i tn th i rH »n a 1 1 1 Ii ! i it^eS 1 oo m cn vo i vo Tt i l |in :»h | ca ^ fc ! ; jes es i rn ] ! III.. a 1 " rt ft __J O IH So Tt Is! " 1 1 ii II 1 r i ii II! Tt i CS iTHCSrHrHrH^O sQ \ rl tn CA 1 Ut 1 p. i a i-i : es tj- rn \ so as i Tt cn es | i r m r ~ i 1 1 j c_o < cn p. 1 " rtS 1 1 1 1 ! 1 i a ~l IP.Ttmc.TTcn 1 I rl 1 1 CS 1 1 1 TH i| 1 IM t-i I cn I i cn j | es cn j | |th | j [ i i i 1 Tt 3 Ph M 1 1 ! i ! 1 II | | a cn i f- cn cn :p.o>~! 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B ¥ at a ■r a a 0 OJ 0 t- i X C a •g c a *a_ E ■_ t c C > _ _ - T 'c - 1 u -•7} c 1 B 1 1/ I C QJ -_ s £ C _- a c X 1 i- 1 ■r i 1 c, i ,2 (/■ C g c u c ■8 . t < Psychosis of other demonstrable Resulting from epilepsy and Secondary or due to infectiv Secondary or due to disea D9 » OO 5 •3 o QJ 3 •O O it O O U CO i X X t. rt C a c t V- c > a 1 c <_ (L ir. fc c c <u c -c 1- c . > 1- cc •c c c u a i C •fl a. p.._ 'O _ qj a S fc 11 3 C •o _= B fc _3 o 'C 1 •= c t >€ "g 1/ C rE u > a" P- i B t > ._ < B ■| o rt CU ■- I C c t rt OJ i- t ! p- RIVERVIEW HOSPITAL G 71 l tn thc-th tntriT-tt^cAtncAT-t cno\sOcAOt*~T-tT-tcA~ rH rH <n Tt rH tn n T-t t-h -B-' 11 I i i I CS ' I " I IT I . f es, i i i tH I | CS rH I I th cs I cn es I I rH Tf TH j Tf III | rH IrHCSrHrH ;rH cnrH ; m CS Cn fib I Os rH ' "i th h "-j ! es I CS rH I rH VO Tt SO | Tt Tt ~| T-t iHHfCl t-i I I tn CA CS th cs cs es rn es I I rH |HH(J\ cs t-- 11/1 ch imm i r-t cS O & 0 " U Vi P >. o S3 OZfc J rrt -rH N _3 Q W _s^«^u« J«l. RIVERVIEW HOSPITAL G 73 B cn s cu § a w CO O I _J < H Z ca « uf gvo 05 rH w - SiS C. %C H* 00 «. rH rH 00 rH rH Ph rH r- Tj- CS VO rH OO Ov rj> 00 CS O 00 CS rH rH rH V) VO O O CS 00 CS -_ V. rH rH rH CS VO rH rH rH CO < P. S « ,3 9 ?« E w I B rH fc) o z _a I pa Z 2 ►j 5 &j o M -3 _. ■rt cnTtooTtot^Ttt^t i 9| so I 2 fc _a_ a i es cn ii i cnirii-irHcn irHTtcnes Mis r-vOcsrn jTtooTtwi<ncs jcn rtcoTtn | t I e "\ I I I ill th Tt TH en CS rH Tt O VO I tH I tH i es >n Tt cs co Ttcncncnes i in m cn «n T I es th Tt vo vo jrtVO | THTH I es m ts esj i ii I I T-i I T-t CA [ h vo ov cn en I I I CO rH rH VO rH I CO VO fc T a &, T Si fc a a p. "ST CSC.- IHIOOIH l irt I ! Irtrt ; |<S I ! I ! th ca Tt es i es en cs j rt I Ct I es r-t Tt cs T-t th i Tt es cs I cs i r-i en I Cn rt rH rt rt I I I II I!I I | IrH | | t>cs I I 11 As T_ rt _h 8 fi H O m B « od ._! ? a ill III o 6 s III »S_ _. ^ w QJ 29 o B a j. S 8 BVg.fi !_. 5. Sou rt «? o o &-a l__ i if 8 CO 4i *H CO ""3 KJ Ph CO Ph Ph < ft. , cn O cft '"3 a "3 _! ^> 2 Q .-§■§■8 ._. d o Si I ll •a j3 g m _. S?»>.5 8b'3»'0 §s8l2 ■ &•§* § U V W g J- 5_ <3 * _. «? o-5oZfc 8 _>' __■ HI ■9 5 fc fl" O CQ 11 0_3 6. 9"S 2 g CU o o ™ 03 •§ ■si8 5 0 0 IH •3 ca S o 1 lis 111 3 O W Ill OfcSC CU _ ill! t. rt < "2 sJ_ fl O b So 9 — iH -fl o -2 o T3 __ ||| J3 a* uwo _? fl.g 00 G 74 MENTAL HEALTH SERVICES REPORT, 1966/67 8 I Q H Z fci 5- m tO pa a o n a g O \o 3 VO < ON O rH CQ -. ., *H Z tr> to pa pa u C-H w pa i-i 3 0 on z o Cfl < o 2 < (_T D o « o 8 « > B. pa s fc o a> H Z w H Hj Ph Ph Eh T),_-. mooencsoooven*- cScScnr-eSrtrtcnTtc- Ov Rf. es en OH iriTten ; Tt m oo irtrtcseNrt inm j cn m 3 fc si! I I Tt H s m I? fc i i i : i i i i i i i : i i © £6 a '"' 5 fc' 1 i i ! i 1 1 I i i MMM a cs vo rt II M 1 i II ! Ml ™ Tt p. 1 i i i i t i M a t~- c ON p. M I M 111 ill tn a tn m cs ; j i III en 5 p. CS ill IS 1 1 1 1 1 1 1 cn m a 1 1 1 1 III 1 1 1 u I p. rt Mi MMMM rH Tt CM Tt a Mil i II i i II i TH - Tt p. es j CS 0. A . rH O ** a ^ M ■ *** 00 fc H 1 1 1 1 Ml MM CS < 1 a en iiii 1 i i i i i i i i M 1 ^ Tt p. i i i i II i i i i II i 1 i i i CJO cn a iii I i i i 1 i ! M i Ml i i i II 1 M M i i ov tn ^ N i | || r | ll || j | ! i i l cn CS : i 1 1 i j 1 'II th es a ! i i 1 1 ! i i i ! ! i 1 i i 1 5 © CS * MM! II II 1 M I II 1 a II II 11 1 1 II II1IIII HI Os 7 fc ! ! ! II 1 II ! II II 1 II II i a 1 1 II II II 1! II II II 1 1 | Tf O & 1 II II 1 1! II II II 1 1 1! j a MMM i 1 Fi o a, c B o 5. a tj *h3 o cn "ca Cf 6 c i s o co cq u o ■3 _. s Q 1 o rH 43 .y VM o a o *__ 3 _3 Q "rt a 1 •a _. c i t 1 r- * S 1 C/_ C c t £ 1 8 1 1 2 c i t 1 fl C o B e 'Z 4J t rt rt __ s £ 1 ei "J? c __: u > "c. C 1 c u g c X s < 1 c c E <u ■a t- < a. '7 C -C u i c ■s _ 0 TJ QJ VC 1 B •a S s 0 1? B? -. rt B OJ 5 •■ 3 > *3 •si o 0 rt c £ i ii IS c ! Ih 1 1 5 m ■c U 1 3 !z p 1 c i tj 1 _- -D o C c 3 0 <u _ 1 > | ■5 | E B ■a t '5 I 2 p. •- c c - < c c t X ti fl __ c 6 § i •a S g a £ i E c t- •o e if & rt _ Q '£ c _. o z s o 1 •1 I Ih X) o •a o 1 U 0 0 0 H RIVERVIEW HOSPITAL G 75 5 o f* o pb O < tn O Z o JS (h -3 H Z pa « a s O vo Z vo W Ov E-h ,-h m v-h ^ p. Z o H a O pa" ►a I z o a> w -? H r-l fc cn > Ph pa fc o o_ H z S H <! a. p. _a P9 a w O pa Q x" pa t/_ D Z < rt ca 3 H fc so fc g >H CO 00 V. CN rt CO i rt *fr rt Iff, rt ICSCS rt Cl vj n O CO ! CO ,„rt I rt CS rt jrt | |CS i i I i MMM i" i r IT p. IT i ~w *a" o a rt S I IrH | | I I I I ! II i i I l i : i l I I MM i ! I i I I MMM i I i i i i i I oug •a rt a K jj y •o .fe *3 oj8 1 & I J_ QJ a O.'Vs O o 3 iH saj. rt j j rt i e ' a ! 8-S i t_ S c ' _3 8 *ri IS? I _?■_■ « ia»S i _ O W OJ U H4 l^fi P r. O U w ',■; n ni n ~ g CO « o a .g .g a 8 _a & _3 rt u QJ Q QJ H QJ >, O >. ri ui «) rt « fc fc fc <fc S3 P ill Iii a rt o •o g i 9 ...fe rt QJ te t3 a __ o-3o 111 2 £ « © ±_ fl c S » co 8 fct fl -fl A ■-■§___- §111 rt 1 S u O Q, o fl a » ._ cu TJ a> f si c3 __. o l|l I-l O I I __0 •|z 4> CD as rt rt f"S'_! S&2 ■g -a jj a SI'S a •° ^ .2 frt a a § _=_3-g UUQ G 76 MENTAL HEALTH SERVICES REPORT, 1966/67 _a < _a ►a < Z < z PJ H pa 2 Z pa S P5 £ >< pa n >< w Q p. w p_ w > Z P < O Q Z < pa ffl < fc 0 PC z 3 w o < O to 1 pa fc n OV o vo H* VO co vo to vo o VO P. vo pa OV OV < OV <1 l-H H v-H pa r-l fcl t-H vo cN rtH Jh v—1 CO CO o CO fN p. pa p. in A . pa i-i < a z o fc fcl -a < W w « « pa 1 < a z a a a fcl pa Q pj o u Z u w to w o w u CO p wo to CO P * I-l X w X ►4 pa < pa cn _a < P-1 w < a Z Ph CO o a z Ph Q Z 3 rr1 fc CO O X < K < to 0 < 5. -1 £ I* < X < rt o £ H cn > H 1/3 va H !/_ 73 <1> pa fc 5 fc w fc a _a > o pa > (3 O W O H-> rO H H > H O a z p. o to O o z c-; O z «_ rD fc O r/i pa 07 fcl fc pa o _l S to" a S CO n O Ph CO O o o to n VJ O PQ Z ffl Z O s Z o pq z o OQ Jj P z o z o < p > O § l-H H Hj 03 H HI ►J H h! i-I __ fc O Ph 6 i-l P fc fc o Ph O Oh _a < o -J < o i-9 < H O H-J 1 1. CO r-t 1 ■rf .2 a •l-H TJ oi pa rtH <u pa _a Ph I-l pa < W I-l PQ < cd +_■ 3 H fcl cn a z < cu 8 p- o fcl 3 8 z o < :-4 < H Z pa <rt t> -H _9 < Q Z o co CO w ►J <! Svo" fc VO on OS O rrt ft" pa > 0- M > a o p- fc </_ w o P>H < X o co pa > pa ►a « fc < •o^ t-vor^mcoOTtoom obo\OTtoocs m th m r. t <*} \o o\ <o tn dTtrt OH tn ca cs vo o as o •a p. CS Ti esi 3 cn«no\t^cnrtTtcoO vo F» th tJ- o\ ^O H a Tt rtVDvOrtVO Q\ Ttrt CSrt It I I \sO 1 i len rotS It*- ITt p. III Mil 1 1 s cS rt i cn j | "j j Tt |i|rt|cn i vo i ifS ics tnTt irtcSrt J & jj j [j 1 ;« cs i iTtrt'irt ics thcs icoesrt to s Mil i r-t 100 ICSrt ICS I tn lOOrt 1 i fc III 1 1 i a ti : ~j Tt "| | —j 1 Tt cn rt j in Tt cs a\ tn 1 in TH^HfSTt IrtVO len QOOOrtOOtn | fc rt | | rt rt m s j I rt j TH Tt in 2 pc< CS rt | CS rt s ti iHOSrin i cn t-m ivotJ- i in 1-1 1,H 3 es i icsm iOv 100 vot*- icsen i ^ fc | Tt 1 CS rt i rt 12 cu m iw-ir-rt ir- it- Ttes \ n s cn i t-h " -,-, ; rH W O rt Os itfv'COCSrtOOr- 1" fl. 5 p. ; m rt rt | cn ! OD a rti-HT-tinovcnm |Tt oomn |Tt | 7 m A Tt th |r) TtcScn»nTtcScn—ics cs 1 1 ~1 *m i cn Tt cn A a eSrt icsesmiS ivo encsrt im p. j cs th th : cn Tt icncno. It** ics Ttrt l |rt i CO »n a cncncncSTtcnoo iQ incS irt fc es rn | cs a : cn rt 1 CS Tt iTtcnooortcs i-H cneSrt i p. | rl TH t-H j Ti (ll a cn cs *h es 1 m cnrtTtirt^Hiito MMM fc M i 1 I 1 1. 1 1 1 s TtrtjenoOjCSTtOO rtjilil iii-Hiit:1' i i i i i i Tt 2 p. ll MMM MMM a II \~ p j ! M || 1 .a fl ri Q TJ ce a a i rH CU .2-. « 3 _rt C rt •£ "2 rt o G (J X h t3 g o 9 ■?*« s i|.s C Tl C zophren Simple Hebeph o a u S a ch y Latent- Schizo-. Childho Chronic ic-depre Manic e Depress Other-„ lutional noia an le psych w a c rt P. _. RIVERVIEW HOSPITAL G 77 © cn r- vo oo Tt as © th so en c- tM ca CA CS rt I j I i i i -^THrt «-h © tr- irtcn I rt T-tO Os I rt rt cs I os es i rt cn Tt m t th mrt i i i cCni t '. th cs cn rt rt cs I it cS es th rt cn rt I t— Os in th th r- cs m l © th irtcn cseysTtTtrtcsy-) I cs ; cn vo cs t-mesa.es i "i rt vo cn rt es lrt| rt en I 00 © rt CS I TH o i © Tt 1 Tt Cn I O rt rt Tt i v& as m ti cs in cS i th vo oo cn cn I * rt vo en cn cs Tt vd i tn Tt i rt os cn ; rt oo ivomen ;cs ov m "n CS es es i CS Tt rl | © rt eSrt iescjNcs<?\rt" cS vo cn l~- cn cn VO TlTH i | vfi ti in rt cn es i i th es \\ il g.SrS CJ X! si ce s g u 0 o 8 J2 _= - ■ S a J.-8-S v. «■ >> _y >> tH «3 rt (A Oh Ch < Oh | 00 1 c ii ■S"3 QJ o o B S .O C afl > u.r. fi 'S 01 ° ._ S ._ QJ a S _! B _ •5 L-s 8 u _: o a « C ^ . 21 _= _f -j CJ <_. - 8 S 3 3 '3 QJ QJ 5 rt rt £ .0s.. - te - - | && £.-§•§ oca 0 o u o QJ QJ CO CO o Ml PH >. & fl c 0 0 o u a PhPh* o CJ CU U CO CO Is! __?•§§ Sa u .2 3 ce rt CJ ^ O O rt •a _3 _= » - C u o h rt >> gj £ - h fc fc 8 i c C fl p 0 N ij N s g Fi Q Q *"■' •*-' i P 1 F 1 O f 0 & & a a. .11 a . t > o ^ o -h HI cd in e .fl > S -M .3 E ?____ ■2". ' W +"- -H ' cs u rt cu o*o o o iits £ <u Ei cu ^ 'fi* <B __•£ Ph o _. o c o e ' f f § I 11 Hi? b- OZft Ph 8 r. .is o « .3 gas quo ' &S 2 e t_ QJ ^ ■o 5 S..3.3 <=•= 2 «_. 6 ! i «.li*a . 3 & § .3 _ •o 9 3-S ffg«rt " C o <u <P m ca v- ft, u >S h. < to O Oft, G 78 MENTAL HEALTH SERVICES REPORT, 1966/67 X a cn PL, 3 ■ pa ffl < o z ffl < z g pa -~ "J t4 VO < as Q rrt z „ O rrt co co CO P-l M ,. O 1% CU co o O H •H v^ ftS rrt > ri HH ^ <2 g o Ph Ph co pa ffl Pd o CO pa 3 pa i-i P. < •OrH -Tfin m m r- r- c- -h cs C7\ rt rt 00 in VD CS rt tn OH Tt TH VO t- rt CS rt Tt 00 VO © vO >n rt es rt •a 5 fc T-t cs" dooo eSrtVDcn£fc»n*N Ph s vo Ov T-t "° _. I "~ i i "i i es m i i Pi I 1 iii i 1 VO s | rt "i es rt | ; cn 00 s fc II i i 1 i 00 .11 1 1 1 VO Tt rt | en so § Ml III i ii i i««n. n cn I fc III i M Ov 1 j I I rt m m I i c* vo s i 1 11 i i il ti i r. i tn rt i Ov 3 m m fc i i ! i i m _3 cn rt j 1 1 Tt 1 Tt 1 rt cN S fc " ™; ■ <n § m rtV M Ov I t-i j j rt 1 1 Tt Cn Tt T-i l-H 00 VO es vo i Tt S oo f fc j th " | 1 vo cs ; i i 3 en i ■fl- S E 00 Ov 7 p. 1 rt i i ; r* i i ) <-• 1 i ii Mi es < J> — — — vo *n s cs r- cn fc ! Ith i cn cs < CS CS rt i m CS 1 rt | m cn X en es I rt i tn i i ti cs rs Ov tn es fc' es -. rt cs i ~i oo f5- rt m | | ] | S It p. Ov vo cn l Tt rt 00 cs s cs Ov T pp ! ~1 *** 1 cs cn \t-iti Tt o o S i I cn Tt 2 fc i s j | rt j« - A 1 S tf .a ei •a C § s* at Ih at 3 u fl X! cn O a 3 ter, be stmem te life. 1 i. Ih ■1> 3 S c nd unspecified charac gence disorders— ite situational maladju ustment reaction of la lit situational reaction brain syndrome with brain syndrome, N.O tion without need for f i & a "o <a oj ■SI 1 t « 0 3$ fl 1 OS « S=o6._l._l 5 o a _-____._! \ O u O Of- X w cn Q z <! >h" < H oo Pa O X H ffl z pa T4 CO O Z S _a < H Z r- krt VO (< dv >H^ Mrtrt" i-i < Q Z o co co w B 3 o H -_l ^T H ^ S Ov ft, rrt 1:" £ 2 w fc ca > HH Ph S O Ph fc CO pa ffl pel X o co <_> & 0) •rt § T_) g_ g H-» ■8 CD rO a ■§ +-» > O ■s i> .fl O <+H d o VO T. v-H U pa Sj ra m < 4-> p H RIVERVIEW HOSPITAL G 79 X pa cn fc 1 ? pa ffl < Z ffl < ►J z pa <h vo >, OV M rtH _a _a < Q Z o m w o I o < « H VO m vo Si °v 8- ffirrt" Be ri S Ph pa > ffl z S Pi 5 o u O CO IB H <: pa Q pa M -H •Ort S? OTt»neSTtes>nTtes __ u. c. c. m m N OV OH 00 fc cs VO -P ,—t H a cs o p. Ml ! 1 i i'l' ii t es s ov es .«*>■■( ; j . j rt CS rt rt Ov Tt rt rt I fc ! Mil rH Ct 1 j 1 1 1 1 1 1 \1 1 |C.rH 1 vO VO __ 1 1 IIIIIII 1 1 1 cn i | O !-. p. I I M 1 III ' ' cn i i r-t s s i : •* 5 n. cn n 1 , , , | jHrt IH 1 in § 3 p. VO rt I""1 | i| | | |l M || : iii: Ov cS j I 1 IN | 1 |N |. jM 1 00 a TH) ^ T fc i i | ( 1 | 1 j ii 1 || cn Tt __ Ml Mil Tt 3 & ! I III j r. r. MM' 1 1 1 1 1 1 rH o Tt s jli it -D Ov fc i j 11 ri ii 111 r ii" < tn tn s Tt p. 1 j i i i i i i j i H i At CO s i ! i i i !II!!II1!!1 Hi 25 7 p. 1 ri 1 1 1 1 1 1 I 1 I 1 1 II i i 1 i i i i i i i i i i i I i | T~t 1 i i j i i i i i i i j i T-H eS s M 1 1 i 1! 1 i i I I 3 Ph || | M || || | M M M | i ,_, ! j I j i i j j 1 | 1 i 1 j rt ri J- M 1 i M i i M M i Ov 7, fc M M i 1 i i M i II es § M M it i ! M i ■ Tt 3 fc i i i i i i i i i i i i ! i i i j s iiiiiii E ] 1 1 t 1 I. ! 1 M fl rt .2 u as l-H 1 Ifl >. o > rt 0< o a c r- g .2 0 Ih rt 3 0 « a QJ i CL l> C V t c t - 1 o 'a 09 O "8 1 rt ■a ■84: u 1 8 J rt O _ Ih rt C o S. r 2 &_ ?|l |1| ■3 % 1* f S -J c/ 1 - syndrome with be syndrome, N.O.S ithout further nee ill gl p 1 o .2 S sis of o nd uns ic-depr c brain s and it deflcie c brain c brain ation v. c t 1 V ■- 1 1 & 1 > P- C .1 5 c 1 i -r- c i 2 _ _ s 1 .1 *3 1 c c -. rC C <u cn rD o « Q Z < H c/_ fc o « H ffl Z pa Z ffl < _a < H Z t-~ pa vo S2 >H r. H rrt pj < Q z o co w X u Pi o < ^° H Ov rtt rtH fc CO " O rt ffi ri ■^ HH !> fc r > ffl z HH P. s p u u O _o 'h-i CO <! pa I o Q 1 .a 00 T3 V—1 D pa •a i-i H-> m <o < (A H G 80 MENTAL HEALTH SERVICES REPORT, 1966/67 pa cn fc •p 0 A S3 w 0 < X H < _a Q pa o w CO 3 < U r-~ >< VO pq Ov _a r. _a rtH < cn Q Z o 0. ro u < WS ►a o «1 H H _, VO VO o ov X £ "H ca rJ HH > p. 0. tu _a > < Pi z l-H __• o u O CO X H pa D Ov rtH fc l-H rn Eh 13 rt T*»- TM f* t»C.mir »M coinoniTttSinv. cs OH i ov rt |t-rHrtesrtcsencs.cseSrtcses 00 rt eS fc' ! i 94 rtin irt iT-icsm ivoesoocncSrtcnen II a 1 vo 5 ij fc' ~i_r ICSrt Irt j j00 j | CS Tt rt rt | 1 1 1 . I 1 'll o es i^lMiMil^^^l! Ov ||l,rti.Otrt|VOjlrt|| o_ 5 fc' iii! ii 1 i M M *H1 a ['"MM « |^ i^ vo vo i Mill i i i i i i i ! Ph i 1 i ii Miii irt irt i irtcn jrtrttN irt j T-H vo i-j 1 1 M 1 ||!| ,~H m m 6h 1 II 1 1 1 1 1 1 ill ! S' rtrt JTrHfH j1""1 | j *""' I ;'"' | r- Irt | 1 th I |tHHiH i rt trtCS 5 tu i i 1 1 I ! | i i X Irt j ! Irt 1 t-H I ,-h rt- t—1 IHH 00 »n 1 1 1 1 1 1 1 1 1 ^ 5 fc i ill i i 1 i i i M i i II i M i -3 | | |1 | |t( IH 1 I 1 1 cn 1 Tt i i i i i M i 1 1 1 M ! 1 3 Tt Ph 11111II111111 111. 11 1 s 1111 r 111111111 n rt O __ 1— 1 1 M i M i M *■* 1 1 II *N 6 00 < cn 1 \n cn fc 5. 111111 r r 1111111 es Tt 2 cn fc iiii i ii i ii ii i ii 11 i i _- llllll'IIIIIIIINI i i Os m cs fc' i | | | i ii i | 1 ii | ii | I i i 1 i i I 1 i i i t i i i I i | ' S" ! 1111111111111 r 1 1 i ! 1 ! I 1 1 1 1 1 ! 1 Ph 1 1 II | | II | I | 1! 1 i M 1 1 1 1 1 1 1 1 1 1 1 i i I 1 1 1 1 i I I ! ! I ! | I : i 1 i i I I" ; rt i- 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 0\ 1* C. IIIIIII I 1 1 1 MM II 2 s i ii 1 1 M M i M I i 1 3 p. | I |II ||| I II | | 1 I I 1 I 1 1 II 1 1 1 1 1 1 MM 1 | i F fl rt ; s» tn \\ 3 c 0 u rt i > H •o fl a Vh a a ■_, o QJ 3 rt u 1 j oi s If Cf I x "3 s £ 5 fl In O >. U Cfl ag _Q > a s j rt^S u Is Ih CU SI »| *__ rt ^_ a w CL w I 1 0, c 1 ■e i ._ E t 0 a V cc a £ c E CL > | B 3 E B CO 5? & rt •1 3 6 | __ tr a '\f c fl u c « fe 1 1 7 2 ! j t i a - d 1 _ _. s c *J R = s g > rt . <u .i: CO 4- •■a g u. £ Of* i D c I CL c E ._ ! 