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Mental Health Branch PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT 1969 British Columbia. Legislative Assembly 1970

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Mental Health Branch
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia
  To Colonel the Honourable John R. Nicholson, P.C., O.B.E., Q.C, LL.D.,
Lieutenant-Governor oj the Province oj British Columbia.
May it please Your Honour:
The undersigned respectfully submits the Annual Report of the Mental Health
Branch, Department of Health Services and Hospital Insurance, for the year 1969.
Minister oj Health Services and Hospital Insurance.
Office oj the Minister oj Health Services and Hospital Insurance,
Victoria, British Columbia, January 22, 1970.
 Department of Health Services and Hospital Insurance,
Mental Health Branch,
Victoria, British Columbia, January 22, 1970.
The Honourable R. R. Loffmark,
Minister oj Health Services and Hospital Insurance,
Victoria, British Columbia.
Sir,—I have the honour to submit the Annual Report of the Mental Health
Branch for 1969.
F. G. TUCKER, M.B., B.S., C.R.C.P., M.Sc,
Deputy Minister oj Mental Health.
The Honourable Ralph Loffmark, Minister of Health Services and Hospital Insurance.
F. G. Tucker, M.B., B.S., C.R.C.P., M.Sc,
Deputy Minister of Mental Health.
Assistant Deputy Minister of Mental
J. S. Bland, B.A., M.B., B.Chir., D.P.M.,
Consultant in Retardation and Children's
Psychiatric Services.
F. A. Matheson,
Departmental Comptroller.
Miss A. K. Carroll, B.A., M.S.W.,
Social Service Consultant.
Miss M. M. Lonergan, B.S.N.Ed.,  M.N.,
Nursing Consultant.
R. H. Goodacre, B.A., M.A., C.P.H.,
R. McInnes, B.A., B.D., M.P.H.,
K. Denecke, B.Com.,
Assistant Statistician.
Mrs. F. Ireland, B.A., M.S.W.,
Co-ordinator of Boarding Homes.
R. H. Thompson,
Director, Information Services.
N. Wylie,
Administrative Officer.
G. R. Mansfield, D.P.M., C.R.C.P.(C),
Director,  West Kootenay Mental Health
A. J. Bennee, M.B., B.Ch., C.R.C.P.,
Director, North Okanagan Mental Health
F. E. McNair, B.A., M.D., CM., C.R.C.P.,
Director, South Okanagan Mental Health
D. Brasset, M.S.W.,
Acting Director, South Central Interior
Mental Health Centre.
P. Adrian, M.S.W.,
Acting Director, Upper Fraser Valley
Mental Health Centre.
J. Brown, M.S.W.,
Acting Director,  East Kootenay  Mental
Health Centre.
P. Flor-Henry, M.B., Ch.B., M.D., D.P.M.,
Director, Simon Fraser Mental Health
W. T. Lawson, M.S.W.,
Acting Director, Central Vancouver Island
Mental Health Centre.
J. A. Steedman, M.D.,
Director, Northern Interior Mental Health
W. C. Holt, M.D., C.R.C.P.(G),
Director, Burnaby Mental Health Centre.
W. W. Black, M.B., B.Sc, D.P.M.,
Director, Boundary Mental Health Centre.
E. Luke, M.B., Ch.B., D.P.M., C.R.C.P.(C),
Director, Central Fraser Valley Mental
Health Centre.
J. T. Wood, M.D.,
Director Saanich Mental Health Centre.
A. L. Aranas, M.D.,
Director, Victoria Mental Health Centre.
K. J. Mackay, M.B., B.S., Ch.B.(Aberd.),
L.M.C.C, C.R.C.P.(C),
Director, Upper Island Mental Health
H. W. Bridge, M.B., B.Ch., M.Sc,
Director of Mental Health Services.
C. B. Watson, B.A., M.A.,
Administrative Officer.
G. L. Tomalty, B.A., M.P.A.,
Departmental Personnel Officer.
A. Bishop, B.Ed.,
Assistant Personnel Officer.
Mrs. P. A. West, R.R.L.,
Consultant in Medical Records and
 B. F. Bryson, B.A., M.D., CM., F.A.P.A., Superintendent, Riverview Hospital.
W. J. G. McFarlane, B.A., M.D., D.Psych., C.R.C.P., Clinical Director, Riverview Hospital.
J. Walsh, M.B., B.Ch., D.P.M., Superintendent, Geriatric Division.
A. P. Hughes, M.D., B.Sc., C.R.C.P., Superintendent, The Woodlands School.
J. Bower, M.D., D.P.M., Superintendent, The Tranquille School.
P. A. Lavelle, M.B., B.Ch., D.P.M.,
Director, Residential Unit, British Columbia Youth Development Centre.
A. A. Cashmore, M.D.(Lond.),
Director, Family and Children's Clinic, British Columbia Youth Development Centre.
D. C. Shalman, Ph.D.,
Director, Psychological Education Clinic, British Columbia Youth Development Centre.
Mrs. E. Paulson, B.S.N., Acting Director of Nursing Education.
Report—Deputy Minister of Mental Health-
Report—Comptroller of Expenditure	
Report—Departmental Personnel Officer	
Report—Consultant in Retardation and Children's Psychiatric Services-
Report—Social Service Consultant	
Report—Nursing Consultant	
Report—Statistician and Medical Records Consultant	
Report—Consultant in Sociology	
Burnaby Mental Health Centre	
South Okanagan Mental Health Centre	
Central Vancouver Island Mental Health Centre-
West Kootenay Mental Health Centre	
South Central Interior Mental Health Centre-
Simon Fraser Mental Health Centre	
Boundary Mental Health Centre	
Central Fraser Valley Mental Health Centre..
Saanich Mental Health Centre	
Victoria Mental Health Centre	
Upper Fraser Valley Mental Health Centre-
Northern Interior Mental Health Centre	
North Okanagan Mental Health Centre	
East Kootenay Mental Health Centre	
Upper Island Mental Health Centre	
Report—Director of Mental Health Services	
Report—Acting Director of Nursing Education-
Report—Superintendent, Riverview Hospital.	
Report—Superintendent, Geriatric Division	
Report—Superintendent, The Woodlands School-
Report—Superintendent, The Tranquille School-
Report—British Columbia Youth Development Centre  102
Patient Movement Trends	
Patient Movement Data	
Deputy Minister of Mental Health
Comptroller of Expenditure
Departmental Personnel Officer
Consultant  in  Retardation  and   Children's   Psychiatric
Social Service Consultant
Nursing Consultant
Statistician and Medical Records Consultant
Consultant in Sociology
  Report of the Mental Health Branch
F. G. Tucker, M.B., B.S., C.R.C.P., M.Sc.
I am pleased to report that during the past year the Mental Health Branch
has made satisfactory progress toward the goals set down in my Annual Report
of 1968.
In order to achieve these aims a further refinement of the Branch Administration took place in April, 1969, and we now have established five divisions, each
functioning under its own Director who is responsible to the Deputy Minister.
They are as follows:—
Planning Division.
Administration Division.
Mental Health Services Division.
Special Services Division.
Community Mental Health Services Division.
Dr. Roger Congdon, who joined the staff as Consultant in Community Psychiatric
Services, resigned in the latter part of the year.   In April, 1969, Dr. Bland, the
Co-ordinator of Mental Retardation Programmes, assumed the additional responsibility of Consultant in Child Psychiatric Services.   As such he will assist in the
planning and development of Children's Psychiatric Programmes throughout the
I have been particularly pleased with the improved statistical and evaluative
studies being undertaken by our staff, our increasing involvement in community
programming, and the excellent liaison and co-operation we have had with other
Government departments, particularly the Department of Social Welfare. The
administration of our in-service facilities, the business administration and personnel
function, and the work of all our consultants, remains at its usual high level of
In this report, the presentation of the statistical material regarding patients
has been greatly simplified. Included are brief tables giving patient-movement
data for the institutions and mental health centres for the calendar year 1969. Other
statistical data will be published separately early in 1970.
The following over-all developments have, in my opinion, been of particular
significance during the past 12 months.
In addition to the 10 mental health centres already established, new centres
have been opened for Boundary, Haney, Courtenay, Cranbrook, and Saanich.
Every effort is being made to place in operation, as soon as possible, the two remaining mental health centres which are planned for the Skeena and the East Selkirk
regions.    Unfortunately, recruitment of mental health professionals for outlying
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areas remains a constant problem, and there has been a particular reluctance on
the part of psychiatrists to establish outside the metropolitan areas. At present,
four mental health centres are being administered on a trial basis by social worker
directors rather than by psychiatrists. I have every reason to believe that this alternative approach will prove successful, providing adequate psychiatric consultative
and treatment services are made available locally. Failing this, the service of
such a centre must, of course, be limited.
All too often the advent of a mental health centre in a community is seen as
the answer to all local mental health problems. It may be appropriate, therefore,
to stress at this time that the prime object of these centres is not to provide a fully
comprehensive diagnostic and treatment programme for a community, but rather
to develop, in co-operation with existing resources, a variety of services to meet the
particular needs of a region. The majority of existing centres have found it necessary to provide the following services in varying proportions:—
(i) Direct treatment services for adults and children:
(ii) Consultative services to physicians, health, welfare, educational, and correctional agencies:
(iii) Educational programmes, both professional and non-professional:
(iv) Special programmes, e.g., supervision of the long-term patient, boarding-
home care, preventative programmes, alcoholism programmes, etc.
The number of acute beds in general hospitals continues to increase with the
addition of 203 additional beds during the past year. The Health Sciences Centre,
Vancouver, opened in 1969 with an establishment of 60 beds, however, in spite of
this addition there remains a continuing need for additional acute psychiatric beds in
the general hospitals in metropolitan Vancouver. I am pleased to report that the
necessary administrative changes have been completed to permit the Riverview
Hospital to be designated as an " open hospital," available to qualified physicians
in private practice, for the treatment of their mentally ill patients. This is a
programme designed to augment the supply of psychiatric beds in major general
hospitals. On September 1, 1969, the Board of Directors of the Royal Jubilee
Hospital assumed responsibility for the operation and administration of the Eric
Martin Institute, in accordance with the terms of a contract drawn up between
the Government of British Columbia and the Board. The majority of administrative
problems involved in opening this complex facility have now been dealt with, and
the first patients will be admitted in January, 1970. Because of the lack of Federal
cost-sharing for 50 of the 170 psychiatric beds, one ward of 50 beds has been
allocated for the care of chronic pediatric cases with retardation, who are eligible
for extended care.
In December, 1968, the regulations of the British Columbia Hospital Insurance Act were amended to permit the Minister to designate certain hospitals for
day-care and out-patient services to psychiatric patients. Once the Department has
gained the necessary experience with this programme, I would hope that the programme would be extended.
We have continued to emphasize that it is highly desirable that the mentally
ill patient eligible for extended care should be treated in his community on the same
basis as the physically ill patient. During the past year we have met with success
in the placement of severely handicapped retarded and psychogeriatric cases.
In order to give impetus to this programme, consideration is being given to the
development of specialized extended-care facilities in association with general hospitals, on a regional basis, for these two categories of patients.
K 13
The boarding-home programme for psychiatrically disabled and retarded, operated jointly by the Department of Social Welfare and the Mental Health Branch,
continues to be most effective, with a case load of approximately 850. The majority of patients continue to be placed in the Lower Mainland and in the vicinity
of Victoria. However, formal agreement has now been reached with the Department of Social Welfare permitting regionalization of this programme. The necessary psychiatric supervision will be provided by the local mental health centre and
the programme will be initiated as soon as the necessary social work staff can be
A very high level of care is being provided by our two facilities for retardates.
On October 1, 1969, The Tranquille School became a regional facility responsible
for the provision of all assessment, admission, and treatment services to the retarded,
in those regions of the Province comprising Mental Health Planning Regions 1, 2,
and 6. Prior to that date, the majority of patients were first admitted to The Woodlands School and later transferred to The Tranquille School for continuing care.
This has necessitated the recruitment of additional professional staff and the admission of a wider variety of diagnostic categories into The Tranquille School programme. The boarding-home and foster-home programme for retardates is running smoothly and the Bevan Lodge, which now nouses 67 patients in intermediate
care, together with 11 patients in day care, has proved a most successful project,
which we hope to repeat in other areas of the Province, thus freeing beds for more
severely retarded patients in our major institutions. In April, 1969, the Department of Public Works purchased Our Lady of Fatima School in Maillardville, which
has now been extensively renovated and was opened in October, 1969, as an annex
to The Woodlands School, for 50 trainees. This facility will be primarily used for
the preparation of trainees for placement in the community.
As already mentioned, one ward of the Eric Martin Institute has been
designated as an extended-care unit for chronic pediatric cases with retardation.
It is anticipated that in the spring of 1971 the Glendale Hospital at Royal Oak
will come into operation and will provide a further 150 extended-care beds and
150 beds for severely retarded. These developments, in conjunction with an expanding boarding-home and intermediate-care programme, should go a long way toward
meeting the needs of severely retarded, with or without physical handicaps, in the
immediate future.
The community programme for the less-severely retarded trainable and edu-
cable individuals has also been proceeding satisfactorily with the provision of special
classes, hostels, and improved training programmes. I would particularly wish to
note the transfer of the Smithers Experimental Farm from the Federal Government
to the Provincial Government, for operation by the local chapter of the Association
for Retarded Children of British Columbia as a training centre. Unfortunately,
difficulty still exists in providing operating costs for workshops where their prime
objective is that of providing activity, rather than training, assessment, or limited
One of the most important advances in the past year has been the establishment
of a Youth Resources Panel, composed of senior administrators from the Departments of the Attorney-General, Education, Welfare, British Columbia Hospital Insurance Service, Health Branch, and Mental Health Branch. The prime purpose of
this group is to assess the needs of emotionally disturbed children throughout the
Province, and to attempt to co-ordinate and integrate planning in the provision of
programmes at the Government level. Children's programmes are administered
under a variety of statutes and varying fiscal arrangements, and involve a wide range
of professional disciplines. The value of such a committee, therefore, cannot be
The Interdepartmental Case Review Committee, established in 1961 in conjunction with the Special Placement Section of the Department of Social Welfare,
continues to deal with the placement of difficult individual cases. It is hoped that,
in collaboration with the Department of Social Welfare, this service can be further
expanded so that a registry of emotionally disturbed children can, in due course, be
established to ensure the most effective use of existing resources.
Capital construction grants have been made available, in accordance with the
Treatment Resources Act upon the recommendation of the Minister of Health Services and Hospital Insurance, to a variety of non-profit societies who provide care
for emotionally disturbed children and retardates. Under this Act, up to one-third
of the capital construction cost can be met by Government grant, providing 10 per
cent is available from the non-profit society. The remaining 56% per cent of the
cost of construction may be obtained through the Central Mortgage and Housing
Corporation, or by other means. In the majority of instances, these facilities have
been operated on a per diem grant provided by the Department of Social Welfare.
It has, therefore, been necessary to establish a Rate Board with representation from
the Department of Social Welfare and the Mental Health Branch to advise on the
administration of this programme. Mention should be made of the increasing in-
volvment of our staff, particularly Dr. J. S. Bland, in the inspection and evaluation
of residential treatment centres for children. Steps have also been taken to ensure
that regular progress reports on individual patients who are the responsibility of the
Superintendent of Child Welfare are submitted on a regular basis.
In August, the British Columbia Youth Development Centre admitted its first
patients to the Residential Unit and to the adolescent day-care programme. The
Family and Children's Service Division of the complex was, of course, in operation
at the beginning of the year, and has continued to provide its high level of service.
Six out of the seven classrooms in the Psychoeducational Unit came into operation
in September, and this promises to be an extremely valuable programme, with good
liaison being established with the Simon Fraser University, Department of Special
In common with other Provinces, British Columbia suffers from a marked
shortage of professionals skilled in working with emotionally disturbed children. It
has, therefore, been necessary not only to recruit child care counsellors, but to train
them before the Residential Unit could be brought into operation. This has led to
some fragmentation of the programme, and as a result time will elapse before the
buildings can be put to optimal use; however, in the coming year, this Centre will
be brought into full operation with complete integration of the three divisions.
Not only should the British Columbia Youth Development Centre provide a high
caliber of consultative, diagnostic, and treatment programmes, but it should become
increasingly involved in the training of the much-needed professional staff.
Mental health is not an easy field in which to work. The demands and expectations of society are all too often unrealistically high, the sense of achievement and
reward limited, and enthusiasm can readily give way to cynicism in the face of criticism. In conclusion, therefore, I would like to commend the staff of the Mental
Health Branch for their continuing dedication to the care of their patients, and their
interest in the mental health of the community at large.
K 15
F. A. Matheson, Comptroller
The following report of the areas for which the Comptroller of Expenditure
is responsible covers the period from April 1, 1968, to September 30, 1969.
Financial statements covering the operation of the Mental Health Branch
will be prepared for the fiscal year April 1, 1968, to March 31, 1969, as soon
as the accounts are reconciled with the public accounts.
The period under review has been a very active one. Major items of particular interest are as follows:—
Headquarters, Victoria.—The Deputy Minister and his staff moved into new
quarters in the Dogwood Building on January 15, 1969.
Eric Martin Institute, Victoria.—The Eric Martin Institute was completed
and, following negotiations, a contract was signed with the Royal Jubilee Hospital
for the operation of the Eric Martin Institute. It is anticipated that this facility
will start admitting patients early in January, 1970.
Glendale Hospital, Victoria.—A contract in the amount of $4,914,000 was
let for the main hospital unit of the Glendale Hospital in March, 1969.
The contractor was making good progress on this project and it is anticipated
that the building will be completed by December, 1970. The boiler-house and
laundry were almost completed and all the machinery and equipment had been
instaUed by the year end.
British Columbia Youth Development Centre, Burnaby.—All buildings for
this project were completed and accepted by the Department of Public Works
from the contractor on March 19, 1969.
The landscaping and the construction of the children's outside play-area was
nearing completion.
The first patients were admitted to this facility for treatment in August, 1969.
Renovation oj Centre Building, Wards J and K, G and Con, The Woodlands
School, New Westminster.—The second phase of this renovation project was
completed in September, 1969.
After discussion with the Department of Public Works regarding the completion of the renovation work in Wing 4 of the Centre Building and the buildings
housing Wards J and K, G and Con, it was decided that it would be in the best
interests of all concerned if these areas were demolished and replaced with five
20-bed cottage units.   A start was made on preliminary planning in this connection.
Renovation oj West Lawn Building, Riverview Hospital, Essondale.—Work
in connection with the major renovation of the West Lawn Building started, and it
was expected that the first phase of this project will be completed in February, 1970.
During the period under review, seven new mental health centres started
operating, as follows:—
(1) South Central Interior Mental Health Centre, Kamloops.—Started operating in July, 1968, in quarters located in the new public health building.
(2) Simon Fraser Mental Health Centre, New Westminster.—Started operating in November, 1968, in rented quarters.
(3) Mental Health Centre, Saanich.—Started operating as a separate unit
from the Victoria Mental Health Centre in May, 1969. Arrangements
were made to provide them with rented quarters located in Royal Oak.
(4) Central Fraser Valley Mental Health Centre, Haney.—Started operating
in June, 1969, in rented quarters.
(5) Upper Island Mental Health Centre, Courtenay.—Started operating in
June, 1969. They have been operating out of inadequate facilities in
the public health building, Courtenay; however, arrangements were
completed to provide them with more suitable rented quarters.
(6) East Kootenay Mental Health Centre, Cranbrook.—Started operating
in October, 1969, in facilities in the public health building.
(7) Boundary Mental Health Centre, Cloverdale.—Started operating in May,
1969. New facilities were provided for this centre in the public health
building in Surrey.
Arrangements were made with the British Columbia Medical Services Plan to
cover all patients in mental health institutions under the plan. This became
effective on March 1, 1969. In addition, the British Columbia Medical Plan is
billed for full-time, part-time, and sessional physicians employed in the institutions,
who are providing direct-treatment services to the patients. Billings in this connection started on July 1, 1968.
Buildings, grounds, equipment, and furnishings of all institutions were maintained in a satisfactory manner during the period under review, and a considerable
amount of new and replacement equipment and furniture was purchased.
Items of special interest where the institutions are concerned are as follows:—
Riverview Hospital, Essondale.—The Canadian Hospital Association Accreditation Committee inspected the Riverview Hospital and in their report, amongst
other things, pointed out certain deficiencies in fire protection. Arrangements
were made for the Fire Marshal's Department to make a complete survey of the
Riverview Hospital, and the report of the inspection contained numerous recommendations, some of which involved major construction. All recommendations
in connection with minor deficiencies were corrected and the Department of Public
Works is developing plans to implement major work, which consists mainly of
enclosed stairwells for the various buildings.
Outside consultants were employed to make a complete survey of the dietary
service at the Riverview Hospital. Their report was received and work has
started in carrying out some of the recommendations.
The Department of Public Works employed outside consultants to make a
survey of the laundry services being supplied by the Riverview Hospital laundry
to not only the Riverview Hospital, but Valleyview Hospital and The Woodlands
School. Work was commenced on some of the recommendations in an effort to
improve the laundry service on a short-term basis. The report indicated that a
new laundry will be required within a five-year period, and preliminary work was
started on the planning for the new facility.
The Woodlands School, New Westminster.—The first phase of the new industrial therapy building was completed and is in operation.
Arrangements were made with the Parks Branch for The Woodlands School
to use the Gold Creek Camp in Garibaldi Park, which was formerly used by the
Attorney-General's Department.   The camp has only been used on a day basis,
K 17
but it is hoped that in the near future accommodation will be provided in order
that the patients may spend a week or two during the summer months in this facility.
Alder Lodge, Maillardville, which was formerly the Lady Fatima School, was
purchased by the Government. It provides accommodation for 50 patients and is
being used to train patients who are nearly ready for discharge.
New fire escapes were installed in all the cottage units.
A new semi-automatic telephone exchange was installed and is in operation.
A contract was let for the renovation of Wards 32 and 33.
The Tranquille School, Tranquille.—New dental facilities were provided for
The Tranquille School.
The renovation and addition to the laundry were completed.
Valleyview Hospital, Essondale.—A new ventilation system was installed on
Wards 4 and 5, 6 and 7, 8 and 9. A contract was let and work was under way for
new fire escapes for these wards.
Skeenaview Hospital, Terrace.—It was expected that this institution would
be gradually phased out, and only essential maintenance work has been carried
out. However, it later developed that the hospital would not be phased out and,
therefore, extensive repairs are now required, including a new kitchen. The
Department of Public Works is working on plans in this regard.
Construction on the new Glendale Hospital, Victoria, is progressing according to
schedule. The above photograph was taken in December and shows a part of the main
building. The hospital will provide care for 300 severely and moderately handicapped,
to profoundly retarded, children and adults.
 The Eric Martin Institute of Psychiatry, Victoria, British Columbia, will be officially
opened on Tuesday, January 20, 1970, by the Honourable W. A. C. Bennett, Prime
Minister of the Province of British Columbia.
The Eric Martin Institute provides accommodation for 150 adult beds and
20 pediatric beds and will serve the residents of Vancouver Island. It was
designed and built by the Department of Public Works of the Province of
British Columbia at a cost of approximately $6,500,000, including equipment and
The building incorporates the modular system of design, which enables the
semi-movable partitions to be changed in keeping with future medical requirements,
at a minimal cost. This also applies to the mechanical and electrical services,
which follow the modular concept. Comprising six floors of reinforced-concrete
construction, the Institute's floor plan consists of the following:—
Basement. — Dietary  services,  staff  dining facilities,  central  storage,   and
mechanical rooms.
First Floor.—Admitting facilities, clinical and administrative offices; the Victoria Mental Health Centre.
Second Floor.—Day-hospital facilities;  occupational and recreation therapy
departments; physiotherapy suite.
Third, Fourth, and Fijth Floors.—Adult psychiatric patient accommodation
of 150 beds; each nursing-unit combines single, double, and 4-bed rooms.
Sixth Floor.—Accommodation for 20 pediatric beds located in two self-
sufficient nursing-units; the floor has an open-air play deck.
The building is fully air-conditioned for the comfort of patients and staff.
A car-park provides parking for 164 cars.
 Most of the second floor is devoted to
patients' activities and provides facilities for occupational and recreational
Large, cheerful dining areas allow
patients to sit at separate tables, and feature modern cafeteria-style equipment.
The building utilizes an outdoor induction system and a high-velocity terminal reheat air system. Steam heat is
piped from the Royal Jubilee Hospital.
Spacious lounge areas, many with
nice views, will be used by patients and
their guests for visiting.
