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Mental Health Services Branch PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT FOR TWELVE MONTHS ENDED MARCH… British Columbia. Legislative Assembly 1965

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 DEPARTMENT OF HEALTH SERVICES
AND HOSPITAL INSURANCE
Mental Health Services Branch
PROVINCE OF BRITISH COLUMBIA
ANNUAL REPORT
FOR TWELVE MONTHS ENDED
MARCH 31
1964
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1965
  To Major-General the Honourable George Randolph Pearkes,
V.C., P.C., C.B., D.S.O., M.C.,
Lieutenant-Governor of the Province of British Columbia.
May it please Your Honour:
The undersigned respectfully submits the Annual Report of the Mental Health
Services Branch, Department of Health Services and Hospital Insurance, for the
year ended March 31, 1964.
ERIC MARTIN,
Minister of Health Services and Hospital Insurance.
Office of the Minister of Health Services and Hospital Insurance,
Victoria, B.C., December IS, 1964.
	
 Department of Health Services and Hospital Insurance,
Mental Health Services Branch,
Vancouver, B.C., December 14, 1964.
The Honourable Eric Martin,
Minister of Health Services and Hospital Insurance,
Victoria, B.C.
Sot,—I have the honour to submit the Annual Report of the Mental Health
Services Branch for the twelve months ended March 31, 1964.
A. E. DAVIDSON, B.A., M.D., F.A.P.A.,
Deputy Minister of Mental Health Services.
 Closing of the doors, Provincial Mental Home, Colquitz, lanuary 29, 1964. The
Honourable Eric Martin, Minister of Health Services and Hospital Insurance; the Honourable W. N. Chant, Minister of Public Works; Dr. L. G. C. d'Easum, Medical Superintendent; Dr. A. E. Davidson, Deputy Minister of Mental Health Services; and staff
members participated.
  TABLE OF CONTENTS
PART I.—GENERAL ADMINISTRATION
Page
Report—Director of Mental Health Services  9
Report—Business Manager  19
Report—Personnel Officer  36
Report—Supervisor of Psychiatric Social Work  41
Report—Director of Nursing Services  46
Report—Medical Records and Statistics  49
PART H.—CREASE CLINIC OF PSYCHOLOGICAL MEDICINE
AND PROVINCIAL MENTAL HOSPITAL
Report—Medical Superintendent 51
Statistical Tables—Crease Clinic    73
Statistical Tables—Provincial Mental Hospital 83
PART m.—THE WOODLANDS SCHOOL
Report—Medical Superintendent 96
Statistical Tables—The Woodlands School 100
PART IV.—THE TRANQUILLE SCHOOL
Report—Medical Superintendents 106
Statistical Tables—The Tranquille School___ 111
PART V—PROVINCIAL MENTAL HOME
Report—Medical Superintendent 112
Statistical Tables—Provincial Mental Home 114
PART VI.—GERIATRIC DIVISION
Report—Medical -Superintendent  116
Statistical Tables—Valleyview Hospital, Essondale  122
Statistical Tables—Dellview Hospital, Vernon   128
Statistical Tables—Skeenaview Hospital, Terrace.  132
PART Vn.—COMMUNITY MENTAL HEALTH SERVICES
Report—Director of Mental Health Centre, Burnaby 136
Report—Director of Mental Health Centre, Victoria  149
Report—Director of Mental Health Centre, Kelowna —— 152
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Nursing Educati
 Report of Mental Health Services Branch
For the Twelve Months Ended March 31,  1964
PART I.—GENERAL ADMINISTRATION
REPORT OF DIRECTOR OF MENTAL HEALTH SERVICES
A. E. Davidson, M.D., Deputy Minister of Mental Health Services
and Director of Mental Health Services
The Mental Health Services Branch continues to provide a variety of services
to mentally ill people of the Province through the various mental hospitals, schools
for retarded, and mental health clinics. The work of these units is supervised and
co-ordinated through the Deputy Minister's office, located at 828 West 10th Avenue,
Vancouver.
The personnel of this office was augmented this year by the appointment of
Dr. F. G. Tucker to the position of Deputy Director of Mental Health Services.
Dr. Tucker has been employed in the Mental Health Services Branch since 1952.
He is certified in the specialty of psychiatry by the Royal College of Physicians and
Surgeons of Canada. He has also taken further training in admioistrative psychiatry
at Columbia University in New York. He will report to the Deputy Minister and
Director of Mental Health Services and will be responsible for the supervision of
the operations of the Crease Clinic, Provincial Mental Hospital, schools for retarded,
and the geriatric facilities. In addition, the Mental Health Centre in Burnaby and
the Department of Nursing Education will be reporting to the Deputy Director.
This reorganization of the Branch office will result in an improvement in the efficiency of operations and will provide the opportunity to offer more in the way of
supervision and direct services to the units.
During the year a complete study has been made of mental health legislation
in the Province, with a view to providing recommendations for changes which would
encompass the most recent advances in psychiatric and mental health concepts. A
oew Mental Health Act was passed at the session of the Legislature in the spring of
1964. This Act consolidates all the features of five Acts dealing with mental health
—namely, Clinics of Psychological Medicine Act, Mental Hospitals Act, Schools
for Mental Defectives Act, Provincial Child Guidance Climes Act, and Provincial
Mental Health Centres Act.
Procedures for admission are modified to emphasize the medical reasons for
the admission of a patient to hospital. Admissions to hospitals under this Act may
be made either on an informal basis or on an involuntary basis, depending upon the
particular circumstances of the patient whose admission is being sought.
Features of the Act are provided to encourage the development of locally
operated mental health services. Provision is made to enable mental health societies
to be formed, which may be authorized to undertake to operate a mental health
service or a part of such service. This provision will also allow the opportunity of
establishing and developing new services under the terms of this new legislation.
This Act will come into force upon proclamation.
 F 10
MENTAL HEALTH SERVICES REPORT, 1963/64
At the present time an extensive and active programme of construction of new
mental health facilities is in the planning stage.
Property has been purchased adjacent to the grounds of the Jubilee Hospital
in Victoria. A new mental health facility is being planned for this site, which will
provide accommodation for comprehensive mental health care both on an in-patient
and an out-patient basis. Plans are being made for the renovation of the apartment
house on this site to provide temporary expanded accommodation for the Mental
Health Centre, Victoria. This will enable the expansion of this service pending the
planning and construction of the new facilities on this site.
The Deerholme Building at Tranquille is being renovated to enable the school
to care for 70 more patients. A new 100-bed unit is being planned for The Tranquille School to provide increased accommodation for retarded children requiring
institutional care. At the same time a site has been chosen in the Royal Oak area
for the locating of an entirely new school for mentally retarded, to accommodate
initially up to 400.   The planning for this unit is proceeding.
STATISTICAL COMMENTS
Examination of the accompanying tables will show a steady increase in the
number of patients seeking help from the divisions of the Mental Health Services.
During the year 4,569 patients were admitted to the in-patient units of this service.
This represents the highest number of admissions to the service in its history. Actually there were 321 more patients admitted during 1963/64 than during the fiscal
year 1962/63. In spite of the increase in admissions, the number of separations
from the services remained very high. This has resulted in a net increase of 31 in
the total resident population throughout the service. The increase in total resident
population during this past year is mainly the result of the increased number of
admissions to the schools for the mentally retarded. The increase of service to the
people is indicated by the extremely high number of patients who have received care
and services throughout our various units. During the year 11,711 patients have
been cared for and received services in the various units of the Branch. This represents a very marked increase in the amount of care and service being provided to
the mentally ill of this Province.
Table 1.—Showing Patients in Residence in the Various Institutions of the Provincial Mental Health Services, April 1,1963, and March 31,1964, Together with
Increase or Decrease.
Institution
In Residence, Apr
1,1963
In Residence, Mar
31,1964
Increase (+)
Men
Women
Total
Men
Women
Total
Decrease (—)
91
1,484
149
706
275
252
106
295
127
1,256
582
143
477
127
218
2,740
149
1,288
418
729
233
295
104
1,552
716
311
277
106
288
142
1,254
600
158
464
129
246
2,806
1.316
469
741
235
288
+28
+66
Mental Home, Tnlqnit*
The Woodland* Rrfiool
-149
+28
+51
Vallewiew Hospital, Kssondal...
Dellview Hospital, Vftrrmn
+ 12
+2
—7
Totals
3,358
2,712
6,070
3,354
2,747
6,101
+31
 GENERAL ADMINISTRATION
F 11
Table 2.—Showing in Summary the Admissions and Population Increase of the
Mental Health Services Branch for the 10-year Period April 1, 1954, to
March 31, 1964.
Year
Total
Admissions
Admissions
65 Years
and Over
Admissions
15 Years
and Under
Voluntary
Admissions
Population
Increase
Index of
Increase
1954/55
2,492
2,855
2,270
2,936
2,993
3,296
3,924
4,193
4,248
4.569
348
392
385
442
425
506
580
557
554
550
71
58
57
106
135
182
254
200
213
243
884
1,153
1,083
1,012
1,118
1,316
1,695
2,023
2,086
88
26
3.53
0.91
1957/58
38                   1.29
1959/60
1960/61
1961/62
1962/63
1061/64
20                 0.61
42                 1.07
—156             —3.72
—63               -1.48
31        I          068
Totals.
33,776
4,739
1,519
14,557        I       —142
1                         1
The psychotic and psychoneurotic cases have been admitted either to the Crease
Clinic or the Provincial Mental Hospital, Essondale. The total admissions to these
two institutions for the year was 3,999. Of these, 1,609 were admitted to the Crease
Clinic and 2,390 to the Provincial Mental Hospital. In the previous year 3,717 were
admitted to these two units. There was, therefore, an increase of 282 admissions
over the previous year.
Of the total number of patients admitted to these two institutions, over 50 per
cent were admitted on a voluntary basis. A total of 2,187 patients was admitted
at their own request. This is a desirable trend, which has been encouraged by the
improvement of treatment services which are available in these hospitals.
While there has been an increase in the number of patients seeking care in the
mental health facilities, the type and variety of services have also been steadily increasing. This results in a heavy demand on the staff, which has been met efficiently. The resident population of the Provincial Mental Hospital, Essondale, has
increased from 2,740 on April 1,1963, to 2,806 on March 31, 1964. This increase
of 66 is largely accounted for by the transfer of patients from the Provincial Mental
Home, Colquitz, to the Provincial Mental Hospital. Taking into account the transfer
of the group of patients from Colquitz, there is actually a decrease in the number
of patients in the psychiatric division. At the beginning of the year 3,107 patients
were in the three units of the psychiatric division, whereas at the end of the year
3,052 patients were in residence.
During the year 23 5 patients were admitted to The Woodlands School. Patients
are not, as yet, admitted to The Tranquille School. Patients are transferred from
The Woodlands School to Tranquille after they have received complete assessment
and after any active care or treatment which may be deemed necessary has been
provided. At the beginning of the year 1,706 patients were in residence in these
two units. As at the end of the year 1,785 patients were in residence. This means
a total increase of 79 in residence in these two areas.
The 30-day admission programme has continued to function effectively during
this past year. The admission of patients to this programme is more active during
the summer months, when a considerable number of residents in each school are
able to be home for a short holiday. An opportunity is provided for assessment of
the patients admitted in this manner, and it is also possible to offer consultative help
to the families of these children.
 F 12 MENTAL HEALTH SERVICES REPORT, 1963/64
The three units of the Geriatric Division have continued to provide services to
a large number of aged patients suffering from mental symptomatology. Three
hundred and thirty-three patients were admitted to these units during the fiscal year.
On April 1, 1963, there were 1,257 patients in residence in these three units, whereas
on March 31,1964,1,264 patients were in residence. There continue to be numerous requests for admission, but it has been possible to provide a variety of services
to the patients requesting such admission.
The Community Services Division functioned from three areas during the past
year. These clinics are centred in the Mental Health Centres in Burnaby, Victoria,
and Kelowna. Each clinic provides services to the immediate community and also
to the more remote areas via the travelling clinic. Altogether in these three units
a total of 1,438 patients was seen for assessment and diagnosis. Of this group, 874
were adults and 564 were children. Of the total number seen for assessment 448
adults and 280 children entered into an active treatment programme, a total of 728
thus receiving treatment.
MAJOR EVENTS AND TRENDS
One of the important achievements of this year has been the closure of the
Provincial Mental Home at Colquitz. This was accomplished in January of 1964.
The building at Colquitz was built as a Provincial gaol in 1913. It was transferred
to the Provincial Mental Health Services in 1919 to be operated as a mental hospital.
It was originally organized to provide care for the " nominally insane." It provided
accommodation for the care of approximately 300 patients. Over the years the
nature of the patients cared for in this institution has gradually changed. Originally
the more disturbed patients and those with criminal propensity were transferred to
this facility, but in recent years more chronically regressed patients have been admitted. Plans were instituted in 1962 to close out the operation at Colquitz. Transfers to this institution were discontinued, and a plan to regularly move small groups
of patients from Colquitz to the institutions on the Mainland was instituted. The
majority of these patients were transferred to the Provincial Mental Hospital at Essondale. This plan proceeded steadily, and the last group" of patients was transferred
from the Provincial Mental Home on January 29th. As the building was originally
designed for a gaol, it did not provide suitable accommodation for the provision of
a modern active-treatment programme. The building was formally closed by the
Minister of Health Services and Hospital Insurance in a brief ceremony on January
29th, when it was transferred to the Public Works Department.
An active rehabilitation service has been organized in the in-patient units. This
service is being provided to all patients, but in particular to patients who have been
in hospital for many years. In the mental hospital each patient is thoroughly
assessed with a view to placement in some suitable area of training which will help
to prepare him for return to the community. The various working areas throughout
the hospital are organized to provide suitable placements for these patients to assist
them in obtaining experience and training which will be of value to them in their
rehabilitation following discharge from hospital. There has been a considerable
increase in this service during this past year.
The after-care services associated with the rehabilitation programme have
shown a steady increase. This service, originally centred in Venture, was transferred
to the Mental Health Centre in Burnaby this year. The facilities in Burnaby are
much more suitable, and many additional services can be provided for the patient
in after-care. At the end of March, 1964,1,168 patients were registered in the aftercare programme.
 GENERAL ADMINISTRATION F 13
Another valuable service in connection with rehabilitation is the boarding-home
care programme. It is operated in liaison with the Social Welfare Department and
provides for the placement of patients outside hospital in supervised homes. Patients
from the Provincial Mental Hospital, The Woodlands School, and Valleyview Hospital have been placed. During the year 288 patients were placed in such boarding
homes. This service makes possible the earlier discharge of many patients, and in
this way does assist in freeing valuable accommodation for those requiring active
hospital care.
With the appointment of a Medical Superintendent and a Superintendent of
Nurses at The Tranquille School, it has been possible to proceed with the opening
of the Greaves Building to provide care for a group of severely mentally retarded
patients with multiple handicaps. Accommodation for 100 patients was provided
in this area. This building was occupied by arranging for transfers of mentally retarded patients from The Woodlands School to Tranquille. As a result, further accommodation at The Woodlands School was provided for the admission of mentally
retarded from the community.
During the year extensive renovations were made in the buildings designated
as Valleyview 1, 2, and 3 at Valleyview Hospital. As a result of the redistribution
of patients in the hospital, it was possible to reallocate all patients occupying basement areas. Additional bed accommodation has been made available for the admission of more geriatric patients from the community.
The report of the Mental Health Centre in Kelowna provides information relative to the first full year's operation of the clinic in the Okanagan region. Prior to
the development of this centre, all psychiatric services were located in the Lower
Mainland in the major cities of Vancouver and Victoria. This new development
represents a trend, therefore, in the provision of services in an increasing amount in
other areas of the Province. The psychiatrist in such a centre has the responsibility
for conducting the affairs of the Mental Health Centre and also has the privilege of
conducting a limited amount of psychiatric practice on a private basis. The presence
of a psychiatrist in Kelowna has made it possible to develop a psychiatric ward in
the general hospital. In this way it has been possible to bring to this area the same
types of psychiatric services which are available in the more concentrated communities. The development of the Okanagan region sets a pattern for the bringing of
similar services to other areas of the Province. Planning is proceeding for the development of services for the Central Vancouver Island area to be centred in
Nanaimo and for the Kootenay area to be centred in Trail. These centres should
be opened during the next fiscal year.
GENERAL COMMENTS
The annual graduation exercises for the Department of Nursing Education
were held this year in the Vincent Massey Junior High School, New Westminster,
on the evening of April 24, 1963. One hundred and six student psychiatric nurses
received diplomas. This total consisted of 72 women and 34 men. The graduating
class was addressed by Dr. Joseph Lagey, director of research, community Chest
and Council of the Greater Vancouver area. The greetings and congratulations
of the Government were conveyed to the graduating class by the Honourable Eric
Martin, Minister of Health Services and Hospital Insurance.
The 1963 annual meeting of the Council of Psychiatric Nurses was held on
April 25, 1963. The Council of Psychiatric Nurses has established a bursary to
be known as the Dr. A. M. Gee Travelling Bursary.    This bursary is offered to
 F 14 MENTAL HEALTH SERVICES REPORT, 1963/64
assist a psychiatric nurse in obtaining more advanced information in the field of
psychiatric nursing by a planned visit to another treatment centre. The first bursary
was awarded to Mr. R. T. Franklin, psychiatric nurse presently employed at Valleyview Hospital. Arrangements were made to have Mr. Franklin visit at the Neuro-
psychiatric Institute at the University of California in Los Angeles for a period of
one month. This visit was arranged for October, 1963. The training experience
resulting from this first Dr. A. M. Gee Travelling Bursary has been reported to be
extremely profitable and rewarding.
The Mental Health Services Branch continues to participate in the in-service
training programme for senior school counsellors which is conducted under the
auspices of the Vancouver School Board. Financial assistance for this programme
is provided through a Mental Health Grant. During the school-year 1963/64 nine
senior teachers from Vancouver, North Vancouver, and Richmond participated in
this programme.
The Canadian Mental Health Association and the Association for Retarded
Children of British Columbia continue to co-operate very effectively with various
units of the Mental Health Services Branch. Many very useful services are provided by these two organizations on a voluntary basis. The effect of this participation is to stimulate the interest and the concern which the general community has
in regard to the operation of the various units of the Mental Health Services. The
contribution which these two voluntary organizations make is sincerely appreciated.
The general public appears to be particularly interested in the work and
services offered by the units of the Mental Health Services. This is evidenced by
the great number of persons who visit the hospitals and schools throughout the
services. During the course of the past year many persons have visited either
singly or in groups for the purpose of seeing actually what type of services is being
provided. This is of great value both to the visitors and to the various units of the
Branch.
During the year the following changes in senior administrative staff occurred:
Dr. F. G. Tucker appointed to the position of Deputy Director of Mental Health
Services; Dr. T. G. Caunt, Medical Superintendent of the Crease Clinic and Provincial Mental Hospital, retired on superannuation; Dr. B. F. Bryson appointed
to the position of Medical Superintendent of the Crease Clinic and Provincial Mental
Hospital Dr. J. Walsh appointed to the position of Medical Superintendent of
Valleyview Hospital; Dr. P. Middleton appointed to the position of Qinical
Director of the Crease Clinic and Provincial Mental Hospital, Essondale; Dr. L. A.
Kerwood, Medical Superintendent, The Woodlands School, resigned; Dr. W. W.
Laughland, Deputy Medical Superintendent of The Woodlands School, resigned;
Dr. R. G. Foulkes appointed to the position of Deputy Medical Superintendent of
The Woodlands School; Dr. A. J. Bennee appointed to the position of Medical
Superintendent of The Tranquille School; Dr. J. Boulding, Deputy Medical Superintendent, Provincial Mental Hospital, resigned.
MENTAL HEALTH GRANT
The Government of Canada, through the Department of National Health and
Welfare, made available to British Columbia a Mental Health Grant " to assist in
an extended programme for the prevention and treatment of mental illness, including
rehabilitation and free treatment." This was the 16th consecutive year that the
Mental Health Grant as described was available.
The Mental Health Grant provided for 1963/64 was $784,923. Project submissions totalling $628,217.58 were made to and approved by the Department of
 GENERAL ADMINISTRATION
F 15
National Health and Welfare. By the end of the fiscal year the Province had received
reimbursement in the sum of $581,386.77 for expenditures made on account of
approved Mental Health Grant projects. The details of the expenditures are provided in tabular form in the Business Manager's report at page 35.
Twenty projects received support from the Mental Health Grant in 1963/64.
Seven of these supported professional staff employed in the programme of the Mental
Health Services Branch and, among other developments, made possible the expansion
of community mental health centres to Central Vancouver Island and the Kootenay
region. There was also provision for expansion of service in the Okanagan Mental
Health Centre.
A project to assist the Department of Psychiatry, University of British Columbia, was continued. The purpose of this project is to support in part the postgraduate training of physicians in the specialty of psychiatry in order that they may be
available upon completion of their training to expand the public psychiatric services
and teaching facilities of the Province.
Mental health programmes for the Metropolitan Health Committees of Victoria
and Vancouver were assisted by grants to make available professional psychiatric
staff and clerical staff for their clinics.
The School of Social Work, University of British Columbia, was aided by a
grant which provided the salary of a student field-work placement supervisor.
Professional training under the grant was provided to a number of social
workers who are enrolled in the School of Social Work at the University of British
Columbia and to one clinical psychologist who is pursuing advanced studies at the
University of Ottawa.
The research projects at the University Departments of Psychiatry and of
Pharmacology continue to be important efforts, and they have again been sustained
largely by Mental Health Grant funds combined with a Provincial grant-in-aid.
COMPARATIVE SUMMARY OF INCREASES AND DECREASES IN RESIDENT POPULATION BY MAJOR DD7ISIONS OF MENTAL HEALTH
SERVICES BRANCH, 1954/55 TO 1963/64.
Fiscal Year
Provincial
Mental
Hospitals
Schools for
Mental
Defectives
Geriatric
Division
Crease
Clinic
Total
1954/55
+44
+2
—70
-49
-135
—253
-71
—247
-100
—83
+19
+19
+14
+76
+86
+93
4-75
+25
—10
—31
+26
—11
+24
-21
+M
—37
+28
+88
1955/56
1956/57
+1S
+9
-15
—30
+ 156
4-59
+26
—78
1957/58
1958/59
+38
—90
1959/60
1960/61
+20
+42
1961 fR>
+73     I           +7
4-62               +12
—156
1967/63
—63
1063/64
+79
+7
+31
 F 16
MENTAL HEALTH SERVICES REPORT, 1963/64
COMPARATIVE SUMMARY OF TOTAL PATIENTS UNDER CARE FOR
MAJOR DIVISIONS OF MENTAL HEALTH SERVICES BRANCH BY
FISCAL YEARS, 1954/55 TO 1963/64.
Provincial
Mental
Hospitals
Schools for
Mental
Defectives
Geriatric
Division
Crease
-.Clinic
1954/55_
1955/56-
1956/57-
1957/58-.
1958/59-
1959/60-
1960/61...
1961/62_
1962/63...
1963/64...
5,051
5,247
5,335
5,408
5,377
5,458
5,530
5,803
5,853
6,099
1,263
1,278
1,275
1,373
1,481
1,740
1,868
1,960
2,023
2,042
1,292
1,330
1,287
1,349
1,373
1,459
1,587
1,642
1,677
1,738
1,606
1,894
1,721
1,714
1,744
1,705
1,846
1,876
1,912
1,832
9,212
9,749
9,618
9,844
9,975
10,362
10,831
11,281
11,465
11,711
MOVEMENT OF POPULATION OF MENTAL HEALTH SERVICES,
APRIL 1, 1963, TO MARCH 31, 1964
Psychiatric
Division
Schools for Mental Defectives
Geriatric
Division
Total
M.
F.
T.
M.
F.      T.
1
M.
F.
T.
M.
F.
T.
T_ resirtMif-., April 1, 1963
On probation, carried forward from
1967.61
On escape, carried forward from
1067/63
1,724
189
4
1,383
448
1
3,107
637
5
981
15
725
10
1,706
25
653
22
604
22
1,257
44
3,358
226
4
2,712
480
1
6,070
706
5
Total as at April 1,1963
1,9171 1,832| 3,749
996
735| 1,731
675
626
1,301
3,588
3,193)  6-781
Admissions-
First admissions to Mental Health
Services
Readmissions to different institutions    _—_—	
Readmissions to same institution.
1,052
156
808
989| 2,041
2181   374
776|1,584
65
6
61
50
55
115
6
116
171
7
2
148
4
1
319
11
3
1,288
169
871
1,187
222
832
2,475
391
1,703
Total admissions	
Transfers in
2,0161 1,98313,999
155      28     183
132
49
105,|   237
25      74
180
94
1531   333
10|   104
2,328
298
2,241
63
4,569
361
Total admissions to individual Institution
2,171
2,011 4,182
181
130
311
274
163)   437
2,626
2,304
4,930
Total under care
4,088| 3,843| 7,931
1,177
865| 2,042
949
789] 1,738
5,916[ 5,434| 11,3501
Separations—
T_s_-harf»_._1 in full
1,875
93
226
4
1,937
62
411
3,812
155
637
4
81
9
14
63
11
10
144
20
24
15
211
34
15
141
37
30
352
71
1,971
313
274
4
2,015
214
458
3,986
527
On probation but not discharged	
Escaped but not discharged
732
4
Total separations
TrpnsferS oi_t
2,198
234
2,410
37
4,608
271
104
46
841    188
23|     69
260
18
1931   453
3      21
2,562
298
2,687.1  5,249
63 j     361
Total separations from individual institution
2,432
2,447
4,879
150
107    257
278
196
474
2,86012,750|  5,610
Net increase or decrease
_68| +13| —55
+461 +331 +79
+ 18
-11|    +7
-4| +35|    +31
Tn residence, March 31, 1064
1,65611,39613,052
1         j
1,027
75811,785
671
593:11,264
3,354
2,747
6,101
i Total under care for all Mental Health Services includes total as at April 1, 1963, plus the total admissions
to individual institutions minus transfers out.
 GENERAL ADMINISTRATION
F 17
MOVEMENT OF POPULATION IN INDIVIDUAL INSTITUTIONS,
APRIL 1, 1963, TO MARCH 31, 1964
Psychiatric Division
Provincial Mental Hospitals
Crease Clinic
Essondale
Colquitz
Total
M.         F.
T.
M.
F.
T.
M.
M.
F.
T.
91
127       218
1,484
189
3
1
1,256    2,740
448 1    637
1
1 |        4
1,724
189
4
1,383
448
1
3,107
On  probation,  carried  forward
1
On escape, carried forward from
1067/63
5
Total as at April 1,1963
91 |     127 |     218
1,676 | 1,705 | 3,381 |     150
1,917 | 1.832 | 3,749
Admissions—
First   admissions   to   Mental
491
21
230
I
580     1,071
38 1      59
249 |    479
561
135
578
1
1
409 |    970
1
180 |     315
1
527 | 1,105
	
1,052
156
808
989
218
776
Readmissions to different in-
374
Readmisslons   to   same   insti-
1,584
Total admissions-
Transfers In
742
3
867 | 1,609
2|        5
1,274
152
1,116 | 2,390
26 |    178
	
2,016
155
1,983
28
3,999
183
Total admissions to individual institution—
745
1
869 1 1,614
1
1,426 | 1,142 | 2,568
	
2,171
2,011 1 4,182
Total under care	
836 |     996 | 1,832
3,102 | 2,847 | 5,949 |    150
4,088 | 3,843 | 7,931
Separations—
Discharged in full
696
3
828
3
1,524
6
1                          1
1,178 | 1,109 | 2,287           1
90 '      59        149 1   	
1            1
226       411       637     	
4 1            1        4 j
I
1,875 i 1,937
93 1      62
226 1    411
4 |   	
3,812
155
On   probation  but   not   discharged
Escaped but not discharged—
637
4
Total separations	
699
33
831
23
1,530
56
1,498 | 1,579 | 3,077
52 |       14 j      66
1
149
2,198 I 2,410
234 1      37
4,608
271
Total separations from
individual institution	
732
!
854 | 1,586
1
1,550 | 1,593 | 3,143
150
2,432 | 2,447
4,879
+ 13 |   +15 |   +28
+68 |     —2 |   +66 | —149
—68 |   +13 |   —55
In residence, March 31,1964-
104 1     142
246
1,552 | 1,254 1 2,806
1,656 I 1,396 1 3,052
1            1
 F 18
MENTAL HEALTH SERVICES REPORT, 1963/64
MOVEMENT OF POPULATION IN INDIVIDUAL INSTITUTIONS,
APRIL 1, 1963, TO MARCH 31, 1964—Continued
Schools for Mental Defectives
The Woodlands School,
New Westminster
The Tranquille School,
Tranquille
Total
M.
a
T.
M.
F.
T.
M.
R
S
In residence, April 1.1963
On  probation,  carried forward  from
1967763
706
14
582
10
1,288
24
275
1
143
418
1
981
15
725
10
1,706
25
Total as at April 1,1963	
720
592 | 1,312
276
143
419
996
735
1,731
Admissions—
First  admissions to  Mental Health
Services	
Readmissions to different institutions _.
Readmissions to same institution	
65
5
61
7
50
55
105
6
115
5
116
236
13
1
	
1
65
6
61
50
*~ 55
H5
6
116
1
42
19
1
61
132
49
105
25
74
Total admissions to individual
138
858
111
249
43
19
62
181
130
Total under care
703 '| 1,561
319
162
481
1,177
865
2,042
Separations—
80
7
13
63
11
10
143
18
23
1
2
1
	