1 X c. 1, «• ..- C 1 7 r | _ C vy- t/ 4 o _ S X ■rt C S ! a w S "fl I X c < 4 3 0 Q cn D Z <: >? < H CZl fc o H ffl Z w T4 X H < Q fc o pa co < vo y ov >< n rtH „ <*. ta i-i « < u WJ Q Oh z < 3 0 CO i Ml o v-i w H el n o i-4 < VO ON c fc 8 T^-( •a a. (J o > Ph Ph < X) 5? p. w e > u K ffl Z S 2 5 o o O CO w H «: w Q o CN pa >-i pa _H u > o I o d o .9 u • rH ca <u Q THE WOODLANDS SCHOOL G 81 PART HI.—THE WOODLANDS SCHOOL, NEW WESTMINSTER REPORT OF THE SUPERINTENDENT J. S. Bland, Superintendent This has been our first full year for unitization, and programming has benefited in all internal areas. Treatment and training have been more individualized and each patient now has an accepted programme based on his or her needs. This desirable goal has been achieved by the enthusiasm of the multi-disciplinary teams involved in each unit. During the year two of our senior administrative positions were vacant for a number of months. In October we welcomed Dr. H. Brooks to be the new Deputy Superintendent, the vacancy having been created by Dr. Foulkes' resignation in February, 1966. Mr. W. O. Booth, our Business Administrator for many years, left in September on being appointed to the more senior position at Riverview Hospital. We thank him for his many years of devoted service to The Woodlands School and wish him well in his new position. In January we welcomed Mr. H. F. Hayes to the position of Business Administrator. The completion of the Sage Building at The Tranquille School enabled us to transfer 100 patients there in the fall. However, the essential renovations to our old buildings prevented our using more than half of these beds for new admissions. Total admissions were approximately the same as last year. Of these, 60 were temporary summer admissions to provide family relief, as well as assessment of the individual patient if this had not previously been carried out. In the middle of the year the Out-patient Department was reorganized. Instead of a separate establishment, each clinical team now spends one day a week in outpatients, seeing appropriate referrals. Cases are screened and allocated to one of the three units, hospital, training, or psychiatric. More emphasis is placed on complete assessments, with inter-disciplinary conferencing, discussion with the parents, and follow-up where indicated. A total of 160 new patients was seen. The majority was referred by private physicians and public health officers, but one-quarter were from family and welfare agencies. In the Hospital Unit, the principal advance during the year was the closer liaison gained with the University Department of Paediatrics. From January 1, it was arranged that each University Pediatric Resident would spend a two months' rotation at The Woodlands School. So far this has proved to be mutually satisfactory, and we are looking forward to its continuance. Close contact was also maintained with the Department of Genetics, and in addition to a genetic-counselling clinic we received guidance in our search for chromosomal abnormalities. The Chromosomal Laboratory was transferred to our jurisdiction. During the year, 34 abnormal karyotypes were discovered. Once again we were fortunate in having no major epidemics. Our full-time health nurse was able to bring all immunizations up to a satisfactory standard. A small pilot project was completed with a number of blind children. The individual learning programme offered these severely retarded children produced a marked increase in their abilities, as measured over an eight-month period. G 82 MENTAL HEALTH SERVICES REPORT, 1966/67 In the Training Unit, the change from a custodial to an educational programme gained momentum. A series of ward activity training programmes was initiated, and curriculum guidelines were prepared and distributed. The programmes are intended to produce a meaningful set of steps in training so that patients can be assessed developmentally and introduced at their present functional level. The staff in this unit, most of whom are psychiatric nurses, have made an excellent start in this reorientation. Sheltered workshop activities increased, but a formal vocational- training department remains to be organized. In the Psychiatric and Rehabilitation Unit, emphasis has been two-fold. First, more individual attention has been possible for some of the mildly retarded with behaviour problems. Secondly, the separate Autistic Unit has allowed more specialized treatment and research with this group of patients. The various departments all functioned satisfactorily during the year. In the Psychology Department more patients were seen and assessed. During part of the year the Physiotherapy Department had two staff members, achievement therefore being greater. The Laboratory staff continued to provide an excellent service, as did our Medical Records Department. New statistical reporting procedures increased the work load in the latter area by 30 per cent. The Dental Department was stabilized by the appointment of a full-time dental surgeon. Preventive work has been increased. The Recreational and Occupational Therapy Departments expanded their activities, and together with the academic school, reached a new understanding in scheduling of patients. Co-ordination and co-operation have increased. As stated last year, the integrated nursing staff has now completely unitized. The Director of Nursing, therefore, has been able to spend more time in operational research. In particular, a survey was carried out indicating actual nursing hours available for patient care. From this survey it is hoped to aim at agreed staff-patient ratios for different types of problems. In-service education continued to be a major responsibility of the Nursing Department. The various service departments have continued to provide an excellent matrix upon which to build clinical and educational programmes. In addition to renovation of our old buildings, a start was made on a new industrial therapy complex, and a new central sterile supply was provided in the Fraserview Building. Once again I would give sincere thanks to our volunteers. Over 200 people gave us 6,740 hours of their time, and enabled a great number of " extra " programmes to take place. General morale was high, and various attempts were made to make all levels of staff feel that they had an active role to play in the institution. A multi-disciplinary orientation tour was held each month for all new personnel, with encouragement to them to take an active and critical role in programming. During the year we have been grateful for co-operation with many community agencies. We are all attempting to provide the best service for the mentally retarded, and with increasing co-ordination of effort I am sure that a satisfactory network of facilities can be provided. THE WOODLANDS SCHOOL STATISTICAL TABLES Table 1.—Movement of Population, The Woodlands School, New Westminster, April 1, 1966, to March 31, 1967 G 83 i Male Female Total 766 37 10 563 60 3 1,329 On extended leave, carried forward from 1965/66— 97 Othpr 13 Total on hooks as at April 1,1966 813 626 1,439 Admissions— 69 8 39 46 7 24 115 15 63 116 77 193 929 703 1,632 Separations— 57 12 60 2 41 11 30 4 67 1 67 3 87 Pied 16 127 3 On extended leave and still out— 108 <">ther 14 183 172 355 -20 746 -32 531 —52 1,277 i Includes 2 male and 4 female transfers from The Tranquille School, 2 male and 4 female transfers from Riverview Hospital. G 84 MENTAL HEALTH SERVICES REPORT, 1966/67 Table 2.—First Admissions to The Woodlands School by Health Unit and School District of Residence and Sex, April 1, 1966, to March 31, 1967 Health Unit Male Female Total Health Unit Male Female Total East Kootenay, Cranbrook— Central Vancouver Island, Na- School District No. 5 1 1 Selkirk, Nelson— School District No. 68 ~ 2 2 School District No. 6 1 1 1 7 2 3 Upper Island, Courtenay— School District No. 71- West Kootenay, Trail- 1 1 2 School District No. 9 2 2 » „ ii 72 1 1 „ „ „ 11 . 1 2 „ „ „ 12 1 School District No. 27 1 1 North Okanagan, Vernon— „ 28 1 2 3 School District No. 20 1 Skeena, Prince Rupert— School District No. 50 22 2 3 2 2 „ „ „ 54 1 1 School District No. 15 1 1 17 1 . 1 School District No. 59 1 1 „ „ „ 23 2 2 „ „ „ 60 1 1 South Central, Kamloops— ii ii ii 83 1 1 School District No. 24... 3 1 4 Northern Interior, Prince 1 „ „ „ 26 1 1 „ 29 1 1 School District No. 55.. 1 1 „ „ „ 30 1 1 2 1 1 Upper Fraser Valley, Chilli 57 2 1 3 wack— Greater Victoria Metropolitan School District No. 33 . ... 2 1 3 Board of Health- ^4 1 1 School District No. 61 2 4 6 „ „ „ 63 1 1 2 City- Metropolitan Health Committee, School District No. 35 1 1 Vancouver— „ „ „ 42 3 3 School District No. 38 1 2 3 39 18 10 28 7 3 10 „ „ „ 41 2 1 3 4 1 5 ster— ii ii „ ^J 1 1 School District No. 40 2 4 6 School district not covered by „ „ 43 4 2 6 health units— Coast Garibaldi, Powell River— School District No. 49 1 1 2 School District No. 48 1 1 1 1 Central Vancouver Island, Na- Totals 77 53 130 School District No. 65 1 1 THE WOODLANDS SCHOOL G 85 Table 3.—First Admissions and Readmissions to The Woodlands School by Method of Admission, Age-group, and Sex, April 1, 1966, to March 31,1967 Age-group (Years) Method of Admission Under 1 1-3 4-6 7-9 10-14 15-19 20-29 30-39 40 and Over Grand Total M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. First Admissions 9 4 1 7 10 6 3 H 4 1 7 2 5 1 5 3 1 4 1 1 2 3 4 1 44 32 2 33 18 3 Involuntary Temporary 1 4 2 2 2 9 6 4 5 9 77 50 Totals 1 ...... 6 4 15 9 5 17| 9 15 10 6| 8| 5 4 3| 4[ 77 53 130 Readmissions 1 2 ~3 2 1 ~3 3 5 8 2 3 ~5 4 4 8 2 4 6 8 3 11 1 2 ~~ 3 2 1 4 ^7 4 1 5 1 1 "2 1 ~_ 1 3 18 18 12 12 3 Involuntary Temporary .. . 30 30 Tntalsl 1 ...... 39 24 63 Table 4.—First Admissions and Readmissions to The Woodlands School by Mental Diagnosis, Age-group, and Sex, April 1, 1966, to March 31, 1967 Age-group (Years) Mental Diagnosis Under 1 1-3 4-6 7-9 10-14 15-19 20-29 30-39 40 and Over lotai Grand Total M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. First Admissions Mental deficiency!— Profound 1 5 1 4 ~4 7 5 2 1 15 3 3 2 1 ~9 3 4 1 1 2 1 2 2 7 4 4 1 2 5 1 3 1 7 4 1 2 2 5 1 1 2 2 1 1 4 2 2 1 2 1 1 1 1 2 1 1 2 1 23 22 20 11 1 13 11 18 10 1 36 33 38 Mild 21 Other and unspecified character, behaviour, and intelligence disorders No mental retardation..... 1 1 Totals 1|......| 6 9| 5| 17| 9| 15| 10 6 8 5 4 3| 4| 77| 53 130 Readmissions Mental deficiency^— 2 1 3 1 6 1 3 1 1 4 3 1 5 1 5 4 2 1 2 1 5 1 1 3 1 1 1 " 1 1 3 17 14 5 12 3 8 1 15 20 22 Mild 6 Totals 3 3 8 5 8 6 11 3 7 5 2 1 1 ...... 39 24 63 1 Includes 3 males and 5 females with mongolism. 2 Includes 7 males and 3 females with mongolism. Table 5.—First Admissions to The Woodlands School by Religion and Sex, April 1, 1966, to March 31, 1967 Detailed information for the above table may be obtained on request. G 86 MENTAL HEALTH SERVICES REPORT, 1966/67 X w cn a Z < § B. O P. 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P. ill i S I -.CATi ! 1 en Ih Ph "111 ! 2 Sill O c s c s H & a o o 1 cn 0 O H « 3 U 0 s tH u sWSS s THE WOODLANDS SCHOOL G 87 Table 8.—Patients of The Woodlands School Out on Extended Leave by Mental Diagnosis, Age-group, and Sex, December 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 Total Grand Total M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Mental deficiency!— 1 1 1 ~1 1 1 4 1 1 1 1 1 ...... 2 7 2 " 2 1 2 2 7 Mild 3 Totals 1 1 1 1 — 6 1 2 1 — 11 3 14 i Includes 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, 1966 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, 1966, to March 31, 1967. Age-group (Years) Mental Diagnosis Under 1 1-3 4-6 7-9 10-14 15-19 20-29 30-39 40 and over roiai Grand Total M. t F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Live Discharges Mental deficiency1— 2 2 1 1 3 6 2 2 1 1 4 2 1 4 2 3 6 6 2 i 1 6 3 5 1 5 8 3 15 4 7 2 12 18 5 4 1 16 6 6 2 11 6 1 i 4 4 2 1! 1 3 1 1 2 34 48 25 11 1 49 83 I 181 66 Moderate Mild 2 25 5 1 50 16 Schizophrenic disorders No mental retardation ~. — 1 1 1 Totals .......|_.... 4 21 11| 4 8| 6| 17| 14| 17| 28 40| 30| 1S| 11| 4| 3 119| 98| 217 Deaths Mental deficiency2— Profound 2 li 1 1 2 2 1 2 1 1 1 1 — 1 1 1 1 1 1 5 4 1 1 1 4 9 4 Moderate Mild —; ___.. 1 ; 1 1 Schizophrenic disorders — — — — J —- — 1 Totals 2 Ii 2 1 — 1 2 3 1 1 1 1 1 2 12 4 16 i Includes 11 males and 12 females with mongolism. 2 Includes 2 males and 1 female with mongolism. G 88 MENTAL HEALTH SERVICES REPORT, 1966/67 Table 11.—Live Discharges from and Deaths Occurring in The Woodlands School by Mental Diagnosis, Length of Stay, and Sex, April 1, 1966, to March 31, 1967. 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, 1966, to March 31, 1967 Age-group (Years) Cause of Death Under 1 1-3 4-6 7-9 10-14 15-19 20-29 30-39 40 and Over Grand Total M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Diseases attributable to viruses... 1 I 1 1 1 1 1 1 1 1 4 1 1 2 2 ~2 1 1 Diseases of the central 1 Arteriosclerotic heart Diseases of the arteries ...... 1 1 1 1 1 ~T 1 Diseases of the genito- Accidental deaths. . . 3 Totals 2 1 2 1 2 3 1 1 — 1 2 ...... 12 4 16 Table 13.—Deaths Occurring in The Woodlands School by Cause of Death, Length of Stay, and Sex, April 1, 1966, to March 31, 1967 Detailed information for the above table may be obtained on request. THE TRANQUILLE SCHOOL G 89 PART IV.