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G. L. Tomalty, Departmental Personnel Officer
The statistics given in Tables A, B, C, D, and E are based on the fiscal year
April 1, 1968, to March 31, 1969. They show the following changes in the establishment of the Mental Health Branch during that period:—
Deputy Minister's office and community services (decrease)    63
In-patient care facilities (increase)  185
Total increase  122
During the fiscal year the number of staff recruited increased by 132. The
number of students recruited decreased by 44, which was attributed to the lower
educational standard of applicants, and a high drop-out in the early stages of training, because of inability to meet the requirements of training.
Recruitment in general was similar to last year, as indicated in Table B.
The over-all nursing-staff total was down 28 from the previous year. There
was an increase of 54 registered nurses and 69 psychiatric nurses on staff from
March 31, 1968, to March 31, 1969. Psychiatric-aide staff decreased by 98, and
the number of student nurses in training was down 53.
For the period April 1, 1969, to October 31, 1969, there were 105 new positions approved by Order in Council. These included 52 at The Woodlands School,
26 at Riverview Hospital, 24 at The Tranquille School, 1 at Valleyview Hospital,
1 at the Victoria Mental Health Centre, and 1 in General Administration. All have
been activated for recruitment, and the majority were filled by the year-end.
Nursing-staff turnover was down from 27.9 per cent in 1968 to 23.26 per cent,
and the total staff turnover for the Branch was down from 26.7 per cent to 23.05
per cent.
During the year this Department was able to take a more active part in classification reviews. As a result of six on-the-job studies, and one other investigation,
five requests for reclassification were handled at the Mental Health Branch level.
Other requests were forwarded with recommendations for a classification review
by the Civil Service Commission. Of these, 22 positions were upgraded, 6 were
left at the same level, and 11 have not been finalized through normal classification
reviews done by the Civil Service Classification Division.
In addition, studies were made of the Industrial Therapists, Recreational Instructors, Occupational Therapists, Physiotherapists, and at the year-end studies
were under way on Telephone Operators and Housekeepers. Industrial Therapists'
classifications were changed to Seamstress, but final decisions have not been reached
on the other studies.
Progress was made in plans for a series of circulars covering personnel administration policy and procedures for the Mental Health Branch, which will eventually
be developed into a complete Personnel Administration Manual.
Recommendations were made to the Civil Service Commission which resulted
in eliminating the requirement for normal birth and marriage certificates, and other
documents, to be sent by registered mail.
A new Change of Address form was recommended and adopted.
Responsibility for accident prevention throughout the Mental Health Branch
was assigned to the Personnel Officer.   A policy was issued and a new Safety Pro-
K 19
gramme was formally launched at a kick-off in May.   Unit personnel were gradually being educated in safety matters.
An organization study of the Nursing Division at Valleyview Hospital was completed, and recommendations forwarded to the Civil Service Commission for approval.
Job specifications were developed and approved for the Mental Health Nurse,
1 and 2; Handicraft Instructors, 1, 2, and 3; Director of Patient Education and
Training at two schools; and submitted on Psychologists, 1, 2, 3, 4, and 5.
Considerable work was done on presenting the Mental Health Branch viewpoint regarding the status of the Business Administrators within the Mental Health
Branch institutions. This was finalized with the Civil Service Commission in October.
Table A.—Summary Showing Over-all Staff Totals in Relation to
Separation and Recruitment
Staff recruited, excluding students
Staff separated, transferred, etc., excluding students  1,237
Total staff, excluding students, as of March 31, 1969
Total staff, excluding students, as of March 31, 1968
Quarterly staff average, excluding students, 1968/69  3,917
Quarterly staff average, excluding students, 1967/68  3,805
Student enrolment as of March 31, 1969     19
Student enrolment as of March 31,1968     20
Student quarterly average, 1968/69
Student quarterly average, 1967/68
 K 20
Table B.—Breakdown by Classification of Recruitment and Separation
Activity for the Mental Health Branch, Excluding Student Psychiatric Nurses.
Registered nurses	
Psychiatric nurses	
Female psychiatric aides
Male psychiatric aides	
Occupational therapists	
Industrial therapists (seamstress)
Recreational therapists	
Social workers (psychiatric)
Kitchen helpers 	
Laundry workers
Miscellaneous professional
Miscellaneous technical	
Miscellaneous adjustments, transfers, etc.
Totals   1,369
Table C.—Summary of Staff Turnover
Nursing Staff
:        4
+ 13
Male psychiatric nurses	
Female psychiatric nurses-
Registered nurses 	
Per Cent
Per Cent
Per Cent
Note.—Calculations made against the year-end staff totals.
By Pay Division
Pay Division
Relief Staff
Relief Staff
General Administration, including Mental Health Centres and Nursing Education..
Riverview Hospital  	
The Woodlands School   	
The Tranquille School  _ 	
Valleyview Hospital	
Dellview Hospital	
Skeenaview Hospital-
Mental Health Centre, Burnaby.	
British Columbia Youth Development Centre..
Over-all turnover	
Per Cent
Per Cent
Note.—Calculations made against the year-end staff totals.
K 21
Table D.—Comparison of Staff Totals by Unit with Totals for the
Preceding Fiscal Year
Fiscal Year 1967/68
Fiscal Year 1968/69
in Establishment as of
March 31,
Number on
Staff as of
March 31,
in Establishment as of
March 31,
Number on
Staff as of
March 31,
General Administration 	
Department of Nursing Education	
Mental health centres	
In-patient care—
Riverview Hospital 	
The Woodlands School  	
The Tranquille School	
Valleyview Hospital 	
Dellview Hospital   	
Skeenaview Hospital 	
British Columbia Youth Development Centre
Total of vote	
Total Civil Service positions	
Student psychiatric nurses  -
 K 22
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K 23
J. S. Bland, B.A., M.B., B.Chir., D.P.M., C.R.C.P.(C)
This Consultant has two principal functions. One is to represent the Deputy
Minister on a number of committees and study groups; the other is to assist community agencies in planning and providing appropriate services and facilities. Of
particular interest during the past 12 months has been the exploration of ways and
means whereby improved standards of care can be attained for all those suffering
from mental retardation, and for all children with emotional disorders.
During the year, the Consultant represented the Mental Health Branch on the
Youth Resources Panel, the interdepartmental committee on rehabilitation resources,
and the Rate Board. Each of these newly formed committees is concerned with
ensuring that all Government departments and community agencies co-operate and
co-ordinate to avoid unnecessary fragmentation and duplication, so that optimum
use may be made of the available resources.
The Consultant visited several communities to learn of their problems at first
hand, and in July made a tour of most of the northern cities, being particularly
interested in the services available for the mentally retarded. A visit was made to
the Smithers Farm, which will provide a much-needed training and occupational
service for many of the young adult retarded in northern British Columbia. It is
envisaged that between 20 and 30 people will be able to live on the farm, and an
increasing number of others attend daily and live in the local community. This
resource will be administered by the Provincial Association for the Retarded, with
Government support.
The two facilities mentioned in last year's report, Bevan Lodge at Courtenay
and Alder Lodge at Maillardville, are now in full operation, with 68 and 50 residents
respectively. In the future, there may be a wider application of this type of care
and training for the young adult retarded who does not need to be in a hospital or
traditional institution.
Many separate agencies provide residential treatment programmes for emotionally disturbed children. Some of these programmes are new and the Mental Health
Branch is co-operating with the agency in determining the type of problem that can
best be handled by any particular facility. There is little doubt that at present many
children are inappropriately placed because of the lack of the needed resource. For
example, there needs to be a widespread provision of psychiatric beds for children in
general hospitals and also a small number of beds for seriously disturbed adolescents
who require long-term care in a security setting.
Definite progress is being made.
Miss A. K. Carroll, B.A., M.S.W.
During the year, all mental health facilities were visited on request. The following consultative social services were provided:—
(1) Community organization and community planning and development programming.
(2) Evaluation of administration, programme goals, and coverage in the social
service departments of the hospitals, training schools, and community
mental health centres in the Mental Health Branch as they related to the
development of co-operative services with community health, welfare, and
rehabilitative resources.
(3) Advice and consultation in the planning and development of family care,
boarding home, and special group-care facilities for the mentally disordered adult. The major task accomplished in the boarding-home programme in 1969 was the drafting, in conjunction with the Department of
Social Welfare, of a plan for the regionalization of this service. The new
programme will serve community public health and social welfare agencies
and physicians, as well as the mental health facilities. Additionally, the
programme will offer assistance to communities in developing suitable
licensed boarding-home resources for the use of mentally disabled citizens
not in need of institutionalization.
The provision of resources was enhanced by the passing of the Treatment Resources Act in 1969, which provides that grants of money may
be made to non-profit organizations for the purpose of providing boarding-
home resources offering intermediate levels of care or programme to mentally handicapped persons.
The Community Care Facilities Licensing Act, of 1969, made it permissible for a home to accept two disabled boarders without the requirement of a Community Care Facilities License. Riverview Hospital and
The Tranquille School were able to expand resources by use of these
foster-home types of care.
Prince George, Trail, Kelowna, and Vernon have committees drawn
from public-minded lay and professional citizens who are studying and
planning their city's resources.
(4) Consultation concerning the development of social service programmes
in the psychiatric divisions of general hospitals was sought by directors of
mental health centres and the regional social work consultants.
(5) At the end of 1969 there were approximately 686 persons living in the
community on boarding-home leave from the Provincial hospitals for the
mentally ill and the institutions for the mentally retarded. In addition,
there were many other persons fully discharged from the mental health
facilities who were also settled into boarding homes.
Gains were made during the year in the provision of boarding-home beds for
adult retardates, primarily with the assistance of Government funds. Placements
were made into Bevan Lodge, the large colony-type home for retardates sponsored
by the Bevan Lodge Association.
At the year-end, inquiries were received from two small licensed private hospitals about the possibility of converting their establishments into boarding homes
offering an intermediate care service. These are resources which might well accommodate special retardates or psychiatrically handicapped groups.
K 25
Much of the programme from Riverview Hospital consisted of replacement of
persons who had come into hospital for brief treatment periods. Many persons in
Riverview Hospital could be placed into the existing type of boarding homes if more
such homes were available. Provision of these resources will be achieved through
regionalization of the programme. The extension of facilities will place increased
emphasis on pre-discharge programmes within the hospital, as many patients who
are well able to leave the facility experience fear of doing so.
There continued to be a great shortage of homes to serve the young but fairly
chronic patient from Riverview Hospital. It is expected that some homes for this
group will be opened with assistance under the Treatment Resources Act and with
new policies in respect of operating costs.
Valleyview Hospital's admission policies and pre-admission services had
the effect of limiting the resident population to persons who need an intermediate
care resource upon release from hospital. Further, the majority of persons who are
released have sufficient private income to pay for a higher level of care, so that this
was the type of placement made most frequently from the hospital in 1969.
Discharges from "released on leave" status were up markedly during 1969
from previous years in line with the policy to not retain on hospital status those
persons doing well under the care of their community physician. The majority of
persons discharged are paying their own care costs. Valleyview Hospital continued
to provide emergency consultation following discharge; priority for re-admission;
and drugs, if this is necessary from a financial standpoint.
Riverview Hospital continued to provide the services of an occupational therapist and a part-time handicrafts assistant to the programme.
Consultative services regarding boarding-home resources with a view to placement were provided to a variety of community agencies, including child-care agencies
and community based psychiatric facilities, as well as to private individuals. Consultation regarding the establishment of boarding-homes resources by organizations
was given, and also community orientations to the boarding-home programme.
Table I.
-Boarding-home Programme, January 1 to October 31, 1969
Mrs. F. Ireland, Boarding Home Co-ordinator
Patient Movement
Patients on boarding-home programme as of January 1, 1969.
•     72
Returns to boarding-home care from institutions (replacements)..
Patients on boarding-home programme as of December 31,19692.
1 Figures in this column include projected figure to December 31,1969.
2 All totals include a projected figure to December 31,1969.
1. Three times as many placements into boarding-home care were made from the institutions serving retardates as was the case in 1968. The opening of Bevan Lodge provided 70 new beds in the community. For the
first time in the history of the boarding-home programme, more persons were returned to boarding-home care
from Riverview Hospital than were placed out for the first time. Please see text of this report for further explanation.
2. Returns to Riverview Hospital were proportionately moderately up from previous years.
3. Of the 14 Riverview Hospital patients discharged from boarding-home leave, six were discharged to full-
time employment, four to family, two to the supervision of the Department of Social Welfare, one to own
resources, and one to private hospital.
 K 26
The policy of Valleyview Hospital was to discharge from leave all persons able to pay their own way in
boarding homes, who were doing well under the care of their community physician. Valleyview continued to
provide a consultative service in these cases.   Seventy-five such discharges were made in 1969 (projected figure).
The high number of discharges made from The Woodlands School and The Tranquille School were chiefly
persons residing in Bevan Lodge, who were discharged to the care of the local community services after three
months of stable residence in the home.
Table II.—Analysis of Returns to Institutions,
January 31 to October 31, 1969
Reason for Return to Institution
Returned for reason of psychiatric illness or behaviour problem
Returned for reason of physical condition or other situation (e.g.,
19                  6
10                11
Of the 88 persons returned to Riverview Hospital because of psychiatric or behavioural reasons, 34 went
out to boarding-home care again during the reporting period, 26 within less than a month. The majority of the
19 persons returned for physical reasons also went back to boarding-home care, so that about one-half of the
total number of persons (107) who were returned to hospital were replaced.
Table III.—Patients on Boarding-home Leave Employed
as of October 31, 1969
Degree of Employment and Earnings
Fully or partially employed, partially self-supporting toward board payment._.
With seasonal job or small but regular job;  earning own comforts, clothing,
Employed in sheltered workshops.—  	
Totals      ..
1. In addition to the five persons from Riverview Hospital who are fully employed but remain on boarding-
home leave, six persons were discharged to full-time employment and one person completed successfully the Chef
Training Course at Burnaby Vocational Institute.
2. Over one-third of the persons on boarding-home leave from The Tranquille School were able to secure a
degree of useful occupation.
Assistance was given to the personnel officers of the Civil Service Commission
and the Branch in recruitment and retention. Assistance was provided to the Branch
in staff patterning and projects for on-going staff development. In April of this
year, the 26 students from the School of Social Work, University of British Columbia, completed their period of supervised social work in mental health facilities. In
September, 24 new social work students started the training programme. Five students were granted Federal Mental Health bursaries to proceed to graduate studies
in September, 1969.
Much of the Consultant's responsibility centred around committee work at
administrative and inter-departmental levels.
During the year, the incumbent served on the Board of Consultants, Vancouver
City College; the Greater Victoria Association for the Retarded; the Voluntary
Association for Health and Welfare of British Columbia; the Education Committee
of the British Columbia Association of Social Workers; and the Inter-agency Committee, School of Social Work, University of British Columbia.
Miss M. M. Lonergan, B.S.N.Ed., M.N.
Nursing consultation during the calendar year 1969 encompassed committee
work, educational activities, and consultation services.
Committee responsibilities included representing the Branch on two standing
committees of the Registered Nurses' Association of British Columbia, which were
concerned with preparation and qualification for the practice of nursing in the
Province; membership on the Advisory Committee to the Nursing Option, British
Columbia Institute of Technology; and on various professional task committees
concerned with the development of standards of practice, and courses in continuing
education for practice.
Within the service, the Consultant represented nursing on various Branch committees of a planning, advisory, co-ordinating, or informative nature. Among these
was the Selection Committee recommending recipients for bursaries for education
purposes. During the year the Nursing Council performed the following functions:
Approved descriptions of nursing procedures developed by the Core Nursing Procedure Committee; submitted a number of recommendations concerning personnel
policies to appropriate authorities; revised an evaluation form used for promotional
purposes; conducted a study of the salary bonus system and submitted recommendations for extensive changes; was instrumental in the development of a policy
enabling nurses to undertake remedial courses required for registration in the Province; and reviewed Council functions.
Mental health nurses met in conference four times during the year. The size of
the membership doubled during this period of time as new mental health centres
opened and membership was extended to include representation from the After
Care Clinic of the Riverview Hospital and Out-patient Department of The Woodlands School. Work was completed on a brief to the Civil Service Commission which
proposed changes in classification and salary for the nurse working in community
pyschiatric services. Most nurses participated in an activity study to determine the
relationship between the amount of direct patient care and the amount of community
centred activities provided by mental health nurses.
The Nursing Liaison Committee met five times. Membership has grown from
an initial representation of five to the present membership of 20, representing the
mental health services and a wide variety of institutions, agencies, and services concerned with mental health programmes and psychiatric care. The meetings served as
a vehicle for communication and education. A number of interesting visits to newly
opened areas of psychiatric care were organized, among them the Psychiatric Unit
of the Health Sciences Centre, University of British Columbia, and the Children's
Psychiatric Unit at the Vancouver General Hospital.
The Consultant's commitments in the realm of education were diverse. They
included describing the services and programmes of the Mental Health Branch to
nursing students enrolled in various nursing programmes, and to groups of graduate
nurses. Meetings were held with nurse educators from the University of British
Columbia, the British Columbia Institute of Technology, and general hospital schools
of nursing, in order to facilitate arrangements for field experience for undergraduate
students and graduate nurses. One- or two-week courses were arranged to orient
newly employed mental health nurses and visiting nurses from other countries to the
Branch organization and its programmes and services for patients. Several exploratory meetings were held with a variety of professional experts in education and
 K 28
mental health, with the purpose of developing short courses to extend the therapeutic
skills of nurses working in community psychiatric services, and to promote a greater
emphasis on mental health and psychiatric content in existing university programmes
for nurses. The Consultant was able to visit a number of new facilities to increase
her information about developing services in the mental health field. These included
the Psychiatric Unit of the University of British Columbia Health Sciences Centre
and the Crisis Clinics of Seattle and Vancouver.
Consultation services were provided to the Deputy Minister's office, to several
institutions, to mental health centres, and to agencies in the community. Other
functions performed during the year included the following: Submissions on education courses for nurses were reviewed; nursing-care complaints were investigated;
requests for reconsidering withdrawals from the School of Psychiatric Nursing were
reviewed; proposals from nursing organizations concerning requirements for organization, practice, standards, and safety were studied; and an inspection of a proposed
facility for retarded infants was conducted.
A number of studies were undertaken, which included: A study of the facts
and problems affecting recruitment of nurses into supervisory positions; a study
identifying the number of nursing-care hours per patient in one segment of the services; and studies of the organizational structure of nursing administration in two
institutions. The Consultant participated in a number of projects undertaken by
other members of the Branch Planning Committee, and took part in discussions
leading to the acceptance of one facility by the community.
Considerable time was spent in recruitment and selection activities. The Consultant participated in selection panels convened by the Civil Service Commission,
interviewed interested nurse applicants for senior nursing positions, and replied to
many requests for detailed information about specific nursing positions.
Visits were made to two institutions and mental health centres at Chilliwack,
Courtenay, Cranbrook, Haney, Kamloops, Kelowna, Nanaimo, New Westminster,
Trail, Saanich, Surrey, Vernon, Victoria, and the Day Hospital of the Burnaby
Mental Health Centre. Continuing regular consultation was provided to the Department of Nursing Education, with weekly visits decreased to monthly during the last
quarter of the year.
During this initial year of full-time responsibilities, the Consultant developed a
keen appreciation of the potential scope of nursing in the multi-disciplinary services
to which the Mental Health Branch is committed.
K 29
R. S. McInnes, B.A., B.D., M.P.H.
K. H. Denecke, B.Com.
Mrs. P. A. West, R.R.L.
During the year an assistant statistician was added to the Branch headquarters,
new units commenced operation and were added to the statistical reporting system.
Serious planning and negotiation regarding computer services was undertaken.
Regional mental health data were produced and a major planning study completed.
Reporting Form Development
In order to provide a more realistic basis for describing patient movement at
the Riverview Hospital and to provide information for purposes of medical audit,
the statistical reporting system for the Riverview Hospital was revised to provide for
an entry-exit system.
With the opening of the Youth Development Centre in Burnaby during the
year, first for out-patient care and later for residential care, a reporting system was
devised to meet the unique needs of this facility.
Routine Data Retrieval
During the year there were approximately 50 requests for data from within the
Branch and other departments of Government, both Provincial and Federal, and
outside the Government. These ranged from simple tabulations to more detailed
studies relating to Branch patients and their characteristics. Commencing with April,
a monthly statistical bulletin was issued containing monthly patient movement and
a brief article dealing with some aspect of patient statistics. In addition, detailed
statistical tables for the calendar year 1968 were issued. It is expected that similar
tables for the calendar year 1969 will be issued some time in the first quarter of 1970.
System Development
At the beginning of the year a diagnostic code conversion was prepared for
translating the code of the American Association on Mental Deficiency to the code
of the American Psychiatric Association, for reporting to the Dominion Bureau of
Statistics. The A.A.M.D. code is used for Branch statistical purposes in describing
the diagnosis for the mentally retarded.
The most significant work on improving the data system for the Mental Health
Branch is the current effort to put the system on electronic data processing. With the
aid of a Branch Committee on Computer Services, a survey was made of mental
health computer applications in North America, and a considerable amount of
material was assembled on each of the major developments under way or being
planned. A final report of this Committee described those applications in the
Branch which promised the greatest payoff in EDP conversion. The computer
should provide considerable gains in administration and clinical management. At
the end of the year the statistician was working closely with a representative from the
Data Processing Centre in considering the needs of the Branch.
The major administrative study during the year was related to the need for
psychogeriatric beds throughout the Province. Because of normal increases in
applications for admission to the Valleyview Hospital, Dellview Hospital, and
Skeenaview Hospital, it became apparent that some assessment of the situation was
necessary. The study included not only the immediate demands upon these facilities, but their relationship to other facilities for the care of elderly persons, such as
general hospitals, extended care, boarding homes, and private hospitals. A variety
of alternatives to increasing beds in the Branch's facilities was outlined.
Toward the end of the year, a time study was developed to describe the full
spectrum of activities in a mental health centre. A pilot administration of this
survey was undertaken in the Victoria Mental Health Centre and results analysed
and circulated throughout the Branch. It is anticipated that this study will be conducted throughout the Branch on an annual sampling basis. It seemed particularly
useful in highlighting the various aspects of community service provided by mental
health centres, as distinct from the direct treatment of patients.
To provide a base for planning in local areas throughout the Province, mental
health and related data were organized in statistical notebooks and distributed
throughout the Branch. These data include characteristics and location of the
residence of Mental Health Branch patients served by various facilities; patients in
psychiatric units of general hospitals; beds in various sheltered-care facilities, including boarding homes, private hospitals, and extended-care units; and general
population characteristics.
Five new mental health centres were opened during the year, and services were
given to each in the form of either a personal visit to the centre or a visit by the
Director and his secretary to the Medical Records Consultant. With a complete
turnover of clerical staff occurring the same month in the Nanaimo Mental Health
Centre, two visits were undertaken to assist the newly appointed clerks. At The
Tranquille School the medical records librarian resigned and was replaced by her
assistant. This, plus the fact that the School is operating as a regional mental retardation facility, necessitated several visits by the Medical Records Consultant to
assist in orientation.
During the year, three staff members at the Riverview Hospital completed the
Accredited Records Technician correspondence course and qualified for the A.R.T.
degree. The Civil Service Commission has now recognized qualified medical records
personnel by providing special categories based on qualification and experience with
appropriate wage scales.
K 31
R. H. Goodacre, B.A., M.A., C.P.H.
Studies of patients in acute general hospitals reveal that a significant number of
patients occupying expensive beds might be better treated in alternative and less
expensive levels of care within the community.
The same observation has been made with respect to bed occupancy in mental
hospitals. Consequently, as a step toward implementing the Branch's policy of
developing levels of care which are most appropriate to the patient's service requirements and as close to the patient's own community as is practicable, two hospital
utilization study projects involving institutions operated by the Mental Health Branch
were under way at the year-end.
1. Patient Categorization.—This project centred on the development of a check
fist for the rapid and systematic recording of patient characteristics and services for
every patient occupying a bed operated by the Branch. Analysis of the data will
reveal the nature, volume, and geographical location of services that would be required by patients for whom a different level of care would be more appropriate.
The check list was designed in co-operation with the Superintendent of the Valleyview Hospital, who has had considerable experience in classifying patients in terms
of their care requirements, and in whose institution initial application of the categorization technique will take place.
2. Psychiatric Home Care.—Care in the patient's own home, as an alternative
to hospital admission, was also under examination by the Branch. As an appropriate level of care for some patients, home care has the potential of replacing a
substantial number of hospital bed-days with a form of care generally believed to be
as effective as hospital care, with the added advantage that it provides a service which
involves the social and familial structure around the patient, as well as with the
patient himself.