1
2
1
81
9
14
63
11
10
144
20
On probation but not discharged	
24
100
42
84
19
184
61
4
~
4
8
104
46
84
23
188
69
Total separations from individual institution
142
103
245
8
4
12
150
107
257
+10
716
4-18 1    -1-28
+36
+15
+51
+46
+33
+79
600
In residence, March 31,1964	
1,316
311
158
469
1,027
758
1,785
Geriatric Division
Valleyview Hospital,
Essondale
Dell.
iew Hospital,
Vernon
Skeena-
view
Hospital,
Terrace
Total
M.
F.
T.
M.
F.
T.
M.
M.
F.
T.
1
In residence, April 1,1963	
On probation, carried forward
252
18
477
18
729
36
106
3
127
4
233
7
295
1
653
22
604
22
1,257
44
Total as at AprU 1,1963
270
495
765
109
131
240
296
675
626
1,301
Admissions—
First  admissions  to  Mental
121
6
2
127
3
1
248
9
3
41
21
1
62
1
9
1
171
7
2
148
4
1
319
Readmissions to different institutions
Readmissions to same institution
11
3
Total admissions	
Transfers Ij,
129
59
131
10
260
69
41
2
22
63
2
10
33
180
94
153
10
333
104
Total admissions to individual institutions-
188
141
329
43
22
65
43
274
163
437
Total under care
458
636
1,094
152
153
305
339
949
789
1,738
Separations—
10
123
33
8
126
35
18
249
68
3
40
1
7
15
2
10
55
3
2
48
15
211
34
15
141
37
30
352
On probation but not discharged
71
Total separations	
TransffTs rmf
166
15
169
3
335
18
44
2
24
68
2
50
1
260
18
193
3
453
21
Total separations from
individual institution
181
172
353
46
24
70
51
278
196
474
Wet increase or . ecrease
+25
-13
+12
+2
+2
—7
+18
-11
+7
In residence, March 31,1964
277
464
741
106
129
235
288
671
593
1,264
 GENERAL ADMINISTRATION F 19
BUSINESS MANAGER'S REPORT
F.A. Matheson, Business Manager
Attached are the financial reports of the British Columbia Mental Health
Services Branch for the fiscal year ended March 31, 1964.
These reports are presented as follows: The in-patient care units in Tables A
through J comprise Crease Clinic, Provincial Mental Hospital, The Woodlands
School, The Tranquille School, Provincial Mental Home (Colquitz), Valleyview
Hospital, Dellview Hospital, and Skeenaview Hospital; the Community Services,
Department of Nursing Education, and General Administration activities are
included further along in this report in Tables K, L, M, and N.
As a point of interest and additional information, it should be mentioned that
all figures, with the exception of per capita costs and daily average population, have
been rounded. This procedure was adopted in conformity with Public Accounts,
which appeared in such format for the first time for 1963/64.
As will be seen from Table A, the average number in residence was 6,113.99,
an increase of 18.84 over the previous year.
On January 29, 1964, the last of the patients at the Provincial Mental Home,
Colquitz, were transferred to the Provincial Mental Hospital, Essondale. With the
transfer of these patients, this institution was closed as a branch of the Mental Health
Services and the buildings and equipment turned over to the Department of Public
Works. The Honourable E. C. F. Martin, Minister of Health Services and Hospital
Insurance, and the Honourable W. N. Chant, Minister of Public Works, attended
the closing-out ceremonies.
As a result of the closing of this institution, Table G covers an operation for
a 10-month period only.
Over-all operational expenditures continued to rise, the total of $17,640,598
shown in this report indicating an increase of $1,285,800 in round figures over the
1962/63 total of $16,354,798.43. Salary increases were the greatest contributing
factor, the difference of $1,285,800 being made up of $1,209,070 in salaries and
the balance of $76,730 in supplies and expenses.
As a result of the increase in maintenance expenditures, the gross and daily
per capita costs rose to $7.90 and $7.12 respectively, or increases of 55 and 68 cents
over 1962/63.
Patients' maintenance revenue, on the other hand, shows a droo from $2,025,-
854.46 in 1962/63 to $1,751,281 in 1963/64, or $274,573.46. This decrease can
be attributed chiefly to changes in Federal-Provincial cost-sharing agreements in
connection with payments on behalf of war veteran patients.
The Department of Agriculture, through farm operations at Essondale, Colquitz, and Tranquille, supplied produce valued at approximately $450,000 to the
various units of the Mental Health Services.
Also appended to this report is a detailed statement listing the assistance provided by the Federal Government in the form of Health Grant projects.
The expenditure of the $581,386.77 made available was a substantial contribution to our programme in the purchase of equipment and provision of personnel
and staff-training.
The After-care Clinic, Vancouver, was transferred to the Mental Health Centre,
Burnaby. This transfer was made in order to provide the clinic with larger and
better quarters in which to carry out this important programme that has expanded
considerably since it was started two years ago.
 F 20 MENTAL HEALTH SERVICES REPORT, 1963/64
At The Woodlands School, separate housekeeping and dietary services to the
wards were introduced. With the introduction of these two departments, it is felt
that it will free the nursing staff to concentrate on the care and treatment of the
patient, but in addition will also improve the dietary service and housekeeping in
the institution.
The Tranquille School continues to expand, with a patient count of 470 as at
March 31, 1964, an increase of 51 patients during the year.
Arrangements were made with the Fire Marshal's department to have its
instructional unit visit both the Dellview Hospital and the Skeena view Hospital at
least annually to instruct the staff at these two institutions in fire prevention and
fire-fighting.
I am most pleased to be able to again report that, in addition to being able to
maintain the buildings, grounds, equipment, and furnishings of all our institutions
in a satisfactory manner and the purchase of a considerable amount of furniture
and equipment, a great deal of planning and major improvements were also carried
out.   Some of the main items of interest in this regard are as follows:—
Provincial Mental Hospital and Crease Clinic, Essondale.—The new Industrial
Therapy Building was officially opened on May 30, 1963, by the Honourable
E. C. F. Martin, Minister of Health Services and Hospital Insurance.
The tenders received for the Hillside Building exceeded the estimates, and new
plans are being prepared.
Tenders in the amount of $147,827 were received for the renovation of the
West Lawn Building kitchen and dining-rooms. The contract for this project is
to be let in April, 1964.
Contract in the amount of $76,925 was let for new fire-escapes in the Centre
Lawn Building.   Work in this connection will be completed in April, 1964.
Plans and specifications have been completed for renovations to ward kitchens,
ward dining-rooms, and garbage-handling facilities in the East Lawn Building. It
is hoped that the contract for this work will be let early in the next fiscal year.
Work in connection with the planning for the new medical clinic is continuing.
Ward North 1 was completely renovated, and major alterations carried out in
the Occupational Therapy Department in the North Lawn Building.
Work in connection with the replacement of the wooden floors in the West
Lawn Building is continuing. During this year the wooden floors in two large
dormitories and five side rooms were replaced with light-weight concrete and tile
floors.
Approximately $25,000 worth of new and replacement furniture was purchased.
Approximately 15,000 worth of new medical equipment was purchased, including a spectrophotofluorometer and a micro projector for the laboratory.
Some $12,000 worth of new laundry equipment and $21,500 worth of new
and replacement motor-vehicles were purchased, including a new ambulance.
Valleyview Hospital, Essondale.—Work in connection with the complete
renovation and refurnishing of Valleyview Buildings 1, 2, and 3 was completed at
a cost of approximately $350,000.
Valleyview Building 10 was demolished, and the site developed into a parking-
lot.
Dish-washing machines were purchased for all wards not so equipped.
All ward buildings were supplied with automatic clothes washers and driers.
Approximately $8,500 worth of new furnishings and equipment were purchased
in addition to the new furniture and equipment for Valleyview Buildings 1, 2, and 3
mentioned above.
 GENERAL ADMINIS__AT_ON F 21
Dellview Hospital, Vernon.—The fire-alarm system was replaced at a cost of
approximately $7,000.
Two new air-operated presses and air-cooling units were installed in the laundry.
During the year some $5,000 worth of new furniture was purchased.
Skeenaview Hospital, Terrace.—During the year a major reorganization of this
unit took place, changing the operation from two wards to four wards.
This change entailed a considerable amount of work but does provide for a
much better segregation of the patients.
A new autoclave was purchased and installed.
Extensive repairs were carried out on the sewage-disposal field.
New automatic battery-operated emergency lights were installed in the dormitories, day rooms, and corridors.
A new window van vehicle was purchased.
A complete public address, record, and tape audio system was purchased and
installed.
The Woodlands School, New Westminster.—A complete new dental suite was
estabUshed in the old administration offices.
The old morgue building was converted into industrial-therapy shops.
A new parking-lot for the Fraserview Building was completed.
Ward " C " was completely renovated.
The Tranquille School, Tranquille.—A considerable amount of work was done
on the water system, including the installation of a new 16-inch transite water-line
from the Canadian National Railway tracks to main buildings.
A new fire-alarm system was installed in the Greaves Building.
An air-cooling system and a dish-washer were installed in the new patients'
dining-room.
An air-cooling system was installed in the laundry.
A new marking-machine and a sox-drier were purchased for the laundry.
The Meadowview Building was renovated for a male staff residence.
Major alterations were made in the Administration Building, and the Public
Works offices have been relocated to the second floor.
Nearly $30,000 worth of new equipment and furnishings were purchased
during the year.
Preliminary planning for a new 100-bed unit was started.
Victoria.—Plans to convert an apartment block adjacent to the Jubilee Hospital to temporary quarters for the Mental Health Centre, Victoria, until such time
as the new mental health facility is built were completed.
Preliminary planning for the new mental health facility to be located adjacent
to the Jubilee Hospital was started.
Preliminary planning for a new school for the retarded and a new adolescent
treatment unit to be located at Royal Oak has also been started.
Mental Health Centre, Burnaby.—The pharmacy was relocated and enlarged,
and a full-time pharmacist employed. This was necessary to take care of the additional load because of the transfer of the After-care Clinic from Vancouver to this
unit.
Mental Health Centre, Nanaimo.—The addition to the Public Health Building
in Nanaimo to provide facilities for the Mental Health Centre was completed and
furnished.
Mental Health Centre, Trail.—Work in connection with the addition to the
Public Health Building, Trail, to provide facilities for the new Mental Health Centre
is nearly complete and the orders for the necessary furnishings and equipment for
this unit forwarded to the Purchasing Commission.
 F 22
MENTAL HEALTH SERVICES REPORT, 1963/64
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, 1954/55 to 1963/64.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1954/55
1,204.60
3,517.75
285.74
527.33
230.72
296.42
238.63
$1,811,848.81
4,685,444.76
426,786.04
739,859.92
368,726.10
328,553.97
860,673.73
$1,504.11
1,331.94
1,493.62
1,403.03
1,598.15
1,108.41
3,606.73
$4.12
3.65
4.09
3.84
Provincial Mental Hospital, Essondale—
Provincial Mental Home, Colquitz	
Home for the Aged, Port Coquitlam.	
Home for the Aged, Terrace
3.04
Totals for the year
6,301.19
$9,221,893.33
$1,463.52
$4.01
1955/56
1,219.45
3,508.79
285.30
539.27
229.62
287.30
257.96
$2,032,263.32
5,377.708.34
428,248.27
797,392.10
371,438.14
351,087.68
935,501.07
$1,666.54
1,532.64
1,501.05
1,478.65
1,617.62
1,222.02
3,626.54
Provincial Mental Hospital, Essondale	
Provincial Mental Home, Colquitz	
Home for the Aged, Port Coquitlam
4.19
4.10
4.04
Home for the Aged, Terrace.
Crease Clinic	
3.34
9.91
6,327.69
$10,293,638.92
$1,626.76
$4.44
1956/57
1,232.48
3,503.60
284.81
541.83
232.58
288.45
232.85
$2,246,193.06
5,851,370.53
446,497.91
831,370.73
402,867.14
350,880.96
996,288.31
$1,822.50
1,670.10
1,567.70
1,534.38
1,732.17
1,216.43
4,278.67
Provincial Mental Hospital, Essondale	
4.58
Home for the Aged, Port Coquitlam
Home for the Aged, Vernon	
4.20
4.75
Crease -.Hnir.
11.72
Total* for the year
6,316.60
$11,125,468.64
$1,761.31
$4.83
1957/58
1,266.21
3,410.79
285.36
538.56
231.34
288.63
235.31
$2,484,024.86
5,716,745.90
460,863.85
898,225.93
395,584.86
379,826.63
1,077,897.96
$1,961.78
1,676.08
1,615.03
1,667.83
1,709.97
1,315.96
4,580.76
$5.37
Provincial Mental Hospital, Essondale	
Provincial Mental Home, Colquitz	
Home for the Aged, Port Coquitlam	
4.59
4.42
4.57
4.68
3.61
12.55
Totals for the yepr
6,256.20
$11,413,169.99
$1,824.30
$5.00
1958/59
1,377.31
3,301.84
282.99
539.13
226.33
282.92
236.88
$2,968,725.50
6,088,091.20
488,028.69
961,921.63
410,529.00
386,804.84
1,149,344.46
$2,155.45
1,843.84
1,724.55
1,784.22
1,813.86
1,367.19
4,852.01
$5.91
Provincial Mental Hospital, Essondale	
Provincial Mental Home, rniqnlt.
Home for the Aged, Port Coquitlam	
5.05
4.72
4.89
4.97
Home for the Aged, Terra. _.
Crease O'tnlr-
3.75
13.29
Totals for the year
6,247.40
$12,453,445.32
$1,993.38
$5.46
1959/60
226.80
3,135.48
1,395.44
53.74
283.50
560.16
230.92
285.18
$1,233,254.59
6,672,849.09
3,443,231.64
400,957.24
523,480.74
1,400,239.30
444,975.54
412,230.25
$5,437.63
2,128.17
2,467.49
7,461.06
1,846.49
2,499.71
1,926.97
1,445.51
$14.86
Provincial Mental Hospital, Essondale	
5.81
6.74
The Tranquille School, Tranquille.
Provincial Mental Home, rolnnit?
Valleyview Hospital, Essondale
Dellview Hospital, Vernon	
Skeenaview Hospital, Terrace-
20.39
5.05
6.83
5_26
3.95
Totals for the year	
6,171.22
$14,531,218.39
$2,354.68
$6.43
 GENERAL ADMINISTRATION
F 23
Table A.—Showing the Average Number of Patients in Residence Each
Year, the Total Amounts Spent for Maintenance, and the Gross
Yearly and Daily per Capita Cost, 1954/55 to 1963/64—Continued
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1960/61
237.72
3,008.02
$1,313,678.32
6,775,567.11
$5,526.16
2,25150
$15.14
Provincial Mental Hospital, Essondale—
6.17
The Woodlands School
1,415.30
3,637,555.12
2,570.17
7.04
The Tranquille School, Tranquille	
126.01
542,556.16
4,305.66
11.80
Provincial Mental Home, Colquitz.-   _
287.16
518,591.72
1,805.93
4.95
Valleyview Hospital, Essondale	
695.41
1,754,500.08
2,522.97
6.91
Dellview Hospital, Vernon
232.05
448,792.02
1,934.03
5.30
Skeenaview Hospital, Terrace
Totals for the year ___________
1961/62
290.70
417,856.55
1,437.41
3.94
6,292.37       |     $15,409,097.08
$2,448.85
$6.71
241.92
$1,344,906.48
$,5559.30
$15.23
Provincial Mental Hospital, Essondale—
2,824.58
6,927,591.07
2,452.61
6.72
1,351.62
3,639,782.25
2,692.90
7.38
The Tranquille School, Tranquille	
250.33
657,736.27
2,627.47
7.20
Provincial Mental Home, Colquitz
284.90
1,780.68
4.88
Valleyview Hospital, Essondale...
736.29
1,848,097.68
2,510.01
6.88
230.38
464,314.47
2,015.43
5.52
Skeenaview Hospital, Terrace—	
Tntak for t" .* y e»r
287.28
443,255.07
1,542.94
4.23
6,207.30             $15,832,999.14
$2,550.71
$6.99
1962/63
Or«»*'*- C\\n\r
236.68
$1,371,120.17
$5,793.14
$15.87
Provincial Mental Hospital, Essondale—
2,719.32
7,058,027.01
2,595.51
7.11
The WoOv.if.ndf. .School
1,365.03
3,817,685.18
2,796.78
7.66
The Tranquille School, Tranquille—,	
307.13
779,642.07
2,538.48
6.95
Provincial Mental Home, Colquitz
214.18
478,229.75
2,232.84
6.12
Valleyview Hospital, Essondale
724.07
1,939,191.04
2,678.18
7.34
TVllvicw F__.QpIt._l. V**""1"
232.55
469,458.08
2,018.74
5.53
$1. MnavifrW Hospital, Terrace
296.21
441,445.13
1,490.31
4.08
Tntnl-s fnr^cyppj-
6,095.15       |     $16,354,798.43
$2,683.25
$7.35
1963/64
220.63
2,791.99
$1,442,627.00
7,534,673.00
$6,538.67
2,698.67
$17.87
Provincial Mental Hospital, Essondale—
7.37
1,306.35
3,916,660.00
2,998.17
8.19
The Tranquille School, Tranquille	
433.92
1,077,011.00
2,482.05
6.78
Provincial Mental Home, Colquitzi—
94.07
414,787.00
4,409.35
14.41
Valleyview Hospital, Pssondaln
737.69       |         2,029,118.00
2,750.64
7.52
236.51                      512.128.00
292.83       |            713,594.00
2,165.35
2,436.89
5.92
6.66
Totals for the year	
6,113.99       I     $17,640,598.00
$2,885.28
$7.90
1 Because Provincial Mental Hospital, Colquitz, was closed January 29, 1964, the daily p
r capita cost
for 1963/64 cannot be arrived at by dividing 366 into the yearly per capita cost but is arrived
it by dividing
the total patient-days, 2,232,073, into $U
,640,598.
 F 24
MENTAL HEALTH SERVICES REPORT, 1963/64
Table B.—Summary Statement Showing the Gross and Net per Capita
Cost of Patients in All Mental Health Services Institutions for
the Year Ended March 31,1964.
Gross operating costs—
Crease Clinic	
  $1,442,627
Provincial Mental Hospital, Essondale  7,534,673
The Woodlands School, New Westminster  3,916,660
Tranquille School, Tranquille  1,077,011
Provincial Mental Home, Colquitz1  414,787
Valleyview Hospital, Essondale  2,029,118
Dell view Hospital, Vernon  512,128
Skeenaview Hospital, Terrace  713,594
Gross cost of all institutions  $17,640,598
Less collections remitted to Treasury  1,751,281
$15,889,317
Daily average population    6,113.99
Gross per capita cost, one year $2,885.28
Gross per capita cost, one day  $7.90
Net per capita cost, one year $2,598.85
Net per capita cost, one day  $7.12
Revenue (Patients' Maintenance Collections) of the Mental Health Services
for the Past 10 Years
1954/55  $1,343,848.02 1959/60  $1,821,810.53
1955/56  1,358,708.26 1960/61  1,906,847.71
1956/57  1,546,266.32 1961/62  2,150,802.56
1957/58  1,724,046.70 1962/63  2,025,854.46
1958/59  1,838,158.33 1963/64  1,751,281.00
* Because the Provincial Mental Home, Colquitz, was closed January 29, 1964, the daily per capita cost for
1963/64 cannot be arrived at by dividing 366 into the yearly per capita oost but is arrived at by dividing the total
patient-days, 2,232,073, into $17,640,598.
Table C.—Expense Statement of the Crease Clinic of Psychological
Medicine, Essondale, for 12 Months Ended March 31, 1964
Salaries, Supplies, and Operating
Expense
Net Vouchered
Expenditure as
per Public
Accounts
Services and
Supplies from
Public Works
Department
Actual Cost
of Operation
Yearly per
Capita Cost
R__1._r.fi.-_                                                        i
$1,094,021
4,060
3,675
2,019
25,000
73,713
112,242
19,861
3,307
715
4,640
41,366
11,830
1,139
$1,094,021
4,060
3,675
2,019
25,000
73,713
112,242
19,861
3,307
715
4,640
41,366
11,830
1,139
49,378
3$47
392
$4,958.62
Office *»xpenw
	
18.40
TravrfU^p _.Yp_*!nl_ifl    ,
16.66
9.15
Heat, l.Rht, pnw_.r. pnri water
113.31
Mfid icai care
334.10
Dietary                     , ,
508.73
90.02
Or___i_iH_«_
14.99
	
3.24
Tramp_.rt._H_.i_
21.03
	
187.49
53.62
General p.xp(.ns«
~$49,378
5.16
223.80
Less—
3,947
392
17.89
Sundry receipts	
US
Tntflls
$1,393,249
$49,378
$1,442,627
$6,538.67
 GENERAL ADMINISTRATION
F 25
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 F 26
MENTAL HEALTH SERVICES REPORT, 1963/64
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 GENERAL ADMINISTRATION
F 27
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 Tl
F 28
MENTAL HEALTH SERVICES REPORT, 1963/64
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 GENERAL ADMINISTRATION
F 29
Table H.-
-Expense Statement of the Valleyview Hospital, Essondale,
for 12 Months Ended March 31, 1964
Salaries, Supplies, and
Operating Expense
Net Vouchered
Expenditure
as per
Public Accounts
Services and
Supplies from
Public Works
Department
Actual Cost of
Operation
Yearly per
Capita Cost
$1,431,056
8,305
2,463
518
63,550
100,012
246,721
19,000
387
5,001
27
85,801
1,692
1,005
1,440
1,191
1J99
449
$1,431,056
8,305
2,463
518
63,550
100.012
246,721
19,000
387
5,001
27
85,801
1,692
1,005
1,440
1,191
62,697
1299
449
$1,939.92
	
11.26
3.34
.70
86.15
135.57
334.45
25.76
Maintenance and operation of equipment-
Transportation
	