—THE TRANQUILLE SCHOOL, TRANQUILLE REPORT OF THE SUPERINTENDENT F. G. Tucker, Acting Superintendent A school for retardates is set up to serve a specific group of persons who, because of a lack of social skills and an inteligence below normal, require care and training. The Tranquille School is the major centre in the interior of British Columbia in the performance of these functions. STUDENT POPULATION All admissions to Tranquille continue to be processed through The Woodlands School. On July 21, 1966, the new residential unit, the Sage Building, was opened by the Minister of Health Services and Hospital Insurance, the Honourable Eric Martin. Occupancy took place during the autumn. By December, 1966, the total residential count was 676; in the seven years since the opening of the school, the student-count has increased 1,129.5 per cent. The health of the students was at a high level as reflected in an average occupancy of 5.4 of the 10-bed infirmary. However, the new residents of the Sage Building had a very high incidence of illness, particularly staphylococcal infections, and the infirmary, from December, had full occupancy. There have been no epidemics and no cases of dysentery. There were two deaths during the year. An oxygen tent with calibrated machine was installed in the infirmary ward in December. All medical cases have been retained for medical and nursing care in the infirmary; all surgical cases were admitted to the Royal Inland Hospital, Kamloops, for their operation. X-rays are performed at the school, with the exception of those requiring a radiologist in attendance, the student is then transferred to the Royal Inland Hospital. With three dentists on staff, it is possible for each student to be seen every six months. Much preventive dentistry can be performed. TRAINING PROGRAMME The intramural employment programme is the basis of the vocational training of our students. No academic classes are held. An average of 312 students are employed in 15 areas, with conditions closely simulating employment in the community. To maintain this labour force, two job placement officers and 10 instructors are on staff. With the opening of Sage Building, training crews under instructors were assigned there to perform bed-making and domestic cleaning duties. Downtown training prior to the granting of downtown shopping privileges is under a separate instructor. A new training programme has been instituted of placing a trainee in an employment situation under a specially selected trainer, with reports made monthly by the trainer. This programme is expanding; it involves a member of the community as part of the habilitation team, and it prepares the trainee for living in the community. Hobby rooms were established on five wards with a generous financial gift from the Auxiliary to the School. The objective has been to provide meaningful G 90 MENTAL HEALTH SERVICES REPORT, 1966/67 occupation for the trainees in their spare time as well as to teach and develop an interest in hobbies that could be used by trainees when they are placed in the community. Six wards had their own gardens. Eight wards at Christmas sold their own handicraft to develop further projects. Ward-originated projects for student training are encouraged and include picnics on the beach, skating on the lake, cook-outs, barbecues, etc. Undoubtedly, the major ward-originated project was that of Pine Crest, a ward of profoundly retarded boys who are developing Pine Park, an area 2 miles from the school on Tranquille Creek. It was here in September, 1966, that Pine Crest held their first annual barbecue, the steer had been fed and watered by the boys themselves, and nearly 500 persons attended on the day we ate Ralph (the steer). RECREATIONAL THERAPY Activities were slightly curtailed due to the necessity of using the recreation hall for feeding, with the temporary closure of the cafeteria. By using a play area in Sage Building, the average monthly attendance was 4,134. Seventy-five students are participating in the Centennial Athletic Programme of the C.A.R.C. OCCUPATIONAL THERAPY Occupational therapy continues to teach male and female handicraft, and woodworking to a senior group of boys. Sense training for junior girls and lapidary craft are also included. Average monthly attendance was 1,252 for girls and 813 for boys. SCHOOL EVENTS May Day was held on May 14 with the crowning of the Queen and two Princesses, and in conjunction with a Sports Day. The Fifth Annual Carnival Day was attended by 600 persons with floats made mainly by the students, and the midway a huge success. The sale of work made in the handicraft areas was held in May and realized $800; one day later the annual Visitors' Day took place during which 250 persons registered, were taken on conducted tours of the school, and were served tea by the Deerholme girls in their residence. Kamp Kiwanis in the Tranquille hills provided a week's holiday for 220 students during June to August, inclusive. Camp Blackthorn was occupied most summer week-ends by members of the 1st Tranquille Boy Scouts. STUDENT RESETTLEMENT A vigorous " selling " campaign has been waged during the year by the Director of the Social Service Department, Mr. R. Atkinson, throughout Greater Kamloops, the Okanagan, and Cariboo areas. This brought the school into the community, with definite results. There are now 17 students employed in the community. There are two students employed in the community and living in a boarding home. Because of the increased offers of boarding homes, after consultation with the Department of Social Welfare, our boarding-home quota was increased from 10 to 40 beds. There are now 31 students residing in boarding homes in Vernon and Greater Kamloops. The resettlement of students in their homes has increased to six. A new programme of placement of students at Venture Training Centre, Vernon, for a six-month period of assessment and training was inaugurated in March with two students. THE TRANQUILLE SCHOOL G 91 In a church parish hall in Kamloops, a club for our boarding-home placements was commenced in February. Weekly meetings have been held with table games, record-playing, and a light snack, the mainstay of the programme. Because of the increasing involvement of our students in part-time as well as full-time employment, our school now operates a daily bus service into the community. MEDICAL RECORDS DEPARTMENT All the files have been brought up to date. A diagnostic register has been established on all students, using the A.A.M.D. Heber classification. CHAPLAINCY Our two chaplains, the Very Rev. J. C. Jolley, M.A., D.D., Dean of St. Paul's Cathedral, and the Most Rev. M. A. Harrington, Bishop of Kamloops Diocese, continue to minister to our students. LIBRARY A library has been established with emphasis on journals with a content of 50 per cent or more of articles on mental subnormality. It is open for usage by all members of the staff. CONSTRUCTION The Sage Building and the new kitchen were completed in July, 1966. The new cafeteria was completed in March, 1967. Air-conditioning in the Greaves Building is being installed. No report from The Tranquille School would be complete without recording the resignation of Mr. H. F. Hayes, on December 31, 1966. Mr. Hayes had been senior nurse at the inception of the school, and then Co-Ordinator of Habilitation and, as such, had been the chief architect of the training programme. G 92 MENTAL HEALTH SERVICES REPORT, 1966/67 STATISTICAL TABLES Table 1.—Movement of Population, The Tranquille School, April 1, 1966, to March 31, 1967 Male Female Total 319 13 1 236 3 3 1 555 On extended leave, carried forward from 1965/66— 16 nther 4 1 333 243 576 Admissions— 4 61 3 1 65 6 5 126 9 68 401 72 315 140 716 Separations— 5 1 2 3 18 4 7 1 4 11 2 12 TMtfd 2 6 3 On extended leave and still out— 29 r_ttipr 6 33 25 58 +49 368 +54 290 +103 658 i Includes 60 male and 67 female transfers from The Woodlands School, 2 male transfers from Riverview Hospital. Table 2.—First Admissions and Readmissions to The Tranquille School by Mental Diagnosis, Age-group, and Sex, April 1, 1966, to March 31, 1967. Age-group (Years) Mental Diagnosis Under 1 1-3 4-6 7-9 10-14 15-19 20-29 30-39 40 and Over Grand Total M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. First Admissions Mental deficiency- — — 3 2 6 1 1 ~8 2 5 1 1 ~9 13 2 2 1 3 1 1 23 14 9 4 1 4 1 1 12 3 2 5 4 1 8 3 1 3 5 1 1 24 21 6 1 10 1 2 36 8 4 6 9 1 1 1 60 1 1 1 29 10 Border-line intelli- 7 19 Other and unspecified Schizophrenic disorders Psychosis of other demonstrable etiology— Chronic brain syn- 2 2 1 1 Totals -— 5 34 27 15 7 2 1 65 66 131 Readmissions Mental deficiency— ~T i ~~ 1 2 1 1 " 2 1 T 1 1 2 3 2 2 4 Schizophrenic disorders. 1 Totals — ...... — 1| X J 1 1 2 — 1 1 2 3| 6 9 THE TRANQUILLE SCHOOL G 93 ovv.cncses-'tr-rHC] o inmM«oci Ov 2,0 CS rn T-t VO o^ tn co en oo co cA \ -n CA, Ov X w ft en oo oo es vo (S •<* w-i o "*t -* ts cs ; C/5 H S ts t- o cs vo Ov cn Z «3 8 VO ft r-iiini CS a rN-1 j 111 -* cu P Q jOTfrtrH j j jiH r- Ov 2 in ft *~* ft S 1 O Ov CS tS 1 ! 1 1 cn 9 i- Ml! cs w o 1 Ti CO T-t Tf 1 | 1 I ^ I ft r~ ! i !i es < 5 ! Ov OO cn VO 1 1 ! 1 ls,H i ! i 1 vO tn og <n Ov © CC rH j ! 1 | cn Ov fe th tS H- vo co cn i ! ! i 1 O 3 Os CO <n Tt C- ti j ! 1 © Z o CO CO rH II O en CA Os en so th \ th \ vn < 2 cS ft rH CS CS rH es 1 r O p s ii r. eo m oo rt h i i rn vo cn rH m vo VO < fe NOin^rtrt 1 | ^H tn i Ov ft — N ! 1 vo Z m $ CS 0\ (S TH TH | r-i | 1 VO w O 00 u rH cs -* ft «nc--* |m j { | j CS 00 2 : i ! ! i m s Is 1 1 1 1 i I 1 •«* ft o 2 ft MMMM! O VO s 1 CS 1 1 I ! 1 1 ! ts X so | j o as Cn r4 w __? H CO 4 ft II M II M 1 I 1 1 ! II II ! 1 ! |9 M w tn 1 ft 1 Ii II 1! II i i S. I|l[||||| i u O ft II ! i II I II i s III!!!!!! i so PS p MMMM! j H ft o rH m M 8 « z o z o .-H H W) < 0 ft c P t_) Ph O s OO 2 0. 3 o ft S a> < S •Sew 5 ■So _ 0 T a > 1. <_ CD 1 o o 2 s a u 0 CO w ft « 3 1 a M "o ii & S3 > 1 _- E c <u .9 1 i (§2 o. g _J s d _ »3 if is g j_ -S n o °.a ■° a o 2 o b_d h il 13 P 53 ■5 > cfl 0 >< < H cn ft o X H O z ft fi Cff 1—i t/_ o z o < Q ft < H Z ft s w pq J vo o S o 2 4-i 2 § 4> Z 0 B < ft go •a H-J -O ft o SI u P JO p>~. ft c? o £ v> M <D 8 ■a CQ. H-* <-> Z > o o J_) z rt o H < _J P s ^rH ft o ti fi o • rtH -J cd 58 c H tn O o ^ s 1 TJ rf «3 ft rt ft H-> 0> pa < Q H G 94 MENTAL HEALTH SERVICES REPORT, 1966/67 PART V.—GERIATRIC DIVISION REPORT OF THE SUPERINTENDENT J. Walsh, Superintendent The Geriatric Division consists of three hospitals, Valleyview Hospital with 791 beds; Dellview Hospital, Vernon, with 239 beds; and Skeenaview Hospital, Terrace, with 300 beds (all male). During the year a total of 1,973 patients received special care and treatment in the three hospitals of the Geriatric Division. Applications for admission totalled 883, an increase of 278 over the previous year. Of this number, 755 were for Valleyview Hospital, 117 were for Dellview Hospital, and 11 were for Skeenaview Hospital. Actual admissions to the three hospitals totalled 568, a decrease of 44. Of this number, 548 were admitted directly from the community and 20 were received on transfer from other mental health facilities. Separations due to death totalled 430, a decrease of 52. Two hundred and ten patients were returned to the community, a decrease of 19. The resident population of the three hospitals as of March 31, 1967, numbered 1,256, a decrease of six. To this number may be added 262 patients who, though resident in the community, are still on the hospital register, making a total of 1,518, an increase of 42 over the previous year. VALLEYVIEW HOSPITAL, ESSONDALE This 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. A total of 755 applications for admission were received, an increase of 268 over the previous year. The demand for beds has shown a persistent increase in the past few years, from an average number of applications of 28 per month in 1963 to an average of 63 per month in the past year. Four hundred and twenty patients were admitted directly from the community, 20 patients were received on transfer from Riverview Hospital, and four patients were received on transfer from other geriatric units. The hospital's social service pre-admission service was successful in finding suitable alternate placement for 104 persons, obviating the need for admission at that time. Separations due to death totalled 254, a decrease of 41. One hundred and eighty-one patients were returned to the community. Of this number 24 were discharged in full and 157 were released on leave. Of the group of patients who were released on leave to the community during the past year and previous years, 34 died and 55 were returned to hospital. Of those patients returned to hospital, a few were returned because of financial problems and social factors caused the return of some more. Of the 55 patients who returned to hospital, 22 were again placed in the community during the year. Twenty-eight patients were discharged in full from leave status. As of March 31, 1967, there were 243 patients on leave in the community. GERIATRIC DIVISION G 95 Fifty-four patients were transferred to Dellview Hospital and 36 patients were transferred to Skeenaview Hospital. In the hospital an active treatment and rehabilitation programme, utilizing modern techniques, has been maintained. Correcting dietary and other deficiencies, stabilizing physical treatments, and eliminating toxic factors are important early therapeutic measures. Psychologically the sympathetic, interested approach to the patient and his problems is of the utmost importance. The aged patient's greatest need is the re-establishment of interest and self-confidence and the response to the correct approach is frequently most rewarding. A high standard of medical care is provided for the patients. Physical illness, either acute or sub-acute, is not uncommon on admission and the course of the mental illness is most often related to the outcome. The services of consultants are available from Riverview Hospital and all surgical procedures are performed there. The X-Ray Department, under the supervision of a visiting radiologist, has provided the necessary diagnostic services. In addition to service to patients, staff chest X-rays are taken annually. The Pathological Laboratory, under the supervision of the pathologist at Riverview Hospital, has provided satisfactory service. Bacteriology continues to be done at Riverview Hospital. The Dental Department has had an active year with some significant changes and new trends in treatment. Denture work is now done by contract with a dental laboratory in New Westminster. This arrangement is very satisfactory. There has been an increase in denture work in the past year. The nursing staff have continued to provide a very good standard of nursing care for patients. Educational opportunities have been availed of where possible. The Assistant Director of Nursing completed one year's postgraduate training at the University of British Columbia and a nursing supervisor commenced an extension course in Nursing Unit Administration. Five supervisors and 24 nurses in all were able to attend various institutes concerned with geriatric nursing. A clinical instructor for student nurses was appointed in August, filling a great need in student training at the hospital. A " Friendship Day " was held in May, during which the hospital's facilities and programme were presented to visitors. One hundred and twenty-five attended. A member of the nursing staff won the Marjorie Hiscott Keyes Award presented by the Canadian Mental Health Association for the psychiatric nurse who contributes most to patient care in the Province of British Columbia. The Social Service staff report a busy year. Due to the increased demands for admission, the emphasis was of necessity shifted toward the pre-admission service. As a result of this change, alternate placements were found for 104 persons, obviating