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Mental Health Branch PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT 1968 British Columbia. Legislative Assembly 1969

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 DEPARTMENT OF HEALTH SERVICES
AND HOSPITAL INSURANCE
Mental Health Branch
PROVINCE OF BRITISH COLUMBIA
ANNUAL REPORT
1968
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1969
  To Colonel the Honourable John R. Nicholson, P.C, O.B.E., Q.C., LL.D.,
Lieutenant-Governor of the Province of British Columbia.
May it please Your Honour:
The undersigned respectfully submits the Annual Report of the Mental Health
Branch, Department of Health Services and Hospital Insurance, for the year 1968.
R. R. LOFFMARK,
Minister of Health Services and Hospital Insurance.
Office of the Minister of Health Services and Hospital Insurance,
Victoria, British Columbia, January 23,1969.
 Department of Health Services and Hospital Insurance,
Mental Health Branch,
Vancouver, British Columbia, January 23, 1969.
The Honourable R. R. Loffmark,
Minister of Health Services and Hospital Insurance,
Victoria, B.C.
Sir,—I have the honour to submit the Annual Report of the Mental Health
Branch for 1968.
F. G. TUCKER, M.B., B.S., C.R.C.P., M.Sc.
Deputy Minister, Mental Health Branch.
 '
■$.
y-m.
The Honourable Ralph R. Loffmark, Minister of Health Services and Hospital Insurance.
 F. G. Tucker, M.B., B.S., C.R.C.P., M.Sc, Deputy Minister of Mental Health.
 TABLE OF CONTENTS
PART 1.—GENERAL ADMINISTRATION
Report—Deputy Minister of Mental Health	
Report—Comptroller of Expenditure	
Page
9
14
Report—Departmental Personnel Officer  3 5
Report—Co-ordinator of Mental Retardation Programmes  41
Report—Social Service Consultant  42
Report—Nursing Consultant  46
Report—Statistician and Medical Records Consultant  49
Report—Consultant jn Sociology  52
Report—Information Services  53
PART II.—COMMUNITY MENTAL HEALTH SERVICES
Mental Health Centre, Burnaby  55
South Vancouver Island Mental Health Centre, Victoria  61
Central Vancouver Island Mental Health Centre, Nanaimo  63
South Okanagan Mental Health Centre, Kelowna
West Kootenay Mental Health Centre, Trail	
Upper Fraser Valley Mental Health Centre, Chilliwack-
North Okanagan Mental Health Centre, Vernon	
Northern Interior Mental Health Centre, Prince George.
66
67
70
73
75
Statistical Tables, Mental Health Centres  77
PART III.—IN-PATIENT SERVICES
Report—Director of Mental Health Services  81
Report—Director of Nursing Education  88
Report—Superintendent, Riverview Hospital  8 9
Report—Superintendent, The Woodlands School  127
Report—Superintendent, The Tranquille School  141
Report—Superintendent, Geriatric Division  147
Report—Executive Director, British Columbia Youth Development Centre,
The Maples, Burnaby  166
Cover photo by Ken Thompson, reproduced
from mental health booklet " When Things
Go Wrong," published by the Canadian Mental Health Association.
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 Report of the Mental Health Branch
April 1, 1967, to December 31, 1968
PART I.—GENERAL ADMINISTRATION
REPORT OF THE DEPUTY MINISTER OF MENTAL HEALTH
F. G. Tucker, M.B., B.S., C.R.C.P., M.Sc.
I hereby submit for your consideration a report on the activities of the Mental
Health Branch covering a period of 21 months from April 1, 1967, to December 31,
1968. Future Annual Reports will be based on the calendar year, thereby permitting an up-to-date presentation of the operation of this Branch to the Legislature.
It is only right that this Report should commence by paying tribute to Dr. A. E.
Davidson, who retired on March 31, 1967, after 38 years of service dedicated to the
mentally ill of this Province. For eight years, as Director and Deputy Minister, he
steered the Mental Health Branch through a period of expansion and through the
many problems which are inevitable in periods of transition. Among his many
accomplishments he will be remembered as the author of the Mental Health Act,
1964, and for the number of major projects which he initiated, including the Eric
Martin Institute, the British Columbia Youth Development Centre in Burnaby, and
The Glendale Hospital, all of which are now drawing to completion or are well
under way. In his new post as Mental Health Consultant to the Federal Government, Dr. Davidson will bring his long experience to bear upon the broad aspects
of mental health at the National level.
In April, 1967, the Honourable Wesley D. Black, Minister of Health Services
and Hospital Insurance, appointed a committee to review the organization and
future role of the Mental Health Services Branch. As a consequence of these deliberations, the Minister made the following statement, which perhaps best summarizes
the principles upon which the operation of the Mental Health Branch will be based
in the foreseeable future and the reorganization necessary to achieve these aims:—
" The Mental Health Branch is undergoing a major reorganization to
meet the changing patterns of care for the mentally ill and retarded. It will no
longer be primarily ' service ' oriented, but will assume increased responsibility for
the over-all aspects of mental health planning in order to facilitate the decentralization and regionalization of mental health programmes throughout the Province.
" The positions of Deputy Minister and Director have been separated, and the
Director of Mental Health Services, Dr. H. W. Bridge, will be located in the Vancouver area, having as his responsibility the management of all mental hospitals and
institutions providing in-patient care, as well as the Mental Health Centre in Burnaby. The Deputy Minister, Dr. F. G. Tucker, will be located in Victoria and will
have a staff of professional consultants whose task it will be to co-operate with local
authorities, mental health professionals, universities, public and private agencies,
as well as with other Government departments in the development of community
programmes.
" Particular emphasis will be placed upon providing professional counsel for
the development of community-based psychiatric programmes, facilities and services
for mental retardates, comprehensive programmes for emotionally disturbed chil-
 L 10
MENTAL HEALTH BRANCH REPORT,  1967/68
dren, integrated services for the aged mentally ill, and for the provision of forensic
clinics. Special epidemiological and sociological studies will be undertaken; emphasis will be placed on the collection, analysis, and interpretation of essential statistical data; ongoing programmes will be continually evaluated; any required regulations, standards, etc., will be developed; in-service training, liaison with universities, organization of seminars, institutes, and workshops for professional groups will
be promoted; and clinical research will be facilitated.
" It will be appreciated that in a period of rapid change and development it is
not possible to provide a detailed blueprint for the future and that the primary
characteristics of all such planning must be flexibility and the continuing evaluation
of programmes. However, it can be assumed that future programmes will be based
upon the following:—
" Decentralization and regionalization will be emphasized and a wide
range of new programmes will be developed to meet local needs . . .
" The existing division in the care of physical and mental illness will gradually lessen and largely disappear . . .
" The larger centralized facilities will be adapted to meet current demands
for psychiatric services to the mentally ill and retarded in such a way
as to facilitate modification to meet changes in requirements occasioned by the development of other regionalized and decentralized
programmes . . .
" The recruitment and training of new professional staff will receive a
high priority due to the anticipated continued shortage of mental
health professionals.   In-service training and retraining will be advanced and special programmes developed to meet staffing requirements . . .
" Increasing emphasis will be placed upon prevention, thereby requiring
more precise problem identification and definitive planning . . .
" The improvement and evaluation of treatment methods will require continuing research at the clinical level.
" In summary, the reorganization will result in the broadening of the Mental
Health Branch from that of  a  ' service'  organization  to  one  which  will  be
involved in all aspects of mental health through involvement, integration, co-operation, and liaison with all those who are concerned in the mental welfare of the Province, the objective of which will be the decentralization and regionalization of mental
health programmes."
On August 1, 1967, Dr. F. G. Tucker was appointed Deputy Minister of the
Mental Health Branch; Mr. A. Porteous, Assistant Deputy Minister; and
Dr. H. W. Bridge, Director of Mental Health Services. Steps were immediately
taken to establish and recruit the positions necessary to effect the organizational
change in the administration to relocate the headquarters Branch office in Victoria,
and the efforts of the Branch were increasingly focused on community programming.
As this year draws to a close, I am pleased to report that in accordance with
the above recommendations the following progress has been made:—
I. The headquarters Branch office was established in temporary quarters in
Victoria in November, 1967, and will move to its permanent quarters in January,
1969. The Branch has been reorganized so that it now consists of two main components under the over-all direction of the Deputy Minister. The Mental Health
Services Division, under the Director of Mental Health Services, is now responsible
for providing the bulk of direct treatment through the various in-patient facilities.
The Community Psychiatric Programmes Division, which will be directed by Dr.
 general administration
L 11
R. Congdon (who will be joining our staff in January, 1969), will be made up of
the regional mental health centres and will concern itself particularly with the coordination and development of regional mental health programmes. Its primary
function will be one of consultation, education, the development of special programmes, and limited direct community-based services.
Neither of these positions can function effectively without adequate planning,
programme evaluation, and an efficient business and fiscal administration. The
necessary positions to carry out these important functions have therefore been established in the Branch office as outlined in the organizational chart which accompanies
this Report.
II. Decentralization and Regionalization.—For the purpose of mental health
planning, the Province has been divided into eight regions based upon clusters of
health units. As the basic unit of these regions is the school district, rigid adherence
to the proposed boundaries is not essential should change be considered desirable
in the future. During the coming years the mental health needs and resources of
these individual regions will be studied, and it is hoped that, in co-operation with
the appropriate groups and agencies, a co-ordinated programme for the mentally ill
and the retarded will be developed.
There are now 10 mental health centres established in this Province, and I am
hopeful that a further two out of the remaining six will be in operation shortly.
However, the shortage of professional staff willing to work in the smaller rural communities renders recruitment a matter of continuing concern. The reports of these
centres is detailed elsewhere in this Report.
I am particularly pleased with the close working relationship that has been
established with the Department of Social Welfare during the past year. As an
example of this co-operative effort, I would draw attention to the Bevan Lodge Association in Courtenay. In conjunction with the Department of Social Welfare and a
group of interested and hard-working citizens, we have been able to set up an intermediate-care facility for 70 moderate to severe adult retardates. This will be administered by a non-profit society—the Bevan Lodge Association. I believe this
programme will not only be beneficial to the trainees concerned, many of whom will
be closer to their homes, but will free urgently needed beds at The Woodlands School
and The Tranquille School.
III. Changing Patterns of Care. — A comprehensive regional mental health
programme must include the following broad categories of care: Acute care, intermediate care, extended care, and chronic care, together with supporting services.
It is envisaged that the acute psychiatric patient will in future be admitted to
the psychiatric ward of the general hospital as these facilities become available.
The expansion of these specialized facilities throughout the Province therefore is of
great significance.* Unfortunately a shortage of acute psychiatric beds continues
in the Greater Vancouver area (Fraser-Burrard region), and for this and other reasons we are presently investigating the possibility of declaring at least part of the
Riverview Hospital an " open " hospital, thereby allowing suitably qualified physicians to admit, treat, and bill their own patients.
The provision of extended care has long been a major responsibility of the
Mental Health Branch, and at the present time over 1,100 in-patients fall within this
category.   These individuals suffer primarily from a physical disability, with mental
* A. Total number of existing psychiatric beds
B. Total number under construction 	
C. Total number—advanced planning  —.
D. Other planning stages  	
149
285
84
313
Total
831
 L 12 MENTAL HEALTH BRANCH REPORT,  1967/68
illness or retardation a secondary component of the over-all illness, and, therefore,
they would be more appropriately placed in future in the expanded extended-care
facilities within their own communities. Only those requiring highly specialized
care should be referred to the larger centralized units. In accordance with this principle, a very small number of cases have been so placed during the latter part of
the year.
The boarding-home or chronic-care programme now in force for over 10 years
has continued to maintain a high level of care, and over 850 patients are currently
placed in supervised boarding homes. In the coming year it is hoped that, in cooperation with the Department of Social Welfare, this programme will be expanded
beyond the immediate precincts of the major metropolitan areas so that patients
will be domiciled in close proximity to their family and friends. The setting-up of
a central referral agency in Victoria has been a useful step in providing maximum
utilization of available resources within that area.
Intermediate care, under which I include day and night hospitals, group-living
homes, nursing homes, and foster homes, out-patient and emergency services, is
presently under review, and I am hopeful that we will be able to initiate a number
of these programmes in the coming year.
IV. Training and Postgraduate Education.—The Mental Health Branch has
continued to provide for and to co-operate in the undergraduate and postgraduate
training of professional staff.
The Department of Nursing Education at Essondale has been concerned in
preparation/training of psychiatric nurses, affiliate student nurses from several general hospital schools of nursing, and basic orientation programmes for psychiatric
aides, as reported elsewhere in the Report.
In September, 1967, a select group of psychiatric nurses was granted educational leave with pay to permit them to enrol in a newly developed course at the
Vancouver College, which provides them with an integrated programme specifically
designed to prepare the nurse to undertake employment in which knowledge of and
competence in the use of community resources is essential. Another group of psychiatric nurses obtained educational leave with pay in order that they might enrol
in specialized courses in administration and supervision at the Simon Fraser University.
In the fall of 1968 a limited number of psychiatric nurses were selected to
enrol in the two-year general nursing course at the British Columbia Institute of
Technology in Burnaby.
The practice of providing bursaries for professional and postgraduate training,
funded by the Mental Health Grant, has been continued. Assistance is provided to
physicians to undertake residency training at the University of British Columbia,
Department of Psychiatry, in the specialty; clinical psychologists are assisted in
obtaining advanced knowledge in their field; social workers are assisted to qualify
for advanced degrees in social work; registered nurses are provided bursaries to
permit them to enrol in university schools of nursing to study for advanced degrees
in the field of nursing administration for nursing education.
Staff are encouraged to improve their qualification by the use of appropriate
correspondence courses. For example, the course for medical records technicians
of the Canadian Hospital Association is most valuable in raising standards in that
department. Similarly the Canadian Hospital Association course in hospital organization and management enables administrative personnel to improve their qualifications and thereby upgrade the quality of the administrative services. The correspondence course of the American Laundry Institute has been useful in assisting the
laundry manager at the Riverview Hospital to upgrade his qualifications.
 GENERAL ADMINISTRATION
L 13
The facilities operated by the Branch are used for field work and practicum
placement for students from the university schools. Examples are social work and
rehabilitation medicine, which have for years used the clinics and hospitals for practical training. The laboratories at the Riverview Hospital are utilized for the training of medical technologists. I would like to draw attention especially to the establishment of a teaching unit in West 3 Ward in the Crease Clinic which is run in conjunction with the Department of Psychiatry, University of British Columbia, to provide experience for the residents in psychiatry.
As will be noted in the appropriate sections of this Report, two major projects
are nearing completion. The Eric Martin Institute will be ready to commence operation in the spring of 1969, hopefully by some form of community association.
Construction of the British Columbia Youth Development Centre in Burnaby is in
its final stages, and I anticipate that the Residential Treatment Centre will phase
into operation following the necessary period of in-service training and orientation
of the staff. The Children's Out-patient, Day Care, and Psycho-educational Programmes will be expanded.
Construction of The Glendale Hospital continues according to plan, and it will
probably be ready for operation as a multi-purpose extended-care facility in about
two years' time.
It is hoped that in the near future the development of societies will permit programming at the local level with the optimum degree of local participation and Government support. The transfer of the Eric Martin Institute to local administration
is the forerunner of such an approach, and it is possible that other units could, in
due course, follow this pattern.
As the Branch becomes increasingly involved in consultation and in planning
for the over-all mental health of the Province, it is essential that communication
and liaison be improved with other Government departments, public and private
agencies. During the past year regular liaison meetings have been taking place with
the Psychiatric Section of the British Columbia Medical Association, and senior
administrative personnel are either on the board of directors or meet regularly with
voluntary and professional organizations, such as the Canadian Mental Health Association, Association for Retarded Children of British Columbia, Registered Nurses'
Association, British Columbia Association of Social Workers, Alcoholism Foundation, and Narcotic Foundation. There is no question that relocation of the Branch
office in Victoria has considerably improved communication with other Government
departments.
In summary, it may be said that in the past 21 months a major reorganization
of the Mental Health Branch administration has taken place, and will permit the
Branch to expand its interest and involvement in the over-all mental health programme of the Province whilst still continuing to provide a high level of direct service to the people of British Columbia.
In the coming year we will place emphasis upon the identification of need, the
evaluation of existing services and programmes, and new delivery systems of care.
 L 14
MENTAL HEALTH BRANCH REPORT, 1967/68
REPORT OF THE COMPTROLLER OF EXPENDITURE
F. A. Matheson, Comptroller
Attached are the financial reports of the British Columbia Mental Health
Branch for the fiscal year ended March 31, 1968.
Table A, covering the in-patient services, shows a daily average population of
5,925.25, a decrease of 9.13 from the fiscal year 1966/67. However, our maintenance expenditures increased by $2,576,523 in 1967/68, causing the average
daily per capita cost to increase from $10.48 to $11.66. The increase of
$2,576,523 is made up of $2,203,419 in salaries and the balance of $373,104
in supplies and expenses. Maintenance revenue increased from $1,948 878 in
1966/67 to $1,967,564 in 1967/68.
The Department of Agriculture supplied dairy produce, vegetables, and
meat valued at approximately $450,000 to mental health units from the farm
operations at Essondale and Tranquille for the period under review.
It is a pleasure to be able to report the excellent progress that has been made
during this fiscal year on a number of major capital projects, as follows:	
(1) Eric Martin Institute, Victoria. The Department of Public Works let
a contract in the amount of $5,715,000 for the completion of this
project. The contractor is making excellent progress and expects to
have it completed by December, 1968.
(2) Glendale School, Victoria. The contract for the shell of the boiler-
house and laundry has been completed. The plans and specifications
for the main hospital unit of some 300 beds are nearly completed and
should be ready for tender early in the next fiscal year.
* ..
The Eric Martin Institute, situated on Lee Avenue and east of the Royal Jubilee
Hospital, is designed as a 170-bed intensive-treatment in-patient and day-care psychiatric unit.
 GENERAL ADMINISTRATION
L 15
Site of the new Glendale Hospital, Victoria, showing boiler-house and laundry
almost completed. The hospital is planned for the care of 300 severely handicapped and
moderately to profoundly retarded children and adults.
(3) British Columbia Youth Development Centre, Burnaby. The contractor is making excellent progress on this project, and the contract should
be completed by the end of 1968.
(4) Renovation of Centre Building, Wards J and K and G and Con, The
Woodlands School, New Westminster. The first phase of this project,
covering the renovation of Wards H, E, and F and the centre section
of the Centre Building, has been completed. Plans and specifications
for the second phase, consisting of renovations to Wards 72, 73, and
74 and the basement of the Centre Building, have been completed and
are ready for tendering.
(5) Renovation of West Lawn Building, Essondale. The Department of
Public Works has started preliminary planning on this project and tenders
have now been called for.
(6) Renovation of Kitchen and Dining-room, Riverside Building, Essondale.
Preliminary plans for this project have been completed.
In addition to these major projects, the Department of Public Works completed a large number of smaller jobs that have done much to further improve
our facilities.
It is also a pleasure to be able to report that during this year we were again
able to maintain buildings, grounds, equipment, and furnishings of all of our
institutions in a satisfactory manner. We purchased a considerable amount of
new and replacement equipment.
 L 16
MENTAL HEALTH BRANCH REPORT,  1967/68
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, 1958/59 to 1967/68.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
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.—
5.05
4.72
Home for the Aged, Port Coquitlam
4.89
4.97
3.75
13.29
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
20.39
5.05
Valleyview Hospital, Essondale 	
6.83
5.26
Skeenaview Hospital, Terrace —    	
3.95
Totals for the year 	
6,171.22
$14,531,218.39
$2,354.68
$6.43
1960/61
237.72
3,008.02
1,415.30
126.01
287.16
695.41
232.05
290.70
$1,313,678.32
6,775,567.11
3,637,555.12
542,556.16
518,591.72
1,754,500.08
448,792.02
417,856.55
$5,526.16
2,252.50
2,570.17
4,305.66
1,805.93
2,522.97
1,934.03
1,437.41
$15.14
Provincial Mental Hospital, Essondale -
The Woodlands School	
6.17
7.04
The Tranquille School, Tranquille	
Provincial Mental Home, Colquitz	
11.80
4.95
Valleyview Hospital, Essondale   	
6.91
Dellview Hospital, Vernon	
Skeenaview Hospital, Terrace	
5.30
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._
6.72
7 38
7.20
Provincial Mental Hospital, Essondale -
Valleyview Hospital, Essondale- —
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
Provincial Mental Hospital, Essondale.-
The Woodlands School               	
7.11
7.66
The Tranquille School, Tranquille	
6.95
6.12
7.34
5.53
Skeenaview Hospital, Terrace 	
4.08
Totals for the year  	
6,095.15
$16,354,798.43
$2,683.25
$7.35
1963/64
220.63
2,791.99
1,306.35
433.92
94.07
737.69
236.51
292.83
$1,442,627.00
7,534,673.00
3,916,660.00
1,077,011.00
414,787.00
2,029,118.00
512,128.00
713,594.00
$6,538.67
2,698.67
2,998.17
2,482.05
4,409.35
2,750.64
2,165.35
2,436.89
$17.87
Provincial Mental Hospital, Essondale.-
The Woodlands School ,„.	
The Tranquille School, Tranquille	
Provincial Mental Home, Colquitz	
Valleyview Hospital, Essondale	
7.37
8.19
6.78
14.41
7.52
5.92
6.66
Totals for the year -	
6.113.99
$17,640,598.00
$2,885.28
$7.90
 GENERAL ADMINISTRATION
L  17
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, 1958/59 to 1967/68—Continued.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1964/65
Crease Clinic   	
Provincial Mental Hospital, Essondale -
Th* W""^la"dc: fSc-hnnl
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
8.05
9.38
8.07
Valleyview Hospital, Essondale	
8.55
6.47
Skeenaview Hospital, Terrace	
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
10.57
The Tranquille School, Tranquille 	
9.14
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	
The Woodlands School	
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
11.27
The Tranquille School, Tranquille	
10.31
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
1967/68
Riverview Hospital, Essondale	
2,716.22
1,282.95
660.10
755.53
220.07
290.38
$12,111,825.00
6,001,180.00
2,813,051.00
2,948,516.00
734,800.00
666,762.00
$4,459.07
4,677.64
4,261.55
3,902.58
3,338.94
2,296.17
$12.18
12 78
11.64
10.66
Dellview Hospital, Vernon -	
9.12
6.27
Totals for the year—	
5,925.25
$25,276,134.00
$4,265.83
$11.66
 L 18 MENTAL HEALTH BRANCH REPORT, 1967/68
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, 1968.
Gross operating costs—
Riverview Hospital, Essondale   $12,111,825
The Woodlands School, New Westminster  6,001,180
The Tranquille School, Tranquille  2,813,051
Valleyview Hospital, Essondale   2,948,516
Dellview Hospital, Vernon  734,800
Skeenaview Hospital, Terrace   666,762
Gross cost, all institutions  $25,276,134
Less collections remitted to Treasury       1,967,564
$23,308,570
Daily average population     5,925.25
Gross per capita cost, one year  $4,265.83
Gross per capita cost, one day        $11.66
Net per capita cost, one year  $3,933.77
Net per capita cost, one day        $10.75
Revenue (Patients' Maintenance Collections) of the Mental Health Branch
for the Past 10 Years
1958/59  $1,838,158.33 1963/64  $1,751,281
1959/60  1,821,810.53 1964/65   1,866,781
1960/61   1,906,847.71 1965/66  1,915,661
1961/62  2,150,802.56 1966/67   1,948,878
1962/63   2,025,854.46 1967/68  1,967,564
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 L 22
MENTAL HEALTH BRANCH REPORT, 1967/68
Table F.—Expense Statement of the Valleyview Hospital, Essondale,
for 12 Months Ended March 31, 1968
Salaries, Supplies, and
Operating Expense
Net Vouchered
Expenditure
Services and
Supplies from
Public Works
Department
Actual Cost of
Operation
Yearly per
Capita Cost
$2,276,059
10,582
1,939
1,422
135,126
320,986
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576
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14.01
	