In order to document the value of home care in a systematic manner and with
some acceptable degree of precision, a demonstration psychiatric home care programme was currently being planned, utilizing Riverview Hospital admissions as a
basis for a controlled study. This programme will be analysed in terms of its impact
on the replacement of hospital bed-days, and also compared with hospital care with
respect to patient progress and costs of providing service. Following completion of
the research design, an application for funds under the Public Health Research Grant
will be made for financial support of the project.
Toward the latter part of the year, this Consultant's area of responsibility was
extended to include the initiation of in-service education programmes, directed at the
staffs of both the Mental Health Centres and institutions. A review of existing staff
development activities, educational resources, and training requirements was being
Burnaby Mental Health Centre, Burnaby
South Okanagan Mental Health Centre, Kelowna
Central Vancouver Island Mental Health Centre, Nanaimo
West Kootenay Mental Health Centre, Trail
South Central Interior Mental Health Centre, Kamloops
Simon Fraser Mental Health Centre, New Westminster
Boundary Mental Health Centre, Surrey
Centra] Fraser Valley Mental Health Centre, Haney
Saanich Mental Health Centre, Victoria
Victoria Mental Health Centre, Victoria
Upper Fraser Valley Mental Health Centre, Chilliwack
Northern Interior Mental Health Centre, Prince George
North Okanagan Mental Health Centre, Vernon
East Kootenay Mental Health Centre,  Cranbrook
Upper Island Mental Health Centre,  Courtenay
K 35
W. C. Holt, B.A., M.D., C.R.C.P.(C), Director
The Mental Health Centre, Burnaby, is an out-patient community psychiatric
facility located in the proximate geographic centre of the Lower Mainland. It is
organized in three functional units—the Burnaby out-patient team, the out-patient
team serving other geographic areas of the Province which do not have mental
health centres, and the day hospital staff. Referrals to the Centre may be made
by medical practitioners, social agencies, school or public health personnel, interested friends or relatives, or by the patient.
The functions of the Burnaby Mental Health Centre are:—
(1) To provide comprehensive, diagnostic, and consultative services to
adults and children with emotional disorders from the Burnaby community, as well as limited treatment facilities:
(2) To provide similar services to adults from other areas of the Province
not served by local mental health centres, especially east Vancouver:
(3) To provide specialized treatment resources, such as day hospitals (milieu
therapy), behaviour therapy, group and family therapies:
(4) To engage in training of health care personnel, and research on emotional
illnesses and their treatment:
(5) To employ the knowledge and skills of multi-disciplinary teams, to
develop and implement a wide variety of community oriented preventive
programmes in the mental health field, using the broadest possible
definitions of mental health and prevention.
During 1969, a number of developments and changes occurred. One of the
most prominent was the gradual withdrawal of the centre from travelling clinic
work, as new local mental health centres opened. In January, 1969, the Centre
was providing regular travelling clinic services to Boundary Health Unit, Central
Fraser Valley Health Unit, Coast-Garibaldi Health Unit, and Skeena Health
Unit. During the summer, with the opening of the Central Fraser Valley Mental
Health Centre at Haney, and the Boundary Mental Health Centre in Surrey, travelling clinic services to these areas were phased out. In the fall, travelling clinic
service to Coast-Garibaldi Health Unit was phased out through the Upper Island
Mental Health Centre in Courtenay assuming responsibility for the services to
Powell River, and services to Squamish and the Sunshine Coast being provided
directly at the British Columbia Youth Development Centre and Mental Health
Centre, Burnaby. At that time it was agreed that the Family and Children's Clinic
of the British Columbia Youth Development Centre would assume responsibility
for the Skeena travelling clinic, due to the specialized nature of the services required
in that region.
There continued to be very considerable direct service demand, especially for
children's services in Burnaby. At the year-end, the Centre was to assume the
provision of services to the Burnaby school system and public health unit, some of
which had formerly been provided by the Mental Hygiene Division of the City of
Vancouver's Metropolitan Health Services. Involvement here will be both in
direct clinical services with individual patients and families, and also in an active
educational and consultative programme with the Burnaby public health and
school personnel.
The day hospital milieu therapy programme continued to be the only one of
its kind available in the Province and had not only a major direct treatment
function, but also provided training and orientation for increasing numbers of
mental health professionals of all disciplines. During the year, one-day workshops
on the programme were held in March and December. The focus of the programme continued to be based on a " here and now " reality, with patients
encouraged to assume major amounts of responsibility for themselves. Work was
under way to use behavioural-rating scales and other measures, to provide more
objective assessment of therapeutic outcomes.
Also in the area of direct services, arrangements were made with Dr. Huck-
vale, Medical Officer at the British Columbia Institute of Technology, to provide
psychiatric assessment, consultation, and treatment on an organized basis with
students for that institution. Another new direct service this past year was a
behavioural-therapy approach to the treatment of agoraphobics in groups, being
undertaken by our chief psychologist and a social worker. There was also a vastly
increased use of the video-tape facilities in the treatment of individuals, couples,
and groups. This was proving to be a most useful and fascinating technique and
new possibilities were constantly being explored. It is hoped that the Centre will
be able to produce several teaching tapes for editing accumulated material, including a tape on Gestalt therapy.
The Mental Health Centre continued to be actively involved in the area of
indirect services. Work with the " Secure " organization continued. Consultation
to schools and community agencies, and a variety of educational and preventive
services with churches, service organizations, and other groups, continued to
occupy a considerable amount of professional time at the Centre. A seminar on
group-therapy techniques for senior secondary-school special counsellors was given
over a three-month period in the spring. The Centre also continued to provide field
training and internship placement for nurses and students in occupational therapy,
social work, and psychology, and visitors from other institutions in all mental health
disciplines continued to study and contribute to the Centre's programme and
During the year a research committee was formed for the first time, composed
of interested members of the major disciplines represented in the Centre. The
purpose of the committee is to stimulate interest in research (primarily directed
toward programme development and evaluation) at the Centre, and also to provide
advice on feasibility and research design.
In the area of staff training and development, the Centre continued to show
a vital and growing interest and activity. Regular self-educational activities in the
Centre continued to take place and there was a great interest on the part of all staff
in attending professional meetings, workshops, and training sessions, both regionally
and nationally. The Centre was fortunate in the past year in being able to present,
in conjunction with the British Columbia Youth Development Centre, the two
educational programmes for staff and other interested professionals.
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F. E. McNair, B.A., M.D., CM., C.R.C.P., Director
During the year an evaluation of the South Okanagan Mental Health Centre
was undertaken, providing the data noted below. The regionally based mental
health centre provides a comprehensive service.
Normally, supervision by the Mental Health Branch office is minimal. Branch
consultants are available for visits, and members of the team can meet regularly with
others of the same profession.
Recruitment and retention of staff are major problems for mental health centres in the Province, as well as for related professions. It would seem that the regional district, set up by the Provincial Government in an attempt to decentralize
administration, should become the sponsor of the community centre. Consideration
should be given to the development of additional decentralized treatment resources,
in particular, to increasing preventative programmes. Various factors are contributing to changes in the role of the mental health centre. Because of changes in the
patterns of medical care, the general practitioner is becoming involved in family
problems not wholly medical, and more general hospitals are offering psychiatric
services locally, which will take some of the load off mental hospitals. Mental health
centres will still be involved with a large number of chronic patients, and will be
increasingly concerned with older people. The extension of social services also
makes demands on the mental health centre team, e.g., to supervise the permanently
unemployable, to provide marriage counselling in case of threatened divorce, to
advise in decisions for abortion, and to assist in the work of the Family Court.
The following were significant factors in evaluating the programme during the
past year at the South Okanagan Mental Health Centre:—
(a) First admissions to Riverview were reduced from 67 to 46 over a five-
year period, while the population increased 50 per cent:
(b) The Centre did not seem to be acquiring a new population of emotionally
disturbed people:
(c) The greatest case load of patients came in the under-16 category, followed
closely by the age-group 16 to 25; approximately 60 per cent of the total
number of patients seen in any one year were under 25 years of age:
(d) Mental health centres were considerably less costly in terms of medication
than, for example, the Riverview Hospital:
(e) Suicide rates in the South Okanagan Health Unit area remained well above
the Provincial and national averages, however, the number of suicides
known to have received previous psychiatric consultation remained relatively low.
In future, greater cognizance must be made of the social-educational model for
mental health centres. Community-centred treatment increasingly requires rehabilitation aids, correctional staff, family and volunteer support, child-protection components, and school consultation, as well as doctors in hospitals. Certain gaps in
psychiatric service must be closed, particularly in terms of treating other than middle-class clientele.
The future needs of the regional mental health centres can only be met through
organized planning, preferably on the basis of epidemiological data. Questions to
be answered include:—
(1) The correlation between the incidence of disorder and a demand for
(2) The critical incidence of such syndromes as autism, pseudoretardation,
dyslexia, and failure of academic motivation:
(3) The number of hospital beds per 1,000 population required for a children's service, and the number of special foster-home beds needed to back
them up.
Mental health centres, until the present, concentrated on therapeutic and secondary preventive services to patients and their families. There is an increasing
need for more primary prevention programmes, plus the provision for extended
consultation to community agencies.
One mental health centre can provide a general psychiatric service for a population of 30,000 people living within an approximate radius of 20 miles. Public
acceptance and confidence in the mental health centre depends primarily on the
services offered. If the services are of high quality, preventive programmes, community education, and consultations to other professional resources are well received. In future planning for other counselling services on a regional basis, consideration should be given to locating the various existing services in adjacent downtown accommodations, for better co-ordination and utilization. All staff members
on the mental health team can serve the community as fully qualified professionals
engaged in treatment and consultative services.
With the increase in community mental health centres, there is a corresponding
decrease in travel to other regions and increased time available for local consultation. As the number of related professional personnel in a community increases,
there is a decrease in the need for psychological assessment, especially of school-
aged children. The result is that more of the psychologist's time is freed for research
into mental health problems in the community, for evaluation of the mental health
centres programmes, and for the training of allied professional groups.
At present, mental health centres can be more effective than the traditional
mental hospital service. There is a need for pilot services in other strategic locations in the Province. It is also recognized that successful planning for future community mental health centres rests upon effective data collection from those already
in existence.
K 39
W. T. Lawson, M.S.W., Acting Director
With the opening of the Mental Health Centre at Courtenay, the Nanaimo
clinic area was reduced considerably, but still serves a population of approximately
125,000, working from the Nanaimo office with bi-monthly travelling clinics to
Duncan and Port Alberni.
Dr. S. E. Jensen, Clinic Director, resigned on September 30, 1969, to take a
teaching position in Eastern Canada, and Mr. W. T. Lawson, M.S.W., was appointed
Acting Director on December 1, 1969.
During the year, the programme of the clinic was moving gradually away from
direct service to individual clients, toward increasing community involvement in the
form of educational programmes, and consultative services to other agencies and
community groups. The Centre staff have been working toward a team approach
to problems where other agencies and organizations are involved. The psychologist
initiated a workshop training programme in group method with teachers, probation
officers, and welfare workers, which will cut down individual referrals to the clinic
by making it possible to handle problems at an intermediary stage. She was also
conducting a training programme in behaviour modification techniques with teachers in the Ladysmith area, which in effect considerably reduced the need for individual contact with the emotionally disturbed children in the school district.
An effective working relationship was established with school districts, with
clinic staff going into the schools for regular conferences and consultations. In
return, some of the school districts were giving psychometric services to children
referred by the clinic outside their area. A programme of formal liaison with the
Medical Health Officer was initiated, and the clinic was participating in a monthly
inter-agency seminar set up by the rehabilitation officer.
Under Dr. Jensen's direction, 28 emotionally disturbed children attended Camp
Nan-Wah-Kawi for a three-week period at Cowichan Lake. Three workshops were
held for parents of children attending the camp. Dr. Mitchell will be camp director
for the coming year, and is already involved in screening referrals, planning programme, and recruiting staff. A study of the effectiveness of this camp programme
conducted under a mental health grant by Dr. Koopman was being written up and
should be completed in 1970.
The mental health nurse carried an active programme of group work with adolescents, helped to develop school conferences, represented the clinic at the monthly
meeting of the Nanaimo rehabilitation committee, provided consultative services to
public health nurses on referrals and follow-up care, did liaison work with family
physicians in referrals of patients who needed chronic care, co-ordinated the liaison
work with the Riverview Hospital, and served as a member of the Board of Directors
of the camp and of the local Canadian Mental Health Association. The clinic
worked closely with the staff of the Central Vancouver Island Health Unit, and
relied heavily on the skilled work being done by the public health nurses in home
visiting and other related services. Dr. Jensen and Dr. Mitchell served as members
of the Board, and on the Screening Committee for the Lions Manor Home for
retarded children. Dr. Jensen was involved with the probation officers in organizing
and carrying out a hiking programme for adolescent boys to the west coast of the
Island. Dr. Mitchell was working with teachers and children at the Christopher
Robbins school for retarded children, in a specialized programme to assist the
development of speech and improving social behaviour.
 K 40
G. R. Mansfield, M.D., D.P.M., C.R.C.P.(C), Director
This annual report covers the activities of the fifth year of service contributed
by this unit. In accordance with the change in philosophy of the Mental Health
Branch, certain changing trends are evident. The change in policy from being a
direct service oriented organization, to one which concerns itself with being a
catalyst in promoting and co-ordinating all programmes having a bearing on mental
health, must be translated into action at the community level.
Efforts have been made to curtail the excessively heavy direct service offered,
with the result that a higher quality, more effective service has been possible. The
wide spectrum of therapy available has not been changed. A substantial amount
of service is being utilized by schools, the medical profession, correctional institutions, the Department of Social Welfare, and Public Health.
A number of factors have made it possible to ease the direct service load. The
travelling clinic to Cranbrook was discontinued with the opening of the East
Kootenay Mental Health Centre. The population in the West Kootenays diminished with the completion of the dam construction and thousands of migrant construction workers left the area.   A psychiatric nurse was added to the staff.
A 24-bed psychiatric unit in the Trail Regional Hospital will be completed
in early 1970 and will provide in-patient, intensive, acute-treatment care. A 50-bed
extended-care unit will open about the same time. Thought was being given to the
need for additional facilities falling into the intermediate and chronic care categories.
The Association for Community Planning of Health and Welfare Services is
becoming a more effective body in identifying community needs. There is always
difficulty in finding interested people to take advantage of the Treatment Resources
Act and make plans a reality.
The Trail Youth Liaison Committee continued to function effectively and is
an excellent example of the harmonious integration of all community agencies.
The Probation Service continued to use the Mental Health Centre on a formal and
informal basis. The Programme for Perceptually Handicapped Children is running
smoothly. The psychiatric nurse is fostering the formation of a local branch of
" Parents of Children with Learning Disabilities." A workshop to help the teachers
identify these children was sponsored by the Adult Education Department, with
whom there has always been a close working liaison. Monthly visits are made
to the two specially equipped classrooms for the perceptually handicapped in this
area. A group for one-parent families has been started. The C.M.H.A. volunteers
continued to receive guidance and orientation lectures.
Community demands for education are heavy. All the professional staff have
participated in radio talks, panels, seminars, group discussions, and lectures.
Nursing education includes formal lectures at the hospital. The clergy have
responded with keen interest in expanding the church's role in fostering mental
health in the community.   Workshops have been held at their request to assist them
K 41
in becoming more skilled as counsellors, in hospital visiting, and in expanding the
church's work in contributing to community mental health.
An active " Family Life " series sponsored by one denomination is being well
received. Requests are still being received from the schools for our educational
approach to drug abuse. Requests for workshops to help young mothers cope more
adequately are now being received from beyond the Trail area.
The year 1969 brought the region served by the West Kootenay Mental Health
Centre one step closer to achieving a comprehensive mental health service. There
have been many satisfactions in broad areas of achievement. The staff are acutely
aware that there are needs yet to be identified, priorities to be established, and
community resources inspired to action. The character of the mental health centre
may change in the future but at the present stage of development, the medical
model finds acceptance by the community more easily and therefore works more
 K 42
David Brasset, M.S.W., Acting Director
The year 1969 was one of steady expansion and entrenchment of services at
the Mental Health Centre. This extension of services accompanied a corresponding
increased proficiency of its staff, and an improvement in the quality of its consultative, educational, and direct-service programmes.
The year began with 28 mental health cases, all of which had been previously
activated and treated by Dr. Bower or Mr. Brasset. At the year-end there were
115 active cases, with some 35 terminations in addition to those. The volume of
activity greatly increased from that provided in January by two part-time personnel,
to over 150 hours of patient interviews per month, numerous and private professional consultations, and an evolving educational programme carried on by a staff
of four.
Referrals for mental health services came from a great variety of sources.
Referral agencies found it increasingly convenient to direct patients to the Centre,
which endeavoured to return information on patients promptly and clearly to the
referral source. Patients came from all parts of the mental health area, though the
city region was the primary area of concern. Referrals originated in particular
with officers of the Department of Social Welfare, the Corrections Branch, Public
Health, private physicians, and the schools, as well as elsewhere. At the year-end
the amount of consultation offered to family physicians was increasing as the
physicians became more aware of the Centre's services, and its programmes were
gaining their support.
The Mental Health Centre assembled interesting data on the results of its
treatment of adolescent drug users. Preliminary results indicated that slightly over
90 per cent of people referred to the Centre for drug abuse ceased to take drugs
with regularity following their first interview. (Regularity was defined as " the
frequency with which one took drugs in the initial problem stage, or planned and
purposeful drug use within a coterie of drug users.")
The Mental Health Centre began using the method of direct observation as
an education method for other agencies. In appropriate cases the assessment of
patients was carried out in the presence of the person who made the referral. This
method had an enthusiastic reception from professional people dealing with the
patients, and resulted in a much greater understanding of the patient's problems on
their behalf. In addition, colleagues mentioned that they had profited from
observing the Centre's techniques of assessment.
Various staff members have, during the past months, participated in staff
education conferences of the school counselling services. In addition to this
participation in staff development conferences for the school, we are now planning
to hold conferences with probation officers and social workers. These meetings
so far have been limited to the discussion of individual patients and our assessment
methods as mentioned above.
Early in 1970 the Mental Health Centre will start a travelling clinic service
on an experimental but regular basis to several key locations in the area. These
travelling clinics were being planned in close consultation with the Medical Health
Officer. The idea was to provide primarily a diagnostic and planning service for
agencies in the local areas. Patients will be assessed in the mornings, and in the
afternoons the Mental Health Centre will convene a meeting with the various
persons in the community responsible for the management of treatment of the
K 43
cases. These meetings will attempt to help with the total planning for the persons
assessed. This proposal has met with enthusiastic approval from those professionals
who are in the areas involved.
The Mental Health Centre, as one of its principle activities, is providing personnel for public education lectures in a programme sponsored by the Canadian
Mental Health Association. This programme will begin on January 13, 1970, and
will continue for 12 weeks. The area of consideration is community mental health,
and the public will be invited, as well as volunteer workers with the Canadian
Mental Health Association. Similar public education lectures were planned in
conjunction with the travelling clinics. These lectures will deal with a variety of
subjects of interest to parents, such as child growth and development, communications theory, and so on.
The year was one of development in terms of programme, policy, public
relations, and staff competency.
 K 44
Dr. P. Flor-Henry, M.B., Ch.B., M.D., D.P.M., Director
During the year it became apparent that, although in the past eight months the
Centre was able to discharge an increasing number of cases (i.e., 22 as opposed to
nil in the previous six months), the total number of ongoing cases was increasing, as
was the total number of new referrals for both adults and children (a total of 10 in
May, 1969, as compared with a total of 23 in September, 1969).
The following statistics indicate that there is a great need for direct treatment in
the Simon Fraser region. There are many collective problems, such as the widespread use of the hallucinogenics and glue and other toxic agents amongst the school
children and young adult population, the problem of alcoholism in run-down areas,
the question of the psychiatric supervision of the boarding homes, and so on. In
spite of the pressure of direct clinical work, the Centre has, nevertheless, systematically integrated itself with a number of public services such as Public Health, Social
Welfare, schools, Probation Services, Royal Columbian Hospital, Riverview Hospital, and the Police Department.
In addition to regular clinical commitments, the Mental Health Centre staff
participated in discussions with various community and professional groups. These
included talks to school principals, school teachers, public health nurses, university
students in the social sciences (U.B.C.), and talks in other mental health centres, as
well as a lecture at the Department of Pediatric Neurology, Health Centre for Children. The community problems discussed centred on the "generation gap," and
more specifically on the use and abuse of illegal drugs, notably L.S.D., but also
glue, amphetamine, and belladonna. These discussions were organized around a
formal presentation of a paper, with the occasional use of tape-recorded interviews
and films.
In order to provide a continuity of patient care, the Mental Health Centre team
regularly conferred about in-patients at Centre Lawn Unit of Riverview Hospital,
which admits patients from the Simon Fraser Health Unit catchment area. Post-
hospitalization disposal was reviewed weekly with Public Health, and follow-up was
initiated in those cases where the patient was not discharged in care of his general
practitioner or appropriate resource.
Consultation and follow-up in conjunction with Public Health and Social Welfare was systematically conducted.
Proposed projects included the systematic follow-up of all attempted suicides
seen in the Emergency Department of the Royal Columbian Hospital. The initiation
of a group-therapy programme was planned. The Mental Health Centre offered the
Royal Columbian Hospital a training programme which would allow interns of the
hospital to learn something about the problems of community mental health and
some elements of child psychiatry and clinical psychiatry in general.
Table 1.—Statistical Report, April 1, 1968, to March 31, 1969*
Children       Adults
" Ongoing "
Grand Total
November, 1968...
December, 1968_~
January, 1969	
February, 1969.	
March, 1969	
* It should be noted that the Simon Fraser Mental Health Centre opened on November 1, 1968.
 community mental health services k 45
Table 2.—New and " Ongoing " Cases Cumulative with Projection
" Ongoing "
Grand Total
April, 1969..	
May, 1969 ...	
June, 1969 -  	
July, 1969	
August, 1969-	
September, 1969 ~ 	
October, 1969 	
November, 1969	
December, 1969	
Note.—Two research projects were under way—(1) organic, environmental, and emotional factors associated
with minimal cerebral dysfunction, and (2) phycho-social definition of adolescent population comparing drug-
users (approximately 25 per cent) versus non-users (approximately 75 per cent). The first project was being
carried out in collaboration with Boundary and Central Fraser Valley Mental Health Centres, and the second
in collaboration with the Public Health Department of the Simon Fraser Health Region and the schools.
W. W. Black, M.B. B.Sc, D.P.M., C.R.C.P.(C), Director
This is a new mental health centre established to serve an area south of the
Fraser River, comprising the Municipalities of Surrey and Delta, with a total population of about 130,000. The greatest concentration of people is in the North
Surrey/North Delta area, with others at Ladner/Tsawwassen, White Rock, and
The Mental Health Centre is located in a new wing attached to the Boundary
Health Centre, which is adjacent to the new Surrey Municipal Centre, at the
junction of Highway No. 10 and the King George VI Highway.
The Director, social worker, and secretary took office on June 1, 1969, and
the psychologist on October 1, 1969. Since the new building was not ready until
October, 1969, temporary accommodation was found in the Cloverdale Health Unit.
Because of the initial accommodation problem and the lack of facilities and
materials (no attempt was made to initiate a direct patient service), the time was
employed in contacting important agencies and key people in the area, particularly
the school personnel with whom close working arrangements are so necessary.
During this period also, members of the team made visits to other mental health
centres and to the in-patient psychiatric centres in the Vancouver area to acquaint
themselves with the various programmes.
Dr. L. D. Kornder, Director of the Boundary Health Unit, arranged the official
opening ceremony, which took place on November 5, 1969. Mr. Robert Wenman,
M.L.A. for Delta, officiated in place of the Honourable Ralph R. Loffmark, Minister
of Health Services and Hospital Insurance, who was unable to be present. There
were 40 guests representing the municipalities, regional health units, and the Mental
Health Branch.
In view of the population of the area and the large school population (about
37,000), as well as the scarcity of other psychiatric facilities (two psychiatrists are
in private practice in North Surrey), a heavy demand for direct clinical service was
to be expected.
Consultations to professionals and agencies in the area had begun before the
new building was opened, and are being continued and plans are under way for
educational programmes directed at these groups, as well as others.
It is anticipated that this first year of operation will necessarily involve a number of modifications and changes in plans, as experience shows where need is greatest
and professional action can be most economically applied.