admission to Valleyview Hospital. Such placements are generally successful. The establishment of a service in the admission area in the previous year has been valuable especially in obtaining information concerning newly admitted patients. The service, however, has extended to the provision of support for spouses or other family members still living in the community to such an extent that nearly half the time of the Social Service staff has been devoted to this problem. The remaining time was mainly devoted to the discharge programme. One hundred and eighty-one patients were placed in the community and follow-up services were provided to these patients. This represents a decrease of 14 compared with G 96 MENTAL HEALTH SERVICES REPORT, 1966/67 the previous year. This flow of patients out of hospital has been maintained despite heavy demands on community resources such as private hospitals and boarding homes. The Department was responsible for orienting 191 visitors to the hospital's programme and facilities. Visitors included physicians, social workers and trainees, nurses, and relatives of prospective patients. While this work may be time consuming, it makes a valuable contribution toward better understanding and awareness in the community of the function, programmes, philosophy, and policies of the hospital. The Physiotherapy Department has been operating successfully since October when a replacement was found for the Director who had resigned some months before. The majority of treatments are done on the ward. Over 50 per cent of patients are orthopedic and most are returned to pre-accident level of functioning. Weakness and paralyses due to cerebrovascular accidents form a large part of the remaining patients under treatment. A part-time podiatry service has been maintained. The Occupational Therapy Department plays an important part in the total treatment programme. Individual attention in the early stages reactivates interest and initiative and patients soon regain skills which they had all but forgotten for want of opportunity and the necessary encouragement. A total of 243 patients were treated. Three second-year students and eight first-year students from the School of Rehabilitation Medicine, University of British Columbia, were attached to the Department for clinical work during the summer. Two volunteers from the Canadian Mental Health Association help in this department. The annual sale of work was held in November and was quite successful. The Vancouver Dahlia Society continues to devote much time and effort to helping the patients and its programme is highly regarded by patients and staff. Protestant and Roman Catholic chaplains provide satisfactory religious services for patients. Dr. H. W. Bridge, Assistant Director of Mental Health Services, spent two days at the hospital during February inspecting its facilities and functioning and making himself acquainted with the activities of the various departments. DELLVIEW HOSPITAL, VERNON This hospital, with a complement of 239 beds, provided special care and treatment for 365 patients during the year. One hundred and seventeen patients were admitted from the community, an increase of 18 over the previous year. Thirty-one patients were received on transfers from other geriatric units. One hundred and twenty-three patients died. One patient was transferred to another mental health facility. Twenty-six patients were returned to the community—5 discharged in full, and 21 released on leave. The resident population at March 31, 1967, was 215 (consisting of 89 men and 126 women). In addition, 19 patients were on leave status in the community. Five patients were returned to hospital from leave and three died while on leave status. To meet the need for more female beds, a readjustment of accommodation was made which made 14 beds available for female patients. The total of female GERIATRIC DIVISION G 97 beds now stands at 143, an increase of 14, while the total of male beds is 96, a reduction of the same amount. Satisfactory medical services are provided for the patients 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. During February a psychiatric consultation service became available. Dr. Bennee of the North Okanagan Mental Health Centre attends the hospital on a regular weekly basis. Considerable progress has been made in all areas in developing an active treatment and rehabilitation programme. X-ray and laboratory facilities are available at the Vernon Jubilee Hospital. Dental services are supplied by a visiting dentist as needed. Podiatry services are available in the community as requested. A mobile unit of the Division of Tuberculosis Control conducted two chest X-ray surveys for both patients and staff, the second annual survey having been moved forward a few months. A good standard of nursing care has been provided for patients. There has been a marked improvement in the ratio of nurses to aides. Toward the end of the year it was possible to initiate a housekeeping service, and three staff positions were allotted to this service. Miss H. O. Lipsey, Director of Nursing, resigned and was replaced by Mr. W. Wharton, formerly Assistant Director of Nursing at Valleyview Hospital. Advantage has been taken of educational opportunities where possible. The Director of Nursing attended a three-day institute for nursing supervisors in Vancouver. Several senior psychiatric nurses attended a seminar in Kelowna in May and another at Kamloops in September. Miss Enser, Senior Instructor of Psychiatric Aide Training conducted classes at the hospital on two occassions of one week each. Mrs. Hill, Assistant Charge Psychiatric Nurse, successfully completed the Civil Service Basic Course in Public Administration by correspondence. The Occupational Therapy Department has provided a variety of handicrafts for patients. This is a very useful form of therapy for those patients who can attend. An extensive programme of recreation and entertainment is provided through the combined efforts of staff and volunteer agencies such as the Canadian Mental Health Association as well as fraternal and service organizations in the Vernon area. Visitors to the hospital included Dr. H. M. Morrison, Chairman of the Civil Service Commission, Dr. Tucker, Dr. Bridge, Mr. Matheson, and Mr. Dowling of Mental Health Services Branch headquarters. SKEENAVIEW HOSPITAL, TERRACE This hospital has a complement of 300 beds, all male, and a staff complement of 71. Eleven patients were admitted directly from the community, 12 patients were received on transfer from other mental health facilities, and 36 were received from other geriatric units. Fifty-three patients died, three were discharged from hospital, and four patients were transferred to other mental health facilities. Satisfactory medical services continue to be supplied by a local physician on a part-time basis. G 98 MENTAL HEALTH SERVICES REPORT, 1966/67 The Travelling Clinic of the Division of Tuberculosis Control has conducted X-ray surveys of staff and patients. A satisfactory standard of nursing care has been provided. The interest and initiative of the staff have accomplished much in the way of improving the standards of care and comfort for patients. Large dormitories and day-rooms are being divided by wardrobe-type partitions allowing for smaller groupings and better classification of patients. The Occupational Therapy programme has been extremely useful to those patients who can avail themselves of the facilities provided. The woodwork shop is particularly attractive to men and much useful work is accomplished there. A varied and interesting recreational programme has been provided by the staff with the help of volunteer groups from the community. Satisfactory dietary and laundry services contribute much to the general health and comfort of the patients. The Public Works Department has completed the project of joining the hospital's sewerage system to that of the municipality. A standby electric generating unit has been installed for continuous operation of stokers on a heating plant. GERIATRIC DIVISION STATISTICAL TABLES G 99 VALLEYVIEW HOSPITAL Table 1.—Movement of Population, Valleyview Hospital, Essondale, April 1, 1966, to March 31, 1967 Male Female Total In residence, April 1, 1966 On extended leave, carried forward from 1965/66— 259 79 497 124 756 203 Other 338 621 959 Admissions— 173 31 9 198 26 7 371 57 16 213 231 444 551 852 1,403 Separations— 25 130 44 2 96 27 158 23 3 147 52 Died 288 67 5 On extended leave and still out— 243 Other 297 358 655 -5 254 -3 494 — 8 In residence, March 31, 1967 748 1 Includes 3 male transfers from other geriatric facilities, 10 male and 11 female transfers from Riverview Hospital. G 100 MENTAL HEALTH SERVICES REPORT, 1966/67 Table 2.—First Admissions to Valleyview Hospital, Essondale, by Health Unit and School District of Residence and Sex, April 1, 1966, to March 31, 1967. Health Unit Male Female Total Health Unit Male Female Total East Kootenay, Cranbrook— Central Vancouver Island, Na School District No. 2 1 1 naimo—• South Okanagan, Kelowna— School District No. 65 2 2 4 School District No. 14 1 1 „ 68 4 4 South Central, Kamloops— „ 70 3 1 4 School District No. 30 2 2 Upper Island, Courtenay— Upper Fraser Valley, Chilli School District No. 72 1 1 2 wack— Cariboo, Williams Lake— School District No. 32 ... 2 2 School District No. 27 3 3 33 1 4 5 „ „ „ 28 1 1 34 3 1 4 Skeena, Prince Rupert—■ „ 76 1 1 School District No. 52 1 1 Central Fraser Valley, Mission Northern Interior, Prince City- George— School District No. 35. 4 1 5 School District No. 56 — 1 1 „ 42 4 6 10 „ 57 1 1 „ 75 3 3 6 Greater Victoria Metropolitan Boundary, Cloverdale— Board of Health- School District No. 36 13 4 6 1 19 5 School District No. 61 „ „ „ 63 18 1 9 27 „ 37 1 Simon Fraser, New Westmin „ 64 1 1 ster— Metropolitan Health Committee, School District No. 40 17 12 29 Vancouver— „ 43 5 10 15 School District No. 38 4 5 9 Coast Garibaldi, Powell River— 39 82 117 199 School District No. 46 1 1 „ 41 11 15 26 „ 47— 3 3 6 „ 44 9 15 24 „ 48. 1 1 „ 45 2 4 6 — 1 1 Totals. 204 224 428 Table 3.—First Admissions and Readmissions to Valleyview Hospital, Essondale, by Method of Admission, Age-group, and Sex, April 1, 1966, to March 31, 1967. Method of Admission Age-group (Years) 60-69 70-79 80-89 90 and Over Grand Total 1 M.IF. 1 M.IF. M. 1 F. M. F. 1 M.IF. 1 First Admissions 1 l'l 1 5| 1 7 79 1 5 2 90 96 5 109 m 11 21 Involuntary 14 13 194 213j 407 Totals .... 61 2'| 861 951 98(114 14] 13|204[224| 428 Readmissions 1. 1 1 1 ....... 1— 1 1 1 1 21 31 .__ 2] 2J 4 1 1 1 1 1 31 4 II 1 6! 3 7 Involuntary 9 Totals ! i 1 41 51 4 1 1 1 9! 7 16 GERIATRIC DIVISION G 101 Table 4.—First Admissions to Valleyview Hospital, Essondale, by Mental Diagnosis, Age-group, and Sex, April 1, 1966, to March 31, 1967 Age_group (Years) Mental Diagnosis 60-69 70-79 80-89 90 and Over Grand Total 1 M.IF. M.| F. '1 M.IF. 1 M. F. M.l F. ■1 1 1 Schizophrenic disorders Manic-depressive reaction ... j 1 1 4 5 ~~1 3 6 _J 7 ~1 4 3 1 3 9 1 2 44 9 2 1 1 2 4 3 1 ~6 74 4 2 1 1 ~~3 3 4 1 1 3 1 1 77 15 1 1 1 J 1 9 2 1 i 6 5 5 5 1 4 7 10 1 9 7 1 2 129 18 5 5 9 1 11 7 7 2 3 13 4 1 3 127 29 3 10 14 1 15 14 17 3 3 Neurotic-depressive reaction . 1 t 1 3 5 1 2 45 9 2 22 11 Alcoholism 2 Other and unspecified character, behaviour, and intelligence dis- 1 5 1 3 1 1 256 47 8 6 2 86 95 98 114 14 13 204 224 428 Table 5.—First Admissions to Valleyview Hospital, Essondale, by Mental Diagnosis, Marital Status, and Sex, April 1, 1966, to March 31, 1967 Table 6.—First Admissions to Valleyview Hospital, Essondale, by Religion and Sex, April 1, 1966, to March 31, 1967 Detailed information for the above tables may be obtained on request. G 102 MENTAL HEALTH SERVICES REPORT, 1966/67 X u_ V_ Q Z <c __ O Pi O i w o < CO o Z o < -J < H z w « w < Q O ^ o_ vg cn Os 4" *h < CO — ^ fc w o_ m *s > w -J < > < W o z fc Q oo w pf. Z o H <C hJ __ fc o ► . n < OH SO I Th 1 as cA ti © vo 3* rj-r-r-it-i-Hi-imcS'-''-' \o \ Tt in th Tt \ TH TH i cs rH cn rH cn Tf rH rH CS Tf ! 0\ : r- as i o i cs i cs tn l CA ! rn Hi •9*3 >S i >H tu y ■ (A W TO ! '•S c : ff-S- O 6 3 o a _2 -> .2 S_. 8 S3 1 f a -a ? a ?. *. ~ sag;. a g .a ' <| | g . - o _ _ - 'S ■sl* O <_ U _. r- .fi __ -» S -5 is i ».!? Slg ■o c 8 a _! s 5 S B ft _*s-f. q tj CO ^ . ?_:«§■? O o s«? •a * I- a S _i S?£ a u <__o«!:z ta _i <u a ta ft . J_ 5 ■_! I £ 3 3 _- £■ ft-o _aO *Z. s s o o -— _• ■o-o-a c C -j _._._! _ .3 .9 u O g gt_ g,o__. „ CCS O O M C- So M j? a OUQ GERIATRIC DIVISION fc § fc O i w o < __ o z o < rt < H z « cn rt s o X o z 3 no o o\ pq ~ Z rn" w rr, £ fc 2 w 3 « 55 2 rt w P. u z &o 8 s w H Ph CA O 33 rt rt rt < > fc O C/3 H Z w H < rt rt « < a a So CN trt 00 cs vo cs -* __-,, CS M Tt m rH On On r- m cs rH cn rH CS OH rH rH rH CS t~- Tt CS cs O t-i >n th S rH ; m rH rH ca tn tn cn cn 1 rH rH ' 1 ! 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E E ' -a i- c CT t '? a) R c 0. > a e u C -S 0- E "Si . c a 9 S| gfi SI 5 •8.2 -< v ° * si w - is of other de reaction witl* ^-depressive r eurosis with s« •o c a 3 >. t- c c as "c. E s a 1 S9 ' Cm-T fi? > brain syndro brain syndro is def erred .... c h c r : ■3 <- C 1 Mm £ ^ 5 ii c C .3.8 o ,CCc u o o _0 fi c cr r 2 > c. p- te > P. < i < 1 1 0 i < 5 o X c Q G 104 MENTAL HEALTH SERVICES REPORT, 1966/67 Table 9.—Live Discharges from and Deaths Occurring in Valleyview Hospital, Essondale, by Mental Diagnosis, Age-group, and Sex, April 1, 1966, to March 31, 1967. Age-group (Years) Total 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. Live Discharges 1 1 1 3 5 4 1 ? 9 7 16 ?. 5 ? 4 5 9 3 1 1 1 1 ? S 7 ? 6 1 3 6 9 3 ? 3 5 3 g 1 1 1 ?, 7 2 1 t ?, 3 7 6 5 11 Chronic brain syndrome with neurotic reaction 1 1 1 1 1 1 1 2 1 1 7. 2 Other and unspecified character, behaviour, and intelli gence disorders - - - 1 1 1 1 2 ? N 6 1ft 11 ?, 1 ?,i 18 43 1 4 2 4 9 2 11 Totals... | lj 6] 1| 31| 22 30 27 4 2 711 531 124 Deaths I ? 1 1 6 1 ■1 8 11 1 ? 1 ? 3 1 1 1 3 1 1 1 4 5 1 ? 8 3 4 6 17 18 1 4 3 5 5 1 1 11 9 20 1 1 ? 2 1 1 1 1 3 1 4 Alcoholism — . - . 1 1 1 ? 1 3 Other and unspecified character, behaviour, and intelli- 1 1 1 1 2 1 73 75 59 67 in 11 PI 103 196 Chronic brain syndrome, N.O.S. , — 1 5 4 7 l 5 6 17 23 Totals ~ 5 33 40 74 96 18| 22|130jl58| 288 1 1 1 1 Table 10.—Live Discharges from and Deaths Occurring in Valleyview Hospital, Essondale, by Mental Diagnosis, Length of Stay, and Sex, April 1, 1966, to March 31, 1967. Detailed information for the above table may be obtained on request. GERIATRIC DIVISION G 105 Table 11.