6.78
.04
116.31
2.29
1.36
	
1.95
Rnilriingc, gr.......... mtr.
Less—
$62,697
84.99
JS1
$1,966,421
$62,697
$2,029,118
$2,750.64
 F 30
MENTAL HEALTH SERVICES REPORT, 1963/64
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 GENERAL ADMINISTRATION                                            F 31
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 F 32
MENTAL HEALTH SERVICES REPORT, 1963/64
Table K.—Expense Statement of the Community Services for
12 Months Ended March 31, 1964
Salaries
Office expense	
Travelling expense	
Office furniture and equipment-
Heat, light, power, and water	
Medical care	
Dietary 	
Laundry.
Mental Health Centre, Burnaby
Transportation	
Maintenance and operation of equipment.
General supplies	
Occupational and recreational therapy	
Patients' education	
General expense	
Buildings, grounds, etc.	
Less rent	
Total.
_ $460,208
3,591
8,502
1,108
_      18,378
_ 20,430
6,398
1,500
1,023
2,059
7,218
1,509
799
1,023
_ 39,652
20
I $573,378
Mental Health Centre, Victoria
Salaries	
Office expense	
Travelling expense	
Office furniture and equipment	
Medical care	
Maintenance and operation of equipment	
General expense	
Total.
$51,239
574
1,573
924
7,115
532
1,312
$63,269
Salaries	
Office expense	
Travelling expense	
Office furniture and equipment.
Medical care	
Mental Health Centre, Kelowna
Maintenance and operation of equipment.
General supplies	
General expense	
Total.
$26,126
160
1,841
531
2,418
318
85
435
$31,914
Expenditure
Expansion of Community Services
$65,055
Grand total, $733,616
 GENERAL ADMINISTRATION F 33
Table L.—Expense Statements of the Rehabilitation Centres
for 12 Months Ended March 31,1964
Vista Rehabilitation Centre
Salaries  $13,589
Office expense  98
Travelling expense  62
Heat, light, power, and water :  1,011
Dietary  3,753
General supplies  218
General Expense  457
Buildings, grounds, etc.  162
Less rent  20
Total $19,330
Venture Rehabilitation Centre
Salaries  $11,897
Office expense  72
Heat, light, power, and water  830
Dietary  7,144
General supplies  754
General expense  306
Buildings, grounds, etc.  175
Total $21,178
Rehabilitation and After-care Programme
Salaries  $37,214
Office expense  248
Travelling expense  2,812
Medical care  41,000
Heat, light, power, and water  1,090
Maintenance and operation of equipment  18
General supplies  24
General expense  232
Less rent  555
Total $82,083
Grand total, $122,591
 F 34 MENTAL HEALTH SERVICES REPORT. 1963/64
Table M.—Expense Statement of General Administration, Mental
Health Services Branch, for 12 Months Ended March 31, 1964
Salaries I  $193,714
Office expense  5,946
Travelling expense  10,042
Office furniture and equipment  1,211
General expense :  1,949
Grant to trustees of Patients' Comfort Fund  5,000
Grant to Department of Neurological Research, University of
British Columbia  22,500
Administration of Psychiatric Nurses Act  2,193
Council of Psychiatric Nurses for Bursary Trust Fund  1,200
Subscription, Social Service Index  245
Less miscellaneous receipts  8,226
Total $235,774
Table N.—Expense Statement of the Department of Nursing Education,
Essondale, for 12 Months Ended March 31,1964
Salaries  $734,099
Office expense  6,842
Travelling expense  427
Office furniture and equipment  158
Medical care  250
Dietary  7,659
Laundry  5,000
General supplies  13,011
General expense  1,514
Less rent deductions  13,080
Total  $755,880
 general administration f 35
Expenditure Made under Federal Health Grants for Province of
British Columbia, Year Ended March 31,1964
Assistance to Provincial Mental Hospitals—
Equipment        $729.00
Staff salaries 298,431.89
  $299,160.89
The Woodlands School, New Westminster—Staff salaries 29,524.14
Assistance to the Geriatric Division (Skeenaview)—Equipment        3,108.00
Mental Health Centre, Burnaby—Staff salaries       14,460.00
Division of Nursing Education—Staff salaries         6,468.00
Consultant staff, Mental Health Services Branch—Staff salaries        4,896.00
Assistance to the Department of Psychiatry      41,281.75
Assistance to the Department of Social Work        4,083.31
Neurological Research Unit at University of British Columbia—
Epidemiologic studies in hospitalized psychiatric
illness $13,961.84
Neurobiologic analysis of behaviour     10,886.70
Central amines and psychoactive drugs     13,467.77
An investigation of short-term memory and 'neural
excitability with special reference to elderly,
memory-disordered psychiatric patients      3,187.35
" p-Methoxyphenyl Derivatives in Human Urine "     7,923.51
" Pharmacological and E.E.G. Analysis of Psychoactive Drugs Used in Combination (Beneficial
and (or) Harmful Effects)"        5,499.96
       54,927.13
University of Victoria—A development and validation study of psychometric test of mental impairment in brain-damaged childrer___ 2,186.86
Mental hygiene programme, Greater Victoria Board of Health  4,263.50
Mental hygiene programme, Metropolitan Health Committee, Vancouver  47,260.00
Psychiatric services, Vancouver General Hospital .  22,381.41
Assistance to the British Columbia Epilepsy Society  5,000.00
Assistance to the Children's Foundation          12,200.00
General personnel training—Postgraduate training  30,185.78
Total . $581,386.77
 F 36 MENTAL HEALTH SERVICES REPORT, 1963/64
PERSONNEL REPORT
J. Dowling, Personnel Officer
The establishment of the Mental Health Services Branch increased by 133
positions during the fiscal year. The quarterly average of persons on staff, excluding
students, rose from 3,107 to 3,223 for an increase of 116 employees. The Branch
improved its position in respect to the numbers employed in professional and
technical classifications with the exception of clinical psychologists and instructors
of nursing. In the latter classification, staff turnover ran to 47 per cent, and two
positions remained vacant throughout the fiscal year, notwithstanding considerable
effort by the Civil Service Commission to fill them. Nursing instructors with
adequate psychiatric preparation are scarce and much in demand. There was a
22-per-cent increase in turnover within all registered nurse classifications. Over-all
staff turnover rose by 2 per cent, which is to be expected in a period of increasing
job opportunities.
The employment of both registered and psychiatric nurses on a part-time basis
(three days per week) has continued, with 57 so employed as of March 31, 1964.
Short-term relief staff, numbering 276, was hired during the year, an increase
of about 28 per cent over the previous fiscal year. This has strengthened our
staffing position in all units of the Branch and is much more effective than trying to
build relief requirements into the permanent establishment.
An extensive training programme was carried on throughout the year.   Parti- ,
culaxs are given elsewhere in this Report.
The staff who became redundant upon the closure of the Provincial Mental I
Home, Colquitz, were dealt with mainly by transfer to vacancies in other units of i
the Mental Health Services Branch.   About 14 were absorbed into vacancies in !
other Government departments.   Every employee was offered a comparable position.   Minor demotions were inevitable, but in no case was an employee's salary
affected.    Generous arrangements were made to cover moving, travelling, and
incidental expenses associated with transfer.    A refresher course was arranged
through the Division of Nursing Education, with the majority of the Colquitz staff
participating.
The problems of providing trained personnel for the 100-bed Greaves Building,
infirmary unit at The Tranquille School, were finally overcome, and the transfer of
patients from The Woodlands School took place in the last quarter of the fiscal year.
Planning to staff a further expansion of facilities in The Tranquille School was
begun.
The Personnel Officer participated in the following matters of some importance:—
(1) A survey of all clerical and stenographic positions within the Department, j
This survey was initiated by the Civil Service Commission.   With a few I
minor exceptions, this section of Branch activity was found to be well
organized, properly staffed and classified.
(2) A realignment of nursing classifications within The Tranquille School staff. ]
(3) A review of staffing in the Business Administration Section of The Tranquille School to determine necessary changes arising out of an expanded
operation.
(4) A review of pharmacy staffing to accommodate expanded treatment
facilities in the Lower Mainland region.
(5) The establishment of new positions for the new Mental Health Centres |
at Nanaimo and Trail and action to recruit into them.
 GENERAL ADMINISTRATION F 37
(6) Further extension of the food-service function and its separation from
nursing service.
(7) Further extension of housekeeping services and the separation of this
function from nursing service.
(8) The provision of additional personnel to staff additional activities within
the new Industrial Therapy Building at the Provincial Mental Hospital,
Essondale.
STATISTICAL TABLES
Table A.—Summary Showing Over-all Staff Totals in Relation to
Separation and Recruitment
Staff recruited, excluding students .       1,059
Staff separated, transferred, etc., excluding students     941
Increase      118
Total staff, excluding students, as of March 31, 1964 3,213
Total staff, excluding students, as of March 31, 1963  3,095
Increase 118
Quarterly staff average, excluding students, 1963/64 3,223
Quarterly staff average, excluding students, 1962/63 3,107
Increase _—      116
Male       Female       Total
Student enrolment as of March 31, 1964      60       204       264
Student enrolment as of March 31, 1963      74       172       246
Change —14      +32      +1J
Student quarterly average, 1963/64 238
Student quarterly average, 1962/63 238
Change Nil
 F 38 MENTAL HEALTH SERVICES REPORT, 1963/64
Table B.—Breakdown by Classification of Recruitment and Separation
Activity for the Mental Health Services, Excluding Student Psychiatric NURSES. Established Positions
Recruited Separated
Physicians  26 18
Registered nurses  46 45
Psychiatric nurses  230 208
Female psychiatric aides  167 107
Male psychiatric aides  67 86
Teachers  1 1
Occupational therapists  11 10
Recreational therapists  4 5
Industrial therapists  4 2
Psychologists  5 8
Social workers  15 9
Dieticians .  4 3
Cooks  2 7
Kitchen helpers  37 27
Clerks  7 5
Clerk-stenographers  42 33
Trades  1 1
Laundry-workers  11 12
Miscellaneous professional  12 6
Miscellaneous technical  5 7
Miscellaneous  86 65
Sub-totals 783 665
Temporary relief staff recruited 276 	
Temporary relief staff separated  214
Temporary relief staff transferred, etc   62
Totals 1,059 941
 GENERAL ADMINISTRATION
Table C.—Summary of Staff Turnover
By Major Classification
F 39
Classification
1962/63
Change
Student psychiatric nurses-
Male psychiatric nurses	
Female psychiatric nurses-
Registered nurses	
Per Cent
IS.6
9.8
29.7
21.2
Percent
19.7
10.4
31.5
43.6
PerCent
+4.1
+.6
+1.8
+22.4
Note.—Item 1 has been calculated against the quarterly average and other items have been calculated
against the year-end staff totals.
By Pay Division
Pay Division
Temporary Relief
Staff Excluded,
1962/63
Temporary Relief
Stan Excluded,
1963/64
General Administration	
Department of Nursing Education*	
Crease Clinic and Provincial Mental Hospital, Essondale	
Provincial Mental Home, Colquitz -	
The Woodlands School  	
The Tranquille School	
Valleyview Hospital	
Dellview Hospital	
Skeenaview Hospital	
Mental Health Centres	
Per Cent
11.4
23.2
15.1
47.7
18.2
19.4
23.6
26.2
14.5
25.8
PerCent
10.8
19.6
18.7
20.8
23.0
29.4
23.1
21.7
17.5
Over-all turnover..
18.6
20.6
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
Fisoal Year 1962/63
Fiscal Year 1963/64
Positions
in Establishment as of
Mar. 31,
1963
Number on
Staff as of
Mar. 31,
1963
Positions
in Establishment as of
Mar. 31,
1964
Number on
Staff as of
Mar. 31,
1964
38
55
106
35
56
93
39
60
135
37
Department nf Nni-ing Education
Mental Health -.Mitres.
56
100
Sub-total!)
199       |          184                  234                  193
In-patient care—■
284
1,153
80
766
189
413
80
62
277
1,137
63
777
113
402
80
62
287
1,232
817
195
440
86
68
282
Provincial Mental Hospital, Essondale	
1,210
770
The Tranquille School
183
424
Dellview Hospital
Skeenaview Hospital        	
85
66
.Vital _f v"te                    	
3,027       |       2,911               3,125
3,020
3,226               3,095       1       3,359
325                  246       [          325
3,2131
Student psychiatric nurses,..
264
3.551        1        3.341
3,684
3,477
1 Includes 69 part-time employees.
 F 40
MENTAL HEALTH SERVICES REPORT, 1963/64
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 GENERAL ADMINISTRATION F 41
REPORT OF THE PROVINCIAL SUPERVISOR OF
PSYCHIATRIC SOCIAL WORK
Miss A. K. Carroll, Provincial Supervisor
The year was an active and challenging one for the social workers in the social
service departments of the divisions of the Mental Health Services. The thrust forward in the evolution of new concepts in the field of intervention and treatment of
mental illness as well as the reafiirmation of the valuable and useful in traditional
approaches has resulted in relatively extensive restructuring of patterns of administration, therapeutic organization, and staffing throughout the social service departments.   Observable throughout are trends toward
(1) a growing flexibility and extension in the functions of all professionals,
including social work;
(2) an integration of hospital treatment services with community health, welfare, education, and rehabilitation services in a way that affords a continuum of treatment and a comprehensiveness of programme;
(3) treatment planning based on the patient in his family group wherein the
family is the unit to be treated;
(4) the evolution of a treatment process which involves a programme of intervention oriented to the clarification, management, and control of crisis
situations as these arise in patients' lives;
(5) the extension of community mental health services through the unitization
of hospital services and their integration on a regional basis with community mental health services;
(6) the growth of decentralization of services and the development of community mental health centres in line with the increasing emphasis on
treating the mentally ill in small units in their community environment.
The impact of the changes as outlined above on mental health social services
continues to stimulate the need for refocussing of social services as well as to require
continuing relocation of social-work staffs. The demands consequent on these
changes continually require that social workers make full use of their professional
training in order that their contribution be effective in the treatment of patients as
well as supportive of the extensive change operative in both the content and environment of community mental health services today. Additionally it is very important
that personnel be given opportunities through the use of advanced-study resources,
institutes, and seminars to keep abreast of current changes in the field of social-work
knowledge and practice consequent upon advances in the behavioural sciences.
The mobility (movement through promotion and resignation) of line staff has
dropped sharply over the past four years. For example, mobility of line staff in
1961 stood at 48 per cent of the total establishment for line social workers, whereas
the mobility of supervisory staff in 1961 stood at 18.7 per cent. This year this
mobility stood at 11.6 per cent of line staff and 13 per cent of supervisory staff.
The increased mobility in the latter group undoubtedly reflects the promotional
opportunities which the development of community mental health centres offers line
workers.
PROFESSIONAL EDUCATION AND STAFF-DEVELOPMENT
PROGRAMME
Social Service Department, Mental Health Services
A total of 24 first- and second-year students was placed within the Mental
Health Services for field-work experience.   This stadent-training programme in
 F 42 MENTAL HEALTH SERVICES REPORT, 1963/64
which social-work supervisory and senior practitioner personnel co-operate with
the field-unit supervisors of the School of Social Work, offers staff a valuable opportunity for contact with the University and for orientation to changes and advances
in the content of social-work knowledge and practice. The responsibility of this
officer in regard to student-training is that of developing a variety of field-work
placements in the Mental Health Services for use in the training of student social
workers. This year, with the aid of Health Grant financing, a project concerned
with the provision of field-work experience to seven first-year B.S.W. students was
developed, attached to the After-care Services, Provincial Mental Hospital and
Crease Clinic, with supervision from a member of the faculty of the School of Social
Work. Cases for field-work practice were assigned from the after-care patient loads
of Centre Lawn and East Lawn Buildings and averaged 10 to 12 cases per student
during the period of their experience. According to the evaluation of the University,
this project operated most effectively as a training resource; additionally, many
patients benefited from the service which this group of students, under adequate
supervision, were able to give to patients, who on leaving hospital face very often
with great courage challenging situations in their resettlement in the community.
Of the group of 24 students,'14 were placed in the Provincial Mental Hospital
and Crease Clinic for field-work experience; 7 in the Mental Health Centre, Burnaby; 2 in The Woodlands School; and 1 in Valleyview Hospital.
Social Work Consultative Service
This is a staff service to medical superintendents and chief social workers in
divisions of the Mental Health Services. This year the service entailed 42.6 per cent
of the consultant's time. Direct consultative service was given to all divisions during this year on social-work programme related to:—
(1) Personnel procurement, maintenance, and retention; staffing and staff
patterning; organization and administration of social services in hospitals
and community centres:
(2) Patient selection; programmes of remotivation to use of intermediate-
care facilities such as boarding and family-care home nursing homes;
community resettlement of improved mentally ill adults, aged, and
retarded; foster-home care programme for mentally retarded children
resident in training-schools:
(3) Administration and organization of an interdivisional family-care and
boarding-home programme and the integration of this service with those
of community health and welfare services:
(4) Admission and discharge functions of social service departments in hospitals and clinics:
(5) Organizational and functional changes in social services, particularly as
these concern relocation of staff, and re-emphasis on basic and new skills
necessary in relation to changes and expansion in mental health community organization.
DISTRIBUTION OF CONSULTATIVE RESPONSIBILITIES
Provincial Mental Hospital and Crease Clinic
In light of demands in the changing situation as noted in item (5) above, the
chief social worker in this division requested consultative services in relation to the
organization of social services to meet treatment and rehabilitation needs of the
large numbers of adolescents being admitted to the Provincial Mental Hospital and
 GENERAL ADMINISTRATION F 43
Crease Clinic. The structuring of a research design and the development of suitable
instruments revealed a marked increase in the admission rate over the last two years;
an average age of 16; the prevailing problems to be those associated largely with
adolescent development and adjustment and only in some instances with mental
illness; the great majority to be native born, of average intelligence, from weak or
broken family groups, and largely resident in urban centres.
In order to cover the needs of the adolescent group as well as to carry out
social-work responsibilities to other priority groups of patients, relocation of staff
was recommended and the institution of a group-centred approach preferable in
pre-admission and pre-discharge service areas of treatment.
The Woodlands School
Consultation was requested and offered in the areas of pre-admission consultation to community public health agencies developed by this social service department
over the last two years. This has required the careful distributing of social service
staff in relation to public health units in order to assist public health nurses active
with families having the care and supervision of retardates, some of whom are awaiting admission, others who are on leave from the School.
Consultation has continued relative to the implementation of the project (described in the report of last year) for the placement of children resident in the School
in foster homes. This is a co-operative service with Child Welfare Division of the
Department of Social Welfare. Its implementation got under way this year as an
urgently needed and valuable additional facility in the care and training of the
retarded child resident in an institution but in need of the nurturing care of a substitute family when own is unable or unfit.
Further consultative services were offered in relation to the community resettlement of trained and socialized adult retardates resident in The Woodlands School.
A beginning to implementation of programme was made this year. Again this programme is a co-operative one with Provincial and municipal departments of social
welfare.
The Tranquille School
This year saw the establishment of a social service department in The Tranquille School. Consultation has been available on a regularly scheduled basis of one
week per month during the year. The service has been focused on social-work
organization, administration, functions, services, and the pattern of staffing requisite
to the present stage of growth of the School and community as resources in a broad
programme for the retarded. A project for the resettlement of trained and socialized adult retardates resident in the School has been submitted, with a beginning
made to its implementation by the organization of School and community services.
Consultation around the implementation of a programme for the resettlement of
trained and socialized adult retarded residents with their families, relatives, or friends
has been completed. A research design was evolved to isolate significant aspects of
the familial situations of these retardates. Incidental to these findings a considerable number of residents have been referred for this service.
Valleyview Hospital
The chief social worker in this division has been active in the development of
a social service programme in the following areas: Pre-admission, post-admission,
and post-discharge. Additional to these foci, an extensive total institutional-centred
community education and interpretation programme concerning newer concepts and
 F 44 MENTAL HEALTH SERVICES REPORT, 1963/64
services in community-based geriatric services has been carried on by the staff of
the hospital.
A pre-admission service to the aged and their families is effective only in relation to the adequacy of community health, welfare, recreational, and housing facilities for the aged, whether these latter be own home, communal or group facilities,
boarding or nursing homes. However, precipitate and unnecessary admissions of
aged persons have been prevented to a degree by the use of resources in the family
itself and in the community before the admission of the aged patient.
The resettlement of aged patients who have benefited from treatment with
either family or in a boarding or nursing home has been extended. Again these
facilities must have available to them adequate health, welfare, and recreational
services as well as services geared to the development of adequate standards of geriatric care in the home or the boarding- and nursing-home setting.
Boarding-home and Family-care Programme
During this year this officer has taken responsibility for the direction of this
programme. In 1959 the Provincial Mental Hospital began a family-care and
boarding-home programme for 100 patients. This was a co-operative service with
the Divisions of Welfare Institutions and Field Services of the Department of Social
Welfare. In 1961 the number of patients for placement was increased to 250, and
in 1963 to 350 following discussion and policy formulation between the departments
concerned. During the year 141 women from the long-term treatment unit of the
Provincial Mental Hospital were placed in boarding or family-care homes; 93 men
patients were placed from the long-term treatment unit of West Lawn. Additionally,
6 adult retardates were placed from The Woodlands School and 48 aged patients
from Valleyview Hospital.
Mental Health Centres, Burnaby, Victoria, and Kelowna
Regular consultation has been available to the social service departments in
the Mental Health Centres, Burnaby and Victoria. Two visits were made to the
Mental Health Centre, Okanagan Region, located in Kelowna. Social workers in
these centres must work as expert generalists as the centres are not only concerned
with mental health services to the community but must be concerned with services
to families and community institutions such as school, church, courts, and industry.
Consultation has therefore been centred on generalized family social services and
the organization and administration of the social workers' contribution, as well as on
those aspects of community development and organization needs, services, and
skills. Individual social problems are largely complex and multifaceted, requiring
extensive treatment competency. Case loads are heavy and intake very high.
Matters pertaining to staff supports and programmes for staff development are extremely important, and programmes to meet these needs are of signal importance.
Central Branch Responsibilities
These have centred largely around two conference bodies—namely, the Unit
Administrative Conference and the Interdepartmental Case Review Committee.
Attendance has involved responsibilities to research, report, and chair sessions.
Also the responsibility for community development has required activity in
the following areas: Community Placements Committee of the Association of Re-
and Valleyview Hospital. The students' background ranged as follows: Academic,
Grade VII to University Entrance; service time, 0 to 16 years; age, 19 to 60 years.
 GENERAL ADMINISTRATION F 45
tarded Children of British Columbia; Canadian Mental Health, Scientific Planning
Committee; Esther Irwin Home Consultants Committee to Executive and Board;
Welfare and Recreation Division of the Council of Agencies; Division for the Guidance of the Handicapped Council of Agencies; and the Welfare Institutions Licensing Board.
This has been a challenging and stimulating year of practice.
 F 46 MENTAL HEALTH SERVICES REPORT, 1963/64
REPORT OF THE DIRECTOR OF NURSING SERVICES
Miss B. J. Mitchell, Director of Nursing Services
THE DEPARTMENT OF NURSING EDUCATION
The major function of the department is to conduct educational programmes
in psychiatric nursing. The psychiatric nursing and the psychiatric aide programmes are designed to provide prepared nursing staff for the Mental Health
Services of this Province; the post-basic programme offers refresher courses to
selected staff of the nursing service departments of the Mental Health Services.
The affiliate and registered nurse programmes are designed to prepare psychiatri-
cally oriented registered nurses for a wide variety of health services in the Province.
Psychiatric Nursing Programme
Student census—
April 1, 1963__.  253 (178 women, 75 men)
March 31, 1964    264 (204 women, 60 men)
Enrolled  147 (121 women, 26 men)
Ninety-five students (69 women and 26 men) completed the programme, a
decrease of 12 compared to the previous year. Withdrawals for the fiscal year
numbered 47, of which nearly 50 per cent were attributed to personality unsuited
to psychiatric nursing.
The graduate of this programme received an average of 650 hours of planned
academic and clinical instruction. Guidance and supervision during tours of duty
on psychiatric, geriatric, mental retardation, and medical-surgical services were
provided by nursing service staffs.
Affiliate Programme
Two hundred and twenty-seven students from the six hospital schools of nursing completed the 12-week experience in psychiatric nursing. At the request of the
Provincial Health Branch, eight public health nurses enrolled in the programme.
It was enriched by additional field trips, meetings, interviews, and clinical assignments to meet their specific needs.
Clinical Programme for Registered Nurses
Thirteen students successfully completed this six-month guided experience in
psychiatric nursing. Each student participated in 250 hours of planned academic
and clinical instruction. Guidance and supervision of the individual student's practice of psychiatric nursing was provided by the instructor responsible for the programme.
Forty-seven students have completed this programme since its implementation
in the fall of 1960. Of this number: 13 (36 per cent) were employed by Mental
Health Services for a period of time;  10 (22 per cent) are currently employed.
Psychiatric Aide Programme
The purposes of the psychiatric aide programme are twofold: to enable the
aide to learn his/her role and responsibilities in relation to other people within the
work setting and to improve his/her quality of nursing care.
Seven 10-day orientation courses were offered to a total enrolment of 88 male
and female psychiatric aides from Crease Clinic and Provincial Mental Hospital
 general administration
Post-basic Programme for Senior Nursing Staff
F 47
Two six-week refresher courses, with a total enroment of 17, were offered to
male psychiatric nurses transferring from the Provincial Mental Home, Colquitz,
to units at Essondale. Course content consisted of 45 hours of psychiatric nursing,
7 hours of medical nursing, and 18 hours of nursing arts. A four-week clinical
assignment included experience on psychiatric and medical wards.
Faculty
Senior instructors carry administrative and academic teaching responsibilities
for their respective educational programmes. All other instructors have classroom
as well as clinical teaching assignments. Activities other than these are organized
and implemented through the department's standing committees. These are the
Administrative, Faculty, Curriculum, Library, Out-of-Department Examinations,
and the Selection and Evaluation Committees. Through these, important projects
begun the previous year were completed or continued. Some of these involved
correlation of curriculum content for the psychiatric nursing programme, reorganization of Ubrary holdings and methods of utilization, preparation and grading of
eligibility and qualifying examinations, review of applications, and evaluation of the
total performance of psychiatric nursing students.
Faculty members were privileged to attend and participate in several educational events. Most noteworthy was a workshop conducted by the Canadian
Nurses' Association on " Schools of Nursing Improvement Programme."
Miss Margaret Lonergan completed her Master's degree programme at the
University of Washington and resumed responsibility for the administration of the
Department of Nursing Education in October.
Consultation to Units
Consultation visits were made to the Crease Clinic and Provincial Mental
Hospital, Valleyview Hospital, The Woodlands School, Mental Health Centre in
Burnaby, and The Tranquille School. Extensive study and plans for the reorganization of the nursing services for the two largest hospital units was considered of
utmost importance to the future development of the nursing services.
Recruitment of Nurses
Following widespread advertising for registered nurses in local papers across
Canada and in journals, a total of 126 nurses requested further information about
employment via letter or interview.
Employment of Psychiatric Nurse Graduates
September, 1963, Class
February, 196*
.Class
Women
Men
Total
Women
Men
Total
30
9
8
9
17
10
2
3
47
19
10
12
29
9
5
5
4
7
3
1
1
36
Number employed in Mental Health Services—
Crease Clinic and Provincial Mental Hospital	
Valleyview Hospital.	
The Woodlands ■HrhnnS
12
6
6
4
26
15
41
23
5
28
 F 48 MENTAL HEALTH SERVICES REPORT, 1963/64
COMMITTEE AND EDUCATIONAL ACTIVITIES
The purpose, function, and structure of the Nursing Council (formerly the
Unit Nursing Conference) were outlined by the members and approved by the
Deputy Director of Mental Health Services. The Council supervised the activities
of the Core Nursing Procedure Committee and Nursing SuppUes Committee, and
several revised nursing procedures were approved. Kardex cards to include nursing-
care plans were prepared and introduced on several wards in the three large hospital units.
The Nursing Liaison Committee met every two months and prepared a detailed
description of the functions of the pubUc health nurse in meeting tike needs of the
psychiatric patient and his family in the community. A blueprint was proposed for
liaison between the Mental Health Services and the pubUc health agencies involving
the use of liason nurses.
 GENERAL ADMINISTRATION F 49
REPORT OF THE CONSULTANT IN MEDICAL
RECORDS AND STATISTICS
Miss A. D. Dingle, Consultant in Medical Records and Statistics
With the appointment of the Deputy Director of Mental Health Services, opportunity has been developed through the new unit administrative conferences to learn
more of the particular functions and goals of each unit in the Lower Mainland, and
this has proven of great value to this Consultant.
CONSULTATION TO UNITS
Provincial Mental Hospital and Crease Clinic
With the return of the Medical Records Supervisor to this area, visits by the
Consultant were lessened. The Medical Records Supervisor completed her course
under Federal grant and passed the qualifying examinations with honours to obtain
registration as a medical record Ubrarian. This is the first such qualified person in
the Mental Health Services of this Province.
Further consultation and assistance were given in the study made of a group
of admissions to Crease Clinic. This project was concluded in March, 1964, at the
end of one year, and the results have been tabulated for the use of the Crease Clinic
Unit Director.
Assistance was given to the Medical Superintendent by supplying statistics for
a study of the problems in treatment of adolescents.
As a result of the work of the Admissions and Discharge Committee, of which
this Consultant is a member, the admission procedures in Crease Clinic have been
reorganized and set up with an admitting clerk in charge of the office. The Consultant attended several planning sessions for this.
A Medical Records Committee has been set up for the Mental Hospital-Crease
Clinic area, with the Consultant as ex officio member.
The co-operation being given to Dr. A. Barbeau, Director of the Neurogenetic
Centre, University of Montreal, in the research project on Huntington's chorea, is
now being shared with Dr. K. Berry, Director of Neurology.
Schools for Mental Defectives
Two visits were paid to The Tranquille School during the year. Assistance
and advice were given in setting up an organized medical records department and
orienting the new staff member for this area. Most of one week was spent in this
department on the second visit. Consultation was requested in setting up an index
at TranquiUe of aU in-patients of the Mental Health Services for civil defence purposes, and this project is proceeding.
Geriatric Division
The statistical data were partially reviewed, and as a foUow-up the Medical
Superintendent has requested statistics regarding the length of stay of patients.
Mental Health Centres
The revision of the forms for gathering administrative and treatment statistics
was completed, and the forms wiU go into use on April 1,1964, in aU Mental Health
Centres.
 F 50 MENTAL HEALTH SERVICES REPORT. 1963/64
An index of cases has been set up in the Consultant's office covering aU the
Mental Health Centres.
With the development of the Mental Health Centre in Kelowna, consultation
was requested by the Director with reference to the duties of the clerk-stenographer
with a view to obtaining assistance.
At the request of the Director of the Mental Health Centre in Kelowna, a report
was compiled covering admissions to the in-patient units from the area served by
this unit.
Statistics
At the request of the Dominion Bureau of Statistics, a check was made of its
Usting of cases in the Mental Health Services in-patient units.
The request for comments for preparation of the next revision of the International Classification of Diseases, now under way by the World Health Organization,
was brought to the attention of the senior medical staff. Their submissions were
forwarded for consideration by the Canadian committee.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL F 51
PART n.—CREASE CLINIC OF PSYCHOLOGICAL MEDICINE
AND PROVINCIAL MENTAL HOSPITAL
REPORT OF THE MEDICAL SUPERINTENDENT
B. V. Bryson, Medical Superintendent
GENERAL COMMENTS
The fiscal year ended March 31, 1964, has been a busy and productive one
for this division of the Mental Health Services, during which time a total of 7,781
patients has received psychiatric care and treatment within the Provincial Mental
Hospital and Crease Clinic. The total in-residence population in the two institutions has increased by 94, and at the year's end stands at 3,052 including 2,806 in
the Mental Hospital and 246 in the Crease Clinic.
Treatment and administrative policies have continued without major changes,
and every effort has been made to provide a progressive and up-to-date standard of
service to aU patients.
Several major changes have occurred in the ranks of the senior officers in this
division foUowing the retirement on superannuation of Dr. T. G. Caunt, August 31,
1963. Dr. Caunt will long be remembered for his devoted interest in the welfare of
patients, his understanding guidance and consideration of staff, and his loyalty to
this hospital, in which many progressive advances in psychiatric care and treatment
have been instituted during his tenure of office.
On September 1, 1963, Dr. B. F. Bryson, formerly Medical Superintendent
of the Geriatric Division, was appointed to the position of Medical Superintendent
of the Provincial Mental Hospital and Crease Clinic.
Dr. John Walsh, Deputy Medical Superintendent of this division since 1956,
was appointed as Medical Superintendent of the Geriatric Division, effective September 1, 1963.
On June 1, 1963, Dr. F. G. Tucker, Clinical Director, left this division to
assume greater responsibiUties as the Deputy Director of Mental Health Services.
On November 1, 1963, Dr. P. M. Middleton, formerly Unit Director of the East
Lawn Building, was appointed to the position of Clinical Director.
During the past year more patients have been received and cared for than ever
before, and several major advances have been achieved, including the opening of
the new Industrial Therapy BuUding and the development to fuU operation of the
RehabiUtation Department. DetaUs of the various department activities covering
the operation of the Crease Clinic and Provincial Mental Hospital wiU be noted in
the foUowing reports.
The Medical Superintendent wishes to commend the staff of this division for
their continued loyalty and support throughout the year. The interdepartmental
co-operation has been most gratifying, and aU have devoted their skUls and interests
toward the common goal of providing the best care and treatment possible.
CREASE CLINIC OF PSYCHOLOGICAL MEDICINE
The Crease Clinic has now served the citizens of British Columbia for 13
years, and has continued to provide an intensive and varied programme of in-resident
psychiatric care for mentally disordered persons whose illnesses were considered
amenable to treatment within a four-month period.
 F 52
MENTAL HEALTH SERVICES REPORT. 1963/64
Pre-admission assessment of prospective patients by the Crease Clinic admitting officer and social service staff wherever possible has ensured that the acute-
treatment services avaUable have been utilized for those persons most in need of
short-term therapy. Although the number of admissions has decreased sUghtly,
the number of voluntary admissions has increased.
As wiU be noted in the foUowing table, there were 1,614 admissions, including
745 men and 869 women, to the Crease Clinic this past year, a decrease of 43
compared to the previous 12 months. Of this total, 1,189 patients came to the
hospital voluntarily, representing 73.6 per cent of admissions. This is an increase
of 13 or 1.1 per cent over the previous year.
Male
Female
Total
91
491
21
230
3
127
580
38
249
2
Admissions—
1,071
59
479
5
745
869
1,614
836
996
1,832
Separations—
696
32
1
3
828
23
3
1,524
Discharged direct to Provincial Mental Hospital .	
55
1
6
732     ■
854
1,586
+13
104
+15
142
+28
246
Separations for the year totalled 1,586, of which 1,524 (696 men and 828
women) or 96 per cent were returned directly to the community. Of the remainder,
55 required a longer period of treatment and were admitted to the Provincial Mental
Hospital.   There were six deaths due to natural causes.
As all diagnostic, treatment, and operational services of this division are avaUable to both the Crease Clinic and Provincial Mental Hospital, the details of each
department wiU be found under reports of the Provincial Mental Hospital.
PROVINCIAL MENTAL HOSPITAL
At the end of the fiscal year the Provincial Mental Hospital completed 91 years
of service to the mentaUy UI of British Columbia. This year has seen the highest
number of admissions and separations ever recorded.
The resident population on March 31, 1964, was 2,806 (1,552 men and 1,254
women) and represents an increase of 66 or 2.4 per cent of the number in residence
a year previously. However, the number of patients admitted for care increased
by 332 or 14.8 per cent as compared to the previous year and totalled 2,568.
The foUowing table gives a summary of the movement of population for the
Provincial Mental Hospital for the year ended March 31,1964:—
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
F 53
Male
Female
Total
1,484
189
3
1,256
448
1
2,740
On escap*. rj_rri__ forward from 1Q67./6.
4
Total as at April Ij 10__.
1,676
1,705
3,381
Admissions—
First admissions
561
135
578
32
409
180
527
23
970
315
1,105
55
1,306
HI
9
1,139
3
2,445
111
12
1,426
1,142
2,568
Total im_ carfi
3,102
2,847     '
5,949
Separations—
1,178
3
90
46
3
226
4
1,109
2
59
10
2
411
2,287
T.t-_harpM Alr.c* to ._■. a_». t—thtlr.
5
1,550
1,593
3,143
+68
1,552
-2
1,254
+66
2,806
As win be noted, there were 1,426 men and 1,142 women admitted from various sources during the year. Of particular interest is the 111 men transferred from
the Provincial Mental Home, Colquitz, which ceased operation as a mental hospital
as of January 29, 1964. It is this large number of continued-treatment patients
which is primarily responsible for the increased resident count.
Of the total admissions, 1,035 or 42 per cent were on a voluntary basis. This
is an increase of 98 or 10.4 per cent compared to last year.
Separations from this area increased markedly by 315, and for the year totaUed
3,143, including practicaUy equal numbers of men and women. The great majority
were returned to the community, there being 2,287 discharges in full and 637 on
probation, representing 93 per cent of total separations. Five patients were considered suitable for transfer to the Crease Clinic, whUe 56 were accepted into the
Geriatric Division and five to the school for mental defectives.
Deaths in the Provincial Mental Hospital decreased this year by 15, to a total
of 149, representing 4.7 per cent of total separations and 2.5 per cent of the total
number of patients under care.
The average daily patient population was 2,791.99. This is an increase of
72.67 compared to the previous year. The average monthly admission rate has
been 182.5.
The number of newly admitted patients requiring special security supervision
increased during the year and totalled 172, there being 119 men and 4 women transferred by Order in CouncU from Oakalla Prison, 18 men admitted from the British
Columbia Penitentiary, and 16 men and 5 women admitted by Magistrate's warrant
for psychiatric assessment.
Treatment Services
This has been another busy year. In general the problems, the stresses, and
the work involved in our operation—but also its satisfactions and interest—are more
nearly proportional to our turnover of patients than to the total number in residence.
 F 54 MENTAL HEALTH SERVICES REPORT, 1963/64
This year, closure of the Provincial Mental Home at Colquitz raised the patient
population of the Provincial Mental Hospital and Crease Clinic above the 3,000
mark, below which it had dropped last year for the first time since 1934. However,
the increase was just under 100, which was less than the number received on transfer
from Colquitz and was achieved in spite of an increase of admissions of 300 over the
previous year. In fact the admissions exceeded 4,000 for the first time in the history
of the Province. Ten years ago they stood at 44 admissions per week; this year,
78 admissions per week.
Sixty per cent of aU our admissions are now volunteers and 40 per cent are
readmissions. This suggests acceptance of our faculties by our citizens in general,
including those who have personal experience of them. These days only 20 per
cent of our patients are transferred to longer-term treatment buUdings from the admission units, and even then half of those so transferred are able to be discharged
within two further months.
Despite the better than fourfold increase during the last 10 years of out-patient
psychiatric facUities of various kinds, many patients stiU arrive who could better be
treated as out-patients whUe continuing to live at home and in some cases while
remaining employed. In the near future we wUl be extending our pre-admission
inquiries and attempting to deflect many such patients to out-patient services, which
wiU need to be considerably increased and augmented by short-stay psychiatric wards
or beds in general hospitals on a regional basis as the years go by.
There has been no major innovation in treatment during the past year, but
emphasis has been redirected to controlling untoward behaviour by means other
than chemical, with the recognition of certain insidious side effects due to administering ataractic drugs over long periods in fairly high dosage. The definitive paper
on this topic by Dr. Greiner and Dr. Berry appeared in the Canadian Medical Association Journal in March, 1964, and has excited world-wide interest.
For the 700 patients in the admission or short-stay areas, the emphasis of
treatment and of the daUy programme of activity in the hospital is, of course, on
eliminating the emotional or behavioural abnormality which caused the need to be
admitted to hospital and thus to promote early return to productive life before dependency on others has become established.
Some 2,000 patients in the continued-treatment areas have already spent a
year or longer in hospital, and with them the emphasis is on strengthening the self-
reliance and overcoming the tendency to be dependent, which, in many cases, persists after the major emotional and behavioural abnormaUties have been eliminated
or at least brought weU under control by means, for example, of smaU doses of
maintenance medication such as can be continued at home.
Activity programmes of many kinds, including participation in various aspects
of the work of the institution, are being extended as far as possible, for it is the idle
and unstimulated patient whose behaviour is most likely to deteriorate. Both in
these work programmes and in our industrial-therapy service, the main product is
the increased motivation and employabUity and self-reUance of the patient. The
other production is incidental, but since realistic work programmes are, of necessity,
productive ones, the output is in many cases most impressive.
Two years ago mention was made in the report of my predecessor of the establishment on the female side of the Crease Clinic of a regime whereby aU patients
were admitted, treated, and eventuaUy discharged from the same ward by the same
treatment team. To achieve this it was necessary that aU the wards should become
open wards. This was extended subsequently to the male side of the Crease Clinic,
and in this last year the same concept has been applied in the female section of the
1
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL F 55
Centre Lawn BuUding, which is the admitting area of the Provincial Mental Hospital.
AU that is preventing its estabUshment in the male side of this unit is the presence
of the problematical group of patients, who have been referred to in the reports of
previous years, who come to us from the prisons and penitentiaries. The emphasis
on security for this group of patients accords poorly with the treatment concepts of
a modern mental hospital. This group is increasing rapidly in number, and last
year was of the order of 150. These male patients, together with 200 voluntary
alcohoUc admissions, have hitherto prevented the establishment of integrated treatment teams on the male side of the Centre Lawn area, and accordingly plans are
weU advanced for the relocation of these two groups to another admitting area.
The total number of male security patients whose freedom of movement is strictly
curtaUed due to their past involvement in criminal activity in residence at any one
time is now of the order of 95.
During the year a new category was established of supervising psychiatrist, two
of whom assist the Unit Director in each of the two admitting areas. In addition,
the North Lawn BuUding was established as a separate unit under the direction of
an internist. Thus only the Riverside area, which accommodates over 400 male
patients, remains to be established as a separate unit in its own right. This process
of unitization, which was started in 1960, has made for much greater clinical flexi-
bUity.
After-care Clinic
The After-care Clinic, established initiaUy in quarters at 445 West 13th Avenue, Vancouver, was moved to its present location in the Mental Health Centre in
Burnaby on September 3, 1963. This doubles the number of offices and waiting-
room space. This move has also brought about the avaUabUity of a pharmacist full
time (shared with the Mental Health Centre), limited use of laboratory services,
avaUability of somatic-treatment facUities, and social functions.
There has been a continuing increase in the number of patients registered, from
863 on March 31, 1963, to 1,168 on March 31, 1964. The total monthly patient
visits increased from an estimated 500 visits per month at the beginning of the year
to 607 visits in March, 1964. This latter increase was the result of increased number of doctors from the hospital being able to give time to foUow-up service. Eighteen doctors and 11 social workers have been assigned to provide Vi-day service
each per week.
Some emergency services have been suppUed, including visiting at the Vancouver General Hospital emergency department, home visits, emergency consultations and treatments, but only during the working hours of the clinic. Evening
foUow-up clinics are held once monthly for a limited number of patients unable to
attend during the day. These services have been focused on foUow-up patients just
discharged from hospital or within the past two years. Where time has permitted,
emergency consultations and treatment of other referrals from general practitioners
have been undertaken, and especiaUy pre-admission assessments have been done
on patients seeking Crease Clinic admission.
It is anticipated that more emergency consultations and brief somatic treatments, such as electroconvulsive therapy, can be used on an out-patient basis, and
thus prevent hospitalization when social service and psychiatric staff are avaUable to
maintain the immediate auxUiary supports. There has been an increasing use of
this service as the year progressed.
 f 56 mental health services report, 1963/.4
Women's Nursing Division
In the Women's Division of Nursing the foUowing trends have become increasingly evident:—
(a) Nursing staff are spending more time with groups of patients either assisting in therapy or in some cases conducting groups:
(_>) There are more ward clerks being utilized, which aUows those in charge of
wards to supervise more adequately the nursing care:
(c) Team or group nursing is now accepted by staff and employed on more
wards throughout the hospital, thereby further changing the tradition of
assigning personnel to specific patients (which is the goal) rather than to
areas:
(d) There is a greater acceptance of in-service education and, in fact, a growing demand for it on the part of aU levels of staff:
(e) A closer relationship is developing between personnel of the Men's and
Women's Divisions of Nursing, which indicates more unity of purpose in
goals for nursing care as weU as readiness for the integration of staff in
ward situations:
(f ) There is evident a better understanding of their administrative and supervisory role by the nursing supervisors.
AU of these trends contribute to the improvement of patient care.
During the year, graduate nurses and students either assisted or led the foUowing groups of patients: Adolescents, those on insulin or electroshock therapy, as
weU as many interest groups, such as music appreciation, activities groups, or more
generally, in aiding patient groups in planning ward entertainment.
Team nursing has spread in the past year from the Crease Clinic to include
the remaining three buUdings. At this date it is in effect on aU three wards in the
Crease Clinic, two of the four wards in Centre Lawn, one ward in East Lawn, and
one ward in North Lawn.
The in-service programme was co-ordinated by one supervisor, assisted by
the Co-ordinator of RehabUitation. The theme was " Rehabilitation," in accordance with the changing trends within this hospital. It was presented to both the
Men's and Women's Divisions of Nursing (a staff of approximately 924), although
it was impossible for all to attend. Specific programmes, consisting of tours, lectures, and discussions, were planned for each of the charge nurse and assistant charge
nurse groups. Individual programmes were also presented to the staff nurses and
psychiatric aides. It was felt that these were most useful in interpreting the philosophy of rehabUitation.
Since first commenced in 1959, in-service programmes have contributed to a
better relationship between the Men's and Women's Divisions of Nursing due to the
fact that both groups have an opportunity to exchange views and information, as
weU as to learn together. Increasingly, nursing procedures and policies have gone
out to ward areas over the signatures of the heads of both departments. In August
of 1963 the Men's Division was acutely short of staff, and, at that time, six psychiatric aides from this division were loaned to that department for several months.
This proved to be a most successful experiment. In July of 1963 this division
employed a male supervisor who was assigned to North Lawn BuUding, where there
are men and women patients as weU as staff. This has proved most useful and satisfactory to aU concerned. September also furthered this precedent, when male staff
were directly employed in the Women's Division upon the opening of a men's
infirmary ward in North Lawn.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL F 57
Nursing supervisors have been involved in administrative problems and the
formation of nursing policies and procedures. For instance, this department has