K 47
Elizabeth Luke, M.B., Ch.B., D.P.M., C.R.C.P.(C), Director
This unit, opened on June 1, 1969, serves the Central Fraser Valley area,
which covers an area of 2,840 square miles with a population of approximately
The Department of Public Works surveyed the accommodation and plans to
carry out alterations which will make the building more functional as a mental health
centre. A children's play area, which allows for observation, is considered important, as the psychologist intends to carry out remedial programming to improve
motor co-ordination and remedy perceptual motor handicaps. The observation
room will also be used for instruction of parents and teachers.
The headquarters are in Haney, but patients are also seen in the Health Units
in Mission and Langley.
The Centre provides community psychiatry, covering the whole spectrum of
mental illness. Assistance is given to the Government agencies dealing with alcoholism and young offenders in the region. A great deal of attention has been given
to the school system, because primary prevention and education are the most valuable areas of work.
The psychologist has done a great deal of useful work in establishing communication with the school and advising them with respect to children who cannot readily
adapt to the school system. An adjustment class for emotionally disturbed children
was recently created in Mission, and Mrs. Palvesky will attend regularly as an observer and to offer assistance to the teacher. The team also visited schools in Haney
and observed the facilities for the trainable retarded, slow learners, and occupational
classes. The Director and psychologist attended a meeting with the School Superintendent and other officials in Mission, to discuss the future development of their
remedial programmes.
Each week a conference is held with the Social Welfare Department, Probation,
public health nurses, and school counsellors to discuss ongoing cases.
The social worker and mental health nurse are involved in making a survey
of groups in the community who are socially isolated and who might participate in
group counselling. The mental health nurse has taken a special interest in marital
counselling, where the problem is social rather than psychiatric. The social worker
attended a meeting of the local clergy and discussed the function of the Mental
Health Centre. In future he will also be lecturing to the schools on mental illness.
It is intended that, at a later date, we will give lectures to the schools on social problems, e.g., the abuse of drugs.
There has been interest expressed on the part of the ministers and community
leaders regarding the advisability of setting up an agency for lay counselling in this
The Centre also takes an active part in giving consultation on psychiatric problems to the Maple Ridge and Mission Hospitals, and rehabilitation agencies in the
The Director and psychologist are involved with the staff at Alouette River Unit
in the assessment of a training programme they are starting for their residents, who
are placed there for involuntary treatment. They also visited the Half-way Home
for Alcoholics in Haney, and intend to promote interest in community resources for
alcoholics. The Director attended the Annual Conference of Alcholics Anonymous
held at the Alouette River Unit.
 K 48
Members of the team alternately visited the monthly graduation ceremony at
the Boulder Bay Camp. This is an outward-bound type of programme, which
serves as part of the total facility of the Haney Correctional Institution. The team
feels it is important to understand the various facilities available, because of their
consultative function at the institution.
The Director and the mental health nurse addressed a meeting of the local
registered nurses, giving a lecture on mental illness and the functions of the clinic.
K 49
J. T. Wood, M.D., Director
The Saanich Mental Health Centre and Victoria Mental Health Centre were
formed on May 1, 1969, from a division of the staff of the South Vancouver Island
Mental Health Centre. Each centre had a designated geographic area for its service.
Saanich Mental Health Centre was planned to serve the communities and areas of
Saanich, Central Saanich, North Saanich, Sidney, and the Gulf Islands—a region
containing some urban areas, some suburban, and some rural lands, and a total
population of about 100,000 persons. The initial staff of the Saanich Mental Health
Centre included five professional mental health workers, i.e., psychiatrist (Director),
clinical psychologist, mental health nurse, and two psychiatric social workers. All
other personnel serving the Centre were shared by both units, since both were
situated in the Eric Martin Institute.
The location of the Saanich Mental Health Centre outside the geographic area
served created some problems resulting in a greater proportion of services being
provided to persons located closer to the Centre. Demographic studies indicated
a population shift to be anticipated over the next 10 years, with Saanich becoming
the most populous municipality in the Greater Victoria area. The decision was
made to seek a more equitable geographic basis and the Royal Oak area was chosen.
This will be more accessible to patients and to those interested in helping, including
staff members of other agencies, teachers, educational counsellors, clergymen, etc.
Diagnostic studies were done with patients who were referred for this service
by their family doctors, and at the request of professionals of other agencies, including those of the Family and Children's Court, Family and Children's Service, Greater
Victoria Metropolitan Health Department, Welfare Department, John Howard
Society, and others. These studies are undertaken if other resources are not available to the referring agency. Some studies were made in response to requests by
clergymen, school counsellors, or the patients themselves. Information derived
from an evaluation is used to help the patient, or the referring agency, make an
appropriate choice of treatment services. In Victoria most of the required services
are in the community and therefore it is up to the family doctor to direct the patient
to a private psychiatrist or to plan so that he can best serve the patient.
In order to avoid the necessity of waiting-lists for services, both diagnostic and
therapeutic, an attempt is made to refer all appropriate cases to private therapists,
or larger agencies able to provide for the service needed.
In some cases there are compelling reasons why the best service to a patient
may be that provided by the Mental Health Centre via direct treatment. If the
Centre undertakes treatment it does not compromise the treatment method in favour
of economy of time, but treats the patient by the plan that will best serve to lead to
his recovery. Fortunately, the brief intensive psychotherapies are often found
appropriate. The Centre also utilizes conjoint methods, including parent-child
therapies, sibling therapy, marriage couple-counselling, etc. Group therapy ranging
from family therapy to larger units was undertaken as required.
Indirect services, included under the heading of " Community Psychiatry,"
were regularly explored and implemented. Primary prevention services in the areas
of education to reduce the incidence of mental illness merit a great deal of effort.
Improving mental health education may ultimately both reduce the incidence and
morbidity of mental illness, and save expensive out-patient and hospitalization costs.
Perhaps the greatest economy is in the reduction of human misery and the enabling
 K 50
of persons who might otherwise be dependent on public support to remain independent and employed.
Efforts in primary prevention occurred in many different activities, all related
to education, regarding problems of mental illness. Some of the services offered
by staff of the Saanich Mental Health Centre in this project include:—
(1) An adult education programme developed by the Canadian Mental Health
Association on the subject of mental health communication. The Centre
assisted in the development of the programme, and Dr. Wood provided
one of the two-hour lectures entitled " Crisis in Family Life."
(2) Consultation with Dr. E. Patriarche on her programme on Family Life
Education and Sex Education as a part of the curriculum of School District
No. 61. The Centre participated with Dr. Patriarche in some innovative
approaches to make the work more effective with Grade VIII, X, and XII
(3) Consultation with a task force of administrators, principals, school counsellors, and a public health physician as a " Task Force to Study the Drug
Problem " in School District No. 63 and to make plans to develop a programme to meet the needs in this area.
(4) Consultation with the Board of Education, School District No. 63, on
research projects involving use of their premises and pupils.
(5) Participation with the Family Life Education Association in developing
a workshop for parents on the subject " How to Help Today's Kids Cope
with Tomorrow."
(6) Lecturing and guidance for Family Life Education Association (now a
branch of Citizens' Counselling Centre) in a voluntary group leadership
development programme.
(7) Regular and frequent consultations with members of the Victoria Council
of Churches, Victoria Medical Society, and social workers from several
agencies in the development of programme, staff, and a training programme for Citizens' Counselling Centre, a supervised volunteer counselling agency with multiple interests in community mental health.
(8) Consultations with the Canadian Mental Health Association at the Advisory Board level on programme and planning; also, in the direct service
area regarding utilization of the White Cross Centre for rehabilitation of
former patients needing a resocialization programme.
(9) Consultations with the supervisor of training of student nurses in the Royal
Jubilee Hospital to provide part of their training programme during their
rotation in a psychiatric unit. Several lectures on " Community Psychiatry " and " The Hostile Patient " were given.
(10) Participation as chairman of a panel discussion at the University of Victoria, sponsored by the Registered Nurses' Association, on the subject of
"Adolescence and Its Roles."
(11) Close liaison, guidance, and support for a group of citizens in Sidney
interested in working toward obtaining better services for their community
in the field of mental health.
(12) Working with the Canadian Mental Health Association, Community
Council, Citizens' Counselling Centre, psychiatric sector, and others of the
medical profession in considering means of meeting community needs via
a " Crisis Centre." This programme is still developing and needs much
community organization and leadership.
K 51
(13) Working with the Canadian Mental Health Association as a " resource
person " in a programme for the police forces of Oak Bay, Esquimalt,
Victoria, Saanich, and the R.C.M.P. on " Managing the Violent Patient "
(40 officers were involved).
(14) Previewing films with Dr. E. Patriarche, Dr. F. E. Wood, Mr. Derek
French, and others, on the subjects of (1) Marijuana, (2) LSD, and (3)
Sex Education, to evaluate their merits for school use. Part of this was
done at the Provincial Education Department, part at School District
No. 61.
(15) Consultation and development of liaison with the Youth Council at the
facility known as " Cool Aide " to facilitate the adolescents being able to
utilize Centre services.
(16) Consultation on a weekly basis with a group of probation officers of the
Children's and Family Court re special problems in their work, and ways
in which the Centre's services can be more effectively utilized.
A. L. Aranas, M.D., Director
From January 1 to April 30, 1969, the South Vancouver Island Mental Health
Centre was under the directorship of Dr. A. R. Stewart. As of May 1, 1969, the
Centre was divided into the Victoria Mental Health Centre, serving School Districts
No. 61 and 62, and the Saanich Mental Health Centre, serving School Districts 63
and 64, with Dr. A. L. Aranas and Dr. J. T. Wood as the respective Directors. Each
Centre functions autonomously, although situated in the same building.
The division of the Centre necessitated the reorganization and assignment of
professional staff. As in previous years, the greater bulk of our case load is focused
on direct-treatment services. To overcome the increasing demands for direct intervention, especially with problem families and children, a child psychiatrist on sessional employment provides a most successful lecture-demonstration course on
family modification with a group of general practitioners of the Greater Victoria
area, in conjunction with the Victoria Medical Society.
For a few months the Centre had the services of a social worker who worked
with the Boarding Home Central Placement of the City Welfare. This facilitated the
placement and follow up of patients who were discharged from Riverview Hospital
back to the community.
The Neuropsychology Laboratory of the Department of Psychology of the University of Victoria is now functioning under the asgis of the Victoria Mental Health
Centre. This is a valuable addition to this Centre, as we have been faced with numerous problems of evaluating brain-damaged patients, especially school children, suspected to have minimal organic brain dysfunction. Although the Centre has a full-
time psychometrician who administers the highly specialized neuropsychological
tests, it is still handicapped by the lack of a full-time Ph.D. neuropsychologist.
The Centre moved to the ground floor of the Eric Martin Institute of Psychiatry
on May 7,1969, without disruption in service.
 K 52
P. G. Adrian, B.A., M.S.W., Acting Director
A number of administrative and organizational changes transpired during the
year. Dr. Jilek, who resigned as Director of the Centre in June, remains affiliated on
a sessional part-time basis as consultant psychiatrist to the Centre. With the change
to non-medical administration, the Centre developed an open referral system, thus
accepting referrals from all social agencies, as well as self-referrals. The Central
Fraser Valley Mental Health Centre in Haney opened in June and serves Mission
and Langley, previously served by travelling clinics from the Upper Fraser Valley
Mental Health Centre. The Centre's region now coincides with the boundaries of the
Upper Fraser Valley Health Unit, and has enabled us to increase services in Abbotsford and Hope from monthly clinics to weekly and bi-monthly respectively. Referrals in these communities are still made to the local health units, with schedules and
appointments being arranged at the Mental Health Centre.
Clinical activity showed considerable increases, with average monthly activations showing a 42 per cent increase with a total of 237 activations in the first nine
months of the year, compared with 163 activations in the same period the previous
year. The average monthly active case load showed a 22 per cent increase, ranging
from a case load of 242 in 1968, compared to 295 in the current year. Direct services provided over the year included psychiatric, psychological, social, and nursing
assessments; chemotherapy; individual, marriage, family, and group therapy. The
schools continue to be our largest referral source.
To date all referrals have been attended to, together with an assessment and
consultation within a reasonably short time. The Centre has tried to control the
demand for direct services by developing more effective patterns for indirect consultation with referring agencies. For example, the Centre has initiated a plan of
school consultation whereby school children who are considered by the teacher and
public health nurse to be in need of mental health assessment have a pre-referral
consultation visit to the classroom by a member of the mental health team, in company with the district public health nurse and special school counsellor. Similarly,
team members have made themselves available in educational, consultative, and
supportive roles by participating in joint interviewing, in case discussion, as co-
therapists in group sessions, in public-speaking engagements, and in committee work
in conjunction with agencies, professional personnel, and other organizations, including social workers, public health nurses, probation officers, Manpower counsellors,
school counsellors, directors of hospital nursing, adult education directors, Canadian
Mental Health Association, Big Brothers' Chapter, Homemakers Service, Volunteer
Bureau, Family Life Institute, and Community Chest and Councils.
Development of auxiliary community services and resources for mental health
has held high priority, as it appears that a range of primary resources are almost
mandatory in order to offer an effective out-patient clinical service. In Chilliwack,
mental health team members have assisted and supported in the formation of a
Volunteer and Information Bureau, Big Brothers' Chapter, Family Life Institute, and
in the revitalization of the local branch of the Canadian Mental Health Association.
In Abbotsford, members have participated in the organization of a Volunteer and
Information Bureau, a Big Brothers' Chapter, and a Family Life Institute similar to
the one already mentioned. Direct and indirect involvement on a continuing basis
is anticipated, due to their function in total concept of community mental health.
K 53
J. A. Steedman, M.D., Director
The Northern Interior Mental Health Centre has been very busy throughout
the whole year. The patient-movement data to August 31, 1969, were: Active
cases, 722; entries, 46; exits, 48; end-of-month active cases, 720. The clinic has
difficulty in closing cases, and therefore the case load is statistically misleading.
The clinic personnel consists of two stenographers, a mental health nurse,
psychiatric social worker, and a psychiatrist. We hope to include a psychologist on
our team in the near future.
The Centre continued its consultative work with the school's special services,
the gaols and R.C.M.P., and local legal and medical professions. The City of Prince
George Resources Planning Board was very active during the year and the city now
has, in addition to Homemaking Services and the Alcoholic Halfway House, a Receiving Home for Children and a Group Living Home for Teenagers. A Red
Feather Campaign was organized, a Day Programme set up, and it would appear
that in the past year and a half there has been a whole evolution in the social services
available to the people of this city and surrounding area. The local general hospital
continues to provide 10 beds for psychiatric patients.
A. J. Bennee, M.B., B.Ch., C.R.C.P., Director
In 1969 the population served by this unit was 56,000. Travelling clinics are
held two days a month at both Salmon Arm and Revelstoke, and the remainder of
the time is devoted to Vernon and district.   Cases are also seen from Golden.
Dellview Hospital is served in a consultative role, and is visited for one hour
each week, when all new cases are psychiatrically assessed and other cases are seen
when necessary.
Regular monthly meetings are held with public health nurses and with school
counsellors in addition to our meetings to discuss individual cases as required.
The Psychiatric Unit at the Vernon Jubilee Hospital has officially eight beds.
The bed occupancy for the first six months of 1969 was 8.5, which is 106 per cent.
The average length of stay of patients in the hospital unit was 13 days.
The attempt by the Mental Health Centre to encourage the development of a
Community Social Co-ordinating and Planning Organization over the past year has
resulted in the formation of a Vernon Social Planning Council whose purposes are to
(1) encourage communication and co-operation among existing health and
welfare services;
(2) identify specific social needs of the community, with a view to meeting
In June, a Steering Committee was named as an interim committee to function
until January, 1970, when terms of reference will be cleared and an election of
officers held. Our mental health nurse, who serves as secretary to the committee,
was largely responsible for laying all the groundwork involved.
The psychologist has spent most of his time assessing children with learning
difficulties. In the last 2Va years he has seen a total of 236 children under the age
of 11, and of these, 146 (56 per cent) have had learning disabilities. This does not
include the figures for children seen by the special school counsellor. It is evident
this is a very serious and prevalent problem. A large percentage of these children
are referred because of behaviour difficulties, and not always because of any particularly obvious learning problem.
The psychologist met regularly with the Supervisor of Elementary Education,
teachers, and other school authorities to discuss problem cases, many of them not yet
referred to the clinic. This proved to be a good screening procedure for those outlying areas without their own special school counsellor or psychologist.
Most of the marriage and family therapy is done by the social worker, and the
following is a short report on 140 cases seen between June, 1967, and August,
S. Zimmerman, M.S.W.
Included in this report are only those couples and families for whom marriage or family therapy was the principal method of treatment, and for whom
treatment has terminated.
An attempt was made to determine the results of treatment of these
patients. It is realized that there must be some degree of subjectivity, but there
was a very strong attempt to remain objective.
Results were tabulated in the following way: — p0ints
No improvement      0
Some improvement, but not sufficient in the opinion of therapist
and patients       1
K 55
Those who felt better, but considered by the therapist to need
more work       2
Those where the therapist and patients both agreed that no more
help was needed       3
Total number of couples and families treated  125
Total number of interviews with all these couples and families 567
Average number of interviews per couple or family 4.23
Total result points  205
Average number of result points per couple or family 1.64
Other points of interest:—
Nineteen families received only one interview, nine of which had 0 result
points.    Average number of result points for other  10 families
was 1.8.
On the other end of the scale, 15 families or couples received 9 to 18
interviews. Their average result point was also 1.8.
The average result of those who received 3, 4, 5, 6 interviews (those right
around average) was 1.75 result points (60 couples and families, 105
result points, and two with unknown results). It looks as if there is
little or no correlation between number of interviews and effectiveness of treatment. (Interviews are almost always weekly or biweekly.)
Twenty-two couples and families were judged to have achieved 3 points,
while 17 were judged to have had 0 points.
Questionnaires were sent out to determine the opinions of the couples and
families as to the degree of help they received from marriage and family treatment. They were asked the question: " What do you feel were the results
of your contact with the Mental Health Centre? " They were given three
No improvement in family relationships.
Slight improvement in family relationships.
Much improvement in family relationships.
Ninety-six of these questionnaires were sent out;  35 were returned, 30 of
which were signed.   The results of these questionnaires showed considerable
similarity between the results which the families gave themselves,  and the
Centre's results.   These 30 families' own assessments indicate a figure of 57
points;  the Centre's evaluation gave them 51.
It had been hoped that the average result points would have been higher.
On the other hand, 117 out of 134 received at least some help.
The low figure for average number of interviews was a pleasant surprise.
This enables us to provide direct treatment to a far-greater population than
is usual in this work.   Also, it was interesting that the average result points
were virtually unaffected by the number of interviews.
During the year the social worker held 28 sessions of class discussions, for two
periods a week, with one of the more-disturbed school classes, with the accent on
social problem solving.
The social worker has also been taking pre-natal classes to discuss with prospective mothers " prevention of emotional problems in children."
The majority of cases referred to the Mental Health Centre are seen by the
psychiatrist first.   Emphasis is placed on the importance of marriage and family
therapy, wherever possible. There is no waiting list and cases are usually seen within
a few days of referral.   Urgent cases are seen almost immediately.
Public health nurses are requested to submit a brief report on their referrals
and audiograms and Snellen eye-tests are done by public health nurses on all the
children they refer to the Centre.
There is a good co-operative relationship in the region between doctors in
private practice and the Mental Health Centre. The majority of cases are channelled
through the family doctor. Some school children are referred by school authorities
in conjunction with the public health nurse, and the family doctor is notified and
invited to submit a report on the patient.
A review of recent statistics shows that the Vernon mental health region saw
427 new cases in the last 12 months. This figure is higher in comparison to most
other areas. One possible explanation is that cases are seen more expeditiously and
less time is taken in work-up and in conferences. Another explanation is that this
unit possibly spends less time on agency contacts, educational programmes, lectures,
and other special projects and devotes more time to therapy.
J. Brown, M.S.W., Acting Director
The East Kootenay Mental Health Centre was officially opened on November
1, 1969. Housed in a new three-story building on the grounds of the Cranbrook
and District Hospital, this latest decentralized community Mental Health Centre will
emphasize prevention as well as treatment. An effective, short-term treatment programme which can reach a large number of people, and a consultative service to
strengthen the knowledge, confidence, and skills of existing community professionals
will be offered by this Centre when appointments have been made to all staff
Until a full staff is recruited, the East Kootenay Mental Health Centre will be
concentrating on the continuing casework treatment of cases already assessed and
diagnosed by the West Kootenay Travelling Clinic. In December, the Centre
accepted approximately 15 new marital and family counselling cases referred from
East Kootenay doctors and agencies. Considerable time was devoted to community
education and to providing an informal psychiatric social work consultative service.
K 57
K. J. Mackay, M.B., B.Ch., M.Sc, C.R.C.P.(C), Director
The Upper Island Mental Health Centre opened in June, 1969, and is situated
in the Upper Island Health Unit in Courtenay.
Direct service was offered on medical and community agency referral to persons
from Comox, Courtenay, Cumberland, and Royston areas, as well as the district
below Oyster River. A travelling clinic was instituted to cover the Campbell River
area. In-hospital consultative services were provided, principally at St. Joseph's
Hospital in Comox, but also at the Cumberland General Hospital, on request by
community physicians. The Director was looking into the possibility of enlarging
services of the Centre by periodic contact at longer intervals with outlying areas of
the upper Island, such as Port Hardy, Port McNeill, Alert Bay, Port Alice, Gold
River, and Tahsis. This Centre was assigned the responsibility of providing travelling clinic service to the Powell River area. School Districts Nos. 47, 71, 72, 84,
and 85 fall within the scope of the area serviced by this Centre.
Consultative services were offered to the Probation Service and Department of
Social Welfare, in both Courtenay and Campbell River. The social worker maintained regular contact with the Department of Social Welfare, particularly in Campbell River, where indirect consultation was provided to case workers covering the
more remote areas in the northern part of the Island. Frequent informal consultations were held with Probation Officers and school counsellors.
The Mental Health Centre is responsible for the supervision of the programme
in the Bevan Lodge, which is a residential boarding home for 70 adult retardates,
operated by the Bevan Lodge Association.
This Centre enjoyed a great deal of community support and interest since its
opening in June.
Director of Mental Health Services
Director of Nursing Education
Superintendent, Riverview Hospital
Superintendent, Geriatric Division
Superintendent,  The Woodlands  School
Superintendent, The Tranquille School
British   Columbia   Youth   Development   Centre,   " The
Maples," Burnaby
H. W. Bridge, M.A., M.B., B.Ch., B.A.O., M.Sc, C.R.C.P.(C)
The work of the Mental Health Services during the year fell into two major
categories. The first category included such services as the provision of in-patient
security for the mentally disordered, whose treatment is a concern of the Courts, or
involves protection of the public. It also included limited but very specialized services to certain categories of the severely mentally retarded.
The second function of Mental Health Services concerned itself with the development of a broad range of services which are needed by communities throughout
the Province and which are the prime goal and objective of this Branch.
The prime responsibility of the Director is in regard to the standards of care
and treatment within the mental health facilities of the Province. In both functional
categories of the Mental Health Services, priority has been given to maintain the
present standards where they are satisfactory, and to upgrade them where they fall
short. This has not been an easy task, but Mental Health Services standards have
continued to rise toward the goal of equalling those applicable to the physically ill.
In most areas trends in patient population continued to show as a slow reduction in admissions and resident population. It is to be hoped that this reflects the
increase in alternative resources in the community. An adverse factor is the difficulty of placing the retarded in the community to make room for new admissions,
and the necessity during part of the year to restrict admissions to the Riverview
Hospital. During the year there was a medical staff shortage. Fortunately, by the
year's end, almost every medical staff vacancy at Riverview had been filled.
Following the assessment of Riverview Hospital by the Canadian Council on
Hospital Accreditation, measures were initiated to meet the requirements of the
Council in the areas that were considered unacceptable. In addition to progressive
changes stimulated by the requirements of the Council, a further progressive move
has been the development of an excellent liaison between the Psychology Department
and Simon Fraser University.
In the Geriatric Division, it has been possible to raise the standards of medical
care at Dellview and Valleyview, and at Valleyview the Community Consultation
Service has been further expanded with the arrival of Dr. John Robertsen to fill the
newly created position of Deputy Superintendent.
Developments in services to the retarded during the year have been made possible with the opening of Bevan Lodge by a private society in Courtenay, which relieved the in-patient institutions of the Mental Health Services of nearly 60 patients.
In October, the opening of Alder Lodge in Maillardville as an extension of The
Woodlands School relieved the school of approximately 50 patients.