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122.65
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$92,669
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 GENERAL ADMINISTRATION L 25
Table I.—Institutional Stores
Net undistributed stores as per Public Accounts  $56,435
Adjustments re farm profits     29,252
$85,687
Inventory adjustment—
Plus on hand, March 31, 1967  $584,074
Less on hand, March 31, 1968     613,174
29,100
Net increase in inventory1  $56,587
1 The increase in inventory has been transferred to the following institutions proportionately using the
' vouchered expenditure " as the basis for distribution:—
Riverview Hospital   - —  31,689
The Woodlands School _ ___  16,410
Valleyview Hospital  _ _     8,488
Total
56,587
Table J.-
-Expense Statement of the Community Services for 12 Months
Ended March 31, 1968
Mental Health Centre, Burnaby
Salaries 	
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	
General expense	
Buildings, grounds, etc.	
$623
3
11
3
96
13
1
2
2
3
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1
65
,154
,298
,041
,820
,536
,774
,500
,856
,683
,278
,491
,613
,499
,810
Total
$832,353
Mental Health Centre, Victoria
Salaries  	
Office expense	
Travelling expense	
Office furniture and equipment
Medical care 	
Maintenance and operation of equipment
Occupational and recreational therapy	
General expense	
Buildings, grounds, etc.	
Total
$110,685
2,265
1,294
653
29,871
536
136
462
14,337
$160,239
 L 26 MENTAL HEALTH BRANCH REPORT, 1967/68
Table J.—Expense Statement of the Community Services for 12 Months
Ended March 31, 1968—Continued
Mental Health Centre, Kelowna
Salaries   $52,115
Office expense  653
Travelling expense  2,498
Office furniture and equipment  500
Medical care  5,040
Maintenance and operation of equipment  317
General supplies  56
General expense  145
Total     $61,324
Mental Health Centre, Trail
Salaries   $37,547
Office expense  889
Travelling expense  2,032
Office furniture and equipment  606
Medical care     6,766
Maintenance and operation of equipment  712
General expense  269
Total      $48,821
Mental Health Centre, Nanaimo
Salaries   $37,457
Office expense  977
Travelling expense  1,172
Office furniture and equipment  131
Medical care  13,078
Maintenance and operation of equipment  530
General supplies  57
General expense  243
Total     $53,645
Mental Health Centre, Prince George
Salaries   $32,310
Office expense  850
Travelling expense  3,185
Office furniture and equipment  1,199
Medical care   3,495
Maintenance and operation of equipment  34
General supplies  536
Motor-vehicles and accessories   2,611
General expense  755
Total   $44,975
 GENERAL ADMINISTRATION L 27
Table J.—Expense Statement of the Community Services for 12 Months
Ended March 31, 1968—Continued
Mental Health Centre, Kamloops
Travelling expense  $205
Motor-vehicles and accessories         2,242
Total         2,447
Mental Health Centre, Chilliwack
Salaries   $36,847
Office expense  856
Travelling expense  528
Office furniture and equipment  938
Medical care   3,117
Maintenance and operation of equipment  335
General supplies   100
Motor-vehicles and accessories   2,294
General expense  454
Total      $45,469
Grand total, $1,369,437.
Mental Health Centre, Vernon
Salaries   $43,492
Office expense  1,049
Travelling expense  2,380
Medical care   6,338
Maintenance and operation of equipment '.  611
General supplies   478
Total      $54,348
Expansion of Community Services
All expenditures     $65,816
 L 28 MENTAL HEALTH BRANCH REPORT, 1967/68
Table K.—Expense Statements of the Rehabilitation Department and
Out-patient Services for 12 Months Ended March 31, 1968
Rehabilitation Department
Salaries     $216,879
Office expense   879
Travelling expense  5,420
Office furniture and equipment  155
Medical care   8,197
Dietary  10,067
Laundry  81
Gratuities to patients  27,521
Transportation  100
General supplies   5,356
Occupational and recreational therapy  661
General expense  810
Buildings, grounds, etc.  4,993
Total   $281,119
Out-patient Services
Salaries  _  $35,498
Office expense  133
Travelling expense  1,873
Medical care r  28,906
Dietary  139
Transportation  903
General supplies   17
General expense  354
Total   $ 67,823
Grand total, $348,942.
 GENERAL ADMINISTRATION L 29
Table L.—Expense Statement of General Administration
for 12 Months Ended March 31, 1968
Salaries   $303,641
Office expense  7,649
Travelling expense  14,310
Office furniture and equipment  1,822
Grant to trustees of Patients' Comfort Fund  8,000
Grant to University of British Columbia for mental health
research   30,000
General expense :  5,809
Subscription, Social Service Index  4
Administration of Psychiatric Nurses Act  2,573
Council of Psychiatric Nurses for Bursary Trust Fund  1,200
Mental health care  249,192
Total   $624,200
Table M.—Expense Statement of the Department of Nursing Education
for 12 Months Ended March 31, 1968
Salaries   $ 1,130,028
Office expense  5,724
Travelling expense  1,856
Office furniture and equipment  293
Medical care  845
Dietary   10,596
Laundry   5,000
General supplies   17,044
Audio-visual  260
General expense  3,795
Total   $1,175,441
 L 30 MENTAL HEALTH BRANCH REPORT, 1967/68
Reconciliation with Public Accounts, 1967/68
Table L—General Administration—
Salaries         $303,641
Expenses   320,559
Vouchered expenditure        $624,200
Deduct salary adjustments  19,548
As per Public Accounts        $604,652
Table M—Department of Nursing Education—
Salaries      $1,130,028
Expenses   45,413
Vouchered expenditure     $1,175,441
Deduct salary adjustments  16,476
As per Public Accounts       1,158,965
Table J—
Mental Health Centre, Burnaby—
Salaries         $623,154
Expenses  209,199
Vouchered expenditure        $832,353
Deduct—
Buildings and grounds __    $65,810
Portion of farm profit  235
  66,045
As per Public Accounts  766,308
Mental Health Centre, Victoria-
Salaries         $110,685
Expenses   49,554
Vouchered expenditure        $ 160,239
Deduct buildings and grounds  14,337
As per Public Accounts  145,902
Mental Health Centre, Kelowna—
Salaries   $52,115
Expenses   9,209
As per Public Accounts  61,324
Mental Health Centre, Trail—
Salaries   $37,547
Expenses   11,274
As per Public Accounts  48,821
 GENERAL ADMINISTRATION L 31
Reconciliation with Public Accounts, 1967/68—Continued
Table J—Continued
Mental Health Centre, Nanaimo—
Salaries  $37,457
Expenses   16,188
As per Public Accounts  53,645
Mental Health Centre, Prince George—
Salaries   $32,310
Expenses   12,665
As per Public Accounts  44,975
Mental Health Centre, Kamloops—
Salaries      	
Expenses   $2,447
As per Public Accounts  2,447
Mental Health Centre, Chilliwack—
Salaries   $36,847
Expenses   8,622
As per Public Accounts  45,469
Mental Health Centre, Vernon—
Salaries   $43,492
Expenses   10,856
As per Public Accounts  54,348
Expansion of Community Services  65,816
Deduct salary  adjustments,  all  community
services   72,576
Table C—Riverview Hospital—
Salaries      $8,240,791
Expenses        3,871,034
Vouchered expenditure  $12,111,825
Deduct—
Salary adjustments     $425,928
Portion of farm profits  59
Building and grounds    1,340,131
       1,766,118
$10,345,707
Add sundry adjustments, board, rent, etc.  109,831
6,760
As per Public Accounts     10,455,538
 L 32 MENTAL HEALTH BRANCH REPORT, 1967/68
Reconciliation with Public Accounts, 1967/68—Continued
Table K—
Rehabilitation Department—
Salaries         $216,879
Expenses   642,240
Vouchered expenditure        $281,119
Deduct—
Salary adjustments      $10,596
Buildings and grounds __        4,993
  15,589
As per Public Accounts  265,530
Out-patient services—
Salaries         $354,498
Expenses   32,325
Vouchered expenditure  $67,823
Deduct salary adjustments  2,448
As per Public Accounts  65,375
Table F—Valleyview Hospital—
Salaries      $2,276,059
Expenses   672,457
Vouchered expenditure      $2,948,516
Deduct—
Salary adjustments  $111,756
Portion of farm profit  4,692
Buildings and grounds       92,669
  209,117
$2,739,399
Add sundry adjustments, board, etc.  22,691
As per Public Accounts       2,762,090
 GENERAL ADMINISTRATION L 33
Reconciliation with Public Accounts, 1967/68—Continued
Table G—Dellview Hospital—
Salaries         $496,797
Expenses   238,003
Vouchered expenditure        $734,800
Deduct—
Salary adjustments      $23,112
Portion of farm profit  293
Buildings and grounds     104,663
Decrease in inventories  37
 128,105
$606,695
Add sundry adjustments, board, etc.  4,538
As per Public Accounts  611,233
Table H—Skeenaview Hospital—
Salaries         $394,896
Expenses   271,866
Vouchered expenditure         $666,762
Deduct—
Salary adjustments      $17,472
Buildings and grounds     117,837
Decrease in inventories         1,005
■  136,314
$530,448
Add sundry adjustments, board, etc.  7,793
As per Public Accounts  538,241
Table D—The Woodlands School-
Salaries      $4,600,977
Expenses        1,400,203
Vouchered expenditure      $6,001,180
Deduct—
Salary adjustments  $215,940
Buildings and grounds     451,689
Portion of farm profit         8,095
  675,724
Add—
Increase in inventories       $8,176
Sundry   adjustments,   board,
etc.        35,382
$5,325,456
43,558
As per Public Accounts       5,369,014
2
 L 34 MENTAL HEALTH BRANCH REPORT, 1967/68
Reconciliation with Public Accounts, 1967/68—Continued
Table E—The Tranquille School—
Salaries      $1,798,061
Expenses        1,014,990
Vouchered expenditure     $2,813,051
Deduct—
Salary adjustments     $80,820
Buildings and grounds     437,730
Portion of farm profit       12,611
  531,161
Add—
Increase in inventories       $9,901
Sundry   adjustments,   board,
etc.        28,593
$2,281,890
38,494
As per Public Accounts       2,320,384
Table I—Net Undistributed Stores (as per Public Accounts)  (prorated to Riverview, Woodlands, and Valleyview)   56,435
Total Mental Health Branch expenditure as per Public
Accounts   $25,423,936
 GENERAL ADMINISTRATION L 35
PERSONNEL REPORT
G. L. Tomalty, Departmental Personnel Officer
Report for April 1, 1967, to March 31, 1968
The establishment of the Mental Health Branch increased during the fiscal year
as follows:—
Deputy Minister's office and community services     54
In-patient care facilities     92
Total  146
As of March 31, 1968, there were 4,060 persons on payroll. This is 49 more
than at the same time last year and is comprised of 54 employees of various classifications and five fewer student psychiatric nurses.
Over-all staff turnover, excluding temporary relief staff, was down slightly, from
28.6 to 26.7 per cent. Turnover of registered nurses, which was high last year, was
down by 11.6 per cent and female psychiatric nurses up by 6.3 per cent.
The declining trend in number of male psychiatric nurses has reversed to a
slight rise of 12 in the past year. Enrolment of male student psychiatric nurses
increased by 6, from 14 to 20, as of March 31, 1968.
Mr. J. Dowling retired during the year, and Mr. G. L. Tomalty was appointed
to take the position as Personnel Consultant.
Report for April 1 to December 31, 1968
Mr. A. A. Bishop was appointed as assistant to Mr. G. L. Tomalty, Personnel
Consultant, on May 7, 1968. As of December 1, 1968, the Personnel Consultant
was designated to be Departmental Personnel Officer. He will carry out personnel
administrative functions for the Deputy Minister, Mental Health Branch and the
Director, Mental Health Services.
The process of determining personnel requirements, writing and obtaining approval on new job specifications, requesting Orders in Council for positions remaining in Schedule B, and recruiting for the new British Columbia Youth Development
Centre in Burnaby has continued throughout the year. The establishment is 107,
and this unit receives administrative support from a combined (Mental Health
Centre, Burnaby, and British Columbia Youth Development Centre) administrative
establishment with 54 positions. All requisitions for new positions in the British
Columbia Youth Development Centre have been submitted, and approximately 50
per cent of them have been filled. All senior positions have been assigned, except
for the senior psychiatric social worker.
The British Columbia Government referred salary and conditions of service
demands of the Psychiatric Nurses' Association to the British Columbia Mediation
Commission. Hearings were held in Vancouver in September and October.
Recommendations of the Commission were tendered in November.
The establishment of the Mental Health Branch increased during this period
as follows:—
Deputy Minister's office and community services     33
In-patient care facilities     89
Total  122
 L 36 MENTAL HEALTH BRANCH REPORT, 1967/68
Mental Health Branch units are now required to review all requests for classification reviews and submit a completed job description questionnaire along with a
report showing objective analysis of the position and justification for a classification
review. This is considered by the Mental Health Branch Personnel Officer, who
may further review the position at the unit. Submissions which warrant further
consideration are then forwarded to the Civil Service Commission Classification
Division for review and final decision.
Progress has been made on bringing all Mental Health Branch personnel regulations up to date.
With priority on the personnel function, only one meeting of the Branch Safety
Committee has occurred. The existing safety programme within the Branch was
reviewed, and an acceptable mental health safety programme is being developed.
 GENERAL ADMINISTRATION L 37
STATISTICAL TABLES
Table A.—Summary Showing Over-all Staff Totals in Relation to
Separation and Recruitment
Staff recruited, excluding students  1,404
Staff separated, transferred, etc., excluding students  1,350
Increase        54
Total staff, excluding students, as of March 31, 1968  3,761
Total staff, excluding students, as of March 31, 1967  3,707
Increase        54
Quarterly staff average, excluding students, 1967/68  3,805
Quarterly staff average, excluding students, 1966/67  3,694
Increase      111
Male Female Total
Student enrolment as of March 31, 1968     20 279 299
Student enrolment as of March 31, 1967     14 290 304
Change  +6 — 11
Student quarterly average, 1967/68      303
Student quarterly average, 1966/67      281
Change    +22
 L 38 MENTAL HEALTH BRANCH REPORT, 1967/68
Table B.—Breakdown by Classification of Recruitment and Separation
Activity for the Mental Health Branch, Excluding Student Psychiatric Nurses.
Recruited Separated
Physicians  42 43
Dentists  1 1
Registered nurses  59 58
Psychiatric nurses  304 289
Female psychiatric aides  318 308
Male psychiatric aides  90 115
Teachers   3 3
Occupational therapists  18 23
Industrial therapists  4 3
Recreational therapists  4 4
Psychologists   14 18
Social workers (psychiatric)   32 29
Dieticians   3 3
Cooks   7 12
Kitchen helpers  75 66
Clerks  18 18
Clerk-stenographers  53 55
Trades   10 8
Laundry-workers   35 34
Miscellaneous professional  18 15
Miscellaneous technical  9 11
Miscellaneous   287 250
Sub-totals   1,404 1,366
Miscellaneous adjustments, transfers, etc      —16
Totals   1,404 1,350
■
 GENERAL ADMINISTRATION
Table C.—Summary of Staff Turnover
By Major Classification
L 39
Classification
1966/67
1967/68
Change
Male psychiatric nurses	
Female psychiatric nurses..
Registered nurses 	
Per Cent
16.3
24.3
45.8
Per Cent
16.9
30.6
34.2
Per Cent
+0.6
+6.3
— 11.6
Note.—Calculations made against the year-end staff totals.
By Pay Division
Pay Division
Temporary
Relief Staff
Excluded,
1966/67
Temporary
Relief Staff
Excluded,
1967/68
Per Cent
Per Cent
16.3
11.1
19.1
23.7
24.7
30.3
26.4
28.7
40.9
40.6
21.5
33.8
36.8
27.4
21.9
48.4
25.9
24.3
General Administration-
Department of Nursing Education1-
Riverview Hospital  	
The Woodlands School	
The Tranquille School	
Valley view Hospital—.	
Dellview Hospital_
Skeenaview Hospital	
Mental health centres	
Over-all turnover..
28.6
26.7
1 Student nurses not included.
Note—Percentages calculated against year-end staff totals.
Table D.—Comparison of Staff Totals by Unit with Totals for the
Preceding Fiscal Year
Fiscal Year 1966/67
Fiscal Year 1967/68
Positions
in Establishment as of
March 31,
1967
Number on
Staff as of
March 31,
1967
Positions
in Establishment as of
March 31,
1968
Number on
Staff as of
March 31,
1968
44
63
160
43
68
135
60
68
193
45
68
Mental health centres 	
138
267
246
321
251
In-patient care—
1,569
868
358
444
92
74
1,574
886
390
446
92
73
1,638
873
372
443
97
74
1,605
The Woodlands School	
897
378
Valleyview Hospital- —	
457
97
76
Total of vote.—          	
3,405
3,461
3,497
3,510
3,672
325
3,707
304
3,818
325
3,7611
299
Totals    „
3,997
4,011
4,143
4,060
1 Includes 123 part-time employees.
 L 40
MENTAL HEALTH BRANCH REPORT,  1967/68
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C
 GENERAL ADMINISTRATION L 41
REPORT OF COORDINATOR OF MENTAL RETARDATION
PROGRAMMES
J. S. Bland, B.A., M.B., B.Chir., D.P.M.
The principal advances in services and facilities for the retarded in the past
year have been in the field of residential care. Two major developments have
taken place.
In November the Bevan Lodge Association in Courtenay finalized agreement
for a long-term lease on the Bevan Lodge complex, and in December the first residents were admitted. Bevan Lodge will ultimately accommodate 70 adult retarded
of both sexes. It is suitable for those who have good self-care skills but who are
unlikely to be able to manage independently. Initially the majority of residents are
coming from Woodlands and Tranquille Schools, but in keeping with the Department's aims of decentralization, they are primarily those whose former place of
residence was on Vancouver Island. Additionally the screening committee is considering suitable applications from the local area. The operation of Bevan Lodge is
a good example of co-operation between different Government departments and
between them and local community effort.
In December the Provincial Government bought a residential school and
convent in Maillardville. This complex, known as the Maillardville Unit, is now
an integral part of The Woodlands School. It will serve as a preplacement training
centre for the adult retarded. The programme will be geared to teaching the
residents self-care skills, socially acceptable behaviour, and basic knowledge about
community life. This will prepare them for subsequent living in supervised group
homes or boarding homes and working in sheltered workshops. The Maillardville
Unit will have 50 residents.
The two facilities described above have provided an additional 120 residential
places for the mentally retarded. As the programmes develop, many of the urgent
cases on the waiting list will be admitted to vacant beds at Woodlands and Tranquille Schools.
Co-ordinating mental retardation programmes implies co-operation, and this
I have received in full measure from community agencies and other Government
departments.   I am grateful to them.
 L 42 MENTAL HEALTH BRANCH REPORT, 1967/68
REPORT OF SOCIAL SERVICE CONSULTANT
Miss A. K. Carroll, B.A., M.S.W.
Report for April 1, 1967, to March 31, 1968
Direct consultative service was given to nearly all facilities concerning the
following:—
(1) Administration and organization of social service departments. Advice
was given in relation to the relocation of staff which the change in
emphases from hospital to community-based services indicated.
(2) Pre-admission and after-care functions of social service departments in
the mental health services.
(3) Advice regarding the continuing need for administrative and organizational development in the family-care and boarding-home programme.
(4) Programme suggestions for the remotivation of groups of patients resident
in boarding and nursing homes.
(5) Personnel recruitment, maintenance, and retention; staff patterning;
staff development; and advice in relation to the possibility of the use of
levels workers to assist and extend the contribution of professionally
trained social workers.
During the year 26 social-work students from the School of Social Work of
the University of British Columbia were placed in the social service department of
the Mental Health Branch for field-work practicum. Of this group, 21 students
were in their second year of graduate study and five were in their first.
Federal mental health bursaries were granted to seven students, six of whom
were proceeding to the second year of graduate studies and one to the first year.
Of this group of seven students, five were members of the social-work staff of the
Mental Health Branch and two were students graduating from the first year of
graduate studies at the School of Social Work of the University of British Columbia.
During the year 10 students who had completed studies under Federal mental health
grants returned to social-work positions in the Mental Health Branch. The scholarship level of this group was notable in that four graduated with first-class standing
and six with a high second-class standing.
This year showed the beginning of a change in the recruitment picture in that
a considerable number of social-work personnel were recruited from the graduating
classes of schools of social work and from social-work practitioners in and outside
of the Province. The activities in recruitment are carried out in close co-operation
with the Chief Personnel Officer of the Civil Service Commission. This year the
Consultant interviewed some 42 persons who were inquiring about opportunities
for social-work practice in the Mental Health Branch. In and around these applications, some 61 letters were written regarding references, etc. In several facilities
in the Mental Health Branch, the welfare aide is being tried and the contribution
evaluated. Additionally, personnel with undergraduate degrees in social welfare
are being employed. This group certainly comes to the services with a very good
background of training, and their contribution indicates that they are a most
valuable levels worker in the field of social work.
At the end of the year, there were 583 patients on boarding-home leave under
supervision of the Mental Health Services. This group is comprised of patients
released from the four major mental health facilities, and is up from a figure of 523
for the previous year.
 GENERAL ADMINISTRATION L 43
The programme from Riverview did not expand to any great extent through
placements from the chronic care units, but the resources of the programme were
used more extensively by the admitting units than was the case in previous years.
It was noted that patients from these latter units, in some cases, did not adjust
easily to boarding-home care, and some investigation of this problem is needed.
Possibly more extended use of the Hillside Unit is indicated for certain cases proposed for boarding-home care. The placements made from Hillside were very
successful, proving the value of the unit for boarding-home preparation.
There was a significant upswing in placements from The Woodlands School
during the year. Some severely retarded persons were placed and one who is
profoundly retarded. It was found that placing retardates and improved mentally
ill together in the same home was good social planning on balance, although this
type of grouping is still being evaluated.
The Burnaby training home continues to function well, showing impressive
results in rehabilitation. In a second home for younger female patients from Riverview, good results are being achieved through the development of a motivational
programme. In a third home, which is a large farm in the country, a good motivational programme for young male schizophrenics is gradually taking shape.
Four patients from Riverview were discharged to full-time employment during
the year, and eight employed and self-supporting persons remain on in their boarding homes still on leave. One of these latter persons is a man of 62 who spent 34
continuous years in Riverview Hospital.
Consolidation, as well as expansion of the programme at two community
centres for occupational therapy, was effected during the year through the efforts
of the occupational therapist from Riverview and community service groups. A
third small centre was started in Maillardville. Retardates from boarding homes
are included in these programmes, as are a few community people with other
handicaps. Some workshop activities were carried on in the centres financed by
community service group funds and returns from sale of goods. This is a small
project as yet, but could expand.
Report for April 1 to December 31, 1968
Over the past nine months a great push forward in regional planning for the
boarding-home programme has taken place, with the development of a Central
Referral Bureau Centre for the South Vancouver Island area. The Mental Health
Branch, as one agency co-operating in the Central Referral Bureau programme, will
provide fully trained and experienced social workers, who will render social services
to residents in boarding and nursing homes. Additionally these social workers will
be active in the development of programmes which have higher motivational standards of care and which permit creative and occupational skills.
The work of the Consultant in the following special committees has continued:—
(1) Interdepartmental Case Review Committee.—This Committee has submitted special studies of the conditions of children in need of residential
treatment and training, as well as produced a written submission concerning the spectrum of services which these troubled children and families
require. The Consultant also submitted a report on programmes and
facilities for the retention and retraining of severely behaviourally disturbed adolescents, and additionally appeared before a special committee
charged with the extensive study of the needs of this group of children
at grave risk.
 L 44
MENTAL HEALTH BRANCH REPORT, 1967/68
(2) Bevan Lodge Association.—The Consultant has assisted the Bevan Lodge
Association of the Courtenay Mental Health Society in its conceptualization of organization and programme in the Bevan Lodge. The Consultant has, additionally, provided assistance to the association in staff
patterning and positioning. An in-service training programme has been
formulated and advice given related to a process of co-ordination of the
Bevan Lodge service with other services existing in the community.
(3) Welfare Institutions Licensing Board.—The Welfare Institutions Licensing Board has approved the development and the licensing of a number
of outstanding boarding homes and special-care facilities for the personal
care and attention or training of the adult mentally disabled. Notably
the opening of two new boarding homes in the Upper Vancouver Island
area has greatly extended and enriched the services to this group of
handicapped persons.
(4) Liaison Committee.—The Liaison Committee has continued as an effective body in the interdepartmental study and interconsultation around
programmes, procedures, and services relative to family and child welfare,
treatment resources, and community care services for both children and
adults.
In all, the last nine months have been notable in bringing to fruition plans and
services so basic to the community care and treatment of the mentally ill and so
important in the furtherance of community mental health programmes and services.
These last months have presented challenge, stimulation, and, to a degree, the
satisfaction of achievement.
TABLES AND NOTES
Table 1.—Boarding-home Programme, Calendar Year 1967
Patient Movement
Riverview
Hospital
Valleyview
Hospital
Woodlands
School
Tranquille
School
Number of patients on boarding-home programme as of January 1, 1967.
Number of new placements during year   	
Number of returns to boarding-home care from hospital (replacements ).
Number of returns to institution during year_.
Deaths	
Discharged from boarding-home programme—- 	
Number of patients on boarding-home programme as of December 31, 1967_ ...   	
337
92
32
86
2
16
1101
56
12
23
1
42
521
30
20
19
357
112
78
362
1 Revised figure.
2 Figures in this column are estimated.
EXPLANATORY NOTES
1. A significantly larger number of patients (86) were returned to Riverview Hospital during the year, and
a significantly larger number of these patients remained in hospital (Table 3) than was the case in 1966. This
may be related to the fact that there was a freer movement back into hospital for examination or assessment due
to shortage of both medical and social-work staff to visit the homes. In-hospital staff shortages resulted in delays
in replacing patients in boarding homes and in less accurate assessments for suitability for boarding-home care.
A number of patients placed directly from the admitting units did not settle in the boarding home, possibly finding this situation too alien to them at their stage of illness. It is interesting to note that in January, 1967, 13
patients returned to hospital.
2. Of the 16 Riverview patients discharged from boarding-home leave, four went to full-time employment,
eight returned to families, three to living independently on Social Allowance, and one to a training programme.
3. The significantly lower net gain in Riverview persons carried on boarding-home leave at the end of the
year as compared with the previous year is related to problems in shortages of in-hospital staff time; lack of
development of new resources; sharing of available resources with The Woodlands School, community agencies,
and admitting units of Riverview (extended-leave patients); availability of suitable candidates for boarding-home
care.
4. The 42 patients discharged from Valleyview were seen in the homes by Dr. Walsh and this decision made.
For the most part, they were persons of independent means.
5. The total of 33 placements made during the year from The Woodlands School was up from nine placements made the previous year.
 GENERAL ADMINISTRATION
Table 2.—Analysis of Returns to Institutions, 1967 (1)
L 45
Reason for Return to Institution
Riverview
Hospital
Woodlands
School
Tranquille
School
Returned for reason of psychiatric illness or behaviour problem 	
76
10
4
3
4
5
Totals                                                                            -
86
7
9
Table 3.—Analysis of Returns to Institutions, 1967 (2)
Disposition of Cases
Riverview
Hospital
Valleyview
Hospital
Woodlands
School
Tranquille
School
Replaced in boarding-home care following hospitalization-	
12
74
12
11
2
5
3
6
Totals                                     	
86
23
7
9
Table 4.—Patients on Boarding-home Leave Employed
as of December 31, 1967
Degree of Employment and Earnings
Riverview
Hospital
Woodlands
School
Tranquille
School
Number of patients fully employed and self-supporting 	
Number of patients fully employed and partially self-supporting	
Number of patients partially employed and partially self-supporting	
Number of patients with seasonable jobs or small but regular job and
earning own comforts, etc.
Number of patients employed in sheltered workshop-
Totals     —
29
43
13
 L 46 MENTAL HEALTH BRANCH REPORT, 1967/68
REPORT OF NURSING CONSULTANT
Miss N. M. Lonergan, B.S., N.Ed., M.N.
Report for April 1, 1967, to March 31, 1968
Responsibilities fulfilled during the period of time reviewed in this report were
divided evenly between those arising from commitments to nursing education and
those to nursing consultation services. A report on the former is confined to major
activities of the Department of Nursing Education, whereas that on the latter encompasses undertakings in conjunction with administrators of nursing services,
periodic tasks concerning mental health programmes, participation in nursing matters involving government, professional and educational organizations, and community health agencies.
NURSING EDUCATION
The Department of Nursing Education continued to operate its basic programmes—the psychiatric nursing programme, the psychiatric aide programme, and
the affiliate programmes in psychiatric nursing. The year-end census for the psychiatric nursing programme was 299 students, compared with 304 for the year ended
March, 1967. The Department processed 389 applications. A total of 171 students
enrolled in the fall and spring classes; 47 per cent of these had been registered in
an academic secondary-school programme and the remainder in a vocational one.
During the year 62 students withdrew, 38 due to personal reasons, 7 because of
illness, and 12 failed academically. One student was fatally injured in a traffic accident. Of the 125 students who completed the programme, 103 were employed by
the Mental Health Branch.
The faculty continued to develop a variety of techniques for improving the
correlation of academic and clinical student learning experiences. In all areas, students participated in planned ward clinics two hours a week. Instructors used interaction studies and nursing-care plans with some measure of success as tools for
enhancing the learning of quality nursing care. Formal teaching hours number
3,692, an average of 263 hours by each teacher. Compared to the previous year,
a significantly greater proportion of each instructor's time was used for clinical teaching in the form of supervision, demonstration, and teacher-student interviews.
The psychiatric aide programme offered 39 five-day courses. Of these, 19 were
conducted at the Education Centre, 18 at The Woodlands School, and 2 at The
Tranquille School. The courses encompassed 1,215 hours of instruction for 375
aides entering the service or on staff at Riverview Hospital, Valleyview Hospital, The
Woodlands School, and The Tranquille School. Courses were also conducted at
Skeenaview and Dellview Hospitals to supplement ongoing orientation and in-service
education provided in these institutions. The number of class hours showed an
increase of 50 per cent; the number of clinic hours, an increase of 130 per cent;
and the number of aides attending class, an increase of 80 per cent, compared with
the figures for the previous year. The scope of the clinical teaching programme was
enlarged to include all three institutions on the Lower Mainland.
Affiliate programmes in psychiatric nursing operated for students in the schools
of nursing of the Royal Columbian Hospital, New Westminster; St. Joseph's Hospital, Victoria; and St. Paul's Hospital, Vancouver, and for public health nurses of
the Health Branch. Numbers enrolled in the eight-week programmes totalled 256.
The annual review of terms of agreement between the Mental Health Branch and
the general hospital schools of nursing took place in March with resultant minor
 GENERAL ADMINISTRATION L 47
modification of some items.    A senior instructor, appointed in September, was
oriented and assigned teaching responsibilities in the programmes.
Faculty committees were productive and enjoyed a noticeable improvement in
quality and efficacy of communication. The residence staff provided accommodation
for 560 residents, of whom 513 were newly enrolled students and transient guests.
Infirmary nurses gave nursing care to 244 students and minor assistance to over
3,000. The secretariat dealt admirably with its large volume of work and the constant demands of programme deadlines. Alterations in work schedules and job
assignments resulted in improved maintenance service. The Department was ably
administered by the Assistant Director during the frequent absence of the Director.
NURSING CONSULTATION
Prominent among nursing matters engaging the Consultant in her work with
nurse administrators were the following:—
(a) Reviewing policies with the purpose of determining their effect on the
amount of nursing-service time available for patient-care.
(b) Determining quantity and quality of nursing care in the institutionalized
services according to nursing personnel-patient ratios.
(c) Developing criteria for determining similarities and differences in the
responsibilities and functions of Director of Nursing positions within the
Branch and their comparability to similar positions in the community.
(d) Studying administrative problems affecting nursing practice.
(e) Actioning matters referred to Nursing Council.
(/) Developing plans and proposals for continuing educational opportunities
for nursing personnel, both in-service and through community resources.
Nurses from community mental health centres met in conference for the first
time in November. They decided that regular meetings were desirable for purposes
of education, communication, consultation, and co-operation. By the end of the
fiscal year, some groundwork had been accomplished in preparation for a study of
the role of the nurse in a community mental health centre. Plans were also formulated for holding a workshop to assist in such a study.
The Nursing Liaison Committee, with a representative membership from
agencies and institutions engaged in mental health work, met bi-monthly. The
major purpose of discussions and presentations was to facilitate exchange of information concerning developments in community health programmes and psychiatric
services, and the implications of these for nursing practice, the role of the nurse in
relation to other health workers, and interagency communication systems.
The Nursing Consultant conducted studies, prepared reports, and participated
in planning concerned with nursing administration, practice, and education. She
represented the Branch at various meetings concerned with nursing matters engaging
the attention of government, professional organizations, and community institutions
and agencies. Visits were made to a number of Mental Health Branch facilities;
in conjunction with these, she was a guest in several health units for orientation and
communication purposes; similarly, she met with nurse administrators of two
general hospitals for discussions concerning psychiatric facilities and nursing care.
The prevailing atmosphere throughout the year was one of optimism as general
reorganization plans were initiated and began to influence and stimulate nursing
departments throughout the Mental Health Branch.
 L 48 MENTAL HEALTH BRANCH REPORT,  1967/68
Report for April 1 to December 31, 1968
During the period reviewed by this report, nursing consultation services were
provided part time from April to September, and then full time to the end of the
calendar year. Many of the Consultant's activities derived from the decisions and
recommendations of various nursing committees.
Through its Nursing Council, Directors of Nursing obtained a widening of
educational opportunities for nursing personnel; achieved some progress regarding
proposed changes in senior nursing positions, classifications, and salaries; submitted estimates concerning the reduction of nursing-service time occasioned by the
introduction of revised personnel policies; conducted studies to determine the effect
of illness, absence, and tardiness on the quantity and quality of nursing care available to patients; and made recommendations relevant to the improvement of nursing
practice.
Through the Nursing Liaison Committee, Directors of Nursing of the Mental
Health Branch and nurse representatives of several community institutions and
agencies held bi-monthly meetings. These provided opportunities to examine facilities and programmes concerned with psychiatric and mental health services in
the Greater Vancouver area.
The Mental Health Nurses Council convened bi-monthly in Vancouver. It
made considerable progress in defining responsibilities and functions of the community mental health nurse. A workshop supported financially by a Federal training grant and directed by a visiting consultant from Rutgers University, New Jersey,
provided opportunities for problem identification, review of theoretical concepts,
and exploration of attitudes, approaches, and techniques useful to the nurse in
therapeutic counselling and collaborative teamwork.
The Nursing Consultant represented the Branch as a member of several standing, task, and advisory committees on nursing standards and education in the
community, at hearings concerned with nursing personnel policies, and by convening
meetings to establish terms of agreement for the use of Branch facilities by affiliating
nursing students from educational institutions. Other activities included participation in recruitment for selected positions, preparation of reports on education, staffing patterns and nursing practice, and the provision of regular consultation to the
Department of Nursing Education.
During the latter three months of the year, time was devoted to the termination
of previous responsibilities, orientation to the nursing position within the terms of
reference of the Deputy Minister's consultant staff, and consideration of the scope of
new responsibilities with beginning delineation of possible priorities.
 GENERAL ADMINISTRATION L 49
REPORT OF THE STATISTICIAN AND THE
MEDICAL RECORDS CONSULTANT
R. S. McInnes, B.A., B.D., M.P.H.
Mrs. P. A. West, R.R.L.
April 1, 1967, to December 31, 1968
In this reporting period, new units were added to the statistical reporting system.
The Branch acquired a statistician on its own staff, and medical records sections in
local units have been strengthened. Early in the period the research officer from
the Division of Vital Statistics of the Health Branch, who gave most of her time to
mental health statistics, resigned. Further assistance on a part-time basis was given
by another research officer from the Vancouver office of the Division of Vital Statistics. In September, 1968, a statistician was hired by the Mental Health Branch
for its headquarters in Victoria. Data processing and tabulation assistance continues to be provided by the Vital Statistics Office in Victoria.
Initial steps have been taken to explore the possibility of putting the Mental
Health Branch statistical system onto a computer. There are many needed analyses,
such as length-of-stay experience of various hospitalized patients, which require the
large capacity and calculating abilities found only in an electronic computer.
THE STATISTICAL DATA SYSTEM
Reporting Form Development
New or revised individual patient statistical reporting forms were developed
for several Branch units. Much time was spent in the revision of the forms used
by the mental health centres. Temporary forms were first introduced in the early
part of the year. From these a streamlined, multi-part, largely pre-coded form
was finalized with an accompanying manual of instructions, definitions, and code.
Also at the beginning of the period, a revised statistical form providing more
detailed diagnostic and treatment data was introduced at the Riverview Hospital.
The Medical Records Consultant and the Vital Statistics research officer held a
consultative meeting with the senior medical records clerks to review the revisions
and the accompanying manual of instructions and definitions.
In the fall of 1968, to meet medical records standards required by the Canadian
Council on Accreditation of Mental Hospitals, the Riverview Hospital reporting
system was changed.   These changes will materialize January 1, 1969.
With the creation of the British Columbia Youth Development Centre at
Burnaby, a statistical form and a manual of instruction were developed. The special
needs of this facility, with its out-patient, day care, and in-residence programme,
required a careful blending of reporting systems previously used, modified to fit
a children's facility.   This package will be implemented on January 1, 1969.
Plans for developing statistical data forms for The Tranquille School, Dellview
Hospital, and Skeenaview Hospital were temporarily deferred as the result of the
resignation of the Vital Statistics research officer in October, 1967.
Procedure Development
In order that all in-patient facilities might report patients' incoming and outgoing movements consistently to the Public Trustee, work was commenced on the
standardization of reporting forms.   A meeting of the business administrators and
 L 50 MENTAL HEALTH BRANCH REPORT, 1967/68
the Public Trustee was held to discuss questions relating to the forms, with drafts
being presented for consideration and approval. These changes take effect in
October, 1968.
A standardized " form for consent for release of information " and " a boarding home treatment record form " were designed and implemented. The latter
provided community doctors with an adequate medical and psychiatric summary
on patients transferred to boarding homes and provides a means for the attending
physician, or hospital psychiatrist, to record patient's progress, changes in medication, and other information which would become part of the patient's permanent
medical record.
A procedure manual for medical records departments in mental health centres
was compiled and copies distributed to each centre. These provide guidelines for
uniform medical records and guidance to clerical staff acting as medical records
clerks.
Data Retrieval
Early in the period the Vital Statistics research officer made a study of the
data collected during the first three months of mental health centre reporting.
Tables were presented at a meeting of the directors of the mental health centres.
These stimulated discussion around some of the apparent trends disclosed in her
study. Many requests for data were received from members of the medical staff
and other professional staff members within the Mental Health Branch. In planning for the British Columbia Youth Development Centre, data were provided in
the form of listings of cases according to age-group, sex, residence, and diagnosis.
Outside the Mental Health Branch, data were provided to the Public Health
Branch—relationship between retardation and postnatal cerebral infection through
measles (rubella) virus; University of British Columbia Departments of Psychology and Psychiatry—studies related to suicides; University of British Columbia
School of Social Work—patients discharged from Riverview Hospital; University
of British Columbia Department of Pharmacology—Huntington's chorea cases
treated in mental health facilities.
ADMINISTRATIVE AND PLANNING STUDIES
A number of studies have been launched by the statistician utilizing Mental
Health Branch data and data from other sources. These include the following:
The need for psychiatric beds for aged persons; regional profiles of mental health
needs and resources; trends in Mental Health Branch services and characteristics
of patients; the role of mental health centres in reducing admissions to the Riverview Hospital.
MEDICAL RECORDS DEVELOPMENT AND REPORTING CONTROL
A large proportion of the time of the Medical Records Consultant was spent
in assistance to medical records units in development of their procedures, and in
the accurate and prompt completion of statistical reporting forms. During the
period both Woodlands and Valleyview Hospitals completed the updating of
admissions statistics detail to bring their data into line with the new procedures