been concerned with orientation programmes for aU levels of staff, and a committee
has been set up to examine the present situation and to draw up plans which would
be used in order to improve the situation and ultimately the efficiency of patient care.
The Central Supply Department received two more nurses' aides, bringing the
staff up to a total of six. This department now has included the Riverside area
within its service, as weU as continuing to expand: for example, in January of 1963
it provided 5,000 dressings to the different areas, and in March of 1964 a Utile over
8,000 were being distributed. At present, plans are being submitted for larger
quarters since it has outgrown its present facUities.
The surgical unit continues to increase in scope. It has increased the number
of surgical procedures, from 130 in 1953, when it opened, to 755 in the past year.
The consultations in the department have also increased from 952 in 1957, when
they first commenced, to 3,523 in the past year.
During the year one head nurse completed the year's extension course in
Administration of Nursing Units, jointly sponsored by the Canadian Nurses' Association and the Hospital Association. One supervisor was granted leave of absence
to attend McGUl University, and one nurse is presently on six months' leave of
absence to attend a clinical course presented at the same university. Six nurses
attended the Operating-room Institute in Vancouver, and many psychiatric nurses
attended the various sessions of the Psychiatric Nurses' Association's educational
programme. The Directors of Nursing Institute in Vancouver was attended by the
Superintendent of Nurses.
Men's Nursing Division
During the past year there has been a steady advance in the cahbre of nursing
care offered by this department. The staff have found themselves being caught up
in a more rapidly moving stream of progress. The changing phUosophies of the
treatment and care of the acutely UI, as weU as recent phUosophies of remotivation
and rehabUitation for the longer-term patients, have stimulated the enthusiasm and
initiative of the nursing staff. They show versatUity and adaptabUity to their changing role in a new era of progress in mental health.
In each nursing unit, weU-organized and skilled psychiatric teams operate under
a unit medical director. The unit nursing supervisor co-ordinates the various nursing activities with other disciplines' activities to carry out the policies and phUosophies deemed to be most appropriate for that particular unit.
In the acute-treatment areas of the Provincial Mental Hospital, nursing staff
have been involved in various mixed-group therapies with other disciplines, such as
medical staff, psychology, social service, occupational therapy, and recreational
therapy.
In the continued-treatment areas of West Lawn and Riverside, greater emphasis has been placed on remotivation, reactivation, and resocialization groups. It has
proven to be a valuable form of therapy for long-term patients. The enthusiasm
and efforts of our staff have been admirable. They have been helped considerably
in their efforts by the generosity of a number of agencies in the community which
donated tickets to enable patients to attend public entertainments. The opening of
the new Coquitlam sports centre proved to be a real boon because of its proximity
to the hospital, and because invitations were received regularly to attend lacrosse
and hockey games as weU as many other major functions.
 F 58 MENTAL HEALTH SERVICES REPORT. 1963/64
Nineteen University of British Columbia affiliate student nurses who were
assigned to Riverside Unit in July assisted in the resocialization programme for
patients. They were chiefly responsible for organizing a boat trip to Wigwam Inn
for a day's outing for 35 of the patients. This was only one of many events which
these students planned and carried out. The patients showed their appreciation by
organizing a party for the student nurses.
AU areas enjoyed the Christmas season, which commenced with parties in the
various units. Community groups and entertainers came in to make the parties
more enjoyable. Wards were colourful with their decorations. Large numbers of
patients were taken on bus tours through Vancouver so that they might enjoy the
Christmas lights. The season ended suitably with a big New Year's Eve dance on
December 31, 1963.
In January, 1964, the last group of patients arrived at the hospital from the
Provincial Mental Home, Colquitz, by bus, and were quickly assigned to various
wards. The 19 staff from the Provincial Mental Home, Colquitz, who were assigned
to this service came, in two groups—one in January and one in February. They
were immediately enroUed in the Department of Nursing Education for a refresher
course of six weeks prior to being assigned to ward duty.
A nursing-care plan and Kardex system has been introduced and put into
operation on a trial basis on the men's wards in Crease Clinic. It has proven very
satisfactory thus far. The Kardex is a compact type of information and reference-
card file which can contain information on 40 patients and can be transported with
ease by the nurse during ward rounds.
The introduction of the narrative chart to aU areas has proven to be quite
valuable to the nursing as weU as medical staff.
Team nursing is another more efficient and progressive step taken by this department. It is now on West 3 and West 4 in Crease Clinic. If it is successful, it
wiU be expanded to include other areas in the male service.
The Central Supply has now extended its service to the Riverside Unit. This
service has eliminated many of the problems of obtaining sterile supplies.
Five nurses were granted leave of absence to attend the second half of an institute sponsored by the British Columbia Psychiatric Nurses' Association and led by
Dr. Bach, a prominent group therapist and psychologist from Los Angeles. This
was a six-day course conducted at Harrison Hot Springs Hotel. The concluding
address of Dr. Bach was given at the Nursing Education Centre, Essondale. AU
levels of staff attended this lecture.
The nursing service has been conducting a series of in-service lectures since
last December for charge, assistant charge, and psychiatric nurses and aides. The
theme this year was " RehabUitation." There has been an average of 93 per cent
attendance from the male staff. In addition, the Department of Nursing Education
has conducted a series of aide orientation lectures extending over 10 days. As many
aides as possible have been aUowed to attend, and the results have been gratifying.
Fire lectures have also been consistently attended by our staff as they could be
spared.  AU medical and staff seminars have been weU attended by the nursing staff.
The grounds supervisors had a very busy year. They have done a lot to keep
our patients out of difficulties on the grounds by counselling and supervision. During the past year they interviewed a total of 3,375 patients (1,836 male and 1,539
female) prior to these patients being granted grounds privUeges.
 crease clinic and provincial mental hospital f 59
Department of Psychology
The past year has been one of satisfactory progress in the Psychology Department, but there was a slight decrement in the activity of the department over that
recorded for the previous year.
One hundred and thirty-three lectures were given, mainly within the framework
of instructional programmes for nurse trainees, but included as weU talks delivered
to affiliating groups and visitors.
A total of 2,141 psychological tests was administered, the greater number of
which were used in the preparation of written reports about patients. Altogether,
605 such reports were submitted in response to requests made for diagnostic evaluation, inteUectual measurement, and personaUty assessment.
The department continued its programmes of group psychotherapy. Seven
hundred and twelve group meetings were conducted, the majority within the context of intensive psychotherapy services for the acutely ill schizophrenic patient and
the neurotic patient within the Crease Clinic. However, attention was given also
to maintaining therapy services at the After-care Centre and to establishing new
programmes within the Provincial Mental Hospital.
Research interest has continued strongly. Seven studies were undertaken:
five examined the efficacy of various therapeutic measures, one elaborated a specific
psychiatric deficit, and one related to staff selection.
The department has continued an affiliation with the University of British
Columbia in repeating, for a fourth summer, an internship programme designed to
familiarize the prospective graduate clinical student with the duties and demands
facing the psychologist working in a clinical setting.
Social Services
As in previous years, the social-work staff was engaged primarily in the provision of services designed to aUeviate the wide range of social problems presented
by the patients in treatment. Understandably a large proportion of social-work
time in every unit of the Provincial Mental Hospital and Crease Clinic was devoted
to the formulation and implementation of discharge or alternate-care plans, including, where necessary, arrangements for ongoing social and casework services, either
through the medium of a mental health faciUty or by referral to other appropriate
community resources. Particular note should be made at this point of those patients
within the adolescent and young adult age range who, because of their peculiar
needs and related problems, required specialized services, not only during hospitalization, but in the area of discharge planning as weU.
For the purpose of estimating the extent of services required by the adolescent
patients generaUy, a survey was undertaken by the Crease Clinic Social Service
Department of aU patients 16 years and under who were admitted to the clinic
during the calendar year 1963. The study encompassed 106 young patients, some
of whom were suffering from psychiatric illnesses, with, however, a significant
number of others exhibiting symptoms of behaviour disorders of varying degrees of
severity. Findings revealed that a comparatively high percentage of social-work
man-hours was, of necessity, devoted to adolescent patients, not only in terms of
direct services (both case and group), but indirectly in effecting Uaison with community social agencies and resources in preparation for discharge.
In both the Crease Clinic and the Centre Lawn BuUding it was found that the
most economical means of providing coverage for these patients was to work with
them in groups.   This has been of value in strengthening and buUding peer relation-
 F 60 MENTAL HEALTH SERVICES REPORT, 1963/64
ships. In the Crease Clinic the casework-group work service was ably augmented
by an activities programme under the leadership of the disciplines of nursing, recreational therapy, and occupational therapy, with the entire programme being coordinated under the direction of the Assistant Unit Director.
In other areas of social-work practice, the Crease Clinic Social Service Department, in co-operation with the admitting officer and Unit Director, initiated a preadmission service to prospective women patients as a pUot project over a six-month
period. On evaluation, the programme was found to be of sufficient benefit to
warrant continuance and possible expansion, since it enabled both patients and
famUies to prepare in advance for the event of hospitalization, thereby relieving them
of many domestic concerns which would otherwise interfere with treatment. In
addition, it contributed to pre-admission screening through the provision of pertinent
social information and subsequently in arranging referral to community social
agencies when this was recommended as a more suitable treatment plan.
In the Centre Lawn (Admitting) BuUding of the Provincial Mental Hospital,
the Brief Services and Admissions Section was particularly active during the year,
in line with the increase of admissions and correspondingly rapid turnover of patient
loads.
The selection and preparation of patients for placement in boarding homes
under the ongoing supervision of the hospital continued to be a major responsibility
of social workers assigned to the long-term treatment units. As of the end of the
year, 207 patients, comprised of 82 men and 125 women, were so placed in Ucensed
boarding homes in the Lower Mainland and Fraser VaUey areas. In addition, a
smaU number of non-ambulatory patients, whose psychiatric disabUities were sufficiently improved to permit discharge, were resettled in community private hospitals,
primarily in the vicinity of the Fraser VaUey.
Members of the department were also active in the area of after-care services.
Eleven team social workers from the Provincial Mental Hospital and Crease Clinic
reported for duty at the After-care Clinic on the basis of one-half day per week, and
were responsible for rendering services to some 33 per cent of the clinic's total
population of 1,000 (March 31, 1964). Although the services were largely of a
brief nature, continuing services were given in situations involving young chUdren
or where the patient was a mentaUy disturbed cluld or adolescent. During the year,
close contact was maintained with various health and welfare agencies, with many
case conferences being held on behalf of patients.
Two developments within the After-care Clinic have been important assets in
meeting the continuing needs of patients and their famiUes. One of these, the housewives' group, has met regularly under the guidance of the social group worker and
has achieved to a considerable degree its purpose of supporting group members in
dealing with day-to-day problems in adjustment. The second development is the
evening clinic, which, for approximately two years, has been conducted on a weekly
basis for the benefit of patients and their relatives in managing problems related to
the psychiatric illness of a famUy member.
In the area of clerical services, a new and useful development initiated by the
head stenographer was the completion of an office manual which standardizes the
most practical clerical procedures within the department, and which should serve
as a valuable aid in the orientation and instruction of new clerical staff.
NumericaUy the work of the department is depicted in the statistical summaries
for the year. In the Provincial Mental Hospital a total of 3,325 patients was given
service, as compared with 2,974 in the previous year, thereby involving the social-
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL F 61
work staff in more than 10,000 interviews with, or on behalf of, patients. Similarly
in the Crease Clinic social and casework services were extended to 1,588 patients,
which figure, except for a sUght increase of 134 cases, remained fairly consistent
with that of the previous year. Coverage of this group entaUed some 8,000 interviews.
Educational commitments were fulfiUed by participation in orientation programmes for professional groups and members of social-work agencies and aUied
disciplines, through speaking engagements with interested community organizations
and in the provision of field-work supervision to seven students from the School of
Social Work, University of British Columbia, who were assigned for practical
experience in the Crease Clinic and Provincial Mental Hospital. A further group
of seven students, aUocated to the After-care Clinic and under the supervision of a
field instructor from the School of Social Work, maintained Uaison with the central
services at Essondale in order to gain a comprehensive understanding of the treatment programme.
A review of the activities of the department for the year points to a continuing
process of integration of social services with those of other treatment disciplines and
Uaison with community agencies in the interest of improved patient service. Changes
in programme have been dictated by demonstrated patient needs and developments
within the treatment programme.
Rehabilitation Department
The RehabUitation Department, established in the early part of 1963, has developed rapidly and successfuUy during the past year.
Job placement of patients in the hospital work areas was already in progress
at the time of the inception of the programme, and two psychiatric nurses (one male
and one female), known as job placement officers, assigned to this particular duty
were transferred to this department at the time of its inception.
With the appointment of an occupational therapist in November, 1963, a programme of work assessments was instituted. The female job placement officer and
the occupational therapist commenced a job analysis of aU the work areas of the
hospital, devising at the same time a grading system whereby patients would be
classified according to ability. This survey made it possible to determine the level
of competence of the patients presently employed, as weU as the complexity of tasks
they would be performing. From this it was possible to evolve job training and payment plans.
By March, 1964, the team was complete with the appointment of a social
worker who is responsible for the patients referred to the RehabUitation Department
for long-term planning.
With the completion of the survey by the end of the year, token payment of
employed patients was anticipated for early in AprU. The patients have been classified into five grades, and the payments will range from 75 cents to $1.50 every two
weeks.
At the present time 60 per cent of the patients (excluding Crease Clinic) are
engaged in some form of occupational therapy. During the year a total of 1,226
men and 724 women were assigned tasks commensurate with their ability in the
hospital work areas. In addition, 429 men and 203 women were transferred to a
different task or work area.
The grading of patients and the prospect of receiving even token payments has
had a most salutary effect upon the patients. There has been an increased interest
in working and a noticeable improvement in the actual performance itself.   In addi-
 F 62 MENTAL HEALTH SERVICES REPORT, 1963/64
tion to the therapeutic aspect of working, many long-term patients have found the
experience invaluable as preparation for eventual adjustment in the community.
The administration of Venture and Vista was transferred to the Department of
Rehabilitation and specificaUy to the social worker on the team. The goal has been
for the two centres to become a rehabUitative resource.
During the year, 71 patients were transferred to Vista and 35 to Venture. The
largest percentage of the patients going to the two half-way houses required a Vancouver address while seeking employment and generaUy an opportunity to test out
their capacity to adjust to Uving in the community again. A goodly number were
placed for the purpose of completing secondary school or taking vocational training.
Of the patients going to Vista, 26 per cent returned to the hospital, whereas only 14
per cent of the Venture patients required rehospitalization. The remaining number
of patients went to boarding homes or on Social AUowance, or made a good adjustment in the community. It is planned that both centres wiU develop programmes
for the benefit of after-care patients on a non-resident basis. A start has been made
in that direction with satisfactory results.
With the appointment of an occupational therapist, the assessment programme
was established. During the period from November, 1963, to March 31, 1964, 100
patients were referred for assessment. Out of this number, only 84 were actuaUy
Involved in an assessment. Some patients were assessed more than once, either
because they were re-referred whUe stiU at the hospital or were readmitted. Those
patients who were not assessed were referred to job placement officers or were discharged before their assessment. Effective assessment of patients is important in the
planning of retraining and seeking of employment as the National Employment Service now uses the work assessment as a reference.
Although the largest number of the patients on the social worker's case
load are located at Vista and Venture, others are in boarding homes or stiU at the
hospital. An attempt has been made to visit with each patient on a weekly basis.
During the interviews, consideration was given chiefly to matters concerning vocational training, seeking of employment, as weU as enabling the patient to achieve
greater self-understanding.
A Consultative CouncU was estabUshed to advise the Medical Superintendent
on the ways in which the rehabUitation programme may be developed to the mutual
benefit of the patient, hospital, and the community agencies to which referrals are
made. The councU is composed of senior representatives of the Mental Health
Services Branch, the Provincial RehabUitation Services, the Social Welfare Department, the National Employment Service, the pubUc health units, vocational training schools, and the Division for Guidance of Handicapped, Community Chest and
CouncUs. Through this councU a close relationship with the National Employment
Service and the Provincial RehabUitative Services has been enjoyed.
The department also participated in the in-service training of the nursing staff,
the subject of rehabUitation having been chosen for presentation for this year's programme.
Occupational Therapy
The Occupational Therapy Department has had a favourable number of staff
and has been able to expand its services in several directions during the year. In
line with the current concepts of rehabUitation, a number of community-oriented
projects have been developed. Work from agencies such as the C.Y.H.A., Y.M.C.A.,
C.M.H.A. of Vancouver, as weU as routine clerical jobs solicited from offices and
departments within the hospital, have provided realistic and meaningful work for
many of the long-term patients.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL F 63
An experimental sheltered workshop was set up to handle aU the material for
the Tuberculosis Society's Christmas seal programme. In this joint project between
the Occupational Therapy Department and the Department of RehabUitation, 50
unemployed patients from the long-term treatment areas of East and West Lawn
worked together folding, stapling, and sorting seals and the appeal letters. During
the three months in which the patients attended the workshop, the majority displayed
an improvement in the level of general functioning, work tolerance, and sociability.
As in the previous year, the second stage of preparing this material for distribution
was carried out by a group of 30 patients at the society's headquarters.
In conjunction with the boarding-home programme, a home visiting service
was initiated. This service was designed to assist and support the boarding-home
operators in providing activities for the patients in their charge. At the present time,
visits are being made to homes in Yarrow, Steelhead, MaiUardvUle, and Haney. It
is anticipated that this service will be extended to other homes as the responsibUity
for the current programmes are assumed by the operators. Some continuity of service is provided by the therapist also working within the hospital with patients
referred for boarding-home assessment. The activities of daUy living unit, previously
used for this evaluation, was considered a more effective training and assessment
faciUty for patients returning to an independent living situation.
To assist the Department of RehabUitation in assessing some of the unemployed
female patients in the East Lawn BuUding, a work-assessment group was initiated
in January, 1964. The aim of the group was to re-establish work habits and to
assess the patients' capabaUties in various work areas. At the completion of each
group, over 70 per cent of the patients were able to be placed in fuU-time employment within the hospital, doing mainly the more simple housekeeping and laundry
tasks.
The appointment of a part-time commercial artist has enabled the department
to provide art instruction to a variety of the patient groups in an extended week-end
and evening programme.
Some instruction in typing was given by a visiting member of the Canadian
Mental Health Association. To this end, a typing-room was equipped with a number of used typewriters provided by the service department of the Purchasing Commission. This proved to be a valuable resource for patients requiring practice and
training in clerical work.
The opening of an infirmary ward in the North Lawn BuUding necessitated the
transfer of the Occupational Therapy Department over to the south side of the
buUding. In planning the new development, a kitchen unit was added to provide a
facUity for patients to learn simple cookery.
Fifty patients submitted work to the Pacific National Exhibition, and 12 prizes
were awarded to this group. The annual sale this year was held in November and
realized $1,888.
During the year the staff was active, with 9,910 patients referred to the department and 111,426 treatments were given in the same period. About 10 per cent
of staff time was devoted to team meetings and ward rounds involving discussion
of referred patients.
An active staff-development programme was carried out with the co-operation
of visiting speakers from other departments. Routine orientation lectures were given
to a variety of staff and affiliating nursing students.
Educational and supervisory responsibilities increased considerably with the
greater number of occupational-therapy students interning in the department.   Seven
 F 64 MENTAL HEALTH SERVICES REPORT, 1963/64
students, all graduates from the Universities of Toronto, McGiU, and Manitoba, were
affitiated with the department during the summer months. AdditionaUy a two-month
rotating practical training experience was provided for 16 second-year students from
the Department of RehabUitation Medicine, University of British Columbia.
Recreational Therapy
It is reported that, as the majority of the recreational staff are assigned almost
full time to units of the hospital, it has been possible to become more aware of the
needs of the patients and to contribute more effectively toward developing plans
designed to meet the needs.
ParaUeling the unit-developed programmes, there has been a continued growth
and diversification in the range, variety, and scope of the activities and opportunities
offered in areas outside the unit buUdings. Notable in this regard is the increasing
use and enjoyment of the facUities afforded in Pennington HaU and through the
related sports fields, golf course, picnic areas, and the swimming-pool.
In addition to the extensive daUy use of the various recreational facUities by
individual patients during their moments of freedom from work or treatment assignments, an increasing number of treatment groups enrolUng patients in special therapy
programmes have found in these facilities and the activities they make possible an
invaluable asset in helping the group to develop the interpersonal relationships,
which give meaning and purpose to the group approach to treatment. InformaUty
in scheduUng and a wUlingness to adapt to meet the needs of the individual group
has made it possible to respond to the many requests and to accommodate or make
avaUable almost unlimited use of facilities at many different hours of the day.
The early spring period saw an extension in the number and frequency of
regular ward activation programmes, whUe the late spring and summer months
brought their fuU complement of picnics, cook-outs, and day-long Stanley Park
outings. Winter bowling leagues became summer softbaU leagues. Smaller groups
were taken on frequent trips to points of interest, such as industrial plants, concerts,
sports events, and fishing trips. Late summer again was the occasion for more than
a thousand patients sharing the enjoyment of the Shrine Circus and the Pacific
National Exhibition.
Fall and winter again renewed interest in regular ward, unit, and hospital-wide
socials, dances, birthday and card parties. Major events included appropriate observations of Carnival Day, HaUowe'en, Thanksgiving, New Year's, Valentine's Day,
and Easter, whUe Christmas celebrations again took the form of unit " open house "
parties which saw more than 500 outside entertainers recruited to share in the festivities. Once again, acknowledgment must be given to the important role played by
the patients' orchestra in helping to make many of these events possible and popular.
Patients' School
The Patients' School has continued to provide an important formal education
service to patients. During the year ended March 31, 1964, the school was open
from 8 a.m. to 4 p.m. for 230.5 regular school-days. Thirty-eight male and 37
female patients, with an average age of 22.9 years, were enroUed. Dafly classes were
conducted for 50 of the students in the East Lawn schoolroom, whfle individual
instruction was provided for 25 who were confined to their wards. Thirty-six
students were discharged during the year, and the average attendance period per
patient was 10.6 weeks.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL F 65
Most of the hospital units were represented by those attending school. Eleven
students were from West Lawn, 24 from Centre Lawn, 27 from East Lawn, 3 from
North Lawn, 1 from Riverside, 1 from VaUeyview, and 8 from Crease Clinic.
The completion of an interrupted school-year and ultimate graduation from secondary school were again the primary goals of the majority. To this end both regular
classroom instruction and tuition by correspondence courses were offered. Thirty-
seven students made use of the latter, foUowing both the General and University
Programmes. Of those who continued with the standard grade curricula, 11 were
enroUed in the primary grades, 17 in the intermediate grades, and 4 in the senior
grades.  A study of English fundamentals was undertaken by six new Canadians.
The school now offers instruction in the Reading Skill Builder series provided
by the Department of Education. This is a progressive series designed for the adult
who has had Uttle formal reading instruction and presents material that is more
chaUenging than the juverule reading courses and more suited to the older student's
abiUty and interests.
Physiotherapy
Physiotherapy services have been provided to patients through the departments
estabUshed in the Crease Clinic and East Lawn and North Lawn BuUdings. During
most of the year a fuU complement of five trained physiotherapists was available.
Service was considerably increased during the year, when a total of 21,207
treatments was provided for 2,523 patients. This represents an increase of 8,231
treatment periods and 626 more patients treated than during the previous year.
New equipment provided for this department included a wax bath, faradic-
galvanic muscle stimulators, ultrasonic equipment, and restorators, aU of which has
made possible a comprehensive physical treatment service for patients.
Department of Radiology
During the year this department has provided a comprehensive diagnostic
service to patients, and year-end reports show an increase in the number of procedures carried out compared to the previous year.
The total number of films taken was 17,638, an increase of 1,395, and involved
12,849 patient examinations and reports. This includes chest films taken as part of
the annual tuberculosis survey, during which 2,931 chest.films were taken for staff
and 6,491 for patients.
Department of Laboratories
There were increased demands for laboratory service throughout the year, both
in the fields of diagnosis and in research.
The number of procedures performed totaUed 67,243, an increase of 4,960
over the previous year. This increase occurred mainly in the department of bacteriology, where there was a marked increase in the number of smears, cultures, and
antibiotic sensitivity tests. In hematology there was an increase in blood transfusion
procedures. The chemistry department showed a significant increase in the number
of routine urinalyses and blood urea nitrogen tests.
There were 197 autopsies performed and 414 surgical tissues examined.
The department has continued to function as a consultative centre in neurology,
providing neurological, electroencephalographical, and neurosurgical consultative
service to the Provincial Mental Health Services.
3
 f 66 mental health services report, 1963/64
Department of Neurology
Clinical neurological consultation in the year totaUed 307. These led to the
foUowing investigative procedures: 14 pneumoencephalograms, 32 lumbar punctures, 6 myelograms, 3 perimetric examinations, and 7 carotid arteriograms.
A total of 996 encephalograms was performed. Most of these were of the
routine variety, but a number of specialized procedures were also carried out, including four alcohol activation studies and two metrazol activation studies.
Dr. Frank Turnbull provided neurosurgical consultation in 53 patients. This
led to 16 neurosurgical procedures, apart from the carotid arteriograms already
mentioned.
A large number of visitors received guided tours through the department and
were given informative talks on electroencephalography. Probably over a dozen
groups, totaUing weU over 200 individuals, were shown through the department.
Groups included secondary-school students, university social-work and psychology
students, and various women's organizations.
Research activities in co-operation with the Department of Medicine led to
the pubUcation of one paper, " Skin Pigmentation and Corneal and Lens Opacities
with Prolonged Chlorpromazine Therapy," by Anthony C. Greiner, M.D., and
Kenneth Berry, M.D., in the Canadian Medical Association Journal.
Pharmacy Department
The pharmacy has continued to provide for the constant and increasing pharmaceutical needs of the Provincial Mental Hospital and Crease Clinic, as weU as operating as a supply and ordering service for the other units and divisions of the Mental
Health Services.
The Pharmacy CouncU has continued to give guidance concerning pharmaceutical poUcy and in the investigation and use of new drugs in the treatment of the
psychiatricaUy ill patient.
During the year 45,000 units of stock items were dispensed to the wards.
Nearly 22,000 individual prescriptions were fiUed.
Service to boarding homes and other units of the Mental Health Services en-
taUed the mailing of 10,000 items.
Optical Department
The Optical Department has continued to operate throughout the year on a
regular part-time basis providing refractive, dispensing, and spectacle-maintenance
services.
During the year 825 procedures were carried out, including 508 refractions,
221 other major services, and 96 minor services.
Dental Department
The dental service has continued to be active in aU fields of dentistry, and every
effort has been made to keep up with increasing demands for all types of dental care
and treatment.
Several obturator cases requiring special forms of dentures were handled with
satisfactory results, and a number of dentures were also made for patients who were
out of hospital on probationary discharge.
A total of 42 patients requiring difficult extraction procedures was successfuUy
treated through the co-operation and faculties of the Crease Clinic Surgical Department.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL F 67
Denture-marking has continued for newly admitted patients as required, and
it is noted that a greater number of patients admitted are in need of proper dentures
or are in a very poor state of oral health.
During the year a total of 3,188 patients was seen, who required a wide variety
of treatment procedures, including 2,445 extractions, 892 fiUings, 1,162 denture
fittings, 400 prophylactic treatments, and 797 initial oral examinations. In addition,
241 dentures were processed to completion and 290 repairs made to damaged sets.
A total of 529 dentures was marked for identification and 79 gold castings prepared.
Chaplain
Rev. John F. O'NeU, E.D., B.A., L.Th., C.P.H.C, Protestant chaplain for the
Provincial Mental Hospital and Crease Clinic, has given general direction to this
department throughout the year.
Rev. R. Fred FUer, the chaplain at VaUeyview Hospital, has continued to aid
this hospital through his wiUing assistance by ministering to the patients in North
Lawn BuUding in addition to his own work at VaUeyview.
On February 17, 1964, Rev. WUliam S. Lacko, S.J., was appointed as the first
fuU-time Catholic chaplain for the Essondale area, and will now be able to give a
more comprehensive service to patients of the Catholic faith compared to that
possible previously whUe serving on a part-time basis. Father Lacko is also proficient as an interpreter in 14 European languages and has been of great assistance
to our medical, nursing, and social service departments in this capacity.
The spiritual needs of the patients have been faithfuUy ministered to through
the efforts of the chaplains that we have on our staff.
Two events of especial importance occurred during the year. One is that
through the efforts of the chaplains, especiaUy those of Reverend O'NeU, a major
portion of one of the television productions of the Heritage series of the Canadian
Broadcasting Corporation was produced in this hospital and was shown on the
nation-wide network. This required a great deal of effort and extra time that was
freely given by the hospital staff and is a credit both to the chaplain service and to
the C.B.C.
Secondly, through the co-operation of the Canadian Mental Health Association
volunteers and the hospital chaplains, 35 choirs from the churches in the Greater
Vancouver-New Westminster area came to the hospital and assisted at the regular
services of divine worship in Pennington HaU on Sunday mornings.
With the appointment of Father Lacko as a fuU-time chaplain, it is now possible
for Roman Catholic patients and staff to observe their feasts of obligation apart
from Sundays and Christmas.
Special services commemorating Remembrance Day, Good Friday, and Christmas have been maintained.
Throughout the year, music for the regular weekly church services in Pennington HaU has been supplied by Mr. Lojze Smrekar, who has also given freely of his
time to provide music for ward services.
Library
Both the patients' Ubrary and the medical library have been greatly augmented
during the year with the appointment of a fuU-time library assistant to work with
the branch Ubrarian.
 F 68 MENTAL HEALTH SERVICES REPORT, 1963/64
Most of the older titles have been removed from the patients' library and sent
to outlying areas to furnish services for patients unable to visit the Crease Clinic,
and a comprehensive selection of new books, both fiction and non-fiction, including
classical works in poetry and drama, for which there has been a considerable demand, is steadUy being acquired. The Ubrary has encouraged with professional
guidance and advice, as weU as the provision of books, the formation of discussion
groups by both nursing staff and volunteers among the patients at the Provincial
Mental Hospital. Awareness of both staff and patients of the Ubrary facUities avaU-
able has been stimulated by the Ubrary undertaking the regular publication of book
lists, critical reviews, and other material in the patients' magazine, The Leader.
During the year 479 additions were made to the patients' Ubrary, whUe 135
volumes each were sent to the Skeenaview and DeUview Hospitals and 400 to the
North Lawn Ubrary. A total of 4,169 titles is avaUable in the Crease Clinic library
for patients' use.
The medical Ubrary has been of increasing service to professional-staff members, especiaUy to the medical staff and allied disciplines. There has been an extensive use of interiibrary loan privUeges, and the Ubrarian has handled a heavy
volume of references for the medical staff. A large number of new journals has
been added to the current list, and the acquisition of many back numbers has permitted the binding of many more volumes than before; these now total 688. The
Ubrarian has made continuing efforts to co-ordinate the Mental Health Services
Ubraries, for example, by cataloguing the newly acquired volumes at the Mental
Health Centre, Burnaby, and at The Woodlands School and by acting as a cataloguing consultant for the School of Nursing Ubrary. The manifold advantages of
this co-ordination are obvious, one of the chief benefits being the interchange of
volumes among the various libraries.
During the year 227 additions were bought for the medical Ubrary, bringing
the total coUection to 3,220.  In addition there are 136 current journal subscriptions.
Business Administration
It was at the beginning of the year that the Industrial Therapy Building was
opened. This fine buUding consolidates a department spread out over the hospital
into one area. Among the new facUities are included a spray-paint booth and bake-
oven facUity, a television and radio repair shop, an expanded and more modern
print-shop, an exceUent shoe manufacture and repair shop, and an expanded mattress-shop. With this new facility our hospital is now able to produce its own spring-
fiUed mattresses, to repair and refinish the patients' beds, and to fulfiU virtuaUy aU
the printing requirements. At the same time it is possible to provide a therapeutic
experience for patients employed in the department.
New equipment in the laundry, which includes four tumblers and three lint-
coUectors, has done much to improve the tumble-dry section of this department and
to make better use of laundry floor space.
Changes have taken place in the admitting procedures in the Crease Clinic,
such that from one master admitting form it is possible to prepare various clinical
forms and cards of different sizes with accuracy and with much saving of time. It
is expected that this procedure wUl be extended to the Provincial Mental Hospital,
and that its potential for wider appUcation wUl be exploited.
New furniture has been purchased in order to improve the appearance of the
wards. This, together with the instaUation of fibreglass drapes, is doing much to
improve the appearance of patients' areas.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL F 69
During the year Mrs. West, of the Medical Records Department, returned from
educational leave as a qualified medical-records librarian, having taken the year's
course at the Royal Columbian Hospital. Mr. W. E. Gueho, general office supervisor, completed the course in Hospital Organization and Management sponsored
by the Canadian Hospital Association and was awarded the diploma.
Diet kitchens are being modernized wherever possible. In the Riverside BuUding a new and vastly improved dish-washing set-up has been instaUed. In the
Centre Lawn BuUding a tray service system for serving the patients has been introduced.
Laundry
The laundry manager reports a year of increased production as weU as increased service. Minor refinements in procedures and techniques were made in a
number of instances and have done much to eliminate problems. During the year
9,645,085 pounds of linen were processed, along with 131,110 pounds of dry-cleaning. This reflected an increase over the previous year's production of 84,315 pounds
of linen and 20,720 pounds of dry-cleaning. The increase in items required to be
processed appears to be a direct result of an increase in the amount of clothing
coUected for patients by the Canadian Mental Health Association volunteer group.
New equipment instaUed during the year included three lint-coUectors and three
dry-tumblers, the latter replacing worn-out equipment.
Audio-Visual Department
The 35-mm. and 16-mm. recreation shows have been lengthened, and the
variety increased as patient outlook has improved.
Many staff members have now been trained to operate the 16-mm. projectors
for educational films. This means that such films can be shown when required at
departmental convenience, with film damage and projector trouble being kept to a
minimum.
The moving of the radio-telephone base and aerial from the Fire HaU to the
Riverside BuUding has resulted in much better radio-telephone coverage to The
Woodlands School and Vancouver, besides Essondale. There are now 16 mobUe
sets in operation.
During the year 35-mm. films were shown 140 times to 34,091 patients and
16-mm. films were shown 324 times to 16,063 patients. The educational film
Ubrary now has 422 registered borrowers, who used 1,473 films from our Ubrary.
Medical Records
During the year the Medical Records Department assisted in several surveys
and projects, the more significant of which included one for the Crease Clinic Unit
Director on 170 admissions and one on Order in CouncU and special-security
patients.
With the extension of Mental Health Services throughout the Province, the
department is now forwarding copies of discharge synopses to the appropriate
Mental Health Centres.
The conveying of medical information between the hospital and the After-care
Clinic has been faciUtated by doing away with dupUcate files and the placing of aU
notes directly on the patient's hospital file.
A Medical Record Committee was organized in February, 1964, for the
purpose of elevating and maintaining- the standards of medical records in the
Provincial Mental Hospital and Crease CUnic.   This committee has already effected
 F 70 MENTAL HEALTH SERVICES REPORT, 1963/64
worth-whUe changes and wiU strive, among other things, to improve forms and
methods presently employed in maintaining the medical records.
Due to the sharp increase in Provincial Mental Hospital admissions and
separations during the year, together with demands by medical staff for more
up-to-date records and the need for accelerating the flow of medical information
to doctors in the community, stenographic staff has been increased. These additions
have enabled us to provide our medical staff with considerably improved service.
Major changes in the organizational set-up of the Crease Clinic admitting
area were effected with the Chief Admitting Clerk and her assistant moving out
of the Crease Clinic records office to the admitting suite. Nursing staff formerly
employed in this area were replaced by the admitting clerks, an additional clerk's
position being established to help assume the duties formerly undertaken by the
nurses. Procedural changes were also Initiated in conjunction with this move, the
main one being the instaUation of a dupUcating-machine for processing the necessary
forms and cards from a master stencU. This has faciUtated procedures related to
the forwarding of admission advice letters to the various agencies involved and in
lessening the burden of typing the numerous index cards required.
Dietary Department
The dietetics administrator reported a year in which there were continued
improvements made in the department. In addition, more dietary aides joined the
department, thus enabling an improved standard of service to be given to patients,
particularly in the East Lawn BuUding. Although misceUaneous items, smaU equipment, and several pieces of much-needed large equipment were received by the
department, the following advances in increased services and new functions are
notable:—
(1) A completely renovated dish-washing area in Riverside kitchen equipped
with a new Hobart dish-washer and garburator.
(2) A stainless-steel canopy, complete with fan to the outside, was instaUed
over aU the electrical equipment in Riverside Cottage kitchen.
(3) New tables and chairs were received in the West Lawn BuUding's two
downstairs dining-rooms. Partial tray service was implemented on A-l
Infirmary Ward in this unit, and the outdated divided trays were replaced
by Melmac plastic service.
(4) N-l Infirmary Ward was opened in North Lawn BuUding, and food
service was increased to include it. The main kitchen received an electric floor-scrubber.
(5) New chairs were received for the two Crease Clinic staff dining-rooms.
(6) Food services in East Lawn BuUding Wards J-3 and H-l were taken over
by dietary aides. The large institutional-size rectangle tables in J-4
dining-room were replaced by smaUer round ones.
(7) Centre Lawn kitchen is now providing hot cart food service to E-3
Admitting Ward. Much work was done here regarding refrigerators and
the steam-kettle cookery yard.
(8) With the automatic telephone exchange, all dietary offices and each kitchen
now have interhospital communication.
Industrial Therapy Department
The new Industrial Therapy BuUding has been a major scene of interest since
its opening a year ago and has been host to many interested groups from outside the
hospital as weU as organized groups within the hospital.   Patient activity has been
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL F 71
very keen in aU training areas, with a marked improvement in patient outlook,
rehabUitation, and over-aU increased productivity.
Patient statistics for the year are as follows:—
Total patients employed in trade-shops.__.        ___ 2,537
Patients progressed to hospital work level...       119
Patients discharged to community      161
Productivity figures for the year are as foUows:—
Dry-goods Section    	
Mending Section 	
TaUorins Section	
Manufactured
Items
74,975
Repaired
Items
110,515
6,250
6,482
,843,798
8,541
1,389
2,219
847
703
9,274
206
1,461
2,367
800
10,113
3,029
2,629
232
Mattress and Canvas Section	
Printing Section _._
Machine and Metalsmithing Section	
Cabinet-shop	
Upholstery Section 	
Uniform Section	
Shoe Section  	
Paint Finishing Section (for nine-month period)
Electronics Section (for six-month period)
Volunteer Services
It is interesting to note that this service now completes 10 years of activity
within the hospital and has developed from a smaU group of six volunteers who
visited the Crease Clinic one-half day per week to the large group which now
numbers 169, providing services on six days and four evenings per week throughout
the whole of the Mental Hospital and Crease Clinic as weU as VaUeyview.
During the year the volunteers made 2,490 individual visits and provided
12,084 hours of direct service to the patients. An additional 10,000 hours of
indirect service was provided through luncheons, picnics, various forms of entertainment, and work related to the apparel-shops.
The apparel-shops continued in the customary fashion of exceUence. A total
of 2,336 patients received 12,219 articles of clothing. In addition to clothing there
were 4,376 smaU articles distributed, most of which were given out as prizes for
Carnival Day games. Preparations are now under way to combine both the men's
and women's apparel-shops in a more suitable structure. It is hoped that this move
wiU improve the efficiency of the shop and in turn raise the standard of quality of
the clothing distributed.
The annual Christmas gift programme was not quite as successful as past
years, although it was stitt possible to give every patient in hospital a suitable
Christmas gift. Over 7,000 individual gifts were received, taUied, and wrapped by
volunteers.
Mr. Hugh Picket, of Famous Artists, has been most helpful this year in assisting patients to attend activities away from the hospital. Over 500 tickets were
donated to plays, concerts, and other activities in the Queen Elizabeth Theatre,
Theatre Under the Stars, and the Moscow Circus. On many occasions we have
had permission to send as many patients as possible to these events.
One of the most popular additions to our programme this year was the Paint
for Fun Club initiated in the Crease Clinic. A local amateur painting group caUed
Garibaldi Workshop volunteered its service.   The programme was organized into
 F 72 MENTAL HEALTH SERVICES REPORT, 1963/64
two groups. Talented or experienced painters could paint in oils or water colours
with the guidance and help of our expert volunteers. The other group was one of
novices who had desire but no experience. A skUled volunteer took this group and
lectured as weU as demonstrated the methods of sketching and painting.
A programme on the male security ward of A-4 initiated another new activity
this year. A bi-weekly discussion group was formed with from 8 to 10 patients,
the group participants being selected by the medical staff and nurses. Arrangements were made to begin by showing appropriate films foUowed by discussion.
GraduaUy preparatory reading material was obtained from the Ubrary and several
Interesting discussions on varied topics took place. The programme has been
successful.
There has been a considerable increase of community interest indicated this
past year. Some 25 groups, representative of aU types of organizations, have
visited the hospital for a total of 587 individuals. There has also been a noticeable
increase in volunteers coming from the districts surrounding the hospital, such as
Port Moody and Port Coquitlam.
One of the most interesting aspects of the community interest is that of the
secondary schools. Apparently several schools now include some instruction in
psychology and sociology, and as a result have requested opportunities to visit the
mental health facilities. Arrangements were made for discussions and presentations
by medical staff for 200 students in groups of 25. From all reports this type of
programme was most meaningful, and the schools have indicated their wish to
continue again in the coming term.
Civil Defence
FoUowing the retirement of Dr. T. G. Caunt at the end of August, Dr. B. F.
Bryson, Medical Superintendent, was appointed as CivU Defence Co-ordinator for
the Essondale area.
During the year there has been a general lessening of interest and activity in
civU defence, but the Essondale Planning Committee has continued to meet each
month in order to maintain its organization and preparedness for local emergencies.
Communication and contact with the Vancouver Target Area and Provincial
CivU Defence authorities has also been maintained through receipt of correspondence and buUetins and by the attendance of senior officers from Vancouver at the
Essondale Planning Committee meetings.
The head of the welfare service attended an Institute in Emergency Welfare
at Victoria, and a member of the Fire Department took part in a rescue course in
the same city during the year.
Two classes of incoming student nurses received orientation and instruction
in hospital disaster preparedness.
The communication department has been active training staff members to
qualify for this necessary work should a local or national emergency arise. The
Provincial Communications Officer is kept aware of our facilities and progress.
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL
STATISTICAL TABLES
F 73
CREASE CLINIC
Table 1.—Movement of Population, Crease Clinic, April 1, 1963,
to March 31, 1964
Male
Female
Total
91
491
21
230
3
580
38
249
2
Admissions—
Readmissions to a different institution of Mental Health Services	
59
Admissions direct from Provincial Mental Hospital, Essondale	
5
745
869
Total under <**«■
836
996
1,832
Separations—
696
32
1
3
828
23
3
6
732
854
N(ft iiwwn _f
+ 13
104
+ 15
142
+28
246
 F 74
MENTAL HEALTH SERVICES REPORT, 1963/64
Table 2.—First Admissions to Crease Clinic by Health Unit and School
District of Residence and Sex, April 1, 1963, to March 31, 1964
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
Metropolitan Health Committee,
1
5
1
5
4
10
5
School District No. 44
„   45
21
8
30
13
._   3
21
„   5
4
4
Simon Fraser, New Westmin
Selkirk, Nelson—
ster—
Srhnnl District No. 7
3
1
4
School District No. 40	
18
24
42
..   10
1
1
2
„   43
14
14
28
West Kootenay, Trail—
North Fraser Valley, Mission—
School District No. 9
2
2
4
School T_._r_i_ Nn  4?,
5
8
13
.,          _.        .."
7
12
19
„   75
7
5
12
.,   12
3
1
4
,,   76
3
3
South Okanagan, Kelowna—
Upper Island, Courtenay—
School District No. 14
1
2
3
School District No. 47	
4
8
12
„   15
1
4
5
„   71
2
1
3
..          ,.        ,,   16
1
2
3
„  72	
2
3
5
,.   ?1
4
3
7
„  73	
1
1
2
„   77
1
1
Skeena, Prince Rupert—
North Okanagan, Vernon—
Rrhnnl 1-i-trir.f T.n   5fl
1
1
2
School District Nn 19
2
	