During the year a great deal of planning took part toward the development, by
The Tranquille School, of a comprehensive regional service for Regions 1, 2, and 6.
This programme was established on October 1, 1969, and relieved The Woodlands
School waiting-list of responsibility for approximately 90 patients, whose residence
is in the Interior, and provision for whose care now falls upon The Tranquille School.
The full benefit of this regionalization in relieving the waiting-list problem will be
more apparent upon the completion within a short time of minor alterations by the
Department of Public Works.
The British Columbia Youth Development Centre at The Maples, Burnaby,
which inaugurated its service in 1968 with only the Family and Children's Clinic
operating, continued to develop, and opened the Residential Unit and the Psychological Education Clinic during the year. The Residential Unit received its first inpatients on August 4, 1969. The function of the Residential Unit has been gradually
gathering pace and, toward the end of the year, two of the three cottages were in
use, one as a day clinic and the other as a residential unit. Subject to completion of
structural repairs, it is anticipated that the third cottage will open in the spring of
In spite of the very real problems, the matrix of a viable and valuable treatment
programme, which is needed by large numbers of children and adolescents in the
Province, is already apparent, and may be expected to develop steadily over the
next 6 to 12 months.
The Psychological Education Clinic, after a difficult inaugural period, went into
almost full operation in September, 1969, and is developing a number of different
programmes which will ultimately provide a valuable resource to the other units and
to other agencies.
The Department of Nursing Education has continued under the Acting Directorship of Mrs. E. Paulson, to whom we are indebted for carrying out the duties
until a suitable replacement is located.
The Department's graduation ceremonies for 7 men and 132 women took place
in the auditorium of the New Westminster Secondary School on the evening of
April 17, 1969. The address to the graduates was given by Dr. L. E. Ranta, Director of Medical Services, Vancouver General Hospital.
The Annual Meeting of the Council of Psychiatric Nurses for 1969 was held
on April 21, 1969.
The continuation of the valuable contribution made to the Mental Health
Services by the various volunteer workers is gratefully acknowledged.
K 63
Mrs. E. Paulson, Acting Director
During the year, the Department experienced a number of faculty changes.
Seven instructors resigned and their positions were subsequently filled. Three instructors were granted educational leave—one senior instructor attended university
during the first four months, another attended a six-week session at summer school,
and the third commenced university in September. The resignations created extensive changes in clinical assignments, which required a period of adjustment for both
the nursing services involved, and the faculty.
The Department received 1,308 requests for Information Bulletins and applications regarding the psychiatric nursing programme. Four hundred and three applications were processed as compared with 389 in the previous year. One hundred
and thirteen (103 women and 10 men) enrolled in the spring and fall classes; 58
less than in 1968. One hundred and three of the students who enrolled had complete secondary-school standing, 82 were on an Academic-Technical programme and
the remainder on a Vocational programme. Of the 290 applications who were rejected, the majority did not have acceptable educational requirements, which accounts for the smaller enrolment in the spring and fall classes. One hundred and
thirty-five students (128 women and 7 men) completed the programme.
The psychiatric aide programme conducted 25 five-day courses, 11 at the Education Centre and 14 at The Woodlands School. The number of aides who attended
the classes totalled 222. In October, the senior instructor in charge of the programme gave classes to 46 aides at the Dellview and Skeenaview Hospitals. A review of the programme was in process at the year-end, and a questionnaire was circulated to all wards in the Riverview Hospital and The Woodlands School.
Affiliate programmes in psychiatric nursing were conducted for students of the
Royal Columbian Hospital, New Westminster; St. Joseph's Hospital, Victoria; St.
Paul's Hospital, Vancouver; University of British Columbia School of Nursing, and
for public health nurses of the Health Branch. Two hundred and sixty-eight students
were enrolled, and of these 226 completed the eight-week programme. The programme co-ordinator had two weeks of field experience at the Fraser Valley Health
Unit, and a week's orientation to the Burnaby Mental Health Centre.
Accommodation was provided for 442 residents. The Department loaned one
of its residences to nursing services for patients from West Lawn Unit, while the
latter is being renovated.
The Department's standing committees accomplished a number of tasks. The
Curriculum Committee completed a philosophy for the psychiatric nursing programme, and was proceeding with curriculum content. The Progress Committee
reviewed the evaluation of students who were unable to perform satisfactorily and
submitted recommendations to the Acting Director of Nursing Education. An Evaluation Guide was prepared and was on a trial basis for the first half of the year. It
was being revised and recommendations made by nursing service were being incorporated. The Library Committee inaugurated new systems of cataloguing, which
facilitated library functioning and decreased the loss of books. The Examination
Committee prepared and marked 57 eligibility examinations for nursing positions.
Faculty members of the Recruitment Committee participated in seven vocational
conferences—six in the Lower Mainland and Fraser Valley Schools and one at
An Acting Assistant Director was appointed in May, 1969.
B. F. Bryson, B.A., M.D., CM., F.A.P.A., Superintendent
During the year, Riverview Hospital continued to provide a comprehensive
psychiatric in-patient and out-patient service for the residents of British Columbia.
An estimated total of 930,305 patient days-of-care and treatment for 6,114 patients
was provided by Riverview Hospital in 1969.
Reports on the activities of the many services and departments which served
the needs of Riverview patients during the past twelve months follow.
During the year, there was a reduction in the number of patients admitted to
Riverview Hospital and a continuing reduction in the resident population of the
hospital. At the same time, there was an increase in the number of patients being
treated on an out-patient basis at the After Care Department and in the boarding-
home programme. These trends, over the past decade, have been plotted on Graph 1
and illustrate an increasing emphasis on care of the patient in the community, wherever appropriate. While the resident population has declined from 3,222 in 1960 to
2,482 in 1969, the total number of patients under care has increased from 3,264 in
1960 to 3,918 in 1969. Unfortunately, the decreased admission rate during 1969 is
also partially a reflection of a restriction of admissions necessitated by seasonal
medical-staff shortages.
A pilot foster-home programme was initiated during the year, whereby selected
patients requiring a family placement would be placed in a supervised family setting.
To date, nine such placements have been made. Difficulties continued to be encountered in locating a sufficient number of places in boarding homes for selected patients.
However, it is hoped that the reorganization and regionalization of the boarding-
home programme will lead to the development of additional such homes in more
remote areas of the Province.
In addition to the increased emphasis on out-patient treatment, there has also
been an increased use of the therapeutic community approach. Techniques for the
administration of somatotherapies and drug therapies have been refined. An intensive nursing-care area for the administration of sleep therapy, intensive pharmacotherapy, and electroconvulsive therapy has been developed on Ward West-4, Crease
Unit. At the end of the year plans were initiated to have all anaesthesia for E.C.T.
administered by a fully qualified anaesthetist.
The Clinical Teaching Unit, operated in affiliation with the University of British
Columbia, now has four psychiatric residents working toward the requirements for
certification in psychiatry of the Royal College of Physicians and Surgeons of Canada. These residents are under the direct supervision of a Teaching Fellow and a
Clinical Supervisor with joint university/hospital appointments. Two members of
the University of British Columbia surgical teaching staff were recruited on a sessional basis to further upgrade the teaching aspects of our surgical residency programme, which is recognized for six months' graduate training in surgery by the
Royal College of Physicians and Surgeons of Canada.
At the beginning of the year, the by-laws, rules, and regulations of the Medical
Staff Organization, as required for hospital accreditation, were approved by the
Minister of Health Services and Hospital Insurance. The prime objective of this organization and its relevant committees is " to promote a high quality of medical care
for all Riverview Hospital patients."
It is with regret that we report the death by suicide of 11 patients, only one of
whom was actually in residence at the time of the suicide. A review of each such
death is made by the Medical Audit Committee and the Clinical Director.
Renovations to the West Lawn Unit commenced during the summer. During
this period of renovations, 56 West Lawn patients were transferred to Nurses' Home
10, 30 transferred to the Centre Lawn Unit, and several groups of male patients
placed in smaller, more home-like treatment units in houses on the hospital grounds.
These renovations to West Lawn will provide a more satisfactory physical treatment
The Department of Nursing has continued to provide a high level of nursing
care, and to seek methods of improving nursing procedures and training experience
for staff. Demands on the nursing service, resulting from changing concepts and
treatment programmes for patients, have been met with enthusiasm.
Illness amongst staff was unusually high during the winter months, particularly
during January, when the incidence of Influenza was high in the hospital, as well as
in the community. At the peak of the outbreak, in one 24-hour period, 207 patients
and 46 staff in this Unit were ill. In the same month, the illness among nursing staff
throughout the hospital reached 1,936 days for nurses and aides, 109 for students,
a total of 2,045 days.
Flu-vaccine inoculations were given to prevent a similar outbreak this winter.
Inoculations are available for nursing staff.
The occupancy of the 16-bed ward for patients with active tuberculosis has
been low throughout the year. Two new drugs for treating this disease, enthambutol
and isoxyl, were used for patients resistive to other antimicrobials.
An integrated 9-bed unit has been developed to provide nursing care for patients requiring intensive physical therapies. The length of stay has ranged between
5 to 65 days. More than half of the 45 patients referred in the first six months
improved. Continuous sleep, or that combined with electroconvulsive therapy, were
treatments used most frequently. Suitable patients from any part of the hospital
may be referred.
Four infant children have been brought to the hospital and remained with their
mothers, who were undergoing treatment. There was beneficial effect on the
mother's progress in three instances. Other patients enjoyed the presence of the
babies, who were one to eight months old.
A growing number of patients are attending events in the community, such as
concerts, the circus, picnics, trips to Stanley Park, swimming, and boat cruises.
Many luncheon outings were arranged in homes of members by the volunteers of the Canadian Mental Health Association.   These were especially enjoyed.
Seventeen patients entered articles in the handicraft competition at the Pacific
National Exhibition, six winning prizes. Four groups of patients again spent a week
at the Garibaldi " Y " Camp, as well as several groups using Government camp-sites.
A day outing to Victoria for 65 women was an outstanding event.
Several pieces of excellent equipment have been provided for the operating
room, as well as oxygen and suction piped into North Lawn, all helpful in improving
K 67
m*u Mi
A well-stocked patients' library offers a variety of reading material,
including current newspapers and magazines.
Skilled instructors in sheltered workshops assist in rehabilitating patients,
prior to their return to a useful life within the community.
Staff education courses included:—
(a) The Extension Course in Nursing Unit Administration, sponsored jointly
by Canadian Nurses' Association and Canadian Hospital Association,
which includes two intramural sessions of one week each at the University
of British Columbia.
(b) Continuing Education Programmes for Nurses, presented by the Extension
Department and School of Nursing at the University of British Columbia.
(c) The Psychiatric Nurses Co-ordinated Programme, offered at Vancouver
City College.
(d) Health Technology, Nursing Option, at the British Columbia Institute of
(e) Tuberculosis and Respiratory Diseases Workshop.
( /) Courses in obstetrics and paediatrics for those with general nursing standing outside of British Columbia.
(g) Executive Training Programme XIV.
The Nursing Service at Riverview Hospital is continuing to provide clinical
areas for education of nursing students in
(a) the psychiatric nursing programme, Mental Health Branch;
(&) the programme at St. Paul's Hospital, Royal Columbian Hospital, and
St. Joseph's Hospital;
(c) the degree programme at the School of Nursing, University of British
Similar opportunities are provided for graduate nursing students from the Provincial Health Branch and from the night programme in psychiatric nursing at the
British Columbia Institute of Technology.
The Psychology Department recorded a year of very satisfactory growth.
Progress has also been facilitated, both by the success of policies permitting more
flexible terms for the recruitment of staff and by the very improved liaison established
with the Psychology Department of the Simon Fraser University. In general, these
factors have fostered the recruitment of students, staff, and consultants of high
quality and have catalysed the Department's endeavours to widen and improve the
basis of its contribution to patient welfare.
In total, 60 lectures were delivered to hospital staff within the framework of
inservice instruction programmes. The Department has been the co-sponsor of a
seminar in epidemiological methods offered to senior undergraduate students in
psychology at Simon Fraser University. The success of this affiliation has led to the
repetition of this seminar and to the Department's participation in a further seminar
relating to behaviour-modification techniques.
The psychometric evaluation of patients continued to be a major service commitment and, appropriately, 360 reports were written in response to referrals for
diagnostic evaluation, intellectual measurement, and personality assessment. Refinement continued in the automated testing system described in the 1968 Annual Report
and supplement.
During the year, 400 group and conjoint therapeutic sessions and approximately 300 individual interviews were conducted, the majority within the context
of hospital and after-care services for security-ward patients. A start was made in
the Department's intended introduction of operant-based behaviour-modification
procedures to personnel responsible for the management of extended-care patients.
In addition to the major developments represented in the automated testing
project and in the operant-ward programme, the Department maintained a variety
of other research interests. All data had been collected and an analysis of results
was under way at the year-end in the study to examine the predictive efficacy of 17
OHC steroid level in anticipating suicide behaviour. Experimental work had also
started in the study to determine the extent to which personality factors rather than
" illness " are a determinant of nervous-system activity in schizophrenia.
Student affiliation with the Department was reintroduced in the summer and
the programme was organized on a project basis. Previously, the orientation provided two full-time students with an exposure to differing aspects of the psychologist's conventional clinical duties. This year, four were retained on a half-time basis
and were given the responsibility of directly participating in two of the projects
outlined above.
A review of the work of the Social Services Department for the past year points
to increased activity at the community level, with some reduction in numbers of
patients served at ward-level. This development is consistent with trends to be
observed in over-all hospital statistics, which depict a decline in patient admissions
in relation to those for previous years. Hospital units admit patients from broad
geographic areas, including many isolated and sparsely populated communities, and
it remained necessary to provide extensive in-patient services in order to compensate
for limitation in local resources.
The need to expand existing out-patient programmes in areas within reasonable
access of hospital treatment facilities continued to be important even in large urban
centres having available for use a multiplicity of health and welfare agencies. In
1968, arrangements were made to commence a pre-admissions and after-care social
service programme in the admitting unit of Centre Lawn which would work in close
co-operation with other disciplines in the provision of direct services to patients
during these two important phases of their treatment. In May, 1969, in conjunction
with local health and welfare authorities, this programme made a further move
toward regionalization of services by instituting a pilot project whereby a group of
patients from one, and later two public health regions, were admitted to one specific
ward in the Centre Lawn Unit. This plan is continuing on a trial basis, subject to
periodic review.
In all hospital units, and particularly those offering longer-term care and treatment, a significant proportion of social work time was again required to plan for
and to implement community resettlement for selected patients. Despite a general
shortage of boarding-home beds in many areas adjacent to the hospital, it was
possible to place 171 patients in boarding-home care under the ongoing treatment
supervision of the hospital between April 1, 1968, and March 31, 1969, with the
co-operation of the Department of Social Welfare and Health Branch. Of this
total, 94 were initial placements and 77 involved patients who, during the period of
hospitalization, had one or more previous such placements. In addition, 16 patients
were sufficiently stabilized to be discharged from the programme to more independent living arrangements. As of September 30, 1969, there were 412 patients
residing in licensed community boarding homes and in receipt of continuing services
under this programme.
Due to the lack of supervised accommodation available in Vancouver in 1968,
and the need for patients discharged from hospitals to engage in normal social living,
a pilot project designed to recruit foster homes was initiated on a modest scale by
Riverview Hospital, in co-operation with the Vancouver City Social Service Department. The purpose of the project was to recruit and select private homes which
could offer a family-like environment initially to a small number of patients on a
trial basis. As a result of recruitment efforts to date, some 50 inquiries have been
received from interested householders, of which six homes located in Vancouver
City have been used for patients discharged from Crease Unit. Supervision of the
homes and the patients is shared between the services of hospital and public welfare.
The work of the Department is depicted in the statistical summaries for the
year, which reveal that social and casework services were given a total of 3,828
patients in hospital, and 984 who were registered with hospital after-care services.
In addition, 888 patients received pre-admission social services during this period.
The Rehabilitation Department continued to focus on the problem of making
the patient's hospital experience a meaningful preparation for returning to community life. While other departments are more involved in specific treatment of
the patient's illness, the Rehabilitation Department is concerned with concrete plans
for an adequate social and vocational adjustment following the period of hospitalization. The programme of work placement for patients in hospitals remains a large
and active one. During the year, 1,338 patients were referred and placed in work-
experience programmes, of these 772 were male and 566 were female. For an
improvement in programme, 455 patients were changed from one work area to
another. Each placement and change involved an interview with the Rehabilitation
Officer, plus follow up of his work and regular written and verbal reports to the
referring clinical team. The typical short-stay patient in hospital results in emphasis
on short-term work placement as a preparation to his returning to outside employment. As this trend continues, more staff may be necessary to cover work areas
which were previously staffed with the long-term patients now discharged.
There has been an increase in community placement activity. The number of
jobs found by the Rehabilitation Officers has risen to 96. There has also been a
growth in follow-up services to patients with 174 follow-up contacts being made in
order to ensure that patients were adjusting satisfactorily to work. There were 292
contacts made with community agencies and employers for this group of patients
Considerable time was spent in working out an improved mode of operation
with Canada Manpower. The Rehabilitation Department is now handling all referrals to that organization and this has resulted in an improved communication with
their staff. Follow-up information is being transmitted back to the Department, and
an improvement in service to patients is developing for those who need help in
re-entering the labour market.
The position of Occupational Therapist was filled and the vocational assessment service resumed. There were 66 assessments completed during the year. As
a supplement to community facilities for vocational adjustments, this is an important
part of the Rehabilitation Department's services.
The Hillside Rehabilitation Unit served a total of 123 patients in 1969. There
were patients referred from other wards in the hospital who required special rehabilitation programmes before being discharged. In order to have a variety of programmes to meet the diverse needs of the Hillside residents, the staff there have
specialized in different fields, from personal development to community orientation,
and classes are available to all residents who need help in these various fields. There
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has been an increase in the group-therapy sessions with improved results, following
an in-service training programme in group therapy. The Hillside Unit and the
Rehabilitation Residence in Vancouver are now working more closely together to
complement each other for a smoother flow of patients from hospital to community
The Rehabilitation Residences have had a very active year, with a 20 per cent
increase in patients served. Seventy-seven patients were resident for various periods
of time as they undertook vocational training, sought employment, and otherwise
prepared to become self-supporting, productive members of society. There has been
more emphasis on group discussion and this has been very useful, both for patients
in the houses and as a follow-up technique for patients who have left but still need
further supportive help. A social interaction programme has been developed for
patients who are temporarily unable to deal with employment problems, or who
are showing some return of symptoms.
An awareness of the need for keeping abreast with new developments in rehabilitation and community resources has led to the establishment of in-service training programmes for staff, to increase their skills. In turn, the staff contribute to the
education and orientation programmes for staff in other hospital departments.
During the year, the Occupational Therapy Department benefited from a fairly
constant, near-full complement of qualified staff. This improved staff situation has
enabled the Department to plan more individualized, goal-focused treatment for
patients in most areas and has led to several new programmes.
The occupational therapy staff in West Lawn have taken on an added role as
activity advisers to assist nursing personnel in planning ward-based programmes to
encourage manual, social, and recreational skills in their patients. They are also
involved in co-ordinating evening and week-end social activities and outings to
community facilities.
Three new programmes have been initiated in Crease Unit to meet the specific
needs of patients—(i) a reactivation group for chronic schizophrenics, (ii) a social
development group for the socially isolated, (iii) a pre-employment course for those
lacking skills in making job applications.
Centre Lawn Unit has been able to expand its services during 1969 (as a result
of the greater number of staff). Six wards are now actively involved in occupational
therapy programmes and some new media used are proving quite successful, i.e.,
music therapy, self-care, cooking and shopping groups, and current events. One
staff member is active in the adolescent group therapy programme in this Unit.
Various contacts with the community were very successful. Some encouraging
responses were met in the realm of sub-contract work for many of the long-stay areas
of the hospital. Programmes emphasizing self-care (grooming and general appearance) were given a boost by the generous donations of make-up and beauty aids
from two cosmetic companies. An excellent article appeared in the press describing
some of the more up-to-date methods being used in psychiatric occupational therapy.
The Construction Shop continued to provide a realistic heavy-work situation
for both treatment and assessment purposes. The nine ward groups involved in
gardening projects were co-ordinated through this Department and were offered
advice and assistance as required. The staff member acts in an advisory capacity
at the ward-level for various projects in West Lawn, Centre Lawn, and East Lawn.
During the past year, boarding-home residents were introduced to a more
community-oriented, educational programme, which included talks by the R.C.M.P.
on " Road Safety," educational films, practical work-oriented projects, and various
competitions judged by members of the community.
Once again the Canadian Mental Health Association volunteers have assisted
this Department in preparing for programmes, working with patients, and running
social activities in many areas.
Staff attended various educational programmes outside the hospital in the past
year, e.g., a three-day course on " New Trends in Psychiatric Occupational Therapy," an afternoon workshop on " Discharge Planning and Community Resources,"
and a lecture by Dr. Glasser on " Reality Therapy."
Other responsibilities included the supervision of occupational-therapy students, 11 from the University of British Columbia and 3 from the University of
Toronto, as well as the orientation and supervision of nursing students and affiliates
in respect to occupational therapy.
The Recreational Therapy Department enjoyed a busy and constructive year,
which saw steady development of the two main areas of the Department's work—
conducting a broad range of daily therapy sessions as part of the total treatment
programme of the hospital, and the provision of a pattern of community recreational
opportunities for the total hospital population. The first section of this dual responsibility involved directing a total of 2,444 group-treatment sessions held in all six
units, with a total patient attendance of 97,644. The second area, provision of
social and recreational opportunities for the whole hospital community, saw numbers of the Rrecreational Therapy Department staff giving leadership and supervision
to some 5,330 group sessions held in ward areas, unit recreation rooms, Pennington
Hall, sports fields, picnic-grounds, and in community parks, beaches, pools, and
facilities throughout the entire Lower Mainland area, with patient attendance
totaling 236,795.
Invaluable support for this second section of responsibility with and for
patients, was afforded through the co-operation of a host of individuals and groups
throughout the community—municipal recreation departments, private agencies,
sports and entertainment promoters, co-operating Provincial institutions, the Canadian Mental Health Association, community centres, musical, cultural, artistic,
fraternal, and charitable organizations—all contributed toward making possible a
broad and stimulating programme of activities for hospital residents.
Such assistance involved scores of people visiting the hospital to contribute
their time and talent as members of concert parties, glee clubs, brass bands, dance
orchestras, entertainment groups, or simply as additional hosts and hostesses for
ward or unit socials. Other contributions took the form of free admissions granted
to our patients at concerts, entertainments, and sporting events held throughout the
community. Ward R2 was the grateful recipient of a piano contributed by the
Canadian Mental Health Association volunteers, while three other pianos purchased
through the Patients' Comfort Fund extended the effort to equip all suitable wards
with this valuable resource.
The over-all programming followed patterns very similar to previous years.
Activities were closely aligned to the passing seasons with a concentration on indoor
programming during the winter, all possible emphasis on the out-of-doors during
the spring and summer, and a return to indoors with the coming fall. Well-established procedures governed the scheduling of ward, inter-ward, and inter-unit social,
recreational, and sports activities throughout the year, while spring and summer
saw a repeat of the provision of a special holiday programme for some 700 vaca-
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tioning patient-workers. Highlights of the summer season included four periods
of resident camping at the Y.M.C.A. Camp Garibaldi; a series of boat trips to
Granite Falls and Victoria; attendance at the Shrine Circus and the Pacific National
Exhibition. Organized league play added interest to softball, volleyball, bowling,
and badminton throughout their seasons, while weekly card socials, bingo parties,
and rehearsal meetings for glee clubs, sing-a-long groups, and musical combos
served to meet these broader interests.
Festive occasions, such as Valentine's Day, St. Patrick's, Easter, Spring, Hallowe'en, the New Year, etc., were duly marked with suitable special events carried on
in ward and unit areas and at the hospital's chief recreation centre, Pennington Hall.
The Christmas season was pleasant and noteworthy for a number of special concert
events, staff and student choirs which visited throughout the wards, and in a very
successful series of Open House celebrations and parties carried out in all six units
of the hospital. These latter events resulted in the attendance of over 1,250 special
visitors, who journeyed to the hospital to share the Christmas season with their
patient-relatives and friends.
The music therapist and her company of talented patient and volunteer musicians were in great demand for ward-centred musical activities, as well as for regular
series of concerts and the weekly Pennington Hall dances. Late in the year a proper
music studio was set up in the former audio-visual area at Pennington Hall, complete
with new piano and a soundproof rehearsal hall.