initiated on April 1, 1966. Visits were made to almost all of the Mental Health
Branch facilities by the Medical Records Consultant for purposes of consultation
and in-service training of medical records personnel. The opening of new units
within the Branch necessitated special efforts on the part of the Medical Records
Consultant to introduce their staff to the reporting system and the essentials of
medical records organization and maintenance.
 GENERAL ADMINISTRATION
L 51
On August 1, 1967, Miss L. McSweeney, R.R.L., was appointed to the position of medical records librarian at the Riverview Hospital. Orientation to Mental
Health Branch and intensive consultative services were given during the first few
weeks following her appointment. It was not long before progress was being made
at Riverview in reactivating the Medical Records Committee and developing a Medical Audit Committee; also preparations to meet the standards required by the
Canadian Council on Accreditation of Mental Hospitals were begun.
In October, 1967, a meeting of the medical records supervisors from all the
mental health centres was held at the Vancouver branch office. The meeting provided instruction on the completion of the statistical forms and discussion regarding
various aspects of the management of medical records in the mental health centres.
The need for formally trained medical records personnel is becoming increasingly apparent as more demands are being placed on medical records departments
for service and research projects. It should be noted that this need will be partially
met at Riverview Hospital when four medical records personnel presently taking
the correspondence course jointly sponsored by the Canadian Hospital Association
and the Canadian Association of Records Librarians will have qualified as medical
records technicians or medical records clerks.
 L 52 MENTAL HEALTH BRANCH REPORT,  1967/68
REPORT OF CONSULTANT IN SOCIOLOGY
Ray H. Goodacre, B.A., M.A., M.P.H.
This consultant was appointed to the Victoria Mental Health Branch office
in June in order to (a) participate in the clarification and definition of over-all goals
for the Mental Health Branch; (b) develop applied research techniques to evaluate
the effectiveness of programmes; (c) act as a consultant to mental health centres
and institutions wishing to carry out sociological research.
Visits, most of which commenced during the fall, were made to mental health
centres and treatment institutions to review the programme of each facility in order
to determine programme objectives and methods available for ascertaining the
extent to which programme objectives were being met.
Consultative service, including the preparation of interview schedules, was
provided to the Northern Interior Mental Health Centre in studying the views of
former patients toward care received and their present level of functioning.
With the co-operation of the Health Branch Division of Vital Statistics and
the staff of Riverview Hospital, a detailed analysis was made of the characteristics
of Riverview patients admitted from Vancouver Island. This study was initiated to
assist in planning for bed occupancy at the new Eric Martin Institute in Victoria.
In order to facilitate decentralization of the planning and operation of mental
health services, the Province has now been divided into a number of planning regions. Following a review of boundaries currently in use by a number of Government departments administering and financing health and social services, eight
mental health planning regions were selected. In determining boundaries appropriate for proposed mental health regions, particular recognition was made not only
of an increasing emphasis by mental health centres on education, prevention, and
rehabilition, but also an active desire by the Branch to encourage community participation in the planning and financing of a range of mental health services.
 GENERAL ADMINISTRATION L 53
REPORT OF THE DIRECTOR, INFORMATION SERVICES
Peter J. Smith, C.P.R.S.
May, 1968, saw the establishment of an Information Services Section at the
Victoria office of the Mental Health Branch. The first and immediate task was to
endeavour to improve communications between the Branch and the general public
via the news media, radio, and television.
During a brief orientation period it was found that some form of communication
was also needed that would convey news of happenings and developments from the
head office and out to the various institutions and mental health centres. To this
end a Mental Health Branch newsletter was designed and is now published on a regular monthly basis, with 300 copies mailed throughout the Branch.
Press releases and news releases have also been prepared and mailed as and
when required. A mailing list of weekly and daily newspapers and radio and television stations has been set up, and it is intended to send out items of special interest
on a regular monthly basis.
In June the writer accompanied a C.B.C. producer and camera crew around the
Valleyview Hospital. Medical staff were interviewed and certain film sequences
were taken for use in a documentary film on "Ageing," which was aired on December 10, 1968.
The Mental Health Branch exhibit in the British Columbia Government Building on the Pacific National Exhibition grounds, Vancouver, was updated.
Co-operation with the Canadian Mental Health Association has been maintained, and during October spot radio announcements were provided by this department for use by the Canadian Mental Health Association on Victoria's Mental
Health Day.
  COMMUNITY MENTAL HEALTH SERVICES L 55
PART II.—COMMUNITY MENTAL HEALTH SERVICES
MENTAL HEALTH CENTRE, BURNABY
A. D. Sleigh, B.A., M.D., C.R.C.P., Director
Report for April 1, 1967, to March 31, 1968
During the period under review there were a number of important changes
occurring in this mental health centre. These changes stem from the organizational
innovations of the previous year, and this period under study should be considered
as a transition period for this centre. It would be useful for the reader to refer back
to the previous year to obtain continuity and perspective.
The over-all changes have been going on to establish this clinic as a true
regional community mental health centre for Burnaby and to ready the unit for the
incorporation of the new residential treatment unit for emotionally disturbed children. Once the reorganization has been completed, then the mental health centre
will be divided into two separate units with very different functions. To summarize,
there will be a community mental health centre for Burnaby and a comprehensive
children's treatment unit for children and adolescents of the Province.
DIRECT SERVICES
Adult Clinic
There was a general levelling-off of service during the year with 855 activations
in 1967 to 1968, compared to 851 activations in the previous year. Nine hundred
and one cases were closed during this year, whereas in the previous year 822 cases
were closed. This shows that there was a large measure of work completed and with
a fairly brisk turnover of patients.
As in the previous year, the sustaining clinic case load showed another increase
and now amounts to 40 per cent of all cases treated in the Adult Clinic. Again this
seems to reflect the fact that many of our patients need fairly intensive chemotherapy.
As in the previous year, special clinics were organized to handle the sustaining
clinic case load. Group therapy and family group therapy continued to be used
extensively by almost all staff members, but the basic treatment tends to remain the
individual psycho-therapy session. The patients seen at this clinic vary a great deal
in their particular needs, and in some cases are seen very intensively, whereas others
are seen for perhaps 15 minutes every month or even every two months.
Innovations, too, have been tried by staff to give better patient-care. One such
innovation has been the use of marathon group therapy.
In the area of the day-hospital operation, the unit functioned effectively during
the year with a part-time psychiatric director. Further development occurred in the
operation of a true therapeutic community with the focus on problem-solving for the
patients through a " here and now " experience or experiences. The day hospital
operated with essentially full capacity all year, with waiting lists needed from time
to time. The admissions increased 14 per cent over the previous year, with the average length of stay decreasing from 24 to 22 days. The readmission rate gives some
reason for concern at 35 per cent, but again this has shown a decrease from the
previous year, when there was a 37-per-cent readmission rate. The population
showed a composition of 66 per cent female patients and 34 per cent male patients,
and this is typical for this day hospital.
 L 56 MENTAL HEALTH BRANCH REPORT, 1967/68
Children's Clinic
In comparing the year under study with the previous year, there seems to be no
basic change in the service given. Records show that there were 956 activations
during the year, as compared to 986 in the previous year. There were 1,207
patients closed from the clinic, as compared to 977 in the previous year. The
out-patient treatment typically centres on individual casework or psychotherapy
sessions but, as in the last few years, there has been a fair emphasis on family group
therapy methods. In the previous year there were four care-giving teams in the
children's unit, but these teams were amalgamated into two treatment teams, and
neither team specialized in a particular treatment mode. This gave the advantage
of comprehensiveness of treatment of a patient on the one team—one of the major
aims of this reorganization. However, the reorganization was also required by the
fact that in the past we have depended on child psychiatrists, or psychiatrists trained
at least in part in child psychiatry, to head up teams, and during the second half of
the year under review there were only two full-time psychiatrists on staff.
In terms of innovations in treatment, it should be mentioned that there was
extensive use of the video-tape recorder unit in both clinics. The Children's Clinic
staff used it very effectively for training purposes, and also for treatment purposes,
especially in regard to confronting patients and families with their ongoing behaviour.
This equipment has proved to be very effective for all forms of group therapy and
in dealing with individuals who need to see very directly how they behave and how
they affect others.
The day centre operation was without a director for much of the year, and this
reduced its effectiveness to some degree. During the year a total of 55 children was
treated in this service, and during the summer a special programme was conducted
for the purposes of more intensive observation and assessment of a number of children on the Out-patient Clinic case load. An afternoon programme was also
organized for children with learning problems, and the very small staff of this unit
was augmented by a psychologist and volunteer teacher coming to the unit to assist
the children with a classroom-type learning experience. Certain conditioning techniques were demonstrated to other staff in this programme and proved very effective.
Forensic Clinic
At the time of writing, this clinic is only partly functional as it presently consists of only the psychiatric social worker and a clerk. During the fiscal year the
director resigned, and as yet a replacement has not been found.
Travelling Clinics
There was no basic change in the functioning of this part of the clinic service
to outlying areas. A certain amount of difficulty was experienced in maintaining
continuity of psychiatrists for the treatment teams that went out to the Skeena area,
Powell River-Sechelt area, Simon Fraser area, and the Boundary area. This was
due to the general shortage of psychiatric personnel and to the fact that the few
psychiatrists on staff were already taxed with other service requirements. In many
instances the social workers acting as travelling clinic and community consultants
had to work on an independent basis.
INDIRECT SERVICES
As before, this Clinic has continued to be very much involved in indirect services to the Province of British Columbia.    One psychiatrist from the Children's
 COMMUNITY MENTAL HEALTH SERVICES L 57
Clinic continued to give special consultation to such agencies as the Children's Aid
Society, the Catholic Children's Aid Society, the Juvenile Courts of Vancouver and
Burnaby, and the Brannan Lake training-school. Again certain group-living homes
in the Lower Mainland area were given a screening and consultation service when
required from our senior psychiatrist of the Children's Unit. He also gave consultation to the New Denver school for boys. As in the previous year, the Special
Placement Division of the Child Welfare Department worked in close liaison with
our Children's Unit.
TRAINING AND EDUCATION
Almost all staff members were involved in lectures, talks, seminars, and workshops that were organized to educate the community in mental health and mental
health practices. This type of education and involvement of our staff ranged from
answering telephone inquiries to giving formal lectures and seminars. Some staff
members gave literally dozens of talks and lectures to the community. Some very
interesting developments occurred, and one that should be mentioned is the fact
that the team psychiatrist for the Burnaby team, and a social worker from that team,
worked very closely with the Canadian Mental Health Association in setting up the
Secure Organization. These two people were involved in open-line discussions on
radio and television appearances to help house-bound phobic people get to treatment
or to the Secure Organization, wherein they were able to get help from volunteers
and others who had suffered from a similar condition. It proved to be a very worthwhile venture and aided us in establishing a closer liaison with the Canadian Mental
Health Association.
This same Burnaby team organized several workshops for teachers from the
Burnaby area, and common problems were worked out together. Communication
between the schools and our treatment centre was vastly improved as a result of
these workshops, and further workshops are anticipated with other help-giving
community agencies.
A training workshop was held during the year under the direction of Dr. George
Bach, and this workshop centred on the techniques of group psychotherapy. A limited number of professional people from outside our clinic were invited and participated. Later in the year another workshop was held, and this one centred on
techniques of psychodrama.
Co-operation was given by the clinic to societies such as the Y.M.C.A. so that
they could hold group marathon and training sessions at the centre. A few of the
more-experienced group psychotherapists conducted training groups for school
counsellors and Probation Officers, and these same therapists also conducted demonstrations on the use of the video-tape equipment.
Besides these activities there were many ongoing training activities for students
from the School of Social Work at the University of British Columbia, for Probation
Officers, for school counsellors, and others. Over 20 social-work students were involved in " field placement " at the Mental Health Centre, Burnaby, and a number
of these students worked in close co-operation with our therapists and received
ongoing tutorage from them.
A number of occupational-therapy students and nursing students experienced
field placement in our day hospital and day centre. Besides these more formal programmes, many visitors from different treatment units in the Lower Mainland area
and throughout British Columbia visited our day centre and day hospital, and whenever possible experienced a total day in one of these units. In this way they were
able to experience first hand the type of advance treatment programme we utilized
in these areas.
 L 58 MENTAL HEALTH BRANCH REPORT, 1967/68
In summary this clinic once again experienced a very busy year in the field of
training and educating both our own staff and the staff from other agencies and
treatment centres.   Only the highlights have been mentioned in this annual report.
RESEARCH
The research activities have included a token reinforcement classroom for
learning and behaviour disorders, a comparison of marathon group psychotherapy
versus the results from more traditional group psychotherapy, the comparison of
normal parents with parents of autistic children on the basis of psychological tests,
decision-making processes and critical incidence studies in day-hospital functioning.
GENERAL
Besides the general problem of having the whole centre in a transition state
because of the amount of reorganization taking place, a very difficult problem has
been encountered in the fact that we are still experiencing drastic staff shortages in
psychiatry and psychology.
The turnover in staff generally increased (when comparing with the previous
year) from 25 to 30 per cent. The highest rate of turnover was in medical specialists, with five full-time psychiatrists and four sessional psychiatrists resigning from
a total establishment of 11.
In the area of psychology there still exists six vacancies in the total of 11 established positions. We do need the psychiatric and psychology positions filled to run
at maximum efficiency in this clinic, and we do need to work toward a greater
continuity of staff members.
Report for April 1 to December 31, 1968
Wm. C. Holt, M.D., C.R.C.P.(C), Director
The most important event in this period for the Mental Health Centre, Burnaby, was the formation of the British Columbia Youth Development Centre to
provide comprehensive care for the children of British Columbia and the formal
separation on June 1st of the two institutions. What was formerly the Children's
Clinic division of the Mental Health Centre became the out-patient section of the
Youth Development Centre. Dr. A. D. Sleigh was appointed Executive Director
of the Youth Development Centre, and Dr. Wm. C. Holt was appointed Director
of the Mental Health Centre, Burnaby.
The functions of the Mental Health Centre, Burnaby, are:—
(1) To provide a comprehensive diagnostic and consultative service to adults
and children with emotional disorders from the Burnaby community, as
well as limited treatment resources.
(2) To provide a similar service for adults from other parts of the Lower
Mainland, and the Province in general, which do not have their own
regional psychiatric facilities.
(3) To provide specialized treatment resources, such as day hospital, group
therapy, family therapy, etc., as seems appropriate and feasible.
(4) To engage in training of health-care personnel and research on emotional
illness.
(5) To employ the knowledge and skills of our multi-disciplinary teams to
develop community-oriented preventive programmes in the mental health
field using the broadest possible definitions of mental health and prevention.
 COMMUNITY MENTAL HEALTH SERVICES L 59
In order to carry out these functions, clinical personnel in the centre are deployed on either of two out-patient teams, one providing comprehensive services to
Burnaby, the other providing adult services to other areas, or on the day-hospital
staff.   Personnel from the out-patient teams also supply services to travelling clinics.
CLINICAL SERVICES
In spite of the advent of medicare, demands for all forms of out-patient
services have continued in excess of our capacity to deliver service, particularly with
respect to children's services in the Burnaby area. Staff shortages have at times
forced reduction of intake services, but treatment loads have been maintained. The
recruiting of a senior psychologist for a long-empty position will enable us to extend
our treatment resources into the behaviour therapy and conditioning treatment field.
Travelling clinics are still functioning on a regular basis in Skeena Health Unit,
Coast-Garibaldi Health Unit, Boundary Health Unit, and Central Fraser Valley
Health Unit. On November 1st, with the establishment of Simon Fraser Mental
Health Centre, travelling clinic services to Coquitlam were discontinued, although
a number of patients from this health unit remain in treatment. Attempts have been
made in the past year to make better use of local resources by travelling clinics, and
emphasis has been placed upon consultative and educational functions of travelling
clinic workers rather than direct-treatment functions.
The day hospital has continued to provide a highly effective treatment milieu.
Its focus remains on treatment in the " here and now," emphasizing reality contact
and making wide use of group techniques. The programme is under continuing
scrutiny and revision. One-day workshops on the programme continue to be held
at approximately six-month intervals; the most recent of these was in October. A
new addition to our therapeutic armamentarium is a weekly psychodrama session.
Occupancy continues high and waiting lists for admission have been necessary from
time to time.
INDIRECT SERVICES AND TRAINING
The centre has continued its major involvement with the community as outlined
in the previous year's report. One might mention particularly that the Secure
Organization (see previous report) continues to flourish, and more Mental Health
Centre personnel have made contributions in past months, including lectures and
demonstrations, as well as supervision of individual groups within the programme.
A preliminary evaluation recently carried out indicates very favourable results and
continued expansion of the programme as well as " graduation " of several groups
to a relative freedom from symptoms.
The placement of social-work, occupational-therapy, and nursing students for
training at the Mental Health Centre, Burnaby, continues, as does the visiting of
professionals in these fields from other institutions to study our programmes and
operation.
A new venture undertaken this fall was the conducting of a survey course in
group therapy techniques for school counsellors, Probation Officers, psychiatric
nurses, and other interested professionals. This was in addition to consultation to
such professionals regarding their conduct of groups and some co-therapist training
experiences which we already offer. At present we are evaluating responses to this
course and, as is appropriate after an initial venture, will be revising our format
and presentation with a view to repeating this service.
A number of educational activities within teams and the centre as a whole are
taking place on a regular basis. Response of the staff to outside educational opportunities has also been very keen, and we have been able to sponsor a limited number
 L 60 MENTAL HEALTH BRANCH REPORT,  1967/68
of staff's attendance at professional training sessions sponsored by the University of
British Columbia Continuing Education Department, Shalal Institute, professional
associations, etc. Those staff members who do attend such meetings always bring
back information and experience to share with fellow staff members, and thus virtually all Mental Health Centre staff ultimately participate both as teachers and
students in the ongoing educational process that must be so much a part of the lives
of professional people today. We look forward to continuation of co-operative
relationships with other institutions and groups to make further training available
to staff from our own centre and to others in the community with common interests.
 COMMUNITY MENTAL HEALTH SERVICES L 61
SOUTH VANCOUVER ISLAND MENTAL HEALTH CENTRE, VICTORIA
A. L. Aranas, M.D., Acting Director
Report for April 1, 1967, to March 31, 1968
Experienced clinical staff at this centre are able to provide intensive short-term
treatment to maintain a large number of patients to adequate functioning in the community. With the co-operation of social welfare agencies, public health personnel,
family physicians, and other community services, the manipulation of the environmental loci of stress has minimized the patient's disabilities. As the therapeutic relationship broadens to include other professions and disciplines, the treatment and
rehabilitation of the psychiatrically disabled have been more effective.
In spite of the fluctuation in the numbers of professional staff at this centre, a
high standard of services to the community has been maintained.
To help develop a highly skilled clinical staff, specially the social workers and
nurses, the Branch has been most co-operative in authorizing their attendance at
local, national, and international conferences and workshops on mental health.
During the period of May to August, 1967, two students from the University of
British Columbia School of Social Work did their block field-work placement at the
centre. They were supervised very closely by Mr. R. N. Crawford and Mrs. A. M.
Newton-White, and were a most valuable addition to our clinic staff during the
summer months.
As in previous years, a Christmas party was held for the after-care patients.
This was a very therapeutic situation for patients without families in the area.
The pharmacy department of the Royal Jubilee Hospital has provided us with
a part-time pharmacist who dispenses our drugs three afternoons a week. Previously
this was done by the doctors and nurse. Since the greater number of our patients
are on one kind or combination of psychopharmacological agents, the pharmacist's
services are most valuable and allow the doctors and nurses more time for their
patients.
To facilitate the boarding-home programme in the absence of adequate staffing,
patients are seen in group therapy. This also applies to the increasing demand for
services to after-care patients.
During the year the following staff members resigned from the Mental Health
Branch: Mr. Robert A. Fatt, Clinical Psychologist, resigned on September 15,
1967, to accept other employment; Mrs. Mary McLean, Social Worker, resigned
on September 22, 1967, to attend the University of Washington School of Social
Work to further her education; Mrs. Verna Lister, Public Health Nurse 2, resigned
on September 29, 1967, to take up residence in Vancouver; Dr. John E. Phillips,
Medical Specialist 1, resigned on February 29, 1968, to accept a university appointment in Vancouver.
Appointments made were as follows: Mr. Richard R. Boersma, Clinical Psychologist, was appointed on October 16, 1967; Dr. Oliver Henderson, Medical
Specialist 1, was appointed on January 15, 1968; Mrs. Lois D. Appleton, Public
Health Nurse 2, was appointed on February 1, 1968.
Report for April 1 to December 31, 1968
Alex Stewart, M.B., D.P.H., Director
The role of this Mental Health Centre in relation to the local community was
closely reviewed during the year in the light of increased demands for service.   A
 L 62 MENTAL HEALTH BRANCH REPORT, 1967/68
system of priorities was instituted to better utilize the time of the professional staff.
This enabled them to become more involved in supporting and helping expand existing agency projects and assist in planning new programmes.
Attention was also focused on encouraging mental health education projects
and planning and implementing early case detection services. A decision was made
to alter the direction of the programme, with emphasis being laid on consultation
with community agencies rather than on direct treatment.
One favourable circumstance was the increase in number of professional staff.
Currently all positions are filled. At the beginning of the year the centre had one
full-time psychiatrist and a private psychiatrist working on a sessional basis. By
the end of the year there were three full-time and two sessional psychiatrists. The
number of social workers at the master's level was increased by one, bringing the
total to five. In addition, one other M.S.W. was employed on a half-time basis as
a consultant in the area of mental retardation. This social worker acts in a liaison
capacity between the local community and Woodlands and Tranquille Schools and
is available as a consultant to the schools for the retarded, to the Association for
the Mentally Retarded, to Family and Children's Service, and to the Greater Victoria Metropolitan Board of Health. An additional psychologist with an M.A.
degree brought the staff of that department to two sessional psychologists with Ph.D.
degrees and two full-time M.A. workers. The centre has also two mental health
nurses on staff. With these changes in personnel, the work load of the clerical staff
increased greatly. This pressure of work was relieved to a certain extent by the
addition of a Clerk-Stenographer 2.
One change in staff organization was the formation of two multi-disciplinary
professional teams set up to increase the level of effective communication between
all staff members. One member of each team acts in a liaison capacity with a specific agency. Meetings were held with the various agencies to set up and formalize
communication channels between the respective agency and the Mental Health
Centre. At the moment it appears impractical to divide the catchment area into
sub-regions with regional responsibility assumed by a particular team, but the breakdown by agency is regarded as a useful first step. This outreaching into the local
community stimulated a good deal of interest in the work of the Mental Health
Centre and resulted in a further rise in the referral rate.
Another trend noted during the year has been an increase in the number of
patients residing locally who have a history of long-term hospitalization. Continued
efforts were made to improve the availability of vocational rehabilitation and recreational activities for this group. The centre has had much support from the local
Canadian Mental Health Association in this particular area.
An organized programme of in-service education was begun to enable the
staff to become more skilled in the various community roles which they are now
assuming. Seminars and training sessions were also held with general hospital
nurses, Probation Officers, school counsellors, and the ministerial association to
help enhance their skill in early case detection.
Research into the effectiveness of the programme is an integral part of the
function of a mental health centre. At present consideration is being given to the
question of how the resources of the centre can best be deployed so that well-
planned and meaningful research can be undertaken. The problem of the role of
the mental health centre in preventive psychiatry has also been given much thought.
While many aspects of the work of the centre involve a preventive approach, no
formal programme has been established as yet.
 COMMUNITY MENTAL HEALTH SERVICES L 63
CENTRAL VANCOUVER ISLAND MENTAL HEALTH CENTRE,
NANAIMO
S. E. Jensen, M.D., C.R.C.P., Director
Report for April 1, 1967, to March 31, 1968
ORGANIZATION AND STAFF
The Central Vancouver Island Mental Health Centre is a community and
family oriented centre for the control of mental illness through prevention, education, and treatment. The centre began operation in April, 1964, serving 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 more than 150,000, there is only one psychiatrist in
private practice.
The clinic is located at the Public Health Centre in Nanaimo. Travelling
clinics serving Duncan, Alberni, Courtenay, and Campbell River work out of
offices in the local public health unit. 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 very few patients referred have needed to be certified to the Riverview Hospital at Essondale. Nevertheless, it is possible that the Mental Health
Centre has made litde impact on the admission or discharge rate of patients from
this area to Riverview Hospital. This in spite of the fact that prevention of com-
mital to the mental hospital is a goal of high priority.
Several factors probably contribute to this, as follows:—
(1) The Mental Health Centre appears to have unintentionally developed
the reputation of being primarily a child guidance centre.
(2) It may be believed that the waiting list at the Mental Health Centre prevents referral of patients in urgent need of treatment. This, however, is
not true. We are generally able to provide immediate treatment for urgent
cases.
(3) There is still a tendency in the community to feel that the acutely mentally
ill person is a nuisance and a danger and should be made to leave the
community; consequently they are not referred to the Mental Health
Centre, which is known to discourage commitment.
In spite of the fact that the Nanaimo Regional General Hospital does not yet
have but has projected a psychiatric ward, it has been the experience that virtually
all mentally ill, except those few who have been involved in criminal activities, can
be successfully treated there.
The objective of the centre has been to provide as comprehensive a service as
is possible in Nanaimo, and to extend the scope and usefulness of the centre by travelling each month to other principal centres in the district.
Great emphasis has also been placed on guiding, counselling, and teaching other
professional groups (welfare workers, nurses, school counsellors, clergy, family
physicians, etc.) so as to enable them to better assist in efforts to keep the patient
employed and functioning in his community. Much of this work of necessity involves evenings, and the staff has, in the period covered by this report, spoken on
more than 150 occasions to groups all over the Island, as well as having participated
on many committees and other meetings of a planning and organizational nature.
 L 64 MENTAL HEALTH BRANCH REPORT,  1967/68
Specifically the clinic staff has been involved in the development of several
important community facilities over the past year, notably the Family Life Centre in
Nanaimo, the Group Living Home for Retarded Children in Nanaimo, the new
branch of the Canadian Mental Health Association in Ladysmith, and the new Day
Care Centre for Pre-schoolers in Nanaimo. The latter is an important mental health
project that enables separated or widowed mothers to work, eliminating their need
for social welfare.
Rehabilitation committees now function in all the centres served by full-time or
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 and important endeavour which,
together with the facilities of the Goodwill Enterprises, has provided an excellent
service to the community. The Goodwill Enterprises is an organization devoted to
employment and rehabilitation of physically and mentally handicapped. The organization, with headquarters in Victoria, has recently established a branch in Nanaimo
and retail outlets in Duncan and Courtenay. This was brought about through a continued effort by the Mental Health Centre, the Rehabilitation Consultant, and local
service clubs.
In an attempt to overcome the serious lack of facilities for psychiatric in-hospital
treatment of children, a camp for emotionally disturbed children was developed.
The camp is, in a sense, a hospital, since it provides all the facilities and types of
treatment which would ordinarily be available in a psychiatric hospital for children,
including intensive nursing care. At the same time the children benefit from the
emphasis on learning and growing up, rather than illness and treatment, the setting
being that of a boarding school rather than a hospital.
Because almost all of the children have been referred primarily as school adjustment problems, it has been natural for us to emphasize school assessment. Each
year we have hired highly competent staff and have been able to make an extensive
study of the child's school development. This has proven to be of great benefit to
the schools and to the children upon returning home.
Twenty-four children from the area served by our clinic attended the camp
for two weeks in 1967, and this has now become an annually recurring part of our
service closely tied in with the general programme of the centre. Both children and
parents are seen in regular counselling and therapy as indicated, and during the year
three full-day workshops for the parents of the 24 children were held. This project
appears to prove that the concept of short-term hospitalization, rather than institutionalizing or residential treatment, is practical for children as well as adults.
In evaluating the statistical part of this report, it should be borne in mind that
for a considerable part of the fiscal year in question the positions of social worker
and psychologist were vacant, and also that the Director was absent for a prolonged
period of time due to surgery.
Report for April 1 to December 31, 1968
During the summer of 1968, for the third consecutive year, 24 children selected
from those referred to this centre had the opportunity of receiving intensive treatment and assessment at our school camp held at Shawnigan Lake. This programme
is planned to continue in the summer of 1969.
In order to provide service to the young teen-age group, a pilot project was
conceived jointly with the Provincial Probation Services. A group of boys, aged
13 to 15, with emotional problems which had resulted in delinquent symptomatology
were taken for a week-long hike to the west coast of Vancouver Island.    It was
 COMMUNITY MENTAL HEALTH SERVICES
L 65
anticipated that this would facilitate both an opportunity to observe and get to know
the youngsters and to improve communication with them; this is difficult in an office
situation. Although it is very difficult to say whether the boys, as a group, are doing
better than they would have done without this form of attention, it is felt that the
tour was worth while and was a good learning experience for them. As a follow-up
to this project, parents and boys meet with the staff of the Mental Health Clinic and
with Probation Officers for a workshop each month.
A one-day workshop on alcoholism was initiated by this centre and sponsored
by the Canadian Mental Health Association during the past month. Two members
of the staff of the Alcoholism Foundation in Saskatchewan were key speakers for
this event. The Director of the Mental Health Centre participated with these
speakers in an " open mike " radio broadcast, which was well received in this community, as also was the open public meeting held in the evening. This brought an
excellent response. A session at the Nanaimo Senior Secondary School was also
well received.
Presently the staff at the centre is involved with the formation of a group-living
home for boys in Nanaimo, a Big Brother Society in Port Alberni and Nanaimo to
help fatherless boys, and a day-care centre for pre-school children which has just
opened, and which promises to improve the mental health of widowed, separated, or
divorced mothers by making it possible for them to find employment rather than
going on welfare.
An important part of the mental health nurse's time has been taken up in providing liaison and consultative services to the public health nurses, particularly in
their efforts to provide follow-up services to patients discharged from the Provincial
mental hospital or otherwise chronically emotionally handicapped. The nurse has
also conducted group therapy with the hospitalized patients and with a group of
teen-age girls.
Recently an approved boarding home for 20 chronically handicapped patients
from the Provincial mental hospital has been established at the Retreit Farm near
Shawnigan Lake, 50 miles south of Nanaimo. The Mental Health Centre has been,
and will be, involved in providing follow-up and supervision of this home.
During the period covered by this report, about 100 patients spent an average
of just over 10 days 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. A general shortage of beds in
the Nanaimo Hospital makes it necessary to restrict admission except to the most
severely ill, and basically this means that most of these patients would have otherwise had to be admitted to the Provincial mental hospital or to the psychiatric wards
in Vancouver or Victoria.
 L 66 MENTAL HEALTH BRANCH REPORT, 1967/68
SOUTH OKANAGAN MENTAL HEALTH CENTRE, KELOWNA
F. E. McNair, B.A., M.D., CM., C.R.C.P., Director
Report for April 1, 1967, to March 31, 1968
The work of this Mental Health Centre during the year has been divided into
several categories. The number of cases under active treatment is close to 300,
and the actual case load is shown in the tabulations.
Since the advent of a psychiatrist in private practice in Penticton, we have
elected to see any continuing Penticton cases requiring our assistance, in Kelowna,
in the hope that the pattern of diversified practice could be encouraged for the
Penticton area, with the psychiatrist in private practice offering service not only in
his own office but also at the health unit.
We have felt that a preventive programme should give attention to adults who
can identify problems of adjustment but are not themselves sick. Accordingly we
have co-operated with the Adult Education Division of the School Board in a
" Marriage for Moderns Programme " and have also taken part under the same
sponsorship and with the assistance of the local Canadian Mental Health Association in a weekly programme for mothers having difficulty managing their young
childern titled " Coping or Crying."
To try to gain some indices of our own effectiveness, we have embarked on
two research projects—one with respect to the children dropping out of the school
system, and the other an evaluation of our treatment load.
The hospital service continues to be used to maximum advantage, with 99.4
per cent bed occupancy. A total of 160 patients was treated during the year, five
of whom were certified to Riverview Hospital. There is a need to improve our
services to children, and the development of a special ward for the treatment of the
emotionally disturbed should not be overlooked.
The Family Court is particularly concerned to maintain the integrity of
families, and the committees assisting the Family Courts in the valley are developing group-living homes for teen-agers requiring this resource. We will be called
upon to give consultant service when these homes are established.
The ideas suggested in the Canadian Mental Health Association report " More
for the Mind" and the American Psychiatric Association report "Action for
Mental Health" are being put into practice in the development of community
mental health centres with close integration of services with existing medical services. The service is close to home and offers a continuity of care. On the other
hand, the medical model as such does not completely answer the social needs of
our patients. Our patients are members of families and, apart from the immediate
symptom picture, much of their treatment has to go on in the community in relationship to their families and with the assistance of, other helping personnel. This
includes the family doctor, the social agencies, the public health nurses, etc.
The time is at hand when further developments within the community must
become the responsibility of a regional group with authority to develop such other
services as are required for this area.
 COMMUNITY MENTAL HEALTH SERVICES L 67
WEST KOOTENAY MENTAL HEALTH CENTRE, TRAIL
G. R. Mansfield, M.D., Director
Report for April 1, 1967, to March 31, 1968
The West Kootenay Mental Health Centre, now in its fourth year of operation,
is still serving both the East and West Kootenay regions. A booming economy has
increased the combined population to an estimated 131,000. The main clinic,
based at Trail, serves the West Kootenay area. The East Kootenay is served once
a month by a travelling clinic to Cranbrook.
There are no private psychiatrists in this area at the present time. This means
that the primary role of the Mental Health Centre in co-ordinating all activities
concerned with mental health must temporarily give way to meeting the heavy demands for direct service.
The present staff is comprised of two stenographers, a social worker, and a
psychiatrist. The positions of nurse and psychologist are currently vacant, although
a psychologist was on staff for four months.
EDUCATION
Attempts to reduce education to a minimum were unsuccessful owing to our
firm integration with other helping agencies and difficulty in turning down requests
for mental health personnel to act as resource people. Furthermore, education and
prevention are closely related, and this centre places strong emphasis on prevention.
The social worker and psychiatrist have given over 50 major addresses and
numerous minor ones. This has involved over a hundred planning meetings as well
as regular meetings associated with ongoing programmes. The permanent programmes will be mentioned first. As a member of the Advisory Board of the Association for Community Planning, there are demands for educational material, project
planning, and guidance in this type of endeavour, which is new to Trail. The Mental
Health Centre has served in the capacity of adviser to the adult education department of the schools in various places. The programme for the perceptually
handicapped child continues to grow in close collaboration with the schools. The
Trail Youth Liaison Committee, representing all agencies dealing with children and
adolescents, serves as a vehicle whereby information can be shared and programmes
developed which are geared to the individual's needs. This organization is also
symbolic of the current trend in the therapy of children, indicating a shift from child-
centred to community-centred treatment.
Education of the public health nurses is carried out by regular weekly meetings
where teaching conferences, formal lectures, films, and group discussion are utilized.
Nurses in the outlying areas working with families and children have an opportunity
to discuss the cases at regular intervals. One of the valuable programmes that had
to be temporarily suspended was the foster-parent training programme. This is very
time-consuming and, like most educational activities, has to be carried out on the
worker's own time. Suspending it was a question of time saved rather than value.
If an additional social worker becomes available to the centre, it will be started again.
Some of the short-term educational ventures include preparation of a monograph, " The Chemical Comforts of Man," which served as a basis to teach school
counsellors how to carry out an ongoing programme for students on the abuse of
drugs. Other educational highlights, to mention only a few, include addresses to
the ministerial association, Canadian Mental Health Association, union boards of
 L 68 MENTAL HEALTH BRANCH REPORT,  1967/68
health, P.-T.A. groups, various women's groups, foster-parent associations, Selkirk
College psychology classes, welfare workers' organizations, teachers' organizations,
registered nurses' association, and various community-sponsored adult educational
series. Perhaps the largest audiences were reached by a number of radio talks on