2
„   52	
3
5
8
2
2
,,              ,.           ._    n
6
,,   77
3
3
Peace River, Dawson Creek—
„   78
1
	
1
School District No. 59	
5
3
8
South Central, Kamloops—
Sch.nl District No, 74
4
4
8
 81	
2
2
4
,,   79
2
2
Greater Victoria Metropolitan
,.   30
3
3
Board of Health—
„   31
3
3
Greater Victoria—School Dis-
School District No. 7.7
4
4
8
Saanich and South Vancou
'                         *>s
3
4
7
ver Island—
Srhnn] District No. 62
1
2
Northern   Interior,   Prince
3
George-
1
3
4
School District No. 55	
1
2
3
Central Vancouver Island, Na
.,   56
1
1
naimo—
10
2
8
2
18
4
3
1
3
1
„          „        „  58	
„  66	
2
Upper Fraser Valley, Chilli-
„         „       „  33
7
10
17
„  70
5
6
11
„  34
9
8
17
School districts not covered by
Boundary, Cloverdale—
health units—
School District No 35
9
7
16
School District No. 46	
	
5
5
36
7
53
7
89
14
, 48
 49	
3
2
2
„          „        „   37
3
Metropolitan Health Committee,
4
4
8
3
3
6
5
1
6
, 39	
181
206
387
Ex-Province	
6
3
9
,.    41
29
48
77
Totals
514
619
1,133
1
 CREASE CLINIC AND PROVINCIAL MENTAL HOSPITAL                F 75
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PROVINCIAL MENTAL HOSPITAL, ESSONDALE
Table 1.—Movement of Population, Provincial Mental Hospital,
Essondale, from April 1, 1963, to March 31, 1964
In residence, April 1, 1963 ,	
On probation, carried forward from 1962/63	
On escape, carried forward from 1962/63	
Total as at April 1, 1963	
Admissions—
First admissions , _, . .	
Readmissions to a different institution of Mental Health Services
Readmissions to the same institution	
Admissions direct from Grease Clinic	
Transfers from Provincial. Mental Home, Colquitz	
Transfers from geriatric units	
Total admissions	
Total under care	
Separations—
Discharged in full . . ,        , „	
Discharged direct to Crease Clinic	
Died	
Transferred to geriatric units	
Transferred to schools for mental defectives	
On probation and stm out	
On escape but not discharged   ,
Total separations	
Net increase or decrease	
In residence, March 31, 1964	
1,484
189
+68
1,552
1,256
448
-2
1,254
2,740
637
1,676
1,705
3,381
561
409
970
135
180
315
578
527
1,105
32
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1,142
2,568
3,102
2,847
5,949
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411
637
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1.593
3,143
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2,806
 MENTAL HEALTH SERVICES REPORT, 1963/64
Table 2.—First Admissions to Provincial Mental Hospital, Essondale,
by Health Unit and School District of Residence and Sex, April 1,
1963, to March 31, 1964.
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
Simon  Fraser,  New  Westmin
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3
5
8
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39
15
54
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14
24
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5
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Selkirk, Nelson—
School District No. 42
7
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3
3
6
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5
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 8	
1
1
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West Kootenay, Trail—
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4
2
6
School District No, _
2
2
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4
7
n
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2
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1
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2
5
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6
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2
4
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2
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15
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5
7
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Board of Health—
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12
7
19
Greater Victoria—School Dis
ii          ,•        8   *">
2
2
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22
17
39
ii          ,i        ,.   ,n
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Saanich  and  South  Vancou
i>          ii        .,   31
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ver Island—
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School District No  67
2
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School District No. 27	
8
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13
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Northern   Interior,   Prince
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 34
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29
51
 49
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25
 ,   39	
335
265
600
Totals
733
609
1,342
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30
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62
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MENTAL HEALTH SERVICES REPORT, 1963/.4
PART HI.—THE WOODLANDS SCHOOL, NEW WESTMINSTER
REPORT OF THE MEDICAL SUPERINTENDENT
F. G. Tucker, Acting Medical Superintendent
The past year has seen steady progress and development in the therapeutic
programme at The Woodlands School in spite of the inevitable disruption arising
from the change in senior administrative personnel.
Dr. L. A. Kerwood resigned on January 31, 1964, to take up an appointment
at the Verdun Protestant Hospital, Montreal, after eight years as Superintendent,
and we are indebted to him for the high standards of care and progressive programme which was developed within the school during his tenure of office. Dr. W.
W. Laughland resigned on January 3, 1964, after carrying out the onerous duties
of Deputy Medical Superintendent for three years. On December 20, 1963, Dr.
R. G. Foulkes was appointed Deputy Medical Superintendent and has proved a
most effective medical administrator. Dr. Stewart Bland, of Greylingwell Hospital,
England, has been appointed Medical Superintendent and will be taking up his post
in August 1964.
There were 1,312 pupils on the register at The Woodlands School on April 1,
1963, with 1,316 registered at the end of the year.
The following table shows the movement of population during the year:—
Male
Female
Total
706
14
582
10
24
720
592
Admissions—
65
5
61
4
3
50
~55
4
2
5
138
111
249
858
703
1,561
Separations—■
9
71
7
42
13
4
59
11
19
10
13
Discharged in full from temporary care
130
18
61
23
Total Reparations
142
103
245
+10
716
+1!
600
+28
1,316
It was considered necessary prior to the year's end to survey various aspects
of the organization of the school with a view to carrying out the remaining recommendations of the 1959 report of the American Psychiatric Association to justify
the request for increased professional staff and to bring the total organization in
line with contemporary hospital administration. The organization was reviewed
in the light of standards of the accrediting agencies, including the American
Psychiatric Association and Canadian Council on Hospital Accreditation, and the
standards for State residential institutions for the mentally retarded recommended
by the American Association on Mental Deficiency.
 THE WOODLANDS SCHOOL F 97
Committee functions of the medical staff at the beginning of the year were
represented by the Pharmacy and Therapeutics Committee alone, but by the year's
end the Admitting Committee and Medical Records Committee were in operation
and committees on disaster planning, medical audit, and credentials were projected.
At the year's end, some ward reorganization was anticipated, and the institution
was considered to be divided, as far as bed allocation is concerned, into the following
broad areas: Prolonged hospitalization facilities for multiple handicapped, 400
beds; psychiatric services for retardates, 200 beds; residential accommodation,
800 beds.
Integration of the male and female nursing divisions into one unified nursing
staff was ordered by the Deputy Minister, and planning for this was well advanced
at the year's end. A high standard of nursing has been maintained in all areas during
the past year. The demands on nursing services increase as the proportion of
severely retarded and handicapped patients rises in the institution, and the activity
programmes increase in scope and intensity.
At the year's end, 200 patients were attending the academic school and increasing numbers receiving the benefits of the play-to-learn therapy classes and the self-
care ward programmes. An active camping programme was carried out throughout the summer months, and the staff gave many hours of time in order to make
this a success.
The diagnostic clinic functioned throughout the year as an efficient means of
applying the multidisciplinary approach to the individual patient and to arrive at a
definitive diagnosis and plan for treatment. The total number of patients processed
by the diagnostic clinic during the year amounted to 140.
Four clinical pathological conferences were conducted on rare and interesting
cases, with visitors from the Department of Paediatrics, University of British Columbia, and the Crease Clinic present.
Wards J and M have acted as psychiatric wards during the past year, caring
for the emotionally disturbed mental retardate. Considerable variation in the degree
of retardation in these patients has led to some difficulty in programming. Under
the supervision and direction of the psychiatrist, numerous group meetings have
been held with patients, staff, and relatives by senior nursing staff, in that way
utilizing to a maximum extent the resources available.
During the year the Occupational Therapy Department organized a sheltered
workshop as a pilot project. This was carried out in the evening, using the facilities
of the Occupational Therapy Department and supported initially by a grant of money
from The Woodlands School Auxiliary and the Psychiatric Nurses' Association. It
was hoped that the pilot study may recommend its incorporation into the daytime
programme where conditions simulating those of actual employment in a small factory can be arranged. We would like to express our appreciation to Mrs. Blackmore
for her initiative and for the time which she has donated to this project.
A limited amount of research has continued to be carried out or planned during
the 1963/64 fiscal year. Dr. B. Tischler, Director of Paediatrics and Medical Services, continued with her investigations into the field of phenylketonuria in co-operation with Dr. Thomas Perry, Associate Professor of Pharmacology, University of
British Columbia. She also worked closely with Dr. J. Miller, Geneticist of the
Department of Pediatrics, University of British Columbia, and three papers are in
process of being published. Dr. Pauline Hughes obtained the necessary requirements to carry out experiments in the " mirror room technique " of treatment of
autistic cluldren, pioneered by Dr. Lilli Hofstatter, St. Louis, Mo.   The Psychology
 F 98 MENTAL HEALTH SERVICES REPORT, 1963/64
Department carried out an investigation of communication training with a small
number of children diagnosed as having perceptual dysfunction. In addition a
number of new laboratory procedures were introduced.
For the second year there has been no turnover in our social service staff, and
this must be considered a major contributing factor to the high level of activity in
the department and has permitted expansion of services. Our working relationship
with the public health units in the metropolitan Vancouver and New Westminster
areas continues to be most satisfactory. We are most appreciative of their cooperation. The Department of Social Welfare field staff and health units continue
to provide us with information for the assessment of priorities for admission, and
it is anticipated that these will be co-ordinated at the local level during the coming
year. Increasing services have been provided for pupils in the school and for their
families, which in part reflects the increased efforts to move children and adults out
of the institution and back into the family.
The most promising developments in the past year have been development of
a foster-home project jointly operated by the Child Welfare Division of the Department of Social Welfare and the Mental Health Services. A boarding-home programme has also been developed for the older well-socialized retarded persons as
a co-operative programme with the Department of Social Welfare. As of March
31st 11 pupils had been placed in boarding homes, many of whom had been in the
institution for many years (one was admitted in 1910), and who are now adjusting
well to their new way of life.
Work placements have continued, although the programme is handicapped by
the lack of adequate training areas, and there is a need for greater co-ordination of
the training programme within the institution and the community. It is felt that
there is an urgent need for group-living accommodation in the community to assist
young adult retardates in transition from the institution to a more normal life.
A number of our pupils are engaged in employment outside the institution but remain
at The Woodlands School for lack of suitable accommodation.
Numerous educational tours, indicating a greatly increased awareness of the
general field of retardation, have been held by all departments during the past year.
We are particularly happy to see the increasing interest of professional persons and
students entering the professions. Some indication of the scope of this service is
evident in the fact that over 1,000 professionals and interested persons visited the
play-to-learn class alone, and 228 professional persons were conducted on orientation tours by the Social Service Department.
During the year the main emphasis in the Recreational Therapy Department
has been on fitness, with the provision of activities that develop strength, flexibility,
endurance, and co-ordination and offer opportunities for wholesome use of leisure
time. We have introduced into the programmes such activities as gymnastic and
tumbling club for boys, bowling for the girls at the local community bowling-alley,
and a girls' basketball team which has been most successful in intercommunity
competition. There have been an increasing number of classes scheduled on the
wards in order to provide coverage for the severely retarded pupil, and a special
class has been introduced for blind pupils in the swimming-pool. The auxiliary
has contributed generously of time and material, and over 11,000 articles of clothing were distributed to the wards. In recognition of the volunteers' contribution to
the school, a reception and buffet was held on May 3rd.
In the business administrative area the most outstanding accomplishments in
the year were the introduction of housekeeping and dietary services to the wards
at The Woodlands School.   Fifty-two positions were established to replace the
 THE WOODLANDS SCHOOL F 99
patient workers transferred to The Tranquille School, and by judicious use of staff
placements, rostering, and proper housekeeping methods, it has been possible to
institute housekeeping service, not only into the female areas as planned, but into
the male areas also. This has not only provided a high standard of housekeeping,
but has freed nursing staff for the duties to which they should be assigned.
The Dietary Division has been reorganized under Mrs. Sylvia May, who joined
the staff in November. We look forward to an extended dietary programme on the
wards during the next fiscal year, with the introduction of cafeteria feeding for many
ambulatory patients.
We are grateful for the dedication of our chaplains, who, in addition to providing religious services and catering to the spiritual needs of our patients, have
shared in the work of the religious education committee to provide the necessary
religious training and to implement catechism classes for the Roman Catholics.
The chaplains have also made themselves available for counselling at any time and
acted as liaison persons between the parents of newly admitted children and their
local pastors where families have indicated a desire for assistance.
At the year's end the outlook by and large appeared to give grounds for optimism. Moves to Tranquille have permitted the planning for admission of a large
number of patients from the waiting list, whose numbers will be reflected in the
1964/65 report. In addition, foster-home and boarding-home placements appear
to offer a way to obtain increased discharges from the institution and at the same
time provide patients with an opportunity for community living. Improved relations with Governmental and other organizations outside The Woodlands School
give promise not only of relieving the immediate pressures, but also of reducing the
numbers actually making application for the use of the facility by providing alternative arrangements in the community.
 F 100
Table 1.
MENTAL HEALTH SERVICES REPORT, 1963/64
STATISTICAL TABLES
-Movement of Population, The Woodlands School, New Westminster, April 1,1963, to March 31,1964
Male
Female
Total
706     ,
14
582
10
1,288
720
592
1,312
Admissions—
65
5
61
4
3
50
55
4
2
Transfers frnm Provincial Mp"tai "HV.v_p.t_... fissmSElaP
5
138
111
858
703
Separations—
9
71
7
42
13
4
59
11
19
10
18
61
23
142
103
245
+10
716
+18
600
+28
WIS
 THE WOODLANDS SCHOOL
F 101
Table 2.—First Admissions to The Woodlands School by Health Unit and
School District of Residence and Sex, April 1, 1963, to March 31. 1964
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
Metropolitan Health Commit-
1
1
„    4
2
2
Rchool District No 44
3
4
7
West Kootenay, Trail—
„   45
1
1
Srii"*. Pi8tr_<-t No, 11
2
2
Simon Fraser,  New Westmin
South Okanagan, Kelowna—
ster—
School District No. 14	
1
1
School District No. 40	
1
2
3
 23	
3
1
4
„          „   43
3
3
North Okanagan, Vernon—
North Fraser Valley, Mission—
School District No 70
1
1
2
School District No 42
1
2
3
„  72
1
1
2
Upper Island, Courtenay—
South Central, Kamloops—
School District No. 47	
2
2
School District No. 24	
4
2
6
,,              1            i.    77
1
1
2
._'•■       „   '6
1
1
Skeena, Prince Rupert—
_,           ,,         „   SI
1
1
1
1
Cariboo, Williams Lake—
Peace River, Dawson Creek—
School District No. 77
4
4
School District No. 59	
1
1
Northern Interior—
Greater Victoria Metropolitan
School r__f_h._-.tNn, 56
1
1
2
Board of Health-
Prince George—
Greater Victoria—School Dis
Si-in/il l-MrM No    .7
1
1
trict No. 61
3
1
4
Upper  Fraser  Valley,   Chilli
Central Vancouver Island, Na
wack—
naimo—
SrllOnl TVl.fTnVf »n    .7
1
1
School District No. 65
1
1
1,            „    *"
2
2
11         .   ""
1
1
1,           „         „   **4
2
1
3
,:    K*
1
1
1
1
Boundary, Cloverdale—
„   70
2
School District No. 35
2
1
3
School districts not covered by
 36
2
2
4
health units—
Metropolitan Health Commit
School District No. 46	
2
2
tee, Vancouver—
 49	
1
1   _
1
S ch™. District No, 38
2
2
4
„   80	
1
1
,',        ,,   41
4
4
8
Tntfll-1
76
54
130
 F 102
MENTAL HEALTH SERVICES REPORT, 1963/64
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 THE WOODLANDS SCHOOL
F 103
Table 4.—First Admissions and Readmissions to The Woodlands School by
Mental Diagnosis, Age-group, and Sex, April 1,1963, to March 31, 1964
Age-group (Years)
Mental Diagnosis
Under
1
1-3
4-6
7-9
10-14
15-19
20-29
30-39
40 and
over
Q
M.
F.
M.
F.
M
F.
M.
F.
M
F.
M.
F.
M
F.
M.
F.
M.
F.
M
F.
q
O
First Admissions
Mental deficiency—
Idiocy and imbecility	
1
6
11
10
2
1
J
11
3
1
6
3
""2
3
3
2
4
10
3
2
2
1
2
4
5
2
1
2
1
3
3
3
2
2
2
1
1
1
1
1
34
26
9
7
29
12
5
7
1
63
Border-line intelligence	
—
1
2
—
14
	