—Deaths Occurring in Valleyview Hospital, Essondale, by Cause of Death, Age-group, and Sex, April 1, 1966, to March 31, 1967 Age-group (Years) Cause of Death 60-69 70-79 80-89 90 and Over Grand Total M. F. M. F. M. F. M. F. M. F. 1 2 1 1 2 1 3 i 11 121 ~~2 6 7 5 1 1 S 1 1 2 31 1 1 3 2 5 22 12 56 9 74 1 13 1 1 1 "l6 2 2 1 21 93 1 1 1 3 2 1 1 3 32 214 1 1 2 1 2 1 ~~1 2 1 1 ~2 4 2 1 1 3 — 1 1 1 9 9 1 1 1 6 2 4 Totals 5 33 40 74 96 18 22 130 158 288 Table 12.—Deaths Occurring in Valleyview Hospital, Essondale, by Cause of Death, Length of Stay, and Sex, April 1, 1966, to March 31, 1967 Detailed information for the above table may be obtained on request. G 106 MENTAL HEALTH SERVICES REPORT, 1966/67 DELLVIEW HOSPITAL Table 1.—Movement of Population, Dellview Hospital, Vernon, April 1, 1966, to March 31, 1967 Male Female Total In residence, April 1,1966 On extended leave, carried forward from 1965/66— Boarding home Other Total on books as at April 1,1966 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 other geriatric facilities-. Transferred to psychiatric facility _ On extended leave and still out— Boarding home Other Total separations- Net increase or decrease- In residence, March 31,1967- 99 3 102 54 10 1 65 T67~ 4 69 78 -10 113 212 11 121 223 50 32 1 104 42 2 83 ~704~ 148 ~371~ 6 57 ~1 14 ~78~ 10 126 ~~I 19 T5(T +13 126 +3 215 - Includes 8 male transfers and 23 female transfers from other geriatric facilities. geriatric division G 107 Table 2.—First Admissions to Dellview Hospital, Vernon, by Health Unit and School District of Residence and Sex, April 1, 1966, to March 31, 1967. Health Unit Male Female Total Health Unit Male Female Total East Kootenay, Cranbrook— School District No. 1 „ „ „ o tt tt tt 4 „ „ „ 18 Selkirk, Nelson— School District No. 7 „ 10- West Kootenay, Trail— School District No. 9 11— North Okanagan, Vernon- School District No. 19— , 20._ 21- „ 78... South Okanagan, Kelowna— School District No. 14 „ 15 „ 16 tt tt » —3 >t tt tt . i South Central, Kamloops— School District No. 24 26 Upper Fraser Valley, Chilliwack— School District No. 33 Central Fraser Valley, Mission City— School District No. 75 2 6 1 13 1 5 13 1 3 2 2 1 1 1 2 2 2 2 1 1 5 3 9 2 21 2 7 21 1 11 6 7 1 Simon Fraser, New Westminster— School District No. 40 43 Central Vancouver Island, Nanaimo— School District No. 68 Cariboo, Williams Lake— School District No. 27 „ 28 Skeena, Prince Rupert— School District No. 52 „ 53.. Peace River, Dawson Creek— School District No. 60 Northern Interior, Prince George— School District No. 57. Greater Victoria Metropolitan Board of Health- School District No. 61 63 „ 64 Metropolitan Health Committee, Vancouver— School District No. 39 41 it tt tt 4*f Totals 64 12 2 82 14 1 2 146 G 108 MENTAL HEALTH SERVICES REPORT, 1966/67 Table 3. — First Admissions and Readmissions to Dellview Hospital, Vernon, by Method of Admission, Age-group, and Sex, April 1, 1966, to March 31, 1967. Age-group (Years) Method of Admission 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. First Admissions _.. 1 5 9 20 28 36 1 42 1 3 2 64 1 82 1 146 Readmissions 2 Table 4.—First Admissions to Dellview Hospital, Vernon, by Mental Diagnosis, Age-group, and Sex, April 1, 1966, to March 31, 1967 Mental Diagnosis Age-group (Years) Under 60 M. F 60-69 M. 70-79 80-89 M. F. M. 90 and Over M. Total M. F. Grand Total Schizophrenic disorders- Manic-depressive reaction- Paranoia and paranoid states- Senile psychosis- Psychosis with cerebral arteriosclerosis.. Other and unspecified psychosis Neurotic-depressive reaction Pathological personality- Chronic brain syndrome with behavioural reaction Chronic brain syndrome, N.O.S.. Totals 20 28 35 29 36 42 64 82 7 1 1 7 3 1 1 1 122 2 ~146~ Table 5.—First Admissions to Dellview Hospital, Vernon, by Mental Diagnosis, Marital Status, and Sex, April 1, 1966, to March 31, 1967 Table 6.—First Admissions to Dellview Hospital, Vernon, by Religion and Sex, April 1, 1966, to March 31, 1967 Detailed information for the above tables may be obtained on request. GERIATRIC DIVISION G 109 Table 7.—Total Number of Patients on Books1 of Dellview Hospital, Vernon, by Mental Diagnosis, Age-group, and Sex, December 31, 1966 Age-group (Years) Total Mental Diagnosis Under 60 60-64 I 65-69 1 70-74 75-79 80-84 85-89 90 and Over Grand Total M. F. M F. M. F. M F. M. F. M F. M. F. M F. M. F. 9 1 1 4 ll 1 8 7 I 1 . 71 7 1 3 18 1 4 12 1 17 30 2 16 Psychosis with cerebral arterio sclerosis i 1 1 2 3 1 4 Psychosis of other demonstrable etiology _J } 1 J 1 Neurotic-depressive reaction ._ 1 I 1 1 Immature personality > 1 • __- |_ . 1 1 Chronic brain syndrome with 1 1i 1 1 ? f i 10 10 1Q T 77 16 30 4 5 fii 101 164 Chronic brain syndrome, N.O.S. Totals _ . 1 1 2 2 1 1 4 6 e 12 1 1 6 1 2 8 15 11 18 22 32 45 17 33 6 13 97 134 231 i Of this total, 3 males and 14 females were in boarding homes at December 31, 1966. Table 8. — Live Discharges from and Deaths Occurring in Dellview Hospital, Vernon, by Mental Diagnosis, Age-group, and Sex, April 1, 1966, to March 31, 1967. Age-group (Years) IT i Mental Diagnosis Un^er | 60-69 70-79 80-89 90 and Over Grand Total M. F. M. F. M. F. M. F. M. F. M. F. Live Discharges Chronic brain syndrome with behavioural 1 1 4 3 7, 4 7 11 Deaths Chronic brain syndrome with behavioural — — 3 2 5 12 2 12 3 35 10 24 8 4 1 5 54 15 46 11 100 26 126 Chronic brain syndrome, N.O.S. Totals .............. — — 5 5 14 15 45 32 5 5 69 57 Table 9. — Live Discharges from and Deaths Occurring in Dellview Hospital, Vernon, by Mental Diagnosis, Length of Stay, and Sex, April 1, 1966, to March 31, 1967. Detailed information for the above table may be obtained on request. G 110 MENTAL HEALTH SERVICES REPORT, 1966/67 Table 10.—Deaths Occurring in Dellview Hospital, Vernon, by Cause of Death, Age-group, and Sex, April 1, 1966, to March 31, 1967 Age-group (Years) Cause of Death 60-69 70-79 80-89 90 and Over Grand Total M. F. M. F. M. F. M. F. M. F. Vascular lesion affecting the central nervous system 5 5 1 12 ~1 1 14 45 2 29 1 5 5 1 67 1 3 53 1 4 120 1 1 Totals 5 5 14 15 45 32 5 5 69 57 126 Table 11.—Deaths Occurring in Dellview Hospital, Vernon, by Cause of Death, Length of Stay, and Sex, April 1, 1966, to March 31, 1967 Detailed information for the above table may be obtained on request. GERIATRIC DIVISION SKEENAVIEW HOSPITAL i G 111 Table 1.—Movement of Population, Skeenaview Hospital, Terrace, April 1, 1966, to March 31, 1967 In residence, April 1, 1966 Total on books as at April 1, 1966 . Admissions— First admissions to Mental Health Services 294 294 10 Readmissions to a different institution of Mental Health Services 48 Readmissions to the same institution 1 Total admissions2 59 Total under care 353 Separations— Discharged in full Died Transferred to other geriatric facilities Transferred to psychiatric facility Total separations Net decrease In residence, March 31, 1967 i This institution cares for male patients only. 2 Includes 36 transfers from other geriatric facilities and 12 transfers from Riverview Hospital. 3 53 3 1 60 -1 293 Table 2.—First Admissions to Skeenaview Hospital, Terrace, by Health Unit and School District of Residence, April 1,1966, to March 31, 1967 Health Unit No. Health Unit No. Selkirk, Nelson— Skeena, Prince Rupert— School District No. 7 1 School District No. 52 4 Boundary, Cloverdale— 53 4 School District Nn. 36 . 1 Northern Interior, Prince George— Simon Fraser, New Westminster— School District No. 57 3 School District No. 40 2 Greater Victoria Metropolitan Board of Health- Coast Garibaldi, Powell River— School District No. 61 .. . 7, School District No. 46 1 „ „ „ 63 1 Central Vancouver Island, Nanaimo— Metropolitan Health Committee, Vancouver— School District No. 65 1 School District No. 39 School district not covered by health units— 34 „ 68 . . 1 „ 70 1 School District No. 49 1 Cariboo, Williams Lake— — School District No. 28 1 Totals 58 G 112 MENTAL HEALTH SERVICES REPORT, 1966/67 Table 3. — First Admissions and Readmissions to Skeenaview Hospital, Terrace, by Method of Admission and Age-group, April 1, 1966, to March 31, 1967. Method of Admission Age-group (Years) Total Under 60 60-69 70-79 80-89 90 and Over First Admissions 1 12 1 22 20 2 1 Involuntary.. 57 Totals 1 12 23 20 2 58 Readmissions - — — 1 — 1 Table 4.—First Admissions to Skeenaview Hospital, Terrace, by Mental Diagnosis and Age-group, April 1, 1966, to March 31, 1967 Mental Diagnosis Age-group (Years) Under 60 60-69 70-79 80-89 90 and Over Total Schizophrenic reactions- Senile psychosis- Psychosis with cerebral arteriosclerosis- Alcoholic psychosis Psychosis of demonstrable etiology- Syphilis and its sequelae Pathological personality Alcoholism Other and unspecified character, behaviour, and intelligence disorders Chronic brain syndrome with behavioural reaction- Chronic brain syndrome, N.O.S. Diagnosis deferred Totals- 12 23 11 5 1 20 16 2 1 1 1 2 1 1 1 18 12 _2_ 58 Table 5.—First Admissions to Skeenaview Hospital, Terrace, by Mental Diagnosis and Marital Status, April 1, 1966, to March 31, 1967 Table 6.—First Admissions to Skeenaview Hospital, Terrace, by Religion, April 1, 1966, to March 31, 1967 Detailed information for the above tables may be obtained on request. GERIATRIC DIVISION G 113 Table 7.—Total Number of Patients on Books of Skeenaview Hospital, Terrace, by Mental Diagnosis and Age-group, December 31, 1966 Mental Diagnosis Age-group (Years) Total Under 60 60-64 65-69 70-74 75-79 80-84 85-89 90 and Over Schizophrenic disorders 10 I 2 i 17 "I 2 3 I 1 33 1 3 3 1 5 1 2 29 1 4 1 ~2 1 5 1 34 2 — 9 2 1 2 2 1 7 7 2 24 2 1 9 5 i 1 14 3 1 : 4 i 8 2 ■ 1 i 5 5 1 1 ._ 1 2 1 152 5 Paranoia and paranoid states _ 1 29 16 Alcoholic psychosis Psychosis of other demonstrable etiology 4 2 2 12 3 6 Chronic brain syndrome with behavioural re- 35 18 4 Totals 13 24 49 44 69 60 25 i 5 289 Table 8. — Live Discharges from and Deaths Occurring in Skeenaview Hospital, Terrace, by Mental Diagnosis and Age-group, April 1, 1966, to March 31, 1967. Mental Diagnosis Age-group (Years) Under 60 60-69 70-79 80-89 90 and Over Total Live Discharges Schizophrenic reactions- Psychosis of other demonstrable etiology- Alcoholism Mental deficiency Chronic brain syndrome with behavioural reaction- Chronic brain syndrome, N.O.S . Totals Deaths Schizophrenic reactions.. Senile psychosis- Psychosis with cerebral arteriosclerosis Alcoholic psychosis- Psychosis of other demonstrable etiology- Other and unspecified psychoses Syphilis and its sequela; .___ Pathological personality- Chronic brain syndrome with behavioural reaction- Chronic brain syndrome, N.O.S. Totals 1 2 1 "io" 3 15 "31" IS 2 5 1 1 2 1 1 6 19_ 53 G 114 MENTAL HEALTH SERVICES REPORT, 1966/67 Table 9. — Live Discharges from and Deaths Occurring in Skeenaview Hospital, Terrace, by Mental Diagnosis and Length of Stay, April 1, 1966, to March 31, 1967. Detailed information for the above table may be obtained on request. Table 10.—Deaths Occurring in Skeenaview Hospital, Terrace, by Cause of Death and Age-group, April 1, 1966, to March 31, 1967 Cause of Death Age-group (Years) Under 60 60-69 70-79 80-89 90 and Over Total Malignant neoplasms- Vascular lesions affecting central nervous system- Rheumatic heart disease Arteriosclerotic and degenerative heart disease- Other diseases of the heart Influenza with pneumonia- Diseases of the digestive system- Accidental deaths Totals- 1 5 ~i i l ~T_ 10 2 13 10 1 3 1 _1_ 31 6 20 1 15 2 5 2 2 53 Table 11.—Deaths Occurring in Skeenaview Hospital, Terrace, by Cause of Death and Length of Stay, April 1, 1966, to March 31, 1967 Detailed information for the above table may be obtained on request. COMMUNITY MENTAL HEALTH SERVICES G 115 PART VI.—COMMUNITY MENTAL HEALTH SERVICES MENTAL HEALTH CENTRE, BURNABY A. D. Sleigh, Director During the year under review this clinic has intensified its efforts to provide improved patient care. This has meant that the clinic as a whole has looked to a closer community liaison and involvement and stressed comprehensiveness and continuity of treatment. Every encouragement has been given to staff to bring this about and there have been many organizational changes made to effect this. However, there were certain major difficulties encountered and the major one was the fact that this is still not a regional clinic with a regional commitment. Another difficulty has been the matter of staffing generally and the particular problem of staff continuity which is so vital to carrying on any efficient treatment programme. The staff turnover was 25 per cent and did involve senior members of the psychiatric staff, including the Director. The same problem existed in the Psychology Department, but fortunately for the clinic there was not quite the same turnover in social work and nursing. In social work there was no problem in recruitment and excellent replacements were obtained, but the same could not be said for the other disciplines. However, despite these problems, the staff morale was generally high and there was enthusiasm seen for the general trend towards the principles of community psychiatry. The clinic has once again shown an increase in the over-all patient load and there continued to be the increase in family involvement as seen in the last two years. Besides increased therapy time being given to the community at large, there was also a major increase in indirect service and education. This involved lectures and talks, public forums, professional workshops, involvement in a variety of community organizations, as well as the usual commitment to consultation service and travelling clinics. ORGANIZATIONAL CHANGES There were major organizational and policy changes during this year and many of the changes were made in readiness for this further community involvement and regionalization that is envisaged for the coming year. There was a major shift in policy in changing the referral system from a medical referral system to an open referral system. The clinic saw this as a move toward closer community liaison and a recognition of the many other help-giving agencies and groups that exist in modern society. However, there continued to be definite efforts made to involve the family physician. Changes were effected to make each health team in the clinic more autonomous and directly responsible for its own work. This involved a change in the intake procedure so that all disciplines shared in this work and responsibility and also involved important, but simple, organizational changes such as having each team as far as possible have its own clerk-stenographer. This has meant a streamlining of team functioning generally. The clinic still is structured so that there is an Adult Clinic caring for patients of 17 years of age and over, and a Children's Clinic looking after patients 16 years of age and under, but liaison has been improved so that there is better communica- G 116 MENTAL HEALTH SERVICES REPORT, 1966/67 tion between the two clinics and so that a sharing of responsibility can occur when needed. It is unofficial policy that family members will be treated by one team, but there is access to consultations from more specialized therapists whenever needed. More specifically, there were the following changes:— 1. Adult Clinic.