subjects related to mental health. These were by invitation of established radio programmes such as " Health Forum " and " Open Line." They provoked a great
deal of interest and favourable comment.
The regular quarterly meetings of the psychiatric social workers from the Mental Health Centres has proved to be a valuable means of upgrading the quality of
social work by providing the opportunity for communication and the stimulating
experience of sharing knowledge. The social worker from this centre is president
of British Columbia Association of Social Workers, Kootenay Branch. The Kootenay Branch is organizing in such a manner that it will serve as a resource for public
education in the fields of mental health and welfare.
TRAVELLING CLINIC
The travelling clinic team serving the East Kootenay holds a clinic at Cranbrook once a month and has seen 242 patients.
It is not possible to provide direct treatment. These are consultations which
are referred back to the family doctor with suggestions for handling, or the family
may be involved with the public health nurse in indirect treatment over a period of
time. The opportunity for consultation with the clinic team in follow-up work is
available to the nurses.
SERVICE
The Mental Health Centre is the only source of direct service in this region;
therefore, it is to be expected that the demands are heavy. The following services
are offered:—
(a) Consultation:
(1) Psychiatric.
(2) Social work.
(3) Psychological.
(4) Nursing.
(b) Treatment:
(1) Child guidance (casework with parents and play therapy with the
child).
(2) Individual psychotherapy.
(3) Family-centred psychotherapy.
(4) Conjoint psychotherapy.
(5) Group psychotherapy.
(6) Pharmacotherapy.
(7) Behavioural therapy.
During the year 482 patients were seen, and, of these, 327 were under 16 years
of age. Patients treated numbered 346, while there were 136 assessments only. At
the end of the fiscal year the clinic team was carrying a case load of 88 patients.
A total of 2,657 hours was devoted to treatment and assessment during the
fiscal year. The psychiatrist carried out 1,287 interviews. The social worker spent
1,253 hours with patients and their families. The psychologist did psychometric
testing on 117 patients.
The following tables indicate service given to the various regions and individual
agencies:-—-
 COMMUNITY MENTAL HEALTH SERVICES
Referrals
L 69
Source
Total
Area
Adults
Children
235
170
43
31
3
Trail	
Cranbrook -
Trail                  	
7
4
95
10
24
1
H
3
91
133
56
Referrals initiated by Attorney-General's Department
Cranbrook	
Trail                   	
9
15
Cranbrook —
Trail-    	
3
15
Cranbrook	
Trail	
Cranbrook '.—
2
1
2
Totals   	
482
155
327
Service
Adults
Children
Patients
Consultations Only
Mental Health Centre, Trail	
27
12
15
16
14
41
6
5
41
53
21
21
70
66
136
Treatment
79
6
153
108
232
114
85
261
346
Report for April 1 to December 31, 1968
The many ongoing programmes outlined in the fiscal year report 1967/68
have been pursued with vigour. Support is being given to the formation of a perceptually handicapped children's parent group. To help bridge the dichotomy
between the generations in the face of anxiety-producing rapid social and technical
changes, a nine-week series " Our Changing World " finishes in December, 1968.
We are fortunate in having a trained nursery-school teacher, and she has been
encouraged to give guidance in starting several classes for the pre-school child
between the ages 3 and 5 years. These volunteer efforts are attracting interest, and
there is indication that they may spread to the outlying areas where they are most
needed. Support is being given to the endorsement of a kindergarten programme
for all instead of just a few. Project " Head Start " in Syracuse and the experience
in Clarkson, Ont., point up the definite advantages of a play-school and kindergarten programme in preparing the child for a successful academic career which
creates a better-integrated personality better able to stand the stresses of life.
Efforts have been made to promote more effective school counselling programmes,
with the result that there are now two more school districts in the Kootenays with
psychologists on staff. Some of the school counsellors as well as staff from the
Department of Social Welfare have asked to join our monthly educational group,
which this year is focused on children and adolescents. Staff of the Mental Health
Centre continue to be guest speakers on two radio programmes dealing with topics
related to mental health.
There is a definite growing awareness of community responsibility for action
in developing and utilizing its human resources. A gratifying trend has been an
even closer working relationship with all helping agencies.
 L 70 MENTAL HEALTH BRANCH REPORT, 1967/68
UPPER FRASER VALLEY MENTAL HEALTH CENTRE, CHILLIWACK
W. G. Jilek, M.D., M.Sc, C.R.C.P., Director
Report for April 1, 1967, to March 31, 1968
This was the second year of service of the Fraser Valley Mental Health Centre
to a region comprising the Upper Fraser Valley and most of the Central Fraser
Valley public health areas.
The psychiatrist-director was joined by a psychiatric social work consultant
and a mental health nurse in May, 1967. A second clerk-stenographer was added
in March, 1968.
CLINICAL SERVICES
Case referrals to this centre are as a rule made through the family physician;
they are not infrequently initiated by members of agencies working in communities,
such as public health nurses, social workers of the Department of Social Welfare,
school counsellors, teachers, ministers, Probation Officers, and Magistrates. It was
noted that an increasing number of referrals were initiated by concerned relatives
through their family physicians, especially in the Chilliwack-Abbotsford area.
In clinical work the mental health case conference has proved to be a useful
problem-solving tool and has contributed to an atmosphere of close co-operation
between the centre team and professionals working in related fields.
From April 1, 1967, to March 31, 1968, the following clinical services were
rendered:—
Chilliwack Clinic
Psychiatric assessments (psychiatrist)  148
Interviews with relatives (psychiatrist)     33
Social assessments (psychiatric social work consultant)      97
Therapeutic sessions (psychiatrist)   316
Therapeutic sessions (psychiatric social work consultant)  204
Mental health case conferences  129
Travelling Clinic, Langley
Psychiatric assessments (psychiatrist)   15
Interviews with relatives (psychiatrist)   5
Social assessments (psychiatric social work consultant)  12
Therapeutic sessions (psychiatrist)   9
Therapeutic sessions (psychiatrict social work consultant)  5
Mental health case conferences  28
Travelling Clinic, Mission
Psychiatric assessments (psychiatrist)  13
Interviews with relatives (psychiatrist)  3
Social assessments (psychiatric social work consultant)  12
Therapeutic sessions (psychiatrist)  18
Therapeutic sessions (psychiatric social work consultant)   7
Mental health case conferences  27
 COMMUNITY MENTAL HEALTH SERVICES L 71
Travelling Clinic, Abbotsford
Psychiatric assessments (psychiatrist)   38
Interviews with relatives (psychiatrist)   14
Social assessments (psychiatric social work consultant)   32
Therapeutic sessions (psychiatrist)  25
Therapeutic sessions (psychiatric social work consultant)  17
Mental health case conferences  52
Travelling Clinic, Hope
Psychiatric assessments (psychiatrist)   7
Social assessments (psychiatric social work consultant)   3
Therapeutic sessions (psychiatrist)  3
Therapeutic sessions (psychiatric social work consultant)   3
Mental health case conferences  9
Services Rendered by the Mental Health Nurse throughout
the Centre Region
Individual and family therapy sessions  245
Group therapy sessions  73
Psychometric and memory testing  13
Consultative sessions with other professionals  21
Home visits  25
During the report period an increasing demand to render direct and ongoing
therapeutic services was felt and is manifested in the relation of assessment to treatment sessions (377 versus 925), although this centre was primarily designed and
staffed to focus on consultative and indirect rather than on direct therapeutic services.
EDUCATIONAL SERVICES AND COMMUNITY CONTACTS
Psychiatrist, psychiatric social work consultant, and mental health nurse, either
as a team or individually, have rendered informative and educational services and
have exchanged mutual experiences in extra-curricular get-togethers arranged by or
for the following groups: Chilliwack Medical Society; Matsqui-Sumas-Abbotsford
Medical Society, Abbotsford; Fraser Canyon Hospital staff, Hope; Chilliwack General Hospital auxiliaries; Matsqui-Sumas-Abbotsford Hospital nursing staff, Abbotsford; Nurses' Association, Hope; School Superintendents' Association; School
Counsellors' Association, Chilliwack; occupational-class teachers, Chilliwack; primary-school teachers, Chilliwack; foster-parents' adult educational class, Chilliwack
Senior Secondary School; foster-parents' night-school class, Langley; nursery
school, Chilliwack; Chilliwack Secondary School students; University Women's
Club, Chilliwack; Upper Fraser Valley Society for the Handicapped Children;
House of Concord Home, Langley; Chisholm School for Retarded Patients; Twin
Firs Receiving Home for Adolescents, Abbotsford; Lutheran Women of the
Church, Chilliwack; St. Andrew's Parish Association, Mission; Community Action
Committee on Alcoholism, Chilliwack.
The psychiatric social work consultant has been taking an active role in the
organization and activity of the Matsqui-Sumas-Abbotsford Community Services
Committee. This centre was instrumental in planning and organizing a regional
branch of the Canadian Mental Health Association in Chilliwack, and continues
 L 72 MENTAL HEALTH BRANCH REPORT,  1967/68
to render assistance, for example, in broadcasting programmes and in the formation
of a volunteer group. An informal way of exchanging information between professionals working in the fields of health, welfare, correction, and education is
provided by the monthly " Academic Luncheon " at the centre, which was started
last summer.
On March 28, 1968, the first mental health workshop was held at the centre,
providing for a full-day involvement of about 90 professionals in the fields of
medicine, public health, social work, probation and correctional services, school
counsellors, and ministers of the entire centre region. Papers presented and discussed dealt with " Schizophrenic Psychosis as Major Mental Health Problem,"
" Psychiatric Disorders of Childhood," " Community Planning for Family and
Children's Services," " Rehabilitation for the Mentally 111," and " Psychological
Test Procedures." Participation in the discussions was very active, especially in
the panel on community mental health problems. Meanwhile we have received
written comments and suggestions which will guide us in further ventures of this
kind.
Report for April 1 to December 31, 1968
In June, 1968, a psychologist M.A. joined the staff of the Upper Fraser Valley
Mental Health Centre, which now consists of a psychiatrist, psychiatric social work
consultant, psychologist, mental health nurse, and two clerk-stenographers.
CLINICAL SERVICES
Direct clinical services comprised assessment and treatment interviews, consultative case conferences with co-operating agencies and professionals, group
and child play therapy, and nurse's visits to homes, schools, and kindergartens in
Chilliwack, Abbotsford, Mission, Langley, and Hope. During the months of
April through October, 1968 (including the summer vacation period), this
psychiatrist had 400, psychiatric social work consultant 276, and mental health
nurse 265 sessions with centre patients or their relatives, and all staff members
participated in 126 conferences.
COMMUNITY PSYCHIATRY
Staff members, either as a team or individually, continued to render informative and educational services to and also participated in discussion meetings with
allied agencies such as public health units, social welfare departments, school
counselling, and rehabilitation and probation services throughout the centre region.
Similar indirect services were rendered to the following resources: Chilliwack
Homemaker Service; M.S.A. Community Services Council, Abbotsford; Canadian
Mental Health Association, Chilliwack (during Mental Health Week in May, 1968,
psychiatrist and psychiatric social worker went on the air at radio station CHWK
on the C.M.H.A. party line); Training Workshop, Vancouver; P.-T.A. and kindergarten parents' groups; Chilliwack junior high schools (panel discussions);
Adult Education Programme, Chilliwack; Y.M.C.A. Youth-Parents Forum, Chilliwack; Twin Firs Receiving Home, Abbotsford; foster-parents' associations;
Youth Council, Abbotsford; Health, Education, and Welfare Committee, Agassiz.
A " teach-in" was sponsored by the Mental Health Centre in December,
1968, and included contributions by psychiatrists and public health, social work,
probation, and education professionals of the area under the broad heading of
" Current Trends, Future Developments, and Prospectives."
 COMMUNITY MENTAL HEALTH SERVICES L 73
NORTH OKANAGAN MENTAL HEALTH CENTRE, VERNON
A. J. Bennee, M.B., B.Ch., C.R.C.P., Director
Report for April 1, 1967, to March 31, 1968
This unit commenced operation in January, 1967, to serve the North Okanagan
Region, which has a population of about 48,000. By July, 1967, the staff consisted
of the director, a psychologist, one stenographer, a social worker, and a mental
health nurse.
Initially our degree of effectiveness and functional ability was largely dependent on our office services (clerical, receptionist, and stenographic). In April, 1967,
we took a second stenographer on strength and things improved.
Travelling clinics have been held two days per month in Salmon Arm and
Revelstoke. A weekly travelling clinic to Kamloops was held from June, 1967,
at The Tranquille School. Although Kamloops is not within the bounds of the
North Okanagan Region, it was felt that it would serve a useful purpose to have a
weekly clinic there.
As from January, 1968, we have been servicing the Golden area because it is
closer to Revelstoke than to its own travelling clinic in Cranbrook.
Dellview Hospital has been visited weekly as a consultation service. Group
conferences are held on a regular basis with school counsellors and public health
nurses. Individual consultations on specific case problems are held whenever
necessary.
Because the boarding-home programme in this region is expected to serve not
only patients from The Tranquille School and Dellview Hospital, but also patients
from Riverview, the Vernon Jubilee Hospital, the Mental Health Clinic, plus referrals from the Department of Social Welfare, the whole programme is under review
with the idea of establishing a co-ordinating committee.
This centre is providing community psychiatry with emphasis on family therapy
and marriage counselling. A full psychiatric service is being provided to the region,
made possible by concentration on short-term therapy.
Cases are seen almost immediately they arise by minimizing the paper work
previously required from the public health nurse. Both patient and family are then
interviewed, together, by the psychiatrist and a decision made as to disposal or
treatment.
The psychologist has spent most of his time treating children with learning
difficulties. A large percentage of the centre's case load consists of these children
who so often end up as drop-outs, delinquents, or social misfits because of a lack
of community facilities.
The social worker held a course in family therapy for interested ministers in
Kamloops.   Four sessions were held and 10 ministers attended.
It has been found that the mental health nurse is best used in this clinic (1)
as the main contact with social agencies (particularly the Canadian Mental Health
Association), (2) to orient nurses in general hospitals, (3) liaison with the health
unit, and (4) to be responsible for public education (helped by the rest of the staff
when necessary).
 L 74 MENTAL HEALTH BRANCH REPORT, 1967/68
Report for April 1 to December 31, 1968
Two staff members have resigned during this period—namely, the Stenographer 1 and the mental health nurse. These positions have now been filled, and
the unit is functioning well and the morale is good.
Since June 30, 1968, our travelling clinic to Kamloops has been discontinued,
the reason being that a director has been appointed to the Mental Health Centre
there.
The subject of boarding homes, which was mentioned in the first part of this
annual report, is being investigated by the Interdepartmental Co-ordinating Committee, which has now met three times to work out regional problems.
Early in November a meeting was called with representatives from the Social
Welfare Department, Public Health, rehabilitation consultant, R.C.M.P., Probation
Officers, John Howard Society, city welfare, Magistrates, and Family and Children's
Court. The meeting was primarily to make personal contacts with the various
departments and agencies, to define and clarify our roles, and to solve present problems. It was so successful that those present requested another meeting in the new
year, and it is our intention to try to involve other agencies and, if possible, to develop
a regional planning council in this area.
This meeting also brought to light the need for co-ordination of effort on the
part of various agencies who might be working with a family so that unnecessary
duplication could be avoided, and the whole question of duplication of services is
now under review.
The social worker, Mr. Zimmerman, has held a profitable meeting with the
local church ministers and found them to be extremely interested in the subject of
marital and family counselling.
Regular consultative meetings are being held with public health nurse groups
and of school counsellors as well as individual consultation to discuss cases whenever
the need arises.
 COMMUNITY MENTAL HEALTH SERVICES L 75
NORTHERN INTERIOR MENTAL HEALTH CENTRE, PRINCE GEORGE
J. A. Steedman, M.D., Director
Report for April 1, 1967, to March 31, 1968
The Northern Interior Mental Health Centre was opened on June 1, 1967, in
the building containing the Northern Interior Health Unit. The Mental Health Clinic
team has consisted of the clinical director (Dr. J. A. Steedman), social worker (Mr.
John Snyder), mental health nurse (Miss Ann Geddes), and a senior and junior
stenographer.
A total of 586 patients was seen by this clinic from June, 1967, until March 30,
1968. The total number of individual interviews conducted was 1,629. There have
been 69 cases closed during this time. The whole range of diagnostic categories has
been seen, with the major treatments directed at problems with children and marital
difficulties.
The centre is functioning as a community psychiatric service, and, as a result,
all therapists have active participation with community personnel and services. The
centre also takes an active part in the psychiatric programme at the regional general
hospital and the Simon Fraser Hospital. The clinic team has been involved with
public lectures, and has worked with voluntary organizations, Courts, welfare, and
the schools.
A number of progressive changes are taking place in the areas served
throughout the last year. An alcoholic half-way house has been opened, a receiving
home for children has been started, and a boarding-home programme for the chronically mentally ill and handicapped is being considered. There are many projected
plans for the future for this town and this area, and we are involved in the planning
of these facilities.
The travelling clinic has visited Williams Lake and Quesnel every month, and
Fort St. John and Dawson Creek every other month. On one occasion the team
made a trip to Vanderhoof and Burns Lake. All personnel are involved in these
trips and in the treatments and assessments conducted. One of the main functions
is to counsel and advise paramedical and other interested personnel, as well as doing
direct treatment in these areas.
The mental health travelling team is using the Mental Health facilities at Williams Lake and Quesnel. Two basement rooms in the Quesnel extension have been
furnished, as will be three rooms in the new extension of the Mental Health Building
at Williams Lake.
The first year of operation has been a rewarding one, and all members of the
team have enjoyed their participation in this community psychiatric project.
Report for April 1 to December 31, 1968
During the clinic trip to the north in October, a first attempt to meet with the
local physicians was made.   On future visits this meeting will be further developed.
In addition to working as a mental health team, the various professional
groups have been contacted by the team members; for example, nurses and social
workers. This assists in bridging the gap between the patient's needs and available
resources.
Meetings with other agency staff in Burns Lake and Vanderhoof were held
in May, June, and September.   As these areas become familiar with the mental
 L 76 MENTAL HEALTH BRANCH REPORT,  1967/68
health team and its services, an increase in referrals is occurring. This also has
resulted in increased consultation to these areas, both in person and by telephone.
This latter is used frequently because of barriers of distance, weather, and time.
Because of the relative closeness of Williams Lake and Quesnel, the service
provided is greater than to west or north. In many instances, people travel 150
miles for appointments between clinic visits, thus the mental health team is able to
provide some ongoing treatment in addition to consultation. In this area as well
as in Prince George, the mental health team has participated in staff education
programmes.
Since April the number of people seen in assessment and treatment in Prince
George has increased from 191 to 255; also the staff have increased their involvement in community activities. In May the local Community Health and Welfare
Council developed a Resource Planning Board. This board consists of representatives from education, welfare, health, hospital, mental health, probations,
city council, regional districts, clergy, Canada Manpower, Indian Affairs, and
rehabilitation. This board establishes a priority of needs for the community, followed by a programme to develop the resources made.
The local half-way house for alcoholics receives consultation from the social
worker. He participates with the men in the rehabilitation programme and on
the board of directors.
In September a psychiatric programme in the regional hospital was established
on a three-month trial basis. This has improved the care to the psychiatric patients,
but still has many problems to be solved. The mental health nurse assists the nursing
staff with planning nursing care for these patients.
The result of working in the community is rewarding and satisfying for the staff.
However, because of the tremendous increase in demands, it becomes obvious that
an increase in staff is essential; also some pressure is felt by the isolation from similar resources. For this reason it has been most effective for staff morale to attend
meetings, conferences, and workshops in other areas. The stimulation these sessions
provide results in improved service to the community.
In September a psychologist was hired from the School Board 1 Vi days a week.
This has assisted greatly in the assessment and planning of treatment, especially for
children. Hopefully, within the next year, this service could be expanded to a full-
time programme for a psychologist with diagnosis, treatment, and some research.
 COMMUNITY MENTAL HEALTH SERVICES
L 77
STATISTICAL TABLES
Table Ia.—Mental Health Centres' Population Movement by Clinic,
Adults and Children, April 1, 1967, to March 31, 1968
Location of
Mental Health
Centre
First Activations
Reactivations
Total Activations
Terminations
Adult
Children
Adult
Children
Adult
Children
Adult
Children
Burnaby- -  	
Victoria  	
Kelowna   	
Nanaimo  	
Trail 	
628
199
161
107
106
81
249
285
711
138
87
115
272
85
191
184
268
80
50
40
32
24
72
43
205
32
19
15
72
26
34
67
896
279
211
147
138
105
321
328
916
170
106
130
344
111
225
251
979
249
213
144
131
23
116
31
950
146
93
69
309
Chilliwack	
Vernon	
20
55
38
Totals	
1,816
1,783
609
470
2,425
2,253
1,886
1,680
Table Ib.—Mental Health Centres' Case Load by Clinic,
April 1, 1967, to March 31, 1968
Location of
Mental Health
Centre
Active
Cases,
Apr. 1, 1967
First
Activations
Reactivations
Total
Case Load
Terminations
Active
Case Load,
Mar. 31,
1968
Burnaby  	
Victoria  	
1,269
425
275
424
46
82
86
1,339
337
248
222
378
166
440
469
473
112
69
55
104
50
106
110
3,081
874
592
701
528
298
632
579
1,929
395
306
213
440
43
171
69
1,152
479
286
Nanaimo 	
Trail  	
488
88
255
461
Prince George1 	
510
Totals	
2,607
3,599
1,079
7,285
3,566
3,719
1 Unit opened in 1968.
 L 78
MENTAL HEALTH BRANCH REPORT, 1967/68
Table 2.—Activations to Mental Health Centres by Health Unit and
School District of Residence, April 1, 1967, to March 31, 1968
Health Unit and School District
First
Activations
Reactivations
Total
Activations
Health Unit and School District
First
Activations
Reactivations
Total
Activa-
tions
East Kootenay, Cranbrook—
8
46
69
17
11
20
35
11
7
45
101
19
1
18
28
1
3
175
17
1
45
9
202
93
1
63
3
2
1
10
10
1
21
42
;
12
29
363
3
1
12
90
41
1
125
21
1
i
57
91
1
13
16
3
~15
13
3
9
31
5
10
11
2
39
4
8
3
49
20
29
3
2
27
23
4
6
52
1
30
10
33
8
30
27
9
59
85
20
11
35
48
14
7
54
132
24
1
28
39
1
5
214
21
53
12
251
113
92
3
5
1
10
12
48
65
16
35
415
3
13
120
51
158
29
87
118
Central Fraser, Mission—
School District No. 35	
„   42	
21
32
16
2
17
377
376
43
17
11
28
8
23
21
3
15
8
1
6
15
2
1
1
273
33
26
4
23
12
18
70
9
42
1
31
22
2
2
2
2
6
3
10
8
9
2
4
146
119
24
2
4
2
7
7
1
5
2
3
5
104
3
6
1
2
2
1
33
3
6
15
3
31
„   2  	
40
„   3     	
„   75	
25
„   4 	
„   76	
4
„   18	
Metropolitan Board of Health of
Greater Vancouver—
School District No. 38	
„   86  	
Selkirk, Nelson—
21
„           „         „   39	
523
„   8         	
„   41 	
495
„   10  	
„   44	
67
West Kootenay, Trail—
School District No. 9	
„   11        	
„   45	
19
Coast-Garibaldi, Powell River—
School District No. 46	
11
„   12       	
„   47	
32
„   13       	
„   48	
10
South Okanagan, Kelowna—
Skeena, Prince Rupert—
School District No. 52	
30
„   15
 53	
28
„   16	
„   17
 54	
„   80.-	
4
20
„   23
 88..	
10
„   77  '	
North Okanagan, Vernon—
Peace River, Dawson Creek—
School District No. 59 	
„   60—	
9
20
„   21. 	
„   22   	
 ,   83 	
Greater   Victoria   Metropolitan
Board of Health-
School District No. 61	
2
„   89-	
South Central, Kamloops—
School District No. 24 	
25
377
„   62	
36
 63..—	
32
,    26
„   64-	
5
„           "          „   29	
Central Vancouver Island, Nanaimo—
School District No. 65.	
„   30	
25
Cariboo, Williams Lake—
„   66	
14
„   67.. 	
19
„   68	
103
Northern    Interior,    Prince
George—
„   69	
12
„   70	
48
„   79 	
Upper Island, Courtenay—
School District No. 71 	
„   72	
1
„   56	
„         „   57 	
46
„   58
25
Upper   Fraser   Valley,   Chilliwack—
„   85.	
2
School districts not covered by
health units—
School District No. 49-	
„   84-
„   33	
„          „         „   34	
2
2
Boundary, Cloverdale—
2
Ex-Province	
6
„   37
Unknown	
3
Simon   Fraser,   New  Westmin-
Totals 	
3,599
1,079
4,678
School District No. 40 	
„   43	
 COMMUNITY MENTAL HEALTH SERVICES
L 79
Table 3.—Total Activations to Mental Health Centres by Clinic,
Age-group, and Sex, April 1, 1967, to March 31, 1968
Clinic and Sex
Age-group (Years)
Total
Activations
0-9
10-16
17-19
20-29
30-39
40-49
50-59
60 and
Over
Burnaby—
Male  	
Female  	
242
93
399
181
97
64
no
160
82
116
54
77
29
62
21
25
1,034
778
Totals	
335    [    580    |    161
270
198    |    131
91
46    |    1,812
Victoria—
Male  -	
Female   	
47
14
79
30
16
27
34
53
25
47
11
26
6
17
7
10
225
224
Totals   	
Al
mq
43
87
72    |      37    |      23    |      17
449
Kelowna—
Male 	
Female -	
26
9
46
25
11
17
19
27
16
28
19
28
9
18
5
14
151
166
Totals 	
35    |      71    |      28
46
44    |      47    |      27
19    |       317
Nanaimo—
Male	
Female. -	
31
11
56            7
32    |      10
13
35
3    |      13
29    j      16
6
8
4
3
133
144
Totals-	
42    |      88    |      17    |      48
32    |      29    |      14    |        7    |       277
Trail—
77         168
34          65
15
15
19
22
1
10    j      14
17    [      13
4
5
2
2
309
173
Female 	
Totals...	
111    |    233
30    [      41
27    |      27    |        9
4
482
Chilliwack—■
Male      	
Female -	
25
10
45
31
15
5
12
15
9
16
9
11
5
3
3
2
123
93
Totals   	
35    |      76    [      20
27
25    |      20    ]        8    |        5
216
Vernon—
Male..	
Female— 	
66
27
80
52
26
20
26
40
22    |      27
59    |      34
10           14
30    1      13
271
275
Totals	
93    |    132    |      46
66
81    |      61
40    |      27
546
Prince George—
70
41
84
56
16
30
54
79
38
50
13
21
11
11
1
4
287
Female	
292
Totals	
111    |    140    |      46    |    133
88
34
22    |        5
Totals-
Male — - 	
584
239
957
472
203         287
188    1    431
205
362
160
226
80
154
57
73
2,533
2,145
823
1,429
391     1    718
567
386
234
130
4,678
Table 4.—Mental Health Centres' Terminations by Type of Service and
Clinic for Children and Adults, April 1, 1967, to March 31, 1968
Location of
Mental Health Centre
Total Terminations
Assessment without
Treatment
Assessment with
Treatment
Adults
Children
Adults
Children
Adults
Children
979
249
213
144
131
23
116
31
950
146
93
69
309
20
55
38
235
22
61
49
62
16
35
5
389
14
35
29
72
20
33
9
744
227
152
95
69
7
81
26
561
132
58
40
Trail        - - - -
237
22
Prince George 	
29
1,886
1,680
485
601
1.401       1       1.079
 L 80
MENTAL HEALTH BRANCH REPORT, 1967/68
Table 5. — Total Cases Terminated from Mental Health Centres by
Psychiatric Diagnosis and Age at Termination, April 1, 1967, to
March 31, 1968
Psychiatric Diagnosis
Adults
Children
Total
Number
Percentage
Brain syndromes—
2
30
22
2
52
0.1
1.4
Totals-   _ 	
32
22
54
1.5
Psychoses—
338
32
13
8
4
21
128
3
466
32
13
8
4
24
13.0
0.9
0.4
0.2
Presenile, senile, with or without cerebral arteriosclerosis
0.1
0.7
Totals	
416
131
547
15.3
Psychoneuroses—
139
337
39
19
21
12
158
358
51
4.5
10.0
1.4
Totals -	
515
52
567
15.9
64
32
96
2.7
Disorders of character, intelligence, and behaviour—
202
204
22
5
8
159
31
3
126
7
34
40
552
442
105
146
14
236
244
22
5
560
601
136
149
126
21
6.6
6.8
Alcoholism—  	
0.6
0.1
15.8
17.0
Mental deficiency   	
3.8
4.2
3.5
0.6
Totals—                             	
767
1,333
2,100
59.0
5
4
33
50
7
63
40
12
4
96
90
0.3
0.1
2.7
Observation without need for further psychiatric care	
2.5
1,886
1,680
3,566
100.0
Table 6.-
-Cases Active in Mental Health Centres as at March 31, 1968,
by Length of Treatment Period and Clinic
Location of Mental Health Centre
Number of Months
Total, All
Under 3
3-5
6-11
12-23
24 and
Over
Cases
310
109
72
99
53
52
142
159
260
61
50
98
19
55
113
179
230
90
60
60
9
85
160
172
207
70
64
129
4
63
46
145
149
40
102
3
1,152
479
286
Nanaimo -	
Trail  	
488
88
255
461
510
996
835
866
583
439
3,719
 IN-PATIENT SERVICES L 81
PART III.—IN-PATIENT SERVICES
REPORT OF THE DIRECTOR OF MENTAL HEALTH SERVICES
H. W. Bridge, M.B., B.Ch., M.Sc, C.R.C.P.(C)
Report for April 1, 1967, to March 31, 1968
This report is based upon the present organization of the Mental Health Branch
and relates only to the Mental Health Services, which constitutes one division of that
Branch. For the first five months of the period reported on, no Deputy Minister had
been appointed to the Branch and Dr. F. G. Tucker was Acting Director. Following
the appointment of Dr. Tucker to be Deputy Minister of Mental Health, the writer
was appointed Director of Mental Health Services, with responsibility for the inpatient facilities operated by the Branch.
The extent and scope of the in-patient services provided is indicated by a few
headline figures which have been extracted from the detailed reports which follow:—
11,175 persons received psychiatric treatment as in-patients (Riverview
Hospital, 6,736; Schools for the Mentally Retarded, 2,319;  Geriatric Division, 2,120).
2,168,643 patient-days of service were provided to the 11,175 in-patients
(Riverview Hospital, 994,137 patient-days; The Woodlands School,
469,560 patient-days; The Tranquille School, 241,598 patient-days;
Valleyview Hospital, 276,524 patient-days; Dellview Hospital, 80,-
546 patient-days; Skeenaview Hospital, 106,278 patient-days).
4,060 persons were employed on March 31, 1968, in the Mental Health
Services to provide the services highlighted above.
$25,276,134 was expended to operate the in-patient institutions of the
Branch.
The daily per capita cost for the institutions was $11.66.
MAJOR EVENTS AND TRENDS
With the resignation of Dr. A. E. Davidson as Deputy Minister of Mental
Health Services and Director of Mental Health Services, a Mental Health Committee
under the chairmanship of Dr. F. G. Tucker was established by the Minister. The
outcome of the work of this Committee largely sets the stage for new developments
and determines the direction of trends which are apparent throughout the Mental
Health Branch, including the Services Division.
The major result has been a recognition of the desirability of decentralization
of the mental health programmes, with concentration on development of community
resources, and maximum involvement of community participation in as wide a
spectrum of programmes as possible. These developments are accompanied by a
recognition of the desirability of the integration of the methods of care with those
of other branches of medical, social, and hospital services throughout the Province.
Since the existing in-patient facilities of the Mental Health Services had grown up
during a period when centralization of services had appeared appropriate, they are
seen in the light of contemporary philosophy and policy as somewhat anachronistic
step-children of the mental health needs of today's society. Thus it was appropriate
that the centralized in-patient services should continue to operate at the highest
possible level of patient-care, but should be seen as an interim service meeting public
needs only until such time as these needs can be more appropriately provided for on
a decentralized, community-oriented, and medically integrated basis.
 L 82 MENTAL HEALTH BRANCH REPORT, 1967/68
It is obvious from the statistical highlights already quoted that the services
rendered are so extensive that it must be anticipated that a considerable number of
years must elapse before any adequate and comprehensive community-based alternatives can be developed, which will suffice to enable the bulk of the central services to
be dispensed with in their present form and the physical plant, wherever suitable,
put to more appropriate uses. During these interim years it is my responsibility to
ensure that the highest possible standard of care and treatment will be available in
these facilities to that proportion of the population of our Province which may still
lack the facilities to receive appropriate treatment in their own local regions.
STATISTICAL COMMENTS
Tables 1 and 2 provide a summary of the movement of patient population in
the facilities of the Services Division of the Mental Health Branch.
During the year 4,179 persons were admitted to the in-patient units. This is a
decrease of 823 as compared with 1966/67. There was a decrease of 805 in the
number of patients admitted to the Riverview Hospital—3,470 compared with 4,275
in 1966/67.
In the schools for the retarded there was a decrease of 106 in the numbers
admitted—227 compared to 333 in 1966/67.
The Geriatric Division experienced a reduction in admissions of 49. The total
was 602 in 1967/68, as compared to 651 the previous year.
The Riverview Hospital provided care for 6,736 patients in 1967/68, a
decrease of 1,018 from 1966/67. There was also a slight decrease in the numbers
cared for in the schools for the retarded—2,319 compared to 2,348 in 1966/67.
In the Geriatric Division there were 2,120 patients under care in 1967/68, a
decrease of 7 from the 1966/67 total of 2,127.
On March 31, 1968, there were 103 fewer patients in residence in the institutions than on the same date in 1967. The satistics relating to the in-patient facilities
of the Mental Health Services suggest that a peak has been passed with respect to
admissions, discharges, and totals under care. The impression gained is that the
increasing provision of alternative resources in the community and the widespread
acceptance of the concept that in-patient institutional care should be reserved only
for very special groups of patients under very special circumstances has led to a
reduction in the demand for in-patient care as the first resort even in those cases in
which it was not necessarily the most appropriate measure.
GENERAL COMMENTS
During the 1967/68 year I have laid great stress with the administrations of
all in-patient facilities on the necessity for a high standard of patient-care and a high
quality of service. I believe there has been an excellent response from the staffs of
the in-patient facilities, and any relief from which they have benefited by a reduction
in number of admissions has been applied to raising the standard of care to the
individual patient. When a medical-staff shortage occurred, no reduction in standard
of care was permitted, but the number of admitting beds in operation in the Riverview Hospital was temporarily reduced. The morale of the staffs of the various
units was considerably raised by direct encouragement and personal contact from
the former Minister, the Honourable Wesley D. Black, who visited the units personally and devoted considerable time to gaining an understanding of the problems.
His approval of the Riverview Hospital's application to request accreditation did
much to boost morale and inaugurated a vigorous programme of reorganization of
the hospital to enable it to meet the required standards.
 IN-PATIENT SERVICES
L 83
The Department of Nursing Education continued under the directorship of Miss
Lonergan and graduated a class of 104 women and 7 men. The graduation ceremonies were held in the auditorium of the New Westminster Secondary School on
the evening of April 26, 1967. The address to the graduates was given by the
Honourable Mr. Justice F. Craig Munroe.
The 1967 annual meeting of the Council of Psychiatric Nurses was held on
April 24, 1967, in Vancouver. Two hundred and sixty-four applicants were licensed
pursuant to the Psychiatric Nurses Act and regulations in 1967/68.
The Mental Health Services have again had occasion to recognize the fine
work undertaken on behalf of the patients by the volunteer groups which have
donated so much time and effort to various facilities.
Report for April 1 to December 31, 1968
This report is an interim narrative to cover the period mentioned during the
change-over from a fiscal to a calendar year as the basis for reporting.
MAJOR TRENDS AND EVENTS
Detailed statistics will be reported separately. Trends appear to indicate a
reduction in the number of admissions, but little change in the total number of
in-patient days of service.
The period under consideration has been characterized by a great deal of
questioning and evaluation of traditional policies and procedures in the in-patient
services. The impact on the traditional role of in-patient institutions of the new
Branch policy of decentralization and community integration announced by the
Honourable W. D. Black during his tenure as Minister made this inevitable.
In spite of anxieties, which are to be expected in association with any such
period of change and self-examination in an organization, staff morale appears to
have improved in response to the hope of improved patterns of service being
introduced.
During October the surveyors from the Canadian Council on Hospital Accreditation made a first visit to Riverview Hospital. Some of their informal comments were regarded as encouraging. No report has as yet been received from
the Council.
Work has continued on the construction of the British Columbia Youth
Development Centre at Burnaby and staff recruitment and training continues, but
it will be 1969 before it is possible to begin admitting in-patients to residence.
The Department of Nursing Education has lost its Director, Miss Margaret M.
Lonergan, who has moved to Victoria on the staff of the Deputy Minister, and
vigorous recruitment activity continues to find a suitable replacement.
Graduation ceremonies took place in the auditorium of the New Westminster
Secondary School on the evening of April 24, 1968. A class of 7 men and 125
women was graduated. The address to the graduates was given by Mr. Russell
K. MacKenzie, Assistant Director of Pupil Personnel Services Division of the Vancouver School Board.
The annual meeting of the Council of Psychiatric Nurses for 1968 was held
on April 23, 1968, and 261 psychiatric nurses and three mental deficiency nurses
were licensed pursuant to the Psychiatric Nurses Act and regulations in the period
under consideration.
The work of the volunteers continues to form a valuable component of the
services provided to the patients in the institutions of the Mental Health Services.
 L 84
MENTAL HEALTH BRANCH REPORT, 1967/68
STATISTICAL TABLES
Table 1.—Showing Patients in Residence in Various Facilities of the
Mental Health Branch, April 1, 1967, and March 31, 1968, Together
with Increase or Decrease.
In Residence, Apr
. 1, 1967
In Residence, Mar.
31,1968
Increase
Men
Women
Total
Men
Women
Total
Decrease
1,456
746
368
254
89
293
1,312
531
290
494
126
2,768
1,277
658
748
215
293
1,414
749
374
251
70
278
1,269
527
285
507
132
2,683
1,276
659
758
202
278
—85
The Woodlands School   	
— 1
The Tranquille School	
Valleyview Hospital, Essondale	
+1
+ 10
— 13
—15
Totals   -                	
3,206
2,753
5,959
3,136
2,720
5,856
— 103
Table 2.—Showing in Summary the Admissions and Population Increase
of the Mental Health Branch for the 10-year Period April 1, 1958,
to March 31, 1968.
Year
Total
Admissions
65 Years
and Over
Admissions
15 Years
and Under
Informal
Population
Index of
Admissions
Admissions
Increase
Increase
2,993
425
135
1,118
-90
—3.00
3,296
506
182
1,316
20
0.61
3,924
580
254
1,695
42
1.07
4,193
557
200
2,023
— 156
—3.72
4,248
554
213
2,086
-63
— 1.48
4,569
550
243
2,187
31
0.68
4,518
702
215
2,194
-39
-0.86
5,069
844
206
2,278
—92
— 1.81
5,002
757
175
2,095
-2
—0.04
4,179
690
166
1,558
-103
— 1.73
41,991
6,165
1,989
18,550
—452
1958/59-
1959/60-
1960/61-
1961/62.
1962/63-
1963/64...
1964/65-
1965/66-
1966/67-
1967/68 .
Totals.
Table 3.—Comparative Summary of Increases and Decreases in Resident
Population by Major Divisions of Mental Health Branch, 1958/59
to 1967/68.
Fiscal Year
Riverview
Hospital
Schools for
Mentally
Retarded
Geriatric
Division
Total
1958/59—
1959/60—
1960/61
1961/62 —
1962/63	
1963/64	
1964/65 ......
1965/66 —
1966/67.	
1967/68	
— 144
-229
—92
—236
-137
-55
-134
— 103
-47
-85
+ 86
+93
+75
+73
+62
+79
+77
+31
+51
-30
+ 156
+59
+7
+ 12
+7
+ 18
—20
-6
— 18
+20
+42
— 156
-63
+31
-39
—92
—2
— 103
 IN-PATIENT services
L 85
Table 4.—Comparative Summary of Total Patients under Care for Major
Divisions of Mental Health Branch by Fiscal Years 1958/59 to
1967/68.
Fiscal Year
Riverview
Hospital
Schools for
Mentally
Retarded
Geriatric
Division
Total
1958/59-
1959/60..
1960/61-
1961/62-
1962/63-
1963/64-
1964/65-
1965/66-
1966/67..
1967/68...
7,121
7,163
7,376
7,679
7,765
7,931
7,540
7,706
7,754
6,736
1,481
1,740
1,868
1,960
2,023
2,042
2,178
2,198
2,348
2,319
1,373
1,459
1,587
1,642
1,677
1,738
1,937
2,097
2,127
2,120
9,975
10,362
10,831
11,281
11,465
11,711
11,655
12,001
12,029
11,175
Table 5.—Movement of Population of Mental Health Branch,
April 1, 1967, to March 31, 1968
Psychiatric
Division
Schools for Mentally Retarded
Division
Geriatric
Division
Total
M.
F.
T.
M.
F.
T.
M.
1
F.
T.
M.
F.
T.
In residence, April 1, 1967	
On extended leave, carried forward
from 1966/67—
1,456
156
52
4
1,312
186
100
2,768
342
152
4
1,114
59
15
821
78
5
1,935
137
20
636
101
620
161
1,256
262
3,206
316
67
4
2,753
425
105
5,959
741
Other     	
172
On  escape,   carried  forward  from
1966/67
4
Total as at April 1,1967	
1,668|1,598| 3,266
1,188
9041 2,092
737
7811 1,518
3,593] 3,283
6,876
Admissions—
First admissions to Mental Health
Services  	
Readmission to different facility-
789
2
952
762
941
1,551
2
1,893
76
12
35
46
8
23
122
20
58
215
21
7
254
23
13
469
44
20
1,080
35
994
1,062
31
977
2,142
66
1,971
1,743| 1,703 [3,446
123
771    200
243
290
533
2,109] 2,070
4,179
Transfers in	
16|        8|      24
13
141      27
41
281      69
701      50
120
Total admissions to individual
facility  	
1
1,759  1,711
3,470
136
91
227
284
318
602
2,179
2,120
4,299
Total under care1  	
3,427[ 3,309] 6,736
1,324
9951 2,319
1,021
1,0991 2,120
5,702| 5,353
11,0551
Separations—
1,662
87
176
65
7
1,558
77
188
206
2
3,220
164
364
271
9
85
10
75
21
38
15
104
12
123
25
179
33
45
237
96
38
237
158
83
474
254
1,792
334
347
86
7
1,634
329
450
218
2
3,426
663
797
304
Died   v
On  extended   leave  in  boarding
homes 	
Other  	
On escape	
9
1,997
16
2,031
9
4,028
25
191
10
169
14
360
24
378
44
433
27
811
71
2,566
70
2,633
50
5,199
120
Total separations from individ-
2,013
2,040
4,053
201
183
384
422
460
882
2,636
2,683
5,319
Net increase or decrease 	
—421  — 431  —85
+9
-9|        0
— 37
+ 19| —18
—701  —33
— 103
In residence, March 31, 1968	
1,414
1,2691 2,683
1
1,123
812
1,935
599
639
1,238
3,136
2,720
5,856
1 Total under care for all Mental Health Services includes total as at April 1, 1967, plus the total admissions
to individual facilities minus transfers out.
 L 86
MENTAL HEALTH BRANCH REPORT, 1967/68
Table 6.—Movement of Population in Individual Institutions,
April 1, 1967, to March 31, 1968
Geriatric Division
Valleyview Hospital,
Essondale
Dellview Hospital,
Vernon
Skeenaview
Hospital,
Terrace
Total
M.
F.
T.
M.
F.
T.
M.
M.
F.
T.
254
96
494
147
748
243
89
5
126
14
215
19
293
636
101
620
161
1,256
On extended leave, carried forward from 1966/67—
262
Other            .   	
Total as at April 1, 1967	
350
641  |     991
94
140
234
293
737
781
1,518
Admissions—
First   admissions   to   Mental
158
19
5
210
22
10
368
41
15
40
2
1
44
1
3
84
3
4
17
i
215
21
7
254
23
13
469
Readmission to  different facility	
Readmission to same facility-
44
20
Total admissions— —
182
242 |     424
43
48
91
18
243
290
533
Transfers in  	
12
7 |       19
6
21
27
23
41
28
69
Total   admissions   to   indi-
194
249 |     443
49
69
118
41
284
318
602
Total under care1	
544
890 |  1,434
143
209
352
334
977
1,072
2,0491
Separations—
35
131
83
32
193
131
67
324
214
7
53
13
6
44
27
13
97
40
3
53
45
237
96
38
237
158
83
Died     .
474
On extended leave in board-
254
Other	
249
356
605
73
77
150
56
378
433
811
44
27
71
	