The Leader, the patient magazine, edited by the Recreational Therapy Department staff, published a full schedule of 14 regular editions, plus a specially
decorated Christmas edition involving the work of some 120 patient residents during
the year.
The school was open for 226.5 regular school-days; 73 patients (52 male and
21 female) were enrolled, which is 12 per cent less than the previous year's total.
Thirty were adolescents with an average age of 16.5 years, and 43 were adults with
an average age of 27 years. The average period of attendance was 9.9 weeks. Daily
classes were conducted for 60 of the students, and individual instruction was provided for 13 who were confined to their wards. Thirty-two patients were discharged.
Through the media of the standard grade curricula and correspondence courses,
a diversified programme of instruction designed to provide for the educational needs
and personal development of the individual was maintained. Instruction in both
academic and vocational subjects was made available and emphasis was placed on
a realistic viewpoint concerning appropriate courses which would lead to either
continued schooling or employment in the community after discharge. The greatest
number of students (35) studied at the junior-secondary grade levels. Eighteen
were enrolled in the elementary grades, 15 in the senior-secondary grades, and 5
in the class for new Canadians.
The experimental programme, which was initiated in January, 1968, wherein
selected Order in Council patients were permitted to attend the daily classes, was
continued and augmented with increasingly satisfactory results. To date, eight patients have participated in this project and two are living in the community in supervised settings, while working and attending upgrading classes. Further expansion of
this programme is under consideration.
The trend to fewer classroom referrals was significant. With the co-operation
of the medical staff and the Department of Nursing, a higher degree of selectivity in
referrals was achieved, making it possible to extend increased individual attention
to the students and enabling this Department to participate more fully in the over-all
treatment programme.
Radiological service was provided for 11,676 patients during the year, involving
the processing and reporting on 17,518 films, a moderate increase over the work-load
of the previous year. The increase in work was particularly noticeable in the examinations requiring the presence of a radiologist, such as barium meals and barium
enemas. The Department is served by six fully qualified radiologists on a part-time
This Department reported a total of 78,993 procedures performed, representing
144,786 units (1958 D.B.S. schedule) of clinical laboratory work. Increases occurred in biochemical and bacteriological procedures.
One hundred and thirty autopsy examinations were performed, representing
approximately 80 per cent of the deaths that occurred at Riverview, Valleyview, and
The Woodlands School.
The Riverview laboratories continue to function as a training-school for laboratory technologists. Two students were successful in receiving their C.S.L.T. certification this year.
The acquisition of an electronic particle counter has proven to be a useful addition to the Haematology Department.
The pathologist and technical staff continue to participate in the biochemical
investigation of the etiology of schizophrenia.
The Department continued to provide service for neurological consultations,
electroencephalograph and echoencephalograph examinations. It meets the needs
of the Riverview Hospital, the Valleyview Hospital, Burnaby Mental Health Centre,
and the Simon Fraser Mental Health Centre. Electroencephalograph examinations
are also done for the Provincial penal institutions in the Lower Mainland, such as
Oakalla Prison Farm, Haney Correctional Institute, Alouette Rehabilitation Camp,
and New Haven.
During the year, 253 neurological consultations were performed and 331 echo-
encephalographs were done. Electroencephalograms totalled 1,193, of which 190
were at The Woodlands School, 35 at the Burnaby Mental Health Centre, and 968
at Riverview Hospital. This represents a moderate increase over that provided
during the previous year.
The provision of a full range of dental service to patients was maintained during
the year. In May, Dr. W. C. Cusack retired as Senior Dental Officer due to ill
health, and was replaced by Dr. W. J. Hilborn, who has been with the Department
for some years. Dr. W. F. Oldfield and Mr. F. Burnie joined the staff, giving the
Department two dental technicians to cope with the constant demand for dental
Laboratory supplies and equipment were increased to provide an orthodontic
appliance service for the patients at The Woodlands School.
Drug security was improved this year by the introduction of sealed polyethylene
tote boxes, and by the introduction of " narcotic counters " on some of the wards.
The narcotic counters also lessen dispensing time.   Direct purchasing was introduced
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in April. Under this system a limited number of more bulky surgical supplies are
delivered directly from the supplier to the hospital pharmacist. It is anticipated an
additional staff pharmacist will be engaged shortly, and this will enable the pharmacy
to exercise a greater degree of control of medications on the wards and permit the
senior pharmacist to assume much-needed ward liaison and pharmacy administrative
duties. A " drug adverse reaction reporting programme " is under study by the
Pharmacy and Therapeutics Committee. It is expected that this programme will
bring considerable benefits to the patients of this hospital. We are also in the process
of establishing a Poison Control Centre for the hospital.
The pharmacist has prepared a " pharmacy letter " to provide a median for
conveying information to the medical and nursing staffs regarding new products in
the pharmacy, change of brands, adverse drug reactions, drug interactions, etc. It is
expected that this will be a regular feature of the pharmacy service to the hospital.
The Riverview Pharmacy Committee met regularly to assess and recommend
new additions to the hospital formulary, and to advise on the management and use
of pharmaceuticals throughout the hospital.
The following graphs illustrate the year's experience in the flow of medications
to patients, by individual prescription, from the Riverview Pharmacy for both inpatients and out-patients. Graph 2 reflects the volume of service to out-patients,
primarily patients on extended leave to boarding homes, and concerns only psychiatric medications provided to assist patients in their adjustment in the community
and to prevent the need for readmission to hospital.
Graph 3 indicates the volume of all types of medications provided for inpatients, and, of course, reflects the increased load on the pharmacy during winter
months when illness amongst the resident population is most prevalent.
Graph 2.
Pharmacy Department, Riverview Hospital
-Average Weekly Prescription Volume, Out-patients
1969 weekly average (10 months), 322.
 K 76
Graph 3.—In-patients
v H
1968 Weekly Average /
1969 weekly average (10 months) ,231.
Graph 4.—Average Weekly Prescription Volume, Staff
R S 3 £ 2^2 = 00
S-siri- tit-- 1
& &        %        *} 2        A        *        A *
A -^Ay
1968 Weekly Average
S   A          A    /
^ Y-.
yV^ V/
V *v/ w V
1969 weekly average (10 months), 35.
Graph 5.—Total Prescription Volume
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The Physiotherapy Department has maintained a continuous service to patients
in all areas of the hospital through two main centres located in North Lawn and East
Lawn Units. In addition, routine pre-operative and post-operative respiratory
therapy was provided daily on the Crease Unit Surgical Ward.
A comprehensive range of physiotherapeutic procedures was provided for
patients in the two centres mentioned, or on the wards, as required.
During most of the year, a full complement of fully-trained physiotherapists
staffed this Department, and in March a Psychiatric Aide (Physio) was added to
the complement.
During the latter part of the year, the staff were able to improve liaison with the
medical and surgical treatment staff, by becoming involved in the ward rounds in
North Lawn. Increased co-operation was developed with the recreational and occupational therapists in this unit, in developing special self-help equipment and individually designed activation programmes for the physically handicapped.
An additional treatment service became available in August with the installation
of an ice machine in the North Lawn Unit to provide crushed ice for cryotherapy (ice
therapy), a new treatment modality which is becoming a useful form of treatment in
selected cases.
Regular church services in Pennington Hall and the Crease Unit Chapel were
maintained by our resident chaplains, with assistance from the Valleyview chaplain
and community chaplains during periods of illness and vacation. Religious programmes were also provided to patients confined to wards in North Lawn, West
Lawn, and East Lawn.
Both chaplains were able to provide individual spiritual support for many
patients through special ward or office visits. Special attention was given to the
seriously ill patients.
The services of the resident chaplains were augmented by the regular visiting
of volunteer chaplains from the Lutheran Church and the Mennonite Brethren
Church and by representatives from the United Church of Canada.
A six-week field training course in clinical pastoral training was again conducted
during the summer at the Crease Unit, with the endorsement of the Vancouver
Council of Churches.
The Riverview Library continued to provide an active service to both patients
and staff, through the Patients' Library and the Medical Library in the Crease Unit.
Efforts were continued to expand services to patients unable to come to the library
personally. The assistance of volunteers in taking books to wards was most
helpful. A small library was set up for patients in West Lawn, as part of the increased activity programmes being developed in that unit. A collection of large-
print books was also introduced and proved of great value to our partially sighted
patients and to those with blurred vision due to drug therapy.
Various German and Chinese organizations in Vancouver generously donated
small collections of books and journals for the use of patients. These were in addition to the new books purchased for the Patients' Library, which now includes 4,905
volumes, plus 37 current journal subscriptions.
Continued efforts were made to provide a comprehensive service to staff through
the Medical Library section. There was a very noticeable increase in demands for
service from mental health centres, The Woodlands School, and The Tranquille
School. A new Xerox service was introduced and medical or other professional staff
may obtain copies of articles for their own personal use at a very nominal charge;
previously such a service could only be obtained through a lengthy inter-library loan
The Library Committee continued to meet regularly to advise and assist the
Librarian in the choice of professional texts. The Medical Library received 70 new
additions during the year and now lists a total collection of 4,013 books. Circulation
of books totalled 1,925, while circulation of journals amounted to 900.
During the year the Medical Records Department continued to study and implement new or changed procedures to improve the recording and communication of
medical record material, to best serve the needs of the patient, the hospital, and responsible authorities in the community to whom the patient is referred on discharge,
e.g., routine notices of discharge are now sent to mental health centres in the patient's
area of residence. Within the hospital, changes were made to ensure that a patient's
medical record was readily available to the treatment staff and that it would follow
the patient upon transfer to the areas.
Greater utilization of statistical data occurred during the year, particularly in
conjunction with the Medical Audit Committee's programme. The committee
changed their criteria from reviewing sample charts to a more intensive programme
of reviewing specific factors of all patients discharged from the hospital. The addi-
tional duties assumed by the Medical Records Department in order to provide significant tables of information from the basic print out of data required hundreds of
hours of manual tabulation. The utilization of this minimal amount of data illustrated
the fact that further development in statistical gauging of medical care requires
computer facilities.
The admitting offices had a number of changes during the year. Renovations
started in September, 1969, in the Crease Unit admitting suite. The new construction
will create a much better impression for the patient's initial contact with the hospital,
and will provide a more compact, cheerful work area for the admitting staff.
The main admitting office in Centre Lawn assumed additional responsibilities
on June 1, 1969, with the development of the Centre Lawn out-patient programme.
The admitting staff is responsible for registration of all out-patients in this area and
also control of the After Care appointment procedures. A pre-admission form was
introduced at this time to provide a record of treatment given to those patients who
do not necessarily become in-patients.
The primary advance in the Medical Records Department occurred in organizational planning. As a result of the formal recommendations of the Canadian Council
on Hospital Accreditation, the Department was reviewed and a draft for reorganization planned.
The reorganization plan separates the Department into three independent divisions, namely: (1) The Medical Secretarial and Stenographic Division, (2) the
Medical Record Division, and (3) the Admitting Division. With the co-operation
and assistance of the Consultant Medical Record Librarian, Mental Health Branch,
and the Classification Section of the Civil Service Commission, the first step of the
reorganization came into effect this year. The Civil Service now has official classifications for Medical Record Librarians and Medical Record Technicians. This will
enable the hospital to recruit trained medical record personnel and assume the
medical record responsibilities recommended by the Accreditation Report.
The volunteers at Riverview Hospital and Valleyview Hospital come under the
auspices of the British Columbia Division of the Canadian Mental Health Association. 1969 was their fifteenth year of service and it is interesting to note that several
of the initial volunteers were still in the regular volunteer programme.
During the past year, 140 regular volunteers (not including volunteer groups)
donated a total of 19,350 hours.
The volunteers in the Apparel Shop were kept extremely busy with 1,748
female residents receiving 11,039 articles of clothing and 776 male residents receiving 4,214 articles of clothing. The Apparel Shop was open daily Monday through
The clothing requisitions for female residents living in boarding homes were
again processed through the Volunteer Department. The Apparel Shop volunteers
were responsible for filling the orders, which were then delivered to the boarding
homes by the social workers. Wherever possible, the residents from the boarding
homes were encouraged to visit the Apparel Shop personally, permitting the patient
to have a better choice of style, colour, etc., and a better fit in shoes and lingerie.
It was noted that the quality and styles of the new lingerie, dresses, sweaters, shoes,
etc., have greatly improved.
Other volunteer activities included visiting in all units of Riverview Hospital;
Activities of Daily Living shopping; personal shopping; ward parties in R3, River-
side Unit; ward parties in East Lawn Unit and West Lawn Unit; monthly birthday
parties in Ward Fl, East Lawn Unit, and Riverside Annex; typing classes; magazine and library service in East Lawn and Centre Lawn Units; assisting in the
Occupational Therapy Departments; assisting in the Recreational Therapy Departments; personal grooming sessions; hostess service in the Centre Lawn admitting
unit; hairdressing service in North Lawn Unit; luncheons and Japanese tea parties.
In addition, special visiting was undertaken at the request of ward staff, the patient's
family, or the Canadian Mental Health Association.
The volunteer staff also received invaluable assistance in their service to patients
from many church organizations, ethnic groups, and private citizens who contributed
in a variety of ways, such as organizing luncheons, assisting at parties, providing
interpreters, etc. The hospital is very much indebted to the Canadian Mental Health
Association volunteers, and the many others who have assisted in their programmes.
Many of the residents were taken for drives and day picnics in the Canadian
Mental Health Association station-wagon. They were mainly long-term residents
who seldom had the opportunity to leave the hospital. Transportation was supplied
for two residents to visit their aged parents in Surrey and Coquitlam nursing homes,
on a regular monthly basis.
In the spring of 1968, a pilot project was started where a volunteer was assigned to work directly with the Social Service Department in Crease Unit. The volunteer's role was to provide a friendly liaison between the hospital and the community, to provide transportation, assist the resident in locating suitable living accommodation, and to continue a friendly acquaintance if the resident so desired. Three
residents were assigned to this particular volunteer throughout the year. The report
from the Social Services Department was most favourable.
The Christmas gift programme was again undertaken by the volunteers and
they obtained the use of Nurses' Home No. 5 for sorting and wrapping gifts. This
year, additional gifts were purchased to supply the necessary requirements and the
gifts donated were superior in quality to those of previous years. A special effort was
made to make the gift more suitable for the individual recipient. The nursing staff
assisted by personally choosing the gifts for each resident before they were wrapped
by the volunteers. Through a great deal of determination and effort on the part of
our regular volunteers and the various groups who helped, 2,657 gifts were wrapped
and distributed to all the wards of Riverview Hospital by the afternoon of Christmas
Eve. Gifts were also sent to Valleyview Hospital, Skeenaview Hospital, Venture,
Vista, and various boarding homes.
The Christmas Pageant was presented at Valleyview Auditorium on December
8th, 9th, and 10th. Riverview residents were invited and transportation was provided by the Recreational Therapy Department. The cast comprised of residents,
staff, and volunteers, whose combined talents were very much appreciated.
The West Lawn Unit remotivation and reactivation programme received a grant
of one thousand dollars from the Canadian Mental Health Association Cigarette
Fund, and North Lawn Unit received a grant of five hundred dollars for a similar
project. Financial help was given to assist many residents who were being discharged from the hospital. Major purchases for the wards included a piano, rugs,
toasters, record-player, records, floral arrangements, coffee percolator, and folding
The Volunteer Department had the services of a staff tailoress. This service was
invaluable to the volunteer programme and was much appreciated by both the volunteers and residents. They also had the services of two residents who assisted in the
Tailor Shop and one resident who assisted with housekeeping.
Personnel Department
During the year the emphasis has been on employee relations, with much time
and effort devoted to the cultivation and promotion of lines of communication within the many departments, in order to locate and deal with a variety of problems.
Regular meetings were held with executive members of the Psychiatric Nurses
Association of British Columbia and the British Columbia Government Employees'
Association, and frank discussions on matters of mutual interest conducted. This
saved much time and effort by obviating the need for processing through grievance procedure.
Ten active safety committees were at work within the institution and met once
each month for a review of conditions and practices within their areas. Problems
arose from a backlog of committee recommendations for the elimination of hazardous conditions. At the year-end a meeting was being arranged between the Hospital
Administrator and the Public Works Department to solve the problem.
The success of the Riverview safety programme created a Branch-wide interest
in safety, and resulted in the implementation in June of a programme for all institutions, patterned on the procedures in use at Riverview. A " Superintendent's
trophy " (a handsomely decorated shield) was donated, to be competed for on an
annual basis by the Riverview safety committees. Crease Unit was successful in
becoming the first winner and was presented with the trophy by the Superintendent
at a special dinner meeting held in February.
On November 12th, some 150 safety committee members from Riverview
Hospital, Valleyview Hospital, and The Woodlands School spent a day at the
Education Centre Auditorium for a presentation of safety films and lectures. Mr.
Tufts, legal counsel for the Workmen's Compensation Board, and Mr. Terry Law-
son, management consultant, addressed the committee members.
On November 26th a start was made on in-service training with the Riverview
dietary staffs. After an initial meeting with senior dietary staff and cooks, a systematic programme of in-service training for employees was commenced.
The Personnel Officer was involved in other projects, including:—
(a) A survey of stenographic services.
(b) The employee appraisal system was the subject of examination and discussion of a committee drawn from several departments. Committee
findings should result in a revised form of employee appraisal system,
more suited to the requirements of our Branch.
(c) A six-week course of familiarization in the application of Employee Appraisal Rating forms was given to the Occupational Therapy Department.
This course was designed to acquaint supervisory staff with the principles
and philosophy of employee appraisal and counselling. Originally designed as a three-session course, the programme was so enthusiastically
received that it was expanded to six, and will be given to other departments.
Assistance was given to the Civil Service Commission at Valleyview Lodge in
the filling of advertised vacancies and in dealing with promotional vacancies. This
Department gratefully acknowledges the assistance and co-operation given by the
staff at the Commission.
The Riverview Staff Bulletin continued to be published on a monthly basis.
 k 82 mental health branch report, 1969
Business Administration
The 1968 Annual Report reflected the attempts of Riverview Hospital to improve and upgrade many of its administrative concepts and practices. Some of
these plans were developed over the past year. Minor administrative improvements
were made in the pay and establishment offices. An attempt was made to update
the accounting system, which required a Civil Service Commission review of staffing
When medicare was introduced during the year, the Medical Care Vote was
reduced by a monthly charge of $9,200 to provide coverage under the medical care
plan for patients without individual coverage.
Alterations in the Business office and Pay office sections permitted the set-up
of a separate Personnel office and a division of Pay, Establishment, and Personnel
Functions. Some personnel paper work and duties were assumed by the Pay and
Establishment office and this has permitted the Personnel Officer to carry out new
and expanding functions.
Laundry Administration
The position of Laundry, Linen, and Clothing Administrator (Administrative
Officer I) was approved into the establishment in 1968, but a suitable applicant was
not found.
A firm of consultants, Balfour-Beatty Limited, was engaged to review laundry
and linen needs and have confirmed the original report that the hospital needs a
new laundry plant and delivery system, together with a well-qualified Administrator
to manage and co-ordinate the system.
Improvements to the laundry production were brought about by the purchase
of new dry-cleaning and finishing equipment, together with small-piece folders and
handling equipment. In addition, staff replaced several patients on two of the flat-
work ironers.
Several planning meetings were held between Hospital Administration architects and engineers, consultants and representatives of the Deputy Minister's office,
and there appeared to be unity of agreement that immediate action must be taken
to improve the laundry plant and management functions.
Dietary Department
The consulting firm of Keith Little and Associates completed their report on
the Dietary Department in March, and several of their recommendations were implemented. Dietitian's duties were reorganized to facilitate the transition into our
ultimate objective of the commissary type of operation. The bakery updated its
bread-slicing and wrapping operation with newer equipment and acquired the equipment necessary for the additional services of producing cookies and doughnuts in
limited quantities. Heated and refrigerated mobile food carts were put in use for
therapeutic diets, in North Lawn and West Lawn buildings. Patient workers, upon
whom the Dietary Department has depended, were again greatly reduced in numbers. The total patient complement was withdrawn for medical reasons from the
West Lawn kitchen, and it was necessary to get casual assistance to augment staff
in this area.
A contract was let for the renovation of the West Lawn dishwashing area. This
work should be completed early in the new year. The staff look forward to these
changes with considerable enthusiasm.
K 83
Housekeeping Department
Significant progress has been made to improve the housekeeping services.
Twelve positions approved by Order in Council in 1968, plus 20 nurse-aide position
reclassifications, will provide a core of staff to service Crease Unit and East Lawn.
Administrative changes were effected to bring about a closer control of housekeeping and related supplies, with the signing authority for supply withdrawals transferred from Nursing to Housekeeping. A method of linen handling and control
was also introduced, together with the establishment of control systems over the
issue and use of institutional ward clothing. This will have the effect of lowering
costs and improving the quality of articles being issued to patients.
Industrial Therapy
The Industrial Therapy Department had a productive and eventful year. Normal production items showed a steady increase in all departments. The trade sections took a keen interest in active and projected programmes directed toward the
updating of hospital facilities, with major emphasis directed toward improving the
patients' environment, the provision of personalized wardrobes, lockers, bed design,
and architectural improvements in ward renovations.
The Audio-Visual Division continued to provide a vital service through the
expanding library of mental health films, which is being used by an increasing number of groups and agencies throughout the Province.
Film use also increased within the Riverview Hospital. New programmes were
initiated on the wards, comprising films which will motivate discussion groups. The
films were of a clinical, travelogue, or industrial nature.
The Mental Health Branch Film Library contains 216 titles. During the year,
emphasis was placed on acquiring scientific films for staff-training purposes; films
on the prevention of emotional disturbances, and films pertaining to rehabilitation
of the mentally ill. The emphasis in mental health education is on prevention and
the scope of the Branch Film Library has become wider.
The Film Library Committee continued to provide professional advice and
guidance to the Audio-Visual staff in the selection of new films.
Transport Division
A vehicle preventive-maintenance programme was introduced in September;
this project requires the call-in and inspection of cars every 2,000 miles and trucks
every 1,000 miles. Plans have been drawn for the renovation of the transport garage
by the Department of Public Works. Orders have been raised for the purchase of
a new ambulance and it is expected that the ambulance services will be transferred
from Nursing to Transport administration as soon as the physical facilities have been
improved. The Transport Division also assists in the process of rehabilitation and
endeavours to assist patients in auto mechanics trades and to assist in their transition
from the hospital.
Communication Service
Riverview Hospital has a very active postal service, with sales during the year
amounting to $81,691.25. Provincial Government postage costs were increased by
approximately 20 per cent on November 1, 1968, which affected the 1969 working-
The switchboard continued to maintain a vital and alert service for the hospital.   The operators serviced an average of 1,207 calls on an eight-hour shift.
Emergencies of all types, such as fires, riots, accidents on wards and grounds, escape
by maximum-security patients, and many others, were handled with speed and
Barbers and Beauticians
The Barbering Department averaged one haircut per patient every 18 working
days. The three beauty parlours and seven licensed operators, who are assisted by
an average of 11 patient helpers, provided 34,955 treatments, which included haircuts, hair styling, permanent waves, and a full range of cosmetology.
Building and Grounds
An " environmental management" programme was promoted and developed
so that patients could have an atmosphere and surroundings which compliment the
therapeutic and treatment processes. For example, a " window dressing " programme was established, providing drapes for the ward areas to relieve the " stark-
ness " of the walls. This was completed in Centre and North Lawn and the Crease
Unit development is due for completion early next year. In addition, a programme
is being considered which will allow lockers and drawers for the patients so that the
patient who is capable of caring for his or her personal effects might be able to have
a place to call " his own." This programme is being followed in the West Lawn
Building, with the co-operation of the Department of Public Works, and in the East
Lawn Building, with the co-operation of the Industrial Therapy Department. Scale
models of typical wards were developed, with prototypes of the furnishings to be
Considerable time was spent in liaison with the Department of Public Works
on capital project planning. The Business Administrator was actively engaged in
the programme of renovations to West Lawn, in planning for the relocation of
patients, and in construction phasing. Excellent co-operation has existed between
the design division of the Department of Public Works and the hospital, and the
West Lawn renovations programme is continuing on schedule. Concurrent with the
construction in West Lawn, arrangements were made to occupy Nurses' Home No.
10 and to convert three of the former doctors' houses into minimal-care units for
male patients. This not only relieved the strain of overcrowding in West Lawn but
greatly benefited the patients assigned to these smaller units. Concurrent with using
the former doctors' houses for patient residences, three of the smaller staff houses
were converted into fully furnished motel-type accommodation for new employees
^arriving from the east or overseas. These are rented to the new employees on a
three-month settlement basis.