—In the Out-patient Department there was a reorganization of the teams so that one team acted as a regional team for the area of the North Shore and Burnaby. At the time of this report this out-patient team still is working toward a very close liaison with an in-patient ward at the Riverview Hospital. This is regarded as a special project with the advantages of giving the patients from this area more comprehensive treatment and definite continuity of care. Too, there are other advantages such as a lessening of the need for 24-hour care in the Riverview Hospital and generally making for early discharge of patients from that hospital with improved follow-up care. 2. Children's Clinic.—There were further organizational changes made in the functioning of the intake team in the Children's Clinic. Unlike the Adult Clinic, the Children's Clinic utilizes this special team to handle the heavy demands in regard to the intake work with children and their families and in giving brief psychotherapy and consultation to community agencies. In regard to the Day Centre, Children's Clinic, a psychiatrist was designated to work part time as Director of the Day Centre and in this way a special day centre team was created. With this change it was possible to open admission to referrals from all the mental health centre teams and case conferences were conducted in the day centre. This resulted in improved communication and afforded this special type of care for more children. 3. Forensic Clinic.—This clinic was established in the fall of 1966 at the Mental Health Centre, Burnaby, and was organized to meet the special forensic psychiatry needs of the Province. During the year under review a psychiatrist and clerk-stenographer were hired. 4. Travelling Clinics.—These clinics were reorganized as to their scheduling of visits to various centres in the Province and the travelling clinic at Chilliwack ceased operation in the fall of 1966 when the Fraser Valley Mental Health Centre was established at Chilliwack. Increased service was given during the year to the Skeena area (Prince Rupert, Terrace, Kitimat) and to the Powell River-Sechelt area. In other areas the service was continued as before. 5. Residential Treatment Centre for Children and Adolescents.—The building of this treatment complex began in early 1967 and at the time of this report this is still under way. The Mental Health Centre, Burnaby, will be required to do a great deal of planning and reorganization to integrate efficiently with the new Treatment Centre for Children and Adolescents. This will lead to major organizational changes in the next year. SERVICE 1. Direct Services: (a) Adult Clinic.—Throughout the Adult Clinic there were increased numbers of patients seen, with more family members involved also. The work with the sustaining clinics has increased proportionately with the requirement for this service and in the past year the sustaining clinic case load increased from 34 per cent of total cases treated. This reflects the fact that many of our patients need long-term assistance, support, and medications. To handle the increased number of referrals and cases carried, the Adult Clinic staff have been utilizing more and more group psychotherapy and also use this COMMUNITY MENTAL HEALTH SERVICES G 117 because of the high proportion of young adults and adolescents seen. Often this is the preferred treatment modality. Family group therapy continues to show an increase in use and this reflects the over-all clinic concern with not only the identified patient but also the family members who often, too, have emotional disturbances. The Regional Services team (serving the North Shore and Burnaby) followed their patients through the Riverview Hospital when they were admitted there. This offered the valued continuity of service and enhanced greatly the after-care and rehabilitative efforts of the team. Two physicians and one social worker from the Crease unit ward were considered a part of this Regional Services team and they followed their patients on an out-patient basis at the Mental Health Centre, Burnaby. The other out-patient team in the Adult Clinic continued to work extremely hard and they continued to draw patients from all other areas that were not covered by a mental health facility. In the operation of the day hospital programme there was an over-all increase of 22.7 per cent in the number of patients over the previous fiscal year. This was brought about without any significant change in length of stay, which averaged 24 days. (b) Children's Clinic.—The Children's Clinic operated with a separate intake team doing the more short-term work and more of the consultative work, but the other teams participated a great deal in this too. There are four care-giving teams in the Children's Clinic and one of these teams tend to specialize in individual care for children and another in family treatment and another in family and group treatment and the fourth team was the intake team. In addition to these treatment modalities being used there was introduction of more conditioning methods of therapy under our psychology department. In our day centre operation the type of service offered remained essentially the same as the year before with programmes for autistic children; a programme for pre-school children requiring guided social learning and peer-group experiences; assessment of pre-school children of mothers attending the day hospital in the Adult Clinic, and an observation and assessment programme for a large group of children during the months of July and August. Too, a member of the psychology staff during the year enriched the day centre programme by conducting operant-condition- ing with several autistic children. More recently this involvement was extended to teaching the parents of the children to conduct the treatment. (c) Forensic Clinic.—This special clinic was organized in the latter part of the year and at the time of this report has just commenced operation. Thus far it has had to restrict the amount of direct treatment work and it has been involved more in consultations with various agencies throughout the Province. (d) Travelling Clinics.—The service of the travelling clinics was discussed under the organizational changes in the clinic, but stress needs to be laid on the fact that these clinics, using Burnaby Mental Health Centre staff, serviced a large number of towns throughout the Province during the year. In all of these towns this was the only psychiatric service available to the professional groups there and a great burden of responsibility was placed on our psychiatric teams. Because of the limited time available and because of the large number of people serviced it was not possible to give more than consultations to the local professionals. However, considerable emphasis once again was placed on efforts to co-ordinate these community professionals. Visits were increased to the Powell River area during this year and this resulted in the doubling of the number of clinics held there. In the Skeena area, likewise, there has been an increased service with a psychologist now going on every trip whereas before, psychologists used to go out every second trip. Many other areas were given this travelling clinic service and in effect this G 118 MENTAL HEALTH SERVICES REPORT, 1966/67 meant our clinic trying to cover all areas of the Province that were not able to obtain treatment or consultation services from a local mental health facility. 2. Indirect Services: As in the last few years, our clinic has been very much involved in indirect services to the community. Consultation and psychiatric treatment, when appropriate, have been given by a child psychiatrist from this centre to such local agencies as the Children's Aid Society, Catholic Children's Aid Society, Juvenile Courts of Vancouver and Burnaby, and the Willingdon School for Girls. A limited consultation service was offered to the Brannan Lake School for Boys, but this was regarded as a temporary arrangement until they could obtain other service. Certain group-living homes in the Burnaby, Surrey, Kamloops, Prince George, and Prince Rupert areas were once again given a screening and consultation service when required. Too, the unit at New Denver operated by the Department of Social Welfare has been given a screening and consultation service by our senior child psychiatrist. Once again this type of work and the general community needs has brought about a closer liaison between our clinic and the Special Placement Division of the Child Welfare Department and it once again has been very useful to have that Division have its offices within our building. Many of our staff have been involved in giving lectures and talks to local community groups, such as the Canadian Mental Health Association organization, the Parent-Teacher Association, and various educational groups and kindergarten and school groups, etc., and this is regarded as an important part of the clinic function. Organizations that have a particular interest in the field of mental health are encouraged to use our auditorium and small meeting-rooms. Too, staff members were more involved during this last year in membership and leadership in a number of community organizations. This has improved our liaison with the community at large. TRAINING AND EDUCATION This clinic has continued to show leadership in the area of staff education and development. In this type of in-service training, experienced therapists were enabled to share ideas and improve further their professional skills. The Psychology Department ran a very effective ongoing staff development schedule and invited a number of guest speakers to discuss issues ranging from neuropsychology, drug addiction, alcoholism, family group diagnostics, to more recent developments such as psycholinguistics and multi-model sensory perception and electronic model of visual perception, etc. Psychologists from outside the clinic also attended regularly and seemed to benefit from this schedule. The clinic continued to be very much involved with the education of social workers, psychologists, and nurses. Social work students at the postgraduate level had a field placement at the mental health centre and they were offered the close co-operation of our staff. The internship programme for the training of clinical psychologists continued during the year and this centre provided one of the few places where students could obtain clinical experience and supervision. Too, the clinic staff have been vitally involved in field experience of occupational therapists from the School of Rehabilitative Medicine and also with nursing students from the University of British Columbia and elsewhere. Again, as with the other training programmes, these students obtain practical experience in dealing with patients and clients. Besides this part the clinic staff have played in these programmes, a number of orientation lectures and courses have been given by the senior staff. School COMMUNITY MENTAL HEALTH SERVICES G 119 counsellors, probation officers, and others have benefited from this type of education. Many visitors have been through the centre during the year and whenever possible they have been provided with a full orientation to the clinic and its functions. These people have been from all disciplines involved in mental health work and also have included personnel from other mental health centres in the Province. It is not too much to say that this can be regarded as a major training centre in British Columbia for mental health personnel. The past several years the clinic has emphasized, first, family group treatment and then group psychotherapy, generally, and now the emphasis seems to be slowly moving toward leadership in the area of community psychiatry. RESEARCH During the year there has been some increase in the energies devoted to research. The Psychology Department has continued to produce research studies and the anamnestic variables and social interaction among Day Hospital patients has been written up and will appear in a coming issue of the International Mental Health Research Newsletter. Another study has been submitted to Canada's Mental Health on the relationship between referral and admission population characteristics of an adult mental health centre. A paper on " Marathon Group Psychotherapy " is in the process of organization and, too, a study has been started investigating the effects of parental attitudes and child-rearing practices on discrimination learning and philanthropic behaviour in children. The special project in the Learning Clinic was dropped during the year due to a general staff shortage in this area of clinical investigation. The project showed its value to the Burnaby School Board the previous year and a teacher employed in our clinic moved over to work with the Burnaby School Board. In other words, this project did prove the usefulness of a learning clinic and special educational procedures. It is envisaged that in the next year, with the establishment of the Residential Treatment Centre, there will be facilities and staff available to renew a learning clinic project. Too, it should be stressed that in the coming year all of the clinic staff will have a great opportunity to be involved in residential and group- living home treatment, day care of all types, and also see the effective use of community psychiatry in this clinic. CONCLUDING REMARKS During the year the clinic underwent a number of organizational and staff changes and over-all this could be thought of as preparation for the year to come when the clinic will almost certainly be involved in some new and exciting developments. These developments will include the establishment of a residential treatment unit and an over-all children's treatment complex (including the residential treatment, group-living home treatment, day care facilities, and special educational facilities) and the establishment of a comprehensive community mental health centre on a regional basis. Further organizational changes will probably be needed, but the clinic in the coming year should be in a position to make an even greater contribution to the mental health of the people of this Province. G 120 MENTAL HEALTH SERVICES REPORT, 1966/67 STATISTICS Table 1.