	
44
27
71
Total separations from in-
293
383
676
73
77
150
56
422
460
882
Net increase or decrease	
-3
+ 13 ]   +10
-19
+6
-13
-15
—37
+19
-18
In residence, March 31, 1968
251
507  |     758
1
70
132
202
278
599
639
1,238
1 Total under care for the Geriatric Division includes total as at April 1, 1967, plus the total admissions to
individual facilities minus transfers out.
 IN-PATIENT SERVICES
L 87
Table 6.—Movement of Population in Individual Institutions,
April 1, 1967, to March 31, 1968—Continued
Schools for Mentally Retarded
The Woodlands School,
New Westminster
The Tranquille School,
Tranquille
Total
M.
F.
T.
M.
F.
T.
M.
F.
T.
746
41
11
531
67
3
—
1,277
108
14
368
18
4
290
11
2
	
658
29
6
1,114
59
15
821
78
5
1,935
On   extended   leave,   carried   forward
from 1966/67—
137
Other —	
20
On   escape,   carried   forward   from
1966/67                       -     -          —.
Total on books, April 1, 1967	
798
601  | 1,399
390
303
693
1,188
904
2,092
Admissions—
First   admissions  to   Mental   Health
64
9
32
40
5
19
104
14
51
12
3
3
6
3
4
18
6
7
76
12
35
46
8
23
122
20
Readmission to same facility  _
58
105
64 |     169
18
13
31
123
13
77
14
200
Transfers in 	
5
4 1         9
8
10
18
27
Total admissions to individual facility	
no
68
178
26
23
49
136
91
227
Total under care1 	
908
669  | 1,577
416
326
742
1,314
981
2,295
Separations—
Discharged in full	
Died           .    .         	
64
10
59
18
30
11
83
9
94
21
142
27
21
16
3
8
4
21
3
29
4
37
6
85
10
75
21
38
15
104
12
123
25
On extended leave in boarding homes
Other                      	
179
33
On escape      	
151
133 ]     284
40
36
76
191
169
360
8
9 |       17
2
5
7
10
14
24
Total separations from individual
facility -	
159
142 1     301
42
41
83
201
183
384
Net increase or decrease 	
+3
-4 ]     -1
+6
-5
+ 1
+9
—9
o
In residence, March 31, 1968—	
749
527
1,276
374
285
659
1,123
812
1,935
i Total under care for Schools for Mentally Retarded Division includes total as at April 1, 1967, plus total
admissions to individual facilities minus transfers out.
 L 88 MENTAL HEALTH BRANCH REPORT,  1967/68
REPORT OF THE DEPARTMENT OF NURSING EDUCATION
Mrs. E. Paulson, B.S.N., Acting Director
The year-end census for the psychiatric nursing programme was 258 students,
as compared with 299 at the end of the fiscal year. During the period of time reviewed in this report, the Department processed 279 applications. Seventy-three
students were accepted for the fall class; of these, 49 had been enrolled in an academic secondary-school programme and the remainder in a vocational programme.
Forty students withdrew for the following reasons: Illness, 3; unsuited, 7; personal,
13; clinical or academic failure, 17. Seventy-five students completed the programme, and, of these, 68 were employed by the Mental Health Services. The faculty continued with the revision of the curriculum. Programme policies and a clinical-experience record book were revised. The first-term class block was extended
from six to eight v/eeks. The added period of time enabled instructors to prepare
students more thoroughly for their assignment to the clinical area. The classroom
course in geriatric nursing was integrated into the clinical programme at Valleyview
Hospital. More " activities " hours were incorporated into classroom blocks, and
all levels of students participated in projects. Students affiliating at The Woodlands
School received experience in the pre-kindergarten and operant conditioning programmes.
In the psychiatric aide programme, 17 five-day courses were conducted—five
at the Education Centre and 12 at The Woodlands School. Numbers enrolled in
the courses totalled 116. At Riverview and Valleyview Hospitals and The Woodlands School, the courses were followed by 112 clinic hours given by instructors.
Supplemental courses were provided for 20 aides at Skeenaview. Minor changes
in curriculum content were made in consultation with nursing service. In September the senior instructor enrolled at Simon Fraser University. The programme continued under the direction of an acting senior instructor.
Two hundred and one students enrolled in the affiliate programmes in psychiatric nursing. This number included six third-year basic baccalaureate students
from the School of Nursing, University of British Columbia. Terms of agreement
for the operation of a nine-week programme, three times annually, were drafted for
approval by the parties concerned. These are subject to reconsideration in 1969.
The co-ordinator resigned in October. A senior instructor who had been assisting
with the programme was appointed to the position.
In September Miss M. M. Lonergan, former Director of Nursing Education,
assumed the position of full-time Nursing Consultant with the Mental Health Branch,
Victoria. The Assistant Director was appointed Acting Director of Nursing Education. An Instructor 1 was promoted to an Instructor 2 position in October. Two
Instructor 1 vacancies exist.
The establishment of the Department comprises 70 persons—instructors, secretariate, infirmary nurses, home supervisors, and maintenance staff. The continued
co-operation of all members contributed substantially to the successful operation of
the Department.
 IN-PATIENT SERVICES
L 89
RIVERVIEW HOSPITAL
B. F. Bryson, B.A., M.D., CM., F.A.P.A., Superintendent
Report for April 1, 1967, to March 31, 1968
GENERAL COMMENTS
The following table gives a summary of the movement of population for Riverview Hospital for the 12 months ended March 31, 1968:—
Male
Female
Total
In residence, April 1, 1967    	
On extended leave—
Boarding home -
Other                                 -                                -
1,456
156
52
4
1,312
186
100
2,768
342
152
4
Totals  ..  -	
1,668
1,598
3,266
1,743
15
1
1,703
7
1
3,446
Transfers from geriatric facilities  —	
22
2
1,759
1,711
3,470
Total under care   —  	
3,427
3,309
6,736
Separations—
1,662
87
12
4
176
65
1
1,558
77
8
1
188
206
2
3,220
Died                      	
164
20
5
On extended leave—
Boarding home	
Other               	
364
271
9
2,013
2,040
4,053
-42
1,414
—43
1,269
— 85
In residence, March 31, 1968.	
2,683
A review of the above statistical summary of patient movement, compared to
that for the previous year, reveals that there has been a marked decrease in both
admissions and separations. This year there were 3,470 patients, including 1,759
men and 1,711 women, admitted to Riverview as either new admissions, readmis-
sions, or transfers from other mental health facilities, a decrease of 805 or 18.82
per cent of the last year's total intake.
Of the total admissions, 1,558 or 44.9 per cent, came of their own accord as
informal admissions, while 1,701 or 49 per cent required certification as involuntary
patients under the Mental Health Act, 1964, including 20 patients transferred from
Federal penal institutions. The remaining 211 or 6.1 per cent were admitted under
various sections of the Criminal Code, including 61 by Orders in Council and 73 by
Court order. Magistrates' warrants (Form A) were used for 76 admissions, a drop
of 25 compared to the number admitted by this procedure last year. Of all admissions from the community, 196 or 12.5 per cent were under 19 years of age. Only
one patient could be accepted for admission for alcoholic treatment under section
26 of the Mental Health Act, 1964, compared to 62 during the previous year. It
is felt that the significant drop in admissions this year has resulted from several
factors, including the need to limit admissions due to a decrease in the number of
physicians on staff during a large portion of the year, as well as the increasing
effectiveness of new treatment resources in various areas of the Province.
 L 90
MENTAL HEALTH BRANCH REPORT,  1967/68
Separations also decreased significantly by 733 and totalled 4,053 for the
year, including 2,013 men and 2,040 women. Of these, 3,220 or 79.4 per cent
were discharged to the community, but were 898 less than were returned to community life the previous year. As may be expected with an increasingly larger
number of aged patients in the hospital population, separations by death increased
by 35 to a total of 164 for the year, representing 4.1 per cent of total separations,
but only 2.4 per cent of the number of patients under care of Riverview Hospital.
The significant drop in the number of patients discharged from hospital care not
only reflects the above-noted need to reduce the admission of new patients but also
the increasing difficulty that has been met in locating suitable boarding homes or
nursing homes in the community for many patients who no longer require care in
a psychiatric facility.
At the year's end there were only 22 more patients in boarding-home care
compared to last year and now total 364, including 176 men and 188 women.
As of March 31, 1968, the number of patients in residence at Riverview Hospital totalled 2,683 (1,414 men and 1,269 women), a decrease of 85 compared to
the same date a year ago.
TREATMENT SERVICES
The past year has been a very active year for all staff in meeting the treatment
requirements of the large number of patients requiring admission and in attempting
to upgrade the standards of treatment and services given. On October 5, 1967,
application was made to the Canadian Council on Hospital Accreditation for a survey of Riverview Hospital for accreditation purposes. The standards for the
Accreditation of Canadian Mental Hospitals have served as a useful guide for the
evaluation and upgrading of hospital standards of treatment.   On December 27th
The highest standards of medical and surgical care are adhered to at the Riverview Hospital.
Here a surgical team is at work in the operating-room for general and neuro surgery.
 INPATIENT SERVICES L 91
the medical staff prepared a proposed set of by-laws, rules, and regulations for a
medical-staff organization on the patterns outlined in this accreditation guide, which
has been forwarded to the Deputy Minister for Governmental approval. A Medical
Audit Committee has been formed and has been extremely busy surveying standards
of care and treatment facilities throughout the various units of the hospital.
While psychoactive drugs are still of great importance, and electroconvulsive
therapy modified by anaesthesia and muscle relaxation used on selective cases, there
has been a significant increase in the use of the therapeutic community approach
and in group therapy sessions. An even greater emphasis is being laid on preparation of the patient for return to the community and in referral to appropriate community resources. In most cases, patients are referred back to the care of their
private physician, but in selected cases they have been seen in follow-up care by
their hospital physician. The number of such patients attending the after-care
department as of March 31, 1968, was 823 patients. Medical and social service
staff are active in providing supervision to 364 patients transferred on boarding-
home leave to approved boarding homes. During the year a pilot project was
initiated whereby a number of patients on discharge were referred from the Crease
Unit to the Vancouver General Hospital Psychiatric Out-patients' Department.
During the year there were several changes in senior medical staff. Dr. Peter
M. Middleton, the former Clinical Director, resigned on September 8, 1967, being
replaced by Dr. W. J. G. McFarlane on October 9, 1967. There were changes in
unit directors in three of the six units. Serious shortages of qualified psychiatrists
throughout much of the year have hampered the maintenance of a satisfactory
standard of medical care, and forced, on January 11, 1968, the reduction of the
operational bed count in the Crease Unit by 40 beds. This in turn forced a restriction of admissions and the accumulation of a waiting list for admission to the
hospital, which may partially explain the reduction in the total number of admissions to the hospital during the year. In spite of this reduced admission rate, a
large number of patients have been admitted who could have been treated more
satisfactorily in the community had adequate pre-admission services and alternative resources to hospitalization existed.
Two categories of patients have continued to pose severe difficulties—the
emotionally disturbed adolescent and the criminally insane. One hundred and
ninety-six patients under the age of 20 years were admitted to hospital this year.
It is hoped, however, that the development of the residential treatment centre at
Burnaby for emotionally disturbed adolescents will provide a more satisfactory
treatment facility.
One hundred and thirty-four patients were admitted under Court order or by
Order in Council during the year, there being 99 such patients in residence on
March 31, 1968. This group of prisoner-patients continues to be disruptive of
treatment services to such an extent that a serious disturbance of riot proportion
occurred on April 2, 1967, and a second such disturbance was narrowly averted
on October 22, 1967, by the emergency transfer of several of these patients to penal
institutions. These occurrences, together with the fact that several patients have
scaled the security fence, illustrate the point that our security area can be considered
only minimal by prison standards, and also points up the need for a separate institution for such patients.
The hospital will continue to be recognized for six months' postgraduate training in surgery on rotation from the University of British Columbia integrated graduate training programme in surgery. Negotiations have subsequently been held with
the University of British Columbia Department of Psychiatry in order to develop a
clinical teaching unit at this hospital in affiliation with the University of British
 L 92
MENTAL HEALTH BRANCH REPORT, 1967/68
Columbia for such postgraduate training in psychiatry, which it is hoped will be
recognized by the Royal College of Physicians and Surgeons of Canada. Undergraduate clinics were held throughout the year for second-, third-, and fourth-year
medical students.
Staff have been active in a variety of research projects. Dr. W. T. Brown has
throughout the year conducted controlled studies of various sedative and tranquillizing drugs. Dr. A. C. Greiner has continued his researches into biochemical factors
in the etiology of schizophrenia. Staff of various disciplines have co-operated with
Dr. Thomas Perry of the University of British Columbia Pharmacology Department
in his research into possible biochemical anomolies in Huntington's chorea and in
schizophrenia.
NURSING SERVICES
In the past year the Department of Nursing has taken several specific steps to
identify and measure the activities occurring within the Department as a basis for
immediate and longer range planning.
A time and activity study for all levels of ward staff, for a seven-day period,
was completed in December, 1967. This provided additional clarification of the
functions carried out by nursing. Eleven positions have been released to the Department of Housekeeping (in addition to those previously released) to free nursing
staff of major housekeeping duties, thus making them available for appropriate
duties.
The standards established by the Committee on Accreditation of Psychiatric
Hospitals, 1964, have been used as a guide to enable us to study and evaluate our
current practices. Some changes have been made to bring the Department of Nursing into accord with the stated expectations.
A great deal of time is spent by psychiatric nurses in participating with their patients.  This
type of personal relationship is important in helping patients work through their problems.
 IN-PATIENT SERVICES L 93
Intensive remotivation programmes have been implemented in two wards, and
minimal care, or intermediate quarters, has been established for 12 women patients.
The latter has been in operation since October, 1967, the goal being to help this
group toward increased independence while living in hospital. It is planned by the
Department to develop several more such residences for separate groups of men and
women.
The number of Order in Council patients and others referred by the Courts has
fluctuated little in the past year. Increased opportunities for work and other activities for these patients have been developed.
The growing numbers of infirm patients in hospital is of great concern. It has
been necessary to establish two more wards of 40 beds each, staffed and equipped,
to provide adequate care for these physically and emotionally handicapped patients.
Throughout the year there has been marked emphasis on staff education, and
we have taken advantage of many opportunities to improve the effectiveness and
skills of our nursing staff.   These include:—
(a) The 10-month diploma course in Administration of Hospital Units,
School of Nursing, University of British Columbia.
(b) The psychiatric nurses' co-ordinated programme, offered for the first time
at Vancouver City College.
(c) The extension course in Nursing Unit Administration, sponsored jointly
by Canadian Nurses' Association and Canadian Hospital Association,
which included two intramural sessions of one week each at the University of British Columbia.
(d) The regional workshop for directors of nursing service in hospitals, held
in Vancouver, May 2 to 5, 1967.
(e) A day's workshop on group psychotherapy at the Mental Health Centre,
in September.
(/) A series of 16 lectures on drugs and somatic complaints, presented at
Vancouver General Hospital from September to February.
(g) The workshop on surgical ward nursing, held December 7 and 8, 1967.
(/.)  The third institute on psychiatric nursing at the University of British Columbia.    The topic was " The Troubled Adolescent."    This was sponsored by the Extension Department and School of Nursing, University
of British Columbia.   The planning committee included two representatives from Riverview Hospital.
(i)  The institute for head nurses, sponsored by the Registered Nurses Association of British Columbia, at which the topic was " Evaluation as a
Means of Improving Staff Performance."    This was the first time the
Registered Nurses Association of British Columbia extended an invitation
for charge nurses to be included by the opening of an R.N.A. educational
project.   The planning committee included a representative from Riverview Hospital.
(/) The orientation classes offered at the Education Centre by instructors in
that department for psychiatric aides.
A total of 226 members of the nursing staff attended these programmes.
The nursing service of Riverview Hospital has continued to provide clinical
areas for the nursing education of students in the psychiatric nursing programme of
the Mental Health Branch, as well as for community agencies, including affiliate
students from St. Paul's, Royal Columbian, and St. Joseph's Hospitals; students from
degree and diploma programmes at the School of Nursing, University of British Columbia;  and public health nurses.
 L 94 MENTAL HEALTH BRANCH REPORT, 1967/68
In order to improve the supervision and general welfare of the many patients
who are engaged in work situations on the grounds, a Nursing Supervisor of Outdoor
Workers was established on January 15, 1968. This has improved communications,
and there is now more emphasis on teaching and assessing changes in patients'
performance and potential. Five aides supervising these patients were given 12
lectures on first aid to prepare them to give any necessary initial treatment before
returning the patient to the ward.
In May, 1967, resignations were received from over 350 psychiatric nurses in
protest over salaries and a desire for changes in certain personnel practices. These
were withdrawn before June 1 by all but nine when a fact-finding committee was
formed to deal with the matters in dispute.
PSYCHOLOGY DEPARTMENT
This year has been one of satisfactory progress in the Psychology Department
despite the acute shortage of full-time personnel. Through the initiation of special
policies permitting the casual employing of psychologists on hourly-rate and sessional basis, it was possible to gain sufficient professional assistance to permit a
maintenance of departmental services.
In total, 27 lectures were given, mostly within the framework of instructional
programmes for nurse trainees, but also included were talks to other affiliating
students and visiting groups.
A total of 1,506 psychological tests were administered, the greater number of
which were used in the preparation of patient evaluations. In total, 428 such reports
were prepared in response to referrals for diagnostic evaluation, intellectual measurement, and personality assessment.
The Department actively continued its therapeutic programmes. In total, 838
therapeutic sessions were conducted, the majority within the context of intensive
in-patient psychotherapy services for the adolescent and neurotic adult, but including out-patient marital group therapy and conjoint interviews.
Research interest has continued strongly. Studies being undertaken altogether
are:—
(1) Examining the efficacy of selection procedures for nursing-school candidates.
(2) Attempting to delineate antecedent factors underlying suicide behaviour.
(3) Relating to the development of an automated testing procedure.
The Department continued an affiliation with the Lower Mainland universities
in repeating, for an eighth summer, an internship programme designed to familiarize
the prospective graduate clinical student with the duties and demands facing the
clinical psychologist.
SOCIAL SERVICE DEPARTMENT
In line with the growing emphasis on community-based services, the Social
Service Department has continued to have as a major objective the expansion of
services at the community rather than the institutional level. To this end an additional social worker from the Crease Unit in-hospital staff was assigned part time
to the After-care Clinic, thereby increasing services available to patients in the
Greater Vancouver area. Social and casework services to patients resident in this
area were further enhanced by the implementation of a pre-admission service designed to assist and to support potential patients and their families in preparing for
the experience of hospitalization, or assisting in referral to other community health
and welfare resources where indicated.
For patients from more remote and less urbanized regions of the Province, it
was necessary to continue to offer a concentration of social services at the ward
 IN-PATIENT SERVICES L 95
level, due largely to insufficient community resources in their home areas. This
was particularly true of minor patients admitted to Centre Lawn Unit, whose numerous and varied needs for supervision, care, and treatment were beyond the capacity
of existing community facilities.
As in previous years, the supervised boarding-home programme continued to
make a worth-while contribution toward the integration of institutional clinical services with those of other health and welfare agencies. During the year, in co-operation with the Departments of Social Welfare and Public Health, and with valuable
assistance from local service clubs, it was possible to resettle 123 patients in licensed
boarding homes under the ongoing treatment and management supervision of Riverview Hospital. Of this total, 91 were initial placements and 32 were concerned with
patients who had had previous placement experiences from the hospital. In addition, 16 patients were discharged from the programme to live in more independent
community situations.
Planning for the community resettlement of patients was hampered considerably by a shortage of boarding-home beds. This shortage was particularly acute in
large municipalities such as the City of Vancouver, and seemed to be closely related
to the current housing crisis coupled with rising construction costs. As a result of
this, a number of beds which had formerly been used specifically for patients from
this hospital were no longer available, the homes in question having been converted
to private dwellings.
In all hospital units, including the After-care Clinic, social workers were increasingly involved in patient therapy groups, either on the basis of casework
treatment to a group of selected patients or in conjunction with other treatment
disciplines. This service was extended to include one boarding home in which the
majority of the patients were young adults suffering from severe problems in interpersonal relationships.
The over-all work of the Department is reflected in the statistical summaries of
services rendered, which reveal that a total of 4,381 patients in hospital and 740
patients in after-care received direct social and casework services. These figures
represent a slight reduction from those of the previous year.
Educational responsibilities were met by various members of the staff through
participation in orientations, workshops, and speaking engagements. In addition,
the services of senior members of staff were again requested by the School of Social
Work, University of British Columbia, in order to provide field-work supervision for
six second-year students who were assigned to the hospital and the After-care Clinic
for practical supervised experience during the final year of their Master's education.
REHABILITATION DEPARTMENT
The Rehabilitation Department has been engaged in a wide variety of services
geared to preparing patients for life in the community. While much of the Department's work is involved in vocational preparation and assessment, there is an increasing concern that our programmes go beyond this to ensure the development of
the type of responsible behaviour necessary for successful community life. Every
opportunity is taken to have realistic community-based experiences for patients as
they prepare to leave the hospital.
The work placement programme handled a total of 1,554 new referrals. These
have involved individual interviews by the staff and follow-up of the patient's work
performance. Efforts have been made in this last year to improve the hospital working conditions for the patients, and a number of reports have been submitted with
specific requests for improvements.   A large berry-picking project was carried on
 L 96
MENTAL HEALTH BRANCH REPORT,  1967/68
during the summer, and the patients involved were very enthusiastic, both for the
experience of the work and the amount of money they were able to earn. We are
working toward even more community-based work projects in order to give our
patients the real work experience they will need after leaving the hospital.
One hundred and eighty-three new referrals for vocational assessment were
handled. This is a service which is valued by outside employment agencies, as the
findings can be most helpful in finding employment in the community for the
patient when he is discharged. We have maintained a close liaison with the Canada
Manpower organization, and arrangements have been made for one of its counsellors to spend one day per week at Riverview Hospital to interview and assist
patients in finding suitable work following discharge. Due to the employment
scarcity this year, it has been necessary to give more service to patients trying to
enter the labour market. Help in job-finding, beyond what is available in the
public agencies, is furnished by the job placement officers at the hospital. It is
felt strongly that the opportunity for the patient to work in the community is most
important therapeutically in terms of his making a good community adjustment,
and the economic advantage is most evident.
The rehabilitation residences Vista and Venture have remained very active,
with more beds being requested than are available. Due to this pressure, a third
residence has been opened next door to Venture with 6 more beds for men. This
residence is just starting operation and will be supervised by the existing staff at
Venture. A total of 53 patients was served in the rehabilitation residences this
year, some of them staying over an extended period of time. Due to the pressure
of referrals, it is likely that the length of individual patient stays will have to be
shortened in order to prevent the formation of waiting lists for services at these
homes. \
Riverview's machine-shop manufactures many items for hospital use and also maintains a
large repair and service department. The shop employs an average of 15 to 20 patients.
 IN-PATIENT SERVICES L 97
The Hillside Rehabilitation Unit has now been in operation for over a year.
During this year a total of 118 patients has been served in programmes designed
specifically for preparing patients to live as successfully as possible in the community. Patients referred to Hillside are those with special problems making discharge difficult. Many have had repeated hospitalizations, and the programme
here is designed to give concrete help on matters related to making a satisfactory
adjustment following discharge. Follow-up services required to make this kind of
programme successful are a little difficult to provide conveniently due to the large
number of patients going into the Vancouver area.
The Department continues to make use of a large variety of community resources and agencies to help patients before and after discharge. We are finding
an increasing acceptance of psychiatric referrals by employers and agencies dealing
with other handicapped groups in the community. This is especially true when
we can provide meaningful assessments of our patients as they utilize the rehabilitation services offered within the community. Good communication with these outside resources has helped to break down the barriers between the hospital and the
normal community.
OCCUPATIONAL THERAPY DEPARTMENT
During the year the resources of the Occupational Therapy Department have
been extended by demands from hospital and community for further coverage.
Conflicting needs to provide occupational therapy for individually referred
patients and assistance to ward-centred activation groups have been difficult to
resolve, particularly as staff stability declined during the summer. Locum tenans
appointments staved off the crisis until permanent staff could be recruited. Vacancies
for senior supervisory staff still exist, however, in five of the six units.
Due to a preponderance of new graduates on staff, staff development and
education has been of major importance. In-service lectures and discussions have
been supplemented by oportunities to attend workshops on " Group Process " and
" Caring for the Dependent Patient " and a course on neuroanatomy.
In addition to treating individually referred patients and participating in therapeutic community situations, some occupational therapists have been involved in
two new programmes. In the short-stay areas, an evening educational programme
dealing with general everyday activities developed from a pilot project on one ward
to serve patients from Crease, Centre Lawn, and Hillside. Weekly, volunteer
experts from the community have been invited to share their experiences about
topics such as job-finding, budget management, child-care, and the use of community facilities. The second programme was centred in East Lawn to train activity
aides. Six patients successfully completed a six-week course to prepare them to
assist in occupational and recreational programmes and with activity groups organized by nursing personnel.
Once again the Canadian Mental Health Association volunteer organization has
assisted this Department in several ways. Volunteers provided equipment for the
A.D.L. (Activities of Daily Living) Unit, assisted with the preparation and distribution of materials, and enriched the pre-boarding-home programme by welcoming
patients to luncheons, community clubs, and community activities.
The boarding-home programme has also been indebted to volunteers as it
continues to grow. Another day centre in Maillardville has been started on a similar
basis to those at White Rock and Haney. One full-time occupational therapist and
an assistant carry a case load of 180 transfer-to-boarding-home patients from
Riverview and The Woodlands School, using social, recreational, and educational
 L 98 MENTAL HEALTH BRANCH REPORT, 1967/68
facilities. The Co-ordinator of Boarding Homes, public health nurse, social welfare
staff, and boarding-home operators have been involved in the programming of this
expanding service, which was featured in a paper read by our boarding-home occupational therapist at the Canadian Association of Occupational Therapists' annual
conference in Halifax this year.
A growing emphasis on activating patients in the extended-care areas has made
increased demands on the Rehabilitation Workshop, a joint venture run by both
the Occupational Therapy and Rehabilitation Departments. Disassembly work in
six different wards is co-ordinated by the workshop staff as limited space has precluded an expansion of the central workshop area. Enlarged storage areas became
vital to cope with the bulk of work needed for the shop and the wards it supplies.
The Construction Shop's programme to provide a realistic heavy-work experience for male patients has also included outdoor projects such as the construction of a summer picnic shelter. Referrals to the shop continue to be co-ordinated
by job placement officers, who use it as an assessment area.
Concern to improve the occupational-therapy service, and particularly transfer
from one activity area to another, has focused attention on progress records. A
new method of recording on colour-coded, shingled report forms was instituted in
conjunction with the other activity departments, and a close liaison with the job
placement officers was encouraged. New procedures were introduced to improve
communication to medical staff and other related departments.
Other activities covered by the Department include the distribution of ward
Christmas decorations, floral arrangements for graduation, and an art show, all of
which provided many reality-based opportunities for collaborative experience for
patient groups. The annual sale of occupational-therapy work realized a total
of $3,948.
In addition to direct patient-care, the staff were responsible for supervising a
total of eight graduate and undergraduate interns from the Universities of Manitoba
and British Columbia during the summer months. They were also involved with
ongoing orientation programmes for affiliating student nurses, and with providing
consultative help to the programming for the New Denver Youth Centre.
Through the year, occupational-therapy staff in all units handled 2,569 patients,
with a daily average of 399.   A total of 95,699 treatment sessions was given.
RECREATIONAL THERAPY DEPARTMENT
A review of the Recreational Therapy Department for the year covers a wide
range of activities, carried out under many different circumstances at widely varying times of the day and evening and on almost every day of the year. The grand
total added up to 5,537 sessions, with total patient attendances of 204,751.
In carrying out its function as part of the treatment team, the recreational-
therapy staff was involved in organizing and giving leadership to a total of 1,680
daily sessions conducted in all six units of the hospital. A total of 55,277 attendances was recorded in these sessions by patients who were thus afforded an opportunity to share in the stimulation and socializing values of group activation.
During the year a notable gain in facilities was made with the opening in
Centre Lawn in January of a new well-equipped centre for recreational therapy.
In each unit, activities were adapted to the needs of the patients.
In addition to the daily treatment-centred activities mentioned above, leisure-
time activities (bingos, card socials, teas, ward parties, dances, etc.) were conducted
within the units on 885 occasions, with a total of 49,529 recorded attendances.
 IN-PATIENT SERVICES L 99
Special events such as Christmas " open house " programmes and observation
of special seasonal holidays (Easter, summer sports days, Hallowe'en, Thanksgiving,
New Year's, St. Valentine's Day, etc.) provided further occasions for unit-centred
activity. Picnics, cook-outs, hikes, fishing expeditions, swimming parties, mystery
bus trips, and the attendance of busload groups of patients at concerts, movies,
sporting events, the Pacific National Exhibition, the Shrine Circus, and other
community events provided considerable opportunities to keep patients aware of,
and to assist in their readjustment to, the world outside the hospital. Such special
outings were held on 395 occasions, with attendances of 10,389.
Not all of hospital life is lived within the individual units, a fact readily discernible from a study of programmes provided in and around the hospital's community centre at Pennington Hall. Here major events, such as visiting concert
parties, weekly bingos, Friday night dances, and individual and group participation
in music, bowling, badminton, roller skating, etc., lead to a total recorded attendance
of 59,993 in 1,090 scheduled events and open sessions. Softball, bowling, and
volleyball league play saw representative teams meet in intense but friendly competition on 194 occasions, with 3,782 in attendance. Continued lack of a swimming-pool cut off this source of healthy recreation for the great majority of our
patients, but advantage was taken of limited off-grounds resources to provide a
swimming opportunity for busload groups of patients on 95 occasions throughout
the year.
The provision of special week-long vacation activities for patient workers was
again provided by the Recreational Therapy Department. Some 624 patients took
part in a 16-week programme enjoying hikes, picnics, outings, tours, and trips to
Stanley Park, special sporting events, etc.; in all, a total of 101 events, with
attendance of 2,433.
A further new development in summer activity lay in the seven weeks of resident camping provided for East and West Lawn patients at Camp Garibaldi, involving some 40 group sessions and a total attendance of 1,196.
Once again music and music-making in all its forms provided a most popular
and sought-after resource throughout the hospital during the year. Group sessions
were held in all six units on 394 occasions, for a total participating attendance of
9,115, while live music provided by combined patient-staff orchestras was a feature
of most ward parties and Pennington Hall dances.
Continuing efforts toward the development of a patients' glee club, a dance
orchestra, and various smaller musical combos brought further dividends when these
patient groupings, assisted by visiting volunteer entertainers, were able to stage a
popular summer series of mid-week concerts on the outdoor stage.
The popular patients' newspaper, The Leader, published every three weeks
under the guidance and supervision of the recreational-therapy staff, has continued
to grow, with a present circulation of 1,200 couples. During the year a total of
225 patients contributed to its production, of which approximately 90 are regular
contributors as ward reporters or assist in The Leader office. In October of 1967
The Leader was granted membership in the International Institutional Press Association, which has headquarters in Washington, D.C, and represents approximately
660 publications.   The Leader exchanges with 134 of these institutions.
PATIENTS' SCHOOL
The school was open for 234 regular school-days, with a total enrolment of
85 pupils (55 male and 30 female). Of these, 34 were adolescents with an average
age of 16 years, and 51 adults averaging 26.9 years.   Seventy-four attended daily
 L 100
MENTAL HEALTH BRANCH REPORT, 1967/68
classes in the schoolroom, while 11 required instruction on the ward. The average
period of attendance per patient was 6.7 weeks. Thirty-five of the school group
were able to leave the hospital on discharge.
Instruction suited to the individual's needs continued to be employed as a
preparation for the patient's return to the community, where he would either resume
his interrupted schooling or prepare for a job. Forty students followed the standard
grade curricula, and 45 undertook one or more correspondence courses. Both
academic and vocational subjects were offered.
The former scholastic achievement levels and age differences of the patients
necessitated a wide grade level of instruction. Twenty-three students were enrolled
in the elementary grades, 33 in the junior secondary grades, and 23 in the senior
secondary grades. In addition, a class in English for New Canadians was attended
by six patients.
In January an experimental programme was initiated wherein four selected
Order in Council patients were permitted to attend the regular afternoon classes
rather than continue to receive individual instruction on their wards. Their greatly
improved work habits and achievements indicate the value of an integrated social
setting as an incentive to learning.
A poll among the major Canadian mental hospitals was recently conducted
by this Department to determine the extent of formal educational facilities available
to patients. Approximately 50 per cent of the hospitals polled were conducting
in-patient programmes similar to that at Riverview, and over 30 per cent are at the
present time engaged in setting up workable plans for such services. These data
reflect the increasing awareness among our hospitals of the importance of an in-
service educational programme as a factor in the rehabilitation and post-hospital
adjustment of many patients.
RADIOLOGY DEPARTMENT
The Radiology Department technicians and visiting radiologists provided a
comprehensive diagnostic service throughout the year, during which time 10,902
patients were examined and 16,541 films taken. A new automatic film-processor
was installed in the Crease Unit, which greatly decreases the time required for film
processing and drying.
PATHOLOGY DEPARTMENT
This Department reports increased activity over the past year. A total of
80,205 procedures was performed in the several laboratories, representing 162,292
units of clinical laboratory work. This is an increase of 3,475 procedures or 17,096
units of work compared to the previous year. These increases occurred mainly in
hsematological, biochemical, and bacteriological procedures.
A total of 150 autopsy examinations was carried out, and constitute approximately 81 per cent of the deaths that occurred both at Riverview and Valleyview
Hospitals.
The Riverview laboratories continue to function as a training-school for laboratory technologists, and the pathologist and technical staff have continued to participate in the investigation of melanin metabolism as it relates to the etiology of
schizophrenia.
DEPARTMENT OF NEUROLOGY
This Department provides neurological, electroencephalographic, and neurosurgical consultative services to the Mental Health Branch. On July 1, 1967, Dr.
R. P. Joneja was appointed as Director of this Department, replacing Dr. P. Bratty,
who previously served part time as our neurological consultant.
 IN-PATIENT SERVICES L 101
During the year 203 neurologic consultations were provided. An echoen-
cephalograph obtained in August, 1967, was put into immediate use, and since that
time 105 examinations have been done. A total of 1,059 E.E.G. examinations was
performed this year, 842 at Riverview Hospital, of which 143 were referrals from
penal institutions, 167 were done at The Woodlands School, and 50 at the Burnaby
Mental Health Centre.
Dr. Frank Turnbull continues as the neurosurgical consultant, and during the
past year carried out 11 neurosurgical operations, 11 carotid arteriograms, and six
pneumoencephalograms.
DENTAL DEPARTMENT
The Dental Department has continued to provide a wide range of dental services to Riverview patients, with emphasis on maintaining a high level of dental care
and hygiene for the long-term resident population. However, emergency service to
short-term patients has been provided wherever necessary. Denture work continues
to be in constant demand. A second technician position has now been added to
the establishment, and recruitment into this early in the new year is anticipated.
Completion of dental care for patients being prepared to leave hospital to boarding-
home care continues to receive priority attention.
Several needed changes were provided by the Public Works staff. The dental
laboratory particularly received a face-lifting with the provision of stainless-steel
bench surfaces, enlarged sinks, and improved cupboard space. The darkroom also
has received new equipment. These improvements have helped considerably, but
there is still need for a general updating of operating equipment and space allocation
in order to provide the most efficient dental service to patients.
A review of the services rendered by the dental staff indicates a general increase
of service to patients. During the year 3,305 patients were treated and 10,166
procedures carried out. This represents an increase of 409 patients and 546 procedures compared to the previous year.
PHARMACY DEPARTMENT
The past year has seen a further increase in the services provided by the Riverview pharmacy. During the early part of the year the increased demands presented
certain problems. However, with the recruitment of an additional part-time pharmacist, some administrative changes, and time-saving equipment, full service was maintained and backlogs in prescriptions caught up.
Prescription service to out-patients and in-patients continues to be the greatest
area of service, and increased by 1,317 to a total of 27,124 prescriptions filled.
The number of prescriptions for narcotics and controlled drugs decreased signifi-
candy.
In addition to the individual prescription service, the pharmacy dispensed
47,200 items of ward stock pharmaceuticals, as well as 20,300 items of surgical
sundries.
Time-saving and control procedures instituted during the year included a system of prepackaging control cards and an improved list to facilitate ward stock
requisitioning. A tube and jar filler, tube crimper, and homogenizer have been
secured and have proven to be very helpful.
As a result of these changes, the senior pharmacist has been able to carry out
a series of ward visits to supervise and assist nursing in the storage and control of
ward stock pharmaceuticals.
 L 102 MENTAL HEALTH BRANCH REPORT, 1967/68
PHYSIOTHERAPY DEPARTMENT
During most of the year this Department has been able to maintain a comprehensive physiotherapy service to patients, but, as a result of fluctuations in staffing
and difficulties in recruitment of fully qualified physiotherapists, there have been
periods when service was affected.
On December 4th a senior physiotherapist was appointed as head of the Department. Since this date the service has expanded and is now better able to cope
with the heavy demands from increasing numbers of elderly and physically handicapped patients. Requests from the acute surgical and medical wards for newer
physiotherapy procedures, such as specialized treatment in the field of chest physiotherapy and intermittent positive pressure breathing treatments, have also increased.
Lack of a therapeutic pool to provide a full range of water-supported exercises
for physically and mentally handicapped persons has limited treatment in this area.
During the year a total of 611 patients received treatment involving 8,677
various treatment procedures.
Department staff, in collaboration with the Department of Nursing Education,
provided a series of lectures on physiotherapy to senior student nurses during their
stay in North Lawn wards. The students were taught how to give passive movements, how to position patients in bed with regard to certain medical conditions,
and were also given instruction on simple bed exercises and the maintenance of
muscle tone to assist in the prevention of contractures and deformities in handicapped patients. Some in-service lecture programmes have also been provided for
graduate nurses.
CHAPLAIN SERVICES
The religious needs of Riverview patients have continued to be served throughout the year by our resident chaplains through regular church services in Pennington Hall, the Crease Unit chapel, and by their regular ward visits and special attentions to the sick and bereaved.
Of special interest this year has been the increased interest of community
churches and their clergy in our patients and the hospital. During the year the
secretary-general of the religious order of our Roman Catholic chaplain visited the
hospital to become acquainted with the service at Riverview. This was later followed by the interest of the religious publication The B.C. Catholic, which printed
a long article on the work of our Roman Catholic chaplain. Senior students from
the Roman Catholic seminary and the Anglican seminary have also visited the hospital to view the scope and challenge of their work in this large patient-group.
There has also been an increase in the regular visiting programme of clergy
from both the Lutheran Church and of the United Church of Canada.
Of particular significance was the inauguration of a six-week field training
course in clinical pastoral training at Riverview, conducted under the auspices of
the New Westminster Foundation.
LIBRARY
In the patients' library efforts were concentrated on expanding the services to
patients lacking grounds privileges. Success is largely due to the co-operation of
the volunteers. Books are deposited at East Lawn, West Lawn, and Centre Lawn,
and volunteer staff see that these books are circulated throughout the units. All
wards in Riverside now have their own small book collections, which are administered by the patients themselves. Book collections in all units are rotated quarterly to ensure variety and interest and to keep patients abreast with new publica-
.
J
 IN-PATIENT SERVICES L 103
tions. Almost 5,500 books were borrowed during the year. This is slightly less
than the previous year, but the decrease can be accounted for by the extension of
library services to other areas. During the year the fiction collection was revitalized
largely through donation of books from members of staff. The hospital Rehabilitation Department has again used the library as a job-placement area, and there has
been a continuous succession of patients assigned to library duties. Magazine subscriptions now total 33. When out of date, these popular journals are circulated to
various wards or used to augment the library's expanding illustrations collection.
Several new services commenced this year in the medical library. A " clippings " file is now kept of articles appearing in the local press concerning the hospital and its services. " What's New in the Library " has been revived but in a
different form. This regular publication now lists current articles likely to interest
the staff instead of reviews of one or two interesting articles. The response to this
list, not only from the hospital staff but also the staff of the Province's Mental Health
Services, adequately justifies the time spent in producing it. Bibliographies on topics
of current interest are now being issued. So far, L.S.D., therapeutic communities,
and barbiturate addiction have been dealt with. Some 1,736 books were circulated
during the year. This is a marked increase over previous years and emphasizes the
continuing heavy use the library receives. Current journal subscriptions now total
196. Approximately half the library's budget is spent purchasing these works;
however, an extensive journal collection is essential if the library is to be kept up
to date. Amongst the more difficult queries received and answered during the year
were those asking for information on histidinemia, pyridoxine deficiency in mental
illness, and excephtalmus (unilateral).
During the year 252 new books were added to the patients' library, bringing
the total collection to 3,931. The medical library received 362 new items, bringing
total stock to 4,736.
MEDICAL RECORDS DEPARTMENT
A main goal throughout the year has been a review of the functions of the
Department using as a guide the Standards for Accreditation of Canadian Mental
Hospitals, 1964, by the Canadian Council on Hospital Accreditation. To provide
the services recommended, the Medical Records Department's responsibilities have
been extended. With the objective of furthering the elevation of the standards of
clinical records, a quantitative analysis of the medical records of patients separated
from the hospital is steadily developing. Thus a better base will be provided for
the medical-care analysis by the Medical Audit Committee. Additional services
also include the expansion of Riverview Hospital indexes to include medical diagnosis and operative procedures, which will provide a wider scope of data for research
and a useful instrument for administrative purposes.
As requirements for higher standards demand more intensive procedures, an
attempt is being made to provide the training necessary to meet the requirements.
Four medical records staff have enrolled in the extension courses for training medical records personnel, sponsored jointly by the Canadian Hospital Association and
the Medical Record Librarians' Association. The approval of mental health bursaries for three of the applicants has greatly assisted this training objective.
In facilitating research programmes which required the use of patients' medical
records, the Department was involved in two projects and supplied 268 medical records for reference purposes. There were 10 special statistical reports compiled in
response to requests by departments of Riverview Hospital and the University of
British Columbia.
 L 104 MENTAL HEALTH BRANCH REPORT, 1967/68
VOLUNTEER SERVICES
During the year 160 Canadian Mental Health Association hospital volunteers
donated 21,920 hours of service to the residents of Riverview Hospital.
Some of the activities which were carried on throughout the hospital were as
follows: Apparel-shop, socialization and activation programmes, luncheons, volunteers assisting with occupational and recreational programmes, shopping trips, ethnic
groups, admission suite hostess service, library service, personal hygiene groups,
typing classes, birthday parties, drives.
The volunteers' apparel-shop has completed another successful and busy year,
and issued a total of 3,331 articles of clothing to 2,178 patients, including many
who are resident in the community under our boarding-home programme.
The annual Christmas gift programme proceeded with success, and each resident of Riverview Hospital received a Christmas present. This totalled 2,870 gifts
which were donated through the community at large.
The volunteers and hospital staff enjoyed a Christmas tea this year at the
Volunteer Centre to endeavour to renew and augment staff-volunteer relationships
and acquaintances. Approximately 300 staff and volunteers enjoyed this brief visit
to the Volunteer Centre.
Luncheon programmes this year increased in numbers; over 200 residents of
the hospital have been taken to private homes and churches for these outings. This
programme has much therapeutic benefit for the residents attending.
Ethnic groups continue to function, our Japanese, Chinese, and Polish volunteers being active. These groups also provide interpreting service for residents of
the hospital when requested and needed.
The tailor-shop, which is under the direction of the Volunteer Services, has
again completed a busy and productive year, much to the benefit of residents in hospital. During the fiscal year there have been 1,852 articles repaired, mended, and
fitted and altered at the shop. This represents a 25-per-cent increase over the past
year.
Tours through the hospital this year have accommodated various community
groups; that is, schools, churches, clubs, university students. Numbers touring
equalled 807 individuals.
GENERAL ADMINISTRATION AND SERVICE DEPARTMENTS
In view of the changing concepts of modern psychiatric care and treatment,
the increasing development of community resources, and the changes that have
occurred in the organization of the Mental Health Branch, a great deal of study and
reassessment has been carried out in most areas of the hospital during the year.
Considerable study and discussion by the senior administrative staff of the hospital
have been directed toward an evaluation of the present and future role and function
of Riverview Hospital within the Mental Health Branch, and in relation to the
various community resources for the treatment of emotional disorders for the
citizens of the Province. In particular, a review has been made of the total organization and administration of the hospital and its interdepartmental relationships,
which resulted in the submission of a comprehensive report and recommendations
early in the year.
The changes that occurred in the reorganization of the office of the Deputy
Minister of Mental Health were welcomed as a new and progressive approach to
mental health care.
 IN-PATIENT SERVICES
L 105
A very considerable amount of effort has gone into endeavours to improve the
functional operations of the departments of the Business Administrator. In particular, much planning and some progress have been achieved in improving our
responsibility and control over hospital accounting functions, the establishment of
a co-ordinated administration of laundry, linen, and clothing services and the provision of a Personnel Officer for Riverview.
We have enjoyed co-operation from the Department of Public Works in our
endeavours to improve the hospital facilities under capital construction programmes.
Considerable work has gone into planning of the Riverside kitchen, dining, and
industrial-therapy facilities. The Centre Lawn Building has been under review,
and plans are going ahead for some of the areas in this building. Ward D5 has
already been completely renovated, and Ward E5 is under development. Ward Dl
has been converted to a very welcome recreation area. Occupational-therapy facilities and the central administrative facilities will be carried out possibly in the forthcoming year. We were pleased to secure a very much needed dining-room for the
Ward HI patients. The conversion of a storage area has turned out to be a real
" bright spot" for Ward HI. We plan to progress with changes in East Lawn as
funds are made available.
Considerable thought has gone into the planning of our laundry facilities. This
is a major project which must be accommodated within the next year. Tenders for
renovations to the West Lawn Unit have been called for. The office and ward areas
of East Lawn have also been under review, as these sections of the hospital will soon
need modernization.
DIETARY DEPARTMENT
Dietary services to patients and staff have been updated with the installation
of large central coffee-making facilities in Centre Lawn, new kitchen equipment in
East Lawn main dining-room, and the renovation of C4-A4 dining-room in West
Lawn. In addition, we have foreseen the need of a reduction in the practice of
utilization of patient workers in the dietary area. It will soon be necessary to replace
these patient workers with paid personnel. For this reason, and in an endeavour
to arrive at a five- or ten-year plan for the Dietary Department, arrangements have
been made for a comprehensive survey by dietary consultants of all dietary facilities,
functions, and services.
HOUSEKEEPING DEPARTMENT
The Housekeeping Department has made a very considerable contribution in
the areas in which it has been engaged, and has been well received by the Nursing
Division. Our building service staff have cleaned an average of 15,000 square feet
per employee day on a five-day-week basis. A recent cost analysis has established
that our cost runs at 30 cents per square foot per annum. It is our belief that we
are receiving excellent value for the funds expended, and that the programme of
housekeeping within this institution should be accelerated so that we might reduce
the costs in the other hospital areas.   Preventive maintenance pays.
INDUSTRIAL THERAPY DEPARTMENT
Production-line methods on a limited scale were introduced to some of the
shops this year. Results have proven both stimulating and instructive for the patient
participants. Many of the items manufactured on assembly-lines were the direct
product of Departmental research and manufactured for specific area needs. Chairs
were designed for incontinent patients; commodes, teaching aides, crib-side beds,
gatch beds, wardrobes, bedside tables, etc., were also manufactured.
 L 106
MENTAL HEALTH BRANCH REPORT,  1967/68
It is of interest to note that the Industrial Therapy Department has played an
important role in relieving tensions in the Order in Council wards by employing two
large groups of patients in the mattress-shop and the upholstery-shop over the past
eight months. The results achieved from this programme have been heart-warming,
educational, and therapeutic.
The Audio-Visual Department is to be praised for its part in a technical achievement of a 16-mm. movie entitled " Ward 71 " produced for the psychiatric unit at
The Woodlands School. This film, telling the story of a ward for autistic boys, is
to be used as a teaching-tool in staff-training and for ward orientation. The conference of the American Association for Mental Deficiency held in New Westminster
was the setting for the first public showing. Comments following this presentation
confirm that this is one of a very few films dealing with autism which is available.
The film library shipped 2,311 educational films to borrowers encompassing
a viewing audience of 70,354 persons.
Day and evening concert music is piped to all parts of the hospital grounds.
Recreational movies, 16 and 35 mm., were enjoyed by many patients throughout
the winter months.
The music activation programme broadcast to East Lawn and North Lawn
wards each morning has proven a stimulating therapy.
There was an average of 200 patients employed daily in the industrial-therapy
shops, with an average turnover of 30 new patients per month.
LAUNDRY
In May of this fiscal year a comprehensive analysis of Riverview laundry, linen,
and clothing problems was prepared by the hospital business administrator. The
laundry, when built in 1953, was designed to process a load demand of 6,240,000
.st
■.,„>■......■
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The broadcasting room, showing recently installed equipment. Daily musical programmes, live broadcasts, and prescribed therapeutic programmes are sent out daily over
this system to the wards and hospital grounds.
 IN-PATIENT SERVICES L 107
pounds per annum. This year a total volume of 10,864,400 pounds of linen was
processed, an increase of 399,956 pounds over the previous year. The Department
of Public Works, however, has demonstrated an interest in our problems and has
been working with us to improve our physical plant. In addition, five laundry staff
were added to the working force this year.
Plans are under way to restructure the laundry administrative organization so
that we might provide a comprehensive laundry, linen, and clothing service which
will meet our changing concepts and standards of care.
BARBER AND BEAUTICIAN SERVICE
Continued stress has been placed in encouraging patients to be interested and
responsible for their grooming and personal appearance through the use of the
barbering and beauty-parlour services. In the longer-stay units especially, patients
have been encouraged to attend at the barber-shop and beauty-parlour on their own
initiative as they would in the community, rather than being served on the wards
in a less personal manner.
This newer concept, however, has required a review of our barbering facilities
and has led to several changes, including the establishment of a well-equipped
barber-shop area in the Riverside Annex to serve patients in the Riverside Unit.
The barber-shop in the West Lawn Building has been moved to a new location in
the same building to make way for a much-needed central linen supply area for
this unit. The new shop has an additional chair, much-improved lighting, and has
been well patronized.
The beauticians have continued to give the many services required for the
proper grooming of our female patients. This year they carried out 44,657
procedures.
PODIATRY SERVICE
In addition to supplying Riverview, Valleyview, and The Woodlands School
with podiatric services, our podiatrist has extended his services to the boarding
homes on a request basis. A new procedure has been established in supplying
orthopaedic and special footwear. We have found that this has resulted in better
control and has expedited the provision of prescription shoes. There was a total
of 2,850 treatments carried out during the fiscal year, involving 1,525 patients.
TRANSPORT SERVICE
It is with regret that we must report the death of Mr. Gordon Nolan, our
transport supervisor, who passed away on January 19, 1968, after giving to the
Mental Health Services 23 years of faithful and loyal service.
The Transport Division is another section of the hospital that has been under
close review and for which many changes are planned. A dispatcher now coordinates all radio-controlled vehicles; the role of the supervisor is being expanded;
schedules of transport priorities have been prepared; we have commenced preliminary planning for garage maintenance and stock-control improvements; offloading facilities have been the subject of review and improvement; a " slick rail "
has been installed in the East Lawn central linen room; several of the older passenger vehicles have been retired from service; a new bus has been added to the
fleet; and a new gas pump was installed. There are many improvements still
needed: we must keep pace with out "mobile generation." Our Transport Division continues to provide a very vital link in our hospital's expanding programme
and increased involvement in the surrounding community.
 L 108
MENTAL HEALTH BRANCH REPORT,  1967/68
COMMUNICATIONS AND RECEPTION SERVICES
Additional telephones have been installed this year to meet the ever-growing
need of the hospital. Our staff of eight operators working around the clock on a
24-hour basis handle well over a thousand calls a day, one hundred of these being
long-distance calls. The telephone services form a vital link in the hospital's communications system and form a part of our emergency call system.
The previously independently operated " centre desks " in each unit were
reorganized this year into a co-ordinated information and reception service, involving a staff of 20 under the direction of a supervisor. While the switchboard is the
first line of contact with the community, the receptionist and information clerk are
the second line of contact between the institution and the public, and in this role
they offer a very important service to the hospital.
The postal services continue to render an efficient communications function in
the distribution of hospital mail and the processing of the Government of Canada
postal services. A small vehicle was added this year to facilitate the distribution
of mail throughout the hospital complex.
ESSONDALE CIVIL DEFENCE DISASTER ORGANIZATION
Although general interest in civil defence activities has been minimal during
the year, the Essondale Disaster Planning Committee has met on several occasions,
and the Superintendent, as Civil Defence Co-ordinator for this area, has kept in
contact with the office of the Zone Co-ordinator of the Vancouver area in the
reception of regular reports and directives.
During the month of November, our senior E.E.G. technician attended the
Provincial Radiological Defence Course in Victoria and is now qualified in radiological analysis, monitoring, and source handling as a Radef officer.
Report for April 1 to December 31, 1968
The following report covers in general special activities of note or new procedures or programmes introduced during the April 1 to December 31, 1968,
period, and supplements the report covering the fiscal year 1967/68.
Although official statistics of patient movement are not available at this time,
a review of the monthly statistical returns indicates that there have been no significant changes or trends compared to the previous 12 months. During the period
April 1st to November 30th, total intake of patients numbered 2,418, with total
separations being only slightly more at 2,429. The number of patients in residence
at the end of November numbered 2,672 (1,423 men and 1,249 women), a decrease
of only 11 compared to the number in residence as of March 31, 1968.
Several important projects designed to improve treatment services to patients
and reported to be in the planning stages in the report for the fiscal year 1967/68
came to fruition during the period under review in this report.
A clinical teaching unit, developed in affiliation with the Department of Psychiatry of the University of British Columbia, began operation on August 1, 1968,
on Ward West-3 of the Crease Unit.
On October 7th and 8th the hospital was visited by Dr. C. J. Doherty, field
representative of the Canadian Council on Hospital Accreditation, and Dr. C. H.
Moorhouse, psychiatric consultant, for the purpose of an accreditation survey.
Although no official report has been received concerning this survey, it has been
intimated that the visit may be regarded as a courtesy consultation with a final
survey to be conducted in about six months.
 IN-PATIENT SERVICES L 109
During November, plans were completed to establish a special area on Ward
West-4 of the Crease Unit for patients receiving intensive somatotherapies, such as
sleep treatment, somnolent insulin, intensive E.C.T., etc. This unit of 9 beds is
to be under the direction of a psychiatric specialist, and specially trained nursing
staff is available to provide safer and more effective application of somatotherapy
for patients in the Crease Unit.
The use of minimal care, or intermediate quarters, has been extended so that
three residences on the hospital grounds are now in use — two for women, and
the newest, which opened October 21, 1968, for men.
During November, integration of patients was introduced on Ward D5 in
Centre Lawn. This is the sixth ward now caring for both men and women patients
with both male and female staff.
The Nursing Service Department is now providing field-work experience for
students from two British Columbia Institute of Technology programmes. This is
in addition to the clinical areas already provided for affiliate students from various
agencies and schools.
Presentations were made by the Psychiatric Nurses' Association to the Mediation Committee at hearings held in September and October. The resulting decisions,
with their effect on the Nursing Department, are not known.
The policy of permitting sessional affiliation with the Department of Psychology
has been continued and modified to permit the extension of fee-for-service privileges
to thoroughly experienced psychologists with Master's degree training along with
those having doctoral qualification. With this adjustment in terms, the prior policy
of retaining casual employment on an hourly-rate basis has been discontinued.
Considerable interest has been expressed in this form of professional affiliation by
community-based psychologists, and it is expected that within the near future it may
be effectively utilized as a service resource.
The Department has strongly maintained its research interest. The study
atttempting to delineate antecedent behavioural factors underlying suicide has been
completed. An attempt is now being made to determine the extent to which a
suggested relationship between sterioid level and suicide propensity may provide
reliable antecedent data. Development continues in the task of constructing an
automated testing procedure. At the moment, effort is being applied to the writing
of necessary computer programmes and the costing of various installations that
might be utilized to make such a testing service operational.
Throughout the year the move toward increased social services at the community level received considerable impetus. The expansion of the boarding-home
programme to Vancouver Island areas, other than Victoria City and its immediate
surroundings, made available to the hospital some additional and much-needed beds.
It was possible during the seven-month period covering April 1 to October 31, 1968,
to place a total of 92 patients in licensed boarding homes under the ongoing supervision of the hospital, of which group 57 were new placements.
During the past nine months special attention has been given toward improvement in the efficiency of the dental service, particularly in respect to improved
recording of dental work accomplished and in the communication of this information
to patients' doctors and the clinical files. To this end, new dental record cards
have been designed and implemented, and new forms and procedures for referral
and reporting on each patient have been instituted.
During the period under review, the Medical Records Department has continued to concentrate on the application of the standards recommended by the
Canadian Council on Hospital Accreditation.
 L 110 MENTAL HEALTH BRANCH REPORT,  1967/68
The accreditation requirement of centralization of all reporting of patient
treatment on the medical record was reviewed and systems initiated to provide
recording from the following treatment services: Dental consultations; optical consultations; podiatry consultations and activity therapies progress; notes which
include psychology group therapy, rehabilitation work, placement reports, and
occupational therapy.
The registration and statistical reporting of all medical and surgical patients
temporarily transferred from other mental health facilities commenced on November
1, 1968.
On June 17, 1968, a major innovation became implemented with the appointment of Mr. R. J. Phillips to the newly established position of Personnel Officer for
Riverview Hospital.
Previously the responsibility for personnel matters had been incorporated in
the duties of the Business Administrator. The new position of Personnel Officer
is a staff position with direct responsibility to the Superintendent for the supervision
and maintenance of all personnel records and route functions of the Personnel
Office. In addition, the Personnel Officer will be in a position to expand the scope
of personnel services, with increased attention to the welfare of Riverview staff on
both an individual and collective basis.
To date, several major projects have been initiated, including the following:—
(a) A safety and accident-prevention programme was inaugurated in July
with a new concept in safety committees being initiated.
(b) Staff-training resources have been investigated, and extensive research
has been undertaken to provide administration with information concerning various resources available, both internally and from community
agencies, for the development of staff. Special attention has been given
to the development of training experiences for first- and second-line
supervisory staff in personnel management.
(c) Employee relations and staff welfare have been of major concern, and
steps have been taken to recognize and assist staff who are ill or bereaved,
through letters and hospital or homes visits.
(d) The Riverview staff bulletin has also been revitalized with a change in
the format and content of this form of communication to staff.
(e) Special attention has also been given to employee job satisfaction through
surveys of job classifications, salary scales, fringe benefits, etc.
 IN-PATIENT SERVICES
STATISTICAL TABLES
L 111
Table 1.—Movement of Population, Riverview Hospital, Essondale,
April 1, 1967, to March 31, 1968
Male
Female
Total
In residence, April 1,1967—	
On extended leave, carried forward from 1966/67-
Boarding home  	
Other 	
On escape, carried forward from 1966/67	
Total on books as at April 1,1967	
Admissions—■
First admissions to Mental Health Services-
Readmissions to a different institution of Mental Health Services..
Readmissions to the same institution 	
Total admissionsi 	
Total under care  _ 	
Separations-
Discharged in full..   	
Died  	
Transferred to geriatric facilities-
Transferred to facilities for mentally retarded-
On extended leave and still out—
Boarding home  - 	
Other   	
On escape but not discharged..
Total separations	
Net decrease 	
In residence, March 31, 1968-
1,456
156
52
4
1,312
186
100
1,662
87
12
4
176
65
7
1,558
77
8
1
188
206
2
2,013 2,040
—42
1,414
-43
1,269
2,768
342
152
4
1,668
1,598
3,266
789
18
952
762
8
941
1,551
26
1,893
1,759
1,711
3,470
3,427
3,309
6,736
3,220
164
20
5
364
271
9
4,053
"^85"
2,683
i Includes 15 male and 7 female transfers from geriatric facilities,  1 male and 1 female transfer from
facilities for the mentally retarded.
 L 112
MENTAL HEALTH BRANCH REPORT, 1967/68
1
Table 2.—First Admissions to Riverview Hospital, Essondale, by Health
Unit and School District of Residence and Sex, April 1, 1967, to
March 31, 1968.
Health Unit and School District
Male
Female
Total
Health Unit and School District
Male
Female
Total
East Kootenay, Cranbrook—
Metropolitan Board of Health of
3
4
7
 3	
4
1
5
School District No. 38	
21
29
50
 4	
3
3
 39	
313
313
626
„   18	
1
1
2
 41 	
34
54
88
„   86	
1
4
5
„   44	
23
20
43
„   45  ...
7
4
11
School District No. 7	
6
7
13
, 8	
1
2
3
School District No. 46	
2
4
6
„          „         „   10	
1
3
4
„          „         „   47	
7
6
13
West Kootenay, Trail—■
School District No. 9	
„   48	
6
7
13
2
1
3
Skeena, Prince Rupert—
„   11	
3
9
12
School District No. 50	
	