The Department of Public Works was carrying out renovations to the Crease
Unit Admitting Suite and provided a new location for the Staff Health Nurse. The
Industrial Therapy storage area and plating shop had not been activated, although
it was understood that funds for this work were available. Changes required in
East Lawn were under consideration by the hospital and the architects. The Department of Public Works was co-operating with the hospital in the provision of a
floor-renovation programme in the East Lawn Building and Crease Unit, preceding
the introduction of housekeeping services to these areas. Sanding and refinishing
of the " F " side of East Lawn and of Wards West-2 and West-4 in Crease Unit was
completed.   Carpets for the halls of these wards had not yet been provided.
K 85
Essondale Civil Defence Disaster Organization
As Civil Defence Co-ordinator for the Essondale area, the Superintendent continued to maintain contact with the office of the Zone Co-ordinator of the Vancouver area through regular Civil Defence reports and directives.
During the spring months, the Essondale Disaster Organization met to review
the situation in regard to flood potential and to evaluate possible hazards in the
event of earthquake. Plans for dealing with various types of emergencies in the
local area were also reviewed and updated.
During November, our Director of Dietetics attended a course on " mass feeding " at the Provincial Civil Defence training centre in Victoria, while another dietitian was accepted to attend a course in " emergency feeding " at the Federal training centre in Arnprior.
John Walsh, M.B., Superintendent
Bed Complement.—The installation of fire escapes on six wards resulted in
a loss of 12 beds, so that the present establishment is 767 beds.
During the year, applications for admission averaged 56 per month, an
increase of five over the previous year.
Medical consultations in the community to assess the need for hospitalization
for those persons living on the Lower Mainland averaged 42 per month.
The rate of admission was 39 per month. Although two-thirds of hospital
beds are allotted to women, an equal number of men and women were admitted.
This was accounted for by the higher turnover of male patients. Of those discharged from hospital, the average length of stay for men was 11 months and for
women it was 17 months. Also, of those patients who died in hospital, the average
length of stay in hospital was 17 months for men and 32 months for women.
About three patients per month were admitted from Vancouver Island and the
Gulf Islands.
Of the total number of patients cared for during the year, just over one-quarter
died in hospital.
Discharges from hospital averaged 10 per month, a decrease of two on the
previous year. There was a significant decrease in the number of patients discharged to nursing homes. A few years ago an equal number of patients were
discharged to self-care or to relatives and friends, to boarding homes and to private
hospitals, however, during the past year the proportion of patients discharged to
private hospitals dropped to 14 per cent. Of those patients discharged to boarding
homes, 88 per cent were able to meet care costs.
The proportion of patients requiring full nursing care in hospital is increasing
and most of these could be adequately cared for in the community and outside a
mental health facility if places could be found for them.
A reclassification of patients to assess need for supervision and nursing care
was carried out in January, 1969.
As compared with a similar classification completed in June, 1966, the
following changes were noted: —
Class 1 (minimal care) patients decreased by 11.4 per cent.
Class 2 and 3 (intermediate care) patients increased by 5.6 per cent.
Class 4 (full nursing care) patients increased by 5.7 per cent.
The increase in the number of patients requiring simple nursing care was
reducing the number of beds available for admissions and forcing a more-rigid
application of criteria for admission, thereby preventing this mental health facility
from accomplishing the task for which it is intended and designed. The work
load of nursing staff has increased accordingly.
Twenty-three patients were transferred to Dellview Hospital to relieve the
demands on Valleyview Hospital.
In the hospital, an active treatment and rehabilitation programme was maintained. A qualified psychiatrist joined the staff during the year, and the services
of consultants were available as needed.
The Dental Department plays a useful role in the total treatment programme.
Each patient is examined on admission and the necessary treatment provided.  The
K 87
need for denture service has increased, but a local dental laboratory provides
a prompt and satisfactory service.
A good standard of nursing care has been provided for patients. Reorganization of this staff at the supervisory level was accomplished, with the object of
providing better over-all supervision and guidance to staff.
The Social Service Department operated at full staff for most of the year; one
position was vacant for a few months. The reluctance of community resources to
accept patients from hospital often detracts from efforts on behalf of those patients.
The post of Director of the Physiotherapy Department, which had been
vacant, was filled during the year and an active treatment programme was again in
operation.   A part-time podiatrist is attached to this Department.
The Occupational Therapy Department has been fully staffed and maintained
its programme. Classes are held in the centre and on the wards. Three volunteer
workers, recently increased to five, provided valuable assistance. The Dahlia
Club of Vancouver continues to help with gardening projects and information, and
members made regular monthly visits to the hospital.
The Pathological Department, under the supervision of the pathologist at
Riverview Hospital, showed an increase of 50 per cent in the number of tests completed over the previous year. A technique for the semi-micro determination of
blood sugars is in use with finger-tip blood, in order to avoid too-frequent vein
puncture in certain of the patients.
The Recreational Therapy Department offered a varied programme of entertainment. Volunteers provided 3,000 hours of valuable help to this Department
during the year, and local entertainment groups were generous in time and effort
on behalf of patients.
In the area of business administration, new fire-alarm systems on all wards
became effective in January, 1969.
Work commenced in June on the installation of fire exits on six wards and
was completed during the year.
A new bulk gaseous-oxygen system was installed in May and is a considerable
improvement over cylinder oxygen used previously.
An accident-prevention programme was organized in July with a view to
reducing the incidence of accidents and the resulting time lost from work.
This hospital has a complement of 239 beds—150 female and 89 male.
Admissions from the community averaged six per month. A rehabilitation programme has enabled the hospital to return patients to private placements, boarding
homes, and nursing homes. The number of patients in the community, but still
on the hospital register, averaged 43 during the year.
Two patients were discharged to the Jubilee Hospital extended-care facility.
Medical coverage for patients has been satisfactory, and the diagnostic and
treatment facilities of the Jubilee Hospital have been used increasingly.
Regular sessions at the hospital by the Director of the local mental health
centre have provided good psychiatric service.
Dental, ophthalmic, and podiatry services are provided on a fee-for-service
A good standard of nursing care has been provided for patients and the ratio of
graduates to aides has increased because of the greater availability of graduates.
The standard of nursing care continues to improve.
In-service training has been stepped up and, where possible, nurses are sent
on courses to Vancouver.
Emphasis is placed on the programme of recreation, and the help of local
volunteers and other agencies makes it possible to provide a satisfactory entertainment programme. An interesting feature of the programme is that patients who
have been discharged from the hospital may take part in the programme and every
effort is made to encourage their participation.
This hospital has a complement of 300 beds and provided care and treatment
for 289 patients. Fifteen patients were admitted from the community, and 27 patients were received on transfer from Valleyview Hospital. Two patients were
discharged in full to the community.
The patient population is decreasing. Due to the hospital's geographic isolation there is not a sufficient demand for beds in this area, and it is not possible to
keep the beds filled to capacity by transfers from Valleyview Hospital, because
patients cannot be separated from relatives and friends. Staffing and maintenance
of the buildings has always been a problem. The resident population as of December 31, 1969, was 237.
Satisfactory medical services were provided by a local physician on a part-time
basis. The services of the Mills Memorial Hospital are available for diagnostic and
surgical procedures.
Despite a low nurse-to-aide ratio, a satisfactory level of care has been maintained.
Occupational therapy was provided for many of the patients, and a good woodworking shop is of especial value.
With the help of local volunteers and several fraternal and church organizations, an extensive programme of entertainment and recreation was provided.
Assistance was given to a few senior nurses to enable them to attend educational courses in the Lower Mainland, and instructional classes for aides were provided by the Department of Nursing Education as part of the programme of
in-service training.
The heating plant was converted from coal to gas during the year and this
should ensure a more consistent supply of heat to the wards.
A. Pauline Hughes, M.D., B.Sc, C.R.C.P., Superintendent
This past year has been one of considerable change for The Woodlands School.
The policy decision of regionalizing the institutions for retarded will make it more
feasible to provide a specialized type of service. Although a catchment area of
Mental Health Regions 2, 3, 4, 5, 7, and 8 is still large, it is more consolidated.
The fact that the waiting list will be decreased by one third, now that this responsibility is shared with The Tranquille School, will mean that more pre-admission
and in-patient service will be available. The increase in community facilities for the
retarded has been very encouraging. These facilities cannot meet the need of the
physically handicapped child or adult. Until extended-care units accept more responsibility for all ages and not just geriatric patients, the minimal services that The
Woodlands School can offer to families having to continue to provide 24-hour nursing care in their own homes will not be adequate. It is expected that the Eric
Martin Institute will provide a measure of relief until Glendale Hospital is completed. Many of the highest priority cases on the waiting list will be admitted to the
Hospital Unit when some of the present patients are transferred to Victoria.
The opening of Alder Lodge, in the Municipality of Coquitlam, provides a
setting in which the staff can prepare residents for living in small residences. The
transfer of 50 residents to Alder Lodge permitted the reorganization of the total
population at The Woodlands School.
1969 was a busy year for renovations and construction. Alder Lodge required many changes, and the centre block of wards 72, 73, 74 were completed.
Although these wards are in an old building, the alterations and bright colours have
provided a very acceptable face-lifting. The first phase of the three-phase Industrial
Therapy Building is occupied, although not completely finished.
The possibility of construction of new ward facilities, instead of renovating old
buildings, is encouraging. The plan to reconstruct some of the accommodation on
a regional basis will make the role of the institution more in line with current trends.
To confine construction in this site to the minimum buildings required to meet very
specialized needs, will permit a more-comprehensive definition of the function of
The Woodlands School. The Woodlands School is being recognized as the resource
for children and adults unable to adapt to community facilities. The function of
The Woodlands School should be to evaluate and assess the problem and then provide the specific programme that will make it possible for the individual resident to
return to the community as quickly as possible. To carry out such a role, The
Woodlands School is dependent on appropriate services being available in the community, adequate physical plant and equipment, and the availability of adequate
staffing. The staffing must be of the quantity and quality to permit carrying out a
specialized service.
The waiting list on January 1, 1969, was 275. There was a gradual but sustained increase during the year, with an average 12 new cases being added, and an
average of 11 names being removed each month. The waiting list at September 30,
1969, after 106 files were sent to The Tranquille School, decreased to 199.
During the year, approximately 70 patients were given 30-day admissions, to
provide family relief and assessment of their condition. Short-stay hostels, developed by the local chapter of the Association for the Retarded Children of British Columbia, decreased the need of The Woodlands School to provide a routine family
relief, and the accommodation has been utilized to provide assessment and short-
term treatment.
Although a number of patients were moved into community resources, this did
not relieve the pressures for admission in the Hospital Unit, nor on the ward for the
treatment of childhood psychosis. The move of patients suitable for extended-care
facilities to the Eric Martin Institute will relieve much of the pressure in the Hospital Unit.
The Waiting List Committee, chaired by the Deputy Superintendent and composed of Unit Directors, nursing administration and social workers of the Hospital,
Training, and Psychiatric Units, met every second week to discuss admissions. The
meetings were valuable in co-ordinating the admission and transfer of residents between the three units. The committee arranged admissions according to priority on
the waiting list, and served as a valuable means of communication between the units.
A weekly meeting of the Deputy Superintendent and the Director of the Social
Service Department dealt with requests for service, such as applications for the
waiting list, temporary admission, request for out-patient assessment, or for transfers
from other institutions.
Since 1965, The Woodlands School has been divided into three separate functional units—Hospital, Training, and Psychiatric. Each unit serves an in-patient
group, as well as the appropriate part of the waiting list, and provides the clinical
team an assessment of assigned cases in the Out-patient Department. This organization encourages involvement in the continuum of care for the retarded.
All new admissions were discussed at a multi-discipline diagnostic clinic, at
which time diagnosis was coded for statistical purposes, a prognosis agreed upon,
and a programme prescribed to help the individual patient reach that prognosis.
Diagnostic clinics were held weekly and served a secondary purpose of education
and orientation for various university groups.
The Hospital Unit continued to give a high standard of medical care. The
team approach remained the basic concept in regard to treatment and training. It
is important to emphasize that this high standard of care is only possible due to the
dedication of the staff, who work in many areas under difficult conditions. The
renovation of some wards will permit improvement of programmes. Low staff-to-
patient ratio is a continuing problem in providing patient care.
A programme for the blind started on Ward 21 as a pilot project in 1966 and
its usefulness is apparent. By transferring all the blind children to one ward, there
is better utilization of facilities and staff. This area will be included in the future
planning of renovations.
This Unit has been without a Director for a time, and is indebted to Dr. Brooks,
Deputy Superintendent, who has been Acting Director during this period.
Over 300 of the residents took part in a variety of successful programmes
during the spring of the year. Because of structural alterations, the movement of
residents to Alder Lodge, and the redistribution of others, programmes were
somewhat curtailed after the summer vacation.
Twice during the summer, Training Unit residents took part in the day camping programme at Gold Creek Camp.    The continued enthusiasm of staff made
each resident's camp-day a highlight of the year.    The location of Gold Creek
Camp, with its surrounding scenery, makes this a truly beautiful setting.
This was the first year that an appreciable number of residents of the Training
Unit were placed in the community. The Alder Lodge programme was developed
specifically for pre-placement training. It had 50 residents (35 men and 15
women) and is considered an additional Training Unit ward. A " neighbourhood tea," held on October 14, was attended by approximately 200 guests, and
almost 500 staff from The Woodlands School visited during a special Open House
Day two days later. Trainees were transferred within the next few weeks. Whenever possible, service and programming will be provided by the community rather
than by the institution. Recognition that those admitted from the waiting list
require a higher staff ratio resulted in an increase in the nursing establishment of
the Training Unit by 14.
Dr. Stringer was Acting Director of the Psychiatric Unit until Dr. Tamir's
appointment on September 1, 1969.
Unit meetings held every second week, and routine ward clinical team meetings, were used to evaluate and plan general programmes, as well as to meet the
needs of the individual patient. Staff eagerly supported the development of a therapeutic community for the male security ward, which will be supervised by the Unit
The ward for the treatment of childhood psychosis continued to be a very
active area. Ward staff organized an operant-conditioning classroom, as well as
a pre-kindergarten programme. Evaluation of the children showed a significant
deficit in the auditory component of speech, and programmes were concentrated
on this need.
Programming in the Psychiatric Unit was hampered by the inadequacy of
ward structures, made temporarily worse because of renovations, as well as a low
staff ratio. The over-all change of patient population in the Psychiatric Unit has
taken place gradually, and the needs for increased staffing are not as apparent as
they were in the Training Unit in connection with the move to Alder Lodge.
The Out-patient Department continued to supply a complete medical, social,
and psychological assessment for the retarded and their families. Recommendations were made in the knowledge that the ideal plan was not always realistic at
the time, because of the lack of certain community resources. Recommendations
were classified as (a) available; (b) difficult to obtain; (c) unavailable. The
conclusions and recommendations were discussed with the family or agency attending the Out-patient Department, and a report was sent to the family physician.
Success of this service is indicated by the increasing number of requests for appointments. This service was not entirely a means of gaining long-term admission to
The Woodlands School, as this is the recommendation for only about five out of
the sixteen new cases seen each month. Counselling and follow-up services were
limited, but it is planned to expand this aspect once Tranquille has its own Outpatient Department. Dr. Tischler continued to see an average of three phenyl-
ketonuric cases a month. Because of her expertise in this field, it is fair to say that
the Department has contact with all known cases of phenylketonuria in the Province.
It is hoped that time and staffing will permit evaluation of the service being
given through the Out-patient Department.
 K 92
" Green says ' Go' " and Billy takes big steps in the simulated cross-walk in the
" Play-to-Learn " classroom of Mr. J. Erdelyi. Field trips to real cross-walks will follow
as part of preparation of community living.   Future teachers are observers.
A sunny arcade joins the boys' and girls' wings of Alder Lodge, the home in a
residential neighbourhood where young people adapt to life in the community before
moving out to boarding-homes.
K 93
The 11 established positions were filled during the year. Part-time and
sessional physicians were employed when full-time staff was not available. There
is still a need for more psychiatrists, but the Department was fortunate in the
numbers and quality of paediatricians available. Many physicians, in addition to
their recognized duties, gave educational service for both in-service and visiting
groups from the university, and the community also participated in research projects.
Medical grand rounds were held monthly, at which important topics were presented,
often by a professor from the university, or one of the staff consultants. In
September, weekly medical rounds in the Hospital Unit were commenced, which
were usually case presentations at the ward-level. Often physicians from other
hospitals, such as the Health Centre for Children, participated in the formal discussions. These have broadened the training available for the paediatric resident,
who spends a two-month rotation at The Woodlands School. When psychiatric
residents are included they will also gain a worth-while perspective of the field of
mental retardation. Our consultant staff were most helpful. There was an extension of service for learning disorders available through the Health Centre for
Children and the Western Institute for the Deaf. Supervision of the Chromosome
Laboratory by the Department of Genetics was appreciated by this Department.
The Radiology Department operated with a technician three days a week.
There were approximately 3,800 films taken during the year, which were sent to
Riverview for interpretation and reporting.
The Physiotherapy Department provided approximately 5,700 individual treatments during the year. There was an increase in the admission of physically
handicapped patients.   This was a very busy and worth-while treatment area.
The Medical Records Department maintained its usual high standard, in spite
of numerous staff changes. The Supervisor of Medical Records was appointed
chairman of a multi-disciplinary Records Committee, and held monthly meetings
to evaluate quantity and quality of the clinical files and review forms. An increasing
number of community placements and admissions added to the work load of the
stenographic and clerical staff.
During the year, the Dental Department placed greater emphasis on the
importance of treating dental disease in children with mental retardation. It recognized that untreated dental disease can severely restrict the child's progress. Specific
steps were taken to produce concrete results in improved dental care. Social
workers remarked on dramatic improvements in the emotional behaviour and
attitude of patients as a result of the dental treatment they received.
Later in the year, general anaesthesia became available at The Woodlands
School to permit a wider dental service. Dr. Baja, the dentist, found that the use
of a direct personal approach to each individual patient added to the ease in
performing chairside procedures. The 1970 outlook for the Dental Department
is optimistic.
This Department expressed concern over the staffing patterns for nursing care
of residents of The Woodlands School. The tabulation on page 94 illustrates the
present situation.
Staffing patterns in the Hospital Unit do not permit consideration of total
nursing care, but nevertheless an excellent standard of basic nursing care is given.
Wards in this unit, apart from the Isolation Ward, do not meet the B.C.H.I.S.
recognized standards of 2.5 nursing-care hours for " extended care."
Miss D. A. Schultz was appointed Instructor of In-Service Education and
1970 will be a year of general upgrading for nursing personnel. Prior to October,
Miss Schultz was residential public health nurse. Under her direction, immunization programmes were kept current. The heaviest part of her responsibility was
to attempt to prevent and control outbreaks of infectious diseases. Three infectious
diseases showed increases in the past year, namely erysipelas, ringworm, and
Salmonella. The consultant dermatologist showed that the spread of ringworm was
due to bare feet, and staff education programme seemed to control its spread.
Salmonella was diagnosed in 11 patients, one of whom died of Salmonella pneumonia and meningitis. Over a three-month period all staff and patients in affected
areas were screened for carrier status. Visiting and admissions were restricted.
Control and prevention of spread was easier than anticipated, and this was attributed
to the effectiveness of the multi-disciplinary in-service education carried out during
the previous winter and spring.
One of the deterrents to better hygiene at The Woodlands School was the
continuing lack of adequate toilet, washbowl, and bathtub facilities. As the intellectual level of the residents admitted continues to drop, the lack of sanitary facilities
will have an increasingly deleterious effect. Newly renovated wards were being
planned at a satisfactory level.
The ratio of nurses to psychiatric aides remained fairly constant, and averaged
as follows:—
Hospital Unit (10 Wards)
Per Cent
Registered nurses   11
Psychiatric nurses  42
Psychiatric aides  47
Psychiatric Unit (10 Wards)
Psychiatric nurses   60
Psychiatric aides  40
Training Unit (14 Wards)
Psychiatric nurses  52
Psychiatric aides  48
The Department of Nursing spent some time with visitors from the Royal
Jubilee Hospital and with the Nurse Consultant from B.C.H.I.S. to familiarize them
with the nursing care in the Fraser View Building. The Superintendent of Nurses
spent considerable time with the Director of Patient Training and Education in
surveying the needs of patients, as well as the numbers and type of staff required
for the developmental programmes which will be available for the residents.
A Director of Training and Education was appointed on June 1, 1969, allowing The Woodlands School to proceed once more toward co-ordinating programmes
into a total spectrum of purposeful training and education. At the year-end nearly
all positions (including those in occupation therapy, recreational therapy, academic
school and pre-school, and the ward activity training programmes) were filled by
K 95
qualified staff. In addition, the services of an education specialist to help supervise
and support developmental programmes were secured.
The objective for the training and education programme, which involves about
850 residents, is to provide an appropriate series of learning experiences for each
resident, directed toward the achievement of his own goal, as specified by the clinical
team. For example, supervised life in the community is such that a goal for many
moderately and severely retarded young people, and the preparation of a pre-
placement curriculum in the new centre at Alder Lodge, and also at The Woodlands
School, was a major effort this year. The ability to handle a job is part of another
such goal for many residents, and systematic evaluation and progress reports were
started by the Vocational Department. The academic school was able, for the first
time, to limit its enrolment to those pupils who were capable of functional literacy,
as other residents were placed in the community or enrolled in pre-placement preparation.
This year also brought a variety of difficulties arising from our growing recognition of goal-directed training and education; for instance, the wholesale movement
of residents seriously disrupted development programming by nursing staff through
the fall. The accurate measurement of progress and the deployment of materials
demanded far more in the way of records, reports, inventory, etc., than current
clerical personnel could provide.
The Director of Training and Education has shown leadership and provided
a valuable link with the university. It has been gratifying to have the assistance and
sympathetic scrutiny of an unprecedented number of university students who worked
in this Department as students or volunteers.
All social work staffing positions were filled with fully trained and qualified
people. Three highly experienced workers resigned during the year and, fortunately, were replaced by three enthusiastic candidates. A great deal of each social
worker's time was spent on waiting list, admission procedures, out-patient service,
and community placement, however they still found time to be a member of a number of ward clinical teams. When waiting-list business is diminished next year,
more direct service will be offered to the residents and their families.
The recent increase of community resources made heavy demands on the Social
Service Department. Approximately one-third of all occupied community beds
were made available during the year for the first time.
The seconding of a social work position to the Victoria Mental Health Centre
was of considerable assistance. This social worker was able to give direct service
to families of retarded persons on the waiting-list, and in other cases recommended
alternate resources to families, that would be more suitable than admission to The
Woodlands School.
Mrs. G. Wing has been Acting Director of the Psychology Department since
the appointment of Mrs. Woodward as the Director of Training and Education in
June. For the two previous years, Mrs. Woodward was on intermittent educational
leaves to obtain her Ph.D., and assisted in programme planning for the Training
Staffing patterns in this Department have not encouraged the psychologists to
participate as members of the clinical team. Much time was taken up with diagnostic testing.
A total of 9,521 volunteer-hours of direct service were contributed during
1969. The indirect-service groups continued to support residential programmes,
providing money, material, and equipment. Ninety-five residents had corresponding sponsors. Ten yearly birthday parties for each ward were sponsored by the
Auxiliary to The Woodlands School and the Volunteers. Recognition of their valuable service was given to the Volunteers on two separate occasions this past year;
a tea for the teenage Volunteers and their mothers was held on May 3rd, and a reception and banquet took place on October 8th.
Approximately 800 residents were sponsored to see the Christmas lights,
through the generosity of the British Columbia Hydro and the Lions Club. Numerous articles of clothing were distributed by the Apparel Shop. Radio station CKNW
continued to be a generous sponsor of residents, at Christmas and throughout the
year.   Many service clubs contributed time and financial support.
The staff establishment was increased this year by 52 new positions, 38 were
assigned to Alder Lodge, and 14 to the Training Unit (see "Training Unit" on
page 90).
Fourteen staff positions were reviewed by the Classification Division of the
Civil Service Commission.
Recruitment was good, with the exception of two senior professional positions,
the Director of the Training and the Head of the Psychology Department. Staff
absenteeism due to illness declined by 10 per cent during the year. Letters of commendation were sent to all staff members who had three years or more continuous
service without absenteeism.
Regular meetings were initiated with representatives of the Psychiatric Nurses
Association and the Government Employees' Association. These are an effective
means of communication and have improved relations between the administration
and staff.