1|    1|    8| 11
16| 15
11|    8| 17|    7| XI|   3
7|   5|   4|   2|    1|   2
Readmissions
Mental deficiency—
1
8
1
2
3
13
3
5
9
3
2
9
1
1
9
8
2
3
4
3
2
4
1
1
3
3
2
1
1
1
2
1
1
—
2
28
19
5
10
29
14
3
11
57
Border-line Intelligence—
—
—
1
—
8
21
1
1
14
21
14
11
22
10
7
7
3
4
1
1
Table 5.—First Admissions to The Woodlands School by Religion and Sex,
April 1, 1963, to March 31, 1964
Table 6.—First Admissions to The Woodlands School by Previous Occupation and Sex, April 1,1963, to March 31, 1964
Detailed information for the above tables may be obtained on request.
 F 104                       MENTAL HEALTH SERVICES REPORT, 1963/64
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SIDE
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GO g
 THE WOODLANDS SCHOOL
F 105
Table 9.—Live Discharges from and Deaths Occurring in The Woodlands
School by Mental Diagnosis, Age-group, and Sex, April 1, 1963, to
March 31, 1964.
Age-group (Years)
Mental Diagnosis
Under
1
1-3
4-6
7-9
10-14
15-19
20-29
30-39
40 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Live Discharges
Other and unspecified psy-
12
3
7
6
4
5
5
1
3
27
12
2
3
9
2
2
3
11
7
4
1
2
1
5
2
3
1
7
2
2
1
3
4
1
2
1
1
1
2
1
—
3
1
64
29
10
16
3
1
44
15
6
16
Mental deficiency—
Idiocy and imbecility
—
—
1
5
1
11
3
1
S
108
44
Border-line Intelligence-
—
—
~2
16
32
Other and unspecified	
	
—
3
1      1   3
6
20
22| 15
9
44| 16| 25| 12
12] 10
3
3
—
4|122| 82|   2041
Deaths
Mental deficiency—
Idiocy and Imbecility	
MVimn
—
2
1
-
2
2    2
 1   1
1
2
—
—
1
2
1
1
1
6
1
7
4
13
4
Totals	
—|—1__|   2
1|      1      1   2
2|   3|   2|__
1    1|      1   2
2|    1     7| 11|      182
1 Includes 41 males and 28 females with epilepsy, 45 imbeciles, 15 morons, 4 border-line intelligence, and
5 mongols.
2 Includes 2 males and 4 females, idiocy and imbecility with epilepsy, and 1 female, mongoloid with epilepsy.
Table 10.—Live Discharges from and Deaths Occurring in The Woodlands
School by Mental Diagnosis, Length of Stay, and Sex, April 1, 1963,
to March 31, 1964.
Detailed information for the above table may be obtained on request.
Table 11.—Deaths Occurring dm The Woodlands School by Cause of Death,
Age-group, and Sex, April 1, 1963, to March 31, 1964
Age-group (Years)
Cause of Death
Under
1
1-3
4-6
7-9       10-14
15-19
20-29
30-39
40 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Septicaemia	
Malignant neoplasm	
Cerebrovascular  acci-
	
	
	
1
—
—
—
1
1
1
1
1
1
—
—
~~i
—
"1
1
1
1
_1
1
1
1
1
1
1
1
1
5
1
2
1
2
1
1
Cerebrovascular arteriosclerosis	
Cerebrospastic  infantile paralysis	
—
2
1
2
6
1
—
1
Congenital anomaly	
Accidental death	
3
	
	
—I—
1
Totals
-— 1— ■
—
2
1}	
2|   2
3
*.■—
•1    ll      1   2|   2
1
7
11
18
Table 12.—Deaths Occurring in The Woodlands School by Cause of Death,
Length of Stay, and Sex, April 1, 1963, to March 31, 1964
Detailed information for the above table may be obtained on request.
 F 106
MENTAL HEALTH SERVICES REPORT, 1963/64
PART IV.—THE TRANQUILLE SCHOOL, TRANQUILLE
REPORT OF THE MEDICAL SUPERINTENDENT
A. J. Bennee, Medical Superintendent
PATIENT POPULATION
Male
Female
Total
275
1
143
Total as <" April 1, 1««
276
143
419
Admissions—
Readmissions to a different institution of Mental Health Services	
1
42
19
1
61
43
19
62
319
162
481
Separations—
1
2
4
1
~4
1
2
8
1
8
4
12
+36
311
+15
158
+51
Tn r____fir-». M_r_b   .1, tOfiA
469
Admissions
The main bulk of the admissions to The Tranquille School were transferred
from The Woodlands School to fill the Greaves Building; one contingent arrived on
August 28, 1963 (23), and another on January 30, 1964 (37), most of them being
severely retarded cerebral palsy bed patients.
MEDICAL
The Medical Superintendent assumed duty on April 1, 1963.
Dr. G. Tomm assumed duty as a part-time medical officer, to visit five mornings
a week, starting on June 1, 1963.
The Tranquille sick bay was opened on August 26th, with accommodation for
five males and five females and in addition one bed for isolation purposes. This
has obviated the need for the vast majority of cases being admitted to the Royal
Inland Hospital. The number of admissions to sick bay has been 122 to March 31,
1964.
A mass tuberculosis X-ray survey was taken on August 14th. On November
20th oral polio vaccine was administered to all patients who were not ill at the time.
Pharmacy
As from January 21, 1964, a part-time pharmacist was employed.
Dentistry
Dr. N. Wilson started duty as a part-time dentist on October 21, 1963, and
Dr. D. Vogel was engaged as a part-time dentist on November 7, 1963. Each
dentist attends for one half-day weekly.   Mrs. M. Mcintosh was engaged as a part-
 THE TRANQUILLE SCHOOL
F 107
time dental assistant.   This obviates the need for any patients to be seen by dentists
in Kamloops.
Nursing
On August 21, 1963, Mr. A. Mcintosh was appointed Superintendent of
Nurses.
The nursing st
iff was made up as follows:
Male
Female
Total
Arifl 1, lot*.**
43
61
29
62
72
Two new wards were opened during the year, both cerebral palsy bed-care
areas.
Two of the cerebral palsy bed-care wards in the Greaves Building have integrated staff on all shifts. Morale in these areas is very high even though the work
load is the heaviest in the institution. Female aides work a 7 to 3 shift in three of the
ambulatory male wards. Our policy has been to employ female aides wherever
possible as good male aides are in short supply due to competition from a booming
construction industry.
Nursing-staff morale is high, with many staff donating some of their off-duty
time to patients and helping to plan special occasions, such as Carnival Day, May
Day, etc. During the year, staff made many suggestions and participated in planning
for expansion of the institution.
Medical Records
This area has been opened up as a separate department with the appointment
of Mrs. M. Anderson on March 5, 1964, as a medical-records clerk.
No facilities exist as yet for the storage and filing of admission and discharge
cards for all the mental health institutions in British Columbia. (This has been
started as a civil defence measure.)
SOCIAL SERVICE DEPARTMENT
On October 7,1963, Miss E. J. Gregg was taken on strength as a social worker.
Since her appointment this department has been concerned with the following
services:—
(1) Indirect social services, such as arranging for pupils' holidays, encouraging relatives to maintain contact with patients, etc.
(2) Direct social service of a consultative nature to organizations of Boy
Scouts, Girl Guides, and chaplaincy.
(3) Assessment of social service required by newly transferred patients.
(4) Extensive and intensive social work involving counselling and rehabilitation services.
(5) Consultant work in the form of (a) group therapy to patients, and (6)
to other agencies, especially the department of public welfare.
This department is gradually taking over more of the social service responsibilities of The Tranquille School.
Arrangements are made to have fairly large contingents of patients sent to the
Lower Mainland for holidays in the summer and for Christmas.
 F 108
MENTAL HEALTH SERVICES REPORT, 1963/64
PATIENT EMPLOYMENT
Patients are employed in the laundry, dietary, stores, and, to some extent,
Departments of Agriculture and Public Works.
Male
Female
Total
Patients employed on April 1,1963
105                     83
188
VOLUNTEER SERVICES
The Auxiliary of The Tranquille School has gradually increased in numbers
and in activity. The organization now has a constitution and is affiliated with the
Association for Retarded Children of British Columbia.
Number of volunteers active on April 1,1963      6
Number of volunteers active on March 31, 1964  116
RECREATIONAL THERAPY
Mr. J. Kelly was appointed and assumed duty as a male recreational-therapy
instructor on July 2, 1963.   A female instructress has not yet been recruited.
A summer camp was arranged.   Carnival Day was a successful undertaking.
OCCUPATIONAL THERAPY
Male
One hundred and seventy-six patients are now attending day classes, and a large
variety of articles have been made by them. The rock-pohshing machine is an
attraction in the department.
A fair number of school repairs have been carried out and various articles made
for The Tranquille School during the year.
Female
An average of 140 girls attend classes, and some are now taking cooking lessons.
Regular visits have been made to the sick bay. A large number of articles were sold
on Visitors' Day, and many items placed on various wards.
CHAPLAINCY
The Roman Catholic chaplain (Bishop M. Harrington) and the Protestant
chaplains (Dean J. C. Jolley and Rev. R. D. McRae) visit weekly.
BUSINESS
On the appointment of the Medical Superintendent, the former Tranquille
School supervisor, Mr. E. V. R. Merrick, assumed the role of Business Manager.
 r
the tranquille school f 109
Staff
Total strength, April 1,1963 :  113
Separations to March 31, 1964    55
58
Recruited to March 31, 1964.  ._ 125
Total  .. 183
Heat, Light, and Power
New installations included steam distribution system, boiler feed-water pump,
condensate transfer pump, concrete floor in pumproom, two condensate tanks, one
deaerating heater, and new steam and return line with condensate return pump and
hot and cold water from Greaves Building to cottage residences.
Water and Sewer
Replacements, additions, or improvements during the year were as follows:—
(1) New 16-inch transite replacement water-line from Canadian National
Railway tracks to the main buildings:
(2) Additions to water distribution; filtered domestic water:
(3) Major repairs, including considerable cement work at the water intake, to
further secure and improve this area:
(4) Relocation and replacement of, and some enlargement of, sewer-lines with
manholes reduced to ground-level.
Fire Protection
Three new No. 16 barrel pumper hydrants have been installed.
An emergency fire and disaster plan has been drafted, approved, and placed
in operation.
A modern fire-alarm system has been completed in the Greaves Building, and
additional fire-lines have been installed.
The Provincial Fire Marshal's 1961 recommendations are 95 per cent complete.
Dietary
We have been able to obtain a dietician of some years' service from the Provincial Mental Hospital at Essondale.
Air-cooling and curtains were installed in the patients' lower dining-room.
A separate dish-washing unit was also installed in this area.
Laundry
In addition to doing our own laundry, we still do the laundry for the Provincial Home, Kamloops.
We have now employed some additional staff in the area because of the marked
laundry increase and will go to a seven-day week shortly.
The air-cooling system for the laundry was completed this year and seems to
be keeping the pressing area much cooler.
Building and Housing
Main Building (Annex) is now in use as a visitors' area—five rooms with
kitchenette and common room.
 F 110 MENTAL HEALTH SERVICES REPORT, 1963/64
Meadowview has been renovated and placed in use as a much-needed staff residence; we have now gone on to the second floor therein.
In East Pavilion, part of upstairs has been set up as a staff common room and
fills a very useful purpose.
High Park, the female staff residence, is just about full to capacity.
Commissionaire Services
These services started last year and proved necessary and useful; they have
again been commenced this year for the period May to October.
J
 THE TRANQUILLE SCHOOL F 111
STATISTICAL TABLES
Table 1.—Movement of Population, The Tranquille School,
April 1, 1963, to March 31, 1964
Male
Female
Total
275
1
143
1
276
143
419
Admissions—
Readmissions to a different institution of Mental Health Services.
1
42
19
1
61
43
19
62
319
162
Separations—
1
2
4
1
4
8
4
+36
311
+15
158
+51
469
Tn rnlAmr. March 31,1964
Table 2.—Transfers to The Tranquille School by Mental Diagnosis,
Age-group, and Sex, April 1, 1963, to March 31, 1964
Age-group (Years)
Under
1
1-3
4-6
7-9
10-14
15-19
20-29
.ft-.Q  40and
30-39 1  Qya
Grand
Total
M.JF.JM.JF.
1     f     1
M.
F.
M.
1
F.  M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Mental deficiency-
Idiocy and imbecility
Moron	
Border-line  intelligence.
—
—
—
3
2
1
18
4
12
4
~1
5
1
1
4
1
1
1
3
40
1
7
17
1
1
57
1
1
3
1      1     1    11
21    11  181    41  121    5
71    51    11    11.     1    3
431 191     62
Table 3.—Resident Population of The Tranquille School by Mental
Diagnosis, Age-group, and Sex, December 31, 1963
Age-group (Years)
Total
Mental Diagnosis
4-6
7-9
10-14
15-19
20-29   30-39
40-49
50-59
60-69
Grand
Total
M.J F.  M.
F.
M.
F.
M. F.  M.
1     .
F.  M.
F.
M.JF.JM.
F.
1
M. F.
M.
F.
Mental deficiency—
1
1      1
Imbecility  ...
2
1
1
1
4
6    7
45   12   36
13
19   12
11
9
1
2
122
60
182
Moron
7	
33   20  25
15
16   12
8
4
2
89
53
142
Border-line intelli
gence
5
1
4
4
11    2     1
11
7
18
Mongolism—	
1
7    4
28
19
13
9
41    41    1]    1
54
37
91
Chronic  brain  syn
'
drome N.O.S.	
	
—
	
	
	
—I—
	
	
.... |    l|—.|	
—
—
1
1
Totals	
2| 1    1
1
2
4
20| 11|111| 52| 78| 41
401 31| 21| 14-|    1|   4
276|158 |  4341
1 Includes 18 males and 20 females with epilepsy.
Table 4.—Resident Population of The Tranquille School by Mental
Diagnosis, Length of Stay, and Sex, December 31, 1963
Detailed information for the above table may be obtained on request.
 F 112 MENTAL HEALTH SERVICES REPORT, 1963/64
PART V.—PROVINCIAL MENTAL HOME, COLQUITZ
REPORT OF THE MEDICAL SUPERINTENDENT
L. G. C. d'Easum, Medical Superintendent
The Provincial Mental Home, Colquitz, ceased to exist as of January 31, 1964.
The last group of patients to be transferred to the mental heath units on the Mainland was completed on January 29, 1964, and there were no patients remaining in
the institution.
The building was built as a gaol in 1913. It is reported that it was used for
a short time as a gaol, and during the 1914—18 war years was used as a naval brig.
It is reported on fairly good authority that two murderers were hanged during the
war years.
In 1919 the building was assigned to the Provincial Mental Health Services.
On March 25, 1919, nine patients came over from Essondale as an advance guard,
but there is no record as to who was in charge at that time. Inquiry from the Provincial Archives failed to reveal any information regarding this matter. In June
of 1919 Mr. Granby Farrant took charge as supervisor. There was a general
increase of patients, and at the last entry in the day book by Mr. Farrant on
November 4, 1933, there were 266 patients present in the hospital. On that date
Mr. F. M. Spooner took charge as supervisor and remained in office until _une 30,
1941, when he was superannuated.
Folowing Mr. Spooner's superannuation, Mr. T. A. Morris was appointed
supervisor and remained as so until he was forced to retire due to an injury occurring in 1947.
On May 1, 1947, Dr. L. G. C. d'Easum was appointed Medical Superintendent, being the first medical doctor to take charge. At that time the hospital was
full to capacity—291 patients with extra beds available in the infirmary. Dr.
d'Easum remained as Medical Superintendent until the close of the institution on
January 31, 1964.
It has always been recognized that this building was not suitable as a mental
hospital, but during the years has served its purpose well. That purpose was to
relieve the Provincial Mental Hospital at Essondale of the difficult and vicious type
of patient who could not be controlled by medications then available. With the
advent of tranquillizers, this condition no longer prevailed, and it became easier
to look after the more difficult patients.
Since April 1st the main concern of the hospital has been the transfer of
patients to other mental health units on the Mainland, and I am happy to say that
they all have been transferred without mishap. Excess staff has also had to be
placed.   This has also been accomplished except for one or two members.
The patient census on April 1, 1963, was 149. Since that time 111 patients
have been transferred to the Provincial Mental Hospital, Essondale; 25 to Skeenaview Hospital, Terrace; and 12 to Valleyview Hospital, Essondale. One patient
was discharged in full to his home in Norway.
The general health of the patients throughout the year was satisfactory, and
there were no deaths. Drs. S. S. Avren and W. Dempsey continued to care for the
medical and dental needs of the patients respectively.
 PROVINCIAL MENTAL HOME F 113
During the year the Top East Ward was closed, the tailor and shoe repair
shop was closed, as was also the Indoor Occupational Therapy Department. The
Outdoor Occupational Therapy Department remained open, but with the gradual
decrease of patients less and less therapy was carried on. However, with patient
help the maintenance of the unit was carried on when and where necessary.
LAUNDRY
During the year past the steady change taking place was felt in all departments
as the patients were taken to the Mainland. The Laundry Department was no
exception, and the work done was reduced from 3,500 pounds per week to about
300 pounds. Mr. Devine, in charge of the laundry, is to be complimented in the
way he carried on with the loss of many of his helpers.
 F 114
MENTAL HEALTH SERVICES REPORT, 1963/64
STATISTICAL TABLES
Table 1.—Movement of Population, Provincial Mental Home, Colquitz,1
April 1, 1963, to March 31, 1964
In residence, April 1, 1963	
On escape, carried forward from 1962/63_
Total as at April 1, 1963	
Separations—
Discharged in ML
Transferred to Provincial Mental Hospital, Essondale..
Transferred to Valleyview Hospital, Essondale	
Transferred to Skeenaview Hospital, Terrace	
Total separations-
1 This Institution cared for male patients only and was closed on January 29, 1964.
149
1
150
1
111
13
25
150
Table 2.—Resident Population of Provincial Mental Home, Colquitz,
by Mental Diagnosis and Age-group, December 31, 1963
Mental Diagnosis
Age-group (Years)
Total
20-24
30-34
35-39
40^14
45-49   50-54
55-59   60-64
65-69
70 and
Over
Schizophrenic reactions.
Manic-depressive reactions	
1
1
2
~1
4
9
—'
4
~1
—
9          7
9
4
1
49
1
4
Rpilnpsy
1
1
1
3
5
9
5
9
8
9
5
55
Table 3.—Resident Population of Provincial Mental Home, Colquitz,
by Mental Diagnosis and Number of Previous Admissions, December
31, 1963.
Table 4.—Resident Population of Provincial Mental Home, Colquitz,
by Mental Diagnosis and Length of Stay, December 31, 1963
Detailed information for the above tables may be obtained on request.
 PROVINCIAL MENTAL HOME                                        F 115
Table 5.—Live Discharges from Provincial Mental Home, Colquitz, by
Mental Diagnosis and Age-group, April 1, 1963, to March 31, 1964
Mental Diagnosis
Age-group (Years)
Total
20-24
25-2930-34
35-39
40^t4
45-49
50-54
55-59
60-64
65-69
and
Over
1         1         1         1         1
14         5         8       17.
19
19
19
15
20
122
—
—
—
1
1
Other and unspecified psychosis —
	
	
1     _
	
1
	
	
_
2
—
—
—
—
	
—
2
	
1
2
1
Chronic alcoholism
1
3
2
3
1
2
1
13
Chronic brain syndrome N.O.S.—
	
	
	
1
1
Epilepsy
  . ——
 !
	
1
	
	
2
3
Totals
1
1
4
6
12
14
24 |   20
1
24
16
28
150
Table 6.—Live Discharges from Provincial Mental Home, Colquitz, by
Mental Diagnosis and
Length of Stay, April 1, 1963, to March 31, 1964
Detailed information for the above table may be obtained on request.
 F 116 MENTAL HEALTH SERVICES REPORT, 1963/64
PART VI.—GERIATRIC DIVISION
REPORT OF THE MEDICAL SUPERINTENDENT
J. Walsh, Medical Superintendent
During the year 1963/64 a total of 1,738 elderly persons received special care
and treatment in the three hospitals of the Geriatric Division of the Mental Health
Services Branch, an increase of 86 over the previous year.
During the year 424 applications for admission were received, a decrease of
nine. Of this number, 334 were for Valleyview Hospital, 79 for Dellview Hospital
at Vernon, and 11 for Skeenaview Hospital at Terrace. Actual admissions to the
three hospitals totalled 428, an increase of 21. Of this number, 333 were direct
admissions from the community, an increase of 12, and 95 were transfers from
other units of the Mental Health Services, an increase of nine.
While every effort is made to accept patients into the hospital which is closest
to the patient's family and friends, patients whose disturbed behaviour creates a
problem in the home or in the community and who cannot be admitted to the nearest hospital at that time are admitted directly to Valleyview Hospital.
Separations due to death totalled 351, an increase of 28. Separations on discharge to the community totalled 67, an increase of one. The resident population
in the three hospitals as of March 31, 1964, was 1,264, a decrease of seven on the
figures for the previous year. To this figure may be added 71 patients who were
discharged on probation but were still on the hospital register, making a total of
1,335. Of this group of patients on discharge to probation or to boarding-home
care, 10 were returned to hospital.
VALLEYVIEW HOSPITAL
The Valleyview Hospital is the largest hospital of the Geriatric Division, and
the majority of patients admitted are from the Lower Mainland and Vancouver
Island. It has a complement of 818 beds and a total staff of 424. During the year
260 patients were admitted directly from the community and 69 patients were transferred from other units of the Mental Health Services.
This hospital provides an active-treatment programme for psychiatric illnesses
associated with the ageing process and is designed to make hospitalization and
treatment readily available to elderly patients whose psychiatric illness has led to
behaviour problems in the community.
In accordance with modern knowledge of psychiatric illness in elderly persons,
every effort is made to emphasize that the capacity of older persons to respond to
treatment programmes is much greater than previously assumed and that hospitalization may be only temporary.
The cause of disturbed behaviour in the aged may lie in the environment, and
the basic approach to the treatment of emotionally disturbed geriatric patients is
to distinguish between the psychological factors which may be dealt with and the
irreversible factors of physical decay. Treatment must be initiated early while relative interest remains high and to prevent the patient from lapsing into a state of
hopeless acceptance of uselessness and dependency.
The treatment programme utilizes modern techniques as indicated. Ataractic
and anti-depressant medication, electroconvulsive therapy, and group psychotherapy
each have a place.   In order to develop as far as possible within the hospital an
 GERIATRIC DIVISION F 117
environment that approximates the community life from which the patient came and
to which he may return, two wards or cottages of 50 beds each have been established
as integrated wards where equal numbers of male and female patients pursue their
daily living together. This stimulates patients to maintain or improve their social
behaviour as well as enabling them to enjoy a degree of companionship. This
arrangement has been confined to the more active patients with prospects of returning to the community.
A high standard of medical care has been provided for the patients. In addition to the hospital medical staff, the services of specialist consultant staff from the
Crease Clinic and Provincial Mental Hospital are available as needed. Every effort
is made to improve the general health of the patients to treat illnesses and to relieve
disabilities which contribute to inactivity and invalidism.   '
Fifty-nine patients were discharged on probation or to boarding-home care,
and of this number, together with others previously discharged, eight were returned
to hospital. In order to maintain contact and to support relatives or others who
are responsible for the care of discharged patients, a policy has been adopted where,
while the patient may leave the hospital on discharge, he still remains on the hospital register indefinitely. In the event of further psychiatric illness his return to
hospital can be effected immediately and without formality. Experience so far
suggests that, with careful planning for the discharge of patients to the community,
the percentage requiring readmission to hospital may be relatively low.
Much credit is due to nursing-home and boarding-home staff and to physicians
in the community for the way in which they extend themselves to care for these
discharged patients.
The nursing staff has continued to provide a high standard of nursing care.
Rearrangement of patient accommodation due to remodelling of buildings has
increased over-all activity. Completion of the remodelling of Wards Wl, W2,
and W3 has provided three pleasant cottage-type wards, all of which are open
wards with open visiting privileges. Escort services for appointments for these
patients is rarely necessary.
The introduction of planned programmes for " reablement," of electroconvul-
.sive therapy with its prompt response in depressed cases, and of discharge planning
has encouraged the nursing staff to still greater efforts for their patients.
The area approved by the School of Nursing for the geriatric training of student
nurses has been extended.
The laying of non-skid flooring on ramps, new walks and curbs on the grounds,
the purchase of thermal blankets, providing adequate warmth with less weight, and
the installation of dish-washers and clothes washers and driers on outside wards
have aided nursing staff in contributing to the better care of patients and are appreciated by the nursing staff.
Seventy-eight members of the nursing staff resigned and 84 were taken on staff.
The turnover in nursing staff, particularly female graduates, remains high. The
employment of part-time nurses was begun in January, 1964, and this arrangement
has proved to be satisfactory.
A pleasant and successful innovation was the holding of a garden party in the
grounds in August. A total of 429 patients was able to enjoy the party. Nursing
staff played a large part, with the willing help of all other departments, in making
it a success.
Attendance at educational programmes has been encouraged at all levels.
Several nurses attended all or part of a Psychiatric Nurses' Association refresher
programme, two senior nurses attended a two-day institute at the University of
 F 118 MENTAL HEALTH SERVICES REPORT, 1963/64
Washington, and one nurse attended a special one-month course on bursary at the
University of California Medical Centre, Los Angeles. One nurse returned to duty
following a year's study at the University of British Columbia.
In-service lectures have been presented regularly. An orientation course for
psychiatric aides has been of great value.
The Social Service Department began the year with one worker, reaching its
full complement of three during May, 1963. Two new positions were established
by the end of the year, and the prospects are that they will be filled by well-qualified
workers.
The work of the department may be divided into three main areas—pre-admission, post-admission, and post-discharge. In the pre-admission, area there were
110 referrals from the Medical Superintendent, which was doube the number for
the previous year. In addition, numerous requests for assistance were received
directly. As a result of these referrals and requests, 130 potential patients were
found suitable alternate placements, relieving families of problems which could not
be accommodated in hospital at the time.
Post-admission services include brief services to patients in relation to concerns of the patients or their relatives and to demands from the Public Trustee
concerning patients' affairs. The major part of this work, however, is concerned
with planning with suitable patients and their relatives for discharge and return to
the community. Improved classification of patients and better communications
with other departments have facilitated prompt action on referral.
In the post-discharge area, follow-up services are wholly provided by the
Social Service Department and are, of necessity, confined to the Lower Mainland
area.   In all cases the patient is referred back to his phycician on discharge.
The department has planned visits and provided orientation to Valleyview
Hospital to 88 persons, 75 per cent of whom were social workers from the Department of Social Welfare and from other agencies and hospitals. The remainder
were persons seeking admission or planning otherwise for relatives. In addition,
social service staff have contributed to the orientation of other visiting professionals
and to student nurses. The School of Social Work, University of British Columbia,
used the facilities of the hospital for student placement.
The X-ray Department, under the supervision of the radiologist from Crease
Clinic, has provided a satisfactory service. Of 4,260 films taken, 41 per cent were
part of the annual tuberculosis survey of patients and staff and 25 per cent were
referred because of possible fractures due to falling. The incidents of osteoporosis
or decalcification of bone is high in old people, and a special project is under way to
counteract this deficiency by hormone therapy with and without large doses of cal-
oium.
The laboratory, under the supervision of the pathologist from the Crease
Clinic, provides a wide range of diagnostic services. Special bacteriological specimens, mainly for cultures, are referred to the Provincial Mental Hospital laboratory.
The Recreational Therapy Department, as well as arranging the garden party,
has provided a varied and suitable programme of entertainment for the patients
throughout the year. An adjustment of working-hours has enabled the staff to
provide entertainment in the evenings and on Saturdays, when patients are, for the
most part, more receptive to such programmes. Apart from regular auditorium
and ward programmes, bus and car trips and picnics have aroused much patient
interest and enjoyment.
The Occupational Therapy Department has been planning suitable programmes.
Activities are geared toward a goal of meeting needs for integration, socialization,
 GERIATRIC DIVISION F 119
and reactivation of interest. The Vancouver Dahlia Society has regularly provided
gardening and social activities for a group of 25 to 35 patients. The society's
efforts are much appreciated by patients and staff. Canadian Mental Health
Association volunteers have rendered valuable assistance in the department's programme. Occupational therapy has been brought to nearly 500 patients during
the year.
Adequate diet is particularly important in correcting nutritional defects, which
are common in elderly patients admitted to hospital. The Dietary Department has
provided an excellent service in providing all types of special diets as required.
Physiotherapy plays a useful part in the over-all programme of maintaining
the maximum activity of which the patient is capable. An average of 39 patients per
month has been treated by a qualified therapist. Treatments included infra-red,
inductotherm, massage, exercises, ultra-violet light, and ultra-sound.
A podiatry service is supplied on two days each week from the Crease Clinic
and Provincial Mental Hospital department.
The Dental Department continued to provide dental care and treatment, as
well as giving part-time service to Provincial Mental Hospital. A systematic recall
programme is proving to be effective in maintaining dental health for many patients.
Of newly admitted patients with some remaining teeth, 50 per cent had poor oral
health. Extractions increased by 20 per cent. There is a sharp increase in the
making of new dentures, and the number of fillings has decreased, indicating that
arrears in this area have been met.
Religious services have been provided by the hospital's Protestant chaplain and
by a Roman Catholic chaplain from Crease Clinic. Pastoral visiting brings much
comfort to the patients, and special programmes of a religious kind arouse great
interest.
The Pharmacy Department has continued to meet the needs of the patients
in a wide range of pharmaceuticals and other medical and nursing supplies. A
Pharmacy Committee, of which the pharmacist at Valleyview Hospital is a member,
meets regularly and makes recommendations to the Mental Health Branch Pharmacy
Council in relation to the special needs at Valleyview Hospital.
In the area of business management, responsibilities have increased in the
administration of comforts trust funds, particularly in relation to heavier purchases
of clothing and personal comforts and admission and discharge arrangements.
Eighteen new positions were addded to the nursing services during the year,
two. existing positions were reclassified to social workers, and one to a stenographer.
DELLVIEW HOSPITAL
This hospital has a complement of 239 beds, with a total staff complement of
85. It has operated to full capacity during the year. Sixty-four patients were
admitted directly from the community, and two patients were received on transfer
from other units. During the same period there were 55 deaths, seven discharges,
and two patients were transferred to other units.
The general health of this patient group has been maintained at a satisfactory
level. For a short period during the winter there was a high incidence of respiratory
infection, in which staff members were also involved. Fortunately the illness
responded to treatment and was short-lived. A trend toward increasing infirmity
of newly admitted patients has been noted. The average age of resident male
patients was 78.6 years and of female patients 82 years. Medical coverage is
provided by a visiting physician, who makes regular visits and responds readily to
emergency calls.
 F 120 MENTAL HEALTH SERVICES REPORT, 1963/64
X-ray and laboratory services have been supplied by the Vernon Jubilee
Hospital. Administrative and technical advice have been made available as needed.
In co-operation with the local public health unit, a clinic was held at the hospital
and Sabin oral vaccine was given to all patients and staff who wished to have it.
A good standard of nursing care has been provided. The wards have been
divided in a manner that permits a better classification of patients by allowing the
placing of patients in groups according to their individual level of capability and
alertness.
Associated with the feebleness of old age, 14 patients sustained fractures due
to accidental falls, seven involved fractured hips, and the remainder were of a minor
nature.
In October a mobile unit of the Division of Tuberculosis Control visited the
hospital to conduct the annual chest survey of both patients and staff. No cases of
active pulmonary tuberculosis were discovered.
Educational programmes for staff are encouraged. Refresher lectures and
discussions have been held in conjunction with the local chapter of the Psychiatric
Nurses' Association. A library of current professional periodicals and other instructive literature has been made available.
One staff member attended an institute on the person with long-term illness
at the University of Washington.
Dental care and treatment have been provided by a visiting dentist, who attends
regularly. A visting optometrist carries out refractions and supplies corrective
lenses when needed.
Occupational- and recreational-therapy programmes have been extended with
the generous help of volunteers from the Vernon branch of the Canadian Mental
Health Association. Interest in community activities is maintained through the
willingness of the church and fraternal and service organizations to provide entertainment of all kinds for the patients. Involvement in handicraft work of various kinds
produces a feeling of usefulness and a degree of satisfaction, which helps to counteract loneliness and depression.
An adequate dietary service has been provided by the Dietary Department.
A dietary aide service, introduced in May, 1963, has proved to be of much value.
The laundry service has also been improved by the addition of three modern
compressed-air presses. The installation of an air-cooling unit has improved working conditions.
The Public Works staff has taken care of necessary maintenance and repairs.
A new modern fire-alarm system, with its own power supply, has been installed.
Fire-prevention and fire-figjiting exercises have been held under the direction of
members of the Vernon Fire Department.
SKEENAVIEW HOSPITAL
This hospital has a complement of 300 beds and a staff of 66. During the
past year 33 patients were transferred in from other units. Ten patients were
admitted directly from the community, an increase of five over the previous year.
Separations due to death totalled 48, two patients were discharged to the community,
and one was transferred to another hospital within the service.
The general physical health of the patients has been maintained at a satisfactory
level. The annual X-ray of all patients and staff was conducted by the travelling
clinic of the Division of Tuberculosis Control. No cases of active tuberculosis
were discovered amongst patients or staff. Ten patients required major surgery.
Two patients sustained fractured hips due to accidental falls.
 GERIATRIC DIVISION F 121
General medical and surgical care and supervision have been provided by
visiting physicians, who attend regularly and respond to emergency calls when
necessary.
The nursing services have maintained a satisfactory level of nursing care. A
change from a two-ward to a four-ward system permitted better classification of
patients, with considerable improvement in patient care. A 100-bed open ward and
50-bed infirmary ward with a 6-bed intense-care unit attached have been developed.
Involved in these changes was the conversion of a dining-room into a much-needed
activities room. This room, with suitable draping, acts as a permanent chapel, a
concert hall, with stage, and a movie theatre. Active and enthusiastic local volunteer
groups have provided a varied programme of activities for patients.
Religious services are provided by visiting clergy from churches in the community.
In the Dietary Department six female aides have been added to the establishment
The Public Works Department has carried out the necessary maintenance and
repair work. This frequently involves quite major projects. New automatic
battery-operated emergency lights have been installed in dormitories, day rooms,
and corridors.
 F 122
MENTAL HEALTH SERVICES REPORT, 1963/64
STATISTICAL TABLES
VALLEYVIEW HOSPITAL
Table 1.—Movement of Population, Valleyview Hospital, Essondale,
April 1, 1963, to March 31, 1964
Male
Female
Total
252
18
477
18
36
Total a« at April 1, 1963
270
495
765
Admissions—
121
6
2
1
1
57
127
3
1
10
Readmissions to a different institution of Mental Health Services	
9
AHmifi qinns d'rfV.f from f__ase Cl""'*
1
67
Total afi1T1',«.pns
188
141
329
Tntfll iinrlpr _•?.■._
458
636
1,094
Separations—■
10
123
8
7
33
9
125
3
35
19
248
11
7
68
181
172
353
+25
277
—13
464
+12
741
 GERIATRIC division
F 123
Table 2.—First Admissions to Valleyview Hospital, Essondale, by Health
Unit and School District of Residence and Sex, April 1, 1963, to
March 31, 1964.
Health Unit
Male
Female
Total
Health Unit
Male
Female
Total
East Kootenay, Cranbrook—
Simon Fraser, New Westmin
School District No. 2	
1
1
2
ster—
„           „       „  4	
2
_
2
School District No. 40
9
7
16
5
.,       „ 18
1
1
North Fraser Valley, Mission—
Selkirk, Nelson—
■School T-istri"-* Mi  4?
2
4
6
School District No. 7
1
_
1
.,  75.
3
3
s
1
	