2
2
„   12	
1
1
„   52 	
11
2
13
South Okanagan, Kelowna—
„   54 	
5
3
8
School District No. 14-_	
2
..
2
„   80	
6
3
9
„   15-	
7
3
10
„   88	
4
5
9
 ,   17	
1
1
2
Peace River, Dawson Creek—
, 23	
6
1
7
School District No. 59	
13
6
19
„   77	
1
1
2
„   60—	
3
2
5
North Okanagan, Vernon—
„   81 	
2
1
3
School District No. 19	
1
2
3
„   83—	
2
2
 22	
1
3
4
Greater  Victoria  Metropolitan
„   89	
2
3
5
Board of Health-
South Central, Kamloops—
School District No. 61	
31
17
48
School District No. 24	
6
4
10
„   62 	
5
2
7
 26	
1
1
„   63	
2
3
5
„   29	
5
5
 64.	
2
2
4
 ,   31	
2
1
3
Central Vancouver Island, Na
Cariboo, Williams Lake—
naimo—
School District No. 27	
6
3
9
School District No. 65	
6
3
9
„   28	
4
9
„           „         „   66~
3
2
5
Northern    Interior,    Prince
„   67	
1
1
George—
,,68	
7
5
12
School District No. 55—	
1
1
2
„   69 	
3
2
5
 56	
1
2
3
„   70	
10
6
16
„   57	
27
13
40
„   79 	
1
	