Mr. Hayes, Business Administrator, served as a member of the Branch Safety
Committee. Many staff attended the safety " kick off," which was organized by the
committee, and the staff was represented at the Annual Safety Conference in Vancouver. The Schools' committee continued to be active and effective. Time-loss
by staff due to accidents was down considerably in 1969. A semi-annual safety
competition was sponsored and an award presented at a special dinner held in
October. Three members of the Safety Committee attended a course sponsored by
the Vancouver School Board and Mrs. Connell achieved the highest standing of
those enrolled.
Mr. Hayes chaired a Core-Committee to co-ordinate and plan all preparations
for the opening of Alder Lodge. The committee was very successful and the final
move of the patients in October was accomplished with only a minimum of problems.
The Housekeeper continued to experience difficulty in maintaining adequate
laundry and linen services, but it is expected that improvements in the central laundry at Riverview will result from the Consultant's report. The Dietary, Pharmacy,
and Hairdressing Departments continued to provide a good standard of service.
K 97
Building and Grounds
Renovations of the wards in Wing 2, Centre Building, were completed, also the
basement area, which is used for patient programmes.
The new Industrial Therapy Building was a welcome addition to the facilities.
The new areas provided are a cabinet shop and a paint shop, while the upholstery
and sheet-metal work have improved facilities. The four cottages were provided
with fire escapes, and new fire doors were installed in the interior ramps. Plans
were being drawn for improved ventilation of these four buildings. Additions were
made to each cottage to provide garbage and linen storage areas.
A new semi-automatic switchboard has improved the communication facilities.
Renovations for Wards 32/33 in the Fraserview Building provided improved
toilet and bathroom facilities, as well as a new dining area. Extensive renovations
were made at Alder Lodge. Heat detectors were installed in a number of the buildings.   The installation of a new fire-alarm system should be completed next year.
The staff of The Woodlands School benefited from the Workshop on Capability,
which was jointly sponsored by the Public Trustee's Department.
The Nursing Department gave two groups of 20 nurses in-service education
on administration and supervision. Multi-discipline programmes were found to be
constructive and many different departments contributed to their success. Numerous staff attended institutes, conventions, and seminars during the year.
Lectures for student psychiatric nurses and psychiatric aides were sponsored
by the Department of Nursing Education, and several lectures were given by the
staff of The Woodlands School. All new staff were given a six-hour orientation of
the institution by Unit Directors and various department heads.
Three members of the nursing staff were granted educational leave of absence
and another was enrolled in the Executive Development Training Programme. The
housekeeper and four supervisors were enrolled in a training programme at Riverview for housekeeping personnel.
The Woodlands School feel an obligation toward public education in the field
of mental retardation. For this reason, various student groups and community organizations were provided with speakers, or an opportunity to learn the methods
of helping retarded persons. Visiting groups spent varying lengths of time, from a
half-day orientation, to a five- to ten-day workshop, or a full placement of several
months. So much staff time was involved in these education programmes that routine visits of high school students and first year university students were dispensed
with, and, as an alternative, a restricted open house was being planned for the spring
of 1970.
Two clinical papers were published, two submitted, and two others ready for
publication, in which one or more of the staff were co-authors. Additional projects
under way this past year were:—
(a) Dr. T. L. Perry, Professor, Department of Pharmacology, University of
British Columbia, and staff of The Woodlands School, were carrying out
biochemical evaluation of mothers of mentally retarded children, especially in instances of more than one retarded sibling.   One unusual situ-
ation, in which the mother was discovered to have biochemical findings
similar to maple syrup urine disease, was being further investigated.
(b) A report and film by Dr. H. Dunn, Professor, Department of Paediatrics,
University of British Columbia, on an unusual case of subacute sclerosing
panencephalitis was submitted and accepted for presentation to the Royal
College of Physicians and Surgeons. Recent literature attributed this
condition to the measles virus, and further research will be conducted.
(c) Dr. W. H. Gaddes, Professor, Department of Psychology, University of
Victoria, was conducting a study on the effect of Vitamin B12 on the
learning abilities of mentally retarded. Dr. M. C. Ellis and other persons
on staff of The Woodlands School were co-ordinating this study.
(d) Dr. H. Patel, Department of Paediatrics, University of British Columbia,
was continuing research at The Woodlands School on carotinemia in mental retardation.
The positive changes during past year, which clearly defined future trends,
were encouraging. It was a year of greater community development and involvement, that highlighted co-operation among staff of The Woodlands School, and constructive relations with other governments and outside agencies.
K 99
J. Bower, M.D., D.P.M., Superintendent
1969 has been an exciting year for The Tranquille School. Early in the year
the School was advised that it would become self-sufficient and take over its own
part of the waiting list previously administered by The Woodlands School. The
policy of the Mental Health Branch was for The Tranquille School to admit patients
from Mental Health Regions 1, 2, and 6, while The Woodlands School would admit
those from all other regions.
The planning of the regional function ran along many lines and The Tranquille
School team had to consider division of wards, provision of extra staff, the planning
teams such as that for the Out-patient Department, and numerous other items. At
year-end, the regional function was in effect, but no regional admissions on a long-
term basis had taken place because the division of wards required for admission
purposes had not been accomplished, however, this is expected in the very near
Virtually all of the staff required to operate regionally are now working at The
Tranquille School.
The School has a waiting list of 160 requests for admission, and this is being
administered by the Admissions Committee team.
During the year, the Medical Superintendent attended a course in psychiatry
at the University of British Columbia, while the Senior Clinical Physician, Dr. M. S.
Neave, also attended one in child neurology at the same medical school.
Dr. G. Tomm, a part-time physician, continues to help in the clinical work of
the School and during the year there have been two resident physicians, other than
the Medical Superintendent, who reside at the School and take part in the clinical
work and duty list.   The last of these physicians arrived during the summer.
The medical services are administered by the Medical Superintendent, Senior
Clinical Physician, and Dr. V. Neumann, who are full-time staff members.
During the year a consultant service embodying all of the specialists in the
nearby city of Kamloops was set up on a rotation system. It is designed firstly to
see that all specialists willing to do so can be associated with The Tranquille School,
and secondly to make The Tranquille School another facility of the medical community of the area.
Many patients were admitted to the Royal Inland Hospital in Kamloops for
various procedures and treatment, and it was necessary to transfer some to the
medical facilities located at the Coast.
Many integrated programmes of a clinical nature, involving the chief members
of the professional staff, have been inaugurated and are being followed through to
the advantage of all concerned.
The Dental Department continues to function with the part-time services of
two dentists.
During the year there were four deaths and no outbreaks of serious illness,
although, in the spring of the year, there was some trouble with a slight epidemic
of influenza.
The Medical Officer of Health for the South Central Interior Health Unit in
Kamloops provides considerable assistance to the School.
Early in the year, Mr. David Brasset, the senior social worker, transferred as
the psychiatric social worker at the Mental Health Centre in Kamloops. He was
succeeded by Mr. H. K. Maerzke. Later, another social worker, Mrs. K. Consta-
baris, was engaged, and Mr. Maerzke's team is now backed up by three other
Mrs. Alic Harmon, a psychologist from Springfield, Illinois, joined the staff.
When the position of Director of Training and Recreation is filled, The Tranquille School will then be able to accomplish its full objectives in the training of the
mentally retarded to enable them to adjust to an outside environment.
The boarding home placement areas has been extended to include Fernie.
In 1969 the Nursing Department was active in many areas of school work
other than strictly nursing duties, and the Director of Nursing has given valuable
assistance to the regionalization team and to other departments.
During the year there were numerous changes in the Department.
Mrs. D. Thoen, Associate Director of Nursing, and other nursing-staff members, have contributed greatly to the clinical teams that now function in the School.
This Department is functioning to capacity under the Acting Director, assisted
by a member of the Recreation Department, together with a staff of occupational
therapists, recreational therapists, and workers from the Department of Nursing.
Scouts and Guides have enjoyed the activities of Camp Blackthorn, where they
live in a tenting situation. A large log cabin at this camp has been completed by
the Scouts under the direction of their Scoutmaster.
Kamp Kiwanis, established by the local Kiwanis Club, continues to supply
healthy and enjoyable holidays to the trainees at The Tranquille School.
During the year, this school held its Annual Carnival Day, with the crowning
of the May Queen and an enjoyable Pine Crest Barbecue. A school float won a
prize in the local Kami Overlander Days Parade.
This Department, ably directed by Mr. E. V. R. Merrick, with the assistance
of Mr. J. Philpot and office staff, has continued to provide a most efficient and comprehensive service to the total programme.
Fire Protection
Completion of the water distribution system for fire protection, together with
the installation of all new No. 1 TC hydrants, was accomplished, and The Tranquille School electricians were proceeding with the installation of the new fire-alarm
During " Fire Prevention Week," Fire Chief Murphy held an " at home " at
the fire station, during which many interesting and informative demonstrations of
the work of our Fire Department were given. This event aroused considerable
interest on the part of the 140 people who attended. It is hoped that this " at home "
will become one of the annual events of the year.
K 101
The Dietitian is evolving interesting dietary programmes, and standard of the
meals is excellent. During a day, the average number of meals served is 2,126 to
1,950 patients and 176 staff.
The Tranquille Laundry operates on a 7-day-week basis and provides good
service to The Tranquille School and the Provincial Men's Home in Kamloops.
Some of the trainees work in the laundry under supervision of staff workers.
Laundry, mending, discards, staff and trainee clothing issue and control, and
linen issue and control operate through the laundry area under the general supervision of Mr. E. Pyle and his assistant, Mr. G. Angus.
The four staff members do a very good job of maintenance and repairs on the
seven school vehicles.   In addition, they attend to a very large driving programme.
A new supervisor, Mr. W. Noblet, was engaged. Four more people were
recruited to the Housekeeping Department, and the women cleaners in the Greaves
Building were reclassified from Cleaning Assistants to Building Service Workers.
The Department maintains a high standard of cleaning and maintenance, including
the repairs and servicing of everything from electric razors to mechanical beds and
Two men work in this area.
The year's total purchase  $541,178
Service charges       49,612
Shoe repair (included in service charges)          3,565
Dry-cleaning services (included in service charges)          2,337
Grounds, Building, and Housing
Highlights of this programme included the laying of a new floor in the recreation hall, together with interior decoration and new drapes. The Central Building
basement area has been completely renewed.
Two washrooms for trainees use have been completed in Hayes and Cooney
The dairy homogenization plant has been completed and major alterations to
the cow barn are currently under way.
Alterations are being made to provide additional office accommodation in the
Administration and East Pavilion buildings for the extra staff required for the regionalization programme.
This has been a very good year for The Tranquille School, with many developments taking place, and it is hoped that this will continue to motivate everyone in
the institution.
All members of The Tranquille School staff have co-operated to the utmost
degree in giving of their best to the trainee/patients.
Dr. Peter A. Lavelle, Director
This Unit was established in August, 1969, to provide intensive psychological
treatment in a residential setting for 45 children; to provide treatment for a further
20 adolescents in a day clinic; to establish a training programme for child care counsellors; and to carry on research in staff selection, in outcome of training, and into
the most effective therapy for adolescents. The Unit consists of three " home " units,
each of which can accommodate 15 children, a gymnasium, swimming-pool, and outdoor-games area, and an administration block containing conference hall and offices.
There is a cafeteria and a seven-classroom school also within the well-landscaped
At the year-end, two of the homes were in use, one as a Day Clinic, the other as
a Residential Unit, and both were treating adolescents 15 to 17 years of age. It is
anticipated that the third home will open in the spring of 1970 and will cater to the
12- to 14-year-old age-group. Once these two homes are functioning well, it is
envisaged that the Day Clinic will be moved to other premises, and the building in
which it is at present located will then be used for residential treatment.
The Unit is now on a three-shift basis, and is staffed by Child Care Counsellors
who were recruited early in the year and given a three-month orientation course prior
to opening the first home in August. The social workers were recruited and were involved in intake and discharge arrangements and providing therapy, when needed,
for the families of adolescents in treatment. In general, the method of whole family
groups is used. In the case of families living some distance away, arrangements are
made, where possible, for the local social worker to undertake treatment. The Director is a child psychiatrist, with wide experience of out-patient and residential
treatment of children and adolescents, as well as family therapy. In addition to his
administrative duties, he selects children for admission, plans and supervises their
treatment, and runs the staff-training programme.
The basis of therapy is good individual relationships between the counsellors
and children within a therapeutic milieu which caters to adolescent needs. They are
encouraged to take responsibility in planning their programme, their school activities
and home activities, to expect age-adequate behaviour from each other, but also to
tolerate regressive or acting-out behaviour. The emphasis is on self-help, within a
relatively free programme, in an " open door " non-custodial setting. Adolescents
are selected on the basis of treatability, which is their capacity to stay in this setting,
to verbalize their problems, and benefit from group therapy.
A daily log is kept in which both the youngsters and counsellors recount the
day's activities, and differing accounts are discussed at the shift meetings held each
morning and evening. Both staff and adolescents participate in some of the case conferences which are held regularly on each child.
In addition to using a reality therapy approach, the Unit uses Gestalt therapy,
a group-based personality integration technique devised by Dr. Fritz Perls.
K 103
Staff Training
In preparation for opening the Unit, staff selection and ordering of equipment
were completed early in the year. The counsellors began an orientation course on
May 2nd which was aimed at fostering open communication, and encouraging the
formation of trust and interdependence, to facilitate good team work on each shift.
The topics afforded some idea of the group's ability to read discriminatingly and
assimilate new material, to work constructively together in covering the field and presenting the material. In the course of learning a new skill, they revealed personal
qualities of leadership and teamwork. The counsellors organized their own programme for swimming and life-saving and for first-aid Red Cross certificates, in
which all were successful.
Toward the end of the third month the counsellors organized a residential
experience during which they played the parts of both counsellors and adolescents.
Following this and at the request of the Minister of Health Services and Hospital
Insurance, some adolescent boys aged 15 to 17 were admitted. Most of these were
children who had not yet been placed by local agencies, or whose summer placement
had broken down. After the children had been returned to their agencies, the staff
spent a week discussing the experience and formulating a plan of operation.
Direct Service
The first residential home was opened on September 8th and eight boys were
admitted, mostly selected from the previous group, at the request of the counsellors.
There were some difficulties over control, and also over the temporary lack of equipment. At the year-end, the residential programme was going well, and some teenage
girls were about to be admitted.
Of the 12 boys admitted in the first two months of operation, five left and
the remaining boys settled in well and a successful outcome is expected for them.
The Day Clinic started on September 15th, admitting three girls and two boys.
It has continued to grow and is expected to have 15 adolescents by the end of the
year. The programme includes use of gymnasium, arts and crafts, some remedial
school work, educational outings, music, all done on a group basis, and therapy is
provided by two encounter groups and one Gestalt therapy group weekly.
Training and Education
In-service education continues with one full day per week for each counsellor.
This usually includes case conferences and study of case histories; a Gestalt therapy
session; and " academic " session, which may include a lecture and discussion or
reading. There is also opportunity for improving skills in games, activities, arts and
crafts, and learning to teach these, and acquiring skills in using equipment.
In keeping with Mental Health Branch's intention to improve services for children, negotiations are continuing with universities and other institutions aimed at
setting up a formal training course for child care counsellors. Since the standard was
set in this Unit of employing people with degrees, and paying a good salary, two
other agencies have accepted the standard and a third is in process of doing so.
The demand for a training course is rapidly increasing and at present it appears
likely that three courses are required—a postgraduate course for those who wish to
specialize in treatment; a more programme-oriented course for workers with Grade
XII education; and an in-service course for all other workers now in the field, to
include all group homes and professional foster parents.   It is anticipated that at
least one of these courses will be starting by 1970.
Another course for which a demand has arisen is for educateurs. This profession, now very popular on the continent of Europe, is a combination of teacher and
child care counsellor, enabling the educateur to work in the whole range of child
care facilities. The Mental Health Branch is also interested in the possibility of
assisting the development of an educateur programme in one of the local universities.
Full records are being kept on all the counsellors so that further selection
methods can be refined and the outcome of the training experience evaluated. It
is intended that these results will be written up for publication when the data are
Dr. Denis C. Shalman, Director
The Psychological Education Clinic began the year in borrowed premises.
When four lower classrooms in the school became available, the Clinic moved to
the new rooms, along with the two classes that were under the direction of Dr. A.
Cashmore. The children admitted into these classes had learning problems and
severe behaviour disorders. Most of them were either out of school or in the process
of being expelled from school. The programme was relatively successful and some
of the children were returned to the regular school system by the end of the school-
year. During this same period, the community, particularly the schools, became
aware of our service and we extended diagnostic assessments and consultations to
the schools and other referring sources.
Since September, the school has been opened and all the rooms have been in
use. Additional facilities used by the school as part of the programme are the gymnasium and swimming-pool. The school has the gymnasium and swimming-pool
for one hour, five mornings a week. Two of the classrooms are under the direction
of Dr. Cashmore and his unit, although the teachers and children are the responsibility of " The Maples " school. The Psychological Education Clinic was scheduled
to have a section in the new activities building, but due to lack of facilities for the
staff in the Residential Unit we moved to a section in the Family and Children's
Clinic where we occupy seven offices, a specialized testing-room, three one-way
observation rooms, and a storage-conference room. This has the decided advantage of keeping the unit close together, but the disadvantage of being removed from
" The Maples " school. In the new activities building there is a large observation
room, an audiometic testing-room, and a special testing-room which will be available to the British Columbia Youth Development Centre and, in particular, the
Psychological Education Clinic.
The School has been developed along behaviour modification procedures based
on operant-conditioning principles for the remediation of learning disabilities and
for changing inappropriate behavours. Programmed materals will be used whenever possible, and a comprehensive rating system is being used to evaluate the
operant programme.
There were several staff changes during this period. The three positions for
psychologists were filled until September, when one psychologist returned to university to continue his Ph.D. programme.   The number of teachers within the unit
K 105
increased to nine. The Burnaby School Board placed two teachers in the school,
as many of the children come from the Burnaby area. They felt it was to their
advantage to have them placed in the school rather than try to offer a programme
within their school system.
In August, teachers were recruited for the vacant positions and they received
a week of intensive orientation, including instruction in the treatment approach as
well as some of the concepts in special learning disabilites. A second programme
began in November and covered the areas of learning disabilities, remediation, and
behaviour modification.   These seminars may be repeated in the new year.
Administrative Concerns
Most of the children coming into " The Maples " school live in the immediate
area, however, several of the children have been referred from outlying areas as far
away as Cloverdale, Richmond, North Vancouver, and Vancouver, and this has
presented a problem with reference to transportation.
At the time the school programme was being planned, the Director of the Residential Unit did not want the adolescents in the programme to be given formal school
instruction. Consequently, a school programme was planned which provided
schooling for children from the community and Family and Children's Clinic for
a morning programme, five days a week. During the afternoon the teachers were
available for tutoring the adolescents in the Residential Unit. This programme
continued for a month and a half and was then discontinued at the request of the
Residential Unit. Consequently, the teachers are now increasing their tutoring load
of children referred from the community.
Internship Programme
The internship programme was continued during the year and consisted of
three students. The programme was run in conjunction with the Mental Health
Centre, Burnaby; Family and Children's Clinic; and Psychological Education
Clinic. It was a successful programme, and two of the interns requested employment at the completion of the summer. The programme was similar to the one
offered over the past six years which included an introduction to testing techniques,
psychotherapeutic approaches, and participation in research programmes.
Dr. A. A. Cashmore, Director
The Clinic continued to have a close functional relationship to the rest of The
Maples, not only in the sharing of facilities, staff education, and public relations
activities, but also in the structure and function of The Maples Intake Committee,
composed of representatives from the Psychological Education and Residential
Units, as well as those from the Clinic's intake team. This committee greatly facilitated the assignment of cases to the most-appropriate sector of The Maples' treatment programme, and promoted one of the original concepts of The Maples, namely
that of a three-phase treatment operation (out-patient, day-care, and residential
phases), which allows for more appropriate and efficient service for the child and his
The Family and Children's Clinic continued with approximately the same staff
composition as it had formerly, when it was functioning as the Children's Clinic of
the Burnaby Mental Health Centre. The clinical emphasis remained on diagnostic
and treatment services and, as a result of the establishment of local regional mental
health centres, these services tended to become more second-line, and were requested for more seriously disturbed children and more " difficult " families. There
was an increasing number of direct referrals for first-line service from areas without
mental health centre facilities, e.g., Vancouver. It was, therefore, decided that
some staff will be decentralized to work with agencies in the eastern part of Vancouver and will work out of the offices of Health Unit No. 4 of the Metropolitan Health
Services. The first community team to be deployed in this fashion will consist of
professionals under the leadership of Mr. D. B. Ricketts, M.S.W., with emphasis on
the treatment aspect. The Clinic also has the responsibility of providing travelling
clinic services to the Skeena region.
Some specialized day programmes were continued and expanded during 1969.
The Maples pre-school programmes cover an age-range of children from 3 to 7
years, and consists mostly of children with language disorders due to emotional
deprivation. The staff consists of three child care counsellors and two pre-school
teachers. The Clinic also provided clinical supervision and treatment services to
two classrooms in The Maples school. One class was composed of autistic children,
with teachers from the Burnaby School Board. The second class consisted of a
group of children in the 8- to 11-year range whose behaviour made education in the
normal school setting impossible. Treatment was being offered to most of the
families of those disturbed school-children.
A summer day-camp and a residential camp, both of one week's duration, was
provided by staff, under the direction of a group social worker, for some of our
more seriously disturbed children. It was felt that this is a programme experience
to young professionals in the mental health field, e.g., students in social work, psychology, and medicine. For advice, support, and the loan of equipment, we were
indebted to Youth Resources Society.
During the year, several staff members contributed to workshops and seminars
and lectures in the fields of psychotherapy and child care, both for our own education, for professionals in other agencies, and for lay groups. Continuing attention
was paid to the refinement of more recently acquired therapeutic techniques, such
as family group therapy, sensitivity and encounter groups, and " fight training " for
married couples. It is intended that short courses in psychotherapy with children
will be arranged for interested professionals in the mental health field.
Requests made by the Clinic for volunteer help with some aspects of programme, e.g., transportation, lunch-hour activities for the school-children, were met
with an enthusiastic response from the Canadian Mental Health Association, and
students of Simon Fraser University. A small committee was set up to deal with
the recruitment of volunteers and to co-ordinate their contributions.
Patient Movement Trends and Data
K 109
Sum of Entries-.
to Date
Per Cent
Resident or Case Load
End of
Per Cent
Residential Programmes
Facilities for the mentally ill—
Youth Development Centre (August, 1969)2
Geriatric facilities, total	
Facilities for the mentally retarded—
The Woodlands School	
The Tranquille School	
Out-patient Programmes
Mental Health Centres, total.  _
Chilliwack ~	
Courtenay (July, 1969) 	
Haney (June, 1969) _	
Kamloops (July, 1968)  _	
Nanaimo   — ~	
New Westminster (November, 1968)____	
Prince George	
Saanich (May, 1969) 	
Victoria4 -	
Riverview Out-patient Service5	
Youth Development Centre..—	
Woodlands and Tranquille Waiting Lists	
+ 12.1
+ 145.6
— 1.9
+ 82.2
+ 14.4
+ 16.5
1 Includes permanent transfers, admissions from community, and returns from leave and escape.
2 Date in parentheses states date opened.
3 The total case load of the Burnaby Mental Health Centre by the end of May, 1968, was 1,262 cases. The
British Columbia Youth Development Centre became active in June, 1968, with a case load of 596, separated
from the Burnaby case load of 1,262. During December, 1968, the Youth Development Centre returned 268
cases to the Burnaby Mental Health Centre, which left the Youth Development Centre with a case load of
198 by the end of December, 1968.
4 After May 1, 1969, the Saanich Mental Health Centre separated from the Victoria Mental Health Centre.
5 Does not include about 50 patients in the Centre Lawn out-patient area case load.
 K 110
ri- rt
All residential facilities..
Facilities for the mentally ill.
Youth Development Centre
(August, 1969) 2	
Geriatric facilities, total.	
Facilities for the mentally retarded
The Woodlands School	
The Tranquille School 	
All out-patient facilities —
Mental Health Centres.
Courtenay (June, 1969)-
Haney (June, 1969)- -
New Westminster-
Prince George
Saanich (May, 1969)..
Youth Development Centre-
Woodlands and Tranquille
Waiting Lists 3_
Riverview Out-patient Service .
i Table compiled from actual data through September, 1969, and projected for the remainder of year.
2 Data in parentheses state date opened.
3 Includes 100 cases on The Tranquille School waiting list.
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.


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