1
Upper Island, Courtenay—■
in
1
_
1
School District No. 47    .
2
1
3
West Kootenay, Trail—
„  71
1
	
1
1
Skeena, Prince Rupert—
School District No, 50     ......
South Okanagan, Kelowna—
2
2
School District No. 16
1
_
1
„   52	
1
1
ii          1             ,1
2
2
„   54
1
1
North Okanagan, Vernon—
Peace River, Dawson Creek—
School District No. 19
1
1
School District No. 60
1
1
2
,n
1
1
..           ,.       „   81
1
1
71
1
1
Greater Victoria Metropolitan
„   22
1
1
Board of Health-
South Central, Kamloops—
Greater Victoria—School Dis
School District No. 30
1
1
trict No. 6!       .....
16
3
19
,.   "
1
1
Saanich and South Vancouver
Upper Fraser Valley, Chilli
Island—
wack—
School District No. 62
1
1
2
School District No. 32
1
1
..          „      „ 63
3
1
4
"
2
2
4
..64
2
	
2
„   34
5   '
3
8
Central Vancouver Island, Na
Boundary, Cloverdale—
naimo—
School District No **5
3
3
School District No. 68   	
1
1
1S
6
7
13
 69..
2
	
2
 ,   37	
2
1
3
School districts not covered by
Metropolitan Health Committee,
health units—
Vancouver—
School District No. 46
2
	
2
Schnnl l-ictrjCt N«   3Q
66
68
134
,,   48
2
2
ii    41
14
9
23
1
	
1
„    44
9
11
20
Unknown
5
	
5
„               ,,          ,     45
4
6
10
Totals	
185
137
322
Table 3.—First Admissions to Valleyview Hospital, Essondale, by Method
of Admission, Age-group, and Sex, April 1,1963, to March 31,1964
Age-group (Years)
Total
Method of Admission
20-39
1
40-49    50-59
60-69
70-__>
_«   90 and
SO-** |   Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Voluntary
|
1
—
1
1
2
78
62
1
1
9
4
3
178
137
4
3
i| i
3
2
15
3
69! 62
10
315
Totals
i
1
3
—
3
—
16
3
81
62
71
G2
10
9
185
137
322
 F 124
MENTAL HEALTH SERVICES REPORT, 1963/64
Table 4.—First Admissions to Valleyview Hospital, Essondale, by Mental
Diagnosis, Age-group, and Sex, April 1,1963, to March 31,1964
Mental Diagnosis
Age-group
(Years
)
Total
20-39
40-49
50-59
60-69
70-79
80-89
90 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.IM.
1
F.
M. F.
1
M.
F.
M.
F.
M.
F.
1
2
__
1
__
2
	
8
2
15
1
16
—
—
~
—
_5
—
3
9
1
1
•1
8
5
I
3
10
5
6
—
~1
3
6
24
2
1
ff_
1
14
11
4
20
35
2
1
1
H
—
—
—
—
—
~2
3
1
2
3
1
—i
—
_
—
2
1
4
6
1
1
1
1
3
1
1
4
7
1
—
—
1
—
i
—
2
1
2
34
5
4
18
3
1
36
5
29
7
2
7
80
14
4
56
3
1
136
17
5
1
1
7
24
12
21
1
1
21
47
68
i
1
3
—
3
—
16
3
81
62
71
62
10
9
18511371   322
1     1
Schizophrenic disorders—
Manic-depressive reaction-
Senile psychosis _
Psychosis with cerebral arteriosclerosis—
Psychosis of other demonstrable etiology
Anxiety   reaction   without   mention   of
somatic symptons.
Hysterical reaction without mention of
somatic symptons.
Neurotic-depressive reaction	
Psychoneurosis   with   somatic   symptons
affecting digestive system
Chronic brain syndrome with neurotic reaction.
Syphilis and its sequela;...
Alcoholism	
Mental deficiency-
Chronic brain syndrome with behavioural
reaction
Chronic brain syndrome, N.O.S..
Epilepsy_
Other, unknown, and unspecified conditions 	
Table 5.—First Admissions to Valleyview Hospital, Essondale, by Mental
Diagnosis, Marital Status, and Sex, April 1,1963, to March 31,1964
Table 6.—First Admissions to Valleyview Hospital, Essondale,
by Religion and Sex, April 1,1963, to March 31,1964
Table 7.—First Admissions to Valleyview Hospital, Essondale, by
Previous Occupation and Sex, April 1,1963, to March 31,1964
.. Detailed information for the above tables may be obtained on request.
 GERIATRIC DIVISION
F 125
Table 8.—Resident Population of Valleyview Hospital, Essondale, by
Mental Diagnosis, Age-group, and Sex, December 31, 1963
Age-group (Years)
Mental Diagnosis
20-39
40-49
50-59
60-64
65-69
70-74
75-79
80 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
R.-___T__p__r*n__. disorders
4
1
4
2
7
—
4
1
1
2
2
1
4
i
6
3
'1
5
1
10
1
~I
9
1
1
~~I
13
7
9
1
1
i
16
1
1
1
1
1
22
2
1
1
13
20
1
1
2
1 22
26
2
1
1
1
35
7
32
4
2
1
3
I M
31
~_
1
"~i
42
6
15
18
2
1
73
51
65
7
1
57
40
6
2
3
29
53
2
2
1
1
1
1
2
3
5
83
13
3
4
30
57
4
1
3
104
86
2
2
1
1
1
2
10
114
15
1
96
97
Involutional melancholia	
Paranoia and paranoid states—
3
6
133
Psychosis with cerebral arterio-
139
Alcoholic psychosis	
Psychosis of other demonstrable
-»He..--_|jY
	
	
	
	
	
z
4
4
Hysterical reaction	
Obsessive-compulsive reaction...
Neurotic-depressive reaction	
Psychoneurosis    with    somatic
symptons  affecting  digestive
—
=
=
—
=
—
1
1
1
Chronic brain  syndrome  with
—
1
1
1
1
1
1
18
4
2
2
3
5
Mental deficiency	
Chronic brain syndrome with
hfthaiHnnrftl jre^CtiO"  ,
2
5
1
2
1
1
2
1
~_
15
197
Chronic brain syndrome, N.O.S.
—
—
~~I
28
4
4
Other, unknown, and unspecified mnHiHAfiji
126
6
6
6
4
8
1
8
4
5
6
45
51
75
153
131
275
284
500
 F 126
MENTAL HEALTH SERVICES REPORT, 1963/64
Table 9.—Live Discharges from and Deaths Occurring in Valleyview
Hospital, Essondale, by Mental Diagnosis, Age-group, and Sex, April
1, 1963, to March 31,1964.
Age-group (Years)
Mental Diagnosis
20-29
30-39
40-49
50-59
60-69
70-79
80-89
90-99
Grand
Total
M.I F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M
F.
M.  F.
1
M.
F.
Live Discharges
Schizophrenic disorders
■
i
1
g
1
1
—
1
1
—
—
1
1
3
3
4
2
1
1
1
~3
3
m
~1
3
~_
2
1
1
3
6
3
1
8
2
1
1
1
3
1
1
1
4
4
Psychosis with cerebral arterio-
Mental deficiency	
Chronic  brain  syndrome  with
behavioural reaction	
Chronic brain syndrome, N.O.S.
Senility, NOS
2
9
3
5
ii__i_i i
1
_1   1|   1
 |	
151    21    61    7
11   1
25| 12|    37
Deaths
—
—
—
—,
—'
1
1
~4
7
1
1
19
-   1
1
7
2
~10
10
~_
i
i
9
8
■   7
9
32
5
9
1
15
12
1
18
~io
2
2
11
1
K
4
7
""2
1
Hi
is
!
~~i
l
63
7
1
17
4
1
26
26
~i
1
_____
1
34
30
5
Manic-depressive reaction	
—
—
—
—
1
39
Psychosis with cerebral arterio-
=
—
—
—
1
	
Psychosis of other demonstrable
1
Other and unspecified psychosis
Wy cterirnl re___.t_._T_
5
—
—
1
1
2
nir.-_t.i_> nlrnhnlictr.
—'
I
1
	
1
1
Chronic  brain  syndrome  with
97
Chronic brain syndrome, N.O.S.
—
—
—
	
—
^j
—
—;
7
1
R^i.iitY,Tvr,n.<_,
47
Trttfli*
—
—
3'
1
42
42
62
67
16
15
123
125
248
Table 10.—Live Discharges from and Deaths Occurring in Valleyview
Hospital, Essondale, by Mental Diagnosis, Length of Stay, and Sex,
April 1, 1963, to March 31, 1964.
Detailed information for the above table may be obtained on request.
 GERIATRIC division
F 127
Table 11.—Deaths Occurring in Valleyview Hospital, Essondale, by
Cause of Death, Age-group, and Sex, April 1, 1963, to March 31,1964
Age-group (Years)
Total
Cause of Death
60-69
70-79
80-89
90-99
3
|
M.IF.
M.
F.
M.
F.
M.
F.
M.
F.
a
1
—'
3
1
4
2
gp
1
51
1
1
3
_1
~4
41
1
1
1
1
2
4
4
~2
2
1
~14
B
"Ii
4
1
3
1
4
98
3
1
I
1
1
2
2
1
7
3
6
84
2
1
1
1
2
5
6
1
3
3
11
1
6
1
1
1
3
32
2
l
28
1
10
182
5
2
1
Generalized arterioscl~_ipi_
1
—'
~I
2
~
1
1
1
1
2
1
2
2
5
7
—
—
1
3
5
4
3
1
42
42
62
67
16
15
123
125
248
Table 12.—Deaths Occurring in Valleyview Hospital, Essondale, by Cause
of Death, Length of Stay, and Sex, April 1,1963, to March 31, 1964
Detailed information for the above table may be obtained on request.
 F 128
MENTAL HEALTH SERVICES REPORT, 1963/64
DELLVIEW HOSPITAL
Table 1.—Movement of Population, Dellview Hospital, Vernon,
April 1, 1963, to March 31, 1964
Male
Female
Total
106
3
127
4
Total as at April 1,1963
109
131
240
Admissions—
41
1
1
21
1
62
1
1
43
22
65
152
153
305
Separations—
3
40
1
1
1
7
15
2
10
55
1
1
3
46
24
70
106
+2
129
+2
235
Table 2.—First Admissions to Dellview Hospital, Vernon, by Health
Unit and School District of Residence and Sex, April 1, 1963, to
March 31, 1964.
Health Unit and School District
Male
Female
Total
Health Unit and School District
Male
Female
Total
East Kootenay, Cranbrook—
1
1
1
1
1
H <f'
4
1
1
5
2
3
2
1
"_
2
6
H
1
2
1
1
1
1
4
2
1
3
11
2
4
North Okanagan, Vernon—
3
1
10
1
1
1
1
1
1
1
1
3
1
2
1
1
„ 2
., Is
Selkirk, Nelson—
School T_R.r__v_ Nn, 7
„         _   a
, 20
„  21.
„   22	
„   78
South Central, Kamloops—j
4
13
2
3
West Kootenay, Trail—
School District No, 11	
„          „       „   13	
South Okanagan, Kelowna—
„   26
Upper   Fraser   Valley,   Chilliwack—
.Mi" ol pj-trt_.__.__, —
Metropolitan Health Committee,
Vancouver—
School District No. 38
Skeena, Prince Rupert—
School District No. 52.
Totals	
1
1
„         ,■    17
.,             „         „   *>■*■
..             .,         ■■   77
1
1
43
22
65
 GERIATRIC DIVISION
F 129
Table 3.—First Admissions to Dellview Hospital, Vernon, by Method of
Admission, Age-group, and Sex, April 1, 1963, to March 31, 1964
Age-group (Years)
Method of Admission
50-59
60-69
70-79
80-89
90 and
Over
Grand
Total
M.
F.
M.      F.
M.
F.
M.
F.
M.
F.
M.
F.
Certification
2
—
1
1
15        5
19
15
6
1
43
22
65
Table 4.—First Admissions to Dellview Hospital, Vernon, by Mental
Diagnosis, Age-group, and Sex, April 1, 1963, to March 31, 1964
Age-group (Years)
Mental Diagnosis
50-59
60-69
70-79
80-89
90 and
Over
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Chronic brain syndrome with behavioural
reaction	
2    _
1
1     15
5
19    15
6
1
43
22
65
Table 5.—First Admissions to Dellview Hospital, Vernon, by Mental
Diagnosis, Marital Status, and Sex, April 1, 1963, to March 31,1964
Table 6.—First Admissions to Dellview Hospital, Vernon, by Religion
and Sex, April 1, 1963, to March 31, 1964
Table 7.—First Admissions to Dellview Hospital, Vernon, by Previous
Occupation and Sex, April 1,1963, to March 31, 1964
Detailed information for the above tables may be obtained on request
 F 130
MENTAL HEALTH SERVICES REPORT, 1963/64
Table 8.—Resident Population of Dellview Hospital, Vernon, by Mental
Diagnosis, Age-group, and Sex, December 31,1963
Age-group (Years)
Mental Diagnosis
50-59
60-64
65-69
70-74
75-79
80 and
Over
Grand
Total
M.
F. IM.
F.
M.
F.
M.|F. M.IF.
i   r   i
m.|f.
1
M
F.
•
1
—
8
1
1
6
1
1
9
1
1
1
8
10
1
2
18
4
9
1
12
6
1
K
3
18
10
5
1|4
1
50
16
1
26   16
1 ■
8| 15
51   1
—
—
Senile psychosis	
23
Psychosis of other demonstrable etiology	
Other anH nnipecifiprt p .yi._n.s_s
—
—
—]
	