1
 58- ,
	
3
3
Upper Island, Courtenay—
Upper   Fraser   Valley,   Chilli
School District No. 71	
3
4
7
wack—
 72	
3
5
8
School District No. 32	
3
6
9
„          „         „   85
3
3
,    33
13
14
27
School districts not covered by
 34	
8
11
19
health units—
Boundary, Cloverdale—
School District No. 49	
2
1
3
School District No. 36„„	
35
39
74
 84	
1
1
„   37—	
7
13
20
, 87	
1
1
2
Simon  Fraser,   New  Westmin
Unorganized	
4
1
5
ster-
18
22
24
42
48
27
2
11
38
School District No. 40 ,
2
Central Fraser, Mission—
Totals	
807
770
1,577
School District No. 35	
8
9
17
„   42 -	
9
14
23
„   75	
6
8
14
„   76      .
2
2
4
 IN-PATIENT SERVICES
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MENTAL HEALTH BRANCH REPORT, 1967/68
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<
 IN-PATIENT SERVICES
L 127
THE WOODLANDS SCHOOL, NEW WESTMINSTER
H. J. Brooks, M.B., Ch.B., D.C.H., Acting Superintendent
Report for April 1, 1967, to March 31, 1968
The year brought a further extension of the concept of unitization, and each
unit became responsible for the administration of its own waiting list. The decision
was also taken to bring the supervisory staff of the Psychiatric Unit together in one
area located close to the wards served by the unit members.
The value of unitization continues to be seen in the more precise evaluation of
the patients' needs, resulting in the provision of the most suitable training for each
patient. These changes were possible ony through the enthusiasm and initiative of
all unit staff members.
Major renovations to the buildings in Centre Block continue. Wards 60, 61,
and 62 (H, E, F) were completed in August, 1968, and will house patients from
Wards 59, 58, and 74, which will be renovated in their turn.
Work done by the out-patient department continues to increase. One hundred
and thirty-three patients were seen during the year, and the numbers waiting for
out-patient appointments are increasing.
Placements in the community continue to show an increase over the previous
year. There were 33 patients placed in boarding homes, of whom five were returned
as unsuitable; seven foster-home placements, of whom three were returned; and
five patients were transferred to nursing homes. The development of group homes
to cater to children who, because of low intellectual and physical functioning, prove
unsuitable for foster-home placement would help greatly in providing vacancies for
the severely retarded.  This is the area in which pressure for admission is greatest.
The general level of health of pupils-patients improved during the year, and
this improvement should continue as training programmes focus more on self-care,
ambulation, and environmental improvement, and as sanitary facilities are improved. The group of pupils-patients who will need an increasing amount of programme planning are the profoundly retarded. These children are largely unsuitable
for community placement and remain in The Woodlands School.
It was suggested by Hospital Unit members and a C.N.I.B. representative that
a ward for the blind mentally retarded at The Woodlands School would be a most
important step forward.   A report on this is being studied.
Dr. Dufresne, representing the Royal College of Physicians and Surgeons of
Canada, reported favourably on the School as suitable for the training of pediatric
and psychiatric residents.
In order to continue with our programme of unitization, it is hoped that we will
be able to divide the duties at present performed by the Director of Education and
Training between the Director of the Training Unit and the Director of Education
and Training. This would require the creation of a separate post of Director of
the Training Unit.
We obtained the lease for Gold Creek Camp from the Corrections Branch and,
with the co-operation of the Public Works Department, hope to use the camp on a
daily basis throughout the summer.
The American Association on Mental Deficiency held its annual convention in
New Westminster in October, 1967, and members of all disciplines at The Woodlands School took an active part in the presentation of papers and demonstration of
training methods. Members of the Hospital Unit were co-authors of three papers
published in various scientific journals.
 A boy, a bike, and a clear corridor to chase along is a sure-fire recipe for hoots of fun.
This young fellow is no exception, and it is all part of the physiotherapy treatment at The
Woodlands School.
 IN-PATIENT SERVICES L 129
The institution of the ward activity training programmes is proving of great
assistance in that the programme is fitted to the child's needs and capabilities, rather
than fitting the child to the programme. With the creation of the post of Rehabilitation Officer, valuable assistance is being given to pupils in obtaining suitable
employment outside The Woodlands School, and in exercising supervision over the
25 pupils who have obtained such work. It is also hoped that this will help in the
much-needed education of employers in accepting the retarded as employees and
recognizing the qualities that make them such useful employees.
Members of the Volunteer Services contributed over 9,000 hours of service to
The Woodlands School. This total does not include the many hours given by the
Provincial Auxiliary, nor by separate groups.
Report for April 1 to December 31, 1968
A most welcome event which occurred during the review period was the
purchase of Our Lady of Fatima School, Maillardville, as a residential centre and
pre-placement facility for 50 trainable pupils. We have submitted staffing requirements for this establishment and also for the extra staff which will be required at
The Woodlands School following the move of 50 trainable patients and their replacement in The Woodlands School by patients from the waiting list whose intellectual level will be much lower, and who will require more supervision and training.
Operating cost estimates and details of renovations required have also been submitted together with a list of furnishings. We expect to occupy the facility early
in 1969.
We were able to use Gold Creek Camp during the past summer on a daily
basis. Structural alterations and repairs are required at this camp and surrounding
area, and unless this action is taken before next spring, our use of this worth-while
facility will be very limited.
The patients' cafeteria has been refurnished, and this has done much to
improve the environment and hygienic operation of the area.
Phase II of the renovations to the Centre Building has started, and we hope it
will be completed by March, 1969. Structural alterations to Ward 84 have been
carried out following inspection by an official of the Public Works Department.
While the renovations were taking place, the pupils were housed in the Recreation
Building.
The possibility of placing patients from the Hospital Unit in extended-care
facilities has been investigated and is being pursued. Dr. MacKay, consultant to
extended-care facilities in British Columbia, visited The Woodlands School at our
invitation and agreed that the majority of patients in the Hospital Unit are eligible
for these facilities, and we are at present submitting applications for admission to
several such institutions.
Directly or indirectly, we are following up all the patients suffering from
phenylketonuria in the Province; we often supply the special dietary requirements
and supervise the treatment.
The appointment of a Rehabilitation Officer has proved worth while. During
the period April to December, 1968, the number of male pupils working full or
part time in gainful occupations varied between five in December, 1968, and 54 in
October, 1968, while their combined monthly earnings varied from $1,016 to
$3,718. The corresponding figures for female pupils were five in December, 1968,
and 25 in September, 1968, and $377.36 to $1,914.00. This employment gives
pupils a feeling of achievement and increases their motivation and demonstrates
to the community the varied abilities of the retarded.
5
 L 130
MENTAL HEALTH BRANCH REPORT,  1967/68
The demand for out-patient services continues, and the average waiting time
for an appointment is about two months. During the next year we hope to assess
the work done by the Out-patient Department, together with the staffing needs
and the need for follow-up services, so that we may improve our service to the
community.
We have recently instituted a multi-discipline in-service training programme
with the object of improving communication between departments and informing
all staff members of the actual work done by each unit and department. This
programme consists of a panel of speakers giving short explanations of the work in
which they are involved, followed by question-and-answer periods. We will evaluate
this programme when it has been in operation for a sufficient length of time to make
a useful decision.
The increasing involvement of unit staff in the care, training, and treatment of
patients is being brought about through the medium of clinical team meetings, and
we hope to improve community involvement in care of the mentally retarded by
including parents in as many of the ward activities as possible. We are finding that
an increasing number of admissions to the Psychiatric Unit are severely disturbed,
and this throws extra burdens on ward staff, where the staffing pattern has been
designed for chronic care rather than the acute type of case which these disturbed
patients present.
The increased rate of placement in the community by the Psychiatric Unit has
allowed an increased rate of admission, and it is the object in this unit to return the
individual patient to the community as soon as the basic need of the individual has
been met and the patient's presenting problem solved. This emphasizes the need for
increased psychiatric help in this unit.
Physiotherapist treats a spastic child in the therapeutic pool at The Woodlands School.
 IN-PATIENT SERVICES
L 131
The problem presented by the increasing numbers of disturbed pupils being
admitted is also reflected in the Education Department, where the presence of these
pupils in classes numbering 15 to 18 pupils makes the teacher's task very difficult.
We reintroduced industrial education for those under 17 years of age in September,
1968; it is too early to evaluate the value of this programme.
In the area of pupil health we are introducing on each ward a simple programme for the improvement of oral hygiene and ensuring the continuance of such
a programme. We hope also to install general anaesthesia equipment in the Dental
Department so that routine procedures can be performed at The Woodlands School
rather than going to the expense and inconvenience of transferring the patient to
Riverview for such treatment.
I would like to acknowledge the help and co-operation I have received from all
staff members at The Woodlands School while I have occupied the post of Acting
Superintendent, and thank them for the loyalty and consideration they have shown.
 L 132
MENTAL HEALTH BRANCH REPORT, 1967/68
STATISTICAL TABLES
Table 1.—Movement of Population, The Woodlands School,
New Westminster, April 1, 1967, to March 31, 1968
Male
Female
Total
746
41
11
531
67
3
1,277
On extended leave, carried forward from 1966/67—
108
Other                                                                                               	
14
798
601
1,399
Admissions—
64
9
37
40
5
23
104
14
60
110
68
178
908
669
1,577
Separations—
64
10
7
1
59
18
30
11
9
83
9
94
Died         	
21
16
1
On extended leave and still out—
142
Other. 	
27
159
142
301
+3
749
-4
527
1
1,276
i Includes 2 male and 4 female transfers from The Tranquille School, 3 male transfers from Riverview
Hospital.
 IN-PATIENT SERVICES
L 133
Table 2.—First Admissions to The Woodlands School by Health Unit and
School District of Residence and Sex, April 1, 1967, to March 31,
1968.
Health Unit and School District
Male
Female
Total
Health Unit and School District
Male
Female
Total
Selkirk, Nelson—
Metropolitan Board of Health of
School District No. 7... -
1
1
2
Greater Vancouver—
West Kootenay, Trail—
School District No. 38	
4
1
5
School District No. 9	
1
	
1
„   39 	
13
13
26
„   11 	
1
1
2
 41-	
6
3
9
„   12	
1
1
„   44...-	
1
1
2
„   13	
1
	
1
Coast-Garibaldi, Powell River—
South Okanagan, Kelowna—
School District No. 46 _	
1
	
1
School District No. 14 	
1
1
2
 47  ...
2
2
„   15. 	
	
1
1
„   48 	
1
1
„   23	
2
	
2
Skeena, Prince Rupert—
North Okanagan, Vernon—
School District No. 52 -	
1
1
School District No. 22	
1
	
1
 ,   54	
2
......
2
South Central, Kamloops—
School District No. 24. 	
,.   88   -
2
2
2
2
Peace River, Dawson Creek—
Cariboo, Williams Lake—
School District No. 59	
1
1
2
School District No. 28-	
1
	
1
„   60  „
1
1
Northern    Interior,    Prince
„   81	
1
1
George—■
Greater   Victoria   Metropolitan
School District No. 56-	
	
1
1
Board of Health-
„   57	
1
1
2
School District No. 61	
6
1
7
Upper   Fraser   Valley,   Chilli
 ,   62	
2
2
wack—
, 63	
1
1
School District No. 33- _	
3
1
4
Central Vancouver Island, Na
„   34	
1
1
2
naimo—
Boundary, Cloverdale—
School District No. 65 .„
5
5
School District No. 36	
5
4
9
 ,   66	
1
1
, 37--- -
1
1
2
„   70	
3
3
Simon   Fraser,   New   Westmin
Upper Island, Courtenay—
ster—
School Distict No. 72 	
1
1
1
, 43	
1
1
Totalis	
73
45
118
Central Fraser, Mission—
School District No. 35 -	
1
1
2
„   42	
2
1
1
3
Table 3.—First Admissions and Readmissions to The Woodlands School by
Method of Admission, Age-group, and Sex, April 1, 1967, to March 31, 1968
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
1
1
4
7
6
1
3
8
14
4
9
1
8
4
6
3
3
3
1
1
2
3
1
2
1
35
37
2
16
27
3
1
1
5
5
5
5
51
Temporary... -	
64
Totals	
|    1
6
5
10
6
13
4
22| 13
13
9
6
4|    3|    1
_|    2| 73
45
118
Readmissions
	
1
2
1
1
1
1
8
3
2
6
i
4
1
2
7
4
2
1
1
4
3
	
1
	
2
8
27
1
7
15
3
Involuntary  	
Temporary 	
15
3
42
Totals.. —
3
	
3
2
10
3
8
5
10
4
3
8
1
37
23
60
 L 134
MENTAL HEALTH BRANCH REPORT, 1967/68
Table 4.—First Admissions and Readmissions to The Woodlands School by
Mental Diagnosis, Age-group, and Sex, April 1, 1967, to March 31, 1968
Mental Diagnosis
Age-group (Years)
Under
1
M.
1-3
M.
4-6
M,
F.
7-9
M.
10-14
F.   M,
15-19    20-29
M.
F.
M.
F.
30-39
M.   F.
40 and
Over
M.
F.
Total
M.
Grand
Total
First Admissions
Encephalopathy due to
postnatal cerebral infection	
Encephalopathy due to
a virus	
Encephalopathy due to
bacteria 	
Bilirubin encephalopathy
Encephalopathy due to
prenatal injury	
Encephalopathy due to
mechanical injury at
birth 	
Encephalopathy due to
anoxemia at birth	
Postnatal anoxemia	
Cerebral lipoidosis,  juvenile  -
Gargoylism..
Intracranial neoplasm—
Hydrocephalus, congenital	
Microcephaly, primary-
Mongolism 	
Mental Retardation
Other, due to unknown
prenatal influence, no
cerebral defect —	
Encephalopathy associated with prematurity..
Encephalopathy, other,
due to unknown or
uncertain cause with
the structural reactions
manifest  	
Cultural-familial mental
retardation 	
Psychogenic mental retardation associated
with environmental deprivation.
Psychogenic mental retardation associated
with emotional disturbance	
Mental retardation associated with psychotic disorder	
Mental retardation, other, due to uncertain
cause with the functional reaction alone
manifest 	
Combination of at least
three of above conditions  	
Totals..
10
22
13
13
1     1
1
10
21 73
45
3
1
1
1
1
1
1
14
26
6
25
3
15
118
 IN-PATIENT SERVICES
L 135
Table 4.—First Admissions and Readmissions to The Woodlands School by
Mental Diagnosis, Age-group, and Sex, April 1, 1967, to March 31,
1968—Continued
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.
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F.
M.
F.
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F.
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F.
M.
F.
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F.
M.
F.
Readmissions
Encephalopathy  due  to
postnatal cerebral in-
1
1
	
1
1
	
—.
	
1
1
1
1
2
1
1
1
1
1
1
2
1
2
1
1
2
3
1
~~
1
—
—
1
2
1
1
1
1
7
10
5
2
2
4
1
1
1
2
10
7
1
2
Encephalopathy due to
2
Encephalopathy due to
prenatal injury	
Encephalopathy  due to
mechanical injury  at
birth     —   ..
-----
	
2
2
Encephalopathy due  to
anoxemia at birth	
Cerebral  lipoidosis, ju-
	
	
	
	
	
1
1
3
4
2
1
1
1
3
2
1
4
1
9
Mental Retardation
Other, due to unknown
prenatal influence, no
	
1
	
1
1
2
20
Encephalopathy,   other,
due  to   unknown  or
uncertain cause with
the structural reactions
manifest 	
Cultural-familial mental
12
2
Mental   retardation   associated with psycho-
1
1
	
2
Mental retardation, other,  due to  uncertain
cause with the functional reaction  alone
4
Combination of at least
1
Totals	
3
3
2
10
3
8
5
10
4
3|    8
1
—. |    1
1
—
37
23
60
Table 5.—First Admissions to The Woodlands School by Religion and Sex,
April 1, 1967, to March 31, 1968
Detailed information for the above table may be obtained on request.
 L 136
MENTAL HEALTH BRANCH REPORT, 1967/68
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 IN-PATIENT SERVICES L 141
THE TRANQUILLE SCHOOL, TRANQUILLE
John Bower, M.D., D.P.M., Acting Superintendent
Report for April 1, 1967, to March 31, 1968
For the first time since it was established in 1959, The Tranquille School had
no increase in its resident population during the year under review.
As a result of a major policy decision, applicants for admission during the year
were selected directly from the waiting list. As far as possible, applicants were
chosen whose residence was in the Interior of the Province. In order to facilitate
proximity to next of kin, transfers by exchange between Tranquille and The Woodlands School have been increasing in number.
The School was also permitted to use Tranquille Farm as a training area for
boys, with the plan of eventual placement in farms in the community.
The health of the students is reflected in the absence of any epidemics, the
absence of dysentery, and the absence of infectious hepatitis. There was an average
occupancy of the 10-bed hospital ward of 6.61. Two deaths occurred during the
year, giving a mortality rate of 2.9 per 1,000. All cases requiring surgery are sent
to the Royal Inland Hospital, Kamloops, for the operation; all medical cases are
retained in the hospital ward for treatment. A family doctor practising in Kamloops
visits this ward daily and also takes sick parade.
Through the continued co-operation of Dr. Ian Findlay and the staff of the
South Central Interior Health Unit, immunization is performed against diphtheria,
tetanus, and poliomyelitis.
TRAINING PROGRAMME
We accept the philosophy that the retarded person is entitled to those experiences which will enable him to adjust to life in his community whether that community is within the School or outside. Our programme, based on milieu therapy,
is geared to serve the needs of three major groups of retarded:—
(1) The group who will always be limited to self-care and home training
programmes.
(2) The group who can be trained in our intramural employment programme.
This is carefully structured under the direct supervision of job placement
officers, with employment in 16 areas. As of February, 1968, permission
was received from the Department of Agriculture and a training crew was
placed on Tranquille Farm.
(3) The group who can be trained for employment in the community. The
programme is flexible, with the persons taught acceptable work habits
rather than a specific job. No undue emphasis is placed on the knowledge
of reading and arithmetic.
Recreational Therapy.—The programme is held on six days and four nights
every week because physical development and the achievement of motor skills is
necessary to the physical health and well-being of all individuals, normal and subnormal, and is the basis of all learning. All mental levels participate in the comprehensive programme, which includes individual and small- and large-group activities.
The average monthly attendance is 5,280, with complete integration of the sexes.
The School participated in the Centennial athletic programme sponsored by the
Canadian Association for Retarded Children under the direction of the Chief Recre-
 L 142 MENTAL HEALTH BRANCH REPORT,  1967/68
ational Instructor; 15 gold medals, 55 silver medals, and 165 participation medals
were won. During the summer months the scheduled events moved out-of-doors
into our large playing-fields; baseball and other such competitive games in Fortune
Field; large muscle activity in Hayes Park, and activities involving play equipment
in Cooney Park.
Kamp Kiwanis, situated in the Cariboo Hills, is our summer camp established
by the Kiwanis Club of Kamloops. It provides a week's summer holiday for students, who live an outdoor life in this lovely valley on Tranquille Creek. They also
enjoy the unique experience of catching trout on barbless hooks, placing them in a
large container, and releasing the fish at the end of their holiday to be caught by
the next group of students.
Occupational Therapy.—A programme is arranged for all mental levels; it
includes a wide range, varying from diversional activities to the production of
jewellery made in the lapidary shop from semi-precious rocks found locally. Hand-
weaving of material, rugs, basketry, rock mosaic pictures, embroidery, knitting,
leathercraft, and woodworking are all produced.
Physiotherapy.—For the first time, from October, 1967, physiotherapy services
for the doubly handicapped individual were provided, with a therapist attending once
weekly. The prescribed movements were carried on by Mr. J. Lynes, Chief Recreational Instructor, during the week.
Scouts and Guides.—The First Tranquille Scout Troop has Camp Blackthorn,
where during most summer week-ends they live in tents and put into practice the
scouting lore learned during the active winter programme. A large log cabin has
been almost completed, with all work done by the boys under supervision of their
Scoutmaster.
COMMUNITY EMPLOYMENT
Based on the training received in the intramural employment programme and
with a community made receptive by education, employment in the community for
students has become a successful programme. Supervision and counselling of employer and employee are given by a specific member of the social service staff. It
is a measure of his ability that students who have been as long as 41 years in an
institution are working in the community with residence in a boarding home. Students who still reside in the School are brought daily to their jobs in the School bus.
Most jobs are in the Greater Kamloops area, with Vernon and Kelowna included.
SCHOOL EVENTS
Carnival Day with bands, floats, and circus atmosphere; May Day with the
crowning of the queen and track events; Pine Crest Barbecue with its gargantuan
feast for 500 persons and the steer fed by Pine Crest boys; Christmas Day with its
happy melange of nine Santa Clauses, 400 paper-hat-crowned trainees sitting down
together to a turkey dinner with all the trimmings, and new gifts—these have all
become a part of the Tranquille picture.
RESEARCH PROJECTS
Two studies were made into possible chromosomal aberrancies—one into the
relationship between Kleinefelter's syndrome and Down's syndrome and one into
sex chromatin abnormalities in the mildly retarded. The third study, a long-term
project, is on the effect on the social skills of 104 profoundly retarded students transferred to The Tranquille School to occupy the Sage Building.
 IN-PATIENT SERVICES L 143
DENTAL DEPARTMENT
A dental suite has been constructed on the fourth floor of the Greaves Building.
It includes the dental X-ray unit and darkroom and an operating theatre for dental
treatment under general anaesthesia. With three dentists on staff, an oral examination
can be made once every six months. A detailed dental report is received monthly,
as of December, 1967. After one year it is anticipated that interesting data will
emerge in respect to dental health in genetic conditions and to mental level.
CHAPLAINCY SERVICES
The chapel has been renovated, including a new floor. Pews donated by St.
Paul's Cathedral in Kamloops have replaced the chairs. The Very Rev. J. C. Jolley,
Dean of St. Paul's Cathedral, and the Most Rev. M. A. Harrington, Bishop of Kamloops Diocese, minister to the spiritual needs of our students.
NEW CONSTRUCTION
A new million-dollar structure, the Centennial Building, was opened during
the year. It houses the student cafeteria, the staff cafeteria, the main kitchen,
stores, pharmacy, and staff lounge.
A new fire-alarm system is in the process of being installed, and a large and
much-needed addition to the laundry is nearly completed.
PERSONNEL
Sixteen new positions were approved into establishment, to bring the total staff
to 372. Dr. H. W. Bridge assumed the position of Acting Superintendent in March,
1967. In January, 1968, Dr. Margaret Neave was appointed Deputy Superintendent.   Mr. E. V. Roy Merrick remains as Business Administrator.
Report for April 1 to December 31, 1968
The writer of this report came to head the School, commencing work on July
1st. With this advent, some reorganization has been necessary and will be proceeding further in the coming year. The former Acting Superintendent, Dr. M. S. Neave,
has now assumed the post of Clinical Director, and her large clinical knowledge will
be directed to completely medical functions. The writer is acting as consultant in
psychiatry to the School, and it is hoped that, with increasing staff, it will not be
necessary for the Medical Department to be too closely involved in the supervision of
ancillary disciplines, such as social work and psychology.
Clinical conferences have been held regularly, and it is hoped to increase these
during the coming year. These are conducted on democratic principles with much
ancillary staff participating, and it is felt that this is increasing both the usefulness
and the interest of the conferences. Conferences between the Superintendent and
other departments are held frequently, and a collegiate team structure is gradually
evolving.
An annual handicraft sale was held this year with both good and bad results,
and it is proposed to try to effect some alteration of the sale philosophy within the
next year in order that the relatives of students and the elder and less-alert members
of the community may have a better chance to avail themselves of products made
by the students of this School.
 L 144 MENTAL HEALTH BRANCH REPORT, 1967/68
The Nursing Department is still the largest one in the School, under the directorship of Mr. A. Mcintosh, R.N. It is the one department probably in most intimate contact with the trainees, and as such has many contributions to offer and
many more are already being offered to the general training programme.
Integration between social work, medicine, and nursing is a desirable picture
which is becoming more acceptable every day. The nursing staff continues to consist of registered nurses with psychiatric training, registered nurses without this latter,
and psychiatric nurses and aides, and a happy atmosphere and association between
all these groups is in evidence.
During the year the usual School events of May Day, Carnival Day, and the
Pine Crest Barbecue were held, and many students spent holidays at Kamp
Kiwanis.
The community interests and resettlement programmes are continual and
have been the direct charge of the Social Work Department. Many students are
employed in this community, some returning to Tranquille at night, while others
are living out in various situations. Integration with Venture training centre in
Vernon continues.
Finally, during the year much work was done in the construction area. The
renovation of the laundry is complete, a dairy section for milk-cooling is finished,
and a renovation of offices is proceeding.
 IN-PATIENT SERVICES
L 145
STATISTICAL TABLES
Table 1.—Movement of Population, The Tranquille School,
April 1, 1967, to March 31, 1968
Male
Female
Total
In residence, April 1, 1967  	
On extended leave, carried forward from 1966/67—
368
18
4
290
11
2
658
29
Other              _	
6
Total on books as at April 1,1967	
390
303
693
Admissions—
12
11
3
6
13
4
18
Readmissions to a different institution of Mental Health Services- 	
Readmissions to the same institution  	
24
7
26
23
49
416
326
742
Separations—
21
2
16
3
8
4
4
1
21
3
29
Died             -	
4
6
1
On extended leave and still out—■
37
Othpr
6
42
41
83
+6
374
—5
285
+ 1
In residence, March 31,1968-   —            .   ...
659
i Includes 7 male and 9 female transfers from The Woodlands School, 1 male and 1 female transfer from
Riverview Hospital.
Table 2.—First Admissions and Readmissions to the Tranquille School
by Mental Diagnosis, Age-group, and Sex, April 1, 1967, to March
31,1968.
Age-group (Years)
Total
Mental Diagnosis
Under
1
1-3
4-6
7-9
10-14
15-19
20-29
30-39
40 and
Over
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—
Idiocy „	
Imbecility	
Moron	
Border-line   intelligence	
Other and unspecified
—
—
	
—
1
1
2
1
1
2
1
1
1
1
1
1
1
~3
1
2
1
5
3
~~1
3
1
i
l
~~1
1
1
——
3
7
8
4
1
2
7
6
3
5
14
14
7
1
Chronic brain syndrome, N.O.S	
__
.....
1
__
1
1
Totals	
—|—
_|_|    1|    1
2|    2|    5|    2
3
6
9|    6
2
2
1
	
23
19
42
Readmissions
Mental deficiency—
Idiocy.... 	
Imbecility	
Moron 	
Border-line   intelli
	
—
	
—
	
	
	
	
1
1
	
~~1
1
1
1
	
	
	
	
1
1
1
2
1
1
3
2
gence	
—
—
—
—
	
	
	
—
—
	
	
	
1
	
	
	
	
1
1
Totals	
—
—
	
—
	
	
	
—
1
1
	
1
2
2
	
	
	