—Mental Health Centres' Case Load by Clinic, Adults and Children, April 1, 1966, to March 31, 1967 Location of Mental Health Active Cases, Apr. 1,1966 First Activations Reactivations Total Case Load Total Terminated Active Cases, Mar. 31,1967 Centre Adult* Child 2 Adult Child Adult Child Adult Child Adult Child Adult Child 662 290 184 225 18 570 124 93 142 27 631 202 191 122 i 114 30 47 780 157 112 101 208 43 18 220 I 68 i 68 13 31 14 19 206 48 26 6 49 10 8 1,513 560 ' 443 360 163 44 66 1,556 329 231 249 284 53 26 822 245 * 242 23 147 10 4 1 977 219 168 30 254 5 2 691 315 201 337 16 34 1 62 579 110 63 Nanaimo^. .. . Trail. .. 219 30 48 24 Totals, all centres- 1,379 956 1,337 1,419 433 353 3,149 2,728 1,493 1,655 1 1,656 1 1,073 i Seventeen years of age and over. 2 Sixteen years of age and under. 3 Approximate figures. COMMUNITY MENTAL HEALTH SERVICES G 121 Table 2.—Activations to Mental Health Centres by Health Unit and School District of Residence, April 1, 1966, to March 31, 1967 Health Unit First Activations Reactivations Total Activations Health Unit First Activations Reactivations Total Activations East Kootenay, Cranbrook— School District No. 1 8 22 47 1 30 8 42 13 6 31 112 7 4 15 29 4 77 2 21 49 4 8 137 6 11 1 2 4 2 67 33 17 29 11 108 16 56 78 9 29 11 10 10 1 2 4 12 5 1 8 30 1 7 9 1 18 1 4 26 2 3 46 3 1 1 1 24 6 2 12 5 40 3 16 16 2 2 8 32 57 2 32 12 54 18 7 39 142 8 4 22 38 5 95 3 25 75 6 11 183 9 12 1 1 2 5 3 91 39 19 41 16 148 19 72 94 11 31 11 Central Vancouver Island, Nanaimo— School District No. 65 „ 66 67 , 68. , 69 „ 70— „ 79. Upper Island, Courtenay— School District No. 71 „ 72.... „ 85... Cariboo, Williams Lake— School District No. 27 28 Skeena, Prince Rupert— School District No. 50 51 tt »» tt ^^ , 53 „ 54 „ 80 Peace River, Dawson Creek— School District No. 59 . „ 60... „ 81 83. Northern Interior, Prince George— School District No. 55 „ „ „ 56 . 27 3 12 92 4 36 2 36 23 2 7 13 2 1 25 27 4 19 11 13 1 2 1 28 296 24 25 2 26 444 287 63 14 2 14 1 2 28 2 5 2 1 1 2 3 i 8 4 ~3 1 11 94 7 9 7 155 82 10 4 ~~1 „ ,, „ 2 tt tt tt 3 „ „ „ 4 . .. 29 3 12 „ „ 5 120 Selkirk, Nelson— 6 41 „ 7 „ „ 8 2 10 West Kootenay, Trail— School District No. 9 „ „ „ 11 38 24 3 12 „ 13... 9 16 North Okanagan, Vernon— School District No. 19 2 „ 20 „ 21 tt »» tt 2Z „ 78 South Okanagan, Kelowna— School District No. 14.. 1 33 35 4 23 tt ,, tt 15 , 16 17 „ „ „ 23 11 16 1 1 „ 77 South Central, Kamloops— School District No. 24 2 25 1 , 29 30 „ 31 Upper Fraser Valley, Chilliwack— School District No. 32 tt it tt ■"— 34. Central Fraser Valley, Mission City- School District No. 35 57— Greater Victoria Metropolitan Board of Health- School District No. 61 62... 63 »» tt tt o4 Metropolitan Health Committee, Vancouver— School District No. 38 »» »» »» »V , 41 „ 44 „ 45 School district not covered by health units— School District No. 49 Unknown 39 390 31 34 2 33 599 „ „ „ 4?. 369 75 Boundary, Cloverdale— School District No. 36 „ 37 Simon Fraser, New Westminster- School District No. 40 73 18 2 15 1 Totals ..... Coast Garibaldi, Powell River— 2,756 786 3,542 School District No. 46 „ 47 . .. .. „ „ 4R G 122 MENTAL HEALTH SERVICES REPORT, 1966/67 Table 3.—Total Activations to Mental Health Centres by Clinic, Age-group, and Sex, April 1, 1966, to March 31, 1967 Clinic and Sex Total Activations Age-group (Years) 0-9 10-16 17-19 20-29 30-39 40-49 50-59 60 and Over Burnaby— 1,045 792 272 88 427 199 71 77 115 142 59 122 61 99 21 52 19 Female.. — . ... 13 Totals 1,837 360 626 148 257 | 181 160 73 32 Victoria— 267 208 50 24 91 40 29 15 36 46 24 34 15 24 16 15 6 10 Totals— . 475 74 131 44 82 )| 58 39 31 16 Kelowna— 201 196 42 15 62 19 13 25 II 20 24 30 1 40 16 34 11 21 13 12 Totals 397 57 81 38 50 | 64 50 32 25 Nanaimo'— 126 116 27 7 45 28 9 8 15 29 13 17 10 20 6 6 1 1 Totals 242 34 1 73 17 44 | 30 30 12 1 2 Trail- 249 153 I 68 18 116 55 20 19 1 15 15 12 17 11 16 4 10 3 3 Totals 402 86 171 39 30 | 29 27 14 , 6 Chilliwack— 55 42 11 2 24 16 3 i 2 1 6 3 5 7 4 9 2 1 2 Totals 97 13 40 5 9 l| 12 13 3 2 Vernon— 42 50 6 4 11 5 5 2 7 7 1 14 8 12 2 3 i 3 3 Totals 92 10 16 7 14 | 14 20 5 6 Totals— 1,985 1,557 476 158 776 362 150 148 1 214 272 137 251 125 214 62 108 45 44 3,542 634 1,138 298 486 388 339 1 170 i 89 i Approximate figures. Table 4.—Mental Health Centres' Terminations by Type of Service, Age at Termination, and Clinic, April 1, 1966, to March 31, 1967 Location of Mental Health Centre Total Terminations Assessment without Treatment Assessment with Treatment Adults Children Adults Children Adults Children 822 245 242 23 147 10 4 977 219 168 30 254 5 2 325 115 101 9 111 10 4 721 102 93 10 185 5 2 497 1 130 141 14 36 256 117 75 20 Trail 69 1,493 1,655 675 1,118 818 537 COMMUNITY MENTAL HEALTH SERVICES G 123 Table 5. — Total Cases Terminated from Mental Health Centres by Psychiatric Diagnosis and Age at Termination, April 1, 1966, to March 31, 1967. Psychiatric Diagnosis Adultsi Children2 Total Number Percentage Brain syndromes— 3 22 3 26 6 48 0.2 1.5 Totals 25 29 54 I 1.7 Psychoses— 284 i 22 11 9 3 13 91 5 1 375 22 11 9 3 18 1 11.9 0.7 0.3 0.3 0.1 0.6 Totals 342 96 438 13.9 Psychoneuroses— 133 296 90 32 13 24 165 309 114 5.3 9.8 3.6 Totals 519 69 588 18.7 25 - 25 1 0.8 Disorders of character, intelligence, and behaviour— 121 i 142 14 3 145 16 54 7 39 51 587 390 84 142 22 160 193 14 3 587 535 100 142 54 29 5.1 6.1 0.4 0.1 18.7 17.0 3.2 4.5 1.7 Other and unspecified character, behaviour, and intelligence disorders 0.9 Totals . _ 502 1,315 1,817 57.7 2 2 11 65 2 69 75 4 2 80 140 0.1 0.1 2.5 Observation without further need for psychiatric care 4.5 1,493 1,655 3,148 100.0 i Seventeen years of age and over. 2 Sixteen years of age and under. Table 6.—Cases Active in Mental Health Centres as at March 31, 1967, by Length of Treatment Period and Clinic Location of Mental Health Centre Total, AU Cases Number of Months Under 3 3-5 6-11 12-23 24 and Over 1,270 425 264 556 46 82 86 445 61 49 69 23 66 86 262 50 48 58 8 16 253 94 60 100 6 152 133 70 132 7 158 87 37 197 Trail 2 2,729 799 442 513 494 481 G 124 MENTAL HEALTH SERVICES REPORT, 1966/67 MENTAL HEALTH CENTRE, VICTORIA A. L. Aranas, Acting Director ORGANIZATION AND FUNCTION The organization and function of this mental health centre continued along the lines and philosophy established during previous years. In spite of the professional staff changes, these functions were adjusted and maintained to meet the increasing demands for psychiatric services by the community. The after-care programme, which is one of the main functions of the centre, has been operating in its full capacity. A great number of the patients are discharged from the Riverview Hospital. Most of these patients, diagnosed as chronic schizophrenics, reside in boarding homes in the Greater Victoria area. The boarding homes are well supervised by a team comprised of a psychiatrist, nurse, and social worker. The team meets weekly to discuss administrative and clinical problems that arise in the boarding homes. These meetings, a crucial means of therapeutic communication between the clinic staff, patients, boarding-home operators, and social welfare agencies involved, proved to be a valuable tool in the rehabilitation of the patients and the education of the paramedical personnel. The majority of the after-care patients are maintained on one or on a combination of two or more psychopharmacological agents, thus the increasing use of drugs parallels the increasing number of after-care patients. Pharmacotherapy has maintained most of the patients at a level of adequate social and functional efficiency outside of hospitals. In December, 1966, a Christmas party for the after-care patients was held at the White Cross Centre of the Canadian Mental Health Association, Victoria Branch. This party was organized by the staff of the mental health centre. It was well attended by the patients and staff. Psychotherapy, whether individual, group, or family, continued to an increasing number of sessions as the techniques and experience of the staff reached a level of sophistication and specialization. Education as a preventive measure in psychiatry is carried out by the professional staff through lectures, talks, meetings, and conferences with different community organizations. These minimized direct therapeutic services to some cases and we focused on consultative work with the majority of cases that were referred to the centre. Co-operation and better working relationships with the medical practitioners, welfare agencies, school boards, Courts, etc., prevailed during the course of the year, thus promoting a much better insight into the needs of the community in general. The second workshop on " The Development of a Mental Health Programme for Greater Victoria " was held in September, 1966. STAFF During the year the following staff members resigned from the mental health centre:— Miss Ann Burridge, Staff Nurse, resigned June 15, 1966, to be married. Mr. A. W. Rippon, Social Worker, resigned October 14, 1966, to accept a position as Research Assistant with the Department of Social Welfare, Victoria. Dr. Charles Gregory, Psychiatrist and Director of the centre, resigned November 30, 1966, to take up private practice. COMMUNITY MENTAL HEALTH SERVICES G 125 Dr. Pierre F. d'Estrube, Psychiatrist, resigned from his full-time position in December, 1966, to enter private practice. He is now with the centre on a sessional basis. Appointments were made as follows:— Dr. A. L. Aranas, Psychiatrist, was appointed Acting Director of the centre as of December 1, 1966. Mrs. R. Hoodless, Staff Nurse, was appointed November 22, 1966. Mrs. J. M. de Cunha, Social Worker, was appointed January 3, 1967. The clerical staff continue to provide their devoted services in maintaining up- to-date statistical data, case records, typewritten psychological reports, correspondence, etc. Their services provide the open network of communication between the professional staff and their patients, and the centre and the community. STATISTICS Cases brought forward at April 1, 1966 Cases opened 415 475 Total under treatment Cases closed 890 454 Cases carried forward at March 31, 1967 Total Patient Interviews 436 Psychiatric Psychological Social work __. Nursing 2,933 346 2,045 1,468 G 126 MENTAL HEALTH SERVICES REPORT, 1966/67 OKANAGAN MENTAL HEALTH CENTRE, KELOWNA F. E. McNair, Director The Okanagan Mental Health Centre is staffed by one psychiatric team consisting of psychiatrist, social worker, clinical psychologist, and mental health nurse. One would envisage this team being the nucleus of a mental health service which would provide case consultation and treatment to sick persons but also provide a preventive service. It is desirable that a community grow in its awareness of mental health principles and provide sufficient resources both to care for the sick within its own boundaries and to have a comprehensive programme of prevention to reduce the incidence of disorder or at least reduce the degree of handicap suffered by persons with illness. Up until June, 1966, Dr. A. J. Bennee, practising psychiatry in Vernon, was devoting half his time to the work of the clinic in the North Okanagan at the public health units at Vernon, Salmon Arm, and Revelstoke. The efforts of citizens in Vernon to establish their own mental health centre for the North Okanagan were rewarded in January, 1967, with the establishment of a unit there. The population of the South Okanagan is 60,000 people and the North Okanagan 40,000 people. According to the best advice we have available, one psychiatric team can give service to 15,000 people. In consequence we have not been able, in this mental health centre, to reduce further the number of first admissions to the Provincial mental health facilities at the Coast, though the 50-per-cent reduction noted earlier has not been lost. We have been happy to have the consultative services of Headquarters staff during the year and to work closely with other community agencies who have the responsibility for mental health as well as ourselves, including the Public Health Branch, the Department of Social Welfare, the Probation Service, the school districts, and the physicians. Although we have regular office hours from 8.30 a.m. to 5 p.m., there are frequent demands for participation in public education through evening meetings and for emergency care either by direct appeal or through the police or through the hospital emergency department. The statistical tables show the amount of actual service rendered. All of the staff function both out of the mental health centre offices at the health unit in Kelowna and also serve patients in the travelling clinics and at the hospital. COMMUNITY MENTAL HEALTH SERVICES G 127 VANCOUVER ISLAND MENTAL HEALTH CENTRE, NANAIMO S. E. Jensen, Director ORGANIZATION AND STAFF 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 mental health centre began operation in April, 1964, in a hereto-unserviced 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. In this area with a population of approximately 150,000 there is only one psychiatrist in private practice. 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 units. Each member of the professional staff has spent one day a month in each of these centres. Beds in the Nanaimo Regional General Hospital have been available for those patients who require hospital care, and as a result few patients have needed to be certified to the Riverview Hospital at 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 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 professionals 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 the staff consisted of a receptionist, a typist, a psychiatric nurse, a psychiatric social worker, and a psychiatric director. The position of clinical psychologist was vacant during most of the period but was filled as of January 1, 1967. EDUCATION The staff has spoken at more than 150 meetings of service clubs and other community organizations, and only some of the more noteworthy educational events can be mentioned here. Courses in counselling involving 10 sessions each have been given to the Ministerial Association in Duncan, Nanaimo, Alberni, and Campbell River. Dr. Jensen provided a refresher course in psychiatry to the medical staff at St. Joseph's Hospital in Comox. The staff has participated in the Marriage Preparation Course sponsored in Nanaimo by the Canadian Mental Health Association and the Ministerial Association. Plans for the coming year include a full day workshop for teachers and a full day workshop for parents of children with nervous handicaps. The clinic staff was also involved in bringing into Nanaimo three important rehabilitation facilities—the Goodwill Enterprises, the Sheltered Workshop for the Handicapped, and a group-living home for retarded children. The Director has on three occasions answered questions from the public over the so-called " Hot Line " programme on local radio stations in Alberni and Nanaimo and this we consider an important contribution to community education. G 128 MENTAL HEALTH SERVICES REPORT, 1966/67 REHABILITATION COMMITTEE Rehabilitation committees now function in all the centres served by the full- time or the travelling clinics, and an important part of the social worker's time has been taken up in liaison with this committee. This is a new endeavour which we feel is important and which has provided an excellent service to the community. CAMP The idea of a camp for emotionally disturbed children developed as an attempt to overcome the serious lack of facilities for psychiatric in-hospital treatment of children which exists, not only in British Columbia, but in all of Canada. The camp was in a sense an open-air hospital providing all the facilities and types of treatment which would ordinarily be available in such a hospital. At the same time, we felt that the children would benefit from the emphasis on learning and growing up rather than illness and treatment, which was possible in the camp situation. Because almost all of the children had been referred primarily as school-adjustment problems, it was natural to emphasize school assessment, and with the co-operation received from the Department of Special Education at the University of British Columbia, we were able to make an extensive study of the child's school development. This later proved to be of great benefit to the schools and to the children upon their returning home. Twenty-two children from the area served by our clinic attended the camp for two weeks and we are planning to repeat this programme during the summer of 1967. SERVICE During the year a total of 511 patients was seen, and 4,796 interviews were conducted either with the patients or their various relatives. The interviews were distributed among the staff as follows:— Psychiatrist 2,350 Social worker 1,195 Nurse 1,251 Conferences with school officials are conducted weekly during the school year in Nanaimo and monthly in each of the centres to which the clinic travels. Close liaison is also maintained with the Department of Social Welfare and with the Probation Services and also with the Courts and the Royal Canadian Mounted Police. Approximately 150 patients spent an average of just over 10 days each in the Nanaimo Regional General Hospital where, although no special psychiatric ward is available, a wide range of psychiatric treatment is possible, including occupational therapy and electrotherapy. COMMUNITY MENTAL HEALTH SERVICES G 129 KOOTENAY MENTAL HEALTH CENTRE, TRAIL G. R. Mansfield, Director This, the third annual report on the activities of the Kootenay Mental Health Centre, records a year characterized by heavy emphasis on service. The goal of providing a comprehensive regional mental health service to the East and West Kootenay regions, representing a widespread and rapidly growing population of approximately 120,000 people, has gone steadily if slowly forward. No dramatic growth has occurred, but the foundations are firm for future expansion. Although the Kootenay centre is referred to as a regional one, it is necessary to think in terms of both community and regional services as integration, communication, and the type of service possible varies between Trail and vicinity and the more remote areas. Clearly, the quality and effectiveness of out-patient treatment service decreases with distance from the treatment centre. FACILITIES The mental health centre occupies the upper floor of the Public Health Building. The present staff consists of two stenographers, a psychologist-in-training, one social worker, and a psychiatrist-director. The psychiatrist has been active in formulating plans for building a psychiatric unit to the general hospital. PROGRAMMES IN THE COMMUNITY OF TRAIL The Foster-Parent Training Programme continues to improve and fill a need for a resource which can handle the more disturbed child that in most places would be handled in an in-patient treatment centre. Expansion of this programme with continued follow-up support is necessary. It has been found unnecessary to establish a special class for the emotionally disturbed child in the school. Medication and understanding of the child by the teacher is the key to success here. It is probably not desirable to separate the emotionally disturbed into a separate class and make him feel different. Development of programmes in collaboration with the schools to fill the teaching needs of the perceptually handicapped is progressing satisfactorily. We have identified over 100 congenitalfy dysphasic children. Classes with special equipment and teachers trained in this field have been established in Trail and Kimberley. Cranbrook is preparing to open a class next fall and Nelson is showing interest. The Trail Youth Liaison Committee is an indispensible means of communication, sharing of knowledge, and planning programmes for youth who are presenting problems in multiple areas. It represents all agencies working with youth and is a symbol of our solidarity and ability to work harmoniously together. EDUCATION AND PREVENTION Education and prevention go together. Knowledge of mental hygiene by professional and lay people means early referral and better results with less effort. Working with the clergy has emphasized their role as first-aid posts in mental health, utilizing their counselling training. Our contacts with school personnel in conferences and workshops has created an awareness of their role in helping children adjust socially and the indications for referral. Most of our education this year has been directed toward professional groups. The family doctors have gained a better knowledge of psychiatry through participation in care of patients and reports G 130 MENTAL HEALTH SERVICES REPORT, 1966/67 free from psychiatric jargon and geared to their understanding. Their increased interest is reflected in the flood of referrals and requests for discussions on drugs. The public health nurses receive ongoing training by formal and informal conferences, group discussions on specific psychiatric subjects, films, and the opportunity to discuss at regular intervals cases in which they are involved. TRAVELLING CLINIC Three days each month are spent in Cranbrook. Everyone is looking forward to the day when a permanent service will be established in Cranbrook. It will go a long way toward taking the pressure off the Trail centre as well as providing more adequately for the large and growing East Kootenays. REGIONAL SERVICE The social worker saw 1,354 people during the year. There were 1,233 interviews by the psychiatrist and psychological testing by the psychiatrist was carried out on 162 children. Service was rendered to various agencies and regions and can readily be determined from the tables that follow:— Referrals Source Total Area Adults Children 174 119 50 24 34 Trail 87 15 5 2 13 7 4 1 17 1 57 Cranbrook 15 Trail. 85 Cranbrook 27 Trail. 24 6 Trail ..... 12 Cranbrook Trail 7 13 Cranbrook 3 401 152 249 Service Adults Children Patients Consultations Mental Health Centre, Trail 31 29 16 33 51 55 24 44 82 1 124 77 109 174 283 Treatment Mental Wealth fentrp Trail 47 71 118 COMMUNITY MENTAL HEALTH SERVICES G 131 FRASER VALLEY MENTAL HEALTH CENTRE, CHILLIWACK W. G. Jilek, Director The Fraser Valley Mental Health Centre started operation in November, 1966, as a regional facility with an area of responsibility extending from Boston Bar to Langley. This includes the Upper Fraser Valley and the Central Fraser Valley Public Health areas with a total population of 114,700. The centre is designed:— (1) To render diagnostic assessment and ongoing consultative and educational services to medical practitioners, public health units, social agencies, pedagogic institutions, correctional officers, and to community organizations concerned with the promotion of mental health: (2) To render treatment services to selected cases constituting difficult therapeutic problems and requiring a multi-disciplinary approach and (or) family-, group-, and play-therapeutic techniques: (3) To direct future planning toward a public mental health orientation with projects in the fields of psychiatric epidemiology and primary prevention of mental ill health. STAFF During the report period the staff consisted of a psychiatrist-director and one clerk-stenographer. A part-time psychologist has been available on a five-days-per- month basis since beginning of March, 1967. Efforts are being made to recruit suitable candidates for the open positions of full-time psychologist, psychiatric social worker, and mental health nurse. CLINICAL SERVICES The permanent clinic is located at the Chilliwack Health Centre; travelling clinics provide a regular service to Abbotsford, Mission City, Langley, and, in the future, also to Hope. Case referral to the centre is as a rule made through the family physician, however, referrals may be initiated by various agencies. Screening committees have been set up in Chilliwack, Abbotsford, Mission City, and Langley to decide upon priorities. Clinical assessment in interviews with the patients and their relatives is supplemented by case conferences where the psychiatrist, family physician, and the delegates of agencies concerned with the patient's welfare convene to offer their advice and to arrive at a detailed recommendation on management of the case. From November 7, 1966, to March 31, 1967, the following clinical services were rendered by the Fraser Valley Mental Health Centre:— Chilliwack Clinic— Cases seen in psychiatric assessment 69 Interview sessions held with relatives 51 Mental health case conferences 65 Follow-up treatment sessions 16 Travelling Clinic, Abbotsford— Cases seen in psychiatric assessment 16 Interview sessions with relatives 12 Mental health case conferences 14 G 132 MENTAL HEALTH SERVICES REPORT, 1966/67 Travelling Clinic, Mission City— Cases seen in psychiatric assessment - Interview sessions held with relatives Mental health case conferences 7 5 7 Travelling Clinic, Langley— Cases seen in psychiatric assessment. Interview sessions with relatives Mental health case conferences Altogether a total of 100 patients was assessed by the Fraser Valley Mental Health Centre psychiatrist. Only 16 sessions were devoted to the follow-up treatment of cases selected according to the criteria mentioned above. It was possible to refer the bulk of the case load for further management by medical practitioners, private psychiatrist, health, welfare, and probation officers maintaining a close consultative contact with the centre. EDUCATIONAL SERVICES AND COMMUNITY CONTACTS Agencies and professional groups, the co-operation of which is indispensable for the centre's work, were addressed in orientation meetings and informed on objectives and activities of the Fraser Valley Mental Health Centre, with particular reference to the mental health aspect relevant to their respective fields. This included meetings with the medical professional groups in Chilliwack, Hope, Abbotsford, and Langley; the public health units of the Upper and Central Fraser Valley Health Departments; the Social Welfare Departments in Abbotsford and Chilliwack; the Salvation Army Rehabilitation Centre, Miracle Valley at Deroche; the school authorities at Langley; the Parent-Teacher Association groups at Agassiz and Harrison Hot Springs; the Association for Retarded Children school at Sardis, and the newly founded Chilliwack Homemaker Service. Upon initiative of the centre, a steering committee was formed with the purpose of organizing a local branch of the Canadian Mental Health Association. COMMUNITY MENTAL HEALTH SERVICES G 133 NORTH OKANAGAN MENTAL HEALTH CENTRE, VERNON A. J. Bennee, Director The North Okanagan Mental Health Centre commenced operating on January 23, 1967, with the appointment of Dr. A. J. Bennee, Director. The psychologist, J. MacGillivray, was appointed on January 24, 1967, and the stenographer, Mrs. K. Hawking, on February 1, 1967. Accommodation has been provided in the North Okanagan Health Unit building. Because of the fact that mental health services had previously been provided in Vernon and district (until September, 1966, by the Okanagan Mental Health Centre in Kelowna), the local doctors immediately resumed the referring of patients. There was some degree of backlog and referrals came in fast right from the start. Travelling clinics have been held in Salmon Arm and Revelstoke as from March 1st. Both centres are visited two days per month and clinics are held in the local health unit buildings. Public health unit staff maintain duplicate files locally while master files are kept in the Vernon mental health centre. Dellview Hospital is being visited one day a week for an hour or more, depending on the number of patients for whom consultation is requested. Mental health services drugs are dispensed by the pharmacist at the Vernon Jubilee Hospital. A supply of drugs is also kept at the mental health centre for emergency use. Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty in right of the Province of British Columbia. 1968 580-1167-9111
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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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Title | Mental Health Services Branch PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT FOR TWELVE MONTHS ENDED MARCH 31 1967 |
Alternate Title | MENTAL HEALTH SERVICES REPORT, 1966/67 |
Creator |
British Columbia. Legislative Assembly |
Publisher | Victoria, BC : Government Printer |
Date Issued | [1967] |
Genre |
Legislative proceedings |
Type |
Text |
FileFormat | application/pdf |
Language | English |
Identifier | J110.L5 S7 1968_V01_10_G1_G133 |
Collection |
Sessional Papers of the Province of British Columbia |
Source | Original Format: Legislative Assembly of British Columbia. Library. Sessional Papers of the Province of British Columbia |
Date Available | 2018-03-16 |
Provider | Vancouver : University of British Columbia Library |
Rights | Images provided for research and reference use only. For permission to publish, copy or otherwise distribute these images please contact the Legislative Library of British Columbia |
CatalogueRecord | http://resolve.library.ubc.ca/cgi-bin/catsearch?bid=1198198 |
DOI | 10.14288/1.0364473 |
AggregatedSourceRepository | CONTENTdm |
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