—
—
1
1
1
1
1
1
1
2
1
5
Chronic brain syndrome with behavioural re-
2
1
1
Chronic brain syndrome, N.O.S.	
16| 22
38
1
1
13
6
18
28
39
86
Table 9. — Live Discharges from and Deaths Occurring in Dellview
Hospital, Vernon, by Mental Diagnosis, Age-group, and Sex, April 1,
1963, to March 31, 1964.
Age-group (Years)
Total
Mental Diagnosis
60-69
70-79
80-89
90-99
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Live Discharges
1
1 _
2 j     4
2
2
1
4
7
1
Chronic brain syndrome with be-
havionrnl rpnrtion
11
Total
-    1      M     3    |      4    1     2    |      2    |    _.    |,   _    |      5    |      7    |    12
Deaths
Chronic brain syndrome with be-
5
8
2
5
18
6
6
3
37
3
14
1
51
Chronic brain syndrome, N.O.S.—
1     ,     1
4
5
10
5
18
7    1       7
3
40
15
55
Table 10. — Live Discharges from and Deaths Occurring in Dellview
Hospital, Vernon, by Mental Diagnosis, Length of Stay, and Sex,
April 1, 1963, to March 31, 1964.
Detailed information for the above table may be obtained on request.
 GERIATRIC DIVISION
F 131
Table 11.—Deaths Occurring in Dellview Hospital, Vernon, by Cause
of Death, Age-group, and Sex, April 1, 1963, to March 31, 1964
Age-group (Years)
Cause of Death
60-69
70-79
80-89
90-99
Grand
Total
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
5
8
_8
1
1
~5
"ii
1
6
7
~_
1
15
1
1
1
15
1
7
15
Table 12.—Deaths Occurring in Dellview Hospital, Vernon, by Cause
of Death, Length of Stay, and Sex, April 1, 1963, to March 31, 1964
Detailed information for the above table may be obtained on request.
 F 132
MENTAL HEALTH SERVICES REPORT, 1963/64
SKEENAVTEW HOSPITAL^
Table 1.—Movement of Population, Skeenaview Hospital, Terrace,
April 1, 1963, to March 31,1964
In residence, April 1, 1963	
On probation, carried forward from 1962/63
Total as at April 1, 1963	
295
1
296
Admissions—
First admissions  9
Readmissions to a different institution of Mental Health Services 1
Transfers from geriatric units  7
Transfers from psychiatric units  26
Total admissions.
Total under care.
Separations—
Discharged in full.
Died	
Transferred to other geriatric units .
Total separations	
Net decrease	
In residence, March 31, 1964.
43
339
2
48
1
51
-7
288
l This institution cares for male patients only.
Table 2.—First Admissions to Skeenaview Hospital, Terrace, by Health
Unit and School District of Residence, April 1, 1963, to March 31,
1964.
Health Unit
Selkirk, Nelson—
Number
Health Unit
Upper Island, Courtenay—
School District No. 47
„   71
..   72
Skeena, Prince Rupert—
<_,-V-.i F^trfrt Nrt. *>
,,          »         »   53
ii         ii   ^d
Number
2
West Kootenay, Trail-
1
1
North Okanagan, Vernon—
s
Cariboo, Williams Lake—
A
1
Northern Interior, Prince George—
Peace River, Dawson Creek—
1
IF               II            „    ra
Greater Victoria Metropolitan Board oi
Greater Victoria—School District No
Central Vancouver Island, Nanaimo—
School District No. 65
*_«
Total
Health—
Metropolitan Health Committee, Vancouver-
School District No. 39
Simon Fraser, New Westminster—
School District Nn. 4ft
10
61     4
1
«
 geriatric division
F 133
Table 3.—First Admissions to Skeenaview Hospital, Terrace, by Method
of Admission and Age-group, April 1, 1963, to March 31, 1964
Method of Admission
Age-group (Years)
Total
40-49 f 50-59   60-69 i 70-79
80-89
90-99
Certification
2
8
14         14           1
-    1      1    1    -
3
42
14
3
Table 4.—First Admissions to Skeenaview Hospital, Terrace, by Mental
Diagnosis and Age-group, April 1, 1963, to March 31, 1964
Mental Diagnosis
Age-group (Years)
40-49 150-59 I 60-69 { 70-79
1           1           1
80-89
90 and
Over
2
7
1
11
"I
1
1
1
2
2
2
3
5
1
1
2
21
2
3
2
1
1
2
Chronic brain syndrome with behavioural reaction	
4
7
Totals
2
8
14
15
1
3
43
Table 5.—First Admissions to Skeenaview Hospital, Terrace, by Mental
Diagnosis and Marital Status, April 1, 1963, to March 31, 1964
Table 6.—First Admissions to Skeenaview Hospital, Terrace, by Religion,
April 1, 1963, to March 31, 1964
Table 7.—First Admissions to Skeenaview Hospital, Terrace, by Previous
Occupation, April 1, 1963, to March 31, 1964
Detailed information for the above tables may be obtained on request.
 F 134
Table
mental health services report, 1963/64
1.—Resident Population of Skeenaview Hospital, Terrace, by
Mental Diagnosis and Age-group, December 31, 1963
Mental Diagnosis
Age-group (Y
ears)
40-49
50-59
60-64
65-69
70-74
75-79
80 and
Over
1
10
1
1
19
1
5
1
25
1
"6
2
2
1
1
1
34
1
~6
1
5
1
1
1
1
2
1
3
2
44
2
1
16
6
4
1
4
3
1
24
1
24
"6
1
1
2
5
_*ani._...>pt. -i-iVA rrarlinn
4
Psychosis with cerebral arteriosclerosis	
23
Psychosis of other demonstrable etiology
other pnH unspecified psychrt-.*
i -_fi
5
1
5
Chronic  brain  syndrome  with  behavioural
:Syphilis nrrt it. .pqiipi^.
Other, unknown, and unspecified conditions
13
8
Total-
1    |      12
26
39
59
82
64
283
Table 9.—Live Discharges from and Deaths Occurring in Skeenaview
Hospital, Terrace, by Mental Diagnosis and Age-group, April 1,
1963, to March 31, 1964.
Mental Diagnosis
Age-group (Years)
Total
60-69
70-79
80-89
90-99
hive Discharges
1
I
1
~
1
Senile p-yr:hrvri.
Se.nilitv, NOS
1
1
1
1     1       1
—
3
Deaths
. .chivnphreni., HlcorHftr.
2
1
8
3
3
2
2
3
2
1
5
3
1
1
4
1
2
1
2
1
9
10
9
2
1
1
3
9
Senility, NOS
4
3
23
16
6
48
Table 10.—Live Discharges from and Deaths Occurring in Skeenaview
Hospital, Terrace, by Mental Diagnosis and Length of Stay, April 1,
1963, to March 31, 1964.
Detailed information for the above table may be obtained on request.
 GERIATRIC DIVISION
F 135
Table 11.—Deaths Occurring in Skeenaview Hospital, Terrace, by Cause
of Death, Age-group, and Sex, April 1, 1963, to March 31, 1964
Cause of Death
Age-group (Years)
Total
60-69
70-79    |     80-89
1
90-99
Malignant neoplasm	
2
1
3
1
1
8
1
3
4
1
1
1
1
8
~>
4
1
2
1
-
3
6
3
6
Table 12.—Deaths Occurring in Skeenaview Hospital, Terrace, by Cause
of Death and Length of Stay, April 1, 1963, to March 31, 1964
Detailed information for the above table may be obtained on request.
 F 136 MENTAL HEALTH SERVICES REPORT, 1963/64
PART VII.—COMMUISITY MENTAL  HEALTH   SERVICES
MENTAL HEALTH CENTRE, BURNABY
K. J. Davies, Director
This has been a remarkable year for staff stability. A record percentage of
positions was filled throughout the year with very few changes. This has meant a
better integration of service within the centre as well as to the community being
served.
The programme of better liaison with the community, which was instituted
last year, has continued. The intake teams (psychiatrist, psychologist, social worker,
and nurse) in both the Adult and Children's Clinics have provided immediate access
to the Mental Health Centre, providing screening, emergency and brief service, consultation or transfer to a treatment team. The number of cases given intensive
assessment and agency consultation approximately doubled. Assessed cases in the
Adult Clinic increased from 583 to 631 and in the Children's Clinic from 271 to
414. The two multidiscipline treatment teams have also expanded their service
from 484 to 535 cases in the Adult Clinic and from 260 to 387 cases in the Children's Clinic. These are record levels of patients treated, and there have been
similar expansions in the number of relatives treated, as well as a heavier treatment
load in the Adult Day Hospital and the Children's Day Centre.
Despite these increased direct services to the community, the staff has also
given increased indirect service by professional education (students of medicine,
psychology, social work, nursing, occupational therapy, special school counsellors,
probation officers, medical health officers, and clergymen), public education by
lecture and demonstration, and liaison committee meetings with other medical and
social agencies. The in-service training programmes for all disciplines have also
been intensified.
OUT-PATIENT DEPARTMENT
In both the Adult and Children's Clinics all professional staff are now providing about equal time to intensive treatment, brief service, and community consultation. This dilutes the centre's special facility in prolonged psychotherapy but is
in keeping with the demands of the community. The greater involvement in family
group therapy and group psychotherapy as well as collaborative therapy has resulted
in the reduction of total treatment time with many patients. Most of the clinic
professional staff have been working on Tuesday evenings to make interviews possible with working family members. The Tuesday evening Social Club has also
provided meaningful contact for many patients, their family members, as well as
ex-patients.
ADULT DAY HOSPITAL
Over the past year there have been increasing referrals of adolescents with
complicated family problems who have not responded to other out-patient and inpatient treatment. This switch of demand for service from adult to adolescent was
related to the increasing facilities for adults in the community and the lack of any
adolescent in-patient treatment units. An attempt was made to provide service to
this group by lowering the admission age to 16 and modifying the Day Hospital
programme.   The focus was switched from individual to group therapy, and the
 COMMUNITY MENTAL HEALTH SERVICES F 137
milieu programme took precedence over the somatic therapies (electroconvulsive
therapy, somnolent insulin, amytal interviews, and medications). Selection necessitated participation of family members and a home assessment became essential
for candidates for Day Hospital treatment. Adolescents increased to two-thirds of
the Day Hospital population, but problems required that this should be limited to
only one-third adolescents. From last year the average stay of patients increased
from 30 to 45 days and total patient-days from 3,716 to 5,868. The treatment
room was converted into an area for sewing, stenography, beauty-parlour, and a
kitchen section.
Direct contacts were made with the various agencies in the community providing educational, rehabilitation, and employment services. Development in these
areas is vital to the best operation of this programme, which is set up to accommodate a maximum of 40 patients with any diagnosis, but with the emphasis on acute
neurotic and psychotic reactions.
CHILDREN'S DAY CENTRE
Two half-day programmes were carried out this year—one for six autistic
children and the other for five children rejected from primary school because of
emotional problems. The ages ranged from 4 to 7 years. The autistic children
received individual relationship therapy within the Day Centre, as well as family
collaborative treatment under a psychiatric team. The mothers were seen weekly
by the charge nurse for group discussion about the management of the children, as
well as being involved in weekly group psychotherapy. These children and their
families are also part of a research project. The other group of primary-school
children was involved in Day Centre activities, with an emphasis on creative, expressive endeavours and peer group interaction. Their families were also involved
in collaborative or family group therapy under a psychiatric team. The Day Centre
staff gave much of their own time to increase knowledge and skill in work with the
children and have learned much from their work with the two groups. Both programmes were gratifying experiences for the staff as positive changes in the behaviour
of the children were observed.
GROUP-LIVING HOMES
A screening and consultation service is being provided to social welfare group-
living homes in Burnaby, Prince George, Smithers, and Kamloops. Individual and
group therapy have also been provided to the adolescent boys in the group-living
home in Burnaby. These homes are providing an essential service which will be
increasing greatly during the coming year, and attempts are being made to provide
the personnel and time necessary to give them the appropriate psychiatric service.
AGENCY CONSULTATION SERVICE
Mental Health Centre child psychiatrists have been making weekly visits to the
Health Centre for Children, Children's Aid Society, Catholic Children's Aid Society,
Juvenile Court, and Willingdon School for Girls to provide consultation, as well as
recommend treatment when appropriate. There have been many requests to increase this service to these agencies, as well as extend it to others.
The trend from diagnostic to consultation to educational travelling clinics has
continued. The basis of the education is the appropriate use of the psychiatric consultation service, with the goal of an establishment of a community psychiatric clinic.
 F 138 MENTAL HEALTH SERVICES REPORT, 1963/64
TRAVELLING CLINICS
To facilitate this education, the travelling team (psychiatrist, psychologist, and social
worker) provide a community service to professionals and to the public. The professional service revolves around referrals (from local physicians, medical health
officers, public health nurses, school counsellors, social welfare workers, probation
officers, and clergymen) who are example cases given full assessment and discussed
in conference regarding treatment, recommendations, and supervision of local personnel in their continued management of these cases (only a limited number of
these patients can be seen in psychotherapy locally or referred to centres for psychiatric treatment). The public education involves lectures and demonstrations
regarding mental health, mental illness, and psychiatric services. Both groups are
encouraged to form the appropriate committees and activities necessary for community mental health programmes.
The establishment of a meaningful communication with the community requires
fairly frequent visits by the same personnel on the travelling clinic team. This has
been set up at one day a week to the Surrey area and 2Vi days per month to the
Chilliwack area. An Interior travelling clinic (Prince George, Quesnel, Williams
Lake, Dawson Creek, and Fort St. John) has been increased during the year to one
week bi-monthly. The Kootenay trip (Trail, Nelson, and Cranbrook) has also
been visited one week bi-monthly during the year. A community Mental Health
Centre is now being established at Trail. A Coastal travelling clinic (Prince Rupert,
Terrace, and Kitimat) has received two one-week clinics during the year, but will
be increased to one week bi-monthly during the coming year. Powell River and
the Sechelt Peninsula have been visited one week bi-annually, which will continue
until the newly established health unit there makes more meaningful communication
with this area possible.
DEPARTMENT REPORTS
Social Work Supervisor
Social workers in the Adult and Children's Clinics have been showing an
increasing concern with the problems related to social supports in the community
in regard to out-patients, Day Centre patients, and Day Hospital patients. A stable
staff situation has meant a considerably increased volume of work during the past
year. The Adult Clinic social workers have a 69-per-cent increase in total interviews and a 32-per-cent increase in numbers of people seen. The Children's Qinic
social workers have a 45-per-cent increase in total interviews and an 83-per-cent
increase in numbers of people being seen in assessment and treatment. These
increases reflect not only increased numbers of patients, but a broader involvement
of families. Family group therapy has been of particular interest to all social
workers in both clinics and has been used effectively and economically in many
cases, as well as being the particular treatment focus of one Children's Clinic team.
Social workers have been actively involved in the Day Hospital and Day Centre
programmes, as well as out-patient group therapy.
The student programme was enlarged this year year, and seven M.S.W. students
from the School of Social Work, University of British Columbia, received their field
training in the centre. This extension was an important one in view of the increased
enrolment at the School of Social Work. The Mental Health Grants have been basic
in improving training, as well as an area of recruiting a high standard of trainees to
the Mental Health Services.
 COMMUNITY MENTAL HEALTH SERVICES F 139
The travelling clinic consultant social workers have been active in educational
efforts in the local communities in their team role but also individually by giving
demonstrations of individual and group therapy techniques. This has proved a very
worth-while method of demonstrating approaches to mental health problems as well
as interpreting the clinic role in providing more continuity between travelling clinic
services and the ongoing services of the local personnel.
Chief Psychologist
The department has two part-time and one full-time psychologist with Ph.D.
degrees and the remainder are at the Master's level. The contribution of a clinical
psychologist is directly related to the calibre of training, and all should be encouraged to continue their training toward the highest level.
The in-service training has intensified with weekly seminars on psychotherapy,
psychodiagnostics, and case presentations. The seminars are open to other sections
of the Mental Health Services and are actively attended. There have been weekly
liaison meetings with other psychologists in the community, which have resulted in
a sharing of ideas and problems. There have been several meetings with the University of British Columbia Department of Psychology to plan a student internship
programme for clinical psychologists. This will result in better-trained staff and
considerably reduce the training time required when they are employed. One
research problem which has involved considerable time is an investigation of childhood autism. The study has involved an assessment of both parents, individually
and collectively, and evaluation of parent-child interaction, a study of the child, and
group psychotherapy for the mothers. Further research continues on the socio-
metric assessment of changes of attitude and behaviour in Day Hospital patients.
Another investigation is under way delineating the etiology of reading and learning
disabilities.
Although psychodiagnostics still occupy the greatest portion of time, there is
increasing involvement of psychologists in research projects, as well as both individual and group psychotherapy.
Supervisor of Nursing
The out-patient team nurses have played a more active role as coordinator,
as well as liaison person, with public health nursing agencies. Home-visiting, mainly
for the purpose of assessment, was added to the nurse's function, with very encouraging results. Nurses have been seeing an increasing number of patients in individual supportive therapy, as well as assisting patients in practical aspects of rehabilitation in the community. With the increasing demands and emerging specificity of
their roles on the team, the Children's Clinic nurses are finding it difficult to share
their time with the Day Centre, where they carry the direct relationship treatment
load. The nurses in the Adult Day Hospital programme have increased their group
therapy role, as well as being responsible for the therapeutic milieu involved in the
somatic therapies. Several revisions have been made in the programme during this
past year in an effort to structure an environment in which the demonstrated Day
Hospital patients' needs can best be met.
This year the Nursing Department has complied with an increased number of
requests from nursing educators and public health agencies for students and staff
to receive lectures or spend time at the centre to increase their knowledge and
experience in the mental health field. Nursing staff were also involved in the education programmes of students from the University of British Columbia School of
 F 140 MENTAL HEALTH SERVICES REPORT, 1963/64
Nursing, the Vancouver General Hospital, St. Paul's Hospital, and the clinical and
affiliate and psychiatric nursing programmes of the Education Centre at the Provincial Mental Hospital.
Supervisor of Occupational Therapy
Despite the shortage in occupational-therapy staff, the department remains an
integral part of the total treatment programme. It plays an important role in the
assessment, treatment, and rehabilitation of the patient. Responsibility for a therapeutic community is shared by staff and patients, and every effort is made to face
the attendant problems in a realistic way. The past year has seen many changes in
patient population, staff structures, treatment programmes, and departmental activities, but improvement in the effectiveness of occupational therapy in the treatment
team has become more and more obvious.
The occupational-therapy staff took part in the in-service training at the centre,
and there were many visits from professionals and students from the outside community. During the past year a total of eight occupational-therapy students did
their internship of approximately two months each at this centre. Of the eight, six
were from the University of British Columbia and two from the University of
Toronto.
Business Manager
Organization.—Changes involved the accommodation of the After-care Clinic,
effective September 9, 1963, with 11 offices and one waiting-room, plus the relocation of the pharmacy and the employment of a full-time pharmacist.
Personnel.—Staff changes during the year involved 13 resignations with three
transferred out, while there were 22 appointments and one transferred in, increasing the strength from 81 to 91 staff members.
1
 COMMUNITY MENTAL HEALTH SERVICES
STATISTICAL TABLES
F 141
Table 1.—Summary of Operations, Mental Health Centre, Burnaby,
Adult Clinic, April 1, 1963, to March 31, 1964
Male
Female
Total
Intake Section
12
23
35
Plus assessments—
18
14
161
44
29
17
256
57
47
31
417
101
237
359
596
249
382
631
Disposition of assessments—
10
14
58
20
21
116
23
28
86
27
19
179
33
42
144
Advice and a ._•«.__. nt only
47
40
239
362
601
10
20
30
Treatment Section
Patient load—
75
104
12
116
164
141
38
179
191
81
343
159
534
Total under treatment at March .1, 1064
110
184
294
Family members under treatment at March 31, 1964:  Parents, 19;  spouses, 15;  other, 3;  total, 37.
Table 2.—First Admissions to Mental Health Centre, Adult Clinic, by
Health Unit and School District of Residence, April 1, 1963, to
March 31, 1964.
Detailed information for the above table may be obtained on request.
 F 142
MENTAL HEALTH SERVICES
REPORT, 1963/64
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F 143
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MENTAL HEALTH SERVICES REPORT, 1963/64
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M'M I"
I-.C. I     IH     |«-     |~t
ri i i r i
l  !■
Ill
! —       *t (S
I I I
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IJ
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__ -_ _>
3  _ — *2
i*S Is
'> _l*s
,-lwO
8 9 *_g ***_! _*'_ <
a.ss9'ss:
|2a|||i
2
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_a_o8&l°g8«
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3 s •_*_ 1 s s _*|sJua i
s.l|iS3|saf r«'
;o_i .So aia_,o^
' 3 °"
•P5
ft, ft, < E ft, O Z ft     OQ
 COMMUNITY MENTAL HEALTH SERVICES
F 145
Table 7.—Movement of Population, Day Hospital, Mental Health
Centre, Adult Clinic, April 1, 1963, to March 31, 1964
Male
Female
Total
10
43
6
13
60
12
23
103
18
59
54
85
76
144
130
5
9
14
Total patient-days of those discharged .
Total discharges .
Average stay in day hospital.
Table 8.—Summary of Operations, Mental Health Centre, Burnaby,
Children's Clinic, April 1, 1963, to March 31,1964
Male
Female
Total
Intake Section
2
1
3
Plus assessments—
5
10
241
21
1
6
120
10
6
16
361
31
277
137
414
279
138
417
Disposition of assessments—
12
7
87
7
155
9
2
53
3
67
21
ntTipr T_.M___.al /-an. rprrtmmpnHpH
9
140
10
222
268
134
402
"
4
15
Treatment Section
Patient load—
123
42
165
124
31
50
17
174
48
155
67
222
__•-. r_ __i fin .pr!
27»
108
109
40
387
148
Total under tr_.ntm_.nt at Marcb 31, l0fi4
170
69
239
 F 146
MENTAL HEALTH SERVICES REPORT, 1963/64
Table 9.—Summary of Diagnostic Service Given to Agencies by Mental
Health Centre, Burnaby, Travelling (Children's) Clinics, April 1,
1963, to March 31, 1964.
Place of Examination
New
Repeat
M.
F.
M.
F.
Local agencies and medical units—
10
5
38
1
51
31
1
20
4
7
13
16
8
10
13
9
3
1
13
24
11
5
10
5
2
7
7
8
3
13
5
9
5
18
34
8
2
17
1
7
8
1
7
4
2
3
1
9
4
6
3
1
6
1
2
4
1
3
Public health units—
115
53
9
53
11
29
35
17
21
30
19
237
117
123
44
521
1
Table 10.—Summary of Mental Health Centre, Burnaby, Travelling
(Children's) Clinics Service, April 1,1963, to March 31, 1964
Vancouver
Ahhotsforrl
T-iirns T .ate
Total Number of
Children Seen on
Travelling Clinic
120
13
Other Agency
Consultative
Cases
74
4
1
CMIiwact
Cranbrook
r>flwi'"i _"____•
39
29
9
20
5
1
Fort St. John
8
9
Kitimat
11
1
Mission
10
Nelson
21
9
Powell Piver
19
6
Prince George
Prince Pnpert
Quesnel
31
19
     12
14
9
6
Surrey
115
21
Terrace
Trail
11
35
10
8
Williams T.aVe
.   _    10
4
Totals
521
193
 COMMUNITY MENTAL HEALTH SERVICES
F 147
Table 11.—Source of All Cases Referred to Children's Clinics and
Service Given, April 1, 1963, to March 31, 1964
Agency or Source
Number
of
Cases
Type of Service Given
Agency
Diagnostic
Study
Clinic
Direct
Service
1. Mental Health Services—
Crease Clinic	
After Care Clinic
The Woodlands School...
2. Medical units-
Beacon Services—.	
Vancouver General Hospital _ _
Canadian Arthritis and Rheumatism Society...
Cerebral Palsy Association .
Children's Hospital	
Sunnyhill Hospital...
Health Centre for Chfldren-
G. F. Strong Rehabilitation Centre..
Coqualeetza Indian Hospital-:	
3. Public health units-
Boundary Health Unit	
Burnaby Health Unit	
Cariboo Health Unit-
North Fraser Health Unit	
Upper Fraser Health Unit	
Gibsons Public Health Services-]
Kitimat Public Health Services-
Bast Kootenay Health Unit	
West Kootenay Health Unit	
Metropolitan Health Unit	
Peace River Health Unit	
Selkirk Health Unit	
Simon Fraser Health Unit	
Skeena Health Unit-
, Upper Island Health Unit	
4. Social agencies—
Department of Social Welfare	
Children's Aid Society	
Catholic Children's Aid Society-
Family Service Agency—. .—
St. Christopher's School	
5. Correctional agencies—
Probation Officers	
Provincial Probation Branch	
Juvenile Court	
Willingdon School for Girls-
6. General practitioners	
7. Private psychiatrists	
Totals	
131
4
53
11
56
14
11
29
35
11
21
21
12
33
24
39
36
28
5
1
86
20
193
31
53
9
53
9
11
29
35
17
21
30
19
25
12
11
4
16
5
193
31
 F 148
MENTAL HEALTH SERVICES REPORT, 1963/64
Table 12.—Diagnoses of All Cases Assessed by Children's Clinic,
April 1, 1963, to March 31, 1964
Psychotic disorders-
Schizophrenic reaction—
Simple type-
Childhood type-
Psychotic reaction without clearly defined structure-
Autism	
Psychoneurotic disorders—
Anxiety reaction	
Dissociative reaction—
Phobic reaction-
Obsessive-compulsive reaction-
Depressive reaction-
Psychoneurosis with somatic symptoms affecting digestive system.
Psychophysiological respiratory reaction —
Psychophysiological skin reaction.
Psychophysiological musculoskeletal reaction..
Psychoneurotic reaction—■
Mixed	
Other	
Psychoneurotic behaviour disorder-
Disorder of character, behaviour, and intelligenct
Schizoid personality—
Paranoid personality	
Cyclothymic personality-
Inadequate personality—
Antisocial personality	
Asocial personality	
Sexual deviation	
Other and unspecified-
Emotionally unstable personality...
Passive dependent personality..—
Aggressiveness	
Enuresis ,	
Other symptomatic habits	
Other and unspecified-
Adjustment reaction of infancy-
Adjustment reaction of childhood-
Adjustment reaction of adolescence-
Mental deficiency—
Idiocy	
Moderate-
Mild	
Mongolism-
Other and unspecified types _
Learning disturbance	
Speech disturbance-
Acute situational maladjustment	
Other and unspecified situational reaction -
Chronic brain syndrome with behavioural reaction-
Chronic brain syndrome of unknown cause-
Chronic brain syndrome associated with other diseases and
conditions.
Chronic brain syndrome associated with intracranial infection
Chronic brain syndrome associated with convulsive disorder	
Chronic brain syndrome associated with trauma	
Chronic brain syndrome associated with convulsive disorder
with behavioural reaction	
Observation only ! ! —
No disease	
Incomplete	
Totals	
11
20
16
1
4
4
12
16
5
2
3
143
78
7
18
28
2
132
1
5
13
2
7
2
2
5
5
10
53
49
5
7
20
1
66
1
2
42
3
10
4
3
2
2
2
1
16
25
26
17
2
1
3
5
3
4
5
17
21
7
4
2
8
3
196
127
2
12
25
48
3
1
24
10
1
1
2
1
2
2
3
I
1
198
2
7
 COMMUNITY MENTAL HEALTH SERVICES F 149
MENTAL HEALTH CENTRE, VICTORIA
C. Gregory, Director
GENERAL POLICY AND DEVELOPMENT
During its second year of operation the Mental Health Centre in Victoria has
been involved nvgiving consultative, assessment, diagnostic, and treatment services
to Greater Victoria through the Adult and Children's Clinics, and to the rest of
Vancouver Island by means of the travelling clinics; in promoting education for
both professional personnel and the general public by participating in P.-T.A.
courses, university courses, etc.; and in establishing good working relationships
with other agencies, both public and private, involved in the mental health field. It
is hoped that by these activities we are laying the basis for a comprehensive community mental health service.
Policy over referral is simple: we wish referrals whenever possible to come
from a physician, but since many patients are referred through agencies, we do not
make this a condition of acceptance. Instead, we accept the case on condition that
the agency or individual concerned contacts the patient's doctor, with the object of
ensuring not only that he is aware of the fact that a patient of his is attending the
centre, but also of extending to him the possibility of participating in planning a
therapeutic programme for the patient.
The estabUshment of good working relations with the various agencies and
individuals in the community has continued, and especially with the Victoria Medical
Society. A meeting was held with the executive, and the Director was invited to
speak to a general meeting of members, and, according to reports, was very well
received. Closer ties with the University of Victoria, Department of Psychology,
have been formed during the year, and this culminated in the appointment of Dr.
Gregory to the post of Honorary Research Fellow in the Department of Psychology
in February. Such affiliation with a university department is eminently desirable,
foir although in itself it is no guarantee of standards of professional service, it is well
recognized as an important contributing factor.
STAFF
Dr. Holland, who has been in charge of the Adult Clinic since its inception,
is leaving Victoria in July, and arrangements were made before the end of the year
for her replacement, Dr. A. Aranas, to commence before she leaves, thus ensuring
the minimum interference with the smooth functioning of the clinic.
CHILDREN'S CLINIC
For the first 10 months of the year this clinic consisted of a psychiatrist, who
is also Director of the centre, and two social workers, and we shared in the services
of a psychologist with the Adult Clinic. The remaining two months were spent
with only one social worker. In spite of this there were 280 psychiatric assessments
and interviews, 1,279 social-work interviews (an average case load per social
worker of 53 per month), and 102 children tested by the psychologist. These
figures include those seen on travelling clinics. Of necessity most of the ongoing
care has been provided by the social workers, with considerable success measured
in terms of improved family relationships, better academic performance and school
behaviour, etc., in those seen.
 F 150 MENTAL HEALTH SERVICES REPORT, 1963/64
The greater part of our efforts has been bent toward service to those children
and families referred by physicians, by the Child Welfare Division (including Brannan Lake School), the Family Court, Family and Children's Service, and Public
Health Services (the last being mainly concerned with school-children). In addition,
a limited number of adolescents were taken into therapy, the main criterion for
acceptance being the likelihood of their benefiting from treatment. With these
selected cases the results were most gratifying. This kind of service is of necessity
a two-way process, and we have been indebted to those agencies for their co-operation in dealing with those aspects of management of cases which we have neither
the staff, the facilities, nor the competence to do. Wherever possible, public health
nurses, social workers from agencies, private physicians, probation officers, special
counsellors, etc., were involved in conferences to delineate plans for specific patients.
ADULT CLINIC
The main functions of the clinic were after-care, assessment and treatment of
new cases where possible, and consulation and education to nurses, agencies, etc.
During this year the Adult Clinic was staffed by one psychiatrist and one social
worker. After-care and rehabilitation have steadily occupied an ever greater part
of the clinic's endeavours, somewhat to the detriment of the acute referrals, although
emergency service was available. An important reason for this is that there is a low
discharge rate amongst after-care patients, with the inevitable accumulation of cases
which must be carried by the clinic. This, plus the fact that Dr. L. Holland planned
to resign in July, necessitated the closing of intake, but it must be stressed that this
would have occurred even if Dr. Holland had been staying, simply because of the
case load being carried reaching saturation.
Several factors contributed to the success of this after-care programme. The
supplying of medication to those who needed it but could not afford it has been
vital, for there is no doubt that a large proportion of those patients attending the
centre would be unable to maintain their level of functioning without the use of the
newer drugs. Throughout the years we have been grateful for the excellent cooperation from physicians, social agencies, law-enforement agencies, the National
Employment Service, and Provincial and Federal Government departments in all
aspects of the adult programme, and most conspicuously in after-care. Another
significant factor permitting us to sustain patients in the community has been the
development of the use of boarding-home care, where patients could remain for a
while under supervision if considered necessary.
Psychotherapy has been in great demand, which has been met by restricting
the duration of this type of therapy to three months. When this course was taken,
it was conditional on the simultaneous consulation with a responsible relative, for
it was found that if this were not done, it led to both a prolongation of therapy and
poorly maintained improvement. A noteworthy fact which emerged is that when
welfare patients were taken into psychotherapy, their motivation and sense of
responsibility improved to such an extent that welfare agencies reported a tendency
for these patients to become self-supporting more often and more quickly. This
demonstrated once again the fact that proper psychiatric treatment of such patients,
in addition to benefiting them individually, represents a direct economic advantage
to the community.
During the year there were 146 new psypchiatric assessments and 1,228
interviews plus 790 social-work interviews (the average social-work case load per
month was 66), and the number of patients receiving ongoing after-care as at
March 31, 1964, was 88.
 COMMUNITY MENTAL HEALTH SERVICES F 151
TRAVELLING CLINICS
These have continued throughout the year and consisted of one visit per month
to Nanaimo and a one-day visit each to the Upper Island Health Unit at Courtenay,
Comox, and Campbell River. Although this is recognized to have been an inadequate amount of service, the local practitioners recognized that under the circumstances this was the best that could be done and expressed their satisfaction
with the quality of service. Naturally this responsibility for the rest of Vancouver
Island detracted substantially from the time we were able to devote to Victoria,
and it was with much relief that we heard of the appointment of a director to the
Mental Health Centre in Nanaimo, who will be responsible for the area covered
by both the Central and Upper Island Health Units as from April 1,1964.
SUMMARY
Consolidation of the first year's work in Victoria in laying the foundations for
a community mental health service has proceeded well during the second year, and
we have, in addition, been able to supply a minimal service to the rest of Vancouver
Island. The purchase of a building and the drawing-up of plans for the new Mental
Health Centre in close proximity to the Royal Jubilee Hospital, together with good
prospects for an increased rate of recruitment, have contributed to the feeling of
optimism with which the year ended.
 F 152 MENTAL HEALTH SERVICES REPORT, 1963/64
OKANAGAN MENTAL HEALTH CENTRE, KELOWNA
F. E. McNair, Director
We are reporting on the first full year's experience in developing a hitherto
unserviced area in British Columbia. There has been a basic clinic out-patient staff
(psychiatrist, social worker, psychologist, and stenographer) working at offices
located at the public health unit. There is also a psychiatric unit of 7 beds at the
Kelowna General Hospital. Nursing personnel there is headed by a university-
graduate registered nurse, and there are occupational-therapy and physiotherapy
services. The area served comprises 35,000 square miles and has a population of
150,000. The headquarters city of the clinic, Kelowna, has the greatest concentration of doctors.
The objective has been to provide as comprehensive a service as possible at
the headquarters out-patient clinic and hospital and to extend the scope and usefulness of the clinic by travel each month to the other principal cities in the district.
Private practice has been carried on up to 15 hours a week, and all hospital patients
have been admitted as private cases. However, no diagnostic or economic barrier
to hospital admission has been raised. There has been public and professional
acceptance and co-ordinated effort from doctors, social workers, public health and
probation staff, and special school personnel.
CONSULTATIONS
In the fiscal year, 390 patients have been seen in consultation at the clinic and
209 privately. From the two groups combined, 104 persons have had 126 admissions to the general hospital, 290 have been carried in out-patient treatment, 17
were certified outright, and 10 were certified during treatment or follow-up. The
first admission rate to the Provincial Mental Hospitals has been reduced one-third
to one-half from the region, and the use of police facilities for the mentally ill has
been reduced.
Utilization and effectiveness have been greater nearer the psychiatrist's home
town.
Acceptance of the new clinical service and utilization have been high. Despite
an average consultation rate of 40 new cases each month at the clinic and 16 new
cases in private practice, appointments have been running one month behind at the
end of the year. Attendance has been excellent, missed appointments have been
rare, and there have been few drop-outs. It has been usual for both parents to
accompany a child to the clinic and for a spouse to accompany an adult.
Demand for service was at a peak in the teen years and in the thirties. Nearly
all patients seen in consultation under the age of 20 were seen at the clinic by the
choice of the psychiatrist. Ancillary services were deemed essential, and consultation with community agencies was the rule.
Psychoneurosis accounts for 28 per cent of the total group but for nearly half
of the patients seen privately; psychosis accounted for 17 per cent of the total.
On the other hand, of the group treated in the psychiatric unit of the hospital, 46
per cent were psychotic and 30 per cent were psychoneurotic. The control of
admissions to the unit lay entirely with the psychiatrist.
TREATMENT
Two hundred and ten patients have been treated at the clinic, 58 of them children's cases.   Some children were treated by play therapy, but the major service
 COMMUNITY MENTAL HEALTH SERVICES F 153
to children was given through interviews with parents and consultation with school
nurses and special school personnel. One hundred and twenty-six persons have
been treated at the psychiatric unit of the Kelowna General Hospital, of whom 79
received follow-up care.
Thirty-one of our hospitalized patients had received previous treatment in a
mental hospital or Crease Clinic. The average patient stay in hospital was 17.7
days.   Twenty-two patients had repeat admissions.
RESOURCES
There are many health resources in this valley. There are 10 hospitals, 801
hospital beds, 141 medical doctors and 60 specialists, 37 public health nurses, 30
social workers, 6 probation workers, and 4 specialized school personnel. In addition, Kamloops has an institution for the retarded (518 beds) and Vernon has a
geriatric hospital (233 beds), managed under other divisions of the Mental Health
Services Branch. Each month the Alcoholism Foundation sends a trained social
worker into the area as a travelling clinic service.
Much of the mental health work continues to be done by the above-mentioned
basic resources. They devote much time and energy in dealing with emotionally
troubled patients and supply vital information to us, thereby making our work more
effective and helping us treat more people.
A citizens' advisory committee was established under the South Okanagan
Union Board of Health to receive quarterly reports and discuss needs for further
development of service. A professional advisory committee has also proved helpful.
Each major city in the region requires its own citizens' committee to review local
mental health needs and gaps in service.
VARIETIES OF SERVICE
Clinic personnel have taken part regularly in professional meetings in each of
the towns and also in Mental Health Association meetings, in groups for the retarded
and correction groups, and in service clubs and other associations. In addition to
the customary office consultations with patients and conferences with community
agencies, treatment interviews, and hospital visits, we have spent one week out of
four on travelling clinics, have done home visits and visits to nursing homes and to
gaol, provided emergency service at nights and on week-ends, and have engaged in
the ongoing education of allied staff and volunteers. Clinic time each day has been
divided by the noon hour into consultation time and treatment time. Referrals have
been accepted from doctors, social workers, public health nurses, and the Court
by apportioning time to each professional group, though doctors have always been
involved.
ACHIEVEMENT
Reference is made to the annual reports of the Mental Health Services to show
that consultation for children from 1957 to 1961 for this region stood at 43, 36,
29, 54, and 44 respectively per annum. In 1962 the figures rose to 155, and this
year it is 147.
Again referring to past Annual Reports, the first admissions to the Mental
Hospitals and Crease Clinic from 1957 to 1961 appear as follows: 175, 147, 151,
180,andl93. In 1962 the figure was 137. From December 1, 1962, to November
31, 1963, it was 121.   The readmission rate has not increased.
 F 154 MENTAL HEALTH SERVICES REPORT, 1963/64
The mental hospital admission rate has varied directly with the distance from
the headquarters city of the clinic. In Kamloops, 110 miles distant, the admission
rate has not been lowered.
Reviewing the mental health reports for the North and South Okanagan, first
admissions to Mental Hospitals and Crease Clinic from 1958 to 1961 show 93,
117, 125, and 128 respectively. In the fiscal year 1962/63 the first-admission rate
fell to 73, and from December 1, 1962, to November 31, 1963, it was down to 56,
less than half the 1961 figure.
There has also been a reduction by one-third in the number of psychiatric cases
falling into police hands in Kelowna and Penticton.
The Community Mental Health Service, including an out-patient centre, a hospital service, and private practice, has striven to provide for the needs of patients
which cannot be provided for in the community outside itself and has engaged the
active participation of other community resources in the total treatment of the
patient.
Much reliance was placed on treatment by brief psychotherapy and availability
of the clinic to see patients at periods of crisis in their lives. Sustaining clinics,
similar to those conducted at the Mental Health Centre, Burnaby, for the chronically
sick, assisted by volunteer workers from the Canadian Mental Health Association,
are successful in aiding rehabilitation and preventing readmission to hospital.
Many patients who would formerly have been sent to mental hospitals are
being treated as out-patients.
SUMMARY
There has been an increased demand for psychiatric service since the advent
of the regional clinic, and a wider service has been given than was previously possible. Utilization of service has been the greater nearer the clinic. There has been
a reduction in mental hospital admissions by one-half in two of the three health units
served. The incidence of death by suicide has not been altered. The service
depends greatly on other professional resources. The only limitation on the admission of cases to the psychiatric unit in the general hospital has been on the basis
of their willingness to remain voluntarily, though this term is very broadly interpreted. Hospital care has not always been needed even for the acutely psychotic
or relapsing psychotic cases. Service has been the key to both professional and
community acceptance of regional development.
More psychiatric beds are being planned in the development of the Kelowna
General Hospital. The initial population served has been 150,000 people, and this
is far too many for one psychiatric team. In the fall of 1963 the Medical Superintendent of the School for the Retarded at Tranquille took over the community
service in the Kamloops area by spending two days a month in the health unit there.
1
 COMMUNITY MENTAL HEALTH SERVICES F 155
STATISTICS FOR THE PERIOD APRIL 1, 1963, TO MARCH 31, 1964
Consultations by Areas
Adults
Children
Male
Female
Total
Male
Female
Total
32
26
19
12
4
2
44
41
25
23
11
4
76
67
44
35
15
6
29
22
15
10
5
5
20
18
8
8
3
4
_rfl_T_i_.i-.j_*
29
Salmon Arm .	
R_.v_.kr_.kr.
8
9
TnfaU
95
148
243
86
61
147
Patients Receiving Regular Treatment
Adults
Children
Male
Female
Total
Male
Female
Total
20
12
17
3
3
37
28
16
11
2
3
57
40
33
14
5
3
20
5
3
2
2
6
8
3
5
2
2
K"_m._.rtpQ
6
f**vels*oVe ....
2
T_.t«l_
55
97
152
32
26
58
Adult Patients Receiving Treatment at Kelowna General Hospital
Male
Female
Total
South Okanagan—
13
11
5
3
35
36
20
1
2
47
1
5
32
94
126
Patients Certified to Crease Clinic, Provincial Mental Hospital,
and The Woodlands School
Adults
Children
Male
Female
Total
Male
Female
Total
South Okanagan—
5
2
1
7
1
1
12
3
2
—-
Penticton
—
8
9
17
—
 Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1965

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