	
3
4
7
 L 146
MENTAL HEALTH BRANCH REPORT,  1967/68
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L 147
GERIATRIC DIVISION
J. Walsh, M.B., B.Ch., D.P.M., Superintendent
Report for April 1, 1967, to March 31, 1968
The Geriatric Division consists of three hospitals—Valleyview Hospital, Essondale, 779 beds; Dellview Hospital, Vernon, 239 beds; and Skeenaview Hosiptal,
Terrace, 300 male beds.
During the year a total of 1,868 patients received care and treatment in the
three hospitals of this Division. Applications for admission totalled 776—590 for
Valleyview Hospital, 105 for Dellview Hospital, and 21 for Skeenaview Hosiptal
Actual admissions totalled 551, of whom 533 were admitted directly from the community and 18 were received on transfer from other mental health facilities One
hundred and eighty-four patients were returned to the community, and 427 patients
died during the year. The resident population of the three hospitals as of March 31
1968, numbered 1,238. To this number may be added 254 patients who, though
resident in the community, are still on the hospital register, making a total of 1,492.
VALLEYVIEW HOSPITAL, ESSONDALE
This is the largest of the three hospitals of the Geriatric Division Eighty per
cent of admissions are from the Lower Mainland up to, but not including Langley
10 per cent are from the Mainland beyond the Lower Mainland, and 10 per cent are
from Vancouver Island and the Gulf Islands.
Occupational therapy for the older folks at Valleyview Hospital provides not only a sense
of personal achievement, but also a wonderful opportunity to socialize.
 L 148
MENTAL HEALTH BRANCH REPORT, 1967/68
During the year 442 patients were admitted—424 direct from the community
and 18 received on transfer from Riverview Hospital.
One hundred and thirty-five patients were returned to the community. Of this
number, 18 were discharged in full and 117 were placed on leave. Forty-nine patients already on leave were discharged in full from leave. Of these patients on leave
during the year, 45 were returned to hospital, representing 12.5 per cent. Of those
patients returned to hospital during the year, 14 were again placed on leave. Factors
other than mental breakdown may contribute to return to hospital in some cases.
Forty-five patients died while on leave.
As of March 31, 1968, the number of patients on leave totalled 214.
Deaths in hospital totalled 279. Twenty-three patients were transferred to
Skeenaview Hospital and 23 to Dellview Hospital.
In June, 1967, a medical consultation service was made available to physicians
in the community on a limited geographical basis. By January 1, 1968, this service
was made available to the whole of the Lower Mainland area. The primary objective of this service is an assessment of the need or urgency for admission to hospital.
By the end of the year 127 patients were seen and early admission for the more
urgent cases was arranged.
In the hospital an active-treatment and rehabilitation programme has been
maintained. At the time of admission both the patient and the relatives are made
aware that hospitalization may be only temporary and that the patient will be returned to the community as soon as he is well enough to do so.
Owing to the high incidence of physical illness in the aged, its investigation and
treatment form a large part of the total medical treatment programme.
The services of consultants are available from Riverview Hospital, and all
surgical procedures are performed there.
No problem with the " generation gap " here as youngsters of the Rainbow Band entertain
older patients during recreational-therapy sessions on the wards at Valleyview Hospital.
 IN-PATIENT SERVICES L 149
The hospital's Dental Department provides a satisfactory dental service for the
patients. The Pathological Department, under the supervision of the pathologist
from Riverview Hospital, provides adequate diagnostic services.
A high standard of nursing care is provided for patients, and the work involved
requires a high degree of dedication on the part of the staff. An organized system
of ward visiting by volunteers was initiated toward the end of the year. It is expected
that this service will be of great value to patients.
The Department of Occupational Health provides useful help in dealing with
cases of long-term illness among staff.
The Social Service Department, with an establishment of five positions, has
operated with an average of 3 Vz workers throughout the year. Post-admission services, including discharge, form the most important area of activity. Despite
increases in the rates payable to nursing homes and boarding homes by the Department of Social Welfare, it is becoming almost impossible to place such patients in
the community.
The physiotherapy programme has been maintained, and a part-time podiatry
service is a useful adjunct.
The Occupational Therapy Department was without a director for part of the
year. A useful programme, however, was arranged by the two handicraft instructors.
The average monthly attendance at the occupational therapy centre was 1,252, with
about 200 patients involved in programmes on the wards.
Three first-year and one second-year student from the School of Rehabilitation
Medicine spent part of their internship in the Department during the summer.
Three volunteers from the Canadian Mental Health Association provide valuable assistance to the programme.
DELLVIEW HOSPITAL, VERNON
This hospital has a complement of 150 female and 89 male beds. Ninety-one
patients were admitted from the community, and 27 were received on transfer from
Valleyview Hospital. Forty patients were returned to the community on leave
status, and six were discharged in full. A promising feature of the rehabilitation
programme is the increasing number of patients placed singly in homes in the community.   As of March 31st there were 13 patients placed in this way.
As of March 31, 1968, the resident population was 202. To this may be added
40 patients on leave, making a total of 242 on the hospital register.
Medical services to patients is provided by a local physician on a part-time basis.
The psychiatrist in charge of the North Okanagan Mental Health Centre attends
on a regular weekly basis and provides a valuable psychiatric service to patients.
Dental and ophthalmic services are provided by the community dentists and
ophthalmologists as needed.
A good standard of nursing care has been provided for patients. Improvement
in the ratio of graduate nurses to aides has been continued. The establishment of
a housekeeping staff has facilitated the work of nursing staff. Reorganization of
staff through reclassification has strengthened the supervisory area.
The Occupational Therapy Department has provided handicraft programmes
for a number of patients.
An extensive programme of recreation and entertainment was made possible
through the combined efforts of staff and volunteer agencies such as Canadian Mental
Health Association, Independent Order of Foresters, and various other service
organizations in the Vernon area.
 L 150 MENTAL HEALTH BRANCH REPORT,  1967/68
Educational opportunities were made use of where possible. One assistant
charge nurse attended an eight-month course at Vancouver College, and the Director
of Nursing attended a four-day nursing institute in Vancouver.
Classes of instruction for nurses' aides were conducted in the hospital by an
instructor from the Department of Nursing Education at Essondale, and two psychiatric nurses attended a two-day nursing institute in Vancouver.
SKEENAVIEW HOSPITAL, TERRACE
This hospital has 300 male beds and provided care and treatment for 334
patients during the year.
Eighteen patients were admitted direct from the community, an increase of
seven over the previous year. Twenty-three patients were received on transfer from
Valleyview Hospital. Three patients were discharged in full to the community, and
53 patients died.   The resident population at March 31st was 278.
Satisfactory medical service has been provided by a local physician on a part-
time basis. The services of the Mills Memorial Hospital are available for diagnostic
and surgical procedures.
The nurse to aide ratio improved during the year, and a satisfactory standard
of care was provided.
The Occupational Therapy Department has given good service to patients, and
many worth-while projects have been completed in the woodworking shop. A
suitable entertainment programme has developed through the efforts of the staff with
the aid of local volunteer groups.
Report for April 1 to December 31, 1968
VALLEYVIEW HOSPITAL, ESSONDALE
Due to the installation of a ventilating system on six wards, there was a loss
of 12 beds, so that the present establishment of beds is 779. Bed occupancy
has been maintained at a consistently high level. The need to use beds to the
maximum frequently presents a threat to elementary classification of patients and
to free movement of patients, requiring special acute treatment in wards allotted
for this purpose.
Applications for Admission
These are received from all areas of the Province, with the exception of
the Okanagan-Kootenays region and the Terrace-Prince Rupert area.
Since April 1, 1968, the number of applications for admission averaged 56
per month, an increase of six over the monthly average for the previous year.
This reverses the trend toward a reduction which appeared in the previous year
and indicates a resumption of the upward trend which has been evident over the
past five years.
Owing to the increased length of stay of female patients as compared with male
patients, the allotment of beds is two-thirds female and one-third male. The higher
proportion of females in the population is also now a more important factor.
The rapid increase in the number of applications demanded that some action
be taken to ensure that the more urgent cases be dealt with and, where necessary,
admitted without undue delay. For this reason, a community consultation service
was instituted in June, 1967, and became fully operative at the beginning of 1968.
This service is available to physicians in the Lower Mainland area. Approximately
80 per cent of admissions come from this geographic area.   During the period April
 IN-PATIENT SERVICES L 151
1st to December 31st an average of 48 patients per month has been seen. Of this
number, almost one-third were not considered in need of committal to a mental
health facility. The demand, however, continued to exceed the number of beds
available for admission, and a lengthy waiting list developed, especially over the
summer months.
The rate of admission is about the same as last year. Because of increasing
demand for beds, the lower age limit of 70 years has been applied. This has contributed to a consistent increase in the average age on admission. A lower limit of
65 years should be the objective to be kept in mind when planning for the future
needs of the mentally ill aged.
Discharges
Patients returning to the community from hospital may be discharged in full
or on a stated period of leave before final discharge. This latter arrangement
enables the patient to be returned to hospital without formality in the event of
further breakdown.
The number of patients discharged in the period from April 1 to December
31, 1968, shows a slight improvement on the figures for the same period of the
previous year. A breakdown of these figures is of some interest. Of 29 patients
discharged to self-care, relatives, or friends, all had adequate finances to meet care
costs. Of 56 patients discharged to boarding homes, rest homes, etc., 46 had
adequate funds to meet care costs. Of 22 patients discharged to private hospitals
or nursing homes, 19 had sufficient funds to meet care costs. Three patients were
discharged to extended-care facilities.
A limited programme of after-care is provided for patients who have returned
to the community. Of those patients who have left the hospital, about 15 per cent
will be readmitted in any one year. In some cases, however, factors other than
mental breakdown will dictate return to hospital, and some are soon discharged
again to a more suitable placement.
In the same period, 38 patients were transferred to Dellview Hospital,
Vernon.
DELLVIEW HOSPITAL, VERNON
From April 1 to December 31, 1968, the admission rate remains the same
as the previous year, at 10 per month. It is projected that 25 patients will be
returned to the community in nine months to December 31, 1968.
More than 40 patients are on leave in the community at any one time.
An improved ratio of trained nursing staff to aides has been maintained.
SKEENAVIEW HOSPITAL, TERRACE
In April a decision was made to seek alternative accommodation and eventually close this hospital. Following on this decision it was decided that patients
would not be transferred there from other units.
Five patients were transferred to Dellview Hospital, Vernon.
There are no facilities in the Terrace area to which patients may be discharged, and few patients return to that community.
Five patients were transferred to Valleyview Hospital for discharge to facilities in the Lower Mainland area.
 L 152 MENTAL HEALTH BRANCH REPORT,  1967/68
STATISTICAL TABLES—VALLEYVIEW HOSPITAL
Table 1.—Movement of Population, Valleyview Hospital, Essondale,
April 1, 1967, to March 31, 1968
Male
Female
Total
254
96
494
147
748
On extended leave, carried forward from 1966/67—
243
Other                             - -	
Total on books as at April 1, 1967	
350
641
991
Admissions—
158
31
5
210
29
10
368
60
15
Total admissions1   	
194
249
443
544
890
1,434
Separations—■
35
131
29
15
83
32
193
20
7
131
67
Died         .
324
49
22
On extended leave and still out—
214
Other  _	
293
383
676
—3
251
+ 13
507
+ 10
758
In residence, March 31, 1968  	
i Includes 12 male transfers and 7 female transfers from Riverview Hospital.
Table 2.—First Admissions to Valleyview Hospital, Essondale, by Health
Unit and School District of Residence and Sex, April 1, 1967, to
March 31, 1968.
Health Unit and School District
Male
Female
Total
Health Unit and School District
Male
Female
Total
East Kootenay, Cranbrook—
School District No. 18	
1
1
1
1
1
4
4
5
1
7
9
5
8
4
1
1
2
10
3
16
4
4
4
4
1
1
1
1
1
1
1
6
4
15
4
23
13
9
12
8
Metropolitan Board of Health of
Greater Vancouver—
School District No. 38	
4
77
9
9
4
1
20
1
1
1
4
3
1
1
1
4
123
13
16
9
4
3
1
6
1
2
5
1
1
1
8
School District No. 7 -
„   39	
200
South Okanagan, Kelowna—
School District No. 23	
„   41„...__	
„   44
22
25
North Okanagan, Vernon—
School District No. 19 	
 ,   22	
, 45	
Coast-Garibaldi, Powell River—
School District No. 46	
„         „   47	
9
8
3
George—■
School District No. 57	
Skeena, Prince Rupert—
School District No. 54	
1
Upper   Fraser   Valley,   Chilliwack—
School District No. 32  	
Peace River, Dawson Creek—
School District No. 59	
Greater   Victoria   Metropolitan
Board of Health-
School District No. 61...
1
„          „         „   33     	
„   34	
26
Boundary, Cloverdale—
School District No. 36
„   62 	
1
„   63	
1
„   37	
„   64	
3
Simon  Fraser,  New  Westminster—
School District No. 40.	
 43 	
Central Fraser, Mission—
School District No. 35	
„  42 -
„   75	
Central Vancouver Island, Nanaimo—■
School District No. 66	
 68	
„   69
1
5
5
„   70
Upper Island, Courtenay—
School District No. 71	
,.        »   72.
3
2
2
Totals ....	
189
239
428
 in-patient services
L 153
Table 3.—First Admissions and Readmissions to Valleyview Hospital,
Essondale, by Method of Admission, Age-group, and Sex, April 1,
1967, to March 31,1968.
Method of Admission
Age-group (Years)
60-69
70-79
80-89
90 and
Over
Grand
Total
M.
F.
M.
F.
M.
1
F.
M.
F.
M.
F.
First admissions
8
—
6
68
11
104
8
92
5
101
7
18
14
175
16
223
30
398
Totals. .
Sl 1 74
115
100|106
71  181189
?V>
428
Readmissions
1
	
2
1
2
4
1
2
1
1
~~1
2
3
~~;5
3
7
10
5
10
Totals....
1
	
3
6
	
3
1
15
Table 4.—First Admissions to Valleyview Hospital, Essondale, by Mental
Diagnosis, Age-group, and Sex, April 1, 1967, to March 31, 1968
Mental Diagnosis
Age-group (Years)
60-69
M.   F.
70-79
M.1F.
'I     i
80-89
M. F.
90 and
Over
M.   F.
Total
Grand
Total
M. F.
Schizophrenic disorders-
Manic-depressive reaction..
Paranoia and paranoid states-
Senile psychosis-
Psychosis with cerebral arteriosclerosis-
Alcoholic psychosis-
Psychosis of other demonstrable etiology..
Other and unspecified psychoses  —
Hysterical reaction.
Neurotic-depressive reaction..
Psychoneurosis with somatic symptoms affecting other symptoms..
Pathological personality. 	
Alcoholism ..
Other and unspecified character, behaviour, and intelligence disorders	
Chronic brain syndrome with behavioural reaction	
Chronic brain syndrome, N.O.S.	
Senility, N.O.S-
Observation without need for further care-
Totals..
74
115
18
189
239
9
10
10
9
28
1
3
4
2
17
1
12
8
7
146
5
152
4
428
Table 5.—First Admissions to Valleyview Hospital, Essondale, by Mental
Diagnosis, Marital Status, and Sex, April 1, 1967, to March 31, 1968
Table 6.—First Admissions to Valleyview Hospital, Essondale, by
Religion and Sex, April 1, 1967, to March 31, 1968
Detailed information for the above tables may be obtained on request.
 L 154
MENTAL HEALTH BRANCH REPORT,  1967/68
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 L 156
MENTAL HEALTH BRANCH REPORT,  1967/68
Table 9.—Live Discharges from and Deaths Occurring in Valleyview
Hospital, Essondale, by Mental Diagnosis, Age-group, and Sex, April
1, 1967, to March 31, 1968.
Age-group (Years)
Mental Diagnosis
Under
60
60-69
70-79
80-89
90 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Live Discharges
9
1
4
2
3
1
	
2
3
1
3
~ 1
3
1
1
1
2
1
1
6
2
2
5
2
1
3
2
4
1
3
1
7
4
1
4
3
6
1
1
2
1
3
3
	
1
1
16
4
4
2
~7
1
2
9
3
4
8
1
1
2
2
1
8
3
3
2
3
1
8
25
7
Paranoia and paranoid state _	
8
10
Presenile psychosis  -	
1
8
Alcoholic psychosis  	
1
4
2
1
1
1
3
3
2
2
6
2
2
2
1
6
1
4
2
1
3
15
3
6
1
1
1
14
1
7
Alcoholism - ,  _	
2
4
Other and unspecified character, behaviour, and intelligence disorders        	
5
18
—
1
1
	
4
Senility  	
14
1
Observation without need for further psychiatric care _
1
Totals  	
9|    4|    8|    I] 30| 25
291 241    2|    3[ 791 59
138
Deaths
1
4
21
~~1
1
10
1
1
4
2
1
24
1
19
1
6
6
4
1
1
41
~ii
3
2
1
12
11
1
2
1
45
42
2
1
4
3
1
1
6
12
3
3
2
17
18
1
4
1
2
74
1
67
4
.....
	
1
	
3
1
Paranoia and paranoid states.. „ 	
2
23
30
1
" 1
1
9
1
1
5
6
4
1
2
1
72
1
1
29
8
Psychoneurosis with somatic symptoms  affecting  diges-
1
3
2
Other and unspecified character, behaviour, and intelli-
1
146
1
Epilepsy                                             	
1
1
96
Total'
1
	
38
53
78
120
14
20
131
193
324
 IN-PATIENT SERVICES
L 157
Table 10.—Live Discharges from and Deaths Occuring in Valleyview
Hospital, Essondale, by Mental Diagnosis, Length of Stay, and Sex,
April 1, 1967, to March 31, 1968.
Detailed information for the above table may be obtained on request.
Table 11.—Deaths Occurring in Valleyview Hospital, Essondale, by
Cause of Death, Age-group, and Sex, April 1, 1967, to March 31, 1968
Age-group (Years)
Cause of Death
60-69
70-79
80-89
90 and
Over
Jrand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
1
1
1
3
11
29
2
7
57
4
18
83
2
8
1
1
1
1
~2
15
1
1
1
4
18
90
1
	
8
2
5
3
5
3
31
127
1
1
14
~1
9
1
9
3
	
9
25
49
	
217
1
1
	
	
1
5
1
3
~~6
1
3
2
1
8
6
1
22
2
1
1
14
Accidents - - -
4
Totfll*
1
38
53
78
120
14
20
131
193
324
Table 12.—Deaths Occurring in Valleyview Hospital, Essondale, by Cause
of Death, Length of Stay, and Sex, April 1, 1967, to March 31, 1968
Detailed information for the above table may be obtained on request.
 L 158
MENTAL HEALTH BRANCH REPORT,  1967/68
STATISTICAL TABLES—DELLVIEW HOSPITAL
Table 1.—Movement of Population, Dellview Hospital, Vernon,
April 1, 1967, to March 31, 1968
Male
Female
Total
89
5
126
14
215
On extended leave, carried forward from 1966/67—
19
Other                          - -	
Total on books as at April 1, 1967	
94
140
234
Admissions—
40
8
1
44
22
3
84
30
Readmissions to the same institution  —- — —
4
Total admissionsi_  	
49
69
118
Total under care  -	
143
209
352
Separations—
7
53
13
6
44
27
13
Died   	
97
On extended leave and still out—
40
Other       ..                                                    	
73
77
150
— 19
70
+6
132
— 13
In residence, March 31, 1968    -	
202
1 Includes 6 male transfers and 20 female transfers from other geriatric facilities, 1 female transfer from
Riverview Hospital.
Table 2.—First Admissions to Dellview Hospital, Vernon, by Health
Unit and School District of Residence and Sex, April 1, 1967, to
March 31, 1968.
Health Unit and School District
Male
Female
Total
Health Unit and School District
Male
Female
Total
East Kootenay, Cranbrook—
School District No. 1 	
„   2 	
2
3
2
1
1
4
3
4
5
1
1
1
7
4
1
1
1
2
2
2
1
4
3
4
1
8
5
3
3
4
4
2
1
1
4
5
1
8
8
1
5
1
1
15
9
3
1
Cariboo, Williams Lake—
School District No. 27	
Boundary, Cloverdale—
School District No. 36	
1
1
4
1
1
2
3
1
1
13
1
1
1
2
1
2
1
3
4
3
„   86	
Selkirk, Nelson—
School District No. 7	
Central Fraser, Mission—
School District No. 35 _	
Metropolitan Board of Health of
Greater Vancouver—
School District No. 38-	
, 39—.	
„   41......	
Coast-Garibaldi, Powell River—
School District No. 46 _	
Skeena, Prince Rupert—
School District No. 52
2
West Kootenay, Trail—
School District No. 9	
1
 11....	
„   12     	
„   13..-	
South Okanagan, Kelowna—
School District No. 14
17
1
1
„           „         „   15
1
„   16	
„   54..—	
1
„   23	
North Okanagan, Vernon—
Peace River, Dawson Creek—
School District No. 59
3
„   60—
1
„   21	
„   22-	
„           „         „   89
Greater   Victoria   Metropolitan
Board of Health-
School District No. 61 	
2
South Central, Kamloops—
School District No. 24	
„   31	
1
Totals	
48
66
114
 IN-PATIENT SERVICES
L 159
Table 3. — First Admissions and Readmissions to Dellview Hospital,
Vernon, by Method of Admission, Age-group, and Sex, April 1, 1967,
to March 31, 1968.
Method of Admission
Age-group (Years)
Total
60-69
70-79
80-89
90 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
First Admissions
3
1
3
18
18
25
36
2
8
48
1
65
1
Involuntary	
Readmissions
113
Totals.
3 |    4
18 | 18 | 25
36
2 |    8
48
66
114
Involuntary	
....
1
1
2
1
3
4
Table 4. — First Admissions and Readmissions to Dellview Hospital,
Vernon, by Mental Diagnosis, Age-group, and Sex, April 1, 1967, to
March 31, 1968.
Mental Diagnosis
Age-group (Years)
60-69
M.    F.
70-79
M.    F.
80-89
M.    F.
90 and
Over
M.    F,
Total
M.    F.
Grand
Total
First Admissions
Schizophrenic disorders	
Paranoia and paranoid states..
Senile psychosis..
Pre-senile psychosis _	
Psychosis with cerebral arteriosclerosis..
Pathological personality-
Other and unspecified character, behaviour,  and intelligence disorders.
Chronic brain syndrome with behavioural reaction..
Chronic brain syndrome, N.O.S	
Senility-
Diagnosis deferred	
Totals	
Readmissions
Chronic brain syndrome with behavioural reaction..
4 | 18
25
36
5
1
6
1
2
1
1
74
17
5
1
2 I    8
48 | 66 |    114
Table 5.—First Admissions to Dellview Hospital, Vernon, by Mental
Diagnosis, Marital Status, and Sex, April 1, 1967, to March 31, 1968
Table 6.—First Admissions to Dellview Hospital, Vernon, by Religion
and Sex, April 1, 1967, to March 31, 1968
Detailed information for the above tables may be obtained on request.
 L 160
MENTAL HEALTH BRANCH REPORT,  1967/68
Table 7.—Total Number of Patients on Books1 of Dellview Hospital,
Vernon, by Mental Diagnosis, Age-group, and Sex, December 31, 1967
Age-group (Years)
Mental Diagnosis
Under
60
60-64
65-69
70-74
n. 79    80 and
75 7y    Over
Grand
Total
M.1
F.
M.
F.
M.
F.
M.I
F.
M.
1
F.   M. F.
1
M.
F.
1
8
1
1
6
3
1
5
1
1
2
1
14
1
18
1
3
1
19
1
1
1
3
1
1
1
59
6
19
1
1
18
1
6
1
2
1
106
12
38
2
|
2
1
19
1
1
 1   2
 1-	
1
9
1
1
1
1
1
	
1
2
1
1
Other and unspecified character, behaviour, and
1
17
1
33
4
70
10
1
Chronic brain syndrome with behavioural re-
1
3
1
3
3
5
3
10
1
17
1
165
Chronic brain syndrome, N.O.S	
18
Totals 	
1
4
3
3
7
13
12
26
26
47
119
93
168
261
1 Of this total, 13 males and 24 females were in boarding homes at December 31, 1967.
Table 8. — Live Discharges from and Deaths Occurring in Dellview
Hospital, Vernon, by Mental Diagnosis, Age-group, and Sex, April 1,
1967, to March 31, 1968.
Age-group (Years)
Total
Mental Diagnosis
60-69
70-79
80-89
90 and
Over
Grand
Total
M.    F.
M.
F.
M.
F.
M.
F.
M.
F.
Live Discharges
—
1
3
1
2
1
3
2
-
6
1
5
1
11
1
1
Totals—  	
-1 1
4
3
3
2 I - 1 -
7
6
13
Deaths
2
1
2
1
7
5
3
3
1
18
13
17
11
5
1
7
2
32
19
28
16
2
60
Chronic brain syndrome, N.O.S  	
35
2
3
13
6
32
28
6
7
53
44
97
Table 9. — Live Discharges from and Deaths Occurring in Dellview
Hospital, Vernon, by Mental Diagnosis, Length of Stay, and Sex,
April 1, 1967, to March 31, 1968.
Detailed information for the above table may be obtained on request.
 IN-PATIENT SERVICES
L 161
Table 10.—Deaths Occurring in Dellview Hospital, Vernon, by Cause of
Death, Age-group, and Sex, April 1, 1967, to March 31, 1968
Age-group (Years)
1
Cause of Death
60-69
70-79
80-89
90 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
2
3
11
1
1
5
1
29
1
1
1
27
1
5
1
6
1
47
2
2
1
1
41
2
1
88
2
4
Influenza _	
1
1
- | -
1
Totals         .„                   	
2
3
13
6
32
28
6
7
53
44
97
Table 11.—Deaths Occurring in Dellview Hospital, Vernon, by Cause of
Death, Length of Stay, and Sex, April 1, 1967, to March 31, 1968
Detailed information for the above table may be obtained on request.
 L 162 MENTAL HEALTH BRANCH REPORT,  1967/68
STATISTICAL TABLES—SKEENAVIEW HOSPITAL
Table 1.—Movement of Population, Skeenaview Hospital,1 Terrace,
April 1, 1967, to March 31, 1968
In residence, April 1, 1967     293
Total on books as at April 1, 1967     293
Admissions—
First admissions to Mental Health Services       17
Readmissions to a different institution of Mental Health Services       23
Readmissions to the same institution         1
Total admissions 2       41
Total under care     334
Separations—
Discharged in full         3
Died       53
Transferred to other geriatric facilities  	
Transferred to psychiatric facility.	
Total separations       5 6
Net decrease  —15
In residence, March 31, 1968     278
i This institution cares for male patients only.
2 Includes 23 transfers from other geriatric facilities.
Table 2.—First Admissions to Skeenaview Hospital, Terrace, by Health
Unit and School District of Residence, April 1, 1967, to March 31, 1968
Health Unit and School District                       No. Health Unit and School District                       No.
North Okanagan, Vernon— Skeena, Prince Rupert—
School District No. 89  _ -    1 School District No. 50      1
Northern Interior, Prince George— „ ,, ,,    52      3
School District No. 57     5 „ „ „    54      1
Boundary, Cloverdale— ,, „ ,,    88      6
School District No. 36      2 Peace River, Dawson Creek—■
Simon Fraser, New Westminster— School District No. 59      1
School District No. 40 _    3 „ „ „    60-   —    1
Central Fraser, Mission— Greater Victoria Metropolitan Board of Health—
School District No. 42   _    1 School District No. 61       2
Metropolitan Board of Health of Greater Van- —
couver— Total- - - - — 40
School District No. 39    __ 11
„    41—     1
„    44 —      1
 in-patient services
L 163
Table 3. — First Admissions and Readmissions to Skeenaview Hospital,
Terrace, by Method of Admission and Age-group, April 1, 1967, to
March 31, 1968.
Age-group (Years)
Total
Method of Admission
60-69
70-79
80-89
90 and
Over
First Admissions
1
4
14
20
1
1
Involuntary
39
Totals                      	
5             14            20               1             40
Readmissions
Involuntary.	
-
1
....
1
Table 4.—First Admissions to Skeenaview Hospital, Terrace, by Mental
Diagnosis and Age-group, April 1, 1967, to March 31, 1968
Age-group (Years)
Total
Mental Diagnosis
60-69
70-79
80-89
90 and
Over
Schizophrenic disorders	
1
2
1
1
1
1
1
2
2
4
1
1
1
2
2
1
2
4
1
7
1
1
2
2
2
2
1
2
1
Other and unspecified character, behaviour, and intelligence dis-
3
6
3
Senility    	
13
3
Totals	
5
14
20
1
40
Table 5.—First Admissions to Skeenaview Hospital, Terrace, by Mental
Diagnosis and Marital Status, April 1, 1967, to March 31, 1968
Table 6.—First Admissions to Skeenaview Hospital, Terrace, by Religion,
April 1, 1967, to March 31, 1968
Detailed information for the above tables may be obtained on request.
 L 164
MENTAL HEALTH BRANCH REPORT,  1967/68
Table 7.—Total Number of Patients on Books of Skeenaview Hospital,
Terrace, by Mental Diagnosis and Age-group, December 31, 1967
Mental Diagnosis
Age-group (Years)
Total
Under
60
60-64
65-69
70-74
75-79
80 and
Over
8
2
1
13
1
2
7
31
1
2
2
1
1
1
1
3
1
2
25
1
3
1
1
2
1
2
5
2
36
1
10
3
1
1
2
2
3
2
7
8
1
1
33
4
1
16
8
1
1
12
10
3
12
Schizophrenic disorders— _	
146
7
1
26
16
Alcoholic psychosis	
Psychosis of other demonstrable etiology —
4
2
2
3
8
Mental deficiency - -	
Other and unspecified character, behaviour, and
6
4
Chronic brain syndrome with behavioural re-
21
27
5
Totals  	
11
16
51
43
79
90
290
Table 8. — Live Discharges from and Deaths Occurring in Skeenaview
Hospital, Terrace, by Mental Diagnosis and Age-group, April 1, 1967,
to March 31, 1968.
Mental Diagnosis
Age-group (Years)
Total
Under
60
60-69
70-79
80-89
90 and
Over
Live Discharges
1
1
1
—
77
1
1
Observation without need for further psychiatric care	
1
-      |        2
1
—
-
3
Deaths
Schizophrenic disorders — —	
1
1
1
1
1
5
3
1
1
3
7
1
3
1
1
9
10
i
i
i
14
1
2
4
1
Alcoholism      - -	
4
12
1
Senility _ -	
14
Totals   	
1
4
13
32
3
53
Table 9. — Live Discharges from and Deaths Occurring in Skeenaview
Hospital, Terrace, by Mental Diagnosis and Length of Stay, April 1,
1967, to March 31, 1968.
Detailed information for the above table may be obtained on request.
 IN-PATIENT services
L 165
Table 10.—Deaths Occurring in Skeenaview Hospital, Terrace, by Cause
of Death and Age-group, April 1, 1967, to March 31, 1968
Cause of Death
Age-
group (Years)
Total
Under
60
60-69
70-79
80-89
90 and
Over
1
3
1
2
2
4
1
2
2
3
6
14
1
1
6
1
1
1
1
5
10
22
2
1
Pneumonia  _	
9
1
1
2
Totals	
1
4
13
32
3
53
Table 11.—Deaths Occurring in Skeenaview Hospital, Terrace, by Cause
of Death and Length of Stay, April 1, 1967, to March 31, 1968
Detailed information for the above table may be obtained on request.
 L 166 MENTAL HEALTH BRANCH REPORT,  1967/68
BRITISH COLUMBIA YOUTH DEVELOPMENT CENTRE,
THE MAPLES
A. D. Sleigh, B.A., M.D., C.R.C.P., Executive Director
Report for April 1 to December 31, 1968
The British Columbia Youth Development Centre began functioning in June,
1968, and during that month I was appointed Executive Director. During this
time major organizational changes were made within the Youth Development
Centre to prepare the way for the expansion into a comprehensive treatment complex for children and adolescents of the Province. With the reorganization, the
complex was divided into three functional units—namely, the Children's and
Adolescents' Clinic (primarily doing out-patient work), the Psycho-education Unit,
and the Residential Unit. At the time of this writing the Children's and Adolescents' Unit (which had been up until now the Children's Clinic) and the Psycho-
education Unit are functioning, and preparations are being made to bring the Residential Treatment Unit into operation sometime in the spring of 1969.
I must stress that this is a major expansion, and the aim is to provide efficient
first-class treatment to emotionally disturbed children and adolescents from throughout the Province of British Columbia. This treatment unit should also be in a
position to give effective consultative services to therapists throughout the Province
and contribute to training and research in mental health work with children and
adolescents.
DIRECT SERVICES
Children's and Adolescents' Clinic
In the complete reorganization of this clinic there has been, as yet, little change
in the actual service given by the out-patient part of the British Columbia Youth
Development Centre. Over 300 children and adolescents are receiving active,
intensive therapy, and this involves many times that number of family members
as there is so often the need to involve the total family when one member of that
family is emotionally disturbed. The principal treatment method is the therapeutic
interview, but, of course, in working with children this is not always a verbal exchange but may involve play therapy, activity group therapy, special education and
learning techniques, family group therapy, and many other special techniques needed
to reach youth. Because our patients are in their formative years, all social influences on them are extremely important. Our clinic therapists are always actively
engaged in attempting to make the social environment of the patient more conducive
to him, or her, getting over the emotional or social difficulties, and spend many hours
in working with such people as teachers, Probation Officers, school counsellors, and
health nurses.
Medications and somatic treatment approaches do not play any great part in
our treatment approach. Of course, the latest medications and somatic therapies
are utilized, if indicated, and we have at our disposal special diagnostic equipment
such as the electroencephalogram and can utilize various psychological measuring
tests and devices.
Under the Children's and Adolescents' Clinic Director, Dr. Alan Cashmore,
we have a small day centre in operation. At the present time two therapists are
working full time in the day centre, and they have been dealing with two small groups
of young children. In the near future, however, we hope to expand this day centre
and bring in additional staff.
 IN-PATIENT SERVICES L 167
There is a small class for emotionally maladjusted children that come from
Burnaby area, and we have a co-operative enterprise going in which we are providing
the special professional staff needed to help with the treatment of these children.
The Burnaby School Board is providing a teacher. This is still in its beginning
phase, having commenced operation in September, but we would hope to see these
children materially aided by this special class.
Our centre has worked very hard with a large number of very disturbed
children. This seems to come about because many of these children were first in
treatment with other agencies or private psychiatrists, then, for practical or economic
reasons, they could no longer be handled by these people and were then referred to
us.   The results are naturally variable although basically encouraging.
Psycho-education Unit
This unit was formed in the fall of 1968 and is under the direction of Dr. D.
Shalman. Basically it consists of three psychologists and two teachers, who provide
a special treatment service to our unit and to therapists in mental health centres
throughout the Province. This treatment group concentrates on the school under-
achiever and the youngster with learning plus emotional problems, and are utilizing
special educational and psychological techniques to help such a patient.
In the months to come the Psycho-education Unit will extend its work into
assisting our residential and day-clinic teachers in their classroom activities and
will also be setting up special teaching groups of their own.
Residential Treatment Unit
This treatment unit is very much in the formative stage, and, at the time of
writing, the construction is still being completed, and the buildings will probably be
turned over to us in January, 1969. Recruitment of therapists for this area is just
beginning, and the main job is to recruit child-care counsellors. Dr. Lavelle,
Residential Treatment Unit Director, has been assisting in planning for the unit
since July, 1968, and he intends to have a modern active-treatment resource for 45
youngster who will need residential care and treatment and for 20 or more
youngsters who will need day-clinic treatment. Besides this comprehensive programme, he and his staff will be involved in the out-patient follow-up of these
youngsters and also in the functioning of other facilities, such as group-living homes,
special boarding homes, and the like. These latter facilities will probably not come
directly under our auspices, but there will have to be co-ordination with them in
some manner.
Children and adolescents with all manner of psychiatric and emotional disturbance will be admitted to this unit, and the principal people doing the therapy will
be the child-care counsellors directed and assisted by other professional staff such
as psychiatrists, psychologists, and social workers. The plan is to have an intensive-
care unit giving these youngsters the very latest in treatment modalities and avoiding
at all costs any tendency toward institutionalization. Work with the families of the
patients will again be stressed, and a close co-ordination and integration of our
service with that carried out by other agencies and therapists will have to be maintained.
A final remark should be made to the effect that the British Columbia Youth
Development Centre will be a co-ordinated treatment unit with the Children's and
Adolescents' Clinic, the Psycho-education Unit, and the Residential Unit (and day
care), working in close harmony for the welfare of the patient and his family.
 L 168 MENTAL HEALTH BRANCH REPORT,  1967/68
INDIRECT SERVICES
Therapists are involved in offering indirect service to helping groups, treatment
agencies, and mental health centres. Consultations are regularly given to a large
number of community agencies and therapists, which is all a part of our ongoing
everyday work. The area of indirect services always overlaps with training and
education functions and with our preventive services. Whenever staff are involved
in treating a patient, they are also involved in educating the community people they
come in contact with, such as school-teachers, counsellors, Probation Officers, social
workers, public health nurses, etc.
Many of our staff give lectures, seminars, and workshops to interested groups
and agencies in the community, and this needs to be considered part of our indirect
service.
TRAINING AND EDUCATION
The Youth Development Centre has been involved in the past year in many
training and educational activities. We welcomed outside groups that have any
helping function in relation to mental health to utilize our special facilities, such as
our auditorium, conference rooms, and group therapy rooms. We collaborated with
the Shalal Institute and the Y.M.C.A. in organizing a workshop by Dr. Yablonsky
on psychodrama, and also worked with them in putting on several group marathon
experiences for group psychotherapists from the general community.
Several of our staff have been instrumental in helping to establish a family
therapy institute in the Greater Vancouver area.
The psychologists from our unit established a twice-a-month lecture series for
all clinical phychologists from the Lower Mainland and presented a variety of topics
of vital clinical import. Our senior psychologists, too, were directly involved in a
summer internship programme for clinical psychologists and gave much-needed field
experience to training psychologists. This programme was worked out in collaboration with others from the Mental Health Services.
Several of our staff psychiatrists gave assistance to the Department of Psychiatry
at the University of British Columbia in regard to helping with examinations of
medical students, training of residents and medical students.
Our social-work staff, and indirectly all of our clinicians in the centre, continued
to play a vital part in assisting the School of Social Work, University of British Columbia, in its field placement programme for training social workers. These social
workers obtained direct experience in working with patients at our centre and are
closely supervised by our staff and university faculty. This collaborative effort seems
to work out very well both from our viewpoint and from the School of Social Work's
viewpoint.
The senior clinicians at the centre were often involved in giving orientation
lectures and tours of the British Columbia Youth Development Centre to public
health nurses, Probation Officers, school counsellors, and other professionals.
In summary, the staff are offering a great deal in the way of practical training
to professional groups and agencies working in the mental health field and are making a contribution that would be hard to duplicate.
RESEARCH
With the planning and development of the total British Columbia Youth Development Centre, there is a recognized need to increase the energies and time put into
research, but there is a realization that this research should be of a practical and
clinical nature.   Plans are being made at this time to do an ongoing evaluation of
 IN-PATIENT SERVICES L 169
all of our treatment programmes. We shall evaluate the various treatment methods
used and look very closely at our outcome studies. There is a general willingness
to have this ongoing evaluation of our work, and we see it as vital to keep searching
for better and more economical treatment methods.
Another area of study that is being planned is to compare our pattern of practice at this centre with psychiatric practice elsewhere in this community.
Many specific research tasks were completed during the year under review.
There was the study completed by several of our psychologists on the auditory discrimination test as used in the schools. The results they have obtained will be of
great practical value to the users of this test. There were also studies done on
modelling techniques and how they can be utilized to change behaviour, an examination of an adolescent group receiving treatment at the clinic with the therapist, and
the researcher looking for factors that bring about desired behavioural changes.
This work is still going on at the time of reporting. A final research project that
should be mentioned is the work being done by one of our sessional psychologists.
This person is utilizing a great deal of marathon group therapy and is conducting
a follow-up study on these groups to find out what kind of changes are effected in
individuals by a marathon experience, and whether or not these changes remain
permanent.
The intention of this Director is to see that further vital clinical research is
carried out as the new unit takes shape.
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1969
580-1